text "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 500 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" "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." "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 13 years has got his left eye -11 and right with -8. 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 son\s eyesight. - 11D and - 8D are high myopic powers and the chances are that the power may progress as your son is still young. My advice to you is: 1. Avoid reading or holding objects very near to the eye. This will cause myopia to progress faster and will worsen the condition. 2. 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 follow-ups help us in picking up changes faster and in preventing such complications as retinal detachment. 3. Ask your son to regularly self-check his vision. This is done by closing each eye one at a time and observing how a particular object or letter looks. 4. 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 100 % 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 1 inch between my lower jawline and cheek area. Is this normal because of swelling or something else. Currently taking Amoxicillin 500 mg and Ibuprofen 600 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 X-ray done to find out the exact problem and stronger antibiotics like Augmentin (Amoxicillin and Clavulanic acid) along with a painkiller for a week" "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 18. 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 cannot 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 infection.I 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, post-exposure being negative. Numerous studies have shown that 97 % 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 everyone\s 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." "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 check-up. The CT showed a right-sided nodule measuring 3 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 one.In the LLL, a 4 mm nodule is representative of an intrapulmonary lymph node. No suspicious lung lesion. Tiny 3 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 3 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 3 mIU/mL, 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 30 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. 1. No, there is not much problem right now as he vomited and also had a lot of water. 2. 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 airways.3." "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" "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 8 mm gestation sac, no fetal and yolk sac. Last week I had brown discharge with mild lower abdominal pain and was prescribed Susten 200 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 200 mg twice daily (Progesterone) for two weeks and Mbryosafe sachet once daily (L-arginine). 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'm 40 & I've 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: Bases on the available data, those who are 60 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" "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 50-year-old female who has had an elevated ferritin level for many years now. My last ferritin level was 342, 20 days back. My ferritin level has been as high as 390. My TIBC, UIBC, iron, and iron saturation have always been within normal range. My glucose has always ranged from 100 to 104. 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" "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 4 to 5 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 0.25 mg and Betonix- 10 prescribed by a dermatologist but there is no improvement. Please help me out of this. ### Response: 1. It looks like you are suffering from aquagenic pruritus. 2. Take the tablet I am prescribing and show me again after 15 days. 3. Get the investigation mentioned below done. Aquagenic pruritus. CBC. Aquagenic pruritus. Aquagenic pruritus. 1. Tablet Teczine-M (Monteleukast and Levocetirizine) 10 mg bd for 15 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 25-year-old male. I do not have any medical history. Been always healthy. For the past 3 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 X-rays 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 alcohol.Since having this facial tightness, I have paid numerous visits to different doctors, even the neuro-specialist 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 3 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 sick.Hope 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 X-ray 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 75 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 continued.However, 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 cotton.Subsequent 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 L3 - L4 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 bed.Finding 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 tablet.When condition persisted thereafter she was given Primosa one tablet daily, Neurox one tablet daily, Maxglobin 50 mg one tablet and Defart 6 mg.But, 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 60 mg per day to 6 mg per day.However, 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 15 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 short-listed 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 5 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 1 year old now and it was a Cesarean. We are not in a position to have a second child now. Her LMP was 22nd of last month. I read that Mifepristone can induce abortion. ### Response: Hello. First, please confirm the pregnancy with a serum beta-hCG test (human chorionic gonadotropin) as urine pregnancy test is not reliable till eight days post missed periods. If the hCG levels are more than 5 ng/dL then she is pregnant. In that case as she has been a post C-section case, medical abortion is not to be undertaken with either Mifepristone or Misoprostol simply. Because, the C-section 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." "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 50 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 5 mg and Amlodipine 5 mg for high BP and it is well-controlled. 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 4 to 6 hours daily and snores at night. ### Response: Hello. I have gone through your mother\s 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 light-headed 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 x-ray 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 cannot 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." "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 results.The blood work came back normal. Low normal TSH, but low normal T4 and lower normal free T4 and free T3. 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 panic.Also, 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 Hashimoto\s with my younger niece having thyroid cancer and got her thyroid removed at age of 22. 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 (thyroid-stimulating hormone) once a year but that does not explain the severity of the symptoms at all" "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 T2 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." "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 result.Is it okay to continue this? ### Response: Hello. Acne is a universal issue in the age group of 15 to 25 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" "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 tumor-like 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: 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 x-ray 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, x-rays 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 18 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 4 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 child\s rash is called urticaria. This is a non-specific rash which may be due to food, dust, insect bite or a viral fever. Once it starts, it persists for anywhere between 15 to 45 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" "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 X-ray. The X-ray 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 non-operative methods then surgery will be required. This professional advice provided by me stands subject to the actual examination of report/image and is based entirely on inputs provided to me. It should be correlated with clinical findings." "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 25th of last month. It lasted for about four to five days. She then got dengue and on the 14th 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 25th of last month, then there is no chance that the bleeding on the 14th of this month was due to pregnancy. If it was due to pregnancy, then it should have come around the 25th of this month. So, do a urine pregnancy test first" "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 work.My 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 eyesight.Eyesight 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 23-year-old female. I am 70 kg, 5\3"" feet.I 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 500 mg three times a day after meal.I also feel like I have a lot of phlegm that I cannot release. It just feels heavy on my right chest that passes through my back. I am having paranoia on having COVID-19, 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 Covid-19 as you do not have a fever. But you need an antibiotic I believe, it may just be pneumonia. For Covid-19 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 40 mg one time a day for one week." "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 20-year-old female, height 166 cm, and weight 65 kg. I had two I-pills in one month. After the first I-pill, I got withdrawal bleeding after five days. It lasted for four days and the flow was normal. After 14 days of this incident, I again had protected sexual intercourse and took another I-pill after 36 hours. But this time even after 11 days, there is no withdrawal bleeding. Is this because of hormonal imbalance or pregnancy? ### Response: Since you have taken an emergency pill within 72 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" "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. 1.Vulvovaginal candidiasis.2.Urinary tract infection. 1.You should get urine routine and microscopy test with midstream sample to see if you have associated urinary tract infection.2.You may require a pap smear.3.Fasting and postprandial blood sugars. 1.Capsule Clotrimazole vaginal pessary at night daily for one week.2.Syrup Citralka one teaspoon with one glass of water thrice daily for one week. 1.Control sugars if you are diabetic.2. 3.Keep 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 M.D. I know a little bit about adverse drug reactions. Tell me if this makes sense to you.Metoprolol tartrate 25 mg half pill twice a day, Potassium Chloride 20 mEq once daily, Losartan potassium 25 mg once daily, Warfarin sodium 5 mg once daily, Atorvastatin 20 mg, Digozin 25 mcg once daily and Furosemide 40 mg once daily.I 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 cannot omit that. The dose is already very low and so we cannot reduce it further. Tablet Losartan, again essential in people with heart attacks. The dose is already less and cannot 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. 5 mg is a minimal dose. It cannot 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 20 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" "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 6-week pregnancy and then she took Mifepristone and then next day four Misoprostol (mouth dissolving). Now it has been more than 24 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 27 years, height is 5\10"" and weight is 83 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 much-complicated operation. So do not worry. Mild exercise usually will not affect 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: 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 work-up. 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 72 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 72 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" "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." "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 5 ml and Crocin DS 7.5 ml. He has not given any antibiotics. Is it fine? Please suggest. ### Response: Do not worry. You can give Augmentin DDS syrup 5.4 GM by 30 ml (Amoxicillin with Clavulanic acid) twice a day for five days along with the above-given 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." "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 x-ray of the right chest, it was normal. But after 36 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 x-ray of the shoulder region is required. Any pain in the shoulder after trauma requires evaluation and any pain cannot be considered as normal? There are chances of soft tissue alone with no bony injury, but I would recommend a re-evaluation. Till then you can apply ice to the affected area and take analgesics for pain relief. Kindly follow up with your x-ray 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 follows:Seven months ago: blood glucose of 105 mg/dl, GTT one hour 160 mg/dl, two hours 118 mg/dl, morning insulin 6.2 \xce\xbcU/ml, HbA1c 5.2 %, A1 6.1 %. This month: BG 110 mg/dl, GTT one hour 184 mg/dl, two hours 115 mg/dl, morning insulin 5.3 \xce\xbcU/ml. Every other blood test within normal ranges. I am male 32 years old 1.86 cm 93 kg 13 to 14 % 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" "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 1 or grade 2. If it is in grade 1, it will resolve on its own and if it is in grade 2, you need to go for scaling and root planing that is a 15 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" "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 9-month-old baby girl. She has five brown marks, two of them are 2 cm size and the other three of 0.5 cm. They are irregular in shape. Initial two marks appeared when she was 3 months old and now when she is 9 months three more for added that are comparatively light and 0.5 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." "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. 1. Insect bite reaction. 2. Follicular eczema. 3. Contact eczema. Please follow these instructions, 1. 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. 2. 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 x-ray 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 19 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 5 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." "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 2 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 high-resolution 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 29-years-old male. I am 173 cm in height and weighs about 68 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 feminine.My 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 21 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 easily.Kindly help me with these questions:Will 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 non-alcoholic 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 non-alcohol 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 alcohol-free mouthwash in such cases, in fact they are better in the patients who consume alcohol and smoke. Alcohol-free 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 doctor.Yellowish 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 B12 supplements since one of your blood tests show macrocytic anemia" "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 5\4"", and my weight is 61 kilogram. My ovary is bulky with right ovary volume 11.5 cc and left ovary volume 11.2 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 Myo-Inositol 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 re-established with the treatment or else you may need assisted techniques" "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, pus-filled 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 60 bpm and my oxygen was at 99 % under two weeks ago. I had a routine 24 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 35-year-old male, height is 174 cm and weight is 100 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 mobile-based 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 life-threatening. 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" "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 1314, 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). Consult your physician for an examination keeping these points in mind. Hope your concern solved" "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 15 years. 20 days ago, my HbA1c was 9.83. I am 54 years old and my weight is 87 kg. My medications are Metformin 500 mg, Hcl 1500 mg, Istavel 100 mg and Glaritus Insulin 30 units. Even then the sugar levels are 246, 265 and 277 after every three hours today. My creatinine, SGOT, SGPT, T3 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" "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. Hope you take this matter to a physician first rather than a chiropractor. As per my practice of 12 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 16. I was not on any medications and started taking Cymbalta a few months ago.After 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" "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 1.15 range along with CMV and rubella IgG positive. Should I wait or can I try to conceive right now? My husband\s torch panel also done, nothing abnormal.I 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 14 months and 1 week old. He has not started to walk by his own but started to crawl since 12 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" "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 antibiotic.Now 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" "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 24 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. ### 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" "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" "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 20X4 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 advise.She thought she was on her period the entire week. Bled for seven days. Sheattributed it to the Plan-b pill she took several weeks back. We hadunprotected sex but I still pulled out. She is on birth control andused a Plan-b pill. How is any of this miscarriage stuffpossible especially after just seeing the doctor the day beforemiscarriage? ### Response: Hi. If Bhcg (beta-human 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 cannot 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 40 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 cannot 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 2 of muscle tension dysphonia. Dysphonia plica ventricularis is when the false cords medialize to produce voice. Continue the speech therapy and anti-reflux 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" "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 self-treating. 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 self-treating 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 white-heads 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 1, P wave followed by a sharp spike called as QRS complex followed by an upright wave called as T-wave. So now, you can see in lead 2, 3, and AVF which are inferior leads, showing downward QRS spike instead of upward and T-wave 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" "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 18.64, 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 5.5. Since your value is 18.64, 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 cannot be diagnosed by inspection only. To exclude tonsillar stone you have to perform lateral neck X-ray 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." "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 cannot breathe and I am really scared and try to calm her down but she cannot breathe. She cannot 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 life-threatening 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 50-130 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 Addison\s.Liver 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 50 ALT, but have recently elevated to 130 ALT.At 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 (1% 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 B&C, 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 49 days ELISA antibody test done, 71 days HIV proviral DNA PCR test, 87 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 107th 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 one-year post exposure and no need for further testing. Weight loss may be a stress-related issue. Just leave this HIV issue here and you will regain weight soon." "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 16 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 13 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 8 to 10 hours a day. If you wear during sleep and for more than 10 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 over-the-counter Motrin 600 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" "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 26 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 O.D. -0.75, -1.25 90 OS: -1.0 -0.75 85. 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 (4 to 6 out of 10). 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" "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 semi-solid 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 40 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." "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 and/or 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." "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 L-Dopa. 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 17-year-old. I am 5\7"" in height and140 lbs weight. My dad is 5\9, and my mom is 5\1. I would like to at least reach 5\9 to 5\10. My diet is exceptional. I am taking a multivitamin, and I do not have any deficiencies. I am thinking of taking 1500 mg of Glucosamine because I read studies concluding that it may help a bit. Would you recommend glucosamine, or something else?Also, 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 5\6. Best way to help increase height is doing stretching exercises three to four times a week for 20 minutes in a 30 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 800 to 1000 mg/d and Vitamin D 1000 to 2000 IU/d 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 cannot 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." "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: 14.3, platelets: 174000, SGOT: 38.9, SGPT: 65.0 and vitamin D: 23.6. All other reports are normal. ### Response: Hello. You seem to be suffering from non-alcoholic 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" "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 173 cm. My mother is 173 cm and father is 189 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 21/42 level testosterone. Is this normal for an 18 year old male? I was devastated that my growth plates were closed, because I also had an x-ray 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 time.I 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 14 hours. But, I did not fast during my first blood test. Please help me. ### Response: Please relax and do not worry. 1. Free and total testosterone.2. Serum FSH and LH levels.3. 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" "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 18-year-old, 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 so-called auto-pilot 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 cannot 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 Alzheimer\s. Please reply, and if you want to ask questions about me,feel 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." "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 anti-inflammatory 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 now.For about 12 months the doctor put her only on Prednisolone 5 mg/day 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 (C-reactive 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 true.Now 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 Retino-A (Retinol) cream in the night, Clindamycin gel in the morning. You can use sunscreens like Shade (Avobenzone, Oxybenzone) lotion. Retino-A helps in pigmentation and to some extent scars. You can consider lasers later if scars persist" "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 query on heavy periods since three weeks. ### Response: Hello. Did you miss periods before that, or is there any chance of pregnancy? If yes, then it may be due to incomplete abortion. If there is no such chance and you never had this before then it may be due to many reasons for which you will need blood tests: Hb, TC, DC, platelets, PT, BT, CT, TSH and ultrasound of pelvis. Please give details. Revert with more information to 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 given hepatitis B blood test that showed the HBsAg negative and the hepatitis B core antibody image as positive. I am currently getting labs done for hepatitis B Surf Ab Quant, HBsAg screen, hepatitis B virus profile, and panel. I am getting conflicting information on websites and from healthcare professionals that hepatitis B does not ever leave the body but I also read that 98 % of the people who get it cleared the disease from the body. My question is what is the real answer, can I beat the virus and remove it from my body completely leaving only anti-bodies? ### Response: Hello. You have positive HBV core IgM which means one of the following: Do you have any symptoms of active hepatitis, like jaundice, or painful liver? I strongly recommend that you perform the whole hepatitis B tests and provide me with the results in order to reach the accurate diagnosis" "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 feeling like something had been at the back of my left side of the throat for a few days. I do not know what it is? Tonsils are not inflamed, throat a bit dry, and does not hurt to swallow. ### Response: One of the reasons for your symptoms is anxiety which you told. Globus hystericus is a feeling of something like a lump in throat which cannot be swallowed, or swallowed and reappears. Tonsils usually are asymptomatic unless very large and obstruct throat are inflamed causing severe pain. If your throat is red, or you run a fever then chances of inflammation are more. Alternatively, you may send a picture of your throat so that I may see any visible inflammation or tonsils." "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: How to use a product called Contractubex? I bought it but for some reason, it does not come with usage instructions. How do I use this product but combining it with SPF 30? I would like to know how to use it for a fresh surgical scar. Can someone please tell me how to use it with SPF 30, that is how to combine SPF 30 for a surgical scar because Contractubex does not come with instructions on how to use it mixing it with SPF 30. I had surgery on right cheek to remove the black birthmark. ### Response: Contractubex (Extractum cepae, Heparin, Allantoin) is a topical medication of scars. Apply this gel to the scar in the morning and night after washing your face and you have to massage the gel over scar with clockwise and anticlockwise wise rotatory movements for 4 to 5 minutes. Once all the gel is absorbed, then you can apply sunscreen SPF 30 on top of it for the full face. Use the sunscreen every four hours, because sunscreen protects skin from UV rays for four hours once applied, you need to apply repeatedly every four hours for maximum benefit" "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: Just a few minutes before I was trying to reach my forehead with my left arm and just after that, I think my nerve got stretched in the neck. I am in extreme pain and I am not able to turn my neck to left. When my neck is on right it feels little fine. I cannot do anything with this pain. Please help me. ### Response: Hi. I have understood your concern about pain in the neck region. Do not panic, this is called acute muscles spasm of neck muscles. You need to apply ice over neck muscles where you feel pain. See to that does not apply hot water over that area, otherwise, the pain will increase. You can take physiotherapy treatment in the form of tens and ultrasound therapy which will give you an immediate relief." "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 32 years old. My sickness started with a slight fever Tuesday night, then Wednesday I got a higher temperature of 38.1. Then Thursday night rashes appeared. I went to a local doctor Friday morning as my fever reach 39 degrees C. They gave me a fast drip to lower my temperature. Then Saturday morning my temperature went down to 37 but I still have few rashes. Then I started feeling my swollen joint, hands, and feet pain. Now I already took a bath as my temperature is 36.3 C. I am just worried about my swollen feet and hands and the pain is troubling.I am currently takin Biogesic Paracetamol. ### Response: Has this happened before or is it the first time? Can you describe the rashes or better a photo of it? Is it itchy, is it generalized or located in specific areas, blanching, flat or elevated? Regarding the swelling of the hands and feet, Is it the first time? Does taking Paracetamol help with the pain? Is it swollen or just painful? And which joints are specifically affected? The wrist or joints along with the fingers? What about feet and ankle? What did the CBC (complete blood test) reveal?" "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 suffering from pain on the right side of my abdomen, from the past three days. It pains more when I press my abdomen. The pain is not very severe, and it comes and goes. I thought it is a gastric pain, so I took medicines for it. But, it did not help me get rid of the pain. What to do now? ### Response: These are a few things we worry about in that particular area: 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: From the last three years, I have severe foot pain. The doctor told me it is because of plantar fasciitis. I took four Cortisone injections, and I wear special boots, but I did not get any relief. So, I took an MRI, and I am attaching my MRI reports with this query. What do the results of my MRI mean? I currently take Levoxyl and Paxil. Please help. ### Response: Hello. I have seen the MRI report (attachment removed to protect patient identity). Hope your concern is solved. Consult an orthopedic surgeon for examination and discuss your treatment plan." "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 a lot of clotting bigger than quarter size back to back, filling my tampon or pad in less than an hour. I am not on any medications and there is no bad medical history. ### Response: If this is the first time that you are experiencing excessive bleeding and clots are being passed, then you can opt for antifibrinolytics for controlling the bleeding presently. You can choose for an ultrasound pelvis once the bleeding stops to look for an organic cause. A single episode can be more likely to be due to stress-induced hormonal imbalances. You may maintain a menstrual calendar for the next three months and see if the pattern persists. If it does, you may be required to be placed on oral contraceptive pills for at least three months to control such menorrhagic episodes." "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 issues while doing intercourse. Please help. ### Response: Hi. Explain your problem in detail so that I can understand the problem and can provide you with an effective solution for the same" "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 40-year-old male. I am a vegetarian. I pursue an active lifestyle. I do not smoke or drink. I am a long distance endurance marathon runner. I also strength train three days a week and run two days a week. I got my sugar test, thyroid profile and vitamin D levels checked yesterday. I am attaching the detailed reports, summary as follows:Blood Glucose (F) 89 mg/dL.Blood Glucose (PP) 102 mg/dL.Urine sugar (both in F and PP) not present.HbA1C 5.8 %.Thyroid profile: T3(CLIA) 57 ng/mL, T4(FPIA) 6.38 ug/dL, TSH(CLIA) 1.81 uIU/mL.Vitamin D (25 hydroxycholecalciferol) 26.97 ng/mL.From the reference ranges, things seem to be fine. I just wanted to check with you for any precautions or preventive measures to be taken. ### Response: Hello. Everything is perfect except vitamin D level, which seems to be on the borderline and for which I suggest taking Cholecalciferol granules, once weekly for one or two months. Hope it helps. Regards." "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 writing on behalf of my mother and she is currently facing the severe recurrent nocturnal high blood pressure problem. She has been constantly relying on anti-hypertensive drugs from the past five years and the situation is aggravating day by day. Moreover, she claims of facing high pulse rate and is positively confirmed by ECG. Currently, she consumes a combination of Cilnidipine and Metoprolol and also other allied drugs in an emergency. ### Response: HelIo. Nocturnal nighttime hypertension is a complication of primary secondary hypertension. It can lead to some cardiovascular complications. I usually treat my patients in this situation with Potassium supplements and advice that they avoid any sodium diet. I advise her to see a cardiologist for proper evaluation, to know the best management possible in her case. I wish her a quick recovery." "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 had unprotected sex with a guy twice in an interval of three days. After the first time, there was a lot of pain, but had a regular whitish discharge. Second time, I started having this brownish or yellowish discharge and I have taken the photo of the discharge. I am not sure what it is? Neither of us have STDs. I am quite scared of being pregnant. I do not remember when I had my last period. Is this discharge normal? Please help me. ### Response: The brownish discharge seems to be due to rupture of your hymen. Generally, if you have sex for the first time in case of a virgin, then the hymen gets partly withered or at times does not. However, during repeated acts of intercourse, there are fair enough chances that it ruptures and maybe that is the cause of brownish discharge after the second time. However, we will wait and watch as there is no such matter of concern. If it happens again, then please do visit a nearby gynecologist and get an internal check done. Coming to the pregnancy point, if you do not remember your periods date, then at least get a urine pregnancy test done after one month and wait for the results. If the result is negative, then repeat the test after a week." "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 sister is having a craniotomy operation. MRI before surgery and post-surgery are attached. Biopsy report is also attached. So, kindly help me to understand the biopsy report. Current medications are Encorate Chrono 500 mg twice daily, Thyronorm 50 mg. Current problems are weight loss, severe hair fall, less appetite, weakness, not able to eat or smell non-veg items, no hunger. ### Response: Hi. The biopsy report and MRI findings are suggesting astrocytoma which is kind of cancerous brain tumor. Post operation MRI is showing that the tumor is not fully removed in surgery. That usually happens in these kinds of tumors because it is sometimes not possible to remove the whole tumor. Please consult with a good radiation oncologist to decide radiotherapy if not yet given. Hair loss is because of Encorate. Restoring the symptoms should be taken seriously and a repeat MRI should be considered after consulting with the neurosurgeon." "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 suffering from a left femoral neck fracture. Is there any other treatment other than surgery? Please suggest. ### Response: I have gone through the attachment (attachment removed to protect patient identity). The age of the patient is 72 years. At this age and with this fracture, there is more harm in not doing surgery as compared to doing surgery. Such patients can develop respiratory difficulties, bed sore, and infection due to immobilization. Hemiarthroplasty is a good option at this age, but in some conditions, a total hip replacement would be ideal. But it is decided after seeing the patient" "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 and I are not known HIV positive. But we have had unprotected anal sex ten times so far. Can we be infected with HIV? ### Response: Hi. If you both do not have HIV (human immunodeficiency virus), then from where can HIV come? Hope your query is answered, but if you still have any other query, please revert. Best wishes." "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: Just two days ago I found out I was about 1-2 weeks pregnant. And it has been about 4 1/2 weeks since my last menstrual period. Unfortunately with labor day being this weekend I have been unable to see my regular OBGYN. But I did go to the ER to confirm the pregnancy 2 days ago. So my blood results came back with an HCG OF 248 and the doctor said I am right around 1-2 weeks.So, here is my question. I have been stressing out badly due to the fact I have been on Lorazepam 1 mg every night for anxiety and PD for the last 2 years as well as Percocet 10 mg as needed for back pain. I have been taking both of the medications during my pregnancy when I had no idea I was pregnant. Since finding out I have tried tapering on both medications. The Percocet is making me sweat and very agitated and when I tried to cut down on the Lorazepam I was shaking and almost hallucinating and delusion. I also tried not taking the Lorazepam at all and woke up crying, shaking and sweating. I want to be off both these medicines but I am worried more about the Lorazepam as it is a class D pregnancy drug. I have read about the terrible problems this causes for infants. I am so scared that I am considering abortion. I do not want to be a terrible mother before I even give birth. I have been having bad panic attacks over this and cannot seem to relax as the complications of these medicines are always on my mind. Any advice at all would be very much appreciated. ### Response: Ideally we advise avoidance of this medicine during and even before till 12 weeks pregnancy to avoid congenital malformations. You have tried leaving/ reducing it, but your 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 have a roll or lump of fat under my left breast, on the top of the ribcage. It comes down from my chest, it kind of fills the gap from under the breast to the ribs. It is not hard, does not hurt nor is it sore. It is just squishy and soft like normal fat. Is it possible to get fat on just one side of the body like that? ### Response: The description you gave indicates likely two possibilities, it may be a simple lipoma, that is just accumulation of fat cells, and the other possibility is fibroadenoma that is relatively firm in consistency and freely mobile, both are non-painful and benign conditions. But I would advise you to get an appointment with either Gynecologist or general surgery doctor. Just get it examined, if they feel, they can order an ultrasound of breast or needle biopsy, (although I am pretty sure that is not needed). A mammogram is not a good option for you as due to age" "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 26 years old, female. I have high blood pressure problem from the last one month (silent BP) and my kidneys are damaging beacuse of this and my platelet count is 12 lakhs. These are continuously increasing from the last eight months, that is 6 lakhs, 8 lakhs, 11 lakhs and now 12 lakhs. My legs and foot pain are increasing day by day. Please reply as soon as possible. ### Response: Hello. The hypertension is multi-systemic disease and can affect many organs in our body including kidney as well. So hypertension need to be controlled with medication. Kindly attach your kidney reports so that I can look how much damages have occured. Your platelet count is very much high. You have to rule out essential thrombocythemia for that. I suggest you consult nearby hematologist for detailed 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: My 21 months old daughter has scratched herself near her clitoris and I was wondering what is the best action to take or remedy is. Please advice. ### Response: This application to be repeated thrice a day and it should heal in next 48 hours. Also, it is important that she does not scratch again over it and hence a befitting diaper or small lower can be worn." "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 not satisfied with dental bonding done on the front left tooth. Enamel was removed to make room for the composite resin and the enamel is now too thin and feels sharp to the tongue\s touch because of this. Shape and feel is not consistent with the natural front right tooth. Is there any way to fix this? Want to be as conservative as possible to avoid further damage. ### Response: Hi. According to your query, I believe it will be easy to solve that problem you have, just a little bit of enamel sharpness or roughness can usually come from a previous bonded composite filling done especially at anterior teeth. So at that time, you should go to a cosmetic dentist or expert. He will do for you abrasive smoothness by composite finishing burs to get the same consistency and then you will feel comfortable or he will go for changing the old filling to get a new one. Do not be afraid about further damage of your teeth. A doctor can do what is must to do for you to restore the aesthetics and function of your tooth. It would be good if you could attach an image of your tooth here to get further details of your question." "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 with a condom. But it tore in the middle of the act. But the guy did not ejaculate. I took unwanted 72 within 15 hours. I experienced withdrawal bleeding a week later that was quite normal like a period and lasted for four days. I took UPT which was negative. Can I still be pregnant? ### Response: Since you have taken an emergency pill within 72 hours of intercourse, there is no chance of pregnancy. So relax and do not worry. There is no chance of pregnancy. However, if you have a doubt then get 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: Dear doctor,My age is 29 years. I had a surgery three months ago, open myomectomy (posterior wall 4x4 cm subserosal 8x7 cm) with right endometriotic cyst (4x4 cm). Now taking Novelon. Shall I try for a baby now? ### Response: Hi. As it is close to three months from the time you had surgery, you can start trying for a pregnancy now. Please take Folic acid 5 mg daily. Also, please meet the doctor who did the surgery for you to check whether healing is complete. Consult an obstetrician and gynaecologist online for queries regarding conception" "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 eye power is only -0.5, but now it has increased to -1.5. I think it is due to the side effects of Perinorm tablets, which I was taking before six months. I am currently taking homeopathic medicines to remove my glass. Please suggest to me how to get rid of spectacles? ### Response: As you grow in height and built, similarly, your eye size changes, so as your glass number. Usually myopia (minus number) starts at 7-8 years of age and keep on changing till 20-22 years. Your glasses number is small. Keep using glasses and visit your doctor once in six months or once in a year for any change in glasses. Once the number stops changing and get stable, then you can get rid of glasses with Laser surgery, that is very simple. But for that you number should be stable and should not be changing. So you might need to wait till that age. No need to take any medication. Change in number is just like your change in height and your shoe size. Do not worry. Do not take unnecessary medicines." "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 it safe to take Chymoral Forte once daily for three days in pregnancy? ### Response: Hi. Chymorol forte (Trypsin-Chymotrypsin) does not have very much research data in pregnancy but it should be avoided in pregnancy as it could be fibrinolytic. It is an anti-inflammatory used to treat pain and inflammation and to have a speedy recovery. It can give side effects as well as vomiting, stomach ache, eye bloating, eye swelling, nausea, allergic reactions, loss of appetite, etc. In normal ladies without pregnancy, long-term use is not recommended. In pregnancy, it is better to avoid actually as its side effects could be different in person to person." "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 lots of anxiety issues. I have taken Deanxit in the past. Then I stopped it for a year. I started taking it back again six months ago. I have a long flight to take soon. I have a fear of flying. Can I take one pill of Valium 5 mg while taking the Deanxit? So, that I can sleep on the plane. I am taking Femostan Conti, Concor 2.5 for heart palpitations. ### Response: According to your history, it seems that you are having generalized anxiety. Yes, you can take Valium (Diazepam) for symptomatic relief. It will help you to get proper sleep in long duration. Deanxit (Melitracen with Flupenthixol) is a good tablet to deal with anxiety symptoms. I would also advise you take a few psychotherapy sessions later to deal with your problem without 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 am having black spots on the tongue. What might be the cause for it? ### Response: Black spots on the tongue might be due to: Avoid colored foods, brush twice daily and clean your tongue with a tongue cleaner. Avoid harsh scraping of the tongue while cleaning to prevent damage to the taste buds. Kindly give a detailed history of the duration of the spots, exact location and family history for more help." "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 daughter aged 7 years has a urine infection. We have done a urine culture as well as regular analysis and found that there is an infection. She has this problem from a long time. She has a bad habit of holding her urine for a long time until she can hold it no more. ### Response: Hello. Once this episode resolves, she needs an ultrasound KUB (kidney, ureters, and bladder) with PVR (post-void residual urine test) and micturating cystourethrogram (MCU). A renal nuclear scan may be required depending upon the result of these investigations." "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 to know about cardiac dysfunction. I was told it was found on venous Doppler looking at DVT. What all information can you tell me about the blood vessels having a pulse and it being a cardiac dysfunction? That is all I was left with until the cardiologist consult. ### Response: These blood clots can often dislodge and go through the right heart to block the pulmonary artery. This condition is known as pulmonary embolism and can cause right ventricular cardiac dysfunction. Pulmonary embolism is a critical medical condition and needs to be treated promptly with anticoagulant and diuretics. I see you are on a diuretics and you are overweight. Please inform about your findings of lower limb venous Doppler and also do some tests I am suggesting promptly and inform" "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 29 year old. My doctor said that I have an umbilical hernia.Either open surgery or laparoscopy, which would be the best? After which surgery, can I lift heavy weights?I am a sports person and a bodybuilder. Please suggest. ### Response: If your cardiovascular status that is heart and lung functions are fine, then you can go for laparoscopic surgery. That is cosmetically better and less invasive. The scar will be much bigger in open, so chances of scar rupture and dehiscence are higher in open. The possibility of strenuous exercise in the future will be less with open surgery. However, whenever you go for laparoscopy surgery the consent for open surgery is always taken." "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 cavities in the front two teeth. I have kept putting off seeing the dentist because of a high profile busy job. I have an upcoming appointment but am worried about a possible infection to the bone? If this is the case would I have severe pain and swelling? ### Response: Hello. Well, not every cavity reaches the bone. For infection, either pain or sensitivity is there. Just consult your dentist and do as he says. Wish you good health and happiness. Keep me updated with the improvements" "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: What are some common causes of one sided SI joint Pain that comes and goes? I\m 25 and just had a baby (naturally) 10 months ago. Back pain started at 8 months Postpartum . ### Response: There are various causes of SI joint pain which range from: Considering your history, it appears more likely due to pregnancy and incorrect posture. It is imperative to know if you are able to fold your legs , any pain in bending forward or backward, any issue in walking. Mild SI joint pains can get relieved with exercises. Severe may require SI joint injections Please let me know if something else is required With regards" "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: Earlier this year approximately five months ago, I was diagnosed with ulnar nerve entrapment at the right elbow. Sadly, I declined rapidly and lost all my hypotheaner and some of my lumbericals in a matter of six weeks. I was operated on exactly 14 weeks ago where I had a decompression of the ulnar nerve and an anterior interosseous nerve transfer to the motor component of the ulnar nerve so that the nerve axons would reach my hand quicker. I still have no improvement and I wanted to ask if it is possible to transfer muscle to fill in the hand? And will this protect my nerves in the hand? Would it be too soon to be considering this operation? ### Response: Your query is genuine and I am extremely sorry to learn about your problems. To answer, let me explain to you how a nerve grows. It takes one month of latency and later nerve grows at 1 mm per day. Even though the nerve might reach your muscle, for bulk to improve, it takes another few months. For one to determine if the nerve signals have improved, you can get an electromyography to see for any improvement. Decompression will improve sensation very fast and then power. But for muscle bulk, it usually takes a while for muscle transfer to be suitable. In case, you have any form of weakness and never to fill up a cosmetic defect such as hypothenar flatness, for that one can consider fat grafting. If the bulk does not improve after six months. I would advise you to wait as it usually takes longer than 14 weeks. If you want to see and have proof of progress go for EMG. No muscle transfer as per my advise for now if you are not having any weakness" "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 undergoing the fifth cycle of chemotherapy for my left breast. For the past five months, I am undergoing this treatment. Prior to chemotherapy, I was taking ayurvedic medicine for the same problem. I took the medicine for about eight months, but it did not have any benefit. At that time, I was not aware of the exact problem. I was advised to remove the breast completely, but by the god\s grace, I was referred to a doctor in oncology. The surgery has not been performed. They started with chemotherapy. Till now, I have completed five cycles. Still, how many cycles are needed for me? Will rest be given to me after the cycles? I am unable to eat, swallow or drink. I have lost my appetite. I have vomiting. Motions are happening from when I start eating my regular diet. I am feeling very depressed and demotivated. I have lost hope from the past five months. My left breast is healing and dressing is done over it. The skin is removed over a part. My breast looks flat as if it is removed. There is itching over the breast. Are there any chances for the regrowth of my breast? If yes, how many months will it take? If it does not regrow, what is the alternative for that? ### Response: From your description, I fear that you have metastatic breast cancer. Usually, the surgery is done after four cycles of chemotherapy for locally advanced breast cancer. As you have undergone five cycles, you must be on palliative chemotherapy to control the disease. Usually, it is reassessed at every three cycles to know the response and treatment is based on it, which may include a change in the type of chemotherapy, hormonal therapy, etc. You may require toilet mastectomy at some stage for your ulceration of the breast or it may be controlled with radiotherapy. These decisions are made by your oncologist and kindly ask him or her in detail. I am answering this based on your description. I can better answer if all reports are presented. Revert back with the reports to a surgical oncologist 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 daughter is 2 years old. Now, she is speaking only 3 to 4 words. She is not talking like other children. Please tell me if she has any kind of disorder. I have been to the doctor once and he told nothing to worry. After 2 years only they can speak. But my elder daughter spoke when she was 1.5 years old. I am so worried about her. Please tell me what to do. Her birth weight is 3.2 and now she is around 9 I think. ### Response: Hello. I got your concern. Based on the above history, my comments are: 1. I think she can listen and understand but there is a problem with expression. 2. Her weight is low according to age, so give her more energy rich food to gain weight. 3." "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 13 year old daughter has been suffering from vomitings and loose motions since two days. She had a fever of about 101.3 the day before yesterday. Our doctor advised her to take Oflox OZ and Sporolac DS. She has had five doses of Oflox OZ till now.The fever has gone and the number of motions has also reduced, though still watery but she is not eating anything. Her appetite is lost and even if she eats a little she complains of nausea though she is not throwing up. I am giving her Emeset for nausea. Is this a normal stomach infection? ### Response: It looks like she had a bad gastroenteritis. She is recovering. Continue both these medicines for at least five days. Can add tablet Pantocid 40 mg (Pantoprazole) daily once for five days. Emeset (Ondansetron) can be taken as needed for nausea. Consult her specialist doctor, discuss with him or her and start taking the medicines with their consent. Her appetite will slowly improve over few 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: My front tooth got chipped away before two days. I am so nervous about it. How to recover my tooth? ### Response: I can understand your concern. It depends upon the vitality of the tooth. If your tooth is vital and if there is no associated pain, then it can be restored with a simple composite filling. In case, if there is a loss of vitality, you can treat it by a root canal treatment. Please mention whether you have pain or sensitivity towards hot, cold, or sweet substances. If you want to save the tooth immediately, it is best to do restoration in the tooth. Please answer the question, so that I can provide you a better possible treatment plan and prognosis." "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 hit his mouth on the bathtub while playing when he was 9 months old, causing both top front teeth to be pushed up into his gums. They came back down, and the dentist said they were fine. Now he is 4.5 years old, one of the teeth is ready to fall, and his dentist wants to pull out the other front tooth with a strong root. He says it is best if they both come out at the same time, but did not explain further. Is pulling an absolutely good tooth the best option? I am attaching the x-rays of the teeth. ### Response: Hi. I have seen the x-rays that you have attached to the complaint (attachment removed to protect patient identity)" "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 suffered from terrible anxiety and OCD that seems to come and go over time. My mother had exactly the same disorder like myself. She was diagnosed with an under active thyroid and autoimmune thyroid issue. On taking medication to sort her levels she has been free from the mental health problems.I recently started getting the issue again and took a thyroid function blood test. All levels were within range but my FT3 was slightly elevated at 8.97 pmol /L. I would love an expert opinion on if periodic FT3 level increases could be causing the anxiety, depression, and OCD issues. I am currently on Sertraline 150 mg. Coupled with my mother's exact issue, and cure, I am not sure what these results could mean? What should my next step be and could this elevated FT3 cause my anxiety to start? ### Response: I just read your query and from what you have mentioned it appears that you have sub-clinical hyperthyroidism and the FT3 here does not seem to be high enough to be causing the symptoms that you have mentioned so rest assured on that front as of now. This condition does not need any treatment as of now. This condition just needs regular follow up thyroid function tests every six weeks to three months. You must consult your psychiatrist for your anxiety and OCD (obsessive compulsive disorder) issues. You can also benefit from avoiding caffeinated beverages and alcohol if at all. So as regards the thyroid function test just keep repeating it regularly. 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: My teeth are black. It looks like it is in the starting stage of tooth decay. I do not want to lose any teeth. Please advise. ### Response: Hi. Black spots on the teeth are indicative of initial stages of teeth decay. But you need not worry since this stage is repairable. There are no chances of losing your teeth at this stage. For healthier teeth and to prevent tooth decay try to follow these suggestions: If there is any food lodgement in the tooth associated with the color change, it should be treated as early as possible because decay might spread deeper leading to a toothache." "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 experienced a rash after an allergic reaction that spans from my chest, neck, and face. I removed the allergen from my diet and was prescribed Elidel to help clear the rash. However, I experienced over the course of two to three days, white patches which look as there is absolutely no pigment present in these areas. Will hypopigmentation from the use of Elidel fade? I was prescribed Elidel for the first time for a rash on my face. I am pale, but these are extremely white patches reminiscent of acne scars (but being completely flat). Is this likely to be permanent? Will it likely fade? If it may fade, how long would this likely take? What are my potential treatment options? No major injury to the sites was noticed aside from the generalized rash that was being treated. ### Response: If the patch is secondary to the use of Elidel (Pimecrolimus) fade cream then it is temporary. Within two or three months gradually it will subside. Right now do not use anything else on the face except for sunscreen and moisturizer. If it does not subside even after three months then you can go for the treatment. In treatment there are medicines available which helps in repigmentation of the skin. But right now do not apply any medicines. Let it heal on its own. Post-inflammatory hypopigmentation. Sunscreen and moisturizer. One month." "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: Hi,I am a 65-year-old female. My sugar level before three months was fasting 180 mg/dl, postprandial 253 mg/dl and HbA1C 8 %. After having medication, the test done a few days back showed fasting 93 mg/dl, postprandial 80 mg/dl, HbA1C 7 %, triglycerides 259 and VLDL cholesterol 51.80. Also, the blood pressure is 200/100 mmHg.I am taking the following medications:Glycomet GP 2 (one tablet in the morning and one tablet in the evening daily).Galvus 50 (one tablet in the morning daily).Tricinod 10/6.5 (one tablet morning daily).Cilamet XL 50 (one tablet evening daily).Neurokind LC (one tablet afternoon daily).Ecosprin AV 75 (one tablet evening daily).Trika 0.5 (one tablet evening daily).In the past, I was on Met XL 100 (one tablet in the morning daily), Met XL (one tablet in the evening daily), Stamlo 0.5 (one tablet in the morning daily), Ecosprin AV 75 (one tablet evening daily) and Gemer 1 (one tablet morning daily).Currently, my blood pressure is high and feeling heavy on in one side the of head and weak. Kindly suggest whether the medicine given above are correct and whether I can continue with the same or not. ### Response: Your sugar is well controlled. In fact, you need to decrease the dose of Glycomet GP 2 (Glimipiride and Metformin) to Glycomet GP 1. Major problem is that you have accelerated bloodstream pressure. You have mildly increased triglycerides. For this, you can increase exercise daily or you may add tablet Fenofibrate" "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 fever for almost three days. The first day it was not a high temperature. I had difficulty swallowing and I had a sore throat. Today, the fever is 39.3 Celsius. I had tonsillitis three times before and I have been prescribed Co-amoxiclav, Dequadin, and Strepsils. Please help. ### Response: I went through your post. You are already on antibiotics. It would be better to get a throat swab done and a CBC (complete blood count). I suggest you change the antibiotic to Levofloxacin 500 mg once a day. Consult your specialist doctor, discuss with him or her and with their consent take the medicines" "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 27 years old, and I have an embarrassing problem with my penis. The opening of my penis, from where the urine comes out is not at the tip, and it is slightly lower. I am still a virgin. Will it be a problem for my sex life? Is it a major problem? ### Response: Hello. Good that you have come out with your issue. If there is a cosmetic concern, then you may get it corrected. But I can comment on the overall scenario only after looking at the picture." "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: About a year ago, I started with tingling symptoms on the face, which was most consistent but also arms, legs, and torso those are more intermittent on both sides of the body. At time B12 was low started taking it after a couple of months symptoms better. Also, I had regular neuro examination and normal MRI of the head and cervical spine.After a few months, I stopped B12 levels up then a few months after the same symptoms again and B12 low again. Started back on B12 symptoms went away in a couple of months. Last month it started signs yet, but still, on B12 it is very high 1270 so symptoms not due to that. Had another head MRI was normal. My cervical MRI did show moderate to severe changes throughout of narrowing of foraminal in all areas c3 to c7. Also flattening of ventral cord c3 through 6. I am anxious about it being multiple sclerosis. ### Response: If your neuro exam and MRI brain and cervical spine are mostly normal, I believe that the symptoms may not be an indication of something serious. However, if the tingling persists, please get the following tests done. 1. Serum Vitamin B12 (to know if your supplements have worked). 2. Serum Vitamin D3. 3. Nerve conduction studies to check the conduction in nerves. I suspect all the tests will come out to be normal." "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 first baby is healthy and my blood group is A positive and my wife\s blood group is B negative. Now, my wife is again pregnant and has completed 26 weeks of pregnancy. She has developed antibodies and the latest ICT with titer test results show 1:64. Last week, we also did sonography and that did not have any impact on the baby.Now, the doctor suggests giving some steroids in this week which will help to develop the baby\s lungs faster to prevent any complication. Is it safe? If my baby\s blood group is also negative then are there any possibilities for antibodies to develop in my wife or does the baby\s blood group does not matter at all? Should I go ahead with NIPT to find the baby\s blood group? ### Response: Hello. Since your blood groups are negative, there is nothing to worry about. Yes, you can go ahead with injection for babies. They are safe. You need not go for a test to detect your baby\s blood group as it is not an issue. However, if you have a doubt then get 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: I am a 30 year old male, who is a competitive athlete. I do not have any structural or plumbing heart issues. I have been diagnosed with WPW accidentally, and I am waiting for an ablation in 17 days. I am mostly asymptomatic, and I never had any extremely rapid heart rates. My resting heart rate is actually in the 40\s. However, I do sometimes get palpitations and every once in awhile get a run of 5 to 7 in a row. The EP I saw in the hospital prescribed me Flecainide 50 mg, twice daily. I saw another EP, who was a much older guy, as a second opinion. He seems to think I do not need the Flecainide, and maybe not even the ablation. I do not agree with him on the ablation due to recent medical studies on WPW and how ablation is recommended even for asymptomatic patients, especially athletes.My question is regarding Flecainide. I have not had any palpitations since I began taking it a few days ago, but I want to make sure this drug is not putting me at risk for creating a dangerous rhythm. Reading case studies and medical journals, it seems there is some risk. I have not been known to go into AF, and besides palpitations, I am asymptomatic with WPW. Do you think Flecainide at this dosage is safe and reasonable for the next two weeks, until my ablation? ### Response: Hi. I can present as palpitation, but the timing cannot be predicted. Regarding Flecainide, I do not think you need to continue for next two weeks. But, your cardiologist who will perform this surgery, is the best judge to advise you whether he wants to continue it prophylactically or not" "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 depression for the last 4 years. I just want to know what Depakin are because my old psychiatrist gave me that medicine and I did not use it. It is about 5 months now but I do not feel good these days. I just feel depressed. ### Response: Depakin (Sodium Valproate) is used as a mood stabilizer medication and is effective in treating people with mood disorders including depression, bipolar affective disorder, etc. It is also used in other conditions like seizure disorder, migraine, etc. If you are having ongoing depressive symptoms, kindly review with your psychiatrist for assessing the nature and severity of symptoms following which your medication can be optimized. Also psychological therapy can be helpful." "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 mother of two - 1.7 months and 4 months old. I am currently breastfeeding the younger one. I have a problem with my right breast which makes me doubt if it is something related to cancer. Nowadays it is getting really dry and there appear cracks on my nipple. I used Avalon nipple cream. But from yesterday my breast has shrunk and my nipples too. There are a few lumps on my nipple as well. Even though I apply cream it is not getting relieved. It is getting worse day by day. ### Response: Hello. I do not think it is related to anything serious issue. So, it is better to avoid feeding the baby from the affected breast for three or four days and keep it clean all the time. If it did not improve, then better to consult your GP. They may prescribe antibiotics" "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 are a newly married couple and had sex two days back without any prevention from pregnancy. Could you please suggest any prevention tablet which can prevent the pregnancy after sex without any side effects? ### Response: If you wish for emergency contraception then you can opt for an emergency contraceptive pill like I-pill or Unwanted 72 (single dose), which is to be taken within 72 hours post intercourse to prevent any unplanned pregnancy. The most common side effect which this pill has is delayed next 1 to 2 cycles and often mild headache and lower abdominal pain due to its progesterone effects. However, this can be controlled by increasing water intake. Also, until 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 26 years old female. I have an abscess in my tooth for over a year now. I am getting it infected for the second time now. The previous infection was before six months. It is present at the bottom of one of my lower molars. It hurts me a lot. How long will it take to spread throughout the body? ### Response: Hi. There is a less chance to have the infection spreading to the whole body. But, sometimes, it happens when the swelling gets increased and when the fever becomes uncontrollable for two to three days. There is a chance to have a cystic lesion due to the chronic infection. You can treat it either by doing a root canal or get it removed as soon as possible. During the meantime, take Augmentin 625 (Amoxycillin with Clavulanic acid) twice daily for five days. It will eradicate your infection at this stage, and it prevents further spread." "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 fever of 38 to 38.5 over past seven days. Right testicle swollen for the past five days and left testicle swollen for the past four days. On IV antibiotics, Cravit and Doribax (which replaced Rochephin). C-reactive test above 231. The doctors still cannot identify the cause. Any thoughts or recommendations? I have got ultrasounds but just shows increased blood, no abscesses. ### Response: You are suffering from bilateral epididymo-orchitis (infection of the testis). You need to rule out any obstruction in your urine tract which might cause this. Do you have any difficulty in passing urine? Or any problem with urine flow? Get done with uroflowmery test which will rule out any urinary obstruction. If everything is fine then it is spontaneous and will resolve on its own." "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 daughter had braces for four years but her midline is off and she has a gummy smile. Her bite is fine but her teeth are not properly aligned and she does not have bone on her left side. Her orthodontist referred her to a maxillofacial surgeon who says she needs her upper jaw broken and rotated clockwise and slightly up to compensate for the lack of bone and her bottom jaw also has to be broken and rotated clockwise. It would all then be held by plates and screws. My biggest concern is that she is a beautiful girl and he says that her face will not change at all. Is that true with this kind of procedure? ### Response: The procedure which you mentioned is called as orthognathic surgery which is done if there is a skeletal malrelation between the two jaws which cannot be corrected by orthodontics alone. The procedure usually improves the aesthetics of the face and is predictable. The expected outcome can be seen by preparing mock up models before undergoing the procedure. In this procedure, the portion of the jaw is fractured to rotate in the desired direction and fixed using using plates and screws." "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 21 year old female. Yesterday, doctors have checked my blood. I am visiting a hospital frequently as I have iron deficiency anemia. The thing I am scared about is, my doctor asked me why my ferritin has not increased (just the opposite, it has decreased from 5.79 to 5.77) after three months of taking iron supplements. My other iron levels are at 39 which has increased considering those references. But, that was probably because I did not use the medicine correctly, I was only taking 5 mg a day. Another thing I am worried about is, my lymphocytes kind of got increased in my blood: (52.8) - the reference is 19.4 to 44.9, and the other one is 3.57. My neutrophils kind of decreased too (36.9) and the reference was between 41.0 to 73.0.In the last week, I had a viral infection as both my parents were sick. Is it why my levels got high? My WBC is 6.77 and RBC is 4.52. My hemoglobin is also increasing actually, last time I checked, it was 11.0 and now it is 11.2. Still low, but it was good to see that it was increasing. My thrombocyte levels got higher again, unfortunately. The first time I was told that I was anemic, my thrombocyte levels were on 485, then in my second blood test (after using iron supplements correctly it decreased to 380. And yesterday, when I checked, it increased to 435 (reference is 156 to 373).I was also told that I have an infection in my urinary system and he gave me antibiotics. Honestly, I have been always getting suspected about it since my anemia has started. Should I be worried about my condition or is it normal? ### Response: Hello. In viral infection, lymphocytosis means increased lymphocytes and neutrophil is relatively low because of increased lymphocytes. Platelet can be high in iron deficiency anemia. It is not a matter of worry just now. You can provide your reports to guide you further. Your hemoglobin level is mildly low and you should be given a good iron-containing medication like Ferrous ascorbate (brand name Orofer that contains 100 mg elemental iron). It should be taken without break for the prescribed duration. The underlying cause for iron deficiency anemia also should be ruled out like bleeding, parasites infestation, etc. Repeat your CBC after a few 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 27 years old, and I have multiple symptoms including nervousness, anxiety and weight loss. These symptoms are troubling me a lot. I experience extreme nervousness, even when I do not have any emotional struggles. I have a feeling of having a fast heartbeat. At the age of 16, my blood report showed me a result of subclinical hyperthyroidism. I have done breast surgery. Due to my health concern, I always have my blood tested for thyroid.Before eight months, I also had done a Holter monitor, which showed my heart palpitations. On my final blood test, my thyroid results came normal. But still, I have the symptoms. I am trying for a baby. But I heard an issue that underlying or undiagnosed thyroid issue could become a terrible one during pregnancy. Do I need to consult an endocrinologist soon? Do these fluctuations are common in hyperthyroidism? ### Response: Hi. I have gone through the query. It appears that you have had subclinical hyperthyroidism. This condition needs regular follow up tests and consult an endocrinologist even if you are not undergoing treatment for hyperthyroidism. If you plan for pregnancy, then it is necessary to have a constant follow-up with an endocrinologist before and during pregnancy. Yes, fluctuations in thyroid function test are common." "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 bumps, which are non-itchy and keep on spreading. Also, I am attaching the picture for your reference. Please explain me. ### Response: Hi. I have read your query and examined your picture (attachment removed to protect patient identity). With that much of the descriptions I can say it may be allergic contact dermatitis or insect bite hypersensitivity or urticarial vasculitis. I suggest you to use Lacto Calamine lotion local application twice daily and one tablet Levocetirizine once daily for five days. Consult your specialist doctor, discuss with him or her and take the medicine with their consent. Revert back with the answers to the above questions 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: On my left eye, on the corner, nearest my nose on the sclera there is a tiny clear bubble. I have has this for years and it does not bother me. On the conjunctiva, it appears also a little puffy but I have noticed on the lacrimal caruncle there seems to be a red little spot. My eyes are always dry and I suffer from allergies. Is this of any concern or is it associated with dry eyes/allergies? ### Response: Hello. I have seen the image (attachment removed to protect patient identity). The clear bubble is kind of retention cyst which is completely harmless. Only trouble if it causes red eye or heaviness while eye movements. Which you are not having.Secondly, I have seen your spot at the nasal angle but do not worry. Red spot does not seem to be connected to a cyst. So, they are not related to each other. I suggest the following medicines: WEar goggles in dust areas. Do not rub your eyes." "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: What is HMD (hereditary macular degeneration) and what is the maximum possible impact of this disease in future on a person? Can this disease make one blind? ### Response: HMD (hereditary macular degeneration) is a broad term given to a group of diseases that mainly affect the retina by deposition of some kind of material in between the retinal layers. These are genetic diseases. Though I have not seen anybody going completely blind with HMD, it can affect the visual acuity to a great extent. The visual loss starts gradually and can get severe in the next 15 to 20 years or so. The patient becomes disable up to the age of 45 years approximately. Right now, there is no intervention possible for this disease" "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 35-year-old male. My weight is 77 kg and height is 5 feet 6 inches. What is a skipping pulse? Is it blockage in the heart or not? My test reports is as follows, Cholesterol : 247, Triglycerides : 283, Hdl : 43, Ldl : 149, VLDL : 57, Non-Hdl cholesterol : 204, Lipoprotein a : 94, HS-CRP : 8, Sugar fasting : 90, and BP mostly : 130 / 85. ### Response: I recommend performing an ambulatory 24-48 hours ECG (electrocardiogram) monitoring to investigate for any cardiac arrhythmia. I would also recommend performing complete blood count and blood electrolytes for any possible imbalance, which could trigger ectopic heartbeats. Regarding your blood lipid profile, I would recommend trying to modify your diet, avoid fatty food or sugar and take a lot of omega fatty acids (fish, fish oil, olive oil, walnuts, etc.). I would also recommend taking a statin, considering your blood lipid profile. Atorvastatin 20 mg daily for a month would help improve your blood lipid profile. Hope to have been helpful! If you have any other questions, please do not hesitate to ask me again" "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 go through the master health check-up reports results and advise me of any abnormalities, deviations, and any detailed follow up that I should take up.I can note vitamin b12 deficiency. Can you please prescribe any medication for this? Otherwise, I am feeling healthy and normal, and it was just a routine preventive test. ### Response: Hello. I have gone through your reports (attachment removed to protect patient identity). I have noted the following abnormalities: Rest of your reports are fine. So overall, there are minor derangements which I mentioned above" "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 hypothyroid. I am currently taking WP Thyroid. I have taken Armour and Nature-thyroid. They all make me sick to my stomach. I tried adding generic T3 and it made my symptoms worse, that is, hair loss, cold hands and feet, weight gain, fatigue, GERD, and constipation. Would a synthetic T4 and T3 be better for me such as Tirosint and Cytomel? ### Response: Hello. I just read your query and from what you have mentioned it appears that you have hypothyroidism. Hope you revert with your thyroid function test results. Good luck." "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 been taking Trazodone 400 mg and Luvox for depression. My doctor prescribed Prednisone 10 mg two tablets daily for 10 days for a cough. However, since taking Prednisone, my insomnia had worsened dramatically. I stopped taking Prednisone after 10 days, but my insomnia had not improved. Is insomnia a permanent side effect of Prednisone? ### Response: Hello. It is a well-known fact that Prednisone causes insomnia, but it is not permanent. It may take a few days to return to a normal sleep pattern as the sleep cycle is disturbed. Try to follow good sleep hygiene. If still unable to sleep after a few days then sleep promoting natural medicine like Melatonin can be tried or any other medication to restore your sleep pattern can be used after discussing it with your psychiatrist. Insomnia is not a permanent side effect of Prednisone. I hope your concern is answered." "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 46-year-old male. A month ago, I had a heart stroke and underwent angio for blood clotting thrombus. My CBC report at that time shows a platelet count at 24 lakhs. I received CALR Exon 9 mutation analysis report today. It reads ""CALR Exon 9 mutation is detected by PCR amplification of Exon 9 of CALR, followed by sequencing of coding and junctional region of the Exon. The sequence is compared with the reference sequence NM-004343 for the analysis of mutations."" Hematologist prescribed me Anagrelide 0.5 mg. Do I have to worry? Can it be cured by medication? ### Response: You have very high levels of platelets which are called \primary thrombocytosis\ or \essential thrombocytosis\, which was confirmed by CALR Gene mutation test. This condition will results in either clots or sometimes bleeding in any part of the body. There are few treatment options available to control the disease, Anagrelide is one of them, which is supposed to be taken along with Aspirin. Please consult a hematologist who will monitor the condition and give you treatment." "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 frequent urination and feeling extremely thirsty, especially during the night after dinner and before bed. While I am sleeping, I get up just once to urinate, sometimes not at all. Do you think I have diabetes? I got my blood sugar checked, and it came out as perfectly normal (91, normal range is 80-100 for fasting). I think it is highly unlikely I am going to get diabetes in less than two years after the last checkup, but I wanted to confirm since my family has a history of this illness, and that is scaring me a bit. I am a 28-year-old male with asthma and acid reflux.I am currently on Montelukast, Advair and Omeprazole. ### Response: I can understand your concern. According to your history you have been suffering from frequent urination and feeling extremely thirsty especially during night after dinner and before bed. You have a family history of DM and you have a history of acid reflux and asthma. According to your description, your present sufferings can occurr in some situations like DI (diabetes insipidus), nephrogenic diabetes, UTI (urinary tract infection), kidney stones, cystitis, hypercalcemia, etc. You should undergo fasting blood sugar test, 2HABF (2hrs after breakfast), HbA1C test, USG of W/A, urine routine, serum electrolytes, serum calcium, water deprivation test, etc. At first, we should find out the causes which are responsible for your present sufferings and then treat them accordingly." "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: Suddenly, my right eye got smaller than my left eye for a few seconds (15 seconds) and then it came back to normal. It has happened a few times now. Why is this? ### Response: I have gone through the picture (attachment removed to protect patient identity). As per your age and as it is occurring for the first time, I want answers to the following questions. Revert back as soon as possible" "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: Hi,I am getting white hair from last 3 years, and the number has increased in the last 3 months. Is this the effect of water. Kindly suggest the medicine for this problem. ### Response: Hi. If your parents also had premature graying of hair then yours is hereditary (genetically inherited). You can start tablet PABA 100mg once a day for 2 months. This will prevent further greying of hair. Revert back to a dermatologist online after 2 months" "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 scar revision surgery is not healing well, and it seems worse than last week. Please see the attached picture. Involuntary frowning causes lines to run through the scar, can this be causing problems? Is it worth taping my forehead, so I cannot make frown lines? Is it worth getting a botox to stop frowning till I am healed? I am using a vitamin C and silicone scar cream to attempt better removal of hyperpigmentation. Is this a problem? I cannot tell if it is this or the creasing making it worse. I am starting to get very depressed about this scar revision. It was bad enough getting mugged and getting this wound. Now it is not healing even after a scar revision surgery. ### Response: I have seen the attached picture (attachment removed to protect patient identity)" "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 my tooth checked up last year, and the doctor told me to go for an OPG as he was planning for a root canal therapy. But due to severe negligence and work, I could not do that. It is almost a year now, and tonight I am having a painful time. Please tell me whether there is a chance of spread of infection. Please help. My infected tooth is the right first molar of the lower jaw. ### Response: As per your history and associated symptoms, it looks like you have now acute pulpitis leading to acute apical periodontitis. That means because of open pulp chamber, it is now infected. You need to take antibiotics and analgesics for this one. In case you do not have any medical, allergic or any other systemic condition, I suggest: Also, visit a dentist again and get it checked if there are any chances of RCT to save this tooth as soon as possible" "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 back tooth has developed a deep cavity within a few months. Now I have a pain in that tooth which got worse this morning. My cheek and throat have a sore, and they are swollen. It became a deep cavity when my filling fell out. ### Response: Hi. I can understand your concern. As per your history and symptoms, it seems to be acute apical periodontitis, that means that you have an infection in that tooth and the associated area. For immediate management and recovery take the following medications. Take tablet Augmentin 625 mg (Amoxycillin with Clavulanic acid) twice daily for five days and tablet Lyser D (Diclofenac with Serratiopeptidase) twice daily for three 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 18 years old. A few days ago, I had a toothache on my molar teeth and have mobility when touched. I have a big hole in that tooth from my childhood. I guess the black circle is the vein of the tooth. I could not afford to get an implant tooth. I had pain in that tooth a year back and then now. Is it possible to cure with rebuilding this tooth instead of removing it? Here is the picture for your reference. ### Response: Hi. Long term curious untreated decay. 1. IOPA.2. Check for the amount of mobility, whether it is sideways or up and down. Chronic pulpitis with periodontitis. 1. Root canal treatment.2. Periodontal treatment.3. Scaling. Follow up with the x-ray to 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 have PCOD, and I am planning to conceive. I am under Macfolate and Metformin tablets for the past seven months. I have regular periods for the past six months. This month, on the 11th day, I missed my period. After two days, when I checked for pregnancy, I got a negative result. Again after seven days, I got a negative result after checking for pregnancy. I am getting mucus discharge in small amounts. It does not have any foul odor. Am I pregnant? Why is it showing negative? ### Response: Hi. You may repeat the test in a week to rule out pregnancy, or you can do a serum beta hCG test. If the hCG levels are less than 3 mIU/ml, then you are not pregnant. The reasons are anovulatory cycles seen in PCOD, or you should get a semen analysis done once for your partner." "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 17, and my wisdom teeth started developing from more than six months, I get sudden occasion pains, it is more like pulsating, the pain feels so bad, and it makes my whole jaw ache, I cannot even eat for one to two days properly. The pains are so sharp, and I can see my wisdom teeth coming out like a halfway through, it is so painful, what should I do? ### Response: I understand your concern. The wisdom tooth usually has abnormal size, shape, and erupting pattern, which can lead to the inflammation of the surrounding soft tissue or gums. This is known as pericoronitis and often involves difficulty in chewing cheek bites, and ulcers. The most straightforward line of treatment is to go for extraction. Since you have given enough time for eruption, now it\s better not to wait. Using topical anesthetic gel (to apply on gums) and lukewarm saline gargle may help you temporarily ease your symptoms. I hope it 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: My mother has a lump on her breast. She underwent a biopsy. In the biopsy report, it came as benign. Another test showed that she has stage 3 breast cancer (she has no symptoms) and the doctor advised us for a mastectomy. The doctor recommended us to do some tests such as blood count, breast X-ray, and ultrasound. The results came normal (there is no mass lesion present, and there is no metastasis seen). Is there any confirmatory test available to find breast cancer? ### Response: Hi. I can understand your concern. The only way to confirm breast cancer is through a tissue biopsy. It is better to repeat a biopsy. There are other investigations like a mammogram, CT Scan and tumor markers, which can help to detect breast cancer." "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 facing water discharge from her eyes. With water, there is also some thick semi-liquid discharge from sides. These symptoms are also accompanied by some heaviness in the eyes. I believe this is contagious as one another family member of mine is facing the same issues. ### Response: Hello. Your mother is most probably suffering from infective conjunctivitis. Probably bacterial. You should consult an Ophthalmologist for the same. Most important is that it should not spread to others." "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 play games on my laptop for hours a day and after a few hours, my eyes become little blurry especially my left eye. It is not that I cannot see a thing but I cannot see clearly either as compared to my right eye. I can see fully clear when it is about 5 to 10 cm from my eye (letters) but it became blurry when the distance increases. Right eye is pretty fine but left eyes are not proper as right. So what kind of medication do I need? ### Response: If you having blurring of vision in one or both eyes first thing to do is get your eyes checked for refractive error, you might need glasses. And glasses will solve your problem. People who sit in front of screens have a greater risk of having" "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 Raynaud\s phenomenon and cutaneous vasculitis. I am concerned about a rash on my finger that is red with a small darker dot in the center. The rash does not itch or hurt. The tissue is soft. ### Response: With your description, it seems like a target lesion which is seen in erythema multiforme. Erythema multiforme is a hypersensitivity skin reaction due to underlying infections, some medications, systemic diseases, and autoimmune disorders. Or it could be purpura - blood leak underneath the skin. I am very sorry I cannot make a precise diagnosis unless I see the clinical picture. I would like to know few more details: I would suggest you attach your clinical picture along with your query so that it is convenient for me to comment on your condition and give you appropriate suggestions. 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 have pain in one of the gums near one of the upper teeth. When after eating or having something hot or cold, I feel sensitive and after that, I get pain for some time but the pain goes away automatically. I have gone to one of the dentists and she suggested me to get a root canal treatment done but I feel that the pulp or tissue of that tooth is not yet damaged and can be recovered without doing a root canal. I am attaching a picture of my tooth. Kindly suggest me whether the root canal is needed for this or I can save my tooth using some other methods? ### Response: Hello. If you have pain after eating cold or hot, it mostly means that the nerves inside are infected. It has to be root canal treated. If you are so sure that it can be saved and want to try something else, ask a dentist to just clean the cavity and fill it with a temporary filling. Then wait for 2 or 3 weeks and check if there is pain. If you do not have any pain then get it permanently filled." "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 31-year-old male with a history of closed globe injury in the right eye 10 years ago. At that time, my vision in the right eye was hand movements only and I was diagnosed with a macular injury. Three months later, my vision slowly improved to 6/36. However, my right eye started to deviate (exotropia) and I started experiencing diplopia. My main problem is diplopia. I have used prisms, but of no use. When I try to focus on an image, I have severe diplopia. The diplopia disappears when I try to correct the squint. At present, I am doing higher studies and the diplopia is really bothering me. Will doing a squint surgery be of any use? Is there anything that I can try? ### Response: Hello. Diplopia is occurring definitely due to squinting because, in this, the image which is formed will be defocussed. It has occurred secondary to the trauma. The only remedy is to correct it by surgery. If it would have been due to other causes which were intrinsic to the eye then the chances would have been to correct by glasses. But still, I would suggest you get to check whether the diplopia is due to the squint only and even after surgery your vision will not recover however the diplopia can be relieved" "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 lower wisdom tooth that has been infected chronically for well over a year. I also have an upper molar that is broken decayed and has been like this for years. The wisdom tooth oozes green pus if you apply pressure with a cotton swab. The decayed tooth is mildly painful. I saw my dentist a few days ago, who did not seem overly concerned. She slightly cleaned the gums around the wisdom tooth and prescribed me Cephalexin and sent me on my way. I have been taking Cephalexin for a few days, and yet the tooth is still oozing. My throat is red and irritated, the gums inflamed and there is no swelling in the mouth. Also, my nostril on that side is tender and painful. I am severely worried about the infection spreading to either my heart or my brain. In fact, I read an article a few days ago about a 26 year old who died from a tooth infection spreading.I do not have a fever. I have mild nausea. It is tender on that side of my jaw. The dentist had said the next thing she could give me was Clindamycin, but I have a fear of the side effects of that medicine. I already have heart problems and mild stomach issues. I have read that Clindamycin can cause severe gastrointestinal problems and arrhythmias. She also suggested Zithromax, but I have had heart palpitations while on that medication as well. I am having the teeth removed by an oral surgeon in two weeks, but am afraid of dying from infection before then. What are my options? What is the best course of action? Are there other antibiotics for this? Am I dying from the infection already? Any of your advice or help is appreciated. My other possibly relevant health history is as follows: I have high blood pressure, tachycardia, high cholesterol and mild PVC\s. I had a MRSA infection in my arm 10 years ago. I have many strep throat infections every year and frequent sinus issues. Also, I would like to mention that when I took smoothed Cephalexin capsule with a sip of water, I got a random salty taste in my mouth. ### Response: I have read your complaint and the relevant details. Please do not panic relating this to death. Maintain good oral hygiene for this two weeks. Revert after a week of extraction to 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 have pain in my upper wisdom teeth for the past one year. I had visited a dentist for a check-up. He did X-ray of my teeth and told me that food stuck between molar teeth and wisdom teeth is causing pain. So he advised me to remove wisdom teeth and filling process. But I am scared that upper teeth have a connection with brain and eyes. So, the process of teeth removal can harm my eyes and brain. Please advise me what I can do. If I do not remove my teeth, then what will be its side effect? ### Response: Hi. I have gone through your question. I can understand your concern. This is a misconception that there is a direct connection between wisdom teeth to brain and eyes. There is no such relationship between the two. Wisdom teeth are vestigial and do not function if your other teeth are in good position. If you get it removed, there will be no problem to your eyes or brain. Let me know if there is severe pain or swelling so that I can prescribe medication for same." "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 positive Widal test and liver function test showed a high eosinophil count. Anything eaten gets vomited out, intense weakness and fatigue. Please help. ### Response: Hi. You are having typhoid infection of the gastrointestinal tract. For that, it is advisable to take soft and bland diet more like banana, mashed potato, khichadi, etc. Avoid heavy fatty food intake. Take fruit juices more. You should take 7 to 10 days course of antibiotics to kill typhoid bacilli." "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 infection of the scrotal hair. At the hair root, there is some white bump. Please suggest medicine for the problem. ### Response: Hello. Well, I did not get any photos from your side. So I can just assume what it can be. As you said it has white bump it could be folliculitis. It contains pus which can get ruptured." "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 51 years old and she had thyroid sometime in the past. There are no signs of it from the last one year. However, she has these bulging eyes all the time, but she can perfectly see everything with her spectacles. I do not really know what happened to her the other day. She was watching her favorite TV show and all of sudden, her right eye popped out of her eye socket and she started shouting. It was such a scary and frightening situation where I and my dad did not know what to do and out of nowhere, my dad suddenly pushed her eye with a little pressure and the eye was back in its position as usual. My mom experienced severe pain after this incident when she was rushed to an Ophthalmologist. The doctor had no clue about the reason for her eye pop out. However, I advised her to go through a few medical tests and the results are yet to come. Meantime, I just want to understand why this happened to her and will this happen regularly and what is the treatment needed to prevent this from happening again. I just do not want to think of any situation where she is alone in the home and the same happens to her. I just want her to be completely cured from this one. Please help me with my query. ### Response: From your question, it is not mentioned if it is hypo or hyperthyroid. But the symptoms suggest it would be hyperthyroidism or Graves' disease. I hope your mother is on medication otherwise the condition might worsen. The condition occurs due to overgrowth of tissues around the eyeball which occurs in this disease. It is not reversible but you can consult an oculoplasty clinic where a surgical decompression can be done. These are complications of the thyroid disease. It would have not developed if diagnosed earlier. T3, T4, TSH (thyroid stimulating hormone), and antithyroid antibodies." "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: Recently, I had a blood test for MMR (measles, mumps, rubella) and the report that I got, am not able to interpret. Could you please see if the report is fine? Will I require a vaccination dose for the same (I had the vaccination in childhood)? Is it harmful to have the vaccination more than once?I had a rheumatic heart surgery four years ago (aortic valve replacement). Currently, I am on Betaloc 12.5 mg, Ecosprin 75 mg, and Warfarin 5 mg. ### Response: Hi. I have checked the attached reports (attachment removed to protect patient identity). The results for measles and mumps show high antibodies which mean immunity is either due to past infection or vaccination. As for rubella, the level of antibodies is low which means that you are prone to rubella infection. Rubella vaccine dose is required. There is no harm if you repeat the vaccine." "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 2-year-old son is having a lot of trouble sleeping. He snores every night and tosses and turns and has trouble breathing through his nose. His doctor says he has enlarged tonsils and adenoids. I think he has obstructed sleep apnea because I hear him gasping for air sometimes.We did a sleep study and the night of the sleep study he slept well. But every night at home he has a lot of trouble sleeping. He wakes up a lot, talks in his sleep has nightmares and I think he has sleep apnea because I hear him gasping for air sometimes.The doctor said we could try Flonaise to help him. But we read that Flonaise can stunt a child's growth. The doctor said he could grow into his tonsils. And I also heard that 2 years old is very young for tonsil surgery.My questions are how worried should I be about his troubled seeping? I am not getting any sleep lately because I listen to him all night. Is it dangerous to let him go on trying to sleep and have so much trouble breathing each night with possible sleep apnea? Please help. I am very concerned. ### Response: If symptoms are too severe we can go for tonsil and adenoid surgery now also. Flonase is a steroid and it does not affect growth as it will be administered inside the nostril and will have the action only there. There will not be any systemic or bloodstream absorption. How much worried you should be about his tonsil and sleep apnea problem are: 1. Change in facial features producing adenoid facies. 2. Irritability of kid. 3. He cannot hear properly due to adenoids blocking ear tubes. 4. Ear discharge. 5. Reduced development of speech. Do not get worried just because of the snoring and sleep apnea. Give him nasal steroids and antihistaminic syrup (like Zyrtec or Allegra syrup) of appropriate dosage. In some cases, we even give oral steroid syrup. It does not cause any stunting the way you have understood. Once you exhaust the above medical treatment option and find no or not much benefit we can discuss about the surgery. Your doctor is right in giving the medicines Flonase, etc. That is the protocol. We can follow the same here. The decision to operate may vary with different surgeon. Take a pediatrician opinion as well. Do revert back to me if you need more support." "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 a premature ejaculation problem. I got married five months back. Initially two months back, I was able to do intercourse well but now before the start of the intercourse, I am getting the ejaculation. We are planning for a child now but I am much worried. My height is 187 cm and weight is 102 kg. ### Response: Hi. I can understand your situation. Premature ejaculation is not a disease of the body and it is seen in almost all men at some point. It occurs because of your tension and anxiety about performing sex or previous bad sexual experiences. Medicines can be taken initially to reduce your anxiety if you are married or having regular sex. Practicing exercises to strengthen the muscles which help in ejaculation and retraining penis to ejaculate late would be a permanent solution rather than medicine. No permanent cure with allopathy, ayurveda or any system. It happens because of so many factors like as follows: 1. You have been training your penis to ejaculate early all these days. 2. You will be very anxious about losing the erection and will hurry up for intercourse. 3. Glans of the penis may be very sensitive. 4. The desire may be too much. You can try tablet Duralast 30 mg two hours before sex only till you get confidence." "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 daughter is 5 years 9 months old. She had a heavy cold and cough last week due to which she got a temperature of 99.8. So I gave her Calpol 250 next day morning similar range so I again continued the medicine and visited the doctor. He said continue fever doses irrespective of whether there is or not for three days post which the same day and next day she had no fever but again suddenly she got 99.5 and till night it went to 102.8 and did not reduce at all till we visited the doctor next day. He asked us to take blood urine reports are prescribed antibiotic Augmentin and continued to Calpol and SOS Meftal syrup as he sighted bacterial infection. Now she is taking antibiotic four doses plus Paracetomol but fever keeps coming back. So, by yesterday night gave her Meftal post which her fever came down. Should I continue Meftal syrup irrespective of fever level along with Calpol and antibiotic as to control the fever levels? I am worried why the fever keeps coming back the same level even though now four doses of antibiotic are completed. ### Response: The symptoms seem secondary to upper respiratory tract infection. Fever sometimes takes time to settle and may take up to a week. If cough and fever continue beyond 10 days then get a chest X-ray done to rule out pneumonia. Meftal (Mefenamic acid) needs to be given only if fever is not controlled with Paracetamol. If there is no fever or mild fever no need to give Meftal. I would suggest waiting for one day and then getting a chest X-ray 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 started my period 15 days back. And it ended a week later. Today (five days after it ended), I had some brown discharge (this was about 11 hours ago). And this is gonna sound really weird but when I was in the shower (11 hours later) I stuck my finger up there and when I pulled my finger out there was a lot of blood and discharge and it smells terrible. Is this normal to have this much discharge so close to my past period? ### Response: Hello. The presence of smell and bleeding with discharge after your menses have stopped, indicates a possibility of cervicitis with bacterial vaginosis (infection). If you are sexually active then the chances of contracting infection are higher. You shall require a per speculum examination by your gynecologist to rule out cervical erosions." "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 took Unwanted 72 eight days back, and she got her periods after five days. The bleeding is not normal, and her period was not due. Please help. ### Response: Hi. Unwanted 72 is a high dose of progesterone hormone, which is the same hormone produced in the body in the second half of period after ovulation. This pill will suddenly increase the thickness of the inner lining of the uterus, making it unfavorable for a possible pregnancy to implant. Hope I have clarified your query, do write back." "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: Before 19 days, I had protected sex with a part-time sex worker and freaked out after the incident. I am worried about any possible infection that could happen. I did a p24 antigen test. The results are p24 antigen on fourth day-0.125, sixth day-0.254, ninth day-0.271, twelfth day-0.274, fifteenth day-0.396, nineteenth day-0.540.I am upset about the increase in count. Please advise. I have done PCR RNA after 15 days for HIV 1, and it is not of detected status and HIV 2 ELISA on the nineteenth day which was also nonreactive. Kindly advise. ### Response: Hi. Yes, the titer of p24 is increased, but still, it is below the threshold value of being positive. Also, your PCR RNA done after two weeks is also negative. Your HIV 1 and HIV 2 tests done on the nineteenth day is also negative. It indicates that you do not have any infection, but it is too early to say with certainty. So you need to repeat the fourth generation HIV test after 12 weeks of possible exposure. So till that you need not worry excessively as the investigation done till to date indicates that most probably you do not have an infection." "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 son and a daughter. My height is 5.7 and wife is 5.1. I am extremely worried about my children height as we are short. My daughter is now 3 years 10 months old and have 14.5 kg weight and 38 inches tall. She had seizure thrice and taking some sodium liquid medicine for the past three years. My son is 1 year old and 10.2 kg weights and 28 inches tall. I want to know what would be the appropriate height of my children as per current status. Is there anything I can do to increase their height? I want my daughter to be 5.6 tall and son to be 6 ft tall. Will giving protein powder make any difference? Kindly do the needful. ### Response: I understand your concern. I will try to sort it out for you. We can add some calcium supplements. Revert back with the answer to the above questions to 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: Seven years ago, I ruptured my right eardrum. I recently went to my doctor because I lost some of my hearing, and I have been having pains in my right ear. My doctor told me that the ear drum healed but there is a lot of scarring on it. Why is my eardrum hurting if it is improved? ### Response: It is a skin-like structure, and it heals like a skin that is cut heals. In your case, you had a perforation in the 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: I have an anal fissure, internal hemorrhoid, SRUS, and constipation. One year ago, I was suffering from a hard stool that was difficult to pass. I went to a gastroenterologist, who did a colonoscopy and found that I had an anal fissure and internal hemorrhoid. He prescribed Sitcom Forte, Eldicet, Velgut, and Pankreoflat. He also gave me Sucralcoat Ano cream. However, every night I was in too much pain. So, early this year, I decided to consult an Ayurveda doctor who gave me some Kashayams and tablets. However, my pain did not subside. I used to evacuate the stools using my fingers. That eliminated the stools, but there was so much mucus released and extreme pain after motion. Two months ago, I went to a GP who gave me some antibiotics and painkillers for five days. During this time, I was always sleepy. I took leave from work and was always tired and fatigued. Earlier this month, I went to another GI specialist who did a sigmoidoscopy and said that it is SRUS. He said that I should not finger evacuate the stools and gave me liquid paraffin and LoX cream. Now, my current situation is that it has been three days and I am very constipated and fatigued. The pain has subsided a little. However, I am not passing stools as I used to before. After I drink water or eat something, I get a vomiting sensation. I get anxiety and panic attacks as I am scared about my condition and do not know which doctor I should consult and what I should do. ### Response: Hello. I have gone through the files uploaded by you. (attachment removed to protect patient identity). Hope your queries have been cleared. Good luck." "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: The stomach blossoms without food, even in the morning. It is felt more in the upper part of the stomach. ### Response: You can have a gas problem due to functional indigestion. I suggest you take gelusil MPS like syrup before bedtime for one week. It is advisable to take Rabeprazole like antacid for the week also. If there is no improvement than USG abdomen scan should be done for further workup, meanwhile avoid gas forming foods like cabbage, cauliflower, etc. I hope I have answered your question. Let me know if I can assist 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: I am getting a cardiac cath this morning. I am currently on Suboxone 12 mg, 6 in AM and 6 in PM. When I asked what they will be using to sedate, they said Fentanyl and Versed. I asked for Profol but got no answer. I spoke to a male nurse, not an anesthesiologist. If the Fenytal overrides the sub will I be in withdraw? Also, are there safety issues combining these medicines? Should I cancel this procedure? ### Response: Hi. Usually, for cardiac procedure anesthesiologist will prefer Fentanyl than Propofol because Fentanyl is opioid and it causes good pain relief and sedation and there is a high probability of heart stability and the chances of losing your breath and consciousness with Fentanyl is very less but still you will be made to sleep and remain pain-free. Propofol causes deep sleep. You may lose your complete consciousness, you may lose your breathing and go to mechanical ventilation. So it is always good to go head with Fentanyl and Versed." "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 unprotected sex on day 13 of my cycle and had an I-pill a day later. Again, I had sex in a gap of three days after the intake of tablet. I am really worried if I should take the pill again. This was a terrible mistake. Please help. ### Response: I am assuming that you have regular monthly periods. In that case, it is the time where you are going to ovulate. So, it is an unsafe period to have sex. And, if you have once unprotected sex and have taken I-pill (emergency contraceptive pill) once, then why to make mistake for the second time. Because, I-pill in itself is not 100% effective even if taken once. There is no study about two times taken I-pill. It works with two mechanisms. First of all, it will delay ovulation and second, it brings bleeding. So, if pregnancy happens, it resists implantation. In your case, if I believe that ovulation is delayed while you have taken the tablet, then it is good. If you have taken the tablet for the second time, then the ovulation is more delayed and period will be somewhat late with more chance of avoiding pregnancy. The second thing is that with I-pill your period cycle can become irregular. The chance of that increases more if you have taken two times. Because, it is a chemical (hormone), which is produced in your body to maintain your regular cycle. And, when you take it from outside it can disturb your normal cycle. If you do not want pregnancy in the first place, then either use condom or other method as preferred by you both after discussing with your doctor. I-pill is an emergency contraceptive and not a regular contraceptive pill that you can take as and when required. It should be taken when fear of failure of normal contraception is more. So, make the thing clear about whether you want pregnancy or not and go for a solution which helps you in future." "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 18 year old female. My height is 167 cm and weight is 53 kg. I have had headaches and pain in the eyes for the last two days. My nose has been blocked for about a week now and every time I blow my nose, my head hurts a lot. It also hurts when I shake my head. ### Response: Hello. I went through your query. I believe you are suffering from sinusitis. I suggest you consult an ENT (ear, nose and throat specialist), who will recommend an X-ray of the paranasal sinuses." "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 know if my hypothyroidism can be cured without taking the synthetic hormones, through Ayurveda only. In the allopathic approach, the hormone needs to be taken for the rest of one\s life and I am a bit scared of it. It is possible I may also be diabetic and will need to treat this as well. Can these conditions be successfully dealt with through ayurvedic treatments alone? ### Response: I just read your query and saw all your reports (attachment removed to protect patient identity). I hope you are satisfied with my answer" "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 important query about the contraceptive pill. On the 2nd, my girlfriend started her period. It is now the 16th. So, I believe she is in her ovulation phase. Since her period stopped, she has begun, for the very first time, taking the combined contraceptive pill consistently at 8 AM every morning. She took the pill yesterday morning. Last night, on the 15th of March, we had unprotected sex (we thought one night without condoms would be fine). However, this morning she was in a rush and forgot to take her pill for today. ### Response: Hello. A morning-after pill is different from the regular oral contraceptive pills. Do you mean to say the daily pill or an additional morning-after pill? I need clarity on this. If you mean the regular pill, do not use the phrase morning-after pill as that means an emergency pill used only once or twice depending on the dose.If you meant the regular pills which seems so from your history, she need not have to worry if the delay in taking the pill has not been more than 24 hours. It is fine to have taken it a few hours late as long as she has not skipped the pill that day. There is no need to take an additional pill if she has not missed the day\s pill. If the pills were started a week before the intercourse and she has taken them daily and not missed a single pill, the effectiveness in preventing a pregnancy is about 99 percent. There is nothing to worry as of now and let her continue taking the pills as usual at the regular time. Hope I have answered your doubts" "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 taking Paxidep 12.5 daily from last one and half year as prescribed by the doctor. It cures my uncontrolled thought and panic attacks. Now sometime I feel shocks in my head. I also want to know that, is there any side effect of this medicine after long time use? ### Response: Paxidep-Cr 12.5 mg tablet is a medicine that belongs to the selective serotonin reuptake inhibitors (SSRI) group. It is used for the treatment of depression, obsessive-compulsive disorder (OCD), panic disorder, and other anxiety disorders. There are many side effects for these medicines, including suicidal thoughts, irregular heartbeat, shaking of hands, etc. But shocks inside the head is not a common side effect. You should talk to your psychiatrist regarding this and get the medicine changed if there is a need." "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 abdomen has been swelling for months and is quite distended. Something felt like it was moving around in my stomach about eight months ago but I did not pay much attention to it. When I awoke yesterday, my rectum was itching and my belly button felt as if it had been cut. It felt worse after work. So, I faced the mirror and pulled the skin open around my belly button and a small white worm came out. I took pictures of it and have it in a baggie and I contacted my doctor\s service but have gotten no response. I have no medical insurance. So, I need to cut to the chase and find out who I need to go to for a diagnosis of the type of parasite and treatment. ### Response: Hello. I went through your post and the images you have posted (attachment removed to protect patient identity). Regards" "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 1-year-old daughter has a WBC count of 20.3, absolute lymphocyte 10.8, and neutrophil 28. We have been asked to consult a hematologist. We are worried as in what type of issue is she having. She does not have a fever, is acting well and eating well. ### Response: But in your child, absolute lymphocytosis is present. Hence, your child should be referred to a hematologist for examination, especially, lymph nodes palpation, liver, and spleen palpation. (If needed, USG scan can be done for that). Tuberculosis, measles, chickenpox, hepatitis, infectious mononucleosis, brucellosis, etc., are some of the infective causes but specific symptoms regarding that are not present as per history. Autoimmune disorder and leukemia also are some of the causes. These are different causes to provide you information regarding lymphocytosis cause. Your latest smear report shows high atypical lymphocytes (attachment removed to protect patient identity), mostly it can be some form of viral infection. But we do not want to take the risk and consult to a Hematologist for examination and investigate with USG abdomen scan also. If needed, then flow cytometry like higher investigation can be planned. Hope this provided information will be beneficial to you while you consult a nearby hematologist for 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: I am a 32-year-old male with a weight of 58 kg and my height is 5 feet 3 inches. I have been married for six years. I have two children. I had yellowish like liquid discharge from my penis a year ago with burning while urinating. I consulted a urologist and he prescribed me Norflox 400 mg for one week and after which it went away. This month, I had pain in my scrotum in the right spermatic cord region above the testicle. My urologist told me to have sonography. My sonography report concluded ""diffuse thickening at the right spermatic cord region."" Otherwise, the report is normal.The doctor prescribed me Cefixime 100 mg and an anti-inflammatory tablet for 10 days. My pain decreased about 60%. A week ago, I had masturbation and I had pain at the same place in the scrotum. I had taken a urine culture test and I have attached the report. My question is do I have sexually transmitted diseases or urinary tract infection? Can I please know what to do? What medicines should I take for a permanent cure? ### Response: I have gone through your symptoms. You seem to be suffering from an infection in your spermatic cord that is the cause of your scrotal pain. This is treated with antibiotics but the duration of treatment is usually for two weeks or more. The pain you have on masturbation is due to the inflammation of the spermatic cord through which the sperms come out into the urethra. I would suggest you keep your scrotum elevated with a tight underwear for pain relief. It would also be necessary to make sure that the infection has been cleared by testing both urine and semen for infection as your symptoms are not resolved" "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 want to lose my weight. I am very obsessed. I want to get slim. Please tell me some exercises to lose weight. Please tell me exercises that I can do anywhere without any types of equipment. ### Response: Hello. Two very good exercises with which you can lose weight without equipment are as follows. Running is considered the best exercise for improving cardiac status and losing weight. A 30 minutes run each day five days a week. Skipping is also a good exercise that can be done in a room. However, restricted calories are as important as the exercise itself to decrease weight." "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: No current medicationsFemale Age: 21 Height: 5\2/159 cm Weight: 115 lbs (last known)Why do I always have recurring knee pain...sometimes alternates from left and right...It hurts so much and it keeps coming back even though im not exerting stress on them such as from running. ### Response: Dear, Sending Love and peace to you ! My dear there are some condition which causes knee pain . I would also suggest to do some test where we can get knee pain on and off these are few condition where there can be like your symptom my dear" "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 C-section three years ago. My stomach started bulging, so I visited a doctor and had sonography. So came to know that I have mild umbilical hernia 0.7. If I do proper exercise and follow ayurvedic medicine suggested by you, then is this mild hernia curable? Please help me with this. Also, can I climb stairs in mild hernia? ### Response: Hello. I understand your concern. Since you had C-section, you are likely to develop incisional hernia which is a common issue faced post C-sections if proper care is not taken during wound healing. It is not curable with only medicines but it can be preventable from reaching further stages. If you find and center close by which practices post partum care in Ayurveda then get the following done. Apply Dhanvantara taila followed by veshta bandhana (abdominal binder). Avoid lifting weights and too much physical exertion." "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 are trying for a baby for three months. I have been facing a couple of issues. I feel the symptoms of periods within 18 to 20 days of my previous cycle. My regular cycle was between 25 to 28 days before. I was taking Folvite (Folic acid tablet) but started using iron tablets for two months. Please let me know what could be the cause? Or is this normal? ### Response: The feeling of symptoms like periods but not actually having bleeding could be due to ovulation pain, what is called in medical terms is Mittelschmerz\s pain. If your cycles are ovulatory, all the more good. Try for conception in the middle of your cycle days, say in 25-28 day cycle 8-18 days. Do not worry if three months are gone. Give a fair trial for six months before undergoing any investigations. Folic acid to continue till you conceive. It will prevent neural tube defects in the baby." "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 18 years old. I did an 8-week cycle that ended 14 days ago. The cycle consisted of applying a topical DHT gel, exactly 100 mg of pure DHT per week (15 mg per day) for eight weeks. I did it because I read that DHT could improve my puberty and increase the size of the penis. Now I am still small and feel that my hormone levels are lower. The question is could it be harmful to make another cycle or should I stop? Now, that I have stopped should I do a PCT? My wish would be to increase the penis dimensions without damaging my HPTA axis. ### Response: Hello. I would recommend that you know what you are doing before you try to use it again. Use of testosterone can cause serious side effects such as heart disease (including heart attack), stroke, liver disease, mental and mood problems, abnormal" "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 20-year-old female. About a week ago, I noticed an ingrown hair in my pubic area. I left it for a couple of days and then put a hot compression on the area, exfoliated, and tried to free the hair. I used a pin to pull the end out of the skin so I could tweeze the hair out, but I ended up popping the pump and pus just started oozing out. It was sore the next morning and I let it go until tonight, I tried to free the hair again and just ended up squeezing the lump, this time it was a bit larger, again blood and pus came out, but I pulled a hair out with the tweezers and I believe that it was the ingrown hair. I just noticed that my right lymph node in my neck and my groin area are swollen. I would rather not go to see my doctor. Any advice? And the tweezers and pin were both sterilized both times. ### Response: Hi. After going through your history, I suppose you are having folliculitis." "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 continuous stuffy nose which gives me brief dizzy spells that go once I try to blow my nose (not hard). It just helps equalize pressure. My glucose, BP, heart tests are normal. I eat and drink regularly. I work in a dusty environment. The dizziness is definitely associated with congestion. How can I stop it? ### Response: Either a dust allergy or infection is causing you an allergic rhinitis. You will need X-ray PNS (Water\s view) and CT PNS for a confirmation. I suggest taking: Avoid dust by covering with a facemask. Follow up with the reports" "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: As of now, I am suffering pain in my left rib which results in difficulty in breathing. I suspect this happens when I fall asleep on the sofa in an awkward position and when I woke up, my throat has a little pain but it did not persist but but it started to ache on the left rib part. I feel the pain towards my shoulder. It is almost about two days since I am suffering from this ache.I got breathing difficulty especially when I am lying in bed. But while standing or sitting, I just felt mild difficulty in breathing. Maybe there is an artery that has been damaged or had been under the bone. I am 24 years old. ### Response: Hi. I can understand your concern. According to your statement, you have been suffering from difficulty in breathing due to aching of the left rib part that radiates toward shoulder which may occur when you fall asleep on sofa in an awkward position. You think your ribs may hurt from sleeping wrong and aching of the rib may radiate towards its intercostal muscle. You may feel a sharp pain after intercostal muscle strain or sprain due to sleeping in the wrong position. The pain will become worse when you stretch, breathe in deeply, cough, or sneeze. The area of the strain between your ribs may be painful to touch. Again this pain can radiate to shoulders or sometimes side sleeping can cause damage to the rotator cuff and create a lot of pressure in this group of tendons and eventually produce pain. You can take Tramadol as a painkiller, Domperidone, Lansoprazole, and Diazepam as a muscle relaxant with a sleeping pill." "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 65 years old. All her general physical parameters are normal and she is leading a normal healthy life. But, she suffers from migraine. So whenever she has migraine headache, she takes Analgin (Novalgin) medicine.Few days back, she took the Analgin and noticed swelling in her left forearm (photo attached). This swelling has occurred in past too, but this time it persists for a week along with general body pain, fatigue and mild sweating at times. BP and temperature are normal. Family doctor suggested full body check up, chest x-ray, few blood tests and thyroid test specifically. All came normal except thyroid (report attached).She did not take any medicine for the swelling yet. Please suggest what could be the cause? How can we prevent it? ### Response: From the reports (attachment removed to protect patient identity) her TSH levels are high with normal T3 and T4 which suggests hypothyroidism. Most of the times hypothyroidism has normal T3 and T4. So hypothyroidism cannot be ruled in that case. Her complaints like sweating and everything fits under hypothyroidism. I would like to know whether she had any recent injury (including minor trauma)? Revert back to a general 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 seem to be getting these dizzy rush sensations. They happen randomly throughout the day, but mostly when I am on the computer. It feels like an electrical pulse is surging up through the back of my head. I also feel dizzy turning side to side and when I get a headache, it feels like it is coming from deep within my left ear. It causes me to panic and get a lot of anxiety afterward. What could this electrical rush sensation be? Then, also, after I get it, I cannot look up too quickly because I feel very dizzy. It usually happens again, while typing on the computer or looking down at a smartphone. ### Response: Hello. I will try my level best to help you out. Your symptoms are mostly dizziness, which worsens with sudden eye movements or body movements, and are sometimes associated with headaches. Based on the symptoms, the most common cause in your age group is a vestibular migraine or benign paroxysmal positional vertigo (BPPV). I assume you do not have any other risk factors such as diabetes, hypertension, previous stroke or diagnosis of epilepsy. A simple neurological exam using Dix Hallpike Maneuver can help differentiate between BPPV and vestibular migraine. Also, further questions on the quality of headache, location and associated symptoms such as light sensitivity, loud noise sensitivity and nausea are other important questions, that can happen with vestibular migraine. Treatment for BPPV is physiotherapy with some specific exercises and medicines such as Topiramate or Valproic acid for vestibular migraine. If there are any red flags on neurological exam, then an MRI (magnetic resonance imaging) of the brain would be needed. Please do not hesitate to ask me any other questions" "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 irregular periods. Shall I take kalarchikai choornam? ### Response: There are several causes for irregular menstruation. PCOD is one of them. If you do have this issue then you can take kalarchikai choornam 3 gm twice a day with warm water after meals for three months regularly. To rule out this issue, once you should go for USG abdomen. PCOD, hypothyroidism, taking contraceptive or emergency pills, inflammatory pelvic diseases, climatic changes, food changes, etc. USG abdomen, thyroid profile. If you have an irregular period due to PCOD, then you can go through Kalarchikai choornam as the above-mentioned dose." "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 a CT scan identify liver metastasis? ### Response: Hello. Yes, CT (computed tomography) scan can detect suspected primary tumor or metastasis in the liver. However, it is not confirmatory, a biopsy is needed to say its malignant origin if the primary tumor is not already found in other organs." "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 problem. My teeth are brittle because if I eat something hard they sometimes break or I would feel a hole developing and this is stressing me out because I have already taken out three of them and now another one is close to being totaled. Earlier today I ate something and I think it damaged them. I am tired of taking them out. ### Response: There must be one of a few reasons for this chipping off of teeth rapidly. You might have calcium and vitamin D deficiency. To rule out this, you can get serum vitamin D laboratory test done. If there is deficiency then I recommend you medicines for it. Another reason might be the hereditary cause, that means even when you maintain your oral hygiene, brush properly, eat less sugary stuff and chocolates, still teeth are breaking off suggests it is because of genes you have got from your parents or grandparents. They would be more prone to damage and their teeth would be weak as well. In this case, you cannot do anything but visit a dentist properly and get all services done before-hand to avoid further damage. Can you provide me with a clinical picture of teeth? So I may suggest accurately what should be your line of treatment. Stay happy and blessed." "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 is suffering from peripartum cardiomyopathy for the past six months. She is taking beta blockers and diuretic medicine for the past four months. Her heart EF is 38 % with flat T in ECG reports. Her heart function is normal. How many days does it take to get cured? ### Response: Hi. Peripartum cardiomyopathy is a condition with an unknown cause. It follows after delivery for a few days to few weeks and manifests with the symptoms of heart failure. Beta blockers and diuretics are suitable. But the condition is not completely curable. The symptoms can reduce with the medications. Please send the ECG (electrocardiography) and echocardiography report to review it. Some cases can also show electrolyte imbalance like hypocalcemia or hypomagnesemia due to diuretics. It can also affect the ECG." "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 age is 23, I have undergone a surgery for bladder augmentation nine years back, since then I am doing Bicarbonate wash every week. Please suggest an alternative for this procedure. ### Response: The point of bicarbonate washing off bladder is to create alkaline nature, which is not a good environment for harmful cell to grow thereby inhibiting cell growth. And it will strengthen the bladder. Yes, what you can do is limit sugar, meat, dairy products, etc., which make our body more acidic. There is no substitute for the method. Bicarbonate washing is the best method. I will advice you to continue it, I understand it may be tiring, but the method itself is effective. Also ask your doctor how may total bladder wash you will be needing. As I know this procedure is not for lifetime." "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: What is your recommendation for someone with PTSD, depression, and anxiety? ### Response: If a person is suffering from PTSD (posttraumatic stress disorder), depression and anxiety, they will probably need a combination of medication and psychological therapy to manage their condition. Lexapro (Escitalopram) is a good antidepressant that can be helpful in this situation. Based on more clinical information and formulation, psychological therapy can be considered. If PTSD is the predominant primary condition, trauma-focused CBT or EM" "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 20-year-old boy. I am very thin. I want to gain weight in short span of time. Is there any ayurvedic medicine for this? ### Response: Hello. You can achieve your goals easily through ayurvedic medicines and yoga practices. Ayurvedic medicines and yoga are able to correct your metabolism and help to improve your concern. Treatment plan includes" "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 37-year-old wife is 14 weeks pregnant with my second child. Her level one scan is normal and the double marker is also fine. But, the doctor has told to get DNA test that is an NIPT test. Is it important? If level 1 and the double marker are fine then DNA and NIPT test should also be fine right? ### Response: Double marker, level 1 scan and NIPT (non-invasive prenatal testing) all are screening test and not diagnostic. They just suggest a possibility of the disease. So, if both the testsare normal you can avoid taking NIPT test. It is not a compulsory test and again a screening test but it is very costly and this test also does not identify all chromosomal disorders as others. These two tests are always recommended at this age. If there is a family history of chromosomal disorders or previous pregnancy with any disease then only one should opt for NIPT" "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 minor Achilles tendinopathy and visited a physiotherapist today to get it checked. During the session, he performed some deep tissue massage on the calf (which was very tight) to relax it, which was very painful. After the massage, I experienced sharp pains while walking (which was not there beforehand), and when I brought this up with the physio, he said it was normal because it was the first time I had gotten deep tissue massage on that area.I have been icing the calf and resting, and while it has gotten a little better, it still hurts to walk. I have my exams tomorrow which I have to get to and other events on the weekend where I have to be (and will involve walking). I am worried about how I can see as I cannot walk at all. Is it normal to experience such pain after deep tissue massage to tight calf muscles, or did I sustain some injury (say a muscle strain or something similar) and need to get it checked out? ### Response: I read your concern. Sometimes, usually, they try to break the trigger points, and it would have caused discomfort. The technique itself is pro-inflammatory techniques and will induce some more inflammation so that healing happens. So do not worry. Now, I request you to ice your calf frequently like once in two hours for 15 minutes as of now and stretch it properly things should settle down fast. Tomorrow morning you might feel a lot of stiffness in the calf, do not worry as you have to stretch your calf gently and roll your calf over a foam roller or if have somebody ask them to massage it for few seconds. Things will be fine. You can walk without pain. I hope this is helpful to you. Kindly revert in case you need any further information in this regard." "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: Approximately one week ago, I had my wisdom teeth removed. On my lower left, I have a dry socket, which I am getting treated for via packing (at least I think that is what it is called). On the right side, healing is just fine, however, I noticed some white stuff lodged in the gum. I am not sure if it is food or scar tissue because when I tried to get it out with a toothpick, it did not come out very easily, so I left it alone. Is this food or scar tissue? It is mildly bothersome.I brush my teeth but know to be careful around the surgical sites so they do not get irritated. It seems like a lot of plaque builds up back there because of this, and I am not quite sure what to do. Also, there is a very small spot of red gums on the front side of my second molar. I put a bit of mouthwash on it with a toothpick and left it alone.I have two questions, what is the whitish stuff that feels like food trapped in my healing gum socket? And what is this small patch of irritated gum on my second molar? Any help is appreciated.I am currently on Celexa (for depression), 600 mg of Ibuprofen (for wisdom tooth pain). ### Response: Hi. As it is just one week of wisdom teeth extraction, the white stuff seems to be most probably healing tissue only. It is a normal appearance of healing tissue post-extraction. A white patch of irritated gum can be due to injury or ulceration that can be due to accidental injury with the extraction instrument or can be due to injury with a toothbrush or any hard food. You can apply Chlorhexidine gel over it. Do warm saline gargles, antiseptic mouthwash gargles and brush your teeth twice a day for keeping plaque and deposits less accumulated. 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 22 years old. I have a problem of hair fall. My hairs fall so quickly, and there is no regrowth of hairs. Please help. ### Response: Nowadays, hair fall is very common due to change in lifestyle and food habits. Excessive use of different kinds of shampoos, conditioners and washing hairs using hard water result in hair fall. Reduced blood supply to the hair roots makes the hair weak, and it leads to hair fall. You should follow some precautions to prevent hair fall. Apply Bhringaraja oil to the hair at night. Massage the hair for five to ten minutes and wash them with water the next morning. Shampoo your hair weekly twice or thrice using protein shampoo. Do these things and provide your valuable feedback." "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 tooth extraction a week back and three days later, the clot came out of the tooth. Now I am not in any pain. I get the occasional tingle or slight pain but I am terrified of getting dry socket. I am rinsing with salt water every half an hour or so. Should I be worried about it developing? ### Response: Hello." "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 psoriasis for a long time for which I have been taking Methotrexate. Last week I got my iron studies and blood test done. My transferrin saturation, and total iron levels are low but hemoglobin is fine. Kindly advice. ### Response: Hello. Your transferrin saturation and iron level are mildly decreased, and your hemoglobin level is normal. So you do not have iron deficiency anemia, but it can be an early sign of iron deficiency. You need to investigate with serum ferritin level because that indicates iron storage level. You need to take iron-rich foods like red meat, beans, pumpkin seeds, and green leafy vegetables, etc. There is no need for taking an iron tablet as hemoglobin level is within the limit. I hope this will help you. Let me know if I can assist 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: I am a 60-year-old male. I have swelling and discomfort in the testicle and sperm canal. I have wandering aches and pain around the groin area including buttocks and inner thigh. I am having these symptoms for the past four to five months. I am not taking medications. I have tried Neurontin with a low dose of 100 mg taken twice daily for two weeks. But I stopped it because of its side effects, and it does not relieve my symptoms. I had shaking episodes of anxiety and worried that I might have contracted herpes 2. I have tested for all the common STDs which showed a negative result except herpes simplex showing a positive outcome.I am also experiencing impotence. I had undergone a hernia operation with a net before 11 years. Also, I had undergone a small hernia surgery on my right side which is not very visible. I do a lot of swimming about 10 kilometers per week. I have overstrained myself. I had a sexual encounter with someone whom I do not know a lot. I have wandering pain around my lower abdomen and groin. Often it is hard to distinguish where the pain gets originated. Sometimes, it involves both upper and inner thigh in the vicinity of the testes sack. I have tenderness and minor swelling in my testis and epididymis. I have difficulty in erection. ### Response: Hi. I understand all your concerns. I have checked the provided information thoroughly. I need to know more details. Do you have any redness, swelling or ulcers in the genital or groin area? Have you performed urinalysis? Please send me some photos if possible." "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 recently started urinating blood when I go to the restroom. I have a constant urge to urine and I have no idea why out of the blue this is happening. I am a male, 36 years old, 6'2"", 190 lbs. I have no medical issues or past history of kidney problems or cancer. Can it be due to STD? ### Response: Hi. Painless hematuria must be evaluated thoroughly and some factors must be taken into consideration like smoking, occupational exposure to certain substances, family history of kidney disease or cancer. Do not get scared sometimes it is something simple like urinary tract infection or mild trauma in the urinary tract or mild stone. Please get the following investigations done so that proper treatment can be initiated. Infection, trauma. Urine routine and microscopic examination, abdominal ultrasound, abdominal CT scan." "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 foreskin of the penis is tight. Is there any problem in the future during sex? My age is 20 years, male, and single. ### Response: If the foreskin has become inflexible, rigid, and inelastic, it may cause pain while having sex. It usually occurs due to a condition known as phimosis. The main cause being poor genital hygiene. Visit a urologist or a general surgeon to assess whether it will need partial or full circumcision or can be retracted fully without any surgical intervention." "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 minor beta thalassemia which I got from my mother, but unlike her (asymptomatic), I have anemia symptoms like paleness, shortness of breath after the least effort, feeling tired all the time, broken nails and I want to know if it could be due to lack of iron? Could people with minor beta thalassemia also get iron deficiency anemia? Knowing that I get heavy cycles and my diet is very poor. ### Response: Hi. I have reviewed your query and here is my advise. Yes, your symptoms point towards iron deficiency anemia. In beta thalassemia minor patient usually feels more fatigue on exertion as compared to normal people without thalassemia. However do not worry regarding thalassemia minor, they can live a normal life. Thalassemia people can develop iron deficiency anemia secondarily. So rule it out by CBC profile with blood indices as well. You can revert back with reports so that I can 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: Me and my fiance had sex and seems out of fear took Ipill because it was unprotected for sometime so many doubts in mind but no leakage or injection of sperm, etc. Three time UPT done but all negative. After taking Ipill period comes as per regular cycle for 4 days but next period only one two hours bleeding and then stopped. This month period is skipped till date say it late by 25 day including today. Do I need to visit doctor or wait? ### Response: If you had taken Ipill within 72 hours of unprotected sex, it works well as emergency contraception (about 90 %). Since you had a regular periods after taking Ipill, pregnancy is unlikely. Ipill is hormonal pill containing synthetic Levonorgestrel which can can sometimes disrupt normal menstrual cycle. It is possible that your regular menstrual cycle has been affected by taking Ipill but the side effects are transient and usually menstrual fluctuations disappears by the following cycle. Since you are reporting persistent delay in having your periods, it is advisable to consult an OG doctor to have a check up and help to re-establish normal periods again. It will be reassuring to you as well. Do not worry there will be no long term side effects due to Ipill but it should not be taken often." "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 of 21 and I am suffering from permanent blurry eye vision in my only right one. It is by birth. Is there any chance to cure it without any permanent glasses and without any operations. Suggest me, please. ### Response: Hello. I understand that you are having blurred vision in your right eye since birth. This kind of presentation can be due to a variety of reasons, the most important being amblyopia. This is a weakness in your vision nerve and the vision centers of your brain. This diagnosis can be made after the examination of your eye and vision. In case you suffer only from a problem which is cured by wearing glasses, you have the option of getting the surgery done. In case you have amblyopia or other neurological problems, they are not corrected by glasses or surgery, that needs attention. My suggestion is to get your eye test done and read through the job requirements of the jobs you are applying for. In case you are having any trouble understanding or need some help with technical details, please send a scanned copy of your doctors report and your job requirements. I will do my best to help 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 saw these lesions on my scrotum and outer genitals yesterday. I am currently on day 6 of chicken pox. What could these lesions possibly be from? Is this an STD? ### Response: Your concern is folliculitis. Start Metronidazole gel in the morning and T-bact (Mupirocin) ointment in the evening on the affected areas. If they resolved, ignore but if they flare then have a physical examination by a dermatologist nearby you. It is not STD." "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 period started a month back. The next week I was on a Z pack for a throat infection. I have not gotten my period this month. I am 7 to 10 days late. Took six different brands, etc. Pregnancy tests are all negative. What could be causing this late period? I am under a lot of stress also. ### Response: The fact that urine pregnancy test is negative, and as this is the first time that your menses have been delayed and there is a likely cause present- the throat infection and the stress factor during this month. So, stress as we know that it can easily cause hormonal imbalances which can delay menses, you are likely experiencing a stress delay." "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 27-year-old female. I have been on Depo-Provera for six years. I am not taking any other medications. Lately, I have been experiencing severe mood swings and have not been myself. One minute I am dancing around the room and could not be happier, the next I am either crying or very angry. Normally, I do not cry and I am usually pretty laid back. I have also been getting dizzy mostly when I stand up or walk up the stairs. I have trouble sleeping and or sleeping too much. I am hungry all the time, however, when I do eat I feel nausea. I have done some research and have found that these symptoms are both common with the injection and also with pregnancy. How do I tell, if these are pregnancy symptoms or if it is because of the Depo shot? I did miss my last shot three months ago. Last month I took a home pregnancy test it came back negative. Will a home test be enough to tell if I am pregnant or not? ### Response: Hi. The home pregnancy test is fairly sensitive and very unlikely to miss pregnancy (except in very early pregnancy). If you suspect pregnancy strongly, you can repeat a home pregnancy test again after a week if period does not start. Most of your symptoms can be either due to indigestion or hormonal imbalance (hypothyroidism or estrogen deficiency). You can take antacids Pantoprazole for three to four days and see if symptoms resolve. If your symptoms do not resolve and pregnancy test comes negative, you can do TSH (thyroid-stimulating hormone) test to rule out hypothyroidism. As you have taken depot for a long time, estrogen deficiency is likely, which can cause all of your symptoms. If possible shift to oral pills for contraception for a few months to avoid the same. 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 had stomach pain after which my report was confirmed as gallbladder stones. What is the further procedure? Please let me know all the details, including the cost. ### Response: The mere presence of gall stones does not mean that your abdominal pain was from the gall bladder. Many people have gall bladder stones which do not give them any symptoms. When the gall bladder gets inflamed or when a gall bladder stones block the bile duct, you get symptoms like pain, fever, and jaundice. So, we need to ascertain whether the gall bladder stone was responsible for your abdominal pain or not. If it appears that the stone was the cause of your pain, then surgery can be considered. Laparoscopic surgery (keyhole operation) can be done, and many hospitals have doctors trained in this. The cost of the procedure varies from hospital to hospital. You should, however, first make sure that the abdominal pain was directly related to the gall bladder stone. Please upload the copy of the scan report, and also indicate in which part of the abdomen you had pain. The gall bladder is located under the right rib cage margin. 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: My 24 days newborn son is suffering from midgut malrotation. Is this a problem? ### Response: Hi. Abnormal relationship of the vessels can cause intestinal obstruction or volvulus. It may be asymptomatic as well. If it is symptomatic in the form of pain that is related to malrotation, then this baby may need corrective surgery. You should show to a pediatric surgeon." "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: Obstructive jaundice has been detected. ERCP was done. Serum bilirubin still very high. MRCP report says everything is alright but neither serum bilirubin nor yellowness has got less. ### Response: Hi. I have gone through your case and can well understand your genuine health concerns. In obstructive jaundice, there is an accumulation of conjugated bilirubin in the body due to obstruction at different levels in the hepatobiliary system which causes yellowish discoloration. ERCP helps in clearing the biliary system. Sometimes, only the biliary sludge will be found in ERCP. Bilirubin takes some time to get completely cleared from the body. Repeat your liver function test after a week. If it is still high, other causes should be ruled out. You can try ursodeoxycholic acid (UDCA) which comes with the name tablet Udiliv 300 mg once daily for two weeks as it helps in clearing bilirubin." "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 28 years old. From the past two weeks, there is a slight pain in my right ear. I tried Clear Wax ear drops and normal ear drops then there is a relief for a certain period then again mild pain is coming the next day. When I wake up in the morning there is a very slight headache kind on the right side and some sort of discomfort in my right ear. There is not severe pain but certainly, there is some sort of mild pain. I also noticed whenever I tried using earbuds in my left ear to clean then I am getting cough as if some sort of itchiness sensation in the ear is causing immediate cough in the throat and normal again after I take earbud out. I want to know whether I should consult ENT specialist immediately or if there are any ear drops in particular to use before I go to ENT doctor. ### Response: The cough which occurs during ear cleaning is due to stimulus to your auricular branch of the vagus nerve, which is normal. Now coming to your problem, many times mild pain occurs due to impacted wax or ETD (eustachian tube dysfunction). Both cases it is advisable to consult an ENT surgeon for the proper examination of the ear. Never try to clean the ear yourself as it can cause injury to your 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: I had a month old twin baby girls. They were born in the 34th week of pregnancy. One baby was 2.2 Kg, and the other was a little weaker weighing 2 Kg. Since there is not enough mother\s milk after several attempts, I had to go for artificial milk powder. Initially, as suggested by the hospital pediatrician, they were given Dexolac Special Care, but after 20th day when their weight was around 2.4 Kg, they were given to Dexolac Premium 1. Out of the 2 babies, the weaker baby is responding well and quickly gaining weight (taking around 75 ml milk every 3 hours). But the baby which was born stronger is not drinking sufficient milk (45 ml in one feed, at an interval of around 3 hours), and is taking around an hour to take one feed. Also, she is having issues of gas and constipation. Because of constipation, she keeps crying. Now, this baby is not gaining weight and seem to be weaker. Please suggest what we can do in this case and shall we switch her milk to Lactogen or some other company? ### Response: Hello. Keep trying to give breastfeeds as much as possible till 6 months completion. Different brands of milk powder have different tastes. So, you can change what they like (as advised). Do not dilute more or give more concentrated milk. Usually, dilution mentioned on the package can be followed, that is, 30 ml for 1 scoop for most of the brands. But check with the manufractures\ note. Do not use feeding bottle. Use bowl and spoon.You can use undiluted dairy milk (pasteurized). Check with your local pediatrician for supplements if needed. Check if there is adequate weight gain. Maintain proper hygiene while feeding, when using formula feed or top milk. Do not compromise on hygiene. I would like to know the following: Finally, breastfeeding is the best for the babies." "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 24 years old. I am married. I have a bit problem in my sexual life. Whenever I insert my penis in her vagina she told me that when I insert full penis in her she feels pain. Is it normal or not? ### Response: Painful penetration in women may be caused by any injury or lacerations in vaginal walls, infection of the genital tract, forceful or violent sex, lack of lubrication in the vagina. I think you should do a lot of foreplay before penetration so that her vagina may get lubricated naturally. Also, it is highly recommended to use a water-based lubricant like KY jelly. Always be gentle to your partner while having sex. That is the key." "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 7 weeks pregnant and I want to terminate it. Please suggest me some natural methods. ### Response: Yes, there are medical methods available which could be availed under a doctor\s supervision only. This is an abortion kit containing one Mifegest (Mifepristone) tablet 200 mg to be taken orally and 4 Misoprostol 200 mcg to be inserted per vagina after 48 hours of taking the Mifegest. You may have a bleeding per vagina just like your cycle. This is a prescription medicine as well as there are some chances of more bleeding per vagina, which you have to keep it in your mind. Just get in touch with your doctor if there are rare chances of excessive bleeding as you may need a surgical evacuation at that time. This method is applicable up to 7 weeks only and if you have to adopt it, do not delay further. Ultrasonography (USG) after 15 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 went for an annual health checkup and found there was a minor change in the ECG. I am 28 years old. My weight is 80 kg and height is 163 cm. My BMI is 30 and waist circumference is 90. My BP 130/90 mmHg. I am also attaching my ECG report to you. I need your suggestion. ### Response: Hi. You may go for electrolyte levels in the blood and renal function tests to be on safer side. Though no need, if you do not have a history of renal disease or medicines that may cause increased potassium levels." "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 baby is 5 months old. I have given vaccine to her on 18th of this month, since then she was having fever every four hours the other day too. After that she is not drinking breastmilk and formula too. Now only drinks at night time while sleeping. What should I do? ### Response: I understand your concern. Usually, vaccines are not related to decreased feeding. Fever might be because of vaccine only but not decreased feeding, it may be a sign of infection. Is the baby dull or lethargic? Is there any recent Formula change? What about stools and urine, is it normal or less? Is the child irritable or is there any swelling at the vaccine site? You should definitely see a pediatrician if this persists." "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 61 year old female and a diabetic for the last ten years. I had a cystocele repair surgery along with hysterectomy and cervix and ovaries removal five months ago. There is a slight discharge on and off. I did a urine culture now and found that there was a colony of Enterococcus faecalis. Please let me know if this is serious and whether I have to take a course of antibiotics for it. I do not have any symptoms of UTI or abscess etc. Also, the cystocele repair was not a success as the bladder is still at the mouth of the vagina. Please also let me know if anything can be done to put the bladder back in place. If this is not done, what are the repercussions? ### Response: I have gone through your query and understand the concerns. Hope you found the answer helpful. Regards" "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 with the same partner for 8 years now. During these all 8 years I have had several UTIs with some leading to severe kidney infections. Last week after almost two years of not having a UTI I felt the horrible symptoms again. When going to the doctors UTI urine test came back positive. The doctor prescribed me seven days Nitrofurantoin antibiotics which cleared the pain and seemed gone entirely. Unfortunately two days later, the symptoms came back (please note that I had sex with my partner the day before) with burning sensation when urinating and painful when standing with the need to go toilet every 2 to 3 minutes. I went back to the clinic the same day to get it checked and take more antibiotics.But to my surprise, the urine test came back clear for UTI, and my symptoms disappeared. Then the doctor advised me to get tested for Chlamydia as the symptoms can sometimes be mistaken to be UTI. I have been diagnosed with Chlamydia at the beginning of this same relationship and was treated for it. My partner was also tested, but his results came back negative. ### Response: In UTI, initially, a broad-spectrum empirical antibiotic given and then according to urine culture report, a specific antibiotic prescribed. A certain antibiotic like Azithromycin if prescribed for UTI will be effective against chlamydia as well. If chlamydia infection present recently then some irritation, itching, discharge like complaint present and swab culture can be done for that if needed. Frequent intercourse, pelvic hygiene if not maintained, stone in the urinary tract, diabetes mellitus, etc., are some causative factor for recurrent UTI. Maintain pelvic cleanliness especially after intercourse. Wash and clean the pelvic area immediately after intercourse. Consume fruit juice like cranberry juice more. Wear loose undergarments rather than tight underwear." "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 42 years old and have been diagnosed with multiple uterine fibroids. Two of them are a little more than 3 cm at different places in the uterus. In the past, I have been operated for endometriosis level 4. As usual, the gynecologist is suggesting a hysterectomy. But since I am in my perimenopausal phase, can the fibroids shrink with medication? I have been suggested Fibroease. ### Response: Hello. The medicine you are taking is good for your condition. If you want to try shrinking it with medicine alone, you can continue that. Along with that, I advise you to visit a nearby Ayurveda physician or a panchakarma center and ask for the procedure related to fibroids. Usually, Virechana which is a purgation therapy which is done and also medicine is given. It helps some patients in getting relief." "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 daughter is 18 months of age. She was born at 38 weeks due to placenta failure and oxygen issues. She was 5 lbs 10 ounces at birth and was healthy (did not have to stay in the NICU). She hit all of her milestones in terms of rolling over, crawling and walking (walked at 14.5 months), but is a toe walker. Her left leg (to us) is weaker than her right and her left leg does not bend as much as her right leg. She began to speak around 10 months of age then her speech left. We came to find out she had chronic fluid and a month back she had tubes placed. I am hearing more vowel and consonants now but no true words yet. She makes fine eye contact. Her non-verbal communication is good. She responds to her name but not always. She is beginning to learn more of what we are saying, she plays with some toys, is not terribly social. We are thinking that she may be on the autism spectrum and we have an evaluation soon to determine that. But my question is, could this be cerebral palsy? ### Response: I understand the situation you are facing with your child. As there is no history of perinatal insult and NICU stay at birth, cerebral palsy could be less likely at this early age to diagnose. The description you made is more of a like to be an autistic spectrum disorder. But this could be just a small delay in catching up all milestones. Some kids learn early and some little late. So, observe over a period and if no improvement is seen, then consult a pediatric neurologist and developmental specialist for further evaluation and management." "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 sat on my testicle before two months, and I experienced an initial sharp pain for a few hours. I went to the ER and did a blood test, urine test and an ultrasound. Torsion, as well as infection, was ruled out.The exact incident occurred before few days. I did a urine test and another ultrasound. Torsion was ruled out once again. When the pain flared up again, I went to the doctor back. Again, I did an ultrasound, urine test, and blood test. Torsion and infection were ruled once again.The doctor pointed out a little bit of fluid around my testicle, and I had no pain. But, still, I have pain in my testicle. What was ruled out with these tests? From where does the pain arises? ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). This acute testicular pain with normal testis examination and ultrasound report look like simple orchialgia. Ruling out torsion is very important in young males presenting with testis pain. It shows that the testis is not twisted on its own. Pathologic pain has associated redness and swelling. From your report, I can say that you do not have torsion and epididymitis. Young males have simple orchialgia due to muscle tone. You need scrotal support. Take tablet Pregabalin 75 mg at bedtime." "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 got an accident before a month. I got a right knee ACL ligament type 2 tear. Is it possible for the type 2 ligament to get cured by itself without operation and if so, how many days does it take to heal? ### Response: ACL (anterior cruciate ligament) tears will not heal on its own as they are inside the joint. To bring the ends together, you need surgery, but even that too is not successful. It is the reason for doing ACL reconstruction. It is not recommended for everyone. Only if your knee is giving way or if it is unstable or when you are unable to lead an athletic life, then you need an ACL reconstruction." "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 30 year old female. I have a minor issue. About a month and a half ago, there was an incident where the condom broke. About 36 hours later, my husband got me four of the morning-after pills, and I took them all at once. Three days later, I started experiencing nausea, soreness of the breasts, lower back as well as abdominal pain, frequent urination, and tiredness. This carried on for almost a week. I then noticed a light brown discharge. And, from the next day, I bled for six days. I usually bleed for seven days. After my periods, I still had the symptoms.Nearly a month later, I got my periods again, but on the first day I had severe cramps and used a tampon. On the third day, there was a slight discharge which was brown in color. On the fourth day, there was some bleeding, but not at night. Today would be day five, and I still do not see blood. My main concern is that my vagina feels different. It is more firm than usual and feels tight. I sometimes feel a pulling sensation. Could it be due to the morning-after pills? I did home pregnancy tests, and it came back negative. It has been a month and 18 days now, since the intercourse. ### Response: Hello. Please let me know if you were previously pregnant. Since you took the emergency contraception pill within 36 hours, and you got your period after the intercourse, you are not pregnant. The emergency contraception pills are progesterone tablets. It is a hormone normally present in the body, which is secreted in the second half of your menstrual cycle. It gradually decreases in concentration due to which you get your menses. When you take progesterone orally in a higher dose to prevent pregnancy, some females experience the side effects of the tablets. Although your menses were on time, some patients may experience irregular menses for two to three months. 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 a 29-year-old female. I was just diagnosed with chronic urticaria. I went to an allergic specialist for skin testing because my skin was so sensitive I reacted to everything. They then did the RAST test on me. Everything came out class 0 except for egg white, wheat, and oats being class 2 and milk, and hazelnut being class 1. Can these cause anaphylaxis? How accurate are the RAST test? I was put on an elimination diet but the hives are still there. I occasionally get angioedema with it also. Can angiodema cause anaphylaxis? As you can see I am so scared for my throat to close up that I am scared to eat anything. I have only been eating a couple of things daily and live off that. ### Response: RAST is a highly accurate test. If the test is positive for a specific allergen, it shows that you are sensitized to that particular allergen. This means that you may mount an allergic response when you are exposed to that allergen. However, it does not mean that you will necessarily have an allergic reaction to that substance and, nor does it mean that any reactions will be severe. If the test is negative, it means that one does not have the ability to mount an allergic reaction to that allergen and any symptoms one may be experiencing are probably not due to an allergic reaction to that substance. However, the results of the RAST need to be interpreted in conjunction with your clinical history. e.g the presence of allergy to some or few allergens which may possibly be present either in the environment or food does not necessarily mean that they are responsible for the symptoms because if they are not even present in the environment or food of an individual, then they are irrelevant. In your case, an elimination diet has not helped thus proving the fact that RAST test results should be carefully interpreted along with clinical history and does not necessarily mean that you will necessarily have an allergic reaction to the substance that you tested. Angioedema is frequently associated with urticaria. Pathogenesis is the same for both urticaria as well as angioedema. The presence of angioedema does not always mean that it is a part of anaphylaxis. Angioedema can be a part of anaphylaxis in those individuals who have a severe allergic reaction to an allergen with high levels of antibodies circulating in the blood. Since you have only class 1 and 2 level antibodies therefore it is unlike that these antigens or allergens would cause anaphylaxis." "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: Since the last 10 months, my periods are very irregular. I get periods only once every three to four months. I am on treatment for abdominal TB since the last one and a half years. I take Sompraz D20 on an empty stomach in the morning. I take Duonase nasal spray (two puffs in each nostril) twice a day. I take Immunace Forte after lunch and Libotryp at bedtime. So, why are my periods not regular? Is this a side effect of my medicine or could it be due to a disease? Recently, I was also prescribed Uprise-D3 (60000) once a month for six months. My recent 25-OH vitamin D total is 21.1 ng/mL. I also have sudden weight gain. My weight in the last one and a half years increased from 57 kg to 81 kg. I also have a chronic nose block. ### Response: Hello. Your irregular periods can be due to your obesity. You need to lose some weight. You have a history of TB (tuberculosis). So, there may be chances that your uterus might have got affected due to that." "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 history of thyroid issue before pregnancy. Currently, I have an issue of hair fall and mild body aches. ### Response: The likely cause for hair loss is low hemoglobin and also for body aches is low hemoglobin and low vitamin D. Your ESR (erythrocyte sedimentation rate) is elevated which is due to low hemoglobin (attachment removed to protect patient identity). Your thyroid is fine. So you should have Iron supplements like tablet Fericip XT (Iron and Folic acid) twice a day after breakfast and after dinner. This may cause some gastritis. Also, you should have tablet Uprise D3 60,000 units once a week for eight weeks, followed by once a month for next six months" "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 generic query. Can we trust the NABL and CAP accreditation laboratories in terms of reliability and accuracy? And what does they mean? And all NABL and CAP labs are of same quality? Please explain in detail. ### Response: Hello. It is good that you are noticing such accreditation. NABL accreditation laboratory definitely has good quality work and is more reliable. NABL is not compulsory to all laboratory but its accreditation ensures that the laboratry is following standards set by NABL board to provide good reports to the patient. So, yes you can rely on NABL accrediated laboratory." "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: How eating habits or certain foods impact sleep? How much should men be stretching at 25, 30, 35, 40, 45? Does the need to be flexible vary by age? ### Response: Eating late heavy dinners will certainly affect sleep and also missing the meal altogether. Should avoid fatty meal especially at dinner time. Meals taken with lots of fluids are to be avoided too. Men should try and remain as flexible as possible, really more stiff, you are more likelihood of osteoarthritis setting in, more likelihood of injuries. Aim to continue with stretches for as long as possible." "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 baby is 10 months old, and he is two months premature. If I feed him with solid food, he does vomiting. Is it not safe for him to feed with solid food? ### Response: Hello. I just read your query. I advise you to try giving some soft and semi-solid foods to your baby right now. Once he starts digesting these then move on slowly towards other food items. Moreover, some babies do not take solid food properly until they develop teeth. But if your baby does not digest semi-solid foods too, then you need to visit a nearby child specialist. Because it can be due to some other underlying cause which needs to be ruled out. I hope you understand my point." "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 23, 51 kg. I had unprotected sex a day before I got my period (on the 38th day of cycle). It lasted for four days (normal). Today is the 13th day from when my period started and I am getting bad backache, my breasts hurt (usually happens just before period) and sticky egg white discharge. Am I pregnant or is it ovulation? I had taken a pregnancy test before I got my period because I was late and it was negative. I have mild PCOS. So, my periods are never on time but happens every month. Is it possible to be pregnant after you get your period? ### Response: I have gone through your history and understand your concern. This is very unlikely to be pregnancy as a proper period followed and when UPT (urine pregnancy test) was negative just before the period. So, you are at present not pregnant and no chances of pregnancy even with that last unprotected intercourse. The nature of discharge is suggestive of ovulation only. However, if still any doubt in your mind you may take two pregnancy tests - one immediately now and another after a week. If both are negative, you are not pregnant" "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: Nowadays, I am getting a migraine for every three days alternatively. Before few days, I usually get a migraine once in 20 days. Often, I have a visual problem and aura symptoms. It relieves after taking Zerodol. Please suggest. ### Response: Hi. A migraine has two types of treatment. When the duration of the attack is more than 24 hours, we need to use both abortive and prophylactic medicine. In your case, you must use both the treatments. Make a daily diary to sort out the triggering factors such as lack of sleep, fatigue, stress, certain foods, and vasodilators. Avoid it soon." "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 epididymitis problem. Sometimes I am having pain in testis while having a gastric issue as well. Kindly help me to get rid of this ### Response: Testicular pain with these doppler findings (attachment removed to protect patient identity) shows some infection of the epididymis. If it is a recent onset symptom, I suggest: Have you been prescribed any medicine for this ailment? Any associated urinary symptoms? How is the flow of urine? Please attach the urine analysis report. Relief of pain will take some time and swelling may take three weeks to subside." "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 32 years old and had an herinated disc and had surgery a few years back, it was a post delayed surgery. Due to the delay in surgery (18 days) I left with a foot drop and right leg weakness. I was bedridden for 4 months. Totally weak. But I gradually developed doing physiotheraphy and with some Ayurvedic treatment. I started waking now with out any help. But my foot drop is still there. But I can lift my toe and ankle little bit from last month. Can I come to my normal life, how long I need to wait to get cured from foot drop? ### Response: Hello. I can advise you in detail if i have your detailed neurological charting including assessment of motor power, sensory charting of lower limbs and evaluation of deep tendon reflexes. Also, latest MRI of LS spine is required to see for adequacy of decompression. To answer your query, the best results come early after the spinal decompression surgery, if motor loss can be ascribed to compression in spinal cord or roots. Also intensive physical therapy helps you to gain power . But since you have started gaining power, it can continue for at least 6 more months, so my advise to you will be to continue with intensive physical therapy including muscle stimulation, vitamin B12 intake and come back to me with your neurological charting and MRI films so that i can see and advise 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: I was at the dentist yesterday and had a gum cleaning and now today there are 2 bumps in the back of my mouth on top and my gums right there also look red and there more looking like balls per say. ### Response: I have been through your query and I can understand your concern. The feeling of strange, weird and sometimes loose tooth are major complaints that a patient generally comes with, after having the cleaning (scaling and root planing) done. This is because of the removal of the debris. Earlier what would have become normal for the patient is now removed (debris) and the patient interprets it somewhat as loose tooth and strange feeling. The redness you are referring to is the erythmatous tissue that generally occurs post cleaning because the gums while cleaning gets separated from the tooth structure (like an injury). However, the healing capacity of gums is very fast and it would be go in 3-4 days. Referring to the picture (attachment removed to protect patient identity), the bumps you are saying, you do not need to worry about. As also you are saying that there is no pain means they are not infected. They might have occured due to the injury of hard palate during cleaning. I would suggest you to not worry as they are generally seen after cleaning is done. They would be gone after some days (generally 3-4 days). However, if the bumps persists beyond one week, I would advise you to have a visit to your nearest dentist for proper and overall examination. Moreover, I would suggest you to keep maintaining good oral hygiene by brushing twice daily and floss regularly. Also rinse your mouth with oral rinses for 4 days a week and 3 weeks a month. I hope I have satisfied you with my answer." "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 milky like white color on my tongue that is more noticeable in the back my tongue should I be worried? I am a non-drinker and smoker. ### Response: Hello. The condition that you mentioned can arise due to a variety of causes. You have not suggested whether it is associated with pain, burning sensation or itching. Let me name a few conditions where the milky white appearance on the tongue is generally seen. 1. Candidiasis associated is with pain and burning sensation at times. Can be scraped off the tongue. Usually occurs in diabetics. 2. Leukoplakia is non-scrappable, painless but can progress to cancerous condition if not treated early. 3. Oral lichen planus is associated with a burning sensation, pain may or may not be present. People with a poor immune system are usually prone. These are the conditions. But be relaxed. It is completely curable. Make sure you see your doctor as early as possible and have the condition diagnosed. Early intervention and prompt treatment is the best solution." "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 29 years old . I am married from the last 1.5 years. My problem is that from the last two weeks I am am not getting proper erection during sex. Erection comes a bit and goes out instantly. It is just happeing from the last two weeks before that I was totally fine. I am taking some herbal medicines. Please suggest me why this happening to me. Right now I cat get any erection sex only a bit if I watch some porn or like that. I am having so much tension because of that. Yes one more thing, I used to take one penis size enlarge oil but very rarely. Might be because of that oil I am having this problem. Please suggest me best possible option to cure this. ### Response: Hi. I can understand your concern. As you are getting erections when you watch porn but are losing during sex this shows that problem is not organic. The issues are more psychological. Confido helps to boost confidence but is not proper treatment. For some times you can try tablet Tadalafil or Sildenafil. Either of these tablets if taken about half to one hour before sexual intercourse help to improve erection. If problem persists then visit a doctor and get serum Testosterone and Prolactin levels done. If levels of both these hormones come normal then remain relaxed. No need to worry." "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 will be facing major surgery for stage three lung cancer contained in the left lobe. I am extremely allergic to Fentanyl, Propofol, and Versed. Are there any alternatives to these anesthetics? I am currently on Synthroid. ### Response: If you are allergic to these agents, I suggest you undergo a detailed allergy test with various agents so that you will be able to know which agents are safer for you. There are so many agents and techniques available nowadays in the field of anesthesia. If you are allergic to Propofol, Thiopentone (Sodium Thiopental) or Etomidate is a safer option. For analgesia, the multimodal technique will be a safer option including regional anesthesia, various blocks, NSAIDS, etc. Versed (Midazolam) can be avoided at all during surgery. So my suggestion to you is to inform your anesthetist about this and leave your worries on him." "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 rheumatoid arthritis. There is a long waiting list to see a rheumatologist in my place. I am thinking of seeing a private doctor but I have limited funds. How often would I need to see a rheumatologist? I cannot afford it every week or maybe every few months. How often do you think I need a doctor visit? I am hoping to be prescribed a DMARD like Methotrexate. Then when my slot comes up with the NHS I will go there.I take Naproxen which is not enough and I had a cortisone injection in my knee a couple of months ago. The swelling did not go down completely but I walked better. It has worn off now, and I have pain in more joints and a feeling of lumps under my feet. I am on a special diet and my CRP, ESR and high rheumatoid factor have gone down by half. But lately, I feel unwell. I would like to know the frequency of visits needed. ### Response: I have gone through your history. It is a bit unusual. If you could throw some light on the history of arthritis, it would be helpful. If it was an intermittent one initially, or now it has become persistent? Well, as per the treatment, if it is confirmed rheumatoid arthritis, they will start you on Methotrexate straight away. The follow-up visits are usually within four to six weeks for the first time, and then after three months. But a lot depends on your treating rheumatologist. Most of them advise liver function tests after two weeks to see if the dose is not giving you side effects. But that can usually be followed up with rheumatology nurse. So once you are through with first visit and improvement comes, then a three months visit suffices. But if the disease keeps bouncing back, then a bit more frequent visits are needed. But hardly before six weeks as that much time, it takes for any new DMARD to act. So it is a bit tough to predict, but do not worry. No rheumatologist will call you back in a week or two. 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: Due to the use of Skinlite, I have sunburn on my face and now it looks like the dark spot. But I am using Kojivit gel for a dark spot. Is Kojivit gel good for the dark spot? ### Response: Hello. You must use a broad spectrum sunscreen throughout the day. Reapply every 2 to 3 hours. Sun protection is important to treat facial pigmentation. This cream should never be used without the supervision of a dermatologist as it can cause irritation, redness and other side effects like acne. Use it only if your dermatologist says after looking at the skin condition. I would request you to upload a picture so that I can assess the condition visually and therefore guide you better." "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 a persistent headache since last 15 days. It started with headache. Consulted various neurologist. Got MRI and CT done, all clear. He gave various medicines, even Noxdorm 250, but no response. ### Response: Hello. I understand your concern and would explain that his symptoms could be related to a tension-type headache. Coming to this point, I agree with the doctors prescription about Citalopram and Sibelium (attachment removed to protect patient identity). For this reason, you should be patient. If the situation does not improve in a couple of weeks, I would recommend trying Amitriptyline and Valproate combination. You should discuss with his doctor about these treatment options. Based on his test reports, I would conclude about a primary headache (benign, related to psychological stress)." "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 and I had some argument about my past. I had lied to her about the number of sex partners I had. That hurts her because she explained that her perception of me was built on the fact that she knew that I only had a few sex partners.We have been discussing this for months, but now after having these discussions and arguments, I realize that when we are to have sex, I get anxious. I will get an erection, but when its time to enter, it falls. I want to know, how to get my mind to a place of not over thinking so that I am not distracted. Kindly help. ### Response: Hello. I am happy that you did understand that the problem behind your erection is, the problem is related to stress and anxiety which is stemmed out of the differences between you and your partner. That itself is the first step of the problem solver. Now the remedial measures are, 1. Do not attempt to have sex when you have the thought and related stress in your mind. 2. Start relaxation breathing for 10 minutes at least once per day. 3. Start physical exercise for one hour daily 4. Write down the cause and effect of the problem you are now facing with all the details. Then clear it logically alongside what you wrote. You may have to write this for two weeks to get the desired result." "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 a strange glitch in my vision. It is quite big and takes up a large portion of my central vision. It is neither a shadow nor a flash, it looks like a greasy fingerprint smudge in my vision which disappears quickly. It happens when I blink, but mostly occurs when my eyes move quickly. I have had it for the past few days and I do not know if it is anything to be concerned about. Please help. ### Response: Hi. As per your description of symptoms it looks to be non-pathological. It will occur when a thick eye secretion covers the cornea, once you blink it will get clear. This needs to be treated with artificial tear" "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 tooth hurts anytime I eat or drink. It feels hot. I feel hot, it is sharp pain that does not go away. My gums are swollen. ### Response: Hello. Your tooth has sharp pain due to tooth sensitivity (due to enamel erosion) once you get it treated pain will subside. If erosion has not involved the pulp then only restoration can help you, or when the pulp is involved, then root canal treatment will be a solution. Please share pictures and radiograph of your affected tooth. Tooth sensitivity. IOPAR related to affected teeth. Restoration or RCT of the affected tooth." "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 permanent cramps and a constant ache in both buttocks. I have pain down the back of the legs in the calf and when I walk it feels like it is about to cramp and I get pain in front of the thigh. I have a constant aching feel. When I press my skin on both thighs it feels sore. I had it for over two months. I have pain on both sides of my thighs and legs regardless of if I am sitting or resting.I got admitted to the hospital for two weeks and they did an MRI scan on my spine and found nothing. They did a lumbar puncture and found nothing. They also did a nerve examination and nothing was found. I am currently on Gabapentin, Codeine, and Paracetamol. ### Response: Hi. It looks like a nerve compression to me. If all investigations are normal, it does not mean it cannot be nerve compression. It could be meralgia paresthesia or neuralgia. I would recommend you to take Vitamin B12 shots. Also, discuss with your doctor to prescribe you a combination of Pregabalin along With Nortryptilline in the night. This may take a few weeks to months to recover. 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 small boils (red and white) on the head of my penis and also inside the skin and itching also. I regularly clean with warm water and sometimes, put some vaseline gel but nowadays, it increases very much. I think it is a fungal infection. Please suggest a good medicine and precautions to be taken to clear this infection. ASAP. This happened for the first time. ### Response: Hello. From your history, it appears to be a fungal infection. Could you please send me pictures for an appropriate diagnosis and treatment? 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 have observed a white smegma on my penis head. There were irritation and red bumps on it before, but I oiled it so now I do not have any pain or irritation. But in the morning the white smegma is still there and my foreskin is hard and rough. What should I do? Please help. ### Response: If your foreskin is hard and rough you may get benefit from removing the foreskin i.e. circumcision. I suggest you show it to the urologist nearby and get it 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: My 2-year-old put my mascara wand in his mouth. His teeth and all around his mouth were black. I used a toothbrush and water to get all the black out. What else should I do? I am not sure how much he swallowed. Can it harm him? ### Response: Hello. Mascara contains iron oxide, carbon black along with a base of paraffin or mineral oil. As your child had taken it in his mouth and you already have cleaned it. Now there is nothing to worry, you may ask him to gargle with Chlorhexidine mouthwash which will improve the oral hygeine. If a very small amount was swallowed, there is nothing to worry, it may not cause any harm." "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 and today I have been experiencing a sharp pain just left of the sternum which is not deep, seemingly on top of the rib where it joins the sternum. It lasts a second or two but may repeat several times before stopping in five minutes or so. I went out in the garden today to dig a bit and wearing my HR monitor (I have got health anxiety, anxiety disorder as well as depression). As I was digging, the pain started hurting with each heartbeat. I looked at my monitor and it read 138 bpm. I am 70 years old and have been on medication (Benzodiazepines) for over 50 years for panic attacks and general anxiety. Two years ago I felt similar pain but not to this extent. I went to ER but nothing was found (the doctor said it could be costochondritis but definitely not my heart). I get bloodwork quarterly and everything was fine except cholesterol which was 235. I tried a statin but the muscle pain was too great. In my EKG I have RBBB or LAFB which 14 years back after a stress test I was told that I was probably born with it. I had gone to see the cardiologist then because of getting skipped beats and GERD he told me to ignore them. Last time I had an EKG was in the ER for six months when I had a weird pain in back and side. They checked out heart anyway and said it was fine. Probably just a colicky gallbladder. I have had stones for more than 20 years and had no surgery. So I hesitate to go to the ER again. My local doctor just closed. HR is still 88 while lying down right now. Usually, my resting heart rate is under 67. Currently, I am on Lorazepam 2 mg, Prevacid 15 mg and baby Aspirin. ### Response: Hello. I have gone through your history and it does not appear to be an ischemic pain. Ischemic pain will not be sharp and so short lasting." "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 in my late 6th month pregnancy. Recently I went for a scan named targeted imaging for fetal anomalies (TIFFA). All the reports were normal except hypoplastic nasal bone and higher normal values of amniotic fluid. I am approaching you for second consultation now. My questions are, what if we go for genetic amniocentesis and results were positive for Down\s syndrome? Can I terminate the pregnancy in my 28th week of pregnancy? How much safe it is to go for amniocentesis test? Is there any alternate test to get better results? I decided not to have a baby who is mentally retarded. Please suggest me your valuable advice. ### Response: I have thoroughly gone through your case and can well understand your genuine health concerns. 1. We can better comment on the outcome after getting the results of the amniocentesis. 2. You may terminate anytime depending on where you opt in for this termination. I mean you need to have expert hands for that.3. Amniocentesis is very widely done test all over the world and as for every diagnostic invasive procedure it has its own safety profile.4. Risk of complications is always there as it is associated with invasive procedure. Again I want to add that if you opt in for the expert hands and a seasoned professional obstetricians and gynecologists and interventional radiologist then there is no to low risk for the baby and the mother.5. Amniocentesis and karyotyping to rule out for genetic disorders that involve chromosomal anomalies is the best test universally. No other choice, as this is what we need to know next and this is the specific test available which may guide us about that.6. It is your right to decide and it is solely you who can decide about your body as to what is better for you. Physician can only guide you about the procedures and the final decision is solely your own as to what should be 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: My mother is 75 years old. She is suffering from head spinning and heaviness problem since the last six months. Her BP, sugar, thyroid and other blood test reports are normal. After getting a suggestion from a doctor (Medicine) she had gone on an MRI test. The MRI test (non-contrast) of brain report was given with a doubt of evidence of blooming in GRE in the left parietal lobe and right basifrontal lobe without evidence of perilesional edema and advised for further evaluation with contrast to rule out calcified granulomas and other etiologies. Also, MRI report findings include:Small vessel white matter ischemic changes.Chronic lacunar infarct in the right external capsule.Mild cerebral atrophic changes.The Doctor of medicine gave medicines for the treatment of vertigo and nerve but suggested to show immediately to a neurologist. My mother does not know the brain problem and she refuses to go to a doctor for further checking due to her fear. So, I need your help. ### Response: I have gone through the detailed query and understand your concerns. In my opinion, there is a definite need for face to face consultation as it seems to me that there is a need for cognitive evaluation. The MRI changes observed are indicative of vascular pathology and should be treated if concomitant symptoms are present. Regarding the doubtful observation over MRI, nobody can help with this. Either one sees the MRI report or you get contrast MRI. This will unearth the true pathology of blooming in the parietal and frontal lobes. Since there is no edema, it can be concluded that there is little possibility of malignancy or recent changes but it does not rule out the chronic healed granuloma. I request you to do following: 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 have a small white scar on the lower lip for seven months. It was not white at first. But now it just stays there and does not show any change. ### Response: Your problem is nasolabial dyssebacia (attachment removed to protect patient identity). It is a type of eczema secondary to mild pityrosporum yeast infection associated with an oily part of the face with affected areas, mild scaling and redness in few individuals. You can start using Cetaphil soap for face wash along with Lulifin cream (Luliconazole) once daily for 30 days. Apply to the affected areas even if the skin becomes normal after 30 days. It flares with stress and over thinking. Nothing serious, it is curable" "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 struggling to get up early in the morning. I sleep for eight hours every day. I press the snooze button many times, but still, I cannot wake up early. I became irregular to the work which became a barrier to my career. Currently, I am taking tablet Fluvoxin 100 mg in the afternoon for OCD and depression, tablet Oxetol 450 mg in the evening for gelastic seizure, tablet Quetiapine 100 mg at night for delusions. ### Response: You have to be strict about your schedule. You are taking tablet Quetiapine at night. It is a standard medication which affects your sleep, mostly due to oversedation. But there is no other option if your delusions are under control with it or you may try another antipsychotic like Risperidone. You must sleep early at night if possible and take night medication soon at least at 9 PM if you are going to sleep at 10 PM. Fix your sleeping time from 10 PM to 6 AM. Do not snooze alarm. It is hard initially after that you will use to get up early. If you have depressive features, then treat your depression, because depression can also cause a problem in sleep (wake up issue)" "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 unprotected sex on 1st of last month and missed my period on 20th. I did a urine pregnancy test on 3rd of this month, it came negative and then I took Regestrone 10 mg for five days one tablet each day from 3rd to 7th. Then on 8th, I did a bhCG which came negative and today I got a slight spotting and when wiping a little brownish kinda discharge came. Am I pregnant? ### Response: No, you are not pregnant as urine pregnancy test and HCG (human chorionic gonadotropin) test are negative. You have taken Regesterone so your period is delayed more. Your period should start now. It normally takes two to seven days after the last Regesterone tablet. So do not worry you are not pregnant because it is already more than 30 days after unprotected sex and all tests are negative. Brownish discharge can be the starting of menses. You are definitely not pregnant. Do not take much stress." "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 running, and I fell into a pit. My ankle got twisted, and I could feel some cracking sound. I had a swollen ankle immediately. I have been icing for 2 days and now the swelling has reduced. I am unable to walk. I have pain when I try to move or walk. I had a fracture fibula of the same ankle 5 years back. Please help. ### Response: As there is a history of twisting injury to your ankle with a kind of cracking sound or sensation which you have felt, I will advise you to undergo an immediate x-ray of the affected part to rule out any bone injury. X-ray ankle (anteroposterior and lateral views). Getting an x-ray is all the more important as you have a prior history of fracture fibula of the same ankle." "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: The semen analysis report is in my hand, but I cannot understand it.Liquefaction time- 30 minutes.Duration of abstinence- four days.Appearance- creamy white.Volume 4.0 ml.Ph 8Fructose- Present.Motility- 100.Spermatozoa- rapid 20%, slow 10%, non-progressive motility 5%, immotile 83%.Vitality count- 15 million.Morphology- normal 20%, abnormal 80%. ### Response: Hello. I read your query and understand your concerns about the semen analysis report. As per the available semen analysis report, you have very low sperm count and most of the available sperms are defective. As you can see that almost 80 % of your sperms are defective and of no use. In addition, the count is just 15 million per ml, which is again very low. Considering this report, there is a low chance of natural pregnancy to your partner as the sperms are low and available ones are defective. I request you to see your doctor as you need treatment for improvement of the health of your sperms. 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 was seen in the ER for a possible kidney stone. I did have blood in my urine. No stone was found. The only thing noted on my CT scan reads \x80\x9ccircumferential urinary bladder wall thickening versus under distension\x80\x9d. What does this mean? Is this a sign of bladder cancer? What follow-up is needed? ### Response: I need to know some more details of the hematuria episode. Was bleeding associated with pain? What was the location of pain? Was it radiating to the back or testes or penis? Were there clots, shape, and size, if present? Past history: Do you have any reports like urine analysis done at that time? Revert with more information to a urologist 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 50-year-old male. I had genital warts five years ago, had them removed via cauterization and received three injections of HPV vaccine Gardasil. The doctor said the vaccine would cure the virus, but after a year, warts reappeared and until now they are still in my scrotum, and they are itchy but not painful. My question is that can I have sex with my partner given my current condition? Have I got cured by HPV vaccine? ### Response: HPV vaccine is not a cure. It is for the prevention of HPV. It prevents the virus from entering in your body. But, it cannot act on cells which are already infected with the virus. About sex, there is a chance that with contact, virus can spread to your partner if not already infected. And being on scrotum, the methods like condom will not help. You would need to get treatment first for warts" "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, 23 years old, weight is 65 kg, height is 5\9"". My penis is not getting hard for sex. The penis is getting erect but not getting hard enough. Due to this, I am not able to put my penis inside the vagina. Also, I ejaculate within 10 to 15 seconds (3 to 4 stock). And now I am avoiding sex because of this problem and getting less interest day by day. I do smoke regularly and drink occasionally also. I used to watch porn in excess and masturbate regularly. Please help me out. I am very much tensed about my future sex life. Please consult me what to do I want to get rid of this major issue. I cannot tell this issue to my family or friends also. I do not have enough money to consult a doctor privately. Please look into the matter. ### Response: Hi. I have read your problems carefully. After getting above mentioned history, my assumption is that your problem is psychological rather than organic. But I need some information and investigation reports to confirm it further. If you want to visit any physician, I advise to consult with endocrinologist first and after excluding organic disease, you need a psychiatrist. Masturbation and doing sex are different issues. In the case of masturbation, we try to ejaculate as soon as possible. But in case of doing sex, we try to do sex as long as possible. So there is a psychological issue. Besides this, anxiety also can precipitate this problem. So after doing some investigation and excluding organic cause, I think you need some psychological counseling." "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: One week ago, I had intercourse on my third day of the period and after approximately 30 hours of that, I have taken an i-pill. From the next day of taking the pill, I had severe back pain and lower abdomen pain which continues for one week. And after one week, I started bleeding and right now do not know why I am still bleeding? Is it my period that came again? ### Response: I read your message. Can you tell me in detail about your periods date, date of intercourse, date of taking I-pill, and date on which bleeding started? After i-pill, bleeding is expected for a few days. But you said you got bleeding twice. So, please tell me all the dates so that I can conclude properly." "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 seeking experts to comment on low-carb diets.What is the complete macronutrient breakdown for a typical low-carb diet? How much fat should you eat on a low-carb diet? How much protein should you eat on a low-carb diet?We are looking for suggestions on vegan foods for energy. Name the foods you are recommending and set description as to why you are suggesting this food. ### Response: I just read your query. In general, a person requires 1500-2000 calories per day. People should usually take around approximately 200-325 grams of carbs daily. But if someone is aimed at losing weight then they should aim for a low carbohy" "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 I am bipolar. Just a couple of weeks ago, I felt and was told by my friends that I was more energetic and crazy than usual. Now, I feel like there is no hope, and nobody really cares. But there is also that little bit of me that is telling me that I am faking this and that all I want is attention. I just want to know what the heck is up with my head. ### Response: Hello. It is a little early at your age to be diagnosed with bipolar illness. Sometimes that part of normal teenage hormones and puberty, when it is mixed with some depressive symptoms. Basically, if you are depressed, you will feel irritable, low, feel like crying, sad, do not wish to eat, have difficulty sleep, there can be anxiety, tiredness, headaches, etc. In bipolar illness, there will be a period of these depressive symptoms and then after a period of normalcy, the reverse happens. So if you have not had the manic or hypomanic phase, then you probably suffered from major depressive disorder or generalized anxiety disorder." "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 29 years of age. I had unprotected sex and I am having sex with the same partner for more than a year and a half. Suddenly, I got itching sensation and found that I have got itchy bumps on my penis which started clustering together. Later, it healed automatically. I also found when I run or walk a long distance and feel sweaty, I feel the sensation and I get the bumps again. These bumps are small and shiny at the tip and often get clustered and gets healed. It does not give me a problem but I really feel demoralized and unfit. I do not have these problems regularly. Also for a long time, I have itchy inner thighs because of which my skin turned blackish white and is still itchy. I am not sure whether I am infected. Please suggest me the solution to get diagnosed. I can provide pictures if required. ### Response: I have noted your concern and I have viewed the images (attachment removed to protect patient identity). You have genital molluscum contagiosum. It is an STD (sexually transmitted disease). They can be removed with electrocautery or radiofrequency cautery. Itchy rashes are due to fungal infection. I suggest you apply Candid-B cream, twice daily. You may also take a tablet Cetirizine 10 mg once daily for symptomatic relief from itching. Regards" "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: There is slight bleeding after anal sex. I had a drop-by-drop bleeding the next morning after passing stool. ### Response: Hello. You have had mild trauma due to penetration in the anal sphincter which is causing bleeding. You will need to follow few steps: It will settle in a few days. Regards." "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 5 year old daughter has stomach aches around the navel area that happens from time to time. It lasts a few minutes each time and goes away. Abdominal X-ray and ultrasound were done and has not found any abnormalities or umbilical hernia. Stomach pain starts while eating or drinking and also at random times. Other symptoms including the passing of stools about four to five times a day, including while having a meal.A most recent development within the last week has had several accidents and says she did not feel it coming. This is not normal for her. No other emotional distress could be a reason. ### Response: I suspect three things, it is just assumption based on history. 1. Stomach ulcer, as she had pain after food and water. 2. Worm infection, need to have a look after food. 3. If non of the above, must be ruled out by investigations. Then it is called functional abdominal pain. I advise you to visit a specialist. She might require one-week antibiotics and if symptoms not settled, then endoscopy also. But the best part is to visit the pediatrician. So he can evaluate her in detail and examine her. Meanwhile, you can give symptomatic treatment. Kindly consult your doctor to discuss the suggestion and take the treatment with 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 am 24 years old. I got married 1 month back. I am bleeding after each sex. It happened around four to five times. Also, I get some pain and this is ignorable. Previously, I suffered with period problem, facial hair and PCOS. Please help. ### Response: You need to undergo a gynecological checkup, especially a speculum examination to rule out any abnormalities of the cervix and vagina because of bleeding during sex. If you are not planning for baby, you can be on Krimson oral contraceptive pills under gynecologist supervision. Or else, you need to consult an infertility specialist and take medicines to regularize your cycles and ovulation. Reducing weight also will improve ovulation and periods. I suggest you not to delay fertility in view of PCOS." "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 uncle is 68 years old. He got a myocardial infarction 23 years back, and another one before 13 years, he had four bypasses that year. In the same year, he was diagnosed with NYHA 2; he also had diastolic dysfunction, aortic sclerosis and akinesia in LV.Now he has shortness of breath, swelling in the abdomen and feet, wheezing, and coughing.Is he now in stage D? And what is his life expectancy after 13 years of diagnosis of HF? ### Response: This does not mean stage D. This is likely stage C. However, he has to undergo echo for ejection fraction, which would tell us regarding stage. If, despite all medical treatment, he remains symptomatic and not able to do any activities then may be considered stage D. Such intermittent worsening of symptoms may occur in heart disease, which gets settled with medicines. You should get his medicine optimized. His life expectancy also depends on ejection fraction. 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: After shaving my face six days ago, I saw a big red bump on the right side of my nose above the mustache. At first, I thought it might be a pimple. Last week, I felt something wrong on my throat and visited a doctor. Doctor said lymph node inflammation and prescribed me Penicillin. Doctor did not ask me anything about that red bump in my mustache area at that time. I have been suffering from mild fever as well after my lymph inflammation. Right now I am worried again since the red bump on my mustache becomes large, and from two or three openings drains watery liquid when I tried to squeeze it. It is really painful and irritates a lot. I am worried about HSV 1 since it is near my mouth. I am having mild fever and lymph infection. I am not in sexual contact for the last seven years. What is your suggestion? What might cause this problem? ### Response: Two broad differential diagnoses are folliculitis or HSV 1 (herpes simplex virus) infection (most likely). I would want you to know that we all are exposed to HSV-1 and it could spread without sexual contact. It stays in the ganglion (nerve endings) and pops up when your immunity goes down. It is also known as fever blister. My feeling is that since you were about to come down with the sore throat, which seems like strep throat, you had a reactivation of the HSV-1 and got these lesions. As you feel better they will subside, you may use Acyclovir if you want but usually, we treat the underlying cause and you are receiving the antibiotics for sore throat. Please do not squeeze it. You can use any anti-inflammatory agent for pain and fever like Acetaminophen. You can also try topical steroids like Desonide. 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 recently tested positive for HIV and had a viral load test which was 160k and CD4 count of 145. My issue now is with how I could have contracted the virus. I have had three sexual partners and there was always protection. Two tested negatives after I informed them about my results and the last and most recent is insisting he is not ready and it was protected all the way. Although we did have anal at times and I cannot be 100 % sure that the condom was there. I have also had a parasitic infection which affects my scalp for a couple of years. Is it possible for something to mimic HIV in tests? I have been to the dentist thrice in all my life for an extraction and checkups. I also had an appendicectomy 13 years back. I have had occasional IV therapy and a few injections. I have never shown any symptoms. I am also anemic. ### Response: Hi. For condoms to be effective, it has to be a latex condom used consistently and correctively and a newer condom for each sexual act. There should not be any break or it should not have slipped off during the act. If all the steps had been followed, then only it is said that 98 to 99 % effective in the prevention of STI and HIV. Unfortunately, condoms are not used properly resulting in failure rates. The tests which you underwent for HIV are highly sensitive and specific. There is no chance of mimicking any other infection. You need to initiate antiretroviral therapy as soon as possible. It is a really effective therapy." "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 26 year old female, and I developed foot drop five weeks ago, the foot was numb, and I could not dorsiflex it. But, now I can dorsiflex, and the steppage gait has disappeared unless I walk long distances. I have more power in the foot now, but it is still a lot weaker than the other one, I cannot walk on my heels yet. However, I have been extremely anxious about this foot drop, and a couple of weeks ago I started to twitch, first in the legs and then all over my body, I can see the twitches. When I am talking with someone and thinking about something else, the twitches go away and come back when I think about it. I do feel weak in my body, especially in the legs. Can it be due to the anxiety? I am going to a neurologist, but there is a three months waiting period, and I am scared. I do not think we have had any ALS in my family. Please help me ease my mind. ### Response: The twitches that you are feeling may be due to anxiety also. If it was ALS (amyotrophic lateral sclerosis), the foot" "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 33 years old and weighs about 86 kg. My whole body hurts. I got pain all over the body, pain in legs and hands. Pain is persistent all the time mostly in the lower feet and hand. I am having pain for the past three months. I just had an appointment with my doctor. He ordered some blood work and told me everything is fine. And he told me to see the rheumatologist once for my peace of mind.I have attached my report. Do you see anything abnormal in my blood report? What is the cause of my body pain? Is anything wrong with my body? Do I have any underlying conditions such as leukemia, lymphoma, or any other cancer? Do I have any liver disease or thyroid disease that can lead me to pain? Before three months I did a blood test and my rheumatoid factor was 8.1 iu/ml and now it is 11 iu/ml. Why it is going up with a short duration of time? What do I need to do?I am eating healthy and getting good sleep but I am not losing weight. My vitamin D level is 40ng/ml and I am taking vitamin B12. I am taking vitamin D for almost one year. I m taking 4000 IU for five days a week. Please explain in detail the treatment plan. ### Response: Hello. Well, I have gone through your history and the reports attached.(attachment removed to protect patient identity). All the reports are normal. I could not find the reports of liver function tests there, but I suppose your doctor had already looked into it. Do not worry, you don\t have any cancers at the current time. If any cancer would cause pain, it surely would have affected your blood counts as well. As for Rheumatoid factor, 8 or 11, can be lab variation or instrument variation, but as long as you do not have joint swellings or pain it is insignificant. My diagnosis for pain would go for fibromyalgia. It is more of a diagnosis of exclusion and one only considers it after ruling out the other causes, which they have done so far. I will give you a link, you can go through it and let me know if your symptoms match this. As treatment will depend on your being convinced about the diagnosis. I hope this helps. Fibromyalgia." "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 worried about ALS. I have had a twitch in my left hypothenar muscle intermittently for three weeks or so. Perhaps a few twitches per hour followed by hours of no twitching. I also have twitches in other parts of my body quite regularly though this one is focal and the others are diffuse. I have not dropped anything. Doing self-tests, my left pinky seems a bit weaker. Though I think I have atrophy in the hypothenar, I have had three general practice doctors tell me it is just asymmetrical with my dominant right hand. The doctors have also performed basic finger strength tests (spread fingers and resist ) and they say they are normal. Reflexes are normal. No tripping, dropping, slurring, etc. ### Response: I read carefully your question and would explain that your symptoms are not typical of ALS (amyotrophic lateral sclerosis). Coming to this point, I would recommend performing some tests to investigate possible causes: Consulting with a neurologist may be needed in case of abnormal EMG" "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 53 years old, and have quit smoking 19 years ago. I still have a chronic cough. Each specialist tells me something different. The pulmonologist told me it was asthma, and another doctor said it was acid reflux disease. Now they are telling me it is COPD. I do not have diminished lung capacity or problem in breathing, no wheezing, out of breath when I run but, I am overweight and out of shape. What do you think? ### Response: Hello. There is not much of difference between asthma and COPD (chronic obstructive pulmonary disease). COPD is usually seen in a person who has smoked a lot while asthma is seen from childhood, which is not in your case. Acid reflux can cause prolonged duration cough, but it shall subside very well once treated for acid reflux. But in your case, it has persisted. So it has to be either COPD or infection of the lung. I would have favored COPD if you were investigated for Infection and found nothing. Hence I recommend specific tests for evaluating infection as the cause. Kindly get the following test done and revert with reports. CT chest, BAL microscopy (bronchoalveolar lavage) and culture, ESR (erythrocyte sedimentation rate), Montoux test. I hope this information was useful for you. Any clarification feel free to ask." "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 nonpenetrative sex with my partner. He did not ejaculate, but a kind of sticky lube came from his penis which he wiped with his hand and then rubbed his hand in the bedsheet. After that, he used his hand in my private areas. I am afraid that I might get pregnant. Please help. ### Response: There is a possibility that you may get pregnant with pre-ejaculate fluid itself if you were in a fertile period, as precum also contains sperms. It is better advised, that you should opt for an emergency contraceptive pill like an i-pill within next 72 hours to avoid the chances for unplanned pregnancy." "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 peeling lips for past one year. It started over last winter when I applied moisturizer. Even after I stopped applying the moisturizer it is peeling still. I went to a doctor and he gave me a vitamin tablet. But, I did not get any cure with that. Then I visited a dermatologist and he gave me Tacrolimus ointment 0.1% and no improvement with that too. Now he has given me the same ointment along with tablets Medrol, Biotin and Celin. Now I feel it has progressed to my upper lip also. Could you please tell me how to cure this? I am so desperate for this to be over. I am under lot of stress because of this. By the way the time when it started, I was under stress. I have searched in internet and I found that many people have been having this problem for many years. Some cured with anxiety medication and some by leaving alone. What shall I do for this? ### Response: I have gone through your history and can very well understand your concern. Kindly revert back with the answers to the above questions 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 am a 21-year-old female. I have preauricular pits, that have drained smelly discharge ever since I was born. I have them in both ears. The right does not drain often. The left drains every day more than once a day. The left has become really swollen and painful recently. I am not sure of what to do because I now understand that the discharge means it is infected and it is hard for the surgery, if infected. Plus they have been infected for so long. I have also read that after surgery, it could reoccur. ### Response: Let me answer your query in parts. It is a developmental anomaly, a branchial cleft anomaly. Once we remove the whole sinus tract, it does not recur. To see till where it extends one must do a fistulogram scan. When infected we do not do surgery. We do culture sensitivity and institute appropriate antibiotics and clear infection and plan for surgery later. It is a curable problem. Do send us a picture of the ears both sides and send 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: I was on a course of Deviry 10 mg for 5 days as I missed my period last month but I am not pregnant. How many days does it take to get my period now? ### Response: It will take a week or so to get back your periods. So relax and do not worry. Do not take any medication without an expert advice. However, if you have a doubt then get 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: I had a cavity in the tooth. The X-rays show it was small but when the dentist drilled the nerve got exposed and is telling me I need a root canal along with crown. He has put a temporary filling for now. How do I know if I need a root canal for sure? ### Response: Hi. If the nerve/pulp of the tooth is exposed, there is no other course of treatment except root canal treatment. You can confirm the same using x-ray, IOPA of the tooth. If no treatment is continued or a permanent filling is placed, the tooth will continue to experience pain. The infection will spread deeper to the root and might even cause an abscess. So, it is very important to continue with the treatment. You can send a picture of x-ray to confirm about the necessity of treatment" "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 was diagnosed with breast cancer early this year. She underwent MRM surgery and now undergoing chemotherapy. Her age is 57, and the doctor advised for eight cycles of chemotherapy. Now she completed five cycles, and now the doctor had advised 17 more injections for hormone blocking. We find 17 more injections are too much and will be highly stressful for my mother. Could you please suggest an alternative treatment.I have attached a few essential reports for your reference. Please let me know if you need any more details. ### Response: Hello. Her cancer will be her 2 neu positive, in this scenario, it is mandatory to give 17 injections of Trastuzumab, otherwise chances of recurrence are high." "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 both the testes experience a reduction in blood supply (and thus oxygen and hormones), in the long run will it increase the risk of more spontaneous mutation present in sperms as lesser blood supply will affect the DNA replication and repairing ability of spermatogonial cells? ### Response: I have gone through your query. What you have mentioned is theoretically true, however reduction in blood supply and hormones will lead to atrophy of the testis and a decrease/ absence in sperm production eventually. Also right now it is clinically impossible to assess the presence of specific mutations in single sperm. What is measured is indirectly the levels of DNA damage" "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 chief complaint is severe lower back pain and pain in upper thighs. My medical history is as follows. Carcinoma of the breast three years back, followed by surgery, chemotherapy, and radiotherapy. I am on Tamoxifen for past 3 years, and now I am taking Arimidex. I have been suffering from osteoporosis for over 7 years. Before six years, I had severe osteopenia with maximum bone loss of 21% on L3 and spine, ribs, trunk, and arms with more on the left side.I had undergone the following investigations. Before three years, I had FNAC which showed invasive ductal carcinoma, right breast ER+, PR+, Hercep score ""0."" Last month, I had an x-ray and MRI, which showed focal altered marrow intensity lesions seen in B/L pelvic bone, sacrum, and left upper femoral shaft consistent with metastasis. I also had a PET scan which showed metabolically active ill-defined lytic destructive lesions in post cortex shaft of left femur, right inferior pubic ramus, B/L iliac bones, sacrum, D5, 7, 11 and L1, 4, sternum, right 3, 5, 7 post ribs with mid-right paravertebral soft tissue lesion at D7 level likely metastasis. ### Response: I do not have full information regarding the case from your query. The conclusion I can make from the information which you have given is that the patient has bone metastasis only. The treatment for such a case is a change in hormone therapy. Your medication has already been changed from Tamoxifen to Arimidex. I do not know since how many days or months you are taking Arimidex. This also helps in bone metastasis. You also need adequate pain medications, maybe Morphine preparation to control your pain." "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: Kindly provide me some information about the keto diet.1. Is it safe? Or unsafe?2. Is it a good way to lose weight? Or a terrible way to lose weight? ### Response: These diets were altered to treat epilepsy. This diet will help to manage the weight reduction as it substitutes while changing the metabolism and force to work for with stored fat. When the body utilizes stored fat, weight reductions are visible, but it is not suitable for long term as it has the own problems. A short period of three months course will increase protein as well as helps to manage the deficiency and increase the stamina with proper weight reduction." "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 get a third opinion in regard to categorizing which uterine abnormality I possess. The initial doctor said it is arcuate. My current doctor thinks it is bicornuate but I am going to do a 3D ultrasound in the middle of my next cycle to get a better idea. I have MRI and hysteroscopy photos to provide. I have had two missed miscarriages, the last one hemorrhaged two days before going septic and sent me to the ER for five days. I have also been diagnosed with a placental site nodule on my right side where both pregnancies have been. Could my problem be surgically corrected?Currently, we are going through genetic, blood clotting disorder, and menstrual cycle/hormone monitoring. Genetic counselor said low risk for any genetic causes but is still waiting to complete the blood tests which should be done in four weeks, same for the blood clotting tests. ### Response: Hello. Having gone through the MRI pelvis and hysteroscopy pictures (attachment removed to protect patient identity), it is evident that you have a bicornuate uterus with a single cervical opening and it is not a septate uterus or an arcuate uterus. Two different horns of uterus are evident on MRI (magnetic resonance imaging), indicating the bicornuate abnormality. The option which you have is called Straussman\s operation where both the horns can be cut in the centre and joined to make a single uterine cavity. You may discuss the option with your gynecologist and make a decision." "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 20 year old female. I have too much dry skin. I mean extra dry skin. I use almond oil and moisturizing soap, but it is not effective. ### Response: The skin has to be moisturized well soon after a shower. Use a moisturizer which has ceramide in it like Eucerine moisturizer. Apply to body as soon as you come out of a shower. Continue using a moisturizing soap. Avoid hot shower, use warm water. The common cause 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: I have a squint in my right eye and it has moved outwards. I do not have a proper vision in my right. I cannot see clearly through my right eye; even I recognize thing pretty hard. I want to know whether it can be corrected, so that both my eyes work together. I am confused as I am now 26 years old. Is the correction going to be difficult at this age? I am looking up for a second opinion from you. ### Response: Hi. I have gone through the pictures of your eyes (attachment removed to protect patient identity). Revert with reports to 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: I am a 42 year old woman. Can I still conceive? Also, can I conceive twins without any risks? ### Response: Hello. How are you doing? Do not lose hope, there is a solution for every problem. Hope I have clarified your query. Do write back. All the best." "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 28-year-old man with very less facial hair. Recent blood check-up shows that my DHEAS value is 195.9. Insulin check-up indicates that there is a high chance of becoming a diabetic patient. My doctor suggested me Ashwagandha, and I have been taking it for a month (two capsules per day). Not much gain. So, I would like to take DHEA supplements for beard growth, is it fine? ### Response: I think it is very normal to have less hair on the face. Even if you have little hairs, it is normal. Do not worry about your DHEAS level. You should not be taking any hormonal treatment unless it is required and so you can consult an endocrinologist for it. If you have normal sexual functioning, you should not worry about it. If it bothers you too much, you can ask a hair transplant surgeon and get a nice beard transplant. Focus on a healthy diet and regular exercise." "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 21-year-old male. I am having a burning sensation and redness in my scrotum. I consulted two doctors from the same hospital. The doctor diagnosed it as scrotal dermatitis. The first doctor prescribed the following: Motimesh cream (to be applied at night) for 10 days, Abzorb Dusting Powder to be applied morning for 15 days, Atarax tablet to be taken at night for 10 days. After taking this course, after 15 days the itching was gone but still there was considerable burning and redness and irritation. So, I visited the hospital again and the following course was prescribed: Venusia max cream to be applied morning and afternoon, Dazit tablet to be taken at night for 10 days, Desowen cream to be applied at night for 10 days. Now, this course is also done and though there is a considerable improvement I am still having little redness mostly on one side of the scrotum and also some burning sensation. Kindly help me from this irritation. ### Response: I have gone through your complaints and reviewed the attached photograph (attachment removed to protect patient identity). It is a chronic disease characterized by redness and burning on the scrotum. If I was your treating doctor, I would recommend you to take capsule Doxycycline 100 mg once daily at bedtime, tablet Gabapentin 300 mg in the morning and tablet Levocetirizine at bedtime. Along with this application of Tacrolimus 0.03 percent ointment on the affected areas at night and moisturizing cream during the daytime. Continue this for three weeks and revert" "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, 58, 5\10"", 239lbs. I am having nausea every morning. It comes and goes during the day. I also have black stools, belly pain, and gas. I am on Lexapro 10 mg, Pramipexole 3 mg, Lamotrigine 25 mg twice daily and 200 mg once, Meloxicam 15 mg, Metformin 500 mg, Gabapentin 300 mg, and Atorvastatin 40 mg. ### Response: Your symptoms are suggestive of upper gastrointestinal intestinal bleed. Please stop Meloxicam 15 mg tablet immediately. I suggest you take proton pump inhibitor medication like Omeprazole 40 mg tablet straightaway and take preferably cold water. Please check with an accident and emergency department for further care for intravenous proton pump inhibitor, antiemetic medications, and further lab investigations such as complete blood count, bleeding and clotting time, prothrombin time with platelets, APTT (activated partial thromboplastin time), INR (international normalized ratio), stool for occult blood, ultrasound abdomen, complete liver function tests to assess the extent of blood loss through stools. In case of evidence of ongoing bleed, you will require packed cells and urgent upper GI endoscopy for diagnosis and stapling of bleeding esophageal varices. Do not take Aspirin tablets or any other painkillers as they can worsen bleeding inside the gut. Stop alcohol, spicy diet, coffee, and tea. After emergency treatment, I suggest the long list of medications be reviewed to see whether it can be simplified" "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 took the first abortion pill but until now, I did not get bleed. What is the reason? ### Response: Hello. It is really a very short description of your concern. It would be better if you would send me your detailed gynecological, menstrual, obstetric, medical and other histories. Which pill have you taken and how much dose? Had you confirmed your pregnancy status before having the pill? If not, have serum beta hCG (blood pregnancy test) to have a clear idea about your pregnancy. Kindly send me your details so that I can guide you. In case of a positive pregnancy test, check again the level of beta hCG after 48 hours from the previous test. It will give us a clear idea about pregnancy progression or the effect of the pill on it as well. If the second level comes less than the previous it is a miscarriage. If the second level shows increase more than 60 % then it is a normal growing pregnancy. If the second level shows less then 60 % increase it is alarming and you need a transvaginal scan to exclude pregnancy outside the uterus (ectopic pregnancy). In case of pain, bleeding, dizziness with a positive pregnancy test, better to report to a tertiary care unit" "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 23-year-old male. I have no symptoms and I am not taking any current medication. Three years ago I once went to the hospital because I felt my heart was beating really fast, and they did some EKG scans and a blood test on me saying that everything is normal. They also gave me the Holter monitor and when they checked the results they said this was normal. I do not smoke or drink alcohol maybe three times a year I will drink. I used to do some shisha but that has stopped for the past three years.Since then I have never been to a hospital for the health of my heart. However, since then, my heartbeat has just been higher than everyone else but I do not get headaches or any other symptoms. I used to stress a lot. However, things are going well now and it has cut down. I wake up at times during the night but fall back asleep very easily. I have done gym and dance classes for over a year and I feel fine when working out.I went to the GP just a week ago due to my girlfriend having some concerns. I asked them to do a regular check and they said my heartbeat at that moment was 98 and he said this was fine. However, my girlfriend gets really worried about this and feels that something will happen to me. She just needs some medical advice in order to get her the assurance. She has been checking online for some answers and it is said stuff like arrhythmia, tachycardia, etc. She also says that the normal is between 80-100 bpm and why is mine on the top end? Is it a serious cause? Or does heart and pulse rate vary? Also, I have been checking the prevalence of heart diseases, etc., online and it is very rare for someone at my age. What more should be done? ### Response: Palpitations or the feeling of fast heart beat is an extremely common symptom. I understand your GP has done the usual tests and has reassured you. I would need a bit more history. Have you fainted anytime? Have you got your thyroid functions checked? Do you have history of any family member dying suddenly, like in sleep? Is your blood pressure normal? If none of the above mentioned problems are there it is likely that your symptoms are benign. Just watch out for fainting episodes. The heart rate you mentioned is perfectly normal. The best way to get your heart rate even lower is to exercise regularly, athletes have very low heart rates. Only if the palpitations are really persisting and are really disabling we need to do further tests." "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: The patient is suffering from loose motions. Kindly help me to deal with it. ### Response: Hello. How many motions are you having in a day and since how many days? It is likely to be enteritis." "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 25-year-old male. I have only one testis. I have sexual feelings as a normal man would do. I am masturbating about once every week. Will a single testis cause any problem in the future? Recently, I had my first sex with my partner. At that time I was tensed and also had difficulty while penetrating her vagina. Please help. ### Response: It appears you are having a condition called cryptorchidism in which one of the testes is not present in the scrotum. There could be one of the two possibilities, either your testis has not developed at all or it has developed normally but has failed to move into the scrotum. At your age, if your sexual desire is normal and your secondary sexual characteristics like facial hair, pubic hair growth is normal then your testosterone production is normal. Your reproductive ability will depend on the number of sperms produced by your normal testis. I would suggest you visit your local urologist for a complete evaluation and identify the type of cryptorchidism you have" "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: Please explain about the causes of the IBS. How can it be managed? Please advice. ### Response: Hi. The other causes are stress, anxiety, hormone changes, genetic factors, and infections such as salmonella. Treatment depends on the cause. We can do a blood test, hormonal test, coproculture, thyroid function test, colonoscopy, and test for celiac disease to identify the cause. After seeing the results, proper treatment can be planned. Stop taking caffeine and alcohol. Avoid eating fatty foods. Eat a fiber diet. It helps to get relief from constipation." "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 was opening a powerful glue bottle, two small drops of glue went into my left eye. After two months, I observed black spots on the whitish part of my eye. Please help. ### Response: Hi. The cause of black spots may since childhood just like moles on the skin. Most probably they are not related to glue. Need an eye checkup once. Please do safety measure while dealing any such thing or any chemical. Use protective glasses. If any accident happens, then first of all wash your eyes with water as early and as much as u can and go to doctor. Revert back with the photos to 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: I am a 22 years old woman. My period got delayed by 20 days. I had intercourse with my partner. I have mild pain in my abdomen and there is brownish vaginal discharge. I took urine test and a faint pink line along with a strong pink line appeared. Am I pregnant? If so what medication should I take to avoid pregnancy? Also, if I take a blood test now, will it be more accurate? ### Response: A faint pink line does not confirm pregnancy. The dark line is for control. As your period is late by 20 days both lines should be dark, you can repeat the test after five days but if you have too much pain then you will need to do ultrasound test of the pelvis or transvaginal ultrasound. Without confirming or excluding pregnancy no medicine should be taken, it may harm you. Also, if the beta hCG level is in the pregnancy range then it will confirm. Otherwise, you will need to repeat the test after two days to see if the level is rising or not. That will be more accurate" "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 19 year old girl. I have a very stupid habit that has caused a lot of problem for me, I have met a lot of psychologists, but I could never talk about my exact problem with them. It seems to be a ridiculous problem, but I ask your sincere help. When I was 15 years old, I watched a romantic movie which caused my problem, since then I made an imaginary life with an imaginary man in my mind. I have got involved with this problem for years. When I was a child, I had difficulties which I could not solve at that time, so I started fantasizing and tried not to involve myself in real life\s problem. But then, there was no love in my imagination, I was a very happy successful girl, and I was a famous, respectful person.But after I got defeated at a state level game, I understood that I am not intelligent enough to achieve such goals, I was so depressed with no enthusiasm in studying. I got to know about sex and intercourse, I was confused and hated my gender, I thought of changing my gender. I had depression, and I was so disappointed about life. Then I started to imagine a man who lived with me, and I loved him so much. Instead of facing my life problems, I used to fantasize about him. From last year I have imaginary sex with him.The problem I have is that my life is interrupted by my imagination. I cannot deal with other students, especially boys. I have lost my confidence, do not have the enthusiasm to study. I cannot focus when I am in the class, and I do not take any efforts to solve my problem. I just keep imaging a peaceful life with no problems, sometimes when I cannot control my anxiety and stress, I start having sex in my mind. I do not know what to do, and I want to stop this imaginary life. How do I stop this imaginary life and love? I know this man is not real, and whenever my imaginary life becomes sad, it has an influence on my real life. I currently take tablet Levebel 500 mg, two tablets a day. ### Response: Hi. I can understand your problem. You have given a complete elaborated history regarding your problem. Hope my answer helped you, and feel free to ask whenever you need my help." "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 and my partner had healthy sex. The next day she had periods and after six days we had unprotected sex due to which she had taken i-pill on that evening. Two months passed she still did not get her periods. I am worried. Please suggest any solution. Two years back also she has taken i-pill. This is the third time she is taking. Is it possible that she may not have periods for the whole life? Please help. ### Response: It is unlikely to be caused by i-pill. Does she has any underlying periods problem? It is probably not a permanent problem and she will have her periods soon. At this stage, we first need to rule out pregnancy. She should undergo a urine pregnancy test twice at an interval of 12 hours for confirmation. If it is negative, then she will need a detailed evaluation of the cause. She will need ultrasound pelvis for uterus and ovaries, and hormonal profile like thyroid function test, serum FSH (follicle-stimulating hormone) and LH (luteinizing hormone). She should visit a gynecologist once for examination and for these investigations. Medicine could be initiated after ruling out the pregnancy and finding the cause. 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: My mother has abdominal tuberculosis, duodenum stricture, and obstruction in rectosigmoid and distal sigmoid colon. She does not take any food, not even liquid food. And she does not pass urine and stools from the past four months. Please help. ### Response: Hope I answered your query. If you have any further doubts, I would be happy to help 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: Can a possible wisdom tooth cause neck and arm pain? My tooth hurts on the same side as neck and arm. ### Response: Hello. It is not possible. It may cause some throat pain but not arm pain. Maybe you have muscular pain. Just take rest and if your wisdom tooth is not in good condition then it is better to get it removed because it has no use in real world. And if you have any neck stretch then just apply warm water bag and see if there is any change. You can try mouth rinse of salt and lukewarm water for good results" "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 student and I have been good at studies always. And I want to be a doctor but I somehow could not manage to get a seat in government medical college. I did not work hard enough. I am 21 now. My parents are very supportive and I am preparing for exam. But I am really scared of everything. I know I am stronger than this but how can I stay calm and happy during this process? ### Response: Hi. I understand your problem. It is actually very tough phase. But all you need to do is gather yourself back, tell yourself that you can and will be able to do it. Try this. Make a full-proof plan. Executive with full motivation. If you feel that there were some mistakes you did in the past, then rectify them. Do not give up. Study in group or in library if you cannot study alone or get distracted. Make short term plans. You can have one or two counseling sessions if you want." "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 bitten an olive pit accidentally, and now, one of my front teeth is moving. There is no pain, and I have a slight sensitivity to cold and hot foods. But now I cannot bite anything using my front teeth. Please advise. ### Response: It is a case of mobility due to trauma on the teeth. The sensitivity and mild pain are due to inflammation around the teeth. Follow these medications. Take tablet Acelofenac 100 mg along with Paracetamol 500 mg two times a day for five days. It reduces the swelling, and it helps to stabilize the teeth back in the socket. If it is not more mobile, then it will get healed soon within 15 days. If it is fractured or more mobile, then you may need other procedures like splinting using wires to fix the teeth. If it is broken anywhere, then you may need RCT (root canal treatment)." "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 strange ECG from my watch. No one else looks like mine, and my primary doctor said that it is anxiety. ### Response: I have thoroughly gone through the ECG results there are no specific changes that would indicate any pathological change. ECG results might show different shapes and morphology, but it does not necessarily mean it is abnormal. I have to ask what are you doing about your weight? You are overweight, and it puts you at risk for cardiovascular disease. I hope you have put in measures to help reduce your excess weight like dieting and exercise." "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 30-year-old female. A thyroid profile done recently shows the TSH at 1.95, T4 at 13.9, and T3 at 113. I am on Eltroxin 100 mcg and folic acid. I am planning for pregnancy. Please advice. ### Response: Hello. I just read your query and from what you have mentioned it appears that you have hypothyroidism (an underactive thyroid disease). From the reports (attachment removed to protect patient identity) you have mentioned, the hypothyroidism seems to be well controlled. I suggest that you continue with the same dose of Levothyroxine tablet till the time you conceive and then once you are pregnant, then you can repeat the same tests and we can manage your dose accordingly. Wish you good luck and hope you found my advice beneficial" "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: Hair loss. I want to increase my hair. In some areas, hair is not coming. Please suggest something. ### Response: How are you? I hope your health condition is good. I have read your problem and have seen attached picture carefully (attachment removed to protect patient identity) and you mentioned that you have tried 2 % Minoxidil. Now you want to know how to improve or grow more hair in some area (shown in picture). There are some options: PRP therapy, oral Finasteride, increase the strength. The strength of tropical Minoxidil should be increased. Besides this, you can take oral Finasteride. But there is some side effect such as deterioration of sexual function but this problem is reversible, that means when you stop the" "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 every STD screen known to man and kidney function tests, my urine is foul smelling and dark. This has been an ongoing issue for a year and it has started to affect my life. I have tried everything. Antibiotics, hydration, douche, apple cider vinegar, AZO pills, yeast infection drugs, UTI drugs. ### Response: Foul smelling and dark urine is indicative of cystitis with highly concentrated urine. If there is no blood or hematuria then renal pathology is unlikely or calculus. You need to take at least 3 to 4 liters of water daily and foul smell is often vaginal and not in urine. You may be suffering from bacterial vaginosis causing a foul smell. Avoid using soaps in the genital region while bathing, use vaginal alkaline washes." "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 four follicles ruptured from my left ovary and one from the right. I have had IUI back to back for two consecutive days. But my major concern is I have a unicornate uterus with a left rudimentary horn. I recently had lap because I had a cyst on my right ovary. The doctor says I have been ovulating perfectly every time. I am depressed abt the fact that left tube is absent but four follicles ruptured on the same side. Please give me some hope of getting pregnant. The endometrium lining is 9 mm which the doctor said is very good. And, this is my first IUI after lap. ### Response: How are you doing? I do not see any reason for you to worry. The movement of egg into the fallopian tube is chemically controlled or attracted. So, no matter which tube is open or blocked, the egg falls into the peritoneal cavity or the space around the uterus. Then, it will be obviously sucked into the open tube. So, you have definitely a chance of pregnancy. Your doctor will have more job to do only after you get pregnant, with lots of close monitoring and medications. Your chances of getting pregnant are on par with any other lady. So, just hope for the best and pray well. All the best" "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 boy, 18 years old. My right knee has clicking sound without any pain. Please help me out of this. Is this symptom of any big disease? Tell me some things to cure this. ### Response: You will need to do a regular exercise of the knee and stretches of the hamstrings and most problems resolve once you stop growing. No need to get tensed up" "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 infected sebaceous cyst has burst 10 days back and daily dressing is being done by professional. I was on antibiotics but the course is over. What should I do next? I do not want to go to the hospital and get the surgery done. Since more than ten years two cyst was there and of late it merged intoone.May be in the second week of last month, I started getting an itching sensation andthe place becoming red and after a few days it burst. Since then regularly it is being dressedwith the removal of pus. It has created a deep hole. Please help. ### Response: Do not worry, I will solve your problem. Wound healing is a very common problem in diabetic and hypertensive patients. Even when they are controlled I will advise you treatment with some basic precautions and investigations. Check your blood sugar levels regularly. Pus is still present so the antibiotic course is required for further five days. Wound" "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 suppose to get the sleeve bariatric surgery and I was taking Adepix and I stopped it a week ago. My surgeon told me he thinks I have to be off Adepix for three months before surgery. I only took it for three weeks. Is this true? He said it may interfere with anesthesia? ### Response: Hello. I understand your concern about your health condition and possible issues related to Adepix. But as per the literature and evidence, stoppage of medicine one week before surgery is usually recommended. So I do not think it should be a problem during surgery" "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: About four weeks ago, my right testicle started moving in an uncomfortable (not painful) way. I had a torsion and surgery to stitch down (both) 2.5 years ago. I went to the first doctor and he tried me on muscle relaxants, nothing changed so he referred me to a specialist. The specialist had a quick feel and then told me it was normal, that I should not worry and that I would have to get used to it. He also implied it has been happening since the operation and I just did not notice.There is still no pain, only discomfort (it varies) normally when I walk. I think that my right testicle is a tiny bit swollen and slightly squishier than my left and while I could live with this, I really do not want to. Though I have suffered no injuries to my testicles recently, I actually think that one of my stitches has come loose as I can feel the end on the stitch lump where I could not before. I am 88 kilos and have lost 12 kg over the last nine months. I have have been running more frequently for about eight weeks. I am 24 years old. ### Response: I have gone through your query. Normally, a detailed clinical exam to identify any other causes like a hernia or varicocele or 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 weaned off of 40 mg of Paroxetine very slowly but my sleep was impacted and as of two months, I have been suffering from extreme insomnia. I have gone back to medication and I am currently on 20 mg of Paroxetine and 10 mg of Fluoxetine, but my insomnia has continued. I was prescribed Ativan (0.5 mg) for sleep, and it sometimes helps, but not always. Even if I take a bit more (I have taken up to .75 total), it does not always help me sleep. My psychiatrist prescribed Trazodone (she suggested I start at 25 mg and if I feel no effect, to take another 25 mg/ go up to 50 mg in one night (but I am concerned about serotonin syndrome from taking another medication that messes with Serotonin). Can you advise if I should be concerned about serotonin syndrome if I take the 25 (or 50) mg of Trazodone? Additionally, should I be concerned about anything else in terms of taking these three medications together? ### Response: Hello. At least not when you have already been taking 40 mg of Paroxetine for years. Also, Trazodone is a safer and better sleep-inducing agent when it comes to being used for sleep." "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 24 and having an active sexual life. I have two questions. First I have noticed that my performance is erratic as in there are times when I can last 5-6 minutes and then the very next day it can go to 30-35 minutes. It is different with different partners. Second and more alarming is that I have been experiencing a stinging pain in my scrotum on the left side it usually happens when I stand up while sitting or laying and sometimes while walking. I tried finding the source of the pain by pressing in different regions but could not find one. Also, it happens at the back side of the scrotum. It is limited to the left side and has been increasing with each passing day. I thought of UTI, but my pee does not burn. ### Response: I can understand your concern. If there is any history of injury to scrotum then most likely it is a hematoma or infection post trauma. The pain could occur because of pressure over testis by tight underpants. This sometimes results in a picture similar to an infection. I would advise you to get USG scrotum done. This will rule out any hematoma or infection. A urine analysis should be done to rule out the cause. Please provide the reports for further assistance." "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: The gums where my wisdom tooth is present is in pain. ### Response: Hi. What is your age? Wisdom tooth gets erupted in ages between 19 to 30. They put eruption pressure after every three weeks or so. If its position is not vertical or they are tilted or are impacted in bone, they start causing severe pain. For it the first line of treatment is taking medications. This will subside eruption pain. The second line of treatment is if it is not getting better with medicines you should get it extracted so that it may not bother surrounding tissues and tooth. Meanwhile, take tablet Brufen 400 mg eight hourly for three days. Give me followup after three days. If pain will persist, then you will be prescribed antibiotics. Stay happy and blessed." "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 unprotected sex with my partner without any penetration. I rubbed my penis over her vagina. I might have a little semen present in it. She usually has a periods cycle of 33 to 35 days. But her periods got delayed this month. Is she pregnant? Why is there a delay in her periods? Is there any typical food available to bring her periods on time? ### Response: Just touching or rubbing will not cause pregnancy. So relax and do not worry. The delay occurs due to hormonal changes. It happens due to stress and strain." "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 20 year old girl and have a small vaginal opening. My husband and I hardly have sex because it hurts me so badly. What can I do to stop it from being so painful? ### Response: A small vaginal opening can lead to a painful sexual intercourse. I would suggest you use a good vaginal lubricant every time before the act. It would help in smoother penetration of the penis thereby reducing the pain. If this does not help you, dilators can be used to expand the vaginal orifice, which does help in many 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: A throbbing and recurring headache, nausea, and dizziness. I am an 18-year-old female. ### Response: Hello. It can be a migraine headache as throbbing in nature and one side with nausea. You can be prescribed Naproxen or Ibuprofen for relief from an acute headache. If it cannot relieve a headache, then Rizatriptan can be prescribed. If a recurrent headache occurs, then prophylactic treatment with Amitryptiline might be needed. Avoid aggravating factors for a headache like stress, smoking, lack of sleep, hypoglycemia, loud noise, bright light, etc. It is advisable to check your blood pressure as well. I suggest you consult a physician for examination and get prescription accordingly." "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 65 years old (height 4\11"", weight 64 kg), and has been doing all the household chores since she was 20 years. She has no problems except diabetes. Since one week, she started getting lower back pain. The symptoms are if she is in a sleeping position and gets up and starts walking, there is no problem. But if she is in a sitting position and gets up to walk, there is sharp lower back pain. Can you please let me know what could be the reason? How can the pain be relieved? Any special exercises or chair or vitamin supplements, etc.? ### Response: At 65, your mother seems to be suffering from spondylosis which is nothing but wear and tear of the spine. This is made worse after any period of rest and sitting usually makes it worse. Is there any radiation of pain to the leg? I will recommend that you get an X-ray of the affected part like lumbar spine AP and lateral. In the meantime, I will also recommend that she tries hot packs or preferably ice packs over the site area to see if that relieves pain. She can also apply Dynapar QPS spray. Take Ultracet for pain one tablet twice a day. Please send me the X-rays for further 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 am having some allergy on the head part and the inner skin of my penis. I have some white bubble like spots. Please help. ### Response: Hello. Allergy over the penis is very uncommon. It would be something else. Please send photos so that I can identify it and give you the proper treatment." "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 not able to conceive after trying for almost one year. I was diagnosed with pituitary microadenoma and I am on medication. My prolactin levels have now reached normal levels after two months taking medication.I suffer from hypothyroidism and on medication. I have had this for five years now and it is well within the limits as per my endocrinologist now. This is due to an autoimmune disease where my TPO (thyroid peroxidase) antibodies were high during the diagnosis five years ago. My husband and I would like to know how should we best prepare for pregnancy and what to look out for. We would have preferred to visit the clinic. Unfortunately, I am not in a position to visit the doctor due to travel restrictions. It would be great to get in touch with a specialist.I am currently on Euthrox 100 mcg, Cabergoline 0.25 mg once a week, and Folic acid 450 mg daily. ### Response: I have gone through all your reports (attachment removed to protect patient identity) and your prolactin and thyroid levels are well in control. What is missing in the follicular monitoring profile of the dummy cycle and also your husband\s semen analysis test? You have been following the correct protocol using LH kits for ovulation and post LH surge if a natural trial or timed intercourse did not work then husband\s semen analysis becomes mandatory. Then when both male and female infertility causes are ruled out then comes mechanical causes where positions and version of uterus need to be considered and measures implemented. Anyways please send these two remaining reports before we can proceed 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: I am a 45 year old male. I had an accident before 10 years. At that time, my knee x-ray was done and I was reported to have osteoarthritis. I have been suffering from pain for few years. I have lower back pain and pain in some of the joints. For the past few weeks, I have pain in my left palm, particularly in my finger joints and more on left middle finger joint. Also, on my foot joints. I also feel very fatigued and tired. My blood pressure (BP) was 110/70 mmHg a week back. I am enclosing a comprehensive blood test report, which was done very recently and I have advised to take tablet Nusam 400 for six months. I have been taking for the past two months. Please suggest me the remedy and preventive measures. ### Response: Vitamin D deficiency and autoimmune cause. Ultrasound abdomen and pelvis, rheumatoid factor, MRI of spine with sacroiliac joint and MRI of the whole spine, screening and ultrasound of hands to look for active arthritis, HBsAg (hepatitis B surface antigen) and HCV (hepatitis C virus). Seronegative spondyloarthropathy. 1. Rheumatoid arthritis.2. Seronegative spondyloarthropathy. Calcirol sachets (vitamin D) 60000 units once in a week with a glass of water for six weeks and tablet Dolo 650 mg (Acetaminophen) for pain. 1. Avoid alcohol and excessive weight lifting.2. Also, try to avoid painkillers as your liver functions are abnormal." "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 right side jaw is paining while having food. On consultation, I was advised for physiotherapy. What could be the reason for it? ### Response: Hello. There might be several issues expected, 1. As you mentioned if there is only jawline problem, then you should have physiotherapy and warm massage at TM joints (tempero mandibular) at the junction of the ear when you open your mouth, it can be felt quickly. Do warm massage for 10 days, twice a day this will relieve symptoms definitely if it is because of the joint. Try not to yawn or open your mouth big, do eat with a spoon, do not have rice with hand. These will relieve jaw pain. 2. If the symptoms do not get better with massage and exercise, and you are having pain in some tooth, then you might be having some infection in the tooth that needs root canal treatment or extraction. If you can provide me with OPG X-ray of your jaw, I can tell you the exact diagnosis and the treatment plan. Tell me about symptoms as well, do you feel more pain at night as compared to day time? Are you feeling hot and cold sensations? Tell me details so I could figure out the root cause of your pain." "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 developed a small white dot on my thigh a few months back. Now, the size has increased. Is this any sign of leucoderma? ### Response: Has this hypopigmented patch occurred after any injury or scab formation (attachment removed to protect patient identity)? If not, then it can be a sign of vitiligo or leucoderma. But, it cannot be confirmed at this stage. Does anyone in your family have such illness? If yes, then it points towards vitiligo. Do not worry as vitiligo can be treated with medicines. Also, search for other patches in the scalp and show to a dermatologist for treatment. 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: I was attacked by mumps around three years back and now my testicle sizes are different. So, I wanted to know about the treatment. Will I get rejected in visa medical test? I am a petroleum engineer. Please help. ### Response: I had gone through all the details posted. Orchitis is inflammation of the testicles, which has happened three years back due to mumps. There will be redness, pain and no fluid around the testis. For decrease of swelling and pain, we need to use anti-inflammatory agents. If there is any bacterial infection, then we need to use antibiotics. In case of 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 stretch marks on my whole body, and I want to remove them as they are white. Please suggest me some medicine to remove them in a year as after a year I have my marriage. And I get these stretch marks at the time of puberty, and I had mentally suffered because of the stretch marks, and I cannot wear sleeveless clothes. ### Response: Stretch marks are formed in areas of a rapid growth spurt or weight gain, due to side effects of certain medications or other medical conditions. Treatment will depend on whether your stretch marks are new or old, color reddish or whitish and the cause of stretch marks. Co2 laser sessions are quite effective. Topical Tretinoin has a role, but you should apply it only with the advice of your dermatologist. You can apply emollients like coconut oil or olive oil and Vitamin E for the time being. You may put up some clear pictures of the affected area for proper evaluation and guidance." "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 was not having her periods from the past five years, but from yesterday, she started bleeding again. In these five years, she has not even bled for a single day. Why is she bleeding all of a sudden? What can be the cause? ### Response: Five years no menstruation and now bleeding needs some detailed examination and investigations. Consult a nearby gynecologist, and let him or her see the source of the bleeding. Get an ultrasonography done. If bleeding is from the uterus, then your mom might need to get a D and C (dilatation and curettage). It is a minor operation, and the tissues are sent for testing. Basically, we have to rule out whether there any cancer cells or not. She may even require a CT scan. If nothing is found and every report comes normal, then she will be given some medicines accordingly. And no need to worry. If something is found in the reports, then it may require major operations, but it will all depend on the reports. So first, consult a nearby 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: Good day, please i was diagnose with hep b positive 18months ago, my consulting tild me my condition i\xc5\x9f inactive and need no medication. some month back i was feeling hurt at my chest i was later diagnose with ulcer. some some weeks now have been having pains around my chest and most especially middle of my check. please what is happening to me? ### Response: Hello, Welcome to i cliniq You have been diagnosed with inactive hepatitis B, for that I will request you to send me all your laboratory work so that a decision about the treatment can be taken. you now having central chest pain which looks like to due to esophageal ulcer called esophagitis and you may be also having some retrosternal burning with it. For this I am prescribing some medications it will help out in this pain. You need to take Cap.Esomeprazole 40mg 1 before breakfast and Syp.Sucralfate 10ml TID. Both of these should be taken for 2 weeks and let me know incase you have no improvement. EGD if no improvement with medications. EsophagitisChronic HBV Esophagitis Cap.Esomeprazole 40mg 1 before breakfastSyp.Sucralfate 10ml TID before meals Avoid spicy foods Needs follow up for HBV" "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 got bitten by what I am thinking a spider a week back. I figured since it seemed to have a little white and liquid coming out. So, I squeezed it. It has been four days and the bite is painful. Now I have a white circle where it once was just red and oozing. I have tried Cortisone but I do not see it getting better. ### Response: Hi. It got infected now with necrotic material inside. Cortisone is not helpful, it may worsen the infection. You need antibiotics, I would say topical antibiotics if necrotic material and redness is not there. But now you need oral antibiotics. Consult your doctor. He may prescribe you Augmentin or Doxycycline or other antibiotics for a couple of days. Redness is there, it is a sign of spread." "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 pain shooting down from my neck (just behind my right ear) down into my fingers. Also, on my right side near my breast with a slight headache as well. What it could be? ### Response: It is likely a cervical pain, due to compression of nerves between the spine. Does this pain increases on neck movement, is it associated with tingling, numbness in the arm or any neck trauma, if yes then it supports the diagnosis. You will need an X-ray of cervical spine AP/lateral view, and further may need MRI. Till that time he can have Tablet Neurobion forte once a day which is a nerve vitamin. Also, You will need Pregabalin after diagnosis is confirmed. I hope this helps you and get back if you have any doubts." "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 an umbilical hernia repair 11 days ago. It went fine, but 10 days later when I laid down my belly button pup out one inch then went back down. The next morning my belly button is out half an inch. My surgeon said just wait for a couple of days to see if it goes back down. I need to know if I should wait or get in right away. The belly button is a little tender. ### Response: As it has been only 10 days since your surgery, I suggest you wait for a few more days and see your surgeon if necessary. It is quite likely that there may be a small collection of fluid in the region which may get absorbed or may need aspiration. It is quite unlikely to have a recurrence so soon unless the surgery did not go well. If the swelling appears on coughing or straining it may suggest a recurrence. It is best tested by the surgeon as attempting the same at home may precipitate a recurrence. Take adequate rest. Be active. Take a good diet. Avoid straining or lifting weight for at least six months. See your surgeon if it still persists next week. 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: My baby is 36 days old. He is passing stool very frequently like 15 times with little or more motion but not very heavy in the last 48 hours. The stool was curdy yellowish color, not like runny or watery, no greenish, no blood, no bubbles. He had the same issue when he was 18 days old, and in between, he was healthy but again he kept going motion and redness spotted in anus area with small spots of skin peel.Baby sleeps well, does not cry, passes urine usually in a good number of times, and only mother breastfeeding every two hours. Please request your advice on how to stop this frequent motion and reason for this happening and is this normal? He also makes a noise like sounding from inside especially more during night time, having trouble while breathing due to a chest cold, so am giving Rinoclear saline drops three to six hours once depending on his nose block. Please advise why baby makes such noise, is it normal?I was feeding breast milk via bottle for four to five days when he was two weeks old since he was unable to suck through mother\s nipple. I stopped bottle when I encountered this frequent motion and with my doctor\s advice. ### Response: I understand your concern. 1. Passing motion too often is a normal phenomenon in neonates (gastrocolic reflex). Make sure baby is passing adequate urine and playful. 2. Redness over the perianal region may be due to prolonged wetness over the part or due to cleaning the area by rubbing. Cleaning not to be done by rubbing, it can peel the skin. 3. Try to keep the perianal region" "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 I get my wisdom teeth extracted, do my second molars shift in that empty spot? ### Response: No, it will not shift to the empty space, but it might tilt and that too very little. Because the third molar is vestigial. If you have any associated problem with the third molar you can extract it. If you do not have any problem, do not remove it. In case you have any caries or repeated pericoronitis, you must remove it. My answer is no shifting but slight tilt 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 am in love with my relative. We both have each other in someplace in our mind and I know it. She is a high achiever in her career, and I work hard to achieve stuff and good at studies but not as high as her. I faced real kind of depression earlier and often get it. So, I find happiness in everything. What I find difficult is to commit to her in some way as I see she may get a better person who will be supportive to her achievement. I do not underestimate myself, but there is a dilemma which is hurting me in my mind. Please advice. ### Response: Hello. You are very considerate that you want the best for your relative even at the cost of your love. Your cousin should be lucky that you have her best interests in your mind. However, if she reciprocates your feelings, you better go ahead and commit yourself to the relationship. If both of you love each other, you can develop a supportive and robust bond. Always remember that academics, career, money, etc., are not the primary factors in a relationship. Of course, they are essential, but a successful marriage needs personal compatibility and care for each other. Do activities to improve your confidence. Try regular exercise, yoga, and have an open talk with a trusted family member or friend about your decision." "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 suspect I may have tapeworms. How can I be sure and what can I do to get rid of them? ### Response: Stool tests can identify tapeworm infestation. However, because the worms and eggs are shed intermittently, the test may have to be repeated three to four times if the initial test is negative. Stool tests can also identify other intestinal parasites. Blood tests (serological tests) are also available, including ELISA (enzyme-linked immunosorbent assay) and PCR (polymerase chain reaction)." "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 periods started 14 days before and I had sex eight days back. Should I take pills after unsafe sex? If yes, what is the procedure to take I-pill? ### Response: According to your cycle, it is the seventh day of your menstrual cycle and considered to be safe. If you have a regular 28 day cycle, then ovulation is less likely on day seven. But, if your cycles are irregular then it is difficult to predict the exact day of ovulation as to when the chance of conception will be there. So, to be on safer side, you should take a pill today only. It is known as morning-after pill or pill 72 (Levonorgestrel 150 mcg) to be taken within 72 hours of unprotected sex only once. In case 72 hours have crossed after sexual intercourse, then also you can prevent pregnancy in this cycle by getting a copper-T (intrauterine device) inserted and that too within five days of unprotected sex." "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 cold sore type infection in my mouth especially at lips. Same was occurred last year and again it repeated this year. And as on today it is the third time it is coming and curing within a period of 10 to 20 days. I want to add photographs but do not know how. Further, currently it is on my lips and additional sores are there inside the upper part of my mouth. There is no pain. Please advise so that this can be permanently cured.I am currently taking Acivir 800. ### Response: Hello. I understand your concern. I have gone through your query, attached pictures, and your previous prescription. (attachment removed to protect patient identity). These cold sores are of viral origin and it is called herpetic stomatitis. This has a high recurrence rate meaning as long as the immune system is little underperforming, it can come again and again. You should compensate by eating healthy foods and" "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 an X-ray last Thursday and I got the result today. It says I have fibrosis in my right upper lobe. I had a history of pulmonary tuberculosis two years back and I took a six months medication and I am done with it. I just want to ask if fibrosis can be cured if I take medication and do exercise daily and eat healthy foods? ### Response: Fibrosis is a feature of chronic inflammation and your lung fibrosis is because of that. Tuberculosis is a chronic granulomatous inflammation and can lead to fibrosis. Fibrosis is irreversible condition and cannot be revert back" "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 9 months pregnant, and I have some doubts with my recent free T3, T4, and TSH levels. My Triiodothyronine total (T3) is 208.57. What is it? Is it something to worry or is it normal? My TSH is under control, and it is 2.63 now. ### Response: I just read your query about your pregnancy and your thyroid function test results. Hope you find my advice of some benefit. Good luck" "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 bump on the right backside of the roof of my mouth. It is right next to the tooth that is farther back. It has pain when I brush my tongue over it. Also giving me a slight headache and earache. I recently went to the dentist for a cleaning, and they said my wisdom teeth were not even showing so what could this be? ### Response: I read your query, and it seems that the bump which is painful and which gives radiating pain to ear and head is because of your third molar and this tooth is infected as the food gets entrapped between the tooth and soft tissue covering that tooth. For this, avoid eating too hot or too cold. Wash out oral cavity after every meal with mouthwash and warm saline. Do not apply external heat to that area, especially keeping your hand on that area. Also, take antibiotic and painkiller. Antibiotic you can use is Amoxicillin and Clavulanic acid combination in 625 mg dosage bd. Painkiller can be Ultracet ((tramadol and acetaminophen) thrice a 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: My friend started vomiting last night and I noticed that his eyelids were red and bruised. Is there something else besides the vomiting that could have caused the bruised eyelids? ### Response: From the history provided, it seems that your friend is having red and bruised eyes following vomiting. This is probably because of rupture of very small blood vessels in the eyelids during vomiting. This will not require any treatment and it will subside in one or two weeks, as the blood gets reabsorbed. Hence, you need not have to worry about this.Applying cold compression over the eyelids will provide symptomatic relief. Attach a photo of the affected eye and consult an ophthalmologist online for appropriate treatment" "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 chest x-ray and chest ct scan done. And they both came back normal. If I had emphysema would it have shown up on one of those two tests? ### Response: Hello. Significant emphysema in the lungs would have been visualized in the x-rays. Early stages of emphysema are difficult to see on x-ray and are visualized only on HRCT (high-resolution computerized tomography) chest scan. If X-rays are normal then more likely that you do not have lung emphysema." "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 daughter is 9 years old. She gets nose bleeding once in few months and also gum bleeding. She complains about occasional back pain, stomach burning, and hip pain too. My family physician has written down a series of tests and asked me to get opinions from a hematologist, gastroenterologist, and an orthopedic doctor respectively. ### Response: From the medical history of your child, I can understand that she is having bleeding manifestations with normal CBC (complete blood count) and coagulation workup. I would like to know about the below-mentioned questions, The most common bleeding disorder is a condition known as Von Willebrand disease. I think she needs to be checked for it and the other condition which needs to be evaluated is platelet dysfunction. Investigations suggested are," "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 facing erectile dysfunction for the last three to four years and also early ejaculation. Presently, I am using medicines for BP - Tenormin 50 mg and also for depression - Aplog 2 mg, Pethidine 50 mg and Mirtaz 15 mg for the past 10 years. My problem of ED and EE is from past five years. For this, I have used Suhagra tablet 50 to 100 mg and some sprays and Tantex capsules but there is no use. I am facing an embarrassing situation. Kindly give me an instant solution to this problem. ### Response: Hello. If your blood pressure remains in the normal range then that is good otherwise this should be controlled. I hope your blood sugar levels are also normal. You should get HbA1c levels checked in order to rule out any altered levels over a period of time. You should also get serum testosterone and prolactin levels done to rule out any hormonal cause. Tadalafil can be tried to make erection strong. You can talk to your doctor about that" "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 19-year-old female. I lost my virginity about 10 months ago with my boyfriend. Now after 10 months has passed I found out that I have two warts inside my vagina. It is white color although, the one on the top started to have a slight pink color. But the second one on the bottom which is much smaller still has completely white color and around the vagina blades, I have a little while dots. Also, there are very tiny warts line along the blades. So, when I went to see the GP near my house he had a look and said that there is nothing to worry it is still small. But in my opinion, I think it is quite big. So the doctor gave me a prescription for Condyline paint which he told me to use for three days only per week and I have to keep using it for three weeks and if it does not get better he told me to see him again. Now I have a few questions. Is this mean I have an HPV virus inside my body? How can I make the virus go away permanently? Will Gardasil injection make it go away? If it does not go away permanently, how can I make sure that I have no HPV viruses and so these warts will not come back again? Is this mean that I have this HPV from my boyfriend? How to use Condyline paint correctly? I wash my vagina blades and use the cotton pads to dry it, then I use start to use the Condyline paint. I only dip the swab once into the reagent and then I open my vagina blades so that I am able to paint the two warts inside my vagina as much as I can. Then I paint it all over the very tiny warts in the vagina blades area. Am I doing it correctly?Now I have been using the Condyline for two days, but the very tiny warts that are around the vagina blades started to grow more. Is this mean anything? Can condoms prevent these HPV viruses? If I break up with my boyfriend, will this help my symptoms and health to become better? I am very scared of whether this can leads to cancer? I do not want this to ever happen to me again, how can I prevent this to happen again?If my warts are gone can I have sex with my boyfriend? Will these symptoms comeback again? If I decided to buy the Gardasil injection and injected it now, then the next after two months, then next after six months, but during this time can I have sex with my boy friend? Will the vaccine still work? ### Response: Hello. I have gone through your history and pictures provided. (attachment removed to protect patient identity). I appreciate that you have consulted the doctor and begun the treatment. As rightly prescribed, Condyline (Podophyllotoxin) paint is very effective in genital warts. Wait till the paint" "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 25-year-old male and I have never been able to fully retract my penis. I have severe phimosis. I know phimosis can be treated, but my biggest concern is that I now have blue-looking veins from the shaft of my penis to the actual penis head that is supposed to be exposed. Is it serious? I have an appointment with a urologist in two weeks but the suspense is really killing me. Is it common? or can it be treated? Will I be able to successfully retract the penis head? I also feel pain sensation when I touch the hole at the tip of the penis. Please help. Of note, I smoke marijuana. I have attached photos for your reference. ### Response: I have gone through the photograph (attachment removed to protect patient identity). It looks like a case of phimosis. It can be treated by a simple circumcision. Those veins seen are normally present. Do not worry about surgery. It will not affect the blood supply to your penis. Phimosis is a pretty common issue and as I said it just takes a minor surgery and a couple of weeks for recovery" "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 TID 14 years back. I will run out of Lantus before the next shipment arrives, but I have plenty of Novolog on hand. My daily dose is 32.5 units Lantus at 10 AM and 12.5 units at 8 PM, with a sliding scale for Novolog (typically 0 to 6 units). What dosage or schedule would you recommend for temporarily relying on Novolog only? ### Response: I can tell you right away that your type 1 DM (diabetes mellitus) is not being managed correctly. Those who have type 1 DM cannot make it without basal insulin so insulin it has to be provided 24/7. You should be on balanced Lantus and scheduled Novolog (and not sliding scale of Novolog- Insulin aspart). You can take Novolog but it has to be every 3 to 4 hours, and it has to be scheduled. Also, you need to check your blood sugar every 3 to 4 hours before taking a shot, that is a must. You will run into very high or very low blood sugar and will see an erratic pattern, you will have to adjust the dose accordingly. Watch and check your ketones 2 to 3 times daily, should not stay without Lantus (Insulin glargine) for more than 24 hours. Novolog dose at least should be seven units every four hours (calculated from your current regimen you should need at least 1.8 units of Insulin every hour to survive). If feeling sick with nausea, vomiting, diarrhea, belly pain, blood sugar less than 70 or more than 300 you should go to ER or urgent care center. You are at high-risk ketoacidosis" "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 57-year-old female. Here is my question constant heart palpitations and fluttering, continuous feeling of adrenaline rushing along with palpitations very bad at night but also during the day when sitting in doing nothing palpitations often make you feel nauseous on a 1 to 10 scale they are about an eight. All labs are normal ECG, echo, and Holter monitor are all normal.Doctor cannot figure it out and prescribed Propranolol 10 mg, told me to try these once a day. Yesterday after doctor visits heart palpitations for four hours got fed up and took one tablet one hour later, all palpitations and adrenaline rush was gone. Slept for the first time without being woke up having to cough to stop the palpitations. Had angio done approximately two years ago due to suspected heart attack or arrhythmia at home with all classic signs crushing chest pain jaw neck left arm down to the floor nauseated?Even with that lab test came back good the next day. Had carotid artery surgery two years ago to remove a piece of plaque in right carotid artery none found anywhere else no stent needed. Again all labs are good cholesterol not high on statins and warfarin. I must be perplexing to all doctors because they cannot figure it out. Was put on warfarin approximately 15 years ago due to DVTs as a result of a surgery, always therapeutic. So I had a heart attack or arrhythmia a few years back the angio came out the great doctor said everything looked fine now I have these crazy heart palpitations that would not stop. They go away as soon as I take the beta-blocker. I am told that beta-blockers even though anti-arrhythmic can also be pro arithmetic as well should I take this every day or should I only take this when I start to feel palpitations. ### Response: Hello, Welcome to ciliniq.com. So palpitations may be due to cardiac arrhythmia, anxiety, and psychological problems or due to increased awareness of one\s heartbeat. Now, since your holter was normal during your palpitations, it rules out the possibility of cardiac arrhythmia. So, these are likely benign palpitations in 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 49-year-old woman and last month I was hospitalized with a necrotizing soft tissue infection on my thigh. I had two debridement surgeries and was discharged after 5 days. I was treated with about 4 IV antibiotics. I do not remember them all, I recall seeing Vancomycin and Penicillin. I was told that the infection was not MRSA, but a ""slower moving bacteria"" they did not tell me what it was. I was swabbed for MRSA in my nose and butt before both surgeries and was told I did not have it. For the last day of my stay, I had a roommate who had a bad MRSA infection on her butt and sometimes had diarrhea incontinence during dressing changes. I had no physical contact with her, but we had the same nurse. I was discharged with a five day course of Augmentin.The wound has been healing very well and has not gotten infected, but three weeks after discharge I got an abscess under my arm. I went to an urgent care and was prescribed Clindamycin and told to return in three days for drainage. The abscess did not improve or get worse over the three days. I got it drained and was prescribed Augmentin and told to also continue the clindamycin. That was a week ago and the wound is healing well. They called today and said cultures show it was MRSA and they prescribed Bactrim and told me to stop the other antibiotics.I am feeling devastated by this and wanting to understand why it happened. Could I have gotten it in the hospital? I am concerned that it will not go away. Are those swabs at the hospital conclusive and mean for sure I did not have MRSA a month ago? I have never had any medical problems before and these experiences have been very frightening. Is there anything else I can do to prevent recurrence? I have read about everything from bleach baths and hibiclens to antibiotics in the nose. ### Response: Hi, I am sorry for what you have had to go through. As you previously did not have MRSA strains, it is possible that now you have hospital-acquired strains in your blood. As you were told to stop other antibiotics and start Bactrim, this means the strain you have got is sensitive to Bactrim. If there is anything else you want to ask, please feel free to contact 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: I am a sufferer of hemiplegic migraine. However, I had unusual collapses three months back. The first one was 40 minutes; I could not recall the whole of that period. I came back with an injured knee and felt dazed. I was fine after around two hours. The next day, I felt pressure in my head and as though I was about to die. I then could not recall getting home or the rest of the night. I was fine in the morning. Two days later, I felt horrendous pain in my head, felt like I was swimming, then tried to go home and again could not recall from deciding to go home to around two hours later and I was foggy for the rest of the night. I have had constant pain in the left side of my head above the temple for four years. It does not go. However, In the past two weeks, I have felt like it is throbbing and at times about to burst out. I was meant to see my neurologist three months back, but his receptionist did not follow the recommendation, and now I am unsure whether to have the tests done. I feel like we are playing with my life. Usually, I am pretty relaxed about the possibilities and know it is a migraine. But this feels different. This feels like intense throbbing above my ear from the temple along towards the back of my head, with a pain in my ear to just behind my jaw under my ear. My instinct says that an aneurysm needs ruling out. I do not know if I am just upset because it feels so different and this pressure is intense. It is a weird feeling. I currently take Sumatriptan as needed.Please, can you advise what to do? As it stands the next neuro appointment is after four months, added complication is that I have been breathless and unable to climb stairs without stopping and panting for past four months. I am having heart tests on the weekend. But, what do I do about my brain? ### Response: Hello. I agree with you on the fact that when dealing with hemiplegic migraine, it is necessary excluding a brain aneurysm or any arterio-venous malformation, which may mimic this clinical situation. That is why it is necessary performing a brain MRI, which would detect any possible brain aneurysm if present. Regarding the loss of conscience, I would also recommend performing an EEG (electroencephalogram) to investigate for seizures (although 40 minutes is a long period for a seizure, not typical)." "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 tested for HIV 1 and 2 many times. My tests are 10 weeks card test negative. 12 weeks Elisa serum test negative. 14 weeks Elisa serum and p24 test negative. 16 weeks Elisa serum test negative. 23 weeks Elisa serum and p24 test negative. Is HIV is still my risk? But from few days I am having lots of pimple on my back and shoulders and they sometimes itch, are they because of HIV or something else? ### Response: I understood your concern and I have viewed the images. (attachment removed to protect patient identity). Your HIV screening tests are conclusive. A screening test at and after three months mark from risk exposure is considered final and conclusive. There is no need to test further. The lesions that you have on your back are actually acne vulgaris. I suggest you apply a topical Benzoyl peroxide 5 % gel, twice daily. They are certainly not due to HIV." "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 32 years old married male. Since two years I am suffering from premature ejaculation. I tried to control it, but did not get better result. My wife is very much unsatisfied. How to cure this issue? ### Response: Hi. As you know that the first thing in medicine is establishing a diagnosis which is correct. So, I would like to ask you a few questions. Revert back with the answers for the above questions to 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 slept with color contacts in my eyes and now I woke and took them out and there is a white cloud blocking my vision. ### Response: Hello. A photograph would have been very helpful for making a diagnosis. It is never advisable to sleep with your contacts. Here is the possibility of your situation: 1. Epithelial edema. In this case, remove and stop wearing your contacts for one month." "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 32 years old and unmarried. I am a patient of PCOD. I also have a family history of breast cancer. My father\s sister had breast cancer recently. I am in a very big financial crisis. So, one of my friends suggested me to donate eggs. Will it be risky if I donate my eggs only once? As I am a patient of PCOD, will I be able to conceive in the future? Will I be given some hormonal treatment to conceive later? Please advise me whether I should proceed with the idea of egg donation. Is there any chance of developing breast or ovarian cancer if I donate eggs? Please guide me. I just want to know about its long term consequences as I am afraid of breast and ovarian cancer. ### Response: A single cycle of ovulation induction for egg donation and then, possibly in the future for yourself would not increase your chance of breast or ovarian cancer. The heredity for a woman is decided from her maternal background and not from the father\s side. So, if your paternal aunt had it and your mother or maternal grandmother did not have it, then there are very minimal chances that you should get it in future. You can safely go ahead with an ova donation if you wish to without fear. So, whenever you decide to get pregnant, conservative management of treatment can always be considered." "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 too many health issues for the last three weeks. I feel sleepy all the time even I sleep eight hours already. I am feeling weak, tiredness, dizziness, and headache on the right side of my head (pressure and dullness). My bowel habit changed to three to four times a day. I have attached my blood work. Do you think I have any abnormality in blood? Do you think I am having a stroke or heart attack? Do I have too much thickness in blood as high hemoglobin and hematocrit? Do I have any kind of blood cancer like polycythemia or polycythemia vera? In spite of having too much hemoglobin and platelets, why am I having weakness? Do I need to take blood thinner medicine? ### Response: Hereby I am giving opinion regarding your case. First, let me know do you have any stress or anxiety issues? As severe stress can lead to hyperventilation and dizziness. Stress can change bowel habits as well and it can lead to headaches as well. If stress is not present, then the causes for weakness are overexertion, lack of exercise, depression, kidney problems (for that urea, creatinine investigation done), myositis, etc. As for three weeks you are not improving you can be investigated with EMG (electromyography), EKG (electrocardiography) investigation for further workup. Answers to your questions are as follows: I do not think this blood report is abnormal. It should be repeated as two weeks passed. In stroke vision problem, half part weakness, slurred speech like problem present. So the stroke chance is very less. But EKG investigation can be done here as dizziness present since many times. Your Hb and HCT are not much high that needs immediate concern. I do not think it is polycythemia vera case. Repeat CBC to check HCT and RBC value now. For weakness rule out the above causes No n\xc3\xa9ed of taking any blood thinner. Include green leafy vegetables and fruits more in your diet." "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 fever two days ago. Then one day ago started frequent urination and I could not hold it every time it happened. And there was pain during urination. Then started pain in the stomach. Today the urination is not that much but I have severe pain in both sides of my abdomen. I am not able to walk because of pain. ### Response: You can have kidney or bladder infection or it can be acute urinary tract infection. You get the following tests done: As per these reports, the further management plan can be decided. You can consult a urologist for the 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: I am 30 Years old, Missed period for 8 days now. Since my 24 day of menstrual cycle was starting using duphaston drug once daily and finish the prescribed dose yesterday. And my menstrual cycle is between 26-28 days, this month on the days of my periods I got cramps but nothing come out. Could this be side effects of duphaston or? ### Response: I would like to know the reason why you had been taking Duphaston? If you have been planning for a pregnancy, then it would be advisable to check your urine pregnancy test once. If negative you can wait upto two week for your Periods to come as you just finished your course of Duphaston yesterday. If you got pregnant this cycle, then you may not have periods even after 2 weeks. So check.accordingly. please feel free to revert back anytime with any further queries. Have a nice 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 50 years old female, went through menopause but otherwise I am healthy. There is a problem with my nails. Out of 10 nails, six nails have one-third of the nails separated from the nail beds, with a v shape, looking white underneath, rest of the nails are looking pinkish pale. The nails are painless unless I press them hard. All the nails have some ridges. I kept my nails short with no polish for over five weeks. My fingers felt dry with mild skin peeling after a travel. Currently, I have a mild skin eczema. I also had seborrheic dermatitis in my scalp a few years ago. But it is under control with special shampoo treatment. I had one fingernail with a similar problem but it was in a milder condition. I thought it was nail fungal. I used Mometasone furoate 0.1 % cream for my skin eczema. It cleared up when my nails grew. I have an allergy to pollen. ### Response: Hi. I have gone through your attachment (attachment removed to protect patient identity). You seem to have a condition known as onycholysis, which is characterized by the separation of the nail from its nail bed. Causes could be either a fungal infection (onychomycosis) or underlying skin eczemas like psoriasis." "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 0.2 cm endobronchial nodule in the right lower lobe. I was a smoker for 20 years. I had a CT scan for cough and now new nodule. Is this cancer? ### Response: I have gone through the reports (attachment removed to protect patient identity). It seems to be a very small nodule. Do not get afraid first. Anyway, we have to confirm the pathology. At present, take treatment for cough. You will need to take follow up if the symptoms continue or after three months if the nodule is progressive" "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 26 year old female. I am worried after reading about the effects of radiation from a CT scan. I had two separate scans within a month. Both the scans were for the chest, abdomen, and pelvis. The doctors were looking for a potential lymphoma, but nothing conclusive was found. I am worried about the future cancer risk. Please help. ### Response: This kind of exposure to CT scan is not harmful, though you must avoid as much as possible. A continuous, long-term exposure daily may cause harmful radiation hazards and ill health. So, do not worry about the exposure. This very minimal exposure does not pose any future cancer risk. Consult a radiologist online to know about the risk levels of radiation exposure" "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 serious constipation problems and Dulcolax is the only thing that works in my body. I take a lot of fruits, tea, and fiber supplements. What can I do? ### Response: Hi. At your age, chronic constipation should be thoroughly investigated. Are there any other symptoms like blood in stool, weight loss, or occasional diarrhea alternating with constipation or loss of appetite? I would advise you to get a colonoscopy done as this has become chronic. If there is an underlying factor causing constipation, Laxatives will only provide temporary relief and will not solve it. 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 suffering from stomach pain. I am taking Sucramal syrup and A-Spas tablet. I have an increase in stomach pain when the acidity condition increases. I have done a scanning. But nothing was shown. ### Response: Your stomach pain can occur due to gastritis, or you can have a small stomach ulcer which may not be seen in ultrasonography. You can take Rabeprazole 20 mg for one time a day for one to two weeks to heal the inflamed stomach mucosa. Avoid taking spicy foods. Cooked oatmeal can help in soothing the stomach. Take soft and bland diet more. Avoid having heavy, fatty foods. Elevate your head while sleeping. Avoid taking excess tea, and coffee. If you have the habit of smoking, please avoid 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 question is, when can I drink more than two glasses of wine a day or a whole bottle without it hindering the healing process after my dermapen session of micro needling? And also, because I was occasionally drinking a few bottles of beer after I had gotten it done, does that mean my healing time has to be longer than six weeks? By the way, I did my acne scar regions with 2.00 mm needles. ### Response: Hi. Alcohol use can diminish wound healing, it increases the blood flow so it can also cause bleeding. Excessive alcohol intake also reduces the immunity of the body which can lead to delayed wound healing. Same principle applied to micro needling. Micro needling is also a small type of injuries created in the facial skin so that the healing process makes a healthy smooth skin and remove the scar. So if you take alcohol during that process alcohol is going to affect that healing process and it can lead to infection. So I advise that you should completely avoid alcohol if possible. A small amount of one glass of beer per day can be taken if you cannot control your urge to take alcohol. 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 hepatitis B patient. My current status is as follows. HBeAg - negative (0.010), HBV E antibody or Ag - positive (0.031) and HBV DNA quantitative (PCR) less than 17.1 IU/mL. Please advise whether this can be cured to become negative as it is affecting my career. ### Response: Anti-HBc (both IgM and IgG), Liver panel, ultrasound of the liver INR/PT and serum albumin if not part of the liver profile. 1. Chronic hepatitis B.2. Chronic carrier state.3. Acute infection in window phase (with less infectivity). Yes, it is treatable, but I would be able to give you a better answer once I have the complete set of blood work and ultrasound results. Revert back with the investigation reports 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: I recently got my CBC done as a part of a routine check-up in which my Hgb, RBC, platelets, WBC counts was entirely within the range except for monocytes. My monocytes were 5.28x10^9/L. I feel healthy otherwise and except for PCOS have no other known medical condition. My GP said that monocytes were nothing to worry about as TLC is fine and I am fine. So can you tell me if it is nothing to worry? ### Response: I read your concern, and below is my opinion. There are many causes for high monocyte count. Your monocyte count is high and cannot be neglected.The temporary viral infection also can cause high monocyte count. You do not have any symptoms, so temporary mild viral infection might be cause for high monocyte. You have to repeat your full CBC with peripheral smear examination report after seven days. If still monocyte count is high, then you have to consult a hematologist for detailed evaluation. I hope I have answered your question. I will be glad to help you further, if required." "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: Hi, doctor I am 13 weeks pregnant last week I undergone for NT scan the report was normal and the same time I gave double marker blood test. Yesterday from the hospital they called me for blood test because the first report shows abnormal. I am so scared whether second time double marker test shows normal. They didn\t give the report of first test but simply told first test was abnormal so we sending for second time. I am confused. Please tell me whether second time test shows normal result. If it is abnormal is there is any early treatment to protect the baby from down syndrome. ### Response: Hello, First of all congrats on your pregnancy. Let me clarify that double marker is only a screening test .It\s not a confirmatory test. Double markers are not repeated if they r showing high risk.Sonif the lab has asked for a second sample ,it may be due to some other reason. It means even if we say ,ur second test shows a high risk (chances of which r less) ,it only means that this baby for some reason has a higher risk for a genetic problem.you still need to do an amniocentesis and do a karyotyping to confirm the genetic problem. We see many double markers which r abnormal,but very few if those have an abnormal Karyotype on confirmation. So rest assured and enjoy your pregnancy .let the results come .Nothing is decided by a double marker test. So pls wait for the result.Theres no need to panic. Have a safe pregnancy." "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 frenuloplasty of the penis ten days back. It all seemed fine at first, and I had very little pain. I have to say the actual incision and stitches were a lot larger than what I was previously led to believe. I have been washing gently with salt water and rinsing twice daily. I took a good look a few days ago, and it seems that the stitches have come apart. To be honest, and I am not a urologist, but it does not look like a good job, though I may be wrong. I went to see the doctor yesterday, and she took a look and said that it all looks fine, the stitches may have come apart slightly. She told me to leave it for two weeks, and if I am still concerned, they will refer me back to the specialist. I was hoping to get a second opinion, this being my penis, I am obviously concerned that it is not going to heal properly and I will end up worse than before the operation. I am primarily looking for reassurance. ### Response: Hi. I saw the photos (attachment removed to protect patient identity). You are correct, a few stitches have come apart. So, be reassured that nothing has gone awfully wrong. Just wait it out till complete healing takes place. Hopefully, it should heal well, as the wound is healthy." "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\m having ache in lower jaw.Last time i visited dentist...i had a root canal same sideAfter a month i started experiencing pain in that jaw sometimes...Doctor said root canal is fine and that i have impacted wisdom tooth after a quick x ray.I am having pain now again in that jaw after 3 months.What should i do?Due to covid 19 I\m not sure i should visit a dentist ### Response: This may be the pain from the same reason you had previously. If you have an impacted wisdom tooth, then that can cause you this kind of problem repeatedly. But if you have pain on biting, that may be from the root canal treated tooth. Do you have the xray? Can you send me a picture of the affected area and the xray ? In the meantime, you can rinse mouth with warm saline water 5-7 times daily. If the pain doesn\t subside, you can take painkiller... Tab Ibuprofen (400mg) two times daily for 2/3 days (after meal) Please send me the pictures for proper diagnosis and better treatment plan." "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 hiatal hernia, I am wondering if protein shake hurt my hernia. The pain is usually mild and comes and goes. Recently, I have been not feeling too well, and my hiatal hernia pain become moderate and doest really go away. I am currently on Rabeprazole and Motilium. ### Response: I reviewed your endoscopy and histopathology report. (attachment removed to protect patient identity). You have a small hiatus hernia and it has no specification association with proteins shake. Your report also shows chronic gastritis which also adds to your discomfort. This issue usually improves with medications but recurs after some time. My recommendations will be some changes in your medications for some time and then will readjust and down titrate again. Meanwhile, you need some precautions as well. Hiatus hernia leading to GERD (gastroesophageal reflux disease), or gastritis. Capsule Rabeprazole one in the morning and one in the evening before meals for four weeks and then only in the morning for four weeks. Tablet Motilium 1-1-1 before meals for two weeks. Syrup Gaviscon (Alginate) 10 ml three times daily after meals for two weeks and then as per need. Avoid late night eating. No eating two hours before bed. Decrease coffee intake. Avoid smoking. One hour regular excercise. After 10 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 have bleeding after sex. I have pain while having sex. I have vaginal discharge and irritation while peeing and itching. Is this an infection or something else? I took an Unwanted 72 before three days. ### Response: Post-coital bleeding often occurs due to cervical erosions or cervicitis. It shows increased vaginal discharge, and it can lead to secondary urinary tract infection with burning sensation and irritation during urination. So meet your gynecologist for a speculum examination and a urine culture. Have a treatment after seeing the results." "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 lot of stress going on right now and most of my anxiety is coming back on having oral intercourse with a guy but he did not ejaculate, there was precum though. I am on birth control but after doing the oral intercourse two days later I started my period that was a week early and lasted 14 days. Can I get pregnant? ### Response: No, you can never get pregnant with oral intercourse only. Vaginal intercourse without precaution would lead to pregnancy during the fertile period. And the periods you are having is not because of pregnancy but may be because of hormonal imbalance. Get your thyroid profile and serum prolactin and fasting insulin FBS. Plus ultrasound to know the endometrial thickness. The birth control pill if you are taking, may result in this if taken irregularly." "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 often have elbow pain due to spending more time with computer and using a mouse or keyboard. I work 7 to 8 hours daily in computer and pain is gradually increasing. The pain earlier used to reduce by taking Voveran tablet and using Voveran gel. The pain has become frequent now and I am taking Tendoshot capsule for the last few days. I also use tennis elbow strap in both hands while working and that gives some comfort. I do a few elbow exercise but that seems not sufficient in reducing pain. What is the treatment for elbow pain due to computer use?Whether should I take Voveran 50 or Tendoshot for pain relief?Is there any other medicine to use for pain relief?Whether tennis elbow strap or sleeve will be appropriate for this purpose?How to prevent elbow pain while using the computer?How serious can be this elbow pain in future? ### Response: Hello. It happens due to excessive use of muscle which causes stretch over the tendon at the origin giving rise to pain. So obviously, best treatment is to somehow restrict the use of muscle as much as possible. Now, you will not be able to avoid computer use but try to restrict other activities like the lifting of heavy weights, and all the motion which involves the use of these muscles like twisting or rotatory motion till it heals. It is not at all serious, it may trouble you, may settle with time or at extremes may need some local injection for the pain to subside. Next thing, you should support your elbow as much as possible during use of computer like keeping on the edge of the chair or using pillows or some other support so as to reduce stress. Also, rather than any medicines, you should use sleeves or brace as much as possible. If not adequately helpful then may have a local Voveran gel (Diclofenac). Tablet Voveran should be avoided as much as possible, and only have if absolutely painful. ) you may have. In painkillers, if you need, safest is Paracetamol like tablet Dolo 650 or Ultracet if it is not helpful then comes Voveran. You may use hot water fomentation. Also, visit local physiotherapists and get some exercises learned for 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: I am 32 years old. I am suffering from stress chest pain for the past one year. 2D echo and ECG are also normal. Is it related to heart or GERD or chest wall?I am taking Cita-S 10 mg and Pantosec. ### Response: Hello. Your pain at your chest wall may be due to stress or heartburn from acid reflux. I am suggesting that you have developed a stress ulcer which can lead to acid reflux esophagitis. Are you on any form of stress lately? If so please take some time off for adequate rest. You can go ahead to do your echocardiogram to rule out any form of heart disease which can produce chest pain. Meanwhile, you can continue the suggested medication for the pain and combine it with some antacids until you receive the outcome of your diagnostic test. Stress. Echocardiogram. 1. Reflux esophagitis.2. Hypertensive heart disease. Reflux esophagitis. Adequate rest and antacids. Reduce stress event. Revert back with the echo report to a vascular 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: My wife was previously diagnosed with bipolar II and was taking 100 mg Lamotrigine daily for depression maintenance. She was on that dosage for nine years. She recently suffered a more chronic depressive episode and went out of town for ketamine infusion therapy. The infusions were very successful, and the psychiatrist who was assessing her for the infusions suggested that she did not need the Lamotrigine, that it was ineffective for treating depression in bipolar II. She tapered off the Lamotrigine, which was very difficult.It has been three to four weeks since her last dose of Lamotrigine, and nine weeks since her infusions. She is feeling very moody and depressed, irritability, fatigue, loss of focus. The question is, do you think she needs to go back on the Lamotrigine? Or does she need to get a booster shot of Ketamine? Both are difficult solutions. Getting off the Lamotrigine was awful, and getting Ketamine requires out of town travel, etc. Kindly advice. ### Response: Hello. I can understand your problem. Ketamine infusion therapy has great roles in depression but regular maintenance treatment is needed and which results in a significant burden on patients." "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 all four wisdom teeth pulled nine days ago. Only the one on the bottom right tooth is very painful and when I push near it all this foul smelling yellow stuff comes out. What is wrong? Also, having headaches. ### Response: Hello. It occurs due to loss of blood clot in the early days since extraction. Use warm salt water gargle twice a day for a week or two to get some relief. You may need antibiotics and painkillers for a week or two. So, go back to your dentist for a thorough clean up of the infected site" "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 is 56 years old. He is having negative thoughts and talks about deaths, has a vivid dream with severe sleepiness. He is not enjoying anything which he enjoyed before. He has short-term memory loss. He has fatigue with increased appetite. He has little issue in breathing during sleeping. He can identify people. But, he is unable to remember what happened before five minutes. He is completely confused by his dreams and reality.These problems have started in my father after a traumatic event in which my father has lost his brother and two sons of his brother in an accident that happened before three months. He has a previous history of Bell\s palsy, a little hearing loss, and was also diagnosed with a small lesion in the hypothalamus which is not cancerous. I want to know whether these traumatic events have played a part in these symptoms or its due to the lesion. The MRI of the brain shows the possibility of glioma. Please suggest. ### Response: Your father may have PTSD (post-traumatic stress disorder). It is less likely to be due to glioma. The symptoms of a vision problem and memory loss are due to gliomas. You can give him a small dose of antidepressants and Benzodiazepine for the sleep disturbances. You can give him Sertraline 50 mg daily and Clonazepam 0.5 mg at night for the sleep. We need to re-evaluate him after 10 days and manage the dose. Your father has symptoms both due to the brain lesion and PTSD (family member loss). If your father starts to have psychotic symptoms due to gliomas, then you can give him a small dose of antipsychotic in the future." "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: Before two weeks, I have undergone I and D for breast abscess, from that day I have stopped feeding my baby. On 21st of March doctor checked and said no need of dressing and there is a small lump still present keep warm compress it will go and told me not to feed the baby. I am keeping warm compress daily once but no result. Yesterday, the wound completely healed and there was no leakage of milk from the wound. So I started feeding my baby.In the night I fed my baby on the wounded breast but in the morning I observed swelling again on the breast. So I kept hot compress and started pumping. Then I observed a very thick pus on my nipple just a drop. After that, I am trying to hand express and pumping but the pus is not coming out. Now I am very afraid that my gynecologist may again suggest I and D. In the present scenario it is very tough for me to go hospital every day for dressing carrying a small baby. Please tell me whether it can be healed by antibiotics? Can I feed my baby? If I feed baby will that pus affect my baby? ### Response: Hi. Please do not worry. A single episode of a small amount of pus exudation may occur. Ideally, you should have pumped away the first set of milk and then started feeding. But please do not get distressed now. Keep breastfeeding your baby keeping following things in mind. After feeding from the affected side, use the breast pump to evacuate any residual milk (Do not worry your body will generate enough milk for the baby). Keep hot compressing twice a day. Maintain proper breast hygiene. Do visit your gynecologist if you develop any fever or rise of local temperature." "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: What is the difference between IntraLasik and Contoura Lasik? ### Response: IntraLasik is a method in which the corneal flap is taken by laser. In regular Lasik, the corneal flap is taken by a mechanical device which has a metal blade. The rest of the procedures are the same. Contoura vision is a personalized Lasik in which the laser correction is done according to the size and specifications of the individual\s eye. It is something like getting a shirt specially stitched to the individual\s size, whereas regular Lasik is like buying a ready-made shirt." "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: For almost a week now I have had recurring random pain just behind both of my ear lobes. It has been almost three weeks since I stopped Lyrica, Pregabalin completely for back pain. For the last week I have been experiencing something different which can be best described as random pressure or light pain almost behind both the ear lobes, sometimes the feeling is localized just there other times it travels towards the neck, occasionally towards the mastoid bone or it extends towards the lower jawline. I have been crazily searching to see if this is a result of any swollen lymph node fearing cancer but I could not find anything out of the ordinary on the body. Very rarely I feel this pressure going upwards to the ear and even more rarely a sudden pain arises inside the ear too but I hear no ringing or sounds. The weirdest thing is today I woke up with this sensation and I could feel heaviness behind my ears.This has come after an acute sinus infection, cough, night sweats (for which I had to take antibiotics) that hit me when I started tapering off Lyrica last month. I have had chronic sinus issues in the past too but this one was different, never had it progress to this level. I have uploaded an image of where exactly the pain or pressure originates but right now the pain or pressure is pretty spread out randomly across the neck. Can you please tell me what is going on and what could be the cause of this pain or pressure? Medicines: Although the sinus problem seems to be resolved now I am still taking Loratadine D, Xynosine nasal spray and Librax for IBS related issues. ### Response: Hello. Pain may be due to mastoiditis seen in chronic allergy or middle ear infection or eustachian tube block patients. Get it done CT brain or X-ray of the mastoid. Use water vapor inhalation and salt water gargling thrice a day for five days. You may use Montelukast and Levocetirizine once a day for five days. If symptoms are not improved please consult your ENT specialist, he will examine and treat you accordingly." "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 started with the gym last week. I trained myself at home for a few weeks. After going to the gym, I began to have pain in the knees. It hurts me a lot. I am unable to do squats for a week. I tried to fix it, and nothing helped me. I do not know what to do. Please help. ### Response: Hi. It is common to have pain when you start an exercise programme after a gap. You can try icing the sore parts after doing exercise as well as do gentle stretches in leg muscles." "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 30 years old and married for 2.4 years. Now we are planning for a child. On 14th of this month, I experienced periods with very little stomach pain and pain in legs. The next day on 15th there was no bleeding at all, 16th I had spotting of light red colored blood flow, 17th the same thing happened and then the flow stopped. Again on 23rd night I had bleeding light red coloured blood flow, on 24th no bleeding at all, 25th I had fresh pink colored spotting. Then 26th pinkish brownish spotting occurred, 27th morning I did pregnancy test by urine, it came negative, and at 8 AM had brownish spotting, 28th had brownish spotting too. Please help me to know whether it is implantation bleeding or anything else. ### Response: Hello. This is not an implantation bleed at all as even urine pregnancy test is negative. Considering that you have been having regular spotting during this month since 14th of this month with hypomenorrhoea, there are possibilities that your serum Estradiol levels are low which is a possible cause of such irregular shedding of the endometrium. It is important that you get an ultrasound pelvis done to check for endometrial thickness which if less than 8 mm then likely that you would not conceive during this cycle. Please tell me what hormonal profile was done with thyroid levels, serum prolactin, serum progesterone, serum estradiol, FSH, LH and AMH levels to establish the cause of such irregular shedding." "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 pee very often (even though I am young and I do not have diabetes or anything), and I get horn whenever my bladder is full. I do not think it as a healthy habit, and it disturbs me. Please help me. ### Response: You should rule out the cause for frequent urination. It can be due to urinary tract infection and due to impaired sugar control. If you have a burning sensation or feeling urgency to void the bladder, it indicates an infection. So, get your urine test done along with fasting blood sugar. It is not abnormal to have an erotic feeling while the bladder is full. The sensations produced by stretching of the bladder wall may give some erotic sensation." "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 periods on 26th and had protected sex on the 4th of the following month. After that, I took an i-pill within 2 hours. Now, I am bleeding like my periods ie after 8 days of i-pill. Is this my period? If not, can I expect my periods on the coming 26th? ### Response: Hi. As you are bleeding now, your menses going to be irregular mostly. Now your period is going to delay mostly and very little chance that it comes on time. I-pill is a hormonal pill so it can disturb your normal cycle. 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: Due to excess of masturbation in my teenage time, I feel my penis size has become short and thin. Now I am 22 years old. So, is it possible to get back that previous size if I follow any instructions advised by you? I do not drink or smoke. ### Response: Masturbation is a safe habit and it does not cause any serious effects on health. Masturbation is not a cause for the reduced size of the penis. Size of penis remains constant and it never decreases. If you are seeing any reduction in size, then that is due to psychological reasons. If you have a normal erection then no need to get worried. Size has no roles in sexual intercourse. Jelqing is an exercise that can help in improving the size. You can think of trying this. This involves milking like repetitive action in a semi-erected penis. This will help in improving the size of the penis to some extent." "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 many deep acne scars on my face. I have shown to many doctors but did not get a good result. I have found now that lastly, I will have to go for laser treatment. Please suggest me what to do. ### Response: Treatment of acne scar depends on the type of scar. There are various treatment modalities for scar for instance subcision, it is a surgical procedure to release the tight bands below the skin that is holding the scar, injection of platelet-rich plasma, TCA (trichloroacetic acid) cross, deep chemical peels, Co2 (carbon dioxide) laser resurfacing. Discuss these options with your Dermatologist. Co2 laser is effective and gives good results but again I do not know the type of acne scar that you have. Please attach your clinical picture along with your query so that it is convenient for me to give appropriate suggestions." "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 suffering from a fungal infection in the inner thighs for more than a month now. I used Terbinaforce tablets. For a month now, I am using only Sebifin cream. But I cannot see much improvement. Can you please suggest me any better treatment or medicine? ### Response: Fungal infections usually take two months to resolve completely provided you take proper dose of medicine for the prescribed duration. Terbinaforce (Terbinafine) is a good antifungal. I suggest if you have taken Terbinaforce for one month then it is sufficient. I would suggest you switch to Seriva cream (Sertaconazole Topical), a newer antifungal. Apply this cream twice a day, in the morning after taking bath and in the night before going to bed. You also can use KZ soap (Ketoconazole). Use only for thigh area while taking bath. Use your regular soap for rest of the body. You can also use Abzorb Dusting Powder. Apply it to the thigh area after you apply Seriva cream. This will reduce sweating and friction. Along with that, I need you to follow few do\s and don\ts" "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 getting severe pain on the left side of the shoulder and chest for the past four days. Is this a cardiac problem? ### Response: Any left-sided chest pain should not be ignored. A history of lifting heavy weight, strenuous work, exercise etc., might also cause shoulder and chest pain. There are chances of pain radiating to the arm and chest due to cervical spondylosis (neck pain). Follow these simple steps: Get a complete hemogram, chest X-ray, X-ray of the cervical spine and ECG done. Consult a cardiologist online with the reports" "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: Impact injury to right ankle eight months ago, still painful and gets swollen. MRI was done on it. I am 20 years old, 158 cm, and 52 kg. All healthy apart from this. My daily medication is 20 mg Fluoxetine. ### Response: The MRI scan does not show any area of strain or gross musculotendinous injury. Keep it elevated as much as possible. Apply Aircast ankle Sturrup orthosis (you can wear shoes over it too). Apply ice thrice daily for two days. I suggest the following medicines: Take these tablets only if you are not allergic to them. Do not take these tablets if you have bronchial asthma. Follow up immediately in case of any untoward reactions. Physical therapy: wobble board exercises to strengthen muscles. This should be done once the pain reduces" "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 unprotected oral sex with a CSW. I ejaculated in her mouth. She ran quickly to spit. I do not know if she was HIV positive or not. Should I be worried about my health? ### Response: Unprotected receptive oral sex is safer than unprotected vaginal or anal sex but not entirely safe. There is a negligible risk of HIV (human immunodeficiency virus) and other STDs (sexually transmitted diseases) like herpes, gonorrhea, chlamydia, and syphilis. The risk is more if the person had oral sores or bleeding gums" "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 17 years old female. I have persistent depression and social anxiety disorder. I have not ever taken medication for this issue. My social anxiety usually springs me into full-blown panic attacks like shaking, feeling unsteady, trouble catching breathes, extreme twitchiness and my throat close up. I wanted to go for an audition for a singing competition, but I have social anxiety, and it is a severe debilitating symptom. I have been wondering if there is any medicine to take as a temporary sedate as it is enough for me to perform, and to stop taking them when it is not needed. ### Response: Your symptoms are suggestive of social phobia and performance anxiety. Do not worry as there are lots of good medicines which will help you to perform without anxiety. Medicines like Beta blockers like Propranolol will help to reduce your anxiety symptoms. You can also attend few psychotherapy sessions to learn relaxation therapies with exposure and response prevention techniques" "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 flaky skin on my scalp. My doctor told me it is sebopsoriasis. The flaking is limited to the scalp, and my doctor has prescribed Folitrax 5 mg and Aprezo 30 mg. I am having this problem for about four to five years. I am able to control flaking in the scalp by washing with shampoo but, it reoccurs after a day with hair loss. Can it be controlled? Or can it spread to other parts of the body? ### Response: Hi. I have gone through the query. Yes, it can be controlled with medications. But, unfortunately, you may experience frequent exacerbations due to stress or steroids or specific medicine or due to a sore throat. Mix one part of Betamethasone lotion with two part of an olive oil and apply it on the night. Do it three times a week and wash it in the morning" "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 follicles on legs from six months it is non-itchy and painless, and when I apply any cream Clop-G it becomes tiny, and after stopping the cream becomes as usual, and from six months, I saw a minor change in the increase or decrease in size. Please suggest what is this? And how I can clear this? ### Response: I understand your concern. It looks to me like lichen planus or vasculitis. But skin biopsy is required to confirm the diagnosis. For that, you need to visit a skin specialist in person. If you have lesions anywhere else on the body, send pictures of them too. Meanwhile, use the following medications. 1. Tacvido Forte 0.1 % (Tacrolimus) ointment apply twice a day for three weeks." "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 nephew is 3 and a half years old. He fell from the bed and hurt his nose around 7 or 8 months back. Now, as the doctors have said, his bone there is moving in the wrong direction, that is towards inside. What is the best course of action for him? Should he go under the knife? I am pleased for your advice. ### Response: Hi. He has got his nasal septal cartilage fractured and due to that there is misalignment of the septum.You need to consult an otorhinolaryngologist for evaluation or you may also go for plastic and reconstructive cosmetic surgeon for better results. It is not like going under the knife. It is very sophisticated procedure and is done with an endoscope and is very successfully done in a matter of minutes with minimum cut and patient can come home after 40 minutes of surgery." "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 46 year old female. I am suffering from extreme rage and irritability for the past two years. I am on Femilon for three months for adenomyosis and adenomyoma. I feel desperate. Please suggest some medication for my rage. ### Response: You can change the medication for adenomyosis. You can opt for Mirena insertion (levonorgestrel-releasing intrauterine device). It is a progesterone intrauterine device. It is a device that looks like and is inserted like a copper-T." "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 protruded mole on my leg (light color but it will become black if in contact with water), it lasts for about two or three years or more. I have no symptoms other than it will fall off as time pasts and grow back itself. I was wondering what would it be as I am worried if that is some kind of melanoma? ### Response: I have seen your query and examined your given picture. (attachment removed to protect patient identity). It seems you have developed seborrheic keratosis or a mole. Do you have this mole since birth? Nothing looks like melanoma. Shave excision with the histopathological examination is a good option in your case because it is curative and diagnostic both." "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 was 11 years old, I was knocked off my bike and cracked my front tooth in half horizontally, shortly after the dentist fixed it. Since then I have had no problems with it and had multiple x-rays to check on it. When it happened, the color of the tooth changed very slightly, to a very slightly more yellow shade than the rest of my teeth. I am curious to know what happened when the trauma occurred. Did my tooth die? What are they checking for when they x-ray the tooth? ### Response: Hello. I have been through your query and can understand your concern. Any trauma to the tooth generally has long-term consequences like tooth discoloration, etc. As you said that your tooth was fractured, it might have led to a slight injury to the pulp or even if not so, the fracture line would have been close to the pulp. In both cases, the pulp over time starts to become non-vital sometimes due to injury and sometimes due to the restorative material lying in close proximity to the pulp. This over time results in the discoloration of the tooth. The characteristic feature of this discoloration will be that only the involved tooth will be discolored and other teeth will be normal or not discolored. If that is the case, it generally means that the tooth is in the process of becoming non-vital till the tooth becomes slight brownish black which means the tooth is entirely non-vital. It is generally not associated with any kind of pain as the process is chronic and takes time to set in. I would advise you to have a visit to your nearest dentist. He would prescribe a vitality test of the tooth and also would get an x-ray for the tooth. By that way, he would come to know if the tooth is dead or still vital and accordingly will propose treatment. If the tooth is vital, he will put some medication over the pulp to let it heal and then fill with the pulp friendly restoration. However, if the tooth is dead, I would suggest you to go for the root canal treatment (after evaluating the condition of the tooth and soft tissue). Meanwhile, keep your oral hygiene good, brush twice daily and floss regularly. Use mouth rinses to clean the mouth after meals." "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 wearing braces for teeth alignment. I am towards the end of my treatment and have developed a high pitched sound in my right ear. I consulted with my orthodontist and temporarily removed the wires on two occasions. Both times, the ringing went down after some weeks. When I put on again, the sound started. One ENT I consulted said it could be an allergy to dust in the area I live in. Based on the information I received and the symptoms, I am not sure how to proceed. What is the cause of this issue? ### Response: Tinnitus due to braces is not possible. Tinnitus can be due to many reasons like hearing loss, or nerve loss, or any loud noise exposure, or trauma to the ear, or even nasal infection, or some medicines. Please tell me do you have any relevant history? Dental procedures that involve the use of dental burs can cause tinnitus but not just the braces. You should get pure tone audiometry done and follow up with the required information so that I can suggest you better." "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 68 years old with a weight of 76 kg and a height of 5 feet 9 inches. I had a bypass surgery seven years ago. I used to walk 45 minutes daily. I feel completely fit and fine. A week ago, I felt that my heart rhythm was irregular. After going through a Holter test, I found that my heart rate increases and slows down with a pause of 1.8 seconds. My minimal heart rate is 50 and the maximum is 144 BPM. My average heart rate is 89. Is there anything serious?More details about the presenting complaint include I rarely get a headache with no other symptoms. I am currently taking Razel Gold once a day. In the past, I have been on Concor 5 mg once a day and Razel Gold once a day. I have gone through TMT three to four months ago with a normal outcome. The doctor also did an echocardiogram and everything seemed normal. Please help. ### Response: Hello. I have gone through the first page of the Holter report (attachment removed to protect patient identity). You seem to have supraventricular tachycardia episodes likely atrial fibrillation or flutter. You have sinus pauses and sinus arrest suggesting sinus node dysfunction. You will need treatment for supraventricular tachycardia episodes like rate control medication and anticoagulation if it is atrial fibrillation. Your sinus node dysfunction currently does not require any treatment. Consult a cardiologist for starting treatment." "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 freckle about 3-4 mm on the side of my foot. It is not different from my skin in appearance. It just seems to be a brown blemish. I think, I have it for a number of years and now I am a bit anxious about what it could be. ### Response: Hi. The brown spot on your foot could be a mole or lentigine (attachment removed to protect patient identity) as it has been there for long. They are just harmless. You need not worry unless you have a change in its size and color or a family history of skin cancer. You may consult your dermatologist to magnify the spot and look for undesirable changes." "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 35 years old. My period was a month back. It sustained for four days. I generally use 3 to 4 pads in my periods. I had sex 10 days later. On the very next day, I had two Ovral G at around 9 AM and there after 12 hours again two Ovral G tablets. I noticed my period 12 days later, though it lasted for four days, the period was less and usually, my period happens four days earlier. In this month, it was six days earlier. I did hCG beta blood test. I am sending you the report. Can I be pregnant or conceive? Please advise because I want to abort. I am an unmarried woman. Can the blood test be wrong? What laboratory test I should do to get to know whether the fetus is there beyond uterus (ectopic pregnancy) as I m 35+. When should I go for ultrasound vagina testing to get the true picture? After that I did not have any sex, so then again can I be pregnant and that could not be detected now and can be detected on later? ### Response: The test result is <0.10 (attachment removed to protect patient identity) which means it is negative and you are not pregnant and your period was six days early this time. nothing else. Do not worry much. And if you still have doubt then do urine pregnancy test weekly for two weeks and if negative then there is no chance of pregnancy. Negative means a single line and positive means double line. You have to see the result within five minutes. No need to go for an ultrasound now. There is no pregnancy as Ovral G (Norgestrel and Ethinylestradiol) has worked this time." "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 hoping you can advise me. I have a mole on my chest that has been changing for about a month now. It is itchy at times and it has bled (small spots) as I am sure from the itching. I am worried it is skin cancer. Can you help? ### Response: From your description and given picture (attachment removed to protect patient identity), it seems you are having a mole or melanocytic nevus. They are considered benign melanomas and nothing actively needs to be done for them. If the mole shows a sudden increase in size, differential pigmentation, bleeding, irregular borders, etc., then you may go for a skin biopsy" "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 41-year-old female and have been diagnosed with viral conjunctivitis by a specialist. My eye health is otherwise perfect (had them checked out a week before this came on). After a few days, it spread to the other eye. I expect the first eye will heal first, even though the second eye is not as bad. One question is when the first eye heals, do I need to protect it from re-infection from the one that is still healing?Also, on the typical length of healing, I am not quite at two weeks yet (this is day 11 for the first eye), but the lack of improvement in my condition is becoming frustrating to me. Today the vision in the first eye is smudgy, and the vision in the second eye is better, but not perfect. The specialist was aware of the vision problems, and she said that it was normal (though I think they have worsened).I was told this could take weeks to heal, beyond the normal one or two. How many weeks are weeks generally? I was told I have a mild to moderate case, but all I know is that I have seen no real progress, and I think the virus might have even spread to one of my sinuses. My mental health is suffering from not knowing how long I am going to be cooped up, partially visually impaired and contagious. Am I impatient or should I have them looked at by a specialist again? ### Response: Hello. I reviewed your history. It seems from the history that you are having viral conjunctivitis involving both the eyes. Coming to your first question, viral conjunctivitis remains infective in the initial three to five days hence no need to worry about the reinfection from the one eye that is still healing. Usually, viral conjunctivitis follows a self-limiting course of 7 to 10 days. Since you are having vision problems in the eye, probably it has involved cornea resulting in viral keratoconjunctivitis. If it has involved the cornea, it takes about three to four weeks to heal. However, the involvement of cornea is not because of infection, but because of immunologically mediated reaction, hence it will resolve even without treatment. If possible, send a photo of the affected eye so that I can confirm the diagnosis and answer your question more accurately. I hope the information is helpful to 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 20 years old. My height is 6'4"", and weight is 205 lbs. I noticed three decent sized painless blisters, looking like bumps on the shaft of my penis. I had sex before two and a half week. I do feel like I masturbate a lot which I am hoping it is, but I am freaking out with it. ### Response: The bumps appear to be normal pimples (attachment removed to protect patient identity). Another possibility is an ingrown hair. Herpes vesicles could also be the possibility, but the chances are rare. Since the site is not common and I hope there is no discharge. If you have unprotected sex with any high-risk partner then you should go for test otherwise there is no need to get worried. Remain relaxed. I do not think this is due to an STD (sexually transmitted disease)." "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 29 year old female. Almost 15 to 20 days ago, I felt that my feet were cold as if they were frozen. I felt numbness in my left leg, and suddenly, I had double vision issues. I thought it was because of increase in my eye number, but I was wrong. I then went to an eye specialist, who told me that it is related to the brain. Then, I got an MRI done. I went to a neurologist, who told me to take Ecosprin. But, after taking one tablet, I feel numb and stuffy. There is no sensation in my lower part of the body starting from my stomach. I have attached my MRI and blood reports. Please assist. ### Response: Hi. I have seen all your reports (attachment removed to protect patient identity). Hope this helps. If there is any further query, feel free to ask" "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 chewing tobacco for the past few years. And I stopped it forever. But sometimes I have a little throbbing on my gums. And the color of my gums changed to black. Is this any serious disease? ### Response: It is good that you stopped chewing tobacco. For how many years you had a habit of tobacco chewing? And what was the frequency? At what site you used to keep the tobacco? Does the change of color of your gums is limited or it is generalized? Do you have any burning sensation over that site? Any loss of taste? Above all counter questions are necessary to rule out possibilities, so kindly answer so that we can come to the diagnosis and can plan treatment. I would like to see the images of your concern area that is your gums where you are noticing the change." "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: Looking for an opinion on tuberculosis skin test. Please answer if you have experience with PPD skin tests. I am 34 years old, former cigarette smoker. My friend got diagnosed with tuberculosis due to strong arthritis medications, and I have had some contact with him. I have attached images of my skin test below. ### Response: Hi. Montoux test, PPD test is a very non-specific test and does not give you any confirmation for tuberculosis. It is used as an adjuvant test for diagnosis and never as sole test. It is read after 48 hours of injection. You have not mentioned the duration. You have to measure its diameter. It should be less then 10 x 10 mm. I cannot measure it online but apparently it is negative for tuberculosis (attachment removed to protect patient identity)." "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 22 years old. I have been on the following antidepressants for two years. Morning: Modapex 50 one pill, Depakene, Lamotrigine 25 mg one pill. Night: Clozapex 25 mg half a pill, Mirtimash 30 g half a pill, Depakine Chrono 500 mg one pill, and Anafranil 75 mg half a pill.I used to take more but I stopped them over the past two years. For example, I used to take double the mentioned dose about nine months ago. I recovered from depression a couple of months ago. I started detoxing but with my doctor, the process was going way too slow and I have gained 45 kilograms over the past two years (25 in the past two months alone!) my muscles, my bones, and my joints started to hurt really bad because of my weight. Nothing works. I go to the gym every day, I workout but still I eat way too much because of the drugs and I cannot control it. My doctor does not want me to stop despite every hardship that I face and even refuses to decrease half a pill from the prescription. However, three weeks ago, I decided to cut all medications once and for all. I lost 7 kilograms, I stopped eating too much and just by cutting down the drugs I saved not less than 1800 calories per day. I started going to the gym more regularly. But here is the problem.Clozapex 25 and Mirtimash make me sleep and without them, I cannot sleep. No kidding, I have not slept in the past three weeks more than a maximum of 70 hours. Even those 70 hours, they are full of nightmares and I usually wake up after two hours with my mind confused and afraid and I cannot sleep back. I want to sleep. My eyes grew tired because I have been opening them for way too long. I do not want to give in and get back to the drugs because I am sick of them and I have had enough. I am not going back but I also want to sleep. Just a single continuous eight hours of sleep without any nightmares. I usually get nightmares that are very weird. I do not even know how to describe them. Mathematical problems and complicated solutions that are presented to me (in my sleep) and I keep thinking about them until my head hurts and I wake up freaked out. Please tell me what to do. I thought that after three weeks it would get easier but it is not getting easier. I have no side effects at all from any of the drugs only the disturbance of sleep. Some of them were written on them that if you would stop them suddenly you would risk getting seizures but nothing happened thankfully. I am not even depressed or sad I am just irritated and sad about the sleeping problem. ### Response: Hello. Because of stopping the medication you have a problem with sleep. You should try some sleep medication for a short time and then taper it. I suggest tablet Diazepam 5 mg before sleep. So, you must taper it within four to six weeks. Or you can try tablet Zolpidem 5 mg before sleep. It is a good medication but it is not so effective like Benzodiazepine. Zolpidem does not get you addicted. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Or you can try tablet Melatonin which is a normal nonprescription medication. You can get it online or over the counter. The non-pharmacological ways to sleep better are: Hope this will help 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 33 years old, male. I am diagnosed with right adhesive otitis with left SOM. Already mastoidectomy was done in right ear nine years back and two myringotomies in right ear when I was 4 and 7 years of age. I have CT scan report, audiometry, impedance test results. ### Response: Can you upload audiometry report? What are the complaints now? Is there discharge or hearing deficit? Any pain or giddiness? Nose CT seems fine (attachment removed to protect patient identity). Ear shows mastoiditis. Have they done an ear under microscope examination? If it is a clearly diagnosed adhesive otitis media supported by audiometry it will need surgery. But which ear to be done first will depend on audiometry. Is there any nasal complaints?" "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: Six months back while travelling in the bus, I got sharp pain in the chest. My heart started beating fast and I had sweat a lot. Then I rushed to the doctor. They carried out ecg, echo, tmt and also blood tests and all turned out to be normal. The doctor that it was anxiety and acidity. Still now I have some chest pain and backache. I am really worried that I might get heart attack or I might have fat deposition in my heart. Can you please go through my reports and advice. ### Response: I have gone through your query and reports (attachment removed to protect patient identity). Since the pain which happened in bus was not anginal, you must not worry. For your information, anxiety or excessive worry is itself a cause of heart attack. There is no test available with medical sciences which can predict occurrence of heart attack. You can only take precautions and having a healthy life style in place.These include avoiding smoking and alcohol, good control of blood pressure/ sugar/ cholesterol, daily exercise, maintaining optimal weight and avoiding stress." "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 nephew is a premature baby. On the third day, his blood glucose level was decreased to 34. Later, he was admitted and kept under surveillance. His blood test revealed elevated bilirubin level. Four days later, his blood values become normal. On the same day, suddenly there was swelling on his body. The biochemistry examination revealed urine spot protein to creatinine ratio 2.19 and moderate grade proteinuria. ### Response: Your baby probably has a problem with his kidneys. A urine spot protein to creatinine ratio of more than two usually suggests that your baby is losing a lot of protein through his kidneys called nephrotic range proteinuria. So, the swelling of the body might have appeared due to protein loss. But, a single value may not be significant, so get it tested once again. If it is still high, then you need to worry. If the repeat test value is high, and body swelling is persisting, then consult a pediatric nephrologist for further evaluation and treatment plan." "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: Why some men cannot grow full beards? Explain why some men are not capable of growing full beards, and can only manage thin, patchy ones. Is this due to testosterone and genetics or something more? How does not being able to grow a full beard potentially impact men psychologically? Can this be emasculating for men or cause issues with self-esteem? Is there anything patchy men can do? ### Response: Hi. Some men cannot grow full beards due to low density of hair follicles in beard area in them and that depends on their genes and hormones. Dihy" "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 sore throat on one side of my throat. But, after looking, it looks like a sore next to my throat on the roof of my mouth. What could it be? ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). It is oral stomatitis with pharyngitis. It can be due to smoking and alcohol infection. Certain investigations like Hb (hemoglobin), TLC (total leucocyte count), DLC (differential leucocyte count), and ESR (erythrocyte sedimentation rate) can be done. It can be treated by taking oral Vitamin B complex tablets with Chlorhexidine mouthwash. Avoid spicy foods and smoking." "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 32 years of age weighing 76 kg and my height is 5 feet 6 inches. I am unable to maintain erection. I have been experiencing this since a year. Prior to that, it was all fine and great.I have not had any other health issue and my BP, sugar levels, cholesterol are all normal. I exercise three to four times a week. I have attached my test reports for your reference. Please advise whether I can take Tadalafil tablets. ### Response: You can safely take tablet Tadalafil (10 mg or 20 mg) half an hour before sexual activity. It can be taken on alternate days if needed because the effect lasts for two days. You could also take tablet Tetrafol plus (combination of Levomefolate calcium, Pyridoxal 5-phosphate and Mecobalamin) one tablet daily for three months. It is helpful in erectile dysfunction." "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: Yesterday I had to have a frenuloplasty. I had to have a general anaesthetic. I woke up and never got any advice off the urologist because I never saw him after the procedure. The nurse who discharged me told me to take off the dressing in the morning and wash the wound and the foreskin twice daily. My concern is today I noticed my foreskin has become swollen and looks similar to a balloon. The stitches are preventing me from pulling my foreskin back over the glans. So, it has been retracted all this time. Is the swelling normal and due to the incision or is it not normal? Also, am I suppose to keep it pulled back or do I try to push it back over the glans? My glans is very sensitive. So, it feels like an electric shock every time I move. ### Response: Hello. You have very likely developed a paraphimosis. It would be more clear if you share a picture of the penis. You are supposed to keep the skin in front of glans. If it is painful to roll the skin over the glans, I suggest using Lignocaine gel and pull it front. After that, the swelling will slowly subside. If red discoloration also is present, then it can be a hematoma. Please share a picture. Revert with more information to a urologist 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 got a sudden heart pain. I took her to the hospital. After ECG And further processing, we came to know that she got ischemic heart disease and her two valves of the heart are closed. She has diabetes and blood pressure problems due to which atherosclerosis occurred three days ago. The doctor told him for angiography. Are angiography and stent good for her? Please also tell me about everything related to heart problems cure and heart diet. ### Response: An angiogram has to be done in your mother\s case to know the extent of the blocks. Also, since she has blocked valves as you said, open heart surgery and valve replacement will be an option for her rather than stenting. In terms of diet to prevent heart disease, it is useful to avoid excess fried foods and red meat. Lean meat like chicken and fish are beneficial. Cook food in oils like sunflower oil or groundnut oil rather than coconut oil. If she is diabetic, make sure the diabetic control is strict" "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: Recently, I have discovered a small lump on the right side of my neck. I am usually the person who starts worrying and gets paranoid whenever I discover something like this. I used to do it all the time with my glands. It feels like a gland, but it is slightly bigger and more tender than the other ones.Also, if you look hard enough, you can slightly see the shape on my neck. I have been run down lately, have a dry throat and I am also very warm. So, I might be coming down with something. I needed to hear from you doctor. Please let me know what you think as I am typically worrying. ### Response: Hello. Is it possible for you to upload a picture of your neck or for the fact any picture from the internet highlighting that area? It seems like it might be a swollen gland, which can happen even with common cold or flu. But, it is hard to confirm without a picture and exact location." "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 with a prostitute and not sure if she has HIV or not. However, I have used a condom as a protection. Now, do I need to do an HIV test to check? ### Response: Hello. I have noted your concern. Protected sex is safe and there is no risk of HIV (human immunodeficiency virus). Regards" "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 1.2 years old. We have recently moved to a new city, and ever since, he is not comfortable passing stool. His stools are hard and cause him pain. Apart from climate change, the water here is very hard. He takes baby food and homemade food, which we also consume. His height, weight, and head circumference are normal. ### Response: Hi. It is one of the common complaints we encounter from the parents. There is nothing to worry." "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 personal dermatitis. I was prescribed 12 weeks of 100 mg Doxycycline. However, I am skeptical about taking antibiotics as I have read that with a lot of people the rash returns upon finishing treatment. Also, it can mess up your gut which is apparently linked to perioral dermatitis. I have gone gluten, dairy and sugar free, started Probiotics, Zinc and Omega 3 supplements and the rash still persists. I also use Metro gel and also it helps my rash is still there. It is mild but is very annoying and sore. If I take antibiotics will it make things worse? Or should I go get allergy testing? I have also cut out flouride toothpaste and eliminated SLS. ### Response: You can skip Doxycycline, if you have gut problems and you cannot tolerate it. If you are suspecting that your perioral dermatitis is due to contact of any allergic material, then go for allergy testing. Otherwise it will not benefit you. I would like to know your work. Any allergy to known material and picture of your leison? You can use mild steroid preparation over it for relief." "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 seven teeth extracted today, just the roots. Anyway, over two of the teeth the dentist said there was an infection. I did not get any antibiotics, but she cleaned the area after. There is a lot of swelling in that area, and the gums are real red and like an ulcer. But not much pain. Is this normal? How do I know if it is infected or dry socket? Or anything else it could be? ### Response: I have seen the photos. (attachment removed to protect patient identity). Nothing to worry about. For the swelling give cold pack from the outside of the extraction area. Do not spit or rinse the mouth for a 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: im a 14 year old child . My concern is that i only have 24 set of teeth , 1 is growing at the back but i only have 13 baby teeth and 11 are permanent teeth . To be add on , i have doubling rows since three years back, and have gotten it out last year but it is still hasnt come back to its place because of the lack of space . My teeth are a mess , i want to get braces but i have so many baby teeth . I dont know what to do please help me ### Response: Now its turn to see where those impacted permanent tooths are present . Hopefully they will errupt a bit late , but they have no tendenxy to erupts they will be removed. If needed ortho treatment at 16 years of age (minimum) So for now Get to your Dentist get an Opg done and get all those baby tooths extracted. You can also upload the xray to me so I can assist you more. You are a good kid , donot worry ... am here to help you when even you need . Focus on your grades . Avoid too much sweet food or chochlates or sticky foods . Brush twice and donot forget to rinse. Your teeth will be fine dont worry . If possible upload the xray image for me to look at . Have a good 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 31 years old, male. My problem is when I am about to go to sleep then there is a sudden jerk. I asked my wife. I do not jerk while sleeping or in middle of sleep. It happens just when I am about to fall asleep. Suddenly a quick jerk. It happens for a couple of times then finally I go to sleep. It happens during the daytime also if after lunch I go for a nap, there is a sudden jerk when I am about to fall asleep. Once I sleep then no issues till I get up. A few months back I had this then it disappeared and now I am getting it again. CT brain was done a few months back. The report does not have it now. But it was normal. No abnormality. No diabetes, no thyroid. Normal LFT, KFT. I m taking medicine for BP. Nothing else as of now. Complete health check-up was done. I was alcoholic for a few years. If I drink and sleep, no issues. I also have a little bit of depression and anxiety due to business or work issues. Please help me out with it. ### Response: Yes, you are suffering from hypnic jerks only. This is not a disease. It is a behavioral issue. I have successfully treated my patients with hypnic jerk by following measures. To reduce caffeine intake and particularly in evening. You can discuss with your doctor to prescribe you Modafinil." "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: 1. Why we are getting frequent colds?2. What can be done to reduce the amount of colds we are getting? ### Response: There are several causes of getting frequent cold. Some of them are as follows. 1." "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 the first upper molar root canal treated 15 years ago. It has undergone two root canals treatment but does it seem incomplete? I did a CBCT and it shows a cyst and sinusitis although I have not that much pain. I am 41 and the dentist told me that I have bone resorption at the upper left maxillary region and I also have been recently diagnosed with Hashimoto thyroiditis. Should I get the tooth extracted? Should I try again for a new third root canal? What about periodontitis which is at the beginning? ### Response: Hello. At first, I appreciate you because you have so much awareness of your oral health. The life span of normal root canal treated tooth is 5 to 6 years. My opinion is you should go for extraction along with cyst removal because third-time root canal of the same tooth is not a good idea. Periodontitis is nothing but an infection of gum tissue which is totally curable and depends upon your oral hygiene. Bone resorption is a kind of bone loss due to demineralization. There are many things which are responsible for that like age factor, some diseases, calcium level, gingivitis with periodontitis is also a cause of bone loss." "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: This is in regards to my daughter who is 5 years old. Four days back suddenly she developed a fever. Fever was around 100 degrees F. Yesterday her fever subsided and now she does not have the same. She did not have a cough, cold, etc. But she lost appetite and she also had left eye white area red. The redness also has disappeared now. She did complain of a little bit of nausea and headache. But yesterday everything subsided and she recovered well. But, yesterday night we saw red bumps around her face, forehead and chest area. It itches sometimes. I am attaching the image for your reference. These bumps are slightly raised. Rest she seems fine now. Her appetite has increased as well.On the second day of her fever, she fainted briefly (a little bit of saliva came out from her mouth) for 5 to 10 seconds. She recovered quickly in a minute or two. This happened in the early morning when she woke up and stood. She had moderately high fever throughout the night. ### Response: It is urticaria. In your daughter's case, that patient may develop this kind of rashes. It will need 5 to 7 days antihistaminics. Tablet Xyzal 5 mg daily for seven days. It is safe and does not have any major or common side effects. It will be fine in 1 to 2 doses but stop it after 5 to 7 days later. As the baby is otherwise fine, no need of other investigations at this moment. But I would like to highlight a point to you that, the possibility of recurrent episodes may be there in future. Whenever it happens you may take Xyzal (Levocetirizine) in an emergency but consult the doctor too without much delay" "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 tore off a mole or a freckle some weeks ago and now the surface, it is like this. Is it good or should I worry? What are those red spots? ### Response: I have gone through your case. Your lesion is active which means the area has not healed after removing your mole (attachment removed to protect patient identity). Keep applying Fucidin acid cream two times a day till red area disappears. It is not something to be worried for as such raw areas take some time to recover. But no opinion can be given for lesion or mole or freckle which you have removed yourself. It could be a simple mole or it could be a wart. Such raw areas are usually seen after wart scratching." "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 some irregularly textured skin on my face that are not even visible if you are not trying to find them. Are they scars or damaged pores? Also, I have been using Dapsone for a month now and have applied BP 205 and Adapalene 0.1 in the past. Can these cause such texture damage? And what is the red part (encircled), is it PIH or something else? Also does Adapalene 0.1 alond with Clindamycin 1 improves skin texture? ### Response: Hi. You have post inflammatory hyperpigmentation with minute acne scars that are very few (attachment removed to protect patient identity). For PIH (post-inflammatory hyperpigmentation) you can use Aziderm (Azelaic acid) 20 % gel in the morning. For acne scars, you can continue Adapalene 0.1 % gel at night. If you want you can go for chemical peeling and derma roller." "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 24 year old male. Last year, I had a few molluscum contagiosum in my lower abdomen. I took the treatment, and they were gone. After two to three months, I got one skin tag on the skin around my penis. I applied a lotion (Salicylic acid 16.7% and Lactic acid 16.7%), and the skin tag was removed. But, it came back after three months. Currently, I am suffering from genital warts and taking treatment.My doctor told me to get some test and here are the results. Lipid profile - triglycerides 125 mg/dL, HDL 35 mg/dL and LDL 113 mg/dL, CBC - lymphocyte 44%, serum amylase 121 IU/L, Helicobacter pylori IgA 0.45 (negative) and urine test - pus cells 3 to 4/HPF. Currently, I am taking these medicine as advised by my doctor. Zincolak one tablet twice daily, Zycolchin one tablet twice daily and Dicaris 150 mg one tablet once a day for three days.My question is that I am a healthy man with high immunity. I never get sick all around the year. How did I catch this infection? I have multiple sex partner, but I never had sex without a condom, or my condom never broke. Please give me a detailed answer and also give me advice for the treatment. ### Response: Warts and molluscum are common sexually acquired infections and can occur in healthy individuals. Warts spread by touch and condoms will only protect the covered area. Base of the penis, thighs, lower abdomen are all exposed. So, both warts and molluscum can be transmitted even with condom usage. For treatment, I suggest you Imiquimod 5% cream. Apply it over the affected area thrice a week and leave it overnight and wash in the morning. Use it for 16 weeks. Consult your specialist doctor, discuss with him or her and take treatment with consent. Also, you should get tested for HIV and hepatitis." "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 30 year old female, who weighs 130 lbs and 5.3 feet tall. For about 12 days, I have had consistent pain in the outer side of my breast up through my armpit. I have a tingling and slightly numb feeling in my left arm. I did not injure it, as far as I am aware. It started suddenly one morning. There is also a heaviness feeling in that whole area. When I look at the area, there is no physical change that I notice. I do not have lumps in breast or armpit that I could find. ### Response: I need to know few more details about your problem: Kindly get back with following answers, so that I can help you better. Revert with more information 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: My penis foreskin does not open softly. If I try opening, I feel pain. Please help. ### Response: Hi. You are suffering from paraphimosis. This is a condition in which the foreskin gets trapped behind the glans penis (head of the penis) and does not return back to its original position when pulled. This induces pain. You need a surgical correction and release. Otherwise, you may have to face problems in your sexual life." "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 30 year old male. I got married a year back. My problem is low sexual drive. Are there any safe medicines to induce sexual desire? Also, my penis is circumcised. So, my penile glans are dry and insensitive. Is there any topical cream available to increase the sensitivity of my penis? Is L arginine cream effective? Please suggest some medicines without side effects. ### Response: You should answer a few questions so that I can help you better. Circumcision of the penis is a good thing, as you do not get diseases like phimosis (inability to retract the foreskin fully over the glans penis) and penis cancer." "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: Dear Doctor,I have been suffering from throat pain, headache, weakness and sickness since last 2 days.Age-21 years/ female. Give me advice. ### Response: Hi,From your query, I understood that you have simple viral infection causing the Upper Respiratory Tract Infection (URTI). If there is no relief with this, you have to do blood test and urine test." "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 37-year-old male. My weight is 77.7 kg. I am facing erectile dysfunction problems. It has been going on for a few months now. I am consulting for the first time regarding my erection issue. ### Response: Hi. I hope you are doing well. Kindly let me know a little more information to guide you better. For how long you are having this complaint? Do you have a problem while masturbation or only during intercourse? Are you able to ejaculate and penetrate into the vagina? Are you a diabetic or hypertensive and on any medications? Do you consume alcohol or smoke?" "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 know a patient who is having hypertension. The doctor has prescribed Losalife H in the morning and Losalex 50 in the night. Is this an excess dose or is it normal? ### Response: It depends entirely on the extent of BP (blood pressure) elevation. Usually, most of the patients become well on once-daily dosing. But in some patients, we need twice daily dosing. So often, once daily is enough. But if the BP is not getting controlled or there is too high elevation say more than 190 mmHg, then we can give twice daily dosing. So the best option, in this case, is monitoring the BP at home using electronic BP apparatus and have the dosing accordingly. Let me know the BP readings if available so that I can suggest the treatment. So overall, if it is a need, a twice-daily dose can be taken." "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 spots on my hands that started about 10 days ago. I also have a couple of spots on my foot. They are mildly tender and itchy. They have gotten worse but not more that 8 to 10. I have no medical history and do not take any medications daily. I had a cut on my finger from opening a metal box a few days before onset. ### Response: I saw your pictures (attachment removed to protect patient identity). There are multiple erythematous (red) plaques and papules (bumps) on palms, sole, and wrist. Few lesions do look like target lesions" "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 19-year-old girl, weighing 151 pounds. I had gallbladder disease. I got to know three months back. The reports showed a thick-walled, non-functioning and sludge-filled gallbladder. The size of the gallbladder is 5.1\xc3\x972.2 mm. I got my tests done again last month and it says that the gallbladder is same sized, no stone or pericholecystic fluid. Currently, I am on homeopathic medicines. Previously, I used to have Nexum and Librax. I have also got my ultrasound done. ### Response: Hello. You had sludge in the gallbladder and now it is not seen. In gallbladder disease, symptoms are more important. So, if you do not have any symptoms then there is nothing to worry. But if you have symptoms, then I would like to repeat ultrasound after few months. Sludge is the initial form of a stone which means it can turn out to be a stone in future. So, kindly mention your symptoms" "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: Right arm joint upto the shoulder neck pain for the last few days it increased from yesterday evening having difficulty moving 490yrs Male ### Response: Hello, I read your concern. In my opinion it could be due to some nerve irritation following neck spasm due to facet joint irritation. Nothing to worry. As of now I would advise you to If irritation reduces, try to Maintain neck in mild arching by placing hand on the chin while lying down over stomach. Hold this for atleast 5 mins.. During this you should not experience any pain in shoulder.. There will be pain in the back of neck. Hope this is helpful for you Kindly revert back to me to let me know your status. Bad posture Facet joint arthropathy Wry neck Rice and mobilisation Avoid aggravating postures After a 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 having back pain. Six months ago I had S1 and L5 fusion. Normally, no surgery or anything. My doctor asked me to take rest. Then two months back I was again having pain in my back and no findings from my X-ray. Then I did an MRI four days back when I was having pain in my legs mainly in the thigh, calf, and foot. The pain is continuous. It is not resting for a minute, but the amount of pain varies sometimes a lot sometimes a little.I am 25 years old male. I was so active with all the sports activity and all, for last one year. After I bought my bike I stopped playing most of the sports, also the walking came down to below average because of the bike. Does the less walking have something to do with all that I am suffering? I had two to three accidents with my bike, but none of them were serious ones. I mean I did not get hurt badly. Just some scratches on my hand. So I am confused if the condition is done from a trauma. The doctors asked me to take one month rest and physiotherapy at this moment. Please suggest me what to do, I am really worried if it is sciatica or something even greater. I only want to heal the issue, recover from it completely even if that takes me one year or two. ### Response: Hi. Does the pain continue even when you lie down to sleep? Does the pain radiate to the legs? MRI report shows problems with the vertebrae (attachment removed to protect patient identity). But it would be better if you can get a second opinion for the vertebral pathology. Try tablet Lyrica (Pregabalin) 75 mg once daily for a month or so and tablet Diclofenac 50 mg one tablet for pain" "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: There is an area on my back that started as a rash and it has now spread and it continues to itch. What should I do? This has been there for approximately two months. I have attached photos for your reference. ### Response: I have noted your concern and I have viewed the image (attachment removed to protect patient identity). I can see several dark nodular lesions on the back. I would keep a possibility of nodular prurigo or hypertrophic lichen planus. I suggest you use a topical ultrapotent steroid either Clobetasol propionate 0.05% or Betamethasone dipropionate 0.05% or Halobetasol propionate 0.05% twice daily. In addition to that, you may take oral antihistamines like tablet Cetrizine (Cetirizine) 10 mg once daily for symptomatic relief from itching. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. Regards" "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 27 year old male. I masturbate twice a week. Recently, during masturbation, I felt some pain on the back side of my neck and head. Please help. ### Response: Masturbating two to three times a week is healthy unless you get addicted to the habit. This kind of pain or sprain happens due to increased blood flow to your penile region and vasoconstriction along with it. It resolves spontaneously once the excitation is over. This can be relieved by a little stretching after masturbation or by doing exercises for 30 minutes every day. There is nothing serious to worry about." "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 insomnia for a couple of weeks. These weeks are being the worst where I have sleepless nights. Last night, I took Trazadone 150 mg which was prescribed and slept. Then again after that, I went back to Trazadone 100 mg tonight along with Melatonin, but I did not get any sleep. Is there anything I can do tonight to get some sleep? How long does insomnia typically last? Am I at risk for anything fatal? Also, I am planning to go back to my GP later on. ### Response: Hi. First, we need to know the reason for insomnia. It is just insomnia, or it is due to depression or due to psychotic or due to a mood disorder. If there is any other underlying condition, then it is important to treat that condition. You can also follow some nonpharmacological way to manage your sleep problem" "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: Hi,I had unprotected intercourse with my partner a month back. I did not ejaculate inside her. Later to be sure, she did a home pregnancy test after 21 days, it came negative. Since yesterday, she is having vomiting sensation, not able to eat anything, light stomach cramps and light fever. She did pregnancy test today morning again; it came negative. We are confused and worried if she is pregnant. She has PCOD also. She had her last periods 45 days back. Do we have to go for a blood test? ### Response: The best way to rule out pregnancy conclusively is serum beta HCG (human chorionic gonadotropin) test if she has not had her menses yet. If the HCG levels are less than 3mIU/ml, then she is not pregnant for sure. The delay in menses is then likely to be due to PCOD (polycystic ovarian disease) itself" "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 hard lump in my mouth since yesterday. There is very little pain, but I am freaking out about this because I used to chew tobacco and smoke for three years but clean since last one year. So, please, can you confirm if I require a biopsy? ### Response: I understand your concern since it is a hard lump. If you are worried, you can visit your nearest dentist for a thorough checkup, before going for a biopsy. As of now, a biopsy is not advisable as it looks like an acute case. Revert with more information to 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 am 50 years old. My echo is normal with LVEF of 50% and dobutamine stress test negative for ischemia (LVEF of 58%). But, it shows a jerky septum? Is jerky septum a normal finding? ### Response: Hello. There are a few causes of jerky septum like bundle branch block, increased pressure in the right side of the heart, and disease in the pericardium. As your echo is normal, because of increased pressure on the right side of the heart, disease in pericardium is less likely. As you have not provided ECG (echocardiogram), I am unable to comment on bundle branch block. Still, a jerky septum in isolation is less likely to be pathological" "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 bottom tooth has a kind of a hole at the gum line. I do not know. When I breathe in, it feels cold like the air went in my tooth. It just does not seem or feel normal. Also, on my upper front tooth, I have some kind of deep line. Example like when you make a line in the sand and it flows into the line but it still stays. It is hard to explain. Is there any way I can fix this without going to the dentist? And yes, I do brush my teeth daily. ### Response: Hi. As per your history, you are having class 5 dental cavity in the lower tooth. You need to do filling (restoration) of the tooth as soon as possible. If you do not take measures at this time you may need RCT (root canal treatment) which will be 10 to 20 expensive and not as successful as filling. On your upper tooth, the line I understand is the gingival recession with abrasion, if you are right handed it must be on the left side or the side you keep your teeth brushing continuously. For this, you only need to use an ultrasoft toothbrush and check the video for modified Bass technique for tooth brushing. Also brush your teeth twice daily and keep the brush time of two to three minutes 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 am a 27-year-old male. I have had a mild burning sensation in the middle of the chest for the past few days and along with slight irritation in my throat. I also sometimes feel bloated and have slightly more than normal amount of burps. I have no cough or fever (checking temperature on a daily basis and highest is 98.6\xbaC). ### Response: Based on your history and symptoms you may be having gastroesophageal reflux disease (GERD). If the acid goes up to the throat area, it might cause thick mucus. In this case, this is classified as laryngopharyngeal reflux disease (LPR). You would need to take a different medication. I recommend you take Omeprazole 40 mg one tablet 30 minutes before breakfast for two to three weeks. I would also recommend you avoid oily, fatty, spicy, and dairy food. Avoid smoking and avoid lying down within one hour after eating. 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: My fiancee is B positive and myself O negative. In the future, will there be any complications in my pregnancy? ### Response: There would be no complications during the first pregnancy but may occur in the subsequent ones due to isoimmunization phenomenon. It is a problem which arises if the mother is having negative blood group and baby is having positive blood group. But treatments are available, so you have nothing to worry about it. I hope it has helped you. If you require any further queries, please do not hesitate to contact 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 30 year old brother has an arachnoid cyst displacing his hypoglossal nerve. He has no tongue problems, but he has epilepsy since the last 10 years. Due to his new medicine Epilive, he has hallucinations and nightmares. He generally takes only sodium valproate. ### Response: Hello. I read your query and reviewed the attached MRI report. I hope this answers you. Feel free to write back to me if you have more questions." "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: Hello,My 15 year old son has nightfall once a month and the quantity is very less, may be three to four drops. Is this normal at this age? Please suggest. ### Response: Hello. Having a nightfall is normal. At this age, adoloscents often engage in masturbation which could have caused it. But even if this is true, you should not be worried as there is no defined frequency or semen quantity, especially during adolescent years. I hope this answers your query. Feel free to contact me in case you require further clarification." "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: Please see the full mouth X-ray that I have uploaded and see if everything is all right or if not, what are the recommendations. I had a root canal on two left sides lower teeth two years back, which along with the cap is visible in the X-ray. ### Response: I am sorry to inform you that there seems to be mild to moderate infection near the root of the lower left first molar. It is better to go for systemic as well as some local or topical antibiotic (gel) and see the regression in three to five days. The other options include repeating the root canal treatment or extraction. (Let us not hope this does not happen). Rest of the teeth appear fine in the x-ray, except for some incipient caries, that need to be examined, diagnosed, and treated clinically. I hope it 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 32-year-old single male. In the past, I have experimented with using non-deglycyrrhizinated licorice to reduce my libido and make single life more manageable. I have hereditary low blood pressure so that the side effect was not an issue for me. However, after a few days of use, the licorice causes me to develop muscle aches all over my body. Which I assume are due to the reduced potassium levels from the licorice. Is there a better alternative to the licorice? Or a way to prevent the loss of potassium so I can use it for more than a few days at a time? No matter what I ate, (bananas, avocados, apricots), it did not seem to be enough. ### Response: I can understand your concern. Non-deglycyrrhizinated licorice contains Glycyrrhizin which has some side-effects like hypertension, hypokalaemia, reduces testosterone, edema, etc., as you mentioned well. Muscle cramps and aches are most probably due to hypokalaemia. To fulfill the requirements of potassium you can take a banana, avocado, orange, lemon, apricots, etc. An alternative to non-deglycyrrhizinated licorice, you can take mint, flex seed, popcorn and soda. They normally reduce the testosterone level and make men libido." "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 getting itching in the area where I wear my undergarments. I tried many medicines for fungal infection, but it does not go away. It has been there for more than a year. It keeps recurring. Currently, I am applying Miconazole cream and Clotrimazole powder. Please help. ### Response: Hi. Itraconazole is a good" "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 ferritin level is 1500, and I want to bring it down to 150. How much will one DFO IV session or each Exjade pill reduce the ferritin level on an average? I am a healthy individual, and I do not have HIV, HCC, or any other disease. ### Response: Your serum ferritin is high, so the cause should be found out first. Hope this will help 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 wife, who is 41 years old, developed lumps in her breast a few months back. She consulted a doctor and was suggested to take Vitamin E tablets and asked to undergo mammogram and FNAC. The test results are enclosed. The doctor told us nothing to worry since the lumps are benign and the lumps have now completely disappeared. But, the report says further tests may be done. My wife does not want to undergo any more tests. Can we conclude that it is safe based on the reports? She had a similar problem about eight to nine years back and at that time also another doctor gave her Vitamin E tablets and the lumps disappeared. No tests were conducted that time. Please advise. ### Response: Hi. I have seen your reports (attachment removed to protect patient identity)." "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 is 32 years old. We have a 5 month old baby girl. My wife is still feeding our baby. From yesterday, my wife has a fever, cold and throat infection. Can she take Paracetamol? Will it affect baby in any way? My wife\s temperature is 99.5 degrees Fahrenheit. ### Response: Hi. First of all, temperature above 100 degrees Fahrenheit is regarded as fever and not below that. Baby is supposed to be breastfed at all times. However, if the mother is suffering from a disease, it is advised for her to wear a mask and feed. Because, that is the route by which infection from the mother can be passed on to the baby and not through milk. Paracetamol taken by the mother in the prescribed doses will not harm the baby." "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 is wearing spectacles. She is going to undergo lasik surgery next week. She suffers from thyroid. Is it comfortable for her to go for lasik surgery for eyes? Will the eyes get swelled after lasik surgery? Please suggest. ### Response: Your partner has thyroid disease and has opted for lasik surgery. Usually, the healing and remodeling time for the cornea is three months at maximum. So she can recover soon. Just like other surgical procedures, lasik also have a few shortcomings. I will try to explain it. The severity of the problem can vary depending on the pre-operative status of the patient, and most patients require lubricant eye" "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 unprotected sex with my husband a month back and my LMP five days before that. I took Plan B pill within 10 hours of intercourse. My cycle is usually 25 days and I have not got periods yet. I tested 10 times, all were negative. Should I go to gynecologist and request for an ultrasound? Will ultrasound detect early pregnancy? ### Response: Hi. I can understand your concern. The possibility of pregnancy is very less and the possibility of hormonal imbalance is more likely. Please let me know. Do you have any other symptoms like breast tenderness, abdominal pain or fullness? Have you taken Plan B before? In my opinion, you should wait for 1 to 2 weeks more before going to the gynecologist for an ultrasound. Please reply me with answers to the above-asked questions, so that I can guide you better. I will be happy to help 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: Dear doctor,I have recently had a baby. I experience sore, stiff hands in the morning, swelling, hard bumps on the elbow. There is a history of rheumatoid arthritis in my family. Blood work is negative. Should I go to a rheumatologist? ### Response: From your history, it seems that you are suffering fromrheumatoid arthritis. This is more in females, having morning stiffness of the joint and improve during the day and presence of nodules over bony prominences. Yes, you need to go to a rheumatologist for proper evaluation and regular follow up. It is an autoimmune disorder which will affect various organs of the body at various stages. If there is a delay in starting with the treatment, it can cause a restriction of movements of the joints, and involvement of other organs also. Investigations to be done are CBC (complete blood count), LFT (liver function test), RFT (renal function test), X-ray, RF (rheumatoid factor), ANA (antinuclear antibody), HIV (human immunodeficiency virus), HBsAg (hepatitis B surface antigen), Anti HCV (anti-hepatitis C virus), TFT (thyroid function test)." "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 44-year-old male with a BMI of 26. During a recent health checkup of blood and urine, the following readings were observed. I have mentioned only the ones who have the higher readings. Protein 1+ detected in dipstick, serum uric acid at 9.2 mg/dL, MPV at 12.5 fL, FBS at 112 mg/dL, HbA1c at 5.5, cholesterol at 227 mg/dL, triglycerides at 181 mg/dL, VLDL is at 36.2 mg/dL, ALT/SGPT at 48 U/L. Serum creatinine at 1.23, increased from 0.99 tested six months back. Other than this, all others were normal. I also have been infected with hepatitis B twice and vaccinated for hepatitis B. I have been a diabetic for more than two years. The HbA1c vary between 5.5 and 6.5. The first one was done two years ago. I also have hypertension for more than five years. It is not very much under control. It varies from 135/80 to 150/100 and now it has reduced a bit to 140/90. I met my general physician who advised me to check my albumin to creatinine ratio. I tested it four times. The results are as follows: 55 ug/mg, 150 mg/g, 11.4 ug/mg, 37.5 mg/g. My ultrasonogram revealed fatty liver and cystitis. All the rest is fine. My ECG was fine. I have been advised to have a urine culture. My current medications are Telma-AM 40, Dynaglipt, Ecosprin AV 75, Levofloxacin, and CTD 12.5 mg. I am not able to understand why my albumin levels are so high and I would like to know how and when can they be rectified. I have attached reports for your further reference. ### Response: I have seen all your reports (attachment removed to protect patient identity). I hope I have cleared your doubts" "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: You were wonderful in allaying some health anxiety over some skin issues several months ago. So, I thought I would consult with you on another question pertaining to my son. Unfortunately, a combination of my health anxiety and the big mistake of searching online has my mind imagining the worst with regard to my son. My son is 19 years old and has no diagnosed medical issues. I noticed back when he was about eight or ten years old that he had a mark resembling a cafe au lait mark on his back, in the upper shoulder area. I had always asked the pediatrician to look at it during his yearly physicals, and they made nothing of it. Throughout the years it has grown a bit and has become darker and more rough in texture. It is probably slightly less than an inch in length and looks like a few small lesions grouped together. Again, I have brought it to the pediatrician\s attention and he was not concerned. Three months ago, I made an appointment for him and my other son with a dermatologist for a skin exam, and I pointed out the spots which I wanted to be checked in particular. We met with the physician\s assistant there, and my younger son had a peculiar spot I pointed out, of which the PA conducted a shave biopsy, which came back as a mildly atypical junctional nevus. For my older son, I pointed out the spot on his back/shoulder, and the PA diagnosed it as a linear epidermal nevus. She said the chances of it becoming dangerous are slim to none. It may darken throughout the years, and they will simply monitor it at yearly visits. Unfortunately, I went on to research online about epidermal nevi and of course I ran into information showing a possible link to epidermal nevus syndrome and all of its associated neurological and skeletal defects. As I said, he is 19 and has no medical issues, is extremely intelligent, etc. In your opinion, is it safe to say that I should not be concerned about those syndromes? I presume it is primarily related to the numerous and systemic epidermal nevi, which he does not have, and I would think it would have presented by now? And my last even more neurotic question. My online research led me to some information saying that a certain type of epidermal nevus could be related to a gene mutation that could be passed along to an offspring, with them having possible serious skin scaling conditions, etc. Again, he has just one solitary small epidermal nevus. No biopsy was done, as the PA did not feel it was necessary. ### Response: A solitary epidermal nevus is very common and does not pose any kind of serious health concern. Neither is a biopsy required. You are right. Any associated symptom should have been present since birth or early childhood in this case. Even if it is passed on to the future generations, it is harmless. A yearly medical examination is more than enough for the nevi in both your kids. Good luck." "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: Every night around 2-3 AM, any thought that crosses my mind makes me overthink about it. I am worried about such things that do not have a fixed solution. It may or may not happen. I\ve tried listening to meditating sounds, calming sound during that time but to no avail. After an hour or two I do get normal but then I am so full of energy that I cannot fall asleep so I get up and start some work. (I am a freelancer working from home).I usually cannot sleep until my head feels heavy, eyes start closing and I start dozing off while working. For a few weeks, I have been sleeping in the afternoon or evening for three to five hours only. Rest of the time I am either thinking or working. Sometimes if I cannot stop thinking I smoke around two to three cigarettes to get over it. It does not help me sleep but helps me focus on work more and overthinking stops quite instantly. ### Response: Hello. Your blood report is absolutely normal (attachment removed to protect patient identity) and I do not think there is anything alarming. Yes, your lipid profile is deranged and if you are overweight then try to reduce weight. At your age, it is not common to see raised cholesterol. Regarding the issues you have during sleep, in my opinion, this is probably occurring due to anxiety. You should seek a psychiatrist consultation for treatment. Improve your sleep hygiene and this will improve the symptoms. Avoid giving attention to minor things. Take a high protein diet and complex carbs and low in fats. 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: My sister is 23 years old. She had unhygienic sex a couple of weeks ago. She started feeling itchy on her vagina. I am worried it might be herpes but I need confirmation from a specialist before we visit the doctor. It looks clustered and yellow. No hard lump under and it just looks inflamed. She does not complain of pain anywhere else. There is no pain inside the urethra, no burning sensation while urinating and the discharge is whitish-yellowish and watery. She does not have any sign of fever. She bought labia herpes cream yesterday. After application it changed the color today to darker yellow and some of it fell off. What could this be? ### Response: Hi. I have reviewed the attached photographs (attachment removed to protect patient identity). The closely grouped fluid filled blisters and yellow crusted lesions seem to be most likely herpes infection. You do not have to apply Acyclovir cream as it will not be much effective in genital herpes. You should start with oral antiviral like tablet Acyclovir 400 mg thrice daily for a week and apply topical antibiotic like Mupirocin cream on the lesions twice daily. Do not use soap over the affected areas and wash only with plain water. Caused by herpes virus; either HSV1 or HSV2 (herpes simplex virus 1 or 2). Herpes genitalis. Avoid intercourse till the healing of lesions." "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 suffering from breathing issues for about two months. At that time, I was coming off Duloxetine HCl. I was also having weird headaches, but that has subsided. I have been to several doctors and had blood work, oxygen level test and pulmonary test. Everything came back normal. With my breathing, I have the constant urge to take a deep breath in hopes of getting that satisfying deep sigh. I am constantly thinking about my breathing, even when I sleep. I am still able to exercise vigorously, run long distances, etc., with no problems. My fear is that I am experiencing diaphragm weakness as a result of something neurological. Here are my questions. I have been placed on anxiety medicines, which have helped to keep me sane. What is your expert opinion? Does this sound like diaphragm weakness? Would I be able to exercise vigorously if my breathing muscles were weakening? ### Response: We are here to help you. I have some questions that you need to answer. Revert back with the answers to the above questions to a pulmonologist 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 PAD before 20 years and I am able to maintain my body by exercising. When I get tensed, it comes back. Again, I have to begin exercising and gradually it gets better. This time, I had a bout of depression and I am not able to do exercise, so, it has taken longer time than usual to get the results. Now, with new blood-thinning medicines and exercise, I am starting to see good results. The doctor wants to do an angiogram next month, after that stents or surgery on my lower legs. I have two stents near my heart. One was placed, when I had an infarction 19 years ago and another one was placed after eight years. They seem to be good and I am afraid of another procedure. Now, I am willing to get a second opinion about this condition. ### Response: It is very good to know that you are doing well with medications and exercise. The development of collateral blood supply in the lower limbs is a good option. You could discuss this with your doctor and postpone angiogram and stenting. However, it is important to realize that collateral vessels are small and do not provide the same amount of blood, as the normal vessels do. Besides, peripheral angiography and stenting are safe procedures. So, I would advise angiography to see the state of the blood vessels and collaterals and then, you can decide for stenting" "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: Sometimes, when I am doing stuff, my vision makes it seem like there is a white haze, like heaven, I guess. Like everything has a white haze light. It is pure not like fog or a dirty color. Sometimes it lasts a few minutes, other times a few seconds. Sometimes I see it, other times weeks pass without seeing it. ### Response: Hello. There are a number of causes which could lead to such a problem. Retinal detachment can cause flashes of light which come and go in an instant especially on eye movements." "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 previously been on syphilis treatment and it healed but yet I had unprotected sex with a lady and she has a vaginal yeast infection and I am starting to see a straight like a bump on the tip of my penis and am also having difficulty swallowing. Then I found white thick stuff at the back of my tongue. Is it candida? ### Response: I read your complaints. It looks like you been having some fungal infection in the tongue which comes only when your immune system is a bit compromised. It also seems that you had been on treatment for syphilis. I want you to know that in syphilis the treatment depends on what stage you have at present. I saw that picture that the lesion on your penis looks like it is asymptomatic so you could be in primary syphilis (attachment removed to protect patient identity). I need to see your complete blood count analysis, your basic blood test analysis so with that I will be able to answer your question better in regards to the treatment of your tongue related lesion. I want you to take Fluconazole 200 milligrams one tablet followed by 150 milligrams once a day for 10 days. I want you to get me the latest blood test reports and any other blood test reports in regards to your health conditions." "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 ringworm on my leg and the upper side of my penis from one month. I have taken antibiotics like Terfaze. Please help. ### Response: Kindly send image and revert back. Without clinical photographs, medications cannot be advised" "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 63 year old male. I had polio affected right leg, but have been leading a normal life since then. Recently, I developed pain in the right thigh joint, but able to walk normally. In some positions, it is painful. I have got my MRI study of the hip joint. The report is enclosed herewith. The doctor has suggested physiotherapy IFT and IPT for 10 days and put on medication for seven days. As I am working, he advised 10 days rest. The medicines are Tolagin 4 mg X1 for seven days, Miofree 8 mg once daily for seven days and Pantodac 40 mg twice daily for seven days. ### Response: Hello. I would have been in a better position to answer your query if I had seen the plain x-ray of pelvis films and MRI films rather than just a report." "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, who is in the first trimester of her pregnancy, slipped on our son\s baseball in our garage yesterday and fell. She landed on some workout equipment, which hurt her stomach at a 45o angle at the mid bottom section. She is still in pain, and now she has a bleeding with a discharge of mucus-like blood chunks. She has never bled before with our first child, and I am in need of some immediate guidance. ### Response: From your description, it appears that there is a cause for concern. It sounds like a threatened abortion to me. You will need to rush her to an obstetrician as soon as possible, to get a scan done, and see the viability of the fetus. Hope everything goes fine and God be with 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 baby daughter is 2 years 5 months old. Weight is 12 kg. Her molar teeth is coming on both left and right side. She is have swollen gum. She is suffering from pain. She always show her finger towards teeth. Also her mouth is also giving very bad smell. Please suggest some medicine doctor. ### Response: Hi. Kindly answer the following questions for a better understanding. Is she having fever as well, if yes how severe because it may probably be infected and may need an antibiotic course." "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 problem with a frequent cough, cold, fatigue, etc. I started taking Chyawanprash and Maha Sudarshana churna in the morning and Chyawanprash and Triphala powder at night. After 1 month of usage, I feel quite better. Further, I also have fatigue, insomnia, and stress. So, I am planning to include Ashwagandha and Brahmi also in my daily intake. Can you please suggest if I can take Chyawanprash, Maha Sudarshana churna, Triphala, Ashwagandha and Brahmi every day? ### Response: I just read your query. Chawyanprash and Maha Sudarshan churan are very good for your problems like cough and cold. You can take Chawyanprash regularly for three to four months. As it is good for increasing immunity, you can continue it. You have already taken Sudarshan churan for one month. Try not to take it for too long, because you cannot depend on medication completely. As you have other problems like insomnia, stress, fatigue, low stamina, etc. you can take Ashwagandha and Brahmi daily. Take the medicines as follows: Try all these things regularly and you will soon feel positive results. I hope you are satisfied with my answer. Follow up after three weeks" "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 25-year-old male. My bpm is 31 during physical and mental exhaustion but my bpm is high of about 178 during hyperventilation and has pointless frustration. My bpm from rest to stand increases by at least 30 points but averages a 50 point increase. My resting bpm is 40, and upon standing it increases to 90 and peaks up to 110.I had done an echo cardiogram and EKG. I feel light-headed upon standing, along with sudden pulsation, headache and muscle spasms. I feel blackout, syncope, and fainting. I had spontaneous jolt, breathless, palpitations, flutters, fatigue, chills and skin rash on the back of hands.My mental disturbances include confusion, inability to maintain thoughts. I also feel pointless random irritability, ankle pain, random lapse of balance, throbbing extremities, vibrating vision, burning sensation, social anxiety, depression, irritating bowl movements, no appetite and chest discomfort.I wast told to mention the possibility of autonomic dysfunction as its often times overlooked. ### Response: Hello. The symptoms you have been suffering from seem to point to a number of possibilities. Since your ECG and echo tests are normal, I would advise you to get some blood work done like, a serum electrolytes test to see if there is any hyponatremia or hyperkalemia. Also a urine test for 24 hours urinary collection of catecholamines. Both of these tests would indicate a disorder of the a" "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 33 year old female. I have never smoked. I am not overweight and I do not have diabetes. I have been having some left leg issues. It started six months back. I started limping because my left calf, ankle and groin were hurting. My emergency Doppler venous ultrasound was clear. I had a D-dimer and that was negative. I had an MRI of my left ankle that showed a talofibular ligament sprain on my left ankle. I also had an arterial Doppler ultrasound that showed decreased flow of left anterior tibial artery and increased peak systolic velocity in the left common femoral artery. But, there was no stenosis, no sclerosis and no plaque. Could the sprain have caused that decreased flow? After three months, it became normal again. Then, while having pedicure the woman massaged my ankle and leg. Since then the pain has returned to my left ankle and left leg. I had another D-dimer done three weeks ago that was negative. I have also recently started experiencing cold left foot and a left cold lower leg at night. By morning, both the legs as well as the feet are of the same temperature. I do get pain in the buttocks and the pain is going down my leg like a sciatic pain on the left leg. Do I have peripheral artery disease? Could a blood clot be causing it? I have a four hours flight next week and I am worried about flying. Is it safe to fly? Would the arterial Doppler and D-dimer be able to tell if I have a blood clot in my artery? Or is a D-dimer just for the veins? My LDL was 10 points above normal in my last blood test. But, my doctor did not seem to be concerned as my HDL was high. I have attached the reports for your reference. Please help me. ### Response: From your description, I understand that the first time you had a problem with your left leg was due to a sprain (talofibular ligament) around the ankle and it got resolved. I suspect the same problem or something similar is causing you the pain again. It is highly unlikely for a 33 year old lady and a non-smoker to have a peripheral vascular disease. The arterial Doppler did show a decreased blood flow, but it might be due to a temporary spasm of the vessel than any specific pathology or disease. Moreover, no clot was found nor was there any change suggesting peripheral vascular disease. It is absolutely safe to fly and you need not worry about it. An arterial Doppler will be able to make out if you have a clot. D-dimer test is only for the veins and is not useful in arterial disease. I suggest you to look for causes either in your footwear or any strain which you have put repeatedly on your ankle causing repeated sprain in the left ankle. You can get an orthopedic consultation to be sure of the same. If he or she does not find any problem and your pain persists even after appropriate treatment then further evaluation can be done by a vascular surgeon. But, I do feel you may not require 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 fiance is so obsessed with getting pregnant, she is 17 years old, and she does not want me to touch her in any way. She does not want to touch herself, and she washes her hands a lot. She is scared of everything like she thinks she can get pregnant somehow. Pleases help. ### Response: Hello. Maybe your fiance is suffering from obsessive-compulsive disorder. There is an obsessive fear of getting pregnant, which is arising out of this illness. Repeated handwashing is also a type of compulsive act results from obsession. It would be in her best interest if you can contact a local psychiatrist get her evaluated to confirm the diagnosis and start the treatment. Any delay in diagnosing and starting the medication would make an illness resistant. If you have any other questions and queries, you can always contact 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 mother is suffering from chronic kidney disease, and her creatinine level is 9.8 mg/dL. She has a history of diabetes for the past 25 years. She is taking Insulin from the beginning. She has hypertension for the past 35 years. Her hemoglobin is about 11.0 gm/dL. Her eyesight has been damaged before four years now. Her urine output is seven to eight times (volume is 1 to 1.5 liters within 24 hours). Can she avoid dialysis and reduced creatinine level? Please help. ### Response: I have reviewed your query. There are specific indications for dialysis in patients with chronic kidney disease. They include low creatinine clearance, high potassium, patient becoming acidotic, symptoms of uremia (increased urea in the blood), loss of appetite, uremic heart problems and accumulation of fluid in body parts like feet causing edema and lungs causing shortness of breath. Even if your mother is not experiencing any of the above symptoms, depending on her history of chronic diabetes and levels of creatinine clearance, (I could not calculate exact creatinine clearance for your mother as you have not mentioned her weight, but taking an average female weight of 60 kilograms, your mother\s creatinine clearance is very low), she might be considered for dialysis, which can be confirmed by a few other tests and examination done by your physician. Postponing the dialysis when she needs, it will make her worse. Though she is producing a decent amount of urine per day, she might still be at risk of various uremic complications based on her creatinine values. Get checked with your physician, and it is better to go on for dialysis if your physician advice to do 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: I am a 46 year old male. I have been having recurring otitis media every year since three years. I was treated with various courses of antibiotics. Amoxicillin is already resistant. So Cefpodoxime and recently Cefuroxime is being used for treatment. I would like to know if there is any permanent solution to cure otitis media as I have also heard it could cause meningitis. I am having another bout right now with my left ear drum is inflamed and this time Cefpodoxime cannot clear it. So, the specialist has put me on Cefuroxime. I am still on this course of antibiotics. I have back aches, cough with phlegm with low-grade fever and feel generally lethargic. I also have high-pitched tinnitus which is very loud. Can you please tell me if I can take a treatment where this issued can be fully resolved? ### Response: Hello. Taking antibiotics is not the solution to the problem." "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: From past one month, I am suffering from chest pain, left arm pain, jaw pain, shortness of breath, sweating and weakness. Day by day, it is worsening and my fear is also increasing day by day. I am 19 years old with no bad habit and with a healthy diet and BMI. I used to go to the gym but due to this problem, I am not able to do all my activities. Recently, I had ECG, echo and stress test and blood tests all tests were normal but after 15 minutes of stress test I had chest pain five minutes and sweating for 20 minutes. My resting heart beat has also decreased. I was in anxiety two years back but my ECG at that time was better than this time. ### Response: I noted your symptoms and reports (attachment removed to protect patient identity). Frankly, they are all normal. I would like to suggest the following medicines and to see if the problem persists. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Please inform your blood pressure. Good 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 have had pain recently in a tooth that has a hole in it for several months and the pain has been horrible and a couple of days back, I woke up with swollen cheek on the side of my bad tooth and pain is also there. When I touch my cheek, pain shoots down to my tooth and I do not know what this means. ### Response: I have gone through your question and I can understand your concern. As per your history, it seems to me that you are having acute apical periodontitis with related buccal space infection. You need antibiotics for at least five days, so have non-steroidal anti-inflammatory medication. In case you want me to prescribe proper dosage, upload your picture of the swollen face so that I know the severity, and also your weight and height too. Or, you can visit a dentist physically but do not avoid it as the space infection can be dangerous too." "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 is suffering from hypothyroidism and was having thyroxine 137.5 mg for the past four months but on his own started 125 mg from the past two months.Report readings:T3 - 1.04.T4 - 12.60.TSH - 0.11.He is a diabetic and even had angioplasty done. Please suggest the best for him. ### Response: I read your query and from what you have mentioned it appears that your father has overcorrected his thyroid. He must take 100 mcg Thyroxine only. Repeat his thyroid test after three months, only TSH (thyroid-stimulating hormone). His diabetes is not controlled. I would like to know his medications name, dose, and times per day. He has some urine infection. Likely because of high blood sugar, once sugar gets controlled, the infection will resolve. Please do not change the dose of Thyroxine on your own as it can be risky in patients with heart disease like your father. 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 pain in my tooth. After the x-ray, the dentist said it is ok. But I still cannot chew food and drinks are painful. Kindly suggest me a second opinion. ### Response: Hello. As I can see in x-ray, (attachment removed to protect patient identity) nothing serious. But one thing I noticed a space between fifth, and sixth tooth and the space between the sixth and seventh tooth are wider than usual. I think there may be food lodgment occurred and you feel pain. I suggest you, please go for a professional dental cleaning and follow oral hygiene instructions. Use floss and interdental brush in that area." "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 ear pain going all the way down to my foot. I also have vertigo and tinnitus. It has been two years. I feel constant pressure around ear and nerve twitches in whole body. Please help. ### Response: I understand your problem. As you say you have radiating ear pain along with pressure around the ear and vertigo and tinnitus. There can be many reasons to this. Have you got any checkup done? If not I feel right away you will need the following investigations: Based on the results of these two investigations, I can further guide you as to need for any more tests or treatment. Meanwhile, I will suggest you the following medicines: If symptoms does not resolve; you may need a neurologist\s opinion as well. However, as of now get the above tests done. Revert back after the tests to 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: My fiance got sickle cell SD. He is 27 and does not suffer from anything else. He takes medication and changes blood every 4 to 6 months. My question is does it affect his life expectancy? ### Response: Usually, in sickle cell anemia, blood transfusion is not needed. The prognosis depends on the severity of sickle cell. So it is better to avoid them and whenever having such incident, consult a doctor immediately. Sickle cell anemia patient\s median age can be considered between 50 to 60 years but still, the exact specific prognosis cannot be predicted." "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 pure vegetarian. I have been hitting the gym on a regular basis during morning hours. I could feel the change in me but not the kind of lean body which I am looking for. I am a foodie and I love to eat everything which is vegetarian. Lots of fat is accumulated in my face and stomach rather than the other parts of my body. Can you suggest a diet plan for the whole day? From 11 AM to 6 PM, I have to sit at my office. So, there are no physical activities involved during that period. ### Response: Hello. Based on your current height and weight, your BMI (body mass index) is in the normal category. In order to give you a personalized diet plan, I need more information about: If you can send me your accurate 24 hours diet and activity diary, I can make a plan which fits in your schedule and is easy to follow" "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 concerned individual with a history of poor oral hygiene. It got significantly improved during these few years. I have a broken tooth in the back left bottom. My front tooth appears green, and they are deeply separated. Is there any way available to save my tooth? ### Response: The permanent solution for you is to put braces to correct the malocclusion of the teeth. So that proper cleaning can be done to have less plaque and calculus. If you cannot start braces presently, at least get your teeth cleaned by a dentist to remove all the calculus that is sticking to your front and back teeth. The decayed teeth present at the back has to be removed or appropriately filled to save it from further decay. Use warm salt water gargle to have healthy gums." "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 dealing with some issues lately regarding panic attacks. I am not sure what it is, but it is scary. I had three panic attacks in one day, or I think they are panic attacks. My fingers will twitch consistently then lock up and lose circulation, along with my whole arm, on both sides. My upper right lip will switch and my eye will too, then my cheek all while pulling my head back in the same motion.And all, while this is happening someone, will be trying to talk to me but I cannot speak, almost like being catatonic. I am a little skeptical about if they are panic attacks or not. Mainly because I usually have them when I am stressed, but I had two more again today, and I am not even stressing about anything. ### Response: The symptoms you are experiencing can be possibly due to hyperventilation during panic attacks. These can give rise to tetanic symptoms like tingling in limbs and face, muscle stiffness, trembling in hands, etc. It is advisable to consult your primary care doctor initially so that he can complete a necessary examination to rule out any physical causes that may cause similar symptoms. It will help to learn regular breathing and relaxation exercises. It will get better with practice. Also, learn strategies to manage stressful situations. I hope this helps. You can contact us again for any further 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 bursitis heel for the last seven months not healing in spite of ultrasound, healing creams, exercises, anti-inflammation medicine. Please suggest. ### Response: Hi. This is called Enthesitis and is due to inflammation of plantar fascia. You need at least 10 days of anti-inflammatory medications. Do an ESR, CRP and if possible PDUS of the heel. Start capsule Indocap SR 75 once a day along with Pantoprozole 40 mg morning." "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 diagnosed with azoaspermia, I also went for FSH, LH, and testosterone test. The results are as follows FSH 20.290, LH 11.92, testosterone:2.55. I need you to explain these results to me. ### Response: This result means that you have undergone testicular insufficiecy, failure which means that testis in your body are not producing enough testosterone hormone to complete the process of sperm formation. Testicular insufficiency is being conformed by the elevated levels of FSH and LH which are being shown in your reports (attachment removed to protect patient identity)." "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 35-year-old female. I am suffering from a vaginal infection. I want to get pregnant. Is it safe and possible for me after treatment? ### Response: Hello. There are different kinds of vaginal infections. The most common are yeast infections and bacterial vaginosis. They are easy to treat most of the time and should not alter your ability to get pregnant. These types of infections can also occur during pregnancy and can safely be treated at that time as well. It is difficult to give more detailed information without knowing the type of infections and the treatment provided." "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 4 years old daughter has an inward turn in her right eye after concentrating for a while. We had an eye test recently. Can you tell me if her results mean she needs glasses as she keeps saying her eyes hurt watching television and readings of her results are: Right eye sph +1.50 cyl -0.50, left eye sph +1.50 cyl -0.50. They told me she is long sighted and we have a strong family history of squints and glasses. I do not know if I should get a second opinion. ### Response: Hello. That is a very normal refractive condition of a 4-year-old child and I would not advise correction. However, you might want to consider reducing the time watching TV along with the brightness of the screen after sunset. Monitor every six months considering the family history." "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 small accident while on holidays. She slipped and fell on a wooden floor and landed on her outstretched right hand. (dominant hand). Her wrist got injured, received immediate medical attention with a splint attached, and an X-ray image was taken about 14 hours after the accident. She received a cast after the diagnosis of a fracture of the tip of the ulna.We would like to have a second opinion based on the attached images, especially whether other damage can be identified on the radius or other wrist bones, and whether more invasive treatment is necessary. Swelling and pain have experience on both sides of the wrist (radius and ulna), but the movement of fingers, including the thumb, did not incur further pain. The swinging of the hand sideways or up and down was also possible and without increased pain. No numbness or circulation issues have been identified. ### Response: There is a fracture involving the lower end of the radius and in the styloid process of ulna bone (attachment removed to protect patient identity). There is not much displacement in the fracture areas. It is essential that you meet a consultant orthopedician and review the injured areas. In such cases, usually a splint and cast are provided, and once the inflammation comes down in four to five days, then a definitive treatment on the fracture might be thought 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: My period was delayed. I had a pregnancy check which was positive. I consulted a gynecologist since I did not want a baby and hence decided to go for medical abortion (as my son is just 12 months). She prescribed me with medicine and after 48 hours she had asked me to place 4 medicines in my genitals before going to bed. My menstrual cycle started the very next morning and continued for 3 days. After 15 days, she had called me for an ultrasound to examine whether all was done perfectly. I had an ultrasound scan (reports attached).The doctor said that it has not come out completely and therefore prescribed medicine (prescription attached). She gave me two medicines to place in my genitals. Next morning, I had very less bleeding which gradually stopped at night. Doctor, I am very much confused as to what is happening. In no case, I want a medical abortion. Please suggest as to what should I do so that all gets fine. ### Response: Hello. I can understand your concerns. I have gone through your history and ultrasound scan and it is showing that the abortion is incomplete and there are a retained products of conception in the uterine cavity. (attachment removed to protect patient identity) Your doctor had given Cytolog (Misoprostol) to clear that product. As you had only minimal bleeding, the chances of retained products are there, so you can repeat your ultrasound scan. If it is still present, then you should consult a gynecologist and get D&C (Dilatation and Curettage) done to clear the retained products of conception." "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 facing a psychological problem. She had a fibroids operation seven years back. Before the operation, she was very active but after this, her health has gradually deteriorated. At present, she cannot recognize anyone, she shouts by seeing everything, she has an involuntary passing of urine and cannot eat on her own. We have also consulted a neurologist, but they said there is no problem. We cannot take her out. Please suggest us what to do. ### Response: I would also recommend checking your thyroid hormone levels and vitamin B12 and vitamin E plasma levels to investigate for a possible deficiency. If all these test results are normal, the next step would be consulting with a psychiatrist. In such a case an antidepressant may be needed. Hope you will find this answer helpful" "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 swollen lymph nodes for over 1.5 years. I have gone through scans and viruses blood test, which resulted negative (attachment removed to protect patient identity). I have them everywhere I can feel. Neck, groin, armpits, chest and even on my face. What are the chances it is cancer? ### Response: Hello. Generalized lymphadenopathy cannot always be due to cancer. However, lymphoma blood cancer is one of the cause for that. I suggest you investigate with biopsy of grossly visible enlarged lymph nodes or FNAC scan to identify the cause for enlarged node. If you have lymphoma, then it will be evident by histopathology of biopsy specimen. It is advisable to rule out HIV also by combo ELISA testing." "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 high eye pressure of 30 and 24, visual field loss, and at times I go completely blind in both eyes. I have also gone blind in just one eye. I just went back to the eye doctor when I had the pressure of 24 and 30. I have been there three times and each time I had a high eye pressure. He at first told me everything looked good until I asked him what my pressure was again because he specifically said my pressure was good when I knew that it was high. He told me that it was fairly high when I asked for it but he says I do not have any optic nerve damage and that it is highly unlikely that I have glaucoma because I am 23 years old. But my research has told me differently that high eye pressure alone does not mean that that you have glaucoma but if you have visual field loss or optic nerve damage with your high eye pressure then you do. So I do not know what is going on? Can you please help me understand and is it possible that I do have glaucoma and should go to another doctor? ### Response: I reviewed your history. The presence of elevated intraocular pressure is called as ocular hypertension. If it is associated with visual field changes or optic disc changes it is called as glaucoma. However, ocular hypertension alone also requires treatment particularly in your case as intraocular pressure is high. Hence you need to consult glaucoma specialist for evaluation and advice accordingly. Increased intraocular pressure. Visual fields, OCT (optic coherence tomography). Glaucoma. Once in six months." "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 kid is 29 months old. She is having high fever till 101 and running nose since afternoon today. Now she has 103 fever. She also complained of shivering in the evening. She has not eaten anything. Given Meftal as of now. Please advice. ### Response: Hi. I understand the situation you are facing. Your daughter most probably has a viral fever. Keep checking the temperature regularly like hourly or second hourly. You can continue Paracetamol every sixth hourly along with tepid sponging. If becoming dull or lethargic or not eating anything or any new symptoms develop, better to get admitted" "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 5 months old baby boy is not sleeping well. He will sleep maximum for one hour continuously. Always he will have disturbed sleep. He used to be awake the whole night. I am breast feeding him. Kindly advise why my baby in not having a peaceful sleep. ### Response: There is no particular reason for the same. Also, you have to note if the child has any blocked nose or coughing that may be disturbing his sleep. However, if the child is growing well in terms of weight and height, you need not worry." "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 baby is 2 months old. He is on pumped milk and once a day formula milk (Enfamil). He is gassy and cries mostly from evening till midnight. Spits up even after burping for 30 minutes. I give exercise, and tummy time, but there is no change. He gets reflux which makes him uncomfortable.His spits are watery. My pediatrician suggested Colicaid and Yamoo which I am using four times a day. Still, he gets gas and spits up. And now he did not poop for the past two days and trying very hard and cries in between feeds by trying to poop. Is this an effect of enzymes? Please help. ### Response: Hello. Please note the following, 1. The clinical picture that you are giving is most suggestive of reflux. It is advisable first to get a reflux study done to find the grade of reflux. 2. The initial medications to be given in reflux are Zantac (Ranitidine) and Perinorm (Metoclopramide). In most cases, this works. The next step beyond this is Gaviscon (antacid) and feed thickening. 3. Also very important is to keep the child in a slightly upright position (30 degrees to ground) after feeding (and most of the time) to reduce the amount of discomfort the child may be facing due to reflux. As the child grows bigger, the need for this reduces eventually. 4. As regards to the crying episodes during stools, if the stools are hard or if there is gas the child may cry. Both are less likely due to the enzymes. They are mostly physiological considering the clinical scenario of the child." "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 62-year-old male. I went for a routine X-ray, and the radiologist found some streakiness in the lower left lung. He said it appeared small and not significant, but it was adviced that I should come back in six months for a comparative X-ray and that it could just be a scar from an earlier infection.I have read that a small scar area is probably non-progressive but I have also read about IPF, and that fills me with fear. Spirometry test was normal as it was a physical exam. I am so scared that it might be a progressive disease, but I hope that it is just an old scar as it is really small. Otherwise mostly healthy with no cough or difficulty breathing at all. Are all lung scars progressive? ### Response: Does not look worrisome (attachment removed to protect patient identity). Small streaks or fibrosis is usually due to old infection or collapses etc., The usual cause for such fibrosis is typically an infection and commonly found at such age groups. The probability of IPF (idiopathic pulmonary fibrosis) is extremely low as the fibrosis is not diffuse or bilateral, no symptoms and spirometry are normal. So, I think it is not worrisome at present and should follow up as advised to be sure. Should consult your doctor earlier if developed any symptoms. Majority of the scar is non-progressive and extremely common to find such scars on routine X-ray and the majority are benign. I hope this helps you and get back if you have any doubts." "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 did my body checkup. I found that some of the reports are not in the normal range. So, I just want to know if I need to check further for some diseases. What should I do to bring it to the normal range? Currently, I am very normal.The following are not in the normal range:Total RBC: 6.05 X 10^6 /\xce\xbcL Range: 4.5-5.5.Mean corpuscular volume (MCV) 81.2 fL Range: 83-101.Mean corpuscular hemoglobin (MCH) 26.8 pq Range: 27-32.Red cell distribution width - SD (RDW-SD) 37.1 fL Range: 39-46.Platelet distribution width (PDW) 15.3 fL Range: 9.6-15.2.You can even check the report file. ### Response: I have just gone through your reports (attachment removed to protect patient identity). I do not think you have to worry much. The only thing that looks abnormal is vitamin D levels which are low, possibly due to sedentary lifestyle and less sun exposure and obesity/overweight which are common causes. That can be corrected with simple Vitamin D capsules of 60,000 IU given weekly for eight weeks. I would be happy to help you further if you have any questions" "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 penis skin end has got tiny cuts around and it is not healing for more than one month. Please help. ### Response: Hello. You need to apply the following things: Clean with Betadine solution twice a day. Apply Candid-B ointment twice a day. Take tablet Kineto Forte 15 mg once a day for ten days. Update your condition after ten 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: My daughter is 7 years old. One month back, she had fever and after that, she has got severe hair fall. It is almost one month, still, hair fall is there. It is not at all decreasing. Even when washing her hair, lots of hair loss is seen. I am worried about it. What could be the reason? Any remedies? ### Response: Perhaps her hair fall is due to telogen effluvium. Telogen is the shedding phase of hair cycle. Usually, after an illness like high-grade fever, typhoid, malaria jaundice, etc., hair gets shifted from growing phase (anagen) to shedding phase (telogen) which is manifested as precipitous hair fall. Telogen starts one to three months after one recovers from the illness. This is self-limiting and recovers in a few months. I would like to know what was the cause of her fever. Was it high-grade fever? How long did it last? Did she lose weight during her illness? 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 and my fiance had unprotected sex a month back but he did not ejaculate inside me. Due to confusion, I had an Ipill after two hours of intercourse. On the eighth day after taking the pill, I got a light bleeding (enough to use a pad) which lasted for three days. My last period started 40 days back and lasted for five days. I missed my next period which was supposed to be a month later. Now after that I did the urine pregnancy test in the afternoon which came negative. I just want to know is there a chance of me getting pregnant. Am I safe now? Please answer it ### Response: Hi. Yes, if now it turns out to be negative urine pregnancy test after 20 days of intercourse than definitely, you are not pregnant. It is almost a month after intercourse and test are negative. So, you are not pregnant for sure. And yes, periods can be delayed and/or disturbed even after Ipill which is in your case. Mostly, it will come. If delayed more than 10 days than do consult nearby gynecologist. You may require hormonal medicines to induce the period." "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 29 weeks pregnant. From the last two days, I am not feeling good. There is sudden nausea. The baby movement is fine but I am not able to eat anything because of nausea and frequent urination. Burning feet is also there accompanied by gas and constipation. ### Response: Hello. Vomiting is more usual in the first trimester. In the second and third trimester, it is less usual and can be due to a urine infection. Have urinalysis and urine culture. If it comes positive for infection, you need antibiotics. Have a strict check on thyroid as well. It should be normal and have recurrent checkups. Have plenty of water and cranberry juice to prevent/have relief from a urine infection. I suggest you have tablet Cyclizine 50 mg eight hourly before 45 minutes of taking food. Have small frequent meals of your choice that you like nowadays and you can have easily like juices, soups, soft diet but homemade. Have walk daily and try to have diet properly with a tablet as improper diet habits cause digestive problems. Have Calcium on alternate days for few days till you have relief from these symptoms. Check thyroid level and consult a maternal medicine specialist if abnormal for readjustment of the dose of Thyroxine. Check urine reports with a 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: My mother is not able to walk properly and she cannot move properly. She met with ischemic stroke eight years back and she is diabetic and has BP, and seizures (epilepsy) treated with Insulin, and BP suppressants, Atorvastatin, Levetiracetam, Phenytoin (Eptoin) since seven years, but she is not able to walk properly and she is not able to move her hands and legs properly. Her thinking and behavior have also become very mild. Please suggest me the correct medication for her. ### Response: Ischemic stroke is a condition where there is incomplete blood supply to a certain part of the brain leading to permanent damage to that part of the brain. Consequently, the function carried out by the affected part of the brain is lost. The only way to recover function following permanent damage is physiotherapy which enables the existing normal part of the brain tore-learn the function that was earlier carried out by the now non-functional brain. In the case of your mother, physiotherapy is the only way to improve the lost function. In addition, we can make things in the house and around in a way that is easy for your mother to navigate such as having a motorized wheelchair, etc." "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 got a minor surgery for liver abscess and a drain was installed. Pus in the color of chocolate and little thick is coming out. Is it normal? How much time it will take to recover? For how many days the drain has to be installed? ### Response: Hello. I had gone through all the data you have posted. We need to know some more details about your problem. Liver abscess is mainly of two types: Bacterial and amebic. From your description as chocolate like pus, it goes more in favor of amebic etiology. So, we need to keep you on tissue agents like Metronidazole, luminal agents like Diloxanide furoate and Paromomycin for elimination of ameba from the intestine. If pus culture grows bacteria or if abscesses are multiple, then we need to provide specific coverage against the organism. Time to recovery depends upon the cause of amebic versus bacterial, size of the abscess and white blood cell count." "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 60 years old. I always had stomach issues but now at the end of the day I have terrible gas trouble, and it does not matter what I eat. Beano helps a little. Could this be IBS?Lab tests performed: All lab test are normal. ### Response: I can understand your concern. Some times it may happen due to intestinal flora. Some food habits also cause such conditions. Stress is one of the primary cause of this issue. It can be managed naturally (without medicines) if you know the origin of the problem. Now you can take Hingwastaka Churna 3gm twice a day with the first bolus of food thrice a day and" "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 recently diagnosed with asthma, bronchitis, and pharyngitis. I am currently on some temporary medicines, and antibiotics to treat these sicknesses along with an inhaler. I do not feel that bad, but I need to take the pills. However, being in college, I have a big game this weekend. This question may seem to be a little stupid but, would mixing of alcohol with antibiotics be deadly? Or would it just slow down the process of making me better? I know it is a silly question to ask, but I am half minded on it and would prefer not to end up in the hospital. ### Response: I guess you are taking medicines for bronchitis and pharyngitis. So most probably it is an antibiotic medicine. Generally, we advise to take medicines after food with water, and within limits taking some medicines with low alcohol does not cause any harm. However, it is best to avoid to do so. The idea of taking medicines with alcohol is not advised as it can be harmful. Alcohol and some medicines cause gastritis, and you may vomit out. Also, it can cause liver toxicity with such combination. So there is no logic of taking medicines with alcohol. Also, alcohol intensifies the effects of certain medicines, and alcohol can not dissolve some medicines. Serious interactions also can occur.So it is a better idea to consult your doctor before doing so." "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: About 6 years ago, I engaged in some urethral play with my partner. I put a small pen into the urethra, only about 2 to 3 inches in. Since then, I feel I may have done damage to the smooth muscles in the corpus spongiosum or the tunica albuginea. I can feel, right inbetween the corpus spongiosum and corpus cavernosa what feels like an enlarged muscle and seem to run the entire length of the urethra, maybe compression damage done to something there. As a result, I have slight difficulty urinating and very very bad premature ejaculation which did not ever happen. I also have nocturnal emissions frequently on a full bladder. I know I may need to have an MRI, but if the muscles are damaged here, what are the surgical options? Can anything be done? I also tried Priligy and it made no difference (10 to 20 seconds). ### Response: Hi. First of all, let me assure you, premature ejaculation is due to excessive sensitivity of the sympathetic nervous system and not due to any trauma. If the urethra is damaged because of foreign body insertion, then the only problem will be urethral stricture, which will cause difficulty in urination. Also, nocturnal emissions are natural, although frequency might vary. If you still have doubts, you can proceed with ultrasound Doppler study of penis and cystoscopy. That would reveal whether you have suffered any injury in the past." "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 doctor has advised taking Adava stat F tablet to reduce cholesterol. I have type 2 diabetes and my cholesterol 175.6, triglycerides 297, and HDL 24.5. So, do I need to take this and how long I need to take? The doctor said only three months or lifelong. ### Response: We can say you have mix dyslipidemia with your results. This means you have a lipid disorder but at this point, you do not need medication. Medication for an increase in triglycerides should be taken when greater than 450 to 600 mg/dL or cholesterol LDL is greater than 130 and you have increased cardiovascular risk (which is not your case). DM (diabetes mellitus) 2 increases your heart risk so it is important you meet your goals of control." "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 24 years old. I had my kidney stone removed a year ago for causing mild hydronephrosis at my right kidney. During the treatment, I was exposed to full of radiation, abdominal CT scan, lithotripsy, fluoroscopy, and another fluoroscopy during stent insertion. I am not sure how the doctor manages the radiation. I did my treatment abroad and it is not really a well-developed country. He might not even care bout it. I studied some about radiation when I was in dental school so I am very scared of the side effects.So if I am to have another case of hydronephrosis, should I just remove the kidney rather than undergoing such radiation which may cause me high risk of future cancer? Because as you can see, I am still so young and I just started my career. What do you suggest? Do the pros outweigh the cons or vice versa? Is there another less risky treatment in terms of radiation? How about invasive treatment? Is the risk higher aside from the slow healing? And I am serious about the removal if indeed it has lower radiation risk, even though I know kidney is very important. Please suggest. ### Response: Hello. There are enough studies and literature which prove that though there is radiation exposure during CT (computed tomography) scan in the removal of kidney stone it is in low dose and chances of cancer do not increase. So do not worry about that. I do not think removing kidney to escape from radiation exposure is a good option. You should not think of that. If there is again stone formation then there is a treatment called ultrasound-guided lithotripsy (ESWL) which can break your stone from outside without any radiation exposure. So you can do ESWL (extracorporeal shock wave lithotripsy) if required later but no need to remove the kidney." "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: For the past week I have been experiencing a \x80\x9cscratchy\x80\x9d feeling on just the left side of my throat right below my Adam's Apple region. Now, it feels as though whatever it is has transformed into a feeling of paralysis from my voice box up to behind my left nasal passage. I am also experiencing shortness of breath. ### Response: Hello. Can you send me a picture of your throat (clear one). I want to see if your posterior pharyngeal wall or tonsils are infected. Are you a diabetic? What problem do you have in your nose? Is it like a nose block? Shortness of breath can be due to nose block as well." "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 29 year old brother had a pacemaker placed three years ago after survival from a sudden cardiac arrest. Doctors found the cause of the cardiac arrest to be a ventricular fibrillation. Last week was the first time he received a shock from his pacemaker, that is, exactly three years after his first episode. My question is, whether we can find the root cause of his ventricular fibrillation. What is the best treatment for his case? ### Response: Ventricular fibrillation, the commonest cause is coronary artery disease. The other causes are dilated cardiomyopathy or low heart function. What is his ejection fraction? Low ejection fraction due to any reason like coronary artery disease or others can lead to ventricular tachycardia and fibrillation. He should undergo angiography, and echocardiogram, if he has not already. His electrolyte levels should also be checked as it is a very important precipitator for ventricular fibrillation. In treatment, he should receive Cordarone (Amiodarone), and multiple other medicines depending upon the echocardiogram and angiography reports. Usually, patients get antiplatelets like Aspirin, Clopidogrel, ACE inhibitor like ramipril, and Spironolactone along with other medications. You can upload his reports if any so that I can opine on the cause. Hope this helps you and get back if you have any doubts" "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 hemoptysis. ### Response: Hi. Hemoptysis is referred to as blood in the sputum/cough. If you are having such symptoms the following workup is recommended: If you have already done a chest X-ray, do upload the images. Also, do you have any other symptoms like weight loss, low-grade fever, history of trauma or breathlessness, history of smoking, etc.? Please follow up with above details" "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 an extraction of a molar in the morning, and a bone graft was placed over it. My surgeon placed a collagen plug over it to make the graft to stay in place. Can I have a blood clot below it? I am afraid of getting a dry socket. Last time, I had a dry socket, when I had a wisdom tooth removal, and I am scared. Please help. ### Response: First, remove your fear present in your mind. Bone graft is not fully utilized in the socket, as it a foreign material. Some amount of graft is rejected in the body. It is a routine procedure of a defense mechanism. In your case, you cannot see blood clots in the socket, as it is covered with a membrane. You have to wait for at least three to five days. Do not try to see it again and again. It can cause a disturbance in the normal healing process. Follow proper oral hygiene and follow all the instructions given by the surgeon. Take medications on time." "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: Eight days ago, I had a deep cut in my foot from a puncture. I got five stitches. A couple of days later, it got infected. So, I went to the doctor and was prescribed antibiotics for five days. While it seems like it is doing better, the redness is not completely gone and now I just took my last antibiotic pill today. Should I go get more antibiotics? ### Response: Usually, a five-day course of antibiotics is enough for wound infection. I suggest you send me some photos of the wound in order to give you a better advice. Is there any pain, pus, or redness in the wound site? I suggest taking Ibuprofen 400 mg tablet every six hours for few days if there is pain" "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 infected piercing. It is already one month since I have got a piercing. My infection is getting worse so I removed it. What should I do to my wound? I removed my piercing. It is my first time to be pierced so I do not know how to clean it and I am using fake pieces of jewelry. I think I am allergic to that earrings. Every day it is getting worse and the hole of my earrings its getting bigger like the size of my earrings. I do not know if it is okay to remove it. ### Response: I am sorry for the infection site you are experiencing. You need to get evaluated by your physician. I think you need prescription oral antibiotics. At the end apply Gentamycin or Bacitracin ointment. During the day apply alternating hot and cold compresses locally to ease" "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 severe hair loss since the past 45 days. I am only losing my hair on the top and front part of my head and it all started like a month ago. I am not using any medications right now.Basic Details: Male, 25 years old, 5\11"", 154 lbs. Please suggest me medications to prevent hair loss and regrow my hair. Any help would be appreciated. ### Response: I understand your concern. However, I would need to see the images of the affected area to help you better which as to what is could be the possible cause of hair loss and advice the best treatment accordingly. Kindly send images of the scalp for the same" "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 college teacher. I feel fatigue and dizzy for past one year. I slept very late one night and the next day while taking class had a dizzy feeling for a second. I felt that my head was reeling and on that afternoon I took off. It did not happen again but I felt myself weak with less energy, as if I am about to fall if I do not sit somewhere. I was unable to stand or walk for a longtime because of fatigue and lack of energy. Nerves were twitching sometimes.I saw several doctors but I was unable to convey my symptoms properly. Sometimes, I get a sudden panic too, with increased heartbeat, dizziness, etc., with a frightful feeling that something is going to happen. An MRI scan was done which is alright. Hypertension, thyroid, and sugar tests were done and that too fine. The doctor said it may be a stress reaction and he gave a tablet for fatigue. After having that tablet for a while, fatigue was gone, but other symptoms of panic attack, occasional tiredness still continues. Please help. ### Response: I have read your complaints very carefully. But what are the causes for other symptoms? Well. There is an explanation. Revert back after a month 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: I have a pain in my parotid gland for about two months. It hurts when I am eating. The first taste of my food was worst. Now, I have a constant throbbing pain throughout the day and have even more pain while eating. I was sent to an ENT who told me to massage the area of pain while drinking water. The pain is almost unbearable. I went to the ER, a week ago for the pain and received some Tramadol, but should I get another opinion? I have done a CT, ultrasound of the parotid gland. ### Response: I can understand your concern. It may be due to inflammation of the parotid gland or stone in the gland or a parotid abscess. After a thorough examination, we need to follow the following basic investigations to finalize the diagnosis: Depending upon these reports, treatment can be planned" "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 suffering from arthritis. Is cow milk harmful to consume in her case (she drinks it daily)? Which foods are very beneficial for this disease or diet plan to remove it from the body as early as possible? Please reply. I need your help. ### Response: Hello. I have seen your reports (attachment removed to protect patient identity). Your RA factor is positive. So, for confirming rheumatoid arthritis, anti-CCP investigation can be done. Local part X-ray also needs to be done. Spinach, beet juice, and green leafy vegetables are beneficial in arthritis." "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 was 19 years old, I slipped in a wet road and my hips bumped on the ground. Now I am 21 years old, and now I experienced muscle back pain or numbness in my lower back sometimes but not often. The pain just happens if I hold heavy objects or been in a long trip in a rocky road or face my computer for hours. ### Response: It seems it is the result of the trauma you have had two years ago. Muscle or spine bone damage may have occurred. That can be understood doing a MRI examination of your spine. Anyway if that does not happen often, there is no any specific treatment you can take about that. Just take any painkiller when you feel pain (Ibuprofen) and nothing more. Avoid weight lifting or hard physical activity. Avoid long time standings. If you are overweight, lose some kilograms. You can do some light spine exercises or physiotherapy to remove pain and numbness of your back. If no improvement, then see a neurologist for further assistance." "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: Every morning when I wake up my mouth is full of saliva and many days it comes out of my mouth while sleeping. And in the day, saliva comes to mouth every 2 to 3 minutes. The problem of morning saliva has been there for more than one year. I have to wake up every morning early because saliva starts coming out of my mouth. ### Response: Hi. As per your complaint, I can provisionally diagnose you as suffering from hypersalivation or sialorrhea." "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: On the my bottom my two front teeth the gums have came up over them but not covered. But the gum is higher up than it is in any other teeth in my mouth. What caused this? Can I fix this in home itself? ### Response: That condition of your gum is called localized gingivitis. It occurs because of the deposition of calculus and plaque on your teeth and inside the gums margins, which causes inflammation of gums that enlarged in size. The first treatment is ideally you should visit a dentist and get the scaling, cleaning, and polishing done. Once your teeth and gums get cleaned, after you will have to maintain your hygiene, then after a few days it will become totally fine. Right now at home you can do proper brushing and flossing and do warm saline i.e. warm water and salt rinses daily, it will heal slowly, but scaling is genuinely required. 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: My partner had extracted a tooth today at the dentist but there are bony fragments left and he is in a lot of pain. What are the bony fragments? Are they bones of the tooth? ### Response: If the bony fragments can be seen outside the wound and are painful to touch with tongue then you should go back to your dentist. Your dentist should have prescribed you painkillers and antibiotics for some relief. Do not touch the wound at all. Today definitely will be painful so take two to three tablets of painkillers at four hours interval. By tomorrow pain will decrease. Bony fragments are chipped bone which surrounds the teeth and may get broken when teeth are being pulled out. If it is outside the wound and can be seen clearly you may go back to the dentist for taking it out or grinding it down" "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 21-year-old male. Before a month, I started jogging. But before three days ago, I saw my ankles with swelling. During the usual time, it does not hurt. But when I sit for a long time and after that when I start to walk, I have the pain. What can I do now for swelling? ### Response: Hi. I think you need to look at the shoes that you are wearing. You also need to look at the jogging track where you run. Take a break from jogging. Let the pain and swelling subside. Ice the area, and take anti-inflammatory tablets. Restart jogging and note any recurrence. If the swelling comes back, then you should consult a doctor and need to do an x-ray" "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 34 year old. I have no allergies to medications. I am schizophrenic. I take Abilify 20 mg and Solotik 200 mg. But, I suffer from negative symptoms (amotivation, alogia, etc.). I heard about a new drug Vraylar (Cariprazine). I would like to know from a specialist about the efficacy of Vraylar for negative symptoms, especially amotivation and alogia. ### Response: It was found to be effective in negative symptoms of schizophrenia. However, only a few studies are available for its comparison with Abilify (Aripiprazole). These studies indicate that it is more effective in negative symptoms compare to Abilify" "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 33-year-old unmarried female with no disease ever diagnosed. I live a sedentary lifestyle with very little or no exercise. I do not smoke, and I do not diet, I am taking normal oily currys with bread. Recently I got my lipid profile done and saw that my triglycrides are 30. Is it severly low? Am I at a risk of heart stroke or brain hemorrhage? Or do I have undiagnosed cancer or just malabsorbtion? Can you tell me which tests should I get done in order to diagnose the cause? ### Response: Hi. These all are important causes of low triglyceride levels and minimum level must be up to 145. So how we can increse and what we should do, let us see. Consequences you may have low vitamins absorption that ultimately leads to other disorders." "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 headache all the time, like a spinning head. Whatever I eat, my headache does not go. I use simple Panadol, but no effects on my headache. It is from the last 10 months, after my pregnancy. ### Response: Hi. Your frequent headaches along with dizziness or spinning could be due to raised blood pressure or hypertension, migraine, tension or stress, hypoglycemia, etc. Hypertension, migraine, and stress are the most common causes for the headache. Without examination it is very difficult to tell the exact cause. I would suggest you measure your blood pressure, if found raised then you have to take antihypertensive medication after consultation with a doctor. Migraine causes head pain. There are certain trigger factors for migraine like lack of sleep, starving, stress, certain food, and smell. The treatment for migraine headache comprises management of acute attack with painkillers like Naproxen, Aspirin, Paracetamol." "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 my last menstrual period before 15 days, and I have 26 days cycle. Before two days, my partner did a blow job and hand rubbing. I am not sure whether he did ejaculation or not. I took two dosages of Unwanted 72 within 14 hours. Am I at risk of getting pregnant? As I was near my ovulation period, Is there any chance for me to get pregnant? What can I do to avoid pregnancy? ### Response: Hi. Chances of getting pregnant are extremely low. As there is no ejaculation done and as you have taken pills, these are highly effective in preventing pregnancy. So pregnancy is very unlikely to occur. At present, you do not need action, and nothing can be done. You should wait until you get your periods, which may get delayed due to the pill. If the periods get delayed, then do a urine pregnancy test to be on a safer side. Overall, the chances of getting pregnant are very less." "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 I have water trapped in my left ear. I feel a moving water sensation in my left ear. I have a ringing sensation in my left ear after water got trapped in the ear. Will this ringing go away if my ear is dried? If the water is removed, then will the ringing sound stop? I do not have any ear pain and ear discharge. And also, I do not have any hearing loss. Please help me. ### Response: Please tell me from how long have you been having these symptoms? Any history of nasal or throat infection in the recent past? Revert with more information to 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 am worried about the weight gain of my baby. She was born three years back and had weight: 3.36 kg, length 51 cm and head circumference 35 cm. We started exclusively breastfeeding. On the 30th day appointment she had weight 4 kg, length 56 cm, and head circumference 38 cm. 60th day appointment: weight 4.75 kg, length: 57 cm, and head circumference 40 cm. 90th day appointment, weight 5.58 kg, length 61 cm, head circumference 41 cm. Since then she did not gain any weight for two weeks, so we started giving also Formula, without much success, she barely drinks 120 ml for one meal. Her weight gain has not been good since, on the 120th day appointment, she was 5.91 kg. How can I make her drink more at each meal? Would my baby be described as failure to thrive? What are the long-term effects of this slow weight gain pattern? ### Response: Hello. The weight of your baby is slightly less. See it is not about the quantity, it is about the frequency of the feeds and the calorie content of each feed. 1. Feeding should be done every two hourly. Even at night. 2. Fortification of the milk can be done by using Simyl MCT oil and HMF sachet in each feed. In food fortification, the quantity of each feed remains same but the calorie content increases. I hope this helps your baby gain weight. Weight should double birth weight by 6 months, triple by 1 year, and be 4 times by 2 years." "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 19-year-old male. I have been to a few ophthalmologists about this and they seem to think it is benign. But I want to get some other input on this. If I widen my eyes and move my head around, I can see shadows in my far peripheral vision moving as my head does. And it seems that the shadows change and become different sizes as time goes on.Now I do have astigmatism in my right eye and from time to time I get aching, almost gnawing pains that are with the movement of the eye. And has happened in both at the same time before. I find that it happens mostly when I am in a place with very weird or bright lighting or when I am looking at a bright screen in a weirdly lit room.I suffer from anxiety and depression which is why I guess I am coming out to ask some more questions. And I also have Asperger's syndrome. The aches radiate to my temple as well. But as I have said I have been to doctors and they have dilated my pupils and looked at my retina and ocular nerves and told me they looked good. So I honestly do not know what could be causing these weird shadows. I have had them for quite a while. And they also get bigger and more noticeable with head tilt like when I exercise or go running or do something very physical.I currently take Prozac 20 mg and Pantoprazole 10 mg. ### Response: Hello. What you are describing is most probably breaks in the gel shaped part of the eye and is called floaters. It is a normal and physiological condition that we see in patients that have refractive errors and have no significant consequences. If these symptoms persist and are causing you discomfort look for an ophthalmologist that does a procedure called laser vitreolysis who could break them down into smaller bits so that you do not notice them that much and that is pretty much the only method of treatment." "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: Yesterday, my wife had bleeding for a minute after we had sex for the first time. What would be the reason for this problem? ### Response: I presume that your wife had bleeding through her vagina.If it is the first time that you both had sex, then you need not have to worry at all. This is due to the rupture of a thin membrane which covers the vaginal orifice (opening). This membrane is called the hymen membrane. This membrane is vascular enough to cause bleeding. But it remits on its own." "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 is very abusive and says the wrong things sometimes. Her mood goes off, and she remains like that for 2 to 3 days. After which, I have to make a lot of efforts by saying sorry so many times, and then she would become normal. During such a period, she will not talk or talk only through messages or talk in an angry way, and she behaves very angrily. Then she says anything and becomes very angry, and she starts shouting. She has mood swing issues. When she was a month and a half pregnant, her mood was bad for seven straight days. She does not like my parents and sister and does not want them staying with us.A month back, when my son was born, my parents had come to see the baby. She did not like them visiting and wanted to send them out. But, she could not succeed in sending my parents back, so she forced me to drop her and our son to her parent\s place. She does not want to come back, and she says that my mom and sister are doing black magic, and I support them. She is threatening for divorce now. Earlier, she told me that during her childhood, her father used to beat her mother and used abusive words. She is very fond of her mother and wants to stay with her mother and does not want to come back. What should I do? ### Response: I read your query and understand your concerns. 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 25 year old unmarried girl. I am curious to know about the various options for abortions (medical and surgical) and up to how many days they can be done. I tried to look online but, I got several different answers. So, I thought of asking a doctor about it. Also, I want to know how safe is emergency contraceptive pill. I have PCOD and I am on ayurvedic treatment since the last four months. ### Response: Hello. The medical or chemical termination of pregnancy is safe and effective until 10 weeks. If it is beyond 12 weeks, surgical procedures may be required. If you take an emergency contraceptive pill within 72 hours of intercourse, there is no chance of a pregnancy. They are safe and effective. However, if you have a doubt then get 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: Does Methamphetamine interfere with local anesthesia? My friend was told she would not have to stop Adderall before surgery. I know that is not the same, but is there anything particularly dangerous about methamphetamine and local anesthesia? What about Phentermine? ### Response: As such local anesthesia is safe and one can readily go through the procedure. It is recommended to avoid any sort of illicit substances during anesthesia." "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 suggest any good skin lightening cream not such that like magical whitening but I meant for healthy skin and color does not matter that much. I have heard about the Golite cream. How is it? Can it be used like other fairness creams? I want to use, Clin shine cream which is newly available in the market. Please suggest me. ### Response: Hi. Start using sunscreen twice daily morning and afternoon over the full face. ) cream. Take Limcee 500 mg (Vitamin C) twice daily for 2 to 3 months." "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 ED and PE, low libido for the past six years. Most of the medication that helps with erection including UpHold, Caverta, Pengra with and without the combination of depressant like Prodep 10 or 20 mg (without any sign of depression) have not helped me. I have even consulted psychologists and have not received any result. There is no obvious concern found during the physical test of the penis. My current medications are L-arginine, Horny goat weed, L-theanine. My blood report indicates:FSH, LH, Serotonin, and Estradiol below normal.Testosterone and Dopamine within range.Prolactin on the higher side of the range.My pituitary MRI is absolutely normal.FSH 3.03 mIU/ml (Range: 1.5 to 12.4 mIU/ml).LH 2.80 mIU/ml (Range: 1.7 to 8.6 mIU/ml).Testosterone total: 458 ng/dl (Range: 249 to 836 ng/dl).Prolactin: 10.57 mg.ml (Range 2.64 to 13.13 mg.ml).Serotonin: 250 ng/ml (Range: 70 to 270 ng/ml).Dopamine: 29.6 pg/mL (Range: 0 to 30 pg/mL). ### Response: Hello. All the tests done seems to be fine except vitamin D deficiency. It seems that you are now diabetic and diabetes is so closely associated with erectile dysfunction. The treatment depends on the cause of erectile dysfunction. Some of the common causes are, In this regard, I would like to advise you to get the following tests done and revert back with reports. Fasting and postprandial blood sugars, HbA1c, fasting thyroid profile, fasting lipid profile, serum vitamin D, and B12 levels. Once the cause is corrected, erectile dysfunction will resolve automatically. Also, it is important that there are no psychological factors affecting your sexual health. Make sure that you and your partner are completely ready for the sexual intercourse. You should also consult a sex therapist in person" "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 heavy ladder fell on my head. Then, dizziness occurred twice and I have some constant chest pain in the middle of the chest. Also, I am feeling chest heaviness. Please help. ### Response: Hi. Fall of heavy object. 1. CT brain plain.2. Chest x-ray PA view. To rule out intracranial injury and intrathoracic injury. I suggest the following medicines. Consult your specialist doctor, discuss with him or her and take the medicine with consent.1. Tablet Dolonex (Piroxicam), one tablet in the morning and at night2. Tablet Myospaz (Chlorzoxazone), one tablet in the morning and at night.3. Tablet Chymoral Forte (trypsin-chymotrypsin combination), one tablet twice a day in the morning and at night.4. Tablet Pan 40 (Pantoprazole) once in the morning. Revert back with the reports 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: I am a 30-year-old man. Recently, I was tested for complete STD checkup with TORCH test. I have a few doubts:Are HIV 1 and 2 with p24 duo test after 28 days window period conclusive? My result is nonreactive.I got a positive result for rubella. CMV and HSV 1 and 2 IgG positive but IgM negative. Am I an eligible person for marriage and sexual relationship?What is the treatment plan for those TORCH IgG positive results?Of note, I had unprotected oral sex twice and protected vaginal sex three times in the last two months. ### Response: Hello. Fourth generation p24 anti-HIV (human immunodeficiency virus) antibody is conclusive after a window of two to three weeks. So a negative result at 28 days is reliable. A positive IgG (immunoglobulin G) for HSV (herpes simplex virus) 1 and 2 means you have an old infection with herpes 1 or 2. HSV type 2 commonly causes genital herpes and HSV type 1 causes orolabial herpes. There is a risk that you may pass on the infection to your sexual partner. CMV (Cytomegalovirus) positivity is quite common in general population. It is a common viral infection and does not cause any issues in immune competent healthy individuals. HSV needs to be treated only if there is a clinical episode. There is no need to treat CMV." "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 78 years old now. Before 12 days back, she had a cough and high fever. She had a wheezing problem along with a cough. She was given Azithromycin and Cratex expectorant. Her temperature got subsided after five days. But the coughing problem has not stopped. Her X-Ray finding suggested COPD. Her hemoglobin level is 9.2 ng/dL. She has WBC of 1980 WBC per microliter of blood. She has neutrophils of 28 % and lymphocytes of 69 %. She has ESR of 60 mm/hr. Currently, she is taking Domperidone, Etizolam, and Olmesartan. ### Response: Hi. She has a chronic obstructive pulmonary disease. Her lymphocytes are elevated. She seems to have viral bronchitis. Her total WBC count is decreased. It can occur due to bone marrow suppression by a viral infection. For wheezing, she can take Ipratropium bromide inhalation through a nebulizer for three to five days. According to the characteristics of a cough, further treatment can be guided. She needs to consult a pulmonologist for chest 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: I had toothache for the past 48 hours. It made the right side of my face to completely swell. The toothache has now gone, but the swelling is increasing and started affecting the eye area. I have applied heat and ice to the swollen area, but neither have worked. Please give me some advice to quickly reduce the swelling as I have an important event later today. ### Response: Tooth infection or abscess spread to vital spaces in the face. Space infection due to tooth decay. 1. 2. Antibiotics.3. Analgesics.4. Serratiopeptidase or other proteolytic enzymes." "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 35 years old and I had sex with my partner last month. My expected period date was a week later. Still, I did not get my periods. I have tried testing pregnancy strips the result was negative. I consumed Regestrone tablets for the past four days. We do not want to have a baby because of the family situation. I want to know if I am pregnant or not. If pregnant, how to start the abortion procedure? ### Response: Hello. If the urine pregnancy test was done after eight days post missed menses was negative then you are not pregnant. However, to be double sure, you may opt for a serum beta hCG test, where if the hCG levels are less than 3 mIU, then you can be sure that you are not pregnant. The bleed shall start in next 3 to 5 days post stoppage of Regesterone. Once the bleed starts, it will again indicate that you are pregnancy safe and you would be starting a fresh cycle" "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 got a leg injury, six months back. On x-ray examination, they did not find any fracture. But there is difficulty in movement, and the doctor said that the anterior tibiofibular ligament is damaged. I used NSAIDs for a short period to avoid inflammation. I am also wearing crepe bandage. How long will it take to bring back normal movements? Please give suggestions. ### Response: Hi. So, see a good physiotherapist near your home and do the exercises with care and discipline. Hope that 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: Right ovary contains 3.6x2.1x3.1cm cyst, thick septation and few punctate echogenic lesions within lumen. Previously cyst measured 3.8x2.4cm abutting ovary. Adjacent ovarian parenchyma contains 6 mm and 15 mm follicles. Small amount of fluid was seen in para-adnexal area and posterior CDS.My questions are: 1. Small amount of fluid in para-adnexal area and posterior CDS. Is this normal? Why is it there?2. The 6 mm and 15 mm follicles in ovarian parenchyma. Are these normal to be there?3. What is the thick septation and how is it formed?4. What are the lesions in my lumen? I believe it is ovarian lumen. Do they form normally with ovarian cysts? They are echogenic so sounds like they may be solid. Could they be malignant?5. Finally, what type of cyst will this fall under? My doctors are not giving me any specific name and I really need to know what kind of cyst name it falls under.I did a blood report and my blood work is normal. My weight is normal and I feel minimal symptoms. So far this cyst has little impact on my quality of life. What are the most worrisome parts of this report? Can I still get pregnant? ### Response: I will try to give you answers to the best of my knoweldge. Small amount of fluid is expected near posterior cul de sac and para adnexal area during ovulation time. Although it can be seen during pelvic inflammatory disease. Multiple follicle grow every month in both the ovaries which later on is dominated by a single follicle which continues to grow to a certain size, and later ruptures releasing the egg. So your 6 mm and 15 mm follicles are normal to be there. Without doing a histopathological examination, it is difficult to tell about the origin of the thick septation but as most of the ovarian cysts are epitheleal in origin, so 90 % chances are they are made of some kind of epitheleal tissue. Any kind of debris inside the cyst will give rise to echogenicity in USG. It could be blood, it could be tissues of different origin. There are different types of ovarian cyst, to rule out malignancy you need to do certain tumor markers like CA 125, etc., and MRI or CT scan. Since it is receding in size, my best guess that your cyst is some kind of retention cyst of ovary. There is a large possibility that the cyst will regress soon. I think your cyst is an incidental finding as you have stated there is minimal symptom. Your gynecologist will be the best person to advise you in this matter. So discuss with her about the various possibilities and methods of treatment." "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 bicep muscle has been twitching and my leg and arms muscles twitch occasionally. I am super anxious about ALS. I am 36 and postpartum six weeks but I cannot stop obsessing about ALS. Please help. ### Response: For this reason, I would recommend performing some tests: Complete blood count, blood electrolytes, thyroid hormone levels, vitamin D and vitamin B12 plasma levels. Nerve conduction studies would help to definitely exclude ALS and put your mind to peace. You should discuss with your doctor on the above tests." "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 40 year old healthy man. I recently got mild tennis elbow because of playing badminton heavily every day. Can you please suggest some precautions and exercises, which help in quick healing? I wish to get it corrected without surgery. I do not want to stop playing for a long time. Is applying ice or warm water in that area helpful? My son, who is 10 years old, also plays badminton and seemed to have milder tennis elbow. ### Response: Hi. Tennis elbow can be treated by the following: For conservative management, I suggest you: Besides, you also can try therapeutic ultrasound or high intensity (HILT) laser therapy by a qualified physiotherapist." "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 49 year old male. Five years ago, I got two stents on the left. Actually, my heart was good only 30 % block. I take Vitoryn and Aspirin until now. I started having arrhythmia two years ago. AF comes out once every one and a half months for two to four hours. When AF attacks, I cannot stand up. I feel dizzy and like I am going to faint. I only took medicines for a month that time. THree and a half months back, I started taking Cordarone 200 mg. And Xarelto 15 mg. Until now, AF never came back. I already stopped Xarelto one month ago. Can I reduce Cordarone into half or take it every two days? Two weeks ago, suddenly my entire body felt itchy and swollen for two hours, then went away by itself. Please advice. ### Response: I have reviewed your health query and can well understand you are worried about your heart health. I would not say to stop Xarelto (Rivaroxaban) and/or Cordarone (Amiodarone) as these are very important medications and you need them. For stent patients, Xarelto reduces the risk of strokes, pulmonary embolism, and deep venous thrombosis, and clots initiating from the stents area. It is a blood thinning agent and keeps the blood running in veins and arteries without excessive clotting. Cordarone, on the other hand, keeps you away from heart rhythm problems like AF (atrial fibrillation). With the fact that you are having no arrhythmias while taking this medication, I do not think there is an obvious need to change the dosage. If your cardiologist gets some indication to reduce the dosage after examining you physically, that would be a different story. My final suggestion is to consult your treating physician before changing medications. Hope this helps. For more infiormation 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: I just want to get my brother\s CBC annual report checked. Is everything fine? I see lymphocytes little high. Is that dangerous? I am worried and he is actually very healthy and fine last week he had loose motion but now he is fine and fit again. ### Response: It is fine. Slightly lymphocytes percentage is elevated, but this much variation is acceptable. Also, last week infection might have contributed to this slightly changed percentage, but it is nothing to worry as he is totally asymptomatic. If possible, get this repeated after two weeks just to see a resolution" "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 teeth have become yellow. I also have stains on my teeth. I am trying to reduce the stains by cleaning the teeth. What can be done? Do you recommend any toothpaste or whitener? ### Response: Hi. Consult a dentist and get a dental scaling (oral prophylaxis) done. It will clear your calculus or stains. Also, get dental bleaching done by a dentist, which will make your teeth to look white and shiny. You can also use toothpaste with ingredients Sodium monofluorophosphate and Calcium peroxide fused with Lemon regularly on alternate days. It will keep your teeth bright. One thing, you need to remember is that most of the shining kinds of toothpaste have more quantity of abrasives. It can lead to specific damage to the enamel of 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: My 4-year-old daughter has asthma. She was diagnosed with a moderate asthma flare at urgent care four days ago. Flovent was increased to 88 mcg twice daily, Albuterol 2.5mg every four hours for 48 hours and Prednisolone 15mg/5ml one and a half tablespoon once daily for five days. She seems to be having retractions at night between 10 PM and 2 AM like clockwork. They are not severe as her respiration rate is 22-28, pulse oximeter reading is 96-98%. Pulse is elevated at times due to Albuterol and the highest recorded is 160 with no fever. She is tired and is pale in the face with dark circles under her eyes.I followed up with the pediatrician yesterday and he diagnosed her with an ear infection and put her on Augmentin. He listened to her lungs and said they sounded fine. She had an Albuterol breathing treatment about one hour prior to her visit. These symptoms that comes on night are scary. Productive cough and the sound of occasional constriction in the throat causing a gag, with these mild subcostal retractions.It is hard for me to determine do we go to the ER or not? It is hard to justify a trip to the ER with normal vitals and these sets of symptoms. Wanting suggestions regarding is my daughter on the right treatment? Could this be something other than ear infection and viral illness causing asthma flare? She has been sick with a stuffy nose, postnasal drip, and mild cough for three weeks. She is also taking Claritin, Singulair, OTC Tylenol or Ibuprofen for ear pain and Mucinex. I also have a video clip of these retractions and I am attaching it. ### Response: As per your history, it is very clear that your daughter has asthma exacerbation. It can be because of an ear infection or viral infection in the airways. As you said in spite of antibiotics, oral steroids and frequent nebulization it is not under control. She needs urgent hospitalization to give her urgent care and to find out other problems if any. This flare up is a valid justification for her hospital admission. As she is very young child she needs treatment under observation. The very fact that oral treatment being not effective. So I advise you to go to the hospital for admission without wasting much time. This will help to recover her fast and find out the exact cause for her flare-up. Once she is settled and the acute problem is under control. She can continue with her inhaler medicines as advised. I think this explanation is enough for you to explain her situation to you. I hope this helps. Ear infection or viral infection. X-ray, blood tests. IV antibiotics, steroid, and Levoalbuterol nebulization." "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 took four Yasmin pills as emergency contraception. But after that, she felt so weak and had heavy breathing. So due to that, we decided not to take another four pills after 12 hours. Will the first four pills stop unplanned pregnancy? That was taken within less than 30 hours after we had sexual intercourse. Looking for your kind advice. She is feeling better now but I am afraid to continue with another four pills. Also, I have read that Yasmin can increase blood clot which can be deadly. Please advise. ### Response: Using Yasmin pills for emergency contraception follows the Yuzpe regimen where oral contraceptive pills are used as ECP within 72 hours of last intercourse. As the first four pills have been taken by her after 30 hours of intercourse as per the regimen, so the next should be taken after 12 hours and should not be missed. The side effects can vary from mild nausea to vomiting, headache, bloating, belching, breast tenderness or even spotting. These effects are secondary to Progesterone and Estrogen in the pills. These can be countered by taking an anti-emetic pill like Metoclopramide10 mg, an hour before starting the regimen and also before the second dose after 12 hours. This shall prevent nausea and Progesterone side effects can be countered by increasing the water intake which can neutralize the Progesterone side effects. To help prevent you from feeling nauseous, one should take pills with food. It also helps if she would timer second dose such that she takes it just before bed. That way, she will sleep through nausea. The clotting is a known rare side effect of OC pills if OC pills are being used for years together for contraception, then predisposition for clotting increases. But the regimen needs to be completed as per protocol to achieve the desired result. The best would have been emergency contraceptive pills like an Ipill or Plan-B, but if it is banned in your country, Regimen is still a reliable means for emergency contraception with OC pills. Emergency contraception through Yuzpe regimen. Yuzpe regimen." "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: Would NorLevo pill work if a female has taken Ecstasy pill and after 10 hours she takes the morning-after pill. Will this have an effect or not? Please, can you advise me on this and ovulation? And also, how long does it take a female to fall pregnant? ### Response: Hello. There have not been documented evidence of ecstasy having a reaction with an OCP (oral contraceptive pill) pill, but some times the efficiency of the pill may come down with medications of this category. It is ideal to consult a gynecologist and look for an additional option like intrauterine device that can be inserted and prevent pregnancy within five days of intercourse, provided you do not have an active pelvic infection and other contraindications for its use. Generally, pregnancy happens when intercourse is done from day 10 to day 19 of the cycle, where ovulation chances are high if done on day 14, pregnancy has a high possibility, and fertilization happens, and implantation happens after 10 days roughly." "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 21-year-old mother of a 10-month-old. I have been diagnosed with generalized anxiety disorder, borderline personality disorder, and major depression. I have been experiencing what sounds like my voice telling me horrible things about myself and the people around me for quite some time now but in the past year, this voice tells me to do horrible awful things to myself and others. The other night it felt like something completely took over my mind and body and did something terrible that could have effected my whole life. Have I been wrongly diagnosed? ### Response: Hello. If you have symptoms like voices telling you to do something wrong and you have feeling that these voices are real and are not your doubts then this needs re-evaluation. This could be due to some psychotic issues. Hearing voices giving running commentary could be due to auditory hallucination. You should discuss this with your psychiatrist during your next visit. Explain the symptoms in detail. This will help 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 understand how bizarre my question can sound, given the circumstances, but still, it is an urgent matter for me. I was staying in a hotel and masturbated in the bathroom (in my room). I fear that I could have obtained HIV, if some semen or blood of the previous visitor had been on the facilities (or on the soap, which was dry and in a box and was not exposed to fresh air or light) and then came in contact with my penis (or some small wounds on penis or hands, if there were some, I do not remember their presence though). Can you look at it seriously and answer (with explanation), what is the probability for me to have obtained HIV? Even small real probability frightens me. I am a virgin. ### Response: There is absolutely no chance of acquiring HIV this way. HIV is only transmitted through unprotected sex e.g., either vaginal, anal or oral sex. Secondly, intact skin does not provide access to the bloodstream. However, even if we assume that you had a break in your skin barrier at that time, then also a paper thin cut or a scratch that is not even bleeding does not provide access to the bloodstream. There has to be a fresh actively bleeding deep cut for the virus to gain access to the bloodstream. In my view, you have no risk of HIV, whatsoever" "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 applied steroid cream (Betnovate-C) and my skin has become extremely thin and dark now. A dermatologist recommended me to try dermaroller so I want to know is it safe? And will it work? Please explain in detail as nothing has worked for me. ### Response: Hello. Indiscriminate use of topical steroids can cause skin thinning (due to collagen degradation) amongst other side effects like acne, facial hair, etc. Most of these side effects resolve gradually over next few months after stopping the topical steroid cream. This recovery can be aided by certain creams as well as certain procedures like dermaroller that help in collagen regeneration. Dermaroller is safe. The extent of improvement would depend on the extent of initial skin damage and the number of sessions. Moreover, results are individualized." "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 redness in my eyes. I began using Tetryzoline but it had no effect. The redness has increased in the past two weeks. It feels dry, itchy, and occasionally gritty on my eyes. I recently began to experience pain around my eyes on the left side. I use to work on the computer for 8 hours a day. What medicine can I use that will cure the redness? ### Response: I will tell the medicines as well as ways to tackle the screen time. Olopatadine 0.2 percent eye" "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 a tight band like pressure around my head while wearing specs. I try not to flinch my head muscles while feeling the head pressure fearing it will escalate the pressure feeling. I started wearing specs from the age of 16, and now I am 19. I do not want to wear contact lenses and cannot go for LASIK because of keratoconus in my right eye. When can I get rid of this feeling or get a proper way of coping with it? ### Response: Hello. You probably have a tension-type headache. This can be managed with medicine and relaxation exercises and by reducing the stress as well. Even with specs, you can manage these headache symptoms. For more clarity on your symptoms and further evaluation, you can visit nearby psychiatrist or neurologist. So as of now, limit your time in watching tv or mobile. Do regular relaxation exercises, manage your stress effectively and have adequate sleep. A" "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 4-year-old kid of 15 kg weight is having a general cold for almost three months. Sometimes cough, and nasal congestion. Otherwise, he is fine. He has no fever or weakness. ### Response: I understand your concern for your child. As you told me, this is happening for long. And there is no fever, it seems to be some allergic condition. Are you still bottle feeding the kid? Is there any difficulty in breathing? Any sounds or snoring while breathing or sleeping? Give syrup Maxtra (Chlorpheniramine) 5 ml thrice a day for five 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: My wife is 23 years old. Since four days, she is suffering from throat pain. When she swallows food or drink it pains. The pain is more on the left side of her throat. She is also having cough with mucus, which is white color. But, there is no rise in temperature. She took Erythromycin for two days and after which the pain reduced. Again from yesterday evening the pain increased. Please help. ### Response: Hi. It seems that your wife is suffering from upper respiratory tract infection (URTI). I would suggest you to take, My advice is to do salt water gargling three to four times a day along with steam inhalation." "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 on Lo Loestrin Fe for four months. I have never missed the pills on any days. I started to develop pregnancy symptoms such as nausea, food aversion, breast tenderness, dizziness, crying and fatigue. I stopped taking the pill and took three pregnancy tests in the morning using fresh urine. All the pregnancy tests were negative and I have been bleeding bright red blood for a day. I have to change the tampon every three to four hours. I am still experiencing nausea, food aversion and have chills. I am not running a fever. I had experienced similar symptoms before also on a 30 mg combined birth control pill. That time, the symptoms resolved when I stopped using the pills. Though my urine pregnancy tests are negative, will these symptoms suggest that I am pregnant? ### Response: Hi. If three tests are negative and you are bleeding after the stoppage of the tablet, then you are not pregnant for sure. The bleeding may be more because you stopped the tablets in between. The symptoms that you are experiencing do not happen only in pregnancy. It can happen because of tablets, a stomach infection, climate changes and acidity." "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 visited an Asian massage parlor and received anilingus and a whole body tongue massage on an exposed pimple on my back that was slightly bleeding from irritation during the massage. After the massage, I immediately showered with soap. Am I at risk for any STDs or STIs? I do not currently have any symptoms or visual changes but I am still worried. Also, should I be concerned about rabies? She was not symptomatic but she mentioned that she was recently from Shanghai and had a dog. I did not notice any bite marks on her and she appeared in good health but I am still worried. Is rabies a concern at all? ### Response: Hello. Rabies can only be transmitted only if she is infected and her saliva is having rabies viruses. So rabies is not a concern because probably she is not infected as she is not having any symptoms. If she does not develop any symptoms for another ten days then it is highly unlikely, because this is the time period within which she develops symptoms if her saliva is having viruses. However, the possibility of STI (sexually transmitted infection) is definitely possible and depends whether she is infected or not. 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 a 22 year old healthy male. Last month, I had undergone Nesbit plication surgery for congenital penile curvature. The surgery resulted in a deep wound that is not healing properly. I had the same surgery five years ago, and there was no wound at all. Now, it has been a month, and I do not seem to notice any improvement. Does penile skin grow back or would I need a skin graft? How long will it take to grow back? I am currently using Jelonet and gauze. I do not smoke or drink alcohol. I do not use drugs. How can I speed up the healing process? I have attached a picture of the wound. Kindly look into it. ### Response: I have read your query and examined your picture (attachment removed to protect patient identity). I understand that you have undergone plication surgery for penile curvature" "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 35 years old and my weight is 56 kg. My daughter is 3 years 3 months old. My doctor advised me to take one Femilon tablet daily from the first day of my period for contraception purpose. Last day of my period was 22nd of last month. At 21st night of this month, I felt that my period has started and took one tablet at bedtime. But, yesterday and today I got only spotting and the period has not started properly. I am continuing the tablet regularly at night for the last two days. Should I continue to take the tablet regularly till completion of the pack of 21? Will protection start from the first month or do we have to use extra protection like a condom? Should I start taking a fresh pack on the first day of every period? ### Response: Hello. This is a hormonal contraceptive pill which could reduce the amount of menstrual bleeding. This will occur in this cycle as well as probably in all your next cycles and this is entirely normal. The recommendation is to continue the pills for 21 days throughout and then wait for 7 days. Again, start a fresh pack from the 8th day. From the second pack onward, you need not have to wait for the commencement of the cycle. You can start the next pack after a gap of 7 days irrespective of cycle. Continue the pills as advised. Start the next pack as I have told and yes, you will have a full protection after seven days of commencement of pills. So, for the first week, use barrier contraception like condom and later you need not take an extra precaution as you will be a regular user." "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 irregular periods with very heavy bleeding, clots, cramps, stabbing pains in my pelvic area with no pattern connecting to bleeding. Some days, I am so fatigue and cannot function. This started five years ago. I had constant bleeding following coil insertion. Then it was removed and had a miscarriage at six weeks. When I was pregnant, there was no bleeding but had spotting throughout. Since delivery I am suffering again with irregular and heavy bleeds. It became worse for the past eight months. I have IBS which is stress related. I am taking Adalat for high blood pressure, which is under control. I was prescribed Mefenamic acid and Tranexamic acid as I refused coil due to previous bleeding with one and refused Esmya due to side effects. My transvaginal ultrasound found two polycystic ovaries and bulky adenomyotic looking anteverted uterus vascular ++ on anterior wall. The size was 2 x 3 x 0.9 cm. There are no fibroids or polyps or other pelvic masses or free fluid. Then what is it? ### Response: The problem which you are facing is most likely due to the adenomyosis and polycystic ovaries. As you have not mentioned your age and the number of kids, it is really difficult to tell you the exact management. Because, management is totally age related and number of kids you have. We can suggest you some hormonal treatment or surgical treatment based on your age and parity. Revert back with the personal details to 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: My 1-year-old child has been diagnosed with tetralogy of Fallot. She has been experiencing fast breathing, difficulty in feeding, failure to thrive, clubbed fingers but the cardiologist told me they will not be in a rush to fix the problem. I cannot stand what she is going through. What is her survival rate? Can I have the problem solved early? Of note, she is currently on Lasix and Aldactone. ### Response: Hello. Operation in tetralogy of Fallot depends on many factors. Some of the factors are patients pulmonary artery size, oxygen saturation, the \xc3\xadnstitution\s experience in doing such operations. So consult your doctor regarding this. Regarding survival, after successful surgery, the survival is good. It is about 90% at 30 years of age. Without the operation, many patients die" "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 18 years old. I have chronic pain in joints and morning stiffness. I have normal C3, C4 blood work. My vitamin D level was 12.6 ng/ml before and at present it is 28 ng/ml. ### Response: Hi. I have gone through your message and understand your concern. You seem to have weak bones and vitamin deficiency. That is causing bone and joint pains. You need to take supplements and symptomatic treatment." "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+ blood group. But, will marrying a girl of the same blood group (A+) create any problems in having children or they lead to a diseased child? ### Response: The same blood group people can marry and can produce a normal child. Check your both thalassemia minor report before marriage by HB electrophoresis, by HPLC (high-performance liquid chromatography) method that is necessary. If you both are relative, then genetic counseling 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 have mild scoliosis convex to the left and was wondering if a left knee arthroscopy can be the cause of my posture and/or pain issues. For example, sitting, standing. Also, having scoliosis, would that cause a blood clot (pulmonary embolism) after this surgery? With being a severe asthmatic. ### Response: Hello. Scoliosis is a structural problem and knee pain will not cause this. Arthroscopy can rarely lead to a clot formation but is not necessarily a known risk factor for DVT (deep vein thrombosis) as you are likely to mobilize very quickly and the procedure is usually short. Scoliosis does not add to the risks either" "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 I was bitten by a bat, so I wanted to know how to know that if I was really bitten by a bat. I did not felt anything at that time but some itching after that. I am not sure that I was bitten by a bat, so I wanted to know how do we feel when bitten by a bat. Also I saw that the thing which landed on my neck was small but had small wings that looked like a bat. I was asking ways to distinguish that I was bitten by a bat or not. ### Response: Hello. If a bat bite there will be bite marks, usually superficial. 1)Early symptoms are fever, headache, and general malaise. If you still have doubt better go for vaccination ARV (anti-rabies vaccine)." "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 aged 38 has been suffering from abnormal hair loss for the last few years. Hair continuously falls the whole day. It is so severe that we have to clean the rooms every few minutes. Even without any touch on the head, it falls continuously.We have a daughter aged 10. We consulted with a doctor and she is taking medicines as per his advice but the condition has not improved. Kindly prescribe for her. ### Response: I have gone through your wife\s concern. Has she done a blood test recently for thyroid profile, hemoglobin level, serum ferritin levels? Could you please attach the prescription and revert back? Also, send the image of her scalp. I would like to see if it is generalized hair loss or pattern hair loss." "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 suspicious of lymphoma. In the summer, I had an itchy rash on my neck, it went away, came back, and now went again. I have bilateral hip and bone pain. I have night sweats two to three times weekly. I had a low-grade fever right before my period and will go away. No palpable or noticeable lymph nodes except in thigh about an inch away from the groin. I have had CBC's and sed rates completed at least five times in two months. I took a chest x-ray, head and abdomen CT scan, and pelvic ultrasound. I consulted an ENT who looked down the throat with a scope, and everything is negative, so doctors will not pursue lymphoma any further. Do you think with everything so far, should I still be investigating lymphoma?I am currently on Lisinopril 20 mg. ### Response: In lymphoma, there is a presence of multiple enlarged lymph nodes. If you have lymphoma, then enlarged node could have been detected in CT (computed tomography) scan. If you do not have multiple enlarged nodes then lymphoma is less likely. The fever and itchy rash are not classical signs of lymphoma. For itchy rash, Levocetirizine can be prescribed. 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: My 9 months old baby had a high fever, cough, and cold. Initially, it was the fever that was concerning. Later the cough was severe and hospitalized for bronchiolitis. He was put on a nebulizer and after three days his condition has improved. So, the doctor suggested moving from the nebulizer to Asthalin huf puf. Later that night, he had a continuous cough for one hour and was then back on nebulizer. He is put on oxygen support as his SpO2 dropped to around 86. We are much worried as he is premature and was formula fed mostly. Please let us know if this behavior is normal with bronchiolitis. ### Response: Hi. The symptoms that your child has been suggestive of bronchiolitis. In bronchiolitis, nebulization needs to be given for five to seven days; usually, the child recovers in seven days. Your child was discharged from the hospital and developed respiratory distress after continuous cough and spO2 has decreased. I think that during continuous cough your child has aspirated the food and this has now led to bronchopneumonia. In my opinion, your child needs antibiotics and nebulization with a repeat chest x-ray to see the extent of pneumonia. I think your child needs admission for a week after which he will be alright." "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 on a business trip and my friend and I went to a high-end brothel. My friend hired two girls and brought them back to the hotel. He had to take a phone call and while the girls were waiting for him they performed oral sex on me for a few minutes without a condom. They had no symptoms in their lips and facial region. I am worried, I contracted herpes. I got tested for chlamydia, syphilis, gonorrhea, hepatitis, and HIV and they came up negative. It has been four weeks since the incindent and I have no herpes symtomps. What are my chances of having herpes? I know people might not show symptoms. I am married and I felt very guilty for what I had done and told my wife. We are planing to have kids. What are the chances of her getting herpes and passing on to our baby? I appreciate all your help with my concerns. ### Response: I can understand your concern. There are very fewer chances of you having herpes since four weeks have passed and you have not developed any symptoms. But yes, herpes can even occur as sub clinical infection without presenting with any signs and symptoms. I would recommend you go for an ELISA (enzyme-linked immunosorbent assay) test for herpesvirus that is HSV 1 IgG and HSV 2 IgG and HSV 1 IgM and HSV 2 IgM. These tests are confirmatory in herpesvirus infection. These will tell your herpes status. If positive there are chances of passing the infection to your wife but not very high since you are asymptomatic. I would recommend you to first get the tests done and find your status. Then we can discuss further possibilities. 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: How accurate are skin prick tests for predicting positive reactions? My family is interested in a pet and I have had negative skin prick and blood work tests for dander. Before we bring a pet in and before my kids become bonded, is it reasonable to assume negative tests will translate in no reactions. Occasionally, when I interact with animals, I have a reaction but it is difficult to determine whether it is actually the pollen which I am highly allergic to. ### Response: Hi. Skin prick allergy testing is one of the most accurate ways of diagnosing the allergen, one is sensitive to. It is definitely more accurate than blood immunoCAP testing (blood allergy testing). Skin prick testing checks your sensitivity to the protein in question. Even if sensitive, it need not mean you are allergic. Whereby, a positive result need not always mean you will get allergy with the protein. It means that your immune system is sensitised to that allergen and that an allergy can occur in subsequent exposures to the allergen. A negative in skin prick testing will mean that you are not sensitive to that protein and that you will not end with an allergy upon its exposure. This is true. But it is specific for the particular type of allergen. What all animal danders were included in your profile and what was the response to each? Is there a photograph or record of the wheal or flare that developed after each prick? Was the test read by a clinical allergist or immunologist and were you provided a report as to that you are not allergic to any animal dander? Were you diagnosed with pollen allergy or sensitivity? Have you observed any symptoms of allergy while in gardens or bushy areas? Or in any particular season? Does any one else in your family have allergies?" "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 the Skyla IUD inserted two months ago to lighten my very heavy menstrual flows hopefully. My first period after insertion was very heavy and painful, more than usual, but I heard that was likely to happen. It lasted for two and a half weeks. Since then, I have had spotting daily, some days heavier than others, but very frequent. I also have been experiencing mild cramping and bleeding after intercourse. Is this a dangerous condition? ### Response: Irregular bleeding is the most common side effects of hormonal IUD (intrauterine device). You should expect irregular bleeding or vaginal spotting for six to eight weeks after the insertion. I recommend you to reach inside your vagina and feel the string. If you can feel the string the chance that IUD is in the right place is very high so you should not worry too much. Taking Motrin (Ibuprofen) and applying heating pads should help with cramping. The string should be checked by yourself now and then to make sure it is still in the right place." "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 began taking Ortho Tri-Cyclen Lo at the start of this month due to follicular cysts. I have observed two bruises on arms and one on my leg. Are these side effects of the contraceptive? ### Response: I would be in a better state to answer if you could attach a photograph of the area" "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 scheduled to receive a frenectomy to close the gap in my two front teeth, but I have done some research and it has all told me I need to get braces following the procedure but my dentist told me it was not necessary although my gap is quite large. I was wondering if you could help me understand the process more. ### Response: The frenectomy procedure as such does not close the gap. It involves the removal of fibrous tissue that is present. Then, closure of the gap can be achieved. The minimal movement to close the gap is with the help of removable appliances like retainers. More movement to close the gap, if required, can only be achieved with braces. Clinical pictures and radiographic evidence will be necessary to predict the treatment plan and the outcome. Just discuss all your doubts with your dentist and take a good decision" "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 boil on my lower leg last month. It was paining and in five days it was filled with pus. Doctor advised it poping and after that, I took Amoxiclav 625 twice daily for three days and keep on dressing.After 15 days another one appeared on the upper side of the knee on the same leg. I used black tape (Atropa) and it popped in five days. On the fifth day, another appeared on the same leg and I took Amoxiclav 625 for five days twice daily. It popped yesterday and today is the fifth day of medicine. Now today, I am feeling another coming near it. What should I do? Please suggest.Should I use Mupirocin on it three to four times a day? Should I continue Amoxiclav more?Please guide me if anything else should I do including any home remedy I can not bear more pain and I do not want to take medicine any longer. ### Response: Hi. From your history, I would say you are suffering from folliculitis i.e bacterial infection. Since you have recurrent episodes I would suggest you to get pus culture sensitivity done. So that specific antibiotics can be decided. Secondly, complete your seven days course of Amoxclav 625 (Amoxycillin and Clavulanic acid). Do not burst boils. Yes, you can use Mupirocin ointment two to three times a day or Fusidic acid cream (Fucidin cream) can be used. If possible please send an image and revert back." "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: Initially, I noticed four red rashes on my chest and neck. On the next day, I got another four rashes on my face and after two days, I got rashes on my hand and fingers. I also have mild fever and joint pain. All the symptoms have started after my treatment for herpes from a hospital. Do all my symptoms say something about HIV? Previously, I was tested negative for HIV on the 27th day of exposure. ### Response: Please send a few good quality photographs taken in a natural light to help you better. Revert back with the photos to a HIV AIDS 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 am a 37-year-old female. For the past couple of weeks, I have foot ache and feel a cold tingling sensation on and off. My blood reports and ECG are normal. I have no health issues. But I have a cheek tingling occasionally. ### Response: Hello. You seem to have mild neural pain. It could be due to the gentle compression of nerves. Please take Vitamin supplements and if persisting, Pregabalin after an evaluation by neurophysician. Please feel free to question me in this regard." "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 high blood pressure, low heart rate. Is my ECG showing infarction? I have no chest pain. At the time of ECG, my blood pressure was 168/100 and heart beat 46. ### Response: I have gone through your ECG (attachment removed to protect patient identity). The reports mentioned on ECG are machine generated and are frequently inaccurate. There is no clear-cut evidence of myocardial infarction on ECG. As you also do not have any history of chest pain, it is unlikely for you to have any heart attack. And yes, heart rate is low and it is sinus bradycardia. Do you have any symptoms of dizziness, syncope, etc? If not then it needs no action at the moment. However, you should undergo thyroid test to rule out hypothyroidism as a cause for low heart rate. Also, should undergo echo, which will additionally provide the assurance to rule out MI. Also, if echo is normal then should have TMT (treadmill test), which will help in ruling out minor blockages, subclinical ischemic heart disease and to look for maximum heart rate you achieve during exercise, which will help in determining the benign nature of sinus bradycardia if the adequate heart rate is achieved. Also, high bp can also cause low heart rate by a reflex mechanism. So you should have medicine for it. I guess you are not receiving any medicines like beta blockers which can reduce heart rate. You should have tablet Telma CTD (Telmisartan and Chlorthalidone) 40/12.5 mg once a day in the morning for hypertension so get it prescribed by a local doctor" "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: Does the keto diet positively affect and alleviate stomach issues such as IBS? ### Response: Hello. Keto diet is a crash diet, which means it can be done for a short period of two to three months or so." "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 missed my period for a month, and he inserted his penis tip into me. But he did not do an ejaculation. Please solve my doubt. ### Response: Hi. If the ejaculation is not done in the vagina, then there is no chance of getting pregnant. The delay could be because of hormonal changes. Get a urine pregnancy test done with an early morning urine sample to confirm pregnancy." "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 prescribed Adderall 10 mg two tablets daily for ADHD and 10 mg Propranolol as needed for anxiety. Adderall is helping my ADHD. However, I have experienced increased anxiety and all the physical symptoms that come along with it, including chest tightness since taking the Adderall. I do not have chest pain or increased heart rate. Is it safe to assume the Propranolol while taking Adderall? ### Response: How long are you taking Adderall? It is known that some people experience increased anxiety when taking Adderall ( Dextroamphetamine, Amphetamine). If the excessive stress continues to be problematic and has not settled in few weeks, discuss with your psychiatrist about possibly reducing the dose of Adderall or looking at alternative medication for managing ADHD (attention-deficit hyperactive disorder). Meanwhile, Propranolol can be used as needed to manage anxiety provided there are no contraindications like asthma. 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: My wife took abortion pills before three weeks, but still, her periods did not stop. She is getting some fiber along with the blood and we think that this is not normal. Can you please suggest? ### Response: Hi. Her symptoms are suggestive of incomplete abortion. First, you should go for pelvic ultrasonography to see the cause. Then you should consult a gynecologist and get your examination done. If any retained products of conception are there then it can be evacuated by surgical method of abortion (D&C). Please do not worry. Please consult a good gynecologist. It is a safe method of abortion. 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 a 35 year old female. I have on and off sharp pain in the left upper chest. Sometimes, it radiates to the neck and sometimes shoulder and upper arm. My ECG, bloods and chest x-ray were normal. With all these tests, is it likely to be the heart? Movement does not seem to influence the pain. Sometimes, I get a bit dizzy too. Pain seems to come randomly. Doctor prescribed Diclac 50 mg thrice a day and Clorom 500 mg twice a day. What else could it be? Colonoscopy has done recently due to family history of cancer and that was clear. Ultrasound of the abdomen was also clear. ### Response: I have carefully worked through your case and can well realize your health worries." "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 months ago, I had sex with my partner. Fourteen days later, I had my normal periods. But now two months have passed by and I have not got my periods. Moreover, I have used home fertility kit and that has shown negative results.Am I pregnant?What is the reason for my missing periods? ### Response: Hello. If you had a period after intercourse which is totally normal like the ones you had before, in terms of flow and days, it is highly unlikely that you would be pregnant. Also, you have stated urine pregnancy test is negative. So that goes against too. There could be many reasons for a missed period. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. You should expect your period to come after completion of the doses between 48 hours to seven days. If you do not get it even after that, it is better to consult a gynaecologist physically to rule out other causes as well." "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 with my fiance one and a half months back and within an hour, I took I-pill. Eight days later, I had some spotting and after that, I usually had my periods a week later. But, this time it did not happen and I am totally freaked out and I did try sugar pregnancy test at home but it did not show any sign of pregnancy. What should I do now and my periods are delayed by I-pill or some other reasons. What should I do? Please help. ### Response: Your periods can be delayed due to I-pill. Periods can also be delayed due to hormonal problems. Do serum beta hCG blood test to rule out pregnancy confirmatively. Let me know your blood report so that I can guide you. Do serum TSH (thyroid stimulating hormone) and serum prolactin blood test on empty stomach tomorrow morning to see if you have any hormonal imbalance. Let me know the report once you get 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: How accurate in your opinion is the Lelli ACL (Lever test)? I am almost three months post-op of having my ACL reconstructed along with a few lesions addressed during the surgery. I am concerned I have ruptured my ACL again after feeling a short sharp pain when turning in the sand on vacation. It has been three days since the incident and the knee now feels a lot looser and I have some pain in different areas. I have tried the Lachman test with no noticeable shifting, and the Lelli test was positive with good leverage hopefully assisted by my intact ACL. I will have to see my surgeon and physio soon but I am just wondering how accurate the Lelli test is. There seems to be no difference when comparing the test in both knees. ### Response: Hello. I read through the concern. The Lelli test is accurate in diagnosing acute on chronic ACL tears, more sensitive than many other traditional tests performed in an acute condition, especially partial and acute tears. Do not be afraid. Keep calm. Take precautions not to strain and exert your knee. Keep it supported with an ACL brace until you get properly diagnosed by a good orthopedic or physio. Do not jump to a conclusion and keep worrying as you might not be accurate enough to say the reason for translation as there could be many factors like muscle inhibitions and imbalances that exist post surgery which may all confuse you leading to false positive tests. Hope this is helpful. Kindly revert back in case you need any further help in this regard." "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 student, and I stay in a highly polluted area. I got shifted here five months ago. Early in the morning as soon as I wake up for five to ten minutes, my eyes start paining and irritating. Few times it also turns red. Due to this I could not wake up on time and also feel uncomfortable. When I study I feel some dryness in my eyes. Please help me out with some suggestion. ### Response: Hi. By your description, it looks like a condition called vernal keratoconjunctivitis. It is a type of allergic condition. It increases in summer and dusty polluted environment. I suggest you wash your eyes with cold filter water twice a 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: My mother is having difficulty in breathing. We have consulted a doctor. Based up on the diagnosis, he advised a surgery for the polyp in the right side of her nose. She is 45 years old. Her weight is 65 kg and height is 5\4"". Currently, no biopsy has been done. Do we need to check biopsy? Can you please provide your opinion and the severity level? ### Response: Hi. I got to understand that the primary complaint of your mother is nasal obstruction. How long is it present? If it is antrochoanal polyp, as CT suggests (attachment removed to protect patient identity), it needs surgery. AC polyp does not reduce with medicines. More important reason to get surgery is that in above 40 years age with nasal polyp is a risk. Biopsy has to be taken to rule out malignancy when it is only on one side. Risk of surgery depends on general condition and surgery when done endoscopically does not cause much risk. BP, diabetes and other underlying systemic diseases are risk factors." "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: Just this morning my brother told me he had pain in his ribs the day before and it seemed a bit weird this morning too. But, he did not have any pain. There seems to be a weird bump on one side of his rib cage. What could be wrong? ### Response: This could possibly be a collection of fat cells called lipoma or collection of a mass of nerves called neuroma. Another possibility is that it could be an inflamed muscle or a bone spur. A clinical examination would be extremely necessary. A biopsy may be needed based on clinical examination findings. 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: Why do I have dry skin around my mouth and how can I treat it? ### Response: I have gone through your case. Use of colored toothpaste, excessive salivation, rubbing tongue on lips, poor oral hygiene, use of lip balms and lipsticks. Treatment involves maintaining good oral hygiene. Mix Clotrimazole and 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 am 24 years old and I have a combination skin type. I have minimal breakouts basically during my periods but these pimples leave a lot of marks. Please suggest me a tablet or a treatment on how to remove these marks. Also, I do not want to take any medicines containing steroids or apply any cream having steroids. Please help. Also, please tell me what to do to make my skin better? Not only my faces but also my body. ### Response: I have gone through your case. First, you need to understand acne is common and you may experience frequent exacerbation due to stress or periods as you already told. Moreover, steroids should never be used in acne skin. In fact, this aggravates acne. Please apply Clindamycin gel two times a day on pimples. Apply Vitamin C serum on dark lesion for three months twice daily. Use Cetaphil cleanser." "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 rash on my right chest for five months. I asked many doctors but no one can say excatly what it is. It is a red small rash without symptoms. I did try some stuff like hydrocortisone 1% cream for two weeks and an antifungal medicine for two weeks but nothing happened. Then more than a week ago, I did go to the doctor and he prescribed Fusidic Acid and betamethasone 20mg/g plus 1mg/g cream. I have taken this for one week and three days with one day pause. I have attached few pictures before and after the treatment and the medicines seem to work very well. I want to know should I continue until the symptoms have totally gone or should I use it only once a day instead of twice a day? What is the best option without side effects and long-term complications? If I have to stop these medicines, should I start using hydrocortisone 1% cream? I have read on the internet that the cream might damage my eyes. Is it true? After I take a shower, is it safe to touch the affected area? Should I be careful when I wash my hair or face after touching the affected area? What can I do to make sure this does not come back after it has gone. ### Response: Hello. I have reviewed the clinical photographs attached (attachment removed to protect patient identity). Regards" "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 35 year old male. What is the normal range of cortisol in a 24-hour collected urine probe? Is having too low cortisol levels in 24-hours collected urine probe a clinical matter? In the last six months, I had three urine testings with the account of cortisol between 10-12 \xb5g/24 hours. I am dealing with PTSD and a distinct fatigue. ### Response: You have not mentioned why you got your urine cortisol levels checked. The normal cortisol levels vary between 10 to 100 micrograms and vary from one person to another and is affected by many factors. What are the symptoms you are experiencing? Are you having any sleep disturbances? Are you on any medications? Please revert back with the above answers for proper diagnosis" "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 2 year old son\s penis tip has a very narrow opening. The foreskin at the bottom part is quite flexible, but it seems to be attached to the inner meatus at the tip. When I try to pull back the foreskin for cleaning gently, the inner meatus is hardly visible. Earlier, he used to have ballooning while peeing. After application of a corticosteroid cream (Betamil GM) for a couple of months, the ballooning has gone completely. But, the opening is very tiny. He has not complained of any pain as yet, but I am just curious to know if I should worry. ### Response: This phenomenon is known as phimosis. Most of the time, steroid ointment that you have applied will help. In your case, it has helped. So, do not worry even if the opening is small as long as there is no ballooning of the prepuce. You can get a circumcision if you want to get rid of this problem altogether. But, no hurry to get it 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: left eyelid very swollen and itchy with pain. It is also very itchy and painful and also having a white discharge from eye. I have been having the issue for a week and it is not getting any better ### Response: Hello, According to picture you have send its likely to be infective in origin. So you have to take antibiotics for the treatment. All these you have to take for 1 weeks. Then you will be fine. Infection As per now nothing ? Sty Infected lid swelling As mention above Do not rub your eye Do not touch your eye After 1 week" "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 aged 80 years is suffering from acute leg pain. She is a patient of filariasis in right leg and also femur fracture in the same leg. Reports of all recently done tests are normal. Please advice. ### Response: Hi. What the patient needs to do is: Keep the affected leg elevated over two pillows. Take tablet Orthal forte thrice a day for three days. Take tablet Carnitor 500 mg twice a day for three days. Revert back with the x-rays and reports to an orthopaedician and traumatologist 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: Dear doctor,Recently, I was diagnosed with diabetes and my blood sugar fasting was 231 and random was 271 mg/dL. I consulted a doctor and he prescribed me Qosmet 500 mg/ 50mg twice a day and Amaryl 1 mg once in the morning. After a week, my sugar was under control and blood sugar fasting was 93 mg/dL and random was 111 mg/dL and 139 mg/dL. Three days I was fine but after that, I am feeling vertigo (dizziness). Kindly tell me why this is happening to me. Is it any side effect of the tablet I am taking or any other issue? ### Response: Hello. You should monitor your blood sugar twice a week and especially at those times when you are feeling dizzy. Initially, with the start of medication, you may have some low blood sugar symptoms due to the first effect of medications for treatment of diabetes. I suggest you buy a glucometer and keep a check of your blood glucose twice a week and also check your blood sugar whenever you have such kind of symptoms like dizziness, sweating, and irritability" "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: From yesterday, I have vaginal swelling, discomfort, and abnormal discharge. I had intercourse with my partner before four days. Please prescribe some home remedies or medicine to cure this problem. ### Response: You have some vaginal infection, and it is causing the problem. Please get yourself checked by a gynecologist internally and get a vaginal swab test done. Avoid having sex till then. Wear cotton panties, and loose lowers. Maintain personal hygiene and take plenty of fluids. Wash your private parts with ordinary tap water whenever you use the washroom. Avoid using vaginal douches and creams. Revert me with the reports 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: If a person is allergic to seafood, can they swim in the ocean? This person cannot touch seafood or have sea-salt either. ### Response: Hi. If a person is allergic to sea food and sea salt both, he should ideally avoid swimming in the ocean so as to avoid getting an attack of anaphylaxis (lethal allergic reaction) while under water. In my years of practice I have never come across any person with allergy to sea salt. It is usually the sea food which contains proteins, to which allergy occurs. Sea salt contains NaCl and KCl and other minerals which are usually inert and do not cause any reaction. However, to be on the safer side, avoid swimming if you are truly allergic to sea food and sea water." "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 do intercourse I am not able to go deep up to the length of my penis. My outer layer of penis is attached to the head. I feel to ejaculate due to excitement. While having sex using condom I am able to insert whole of my penis and enjoy good sex. But without condom, I ejaculate in few minutes and not able to insert inside properly. As my wife is more supportive I feel bad for her now. I am afraid whether it is phimosis. Please suggest some remedy. ### Response: I have read and understood your problem. Yes, it may be Phimosis, the symptoms like difficulty during intercourse, hard to urinate will occur. You should use some lubricant or soap and try to pull the foreskin back by holding your penis in one hand and pulling back with another. Do not apply force and over few days it will be pulled back gradually. If skin remains stuck, then you may need a simple surgical procedure called Circumcision. As you are enjoying good sex with condom? You can apply Lignocaine gel to the head of penis 10 minutes before sex and wipe it off." "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 54 years old, female. I am having no fat loss at all. Even after excercise and proper diet plan. I am taking medication (inhaler) for asthma, nasal spray, and vaccines for allergy and Thyroxine for thyroid. ### Response: Hi." "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: Hi ,MY query is i suffer from chronic ear infection. This time when ear infection started i started taking ear drops preemptively which worked for me. But the problem is infection is in the inner walls which keeps coming back after out walls are healed and i stop taking drops for 2 weeks. Now i want to ask can ear drops cure inner infection too if i keep taking my drops. Dexatob/Clotrim ### Response: In such a situation plain 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: I have crooked teeth at front and tooth behind the crooked teeth was decayed and half broke in sideways. It was touching the crooked teeth in backward and my teeth in under jaws are somewhat misaligned. Do I need a tooth extraction for braces? ### Response: Hi. You have crowded teeth and in medical terminology, it is called malocclusion. Early growth issues, small arches, delay in the eruption and delay in fall of milk teeth, habits like tongue thrust. General oral examination. Crowding (malocclusion). There are treatment options available as follows:1.Removable orthodontics using prosthetic appliances.2.Fixed orthodontic appliances.3.Removal of some teeth can be needed to create space for crowded teeth to align but that is normal procedure, not to be worried.4.Visit nearby hospital for an orthodontic treatment. 1.Avoid tongue thrust, nail-biting in early life, especially among babies.2. 3.Visit nearby dental hospital after every six months particularly during initial 12 years of age to avoid any misguided eruption and decay. Growing period stretches up to 25 to 30 years of age. So, it is better to approach the nearby dentist early so that your defect can be corrected before it is too late." "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 brown spotting with blood clots, and there is no pain or cramps. I had my periods in the first week of June. I had unprotected intercourse in the first week of October, but my partner did not ejaculate inside me. I again had intercourse (protected) and I had slight bleeding after that. Whenever I have the orgasm I bleed, this never happened before. I have an irregular cycle for one year. My periods come in about three or four months duration. Now it is four months already, and I am experiencing this dark brown spotting instead of my periods. Why is this happening? Please help. ### Response: Hello. Considering the fact that your periods have been irregular since long and the interval is three to four months, then for sure, you should be evaluated for causes of oligomenorrhea like PCOD (polycystic ovary disease), hypothyroidism, and hyperprolactinemia. Also important is to rule out the pregnancy as you have been sexually active. Once ruled out then a per speculum examination can be conducted to rule out cervicitis, or erosions which can cause post-coital bleeding. So a gynecologist examination would be recommended." "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 right inner cheek is swollen. This happened for the second time this month. The swollen cheek falls between the teeth while talking or eating. I am having pain too. ### Response: I have read through your complaint and the relevant details. The swelling should be the reason for any tooth infection associated with the right lower back tooth region in the least case. If that is ruled out during a dental consultation, then it could be the infection in the salivary gland. I say this because you have mentioned a history of swelling interferes with eating and talking. Usually, salivary gland swellings affect both the sides of the cheek region and also below the tongue with or without pain." "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 baby is one year old. She has soft teeth in the front and she is not able to bite anything with the upper teeth. If she bites, the teeth start chipping. What am I to do? ### Response: Hi. If the enamel matrix formation is deficient, it will result in soft teeth that chips and/or decays easily. It may also result in an atypical or abnormal tooth shape. This is called enamel hypoplasia. Treatment for this dental condition includes removal of the very soft enamel and placement of a white tooth-colored filling in that area. Occasionally, the aberration or deviation from normal growth in the enamel is extensive enough that we recommend a white stainless steel cap as a temporary crown during the growing years. Maintain proper oral hygiene of the child by wiping the teeth with a soft cloth or a very soft brush." "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 32 years old. I was using self-tanning creams around seven years all year long. I have stopped for the last two years. I am worried because I have read that self-tanning creams are causing cancer and tumors. Is it true? Are they out of my system or will it take years to appear if they caused me cancer? ### Response: Yes, self-tanning lotions are known to cause skin cancer. Please stop using it and avoid exposure to sunlight without a sunscreen. Use a sunscreen with SPF 50 or more, apply every fourth hourly. Look for any changes in the skin, any bumps that look different, any changes in moles. Seven years is too long. I would suggest you visit a dermatologist for full skin examination so that any abnormal skin lesion if present, can be picked up early" "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 34 year old female. I have got my STD and HIV done. I have attached my reports for your reference. All look clear, but herpes simplex virus IgM and IgG are 3.5 and 4. I have no other symptoms. Please help. ### Response: 1. IgG HSV1 and IgG HSV2 to check for immunity against these subtypes individually.2. The IgM antibodies may still be positive with progressive fading acute infection. 1. If you do not have active lesions or are not pregnant, there is no indication for treatment.2. If you have active lesions, avoid unprotected sexual contact. It may however still transmit even if you do not see active lesions, since they may be hidden in the genital tract." "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 LASIK done for my eyes two months back. My vision is all right but, I feel a burning sensation at the corners of the eyes (corners from where tear comes). After 20 days of LASIK, (back then) whenever I put any eye drops my eyes started burning. Due to the burning sensation, my eyes started watering. I had consulted many doctors, and they prescribed eye drops like Systane Ultra, L-Pred, and Eubri. But no eye drops help me. I do not know what to do. Sometimes I also get redness in the eyes. Is it dryness or something else? ### Response: LASIK when it is done, corneal nerves will be cut. These corneal nerves take several months to regenerate. Eyes also become hypersensitive. Systane ultra is artificial tear eye" "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 problem with my teeth. I started using Hexidine mouthwash last month for whitening of teeth, but it is not helping me, and soon my teeth are becoming brownish at some places. What should I do to clean it? ### Response: Hi. Using Chlorhexidine mouthwash for more than 15 days in continuation causes brownish discoloration, that is the reason your teeth are becoming brownish. Now that you have developed chlorhexidine discoloration, I do not think scaling will be of any use. Instead, I would suggest you for either bleaching or veneering. Veneering is the solution for the type of stains that you have developed. Dental veneers are thin flakes of tooth-colored material, which are applied over the original teeth. Good luck." "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 suffered from common cold symptoms three months back. It resolved completely in about 18 to 19 days. Started with constant sneezing followed by a runny nose, then nose cleared and sneezing stopped but felt an uneasiness in palate and throat turned sore, getting worse with time and then persistent coughing. I consulted my general practitioner on the fourth or fifth day who prescribed some medications. I started feeling better after the seventh day and the throat improved. But almost the next day onwards I started feeling worse again but this time it was not sore throat or a runny nose exactly, just felt the mucous inside throat all the time. Never felt feverish as such or found raised body temperature (by touching only) and experienced mild body ache here and there. Nevertheless, around 1 month after this resolved totally as said above, since yesterday I have started feeling same common cold symptoms, runny nose (not sneezing or coughing much though) with uneasiness in the palate, no raised body temperature but little feverish with mild body ache here and there.In both the aforesaid cases I had taken a Cetirizine tablet on the same day (but little later in the day) the symptoms started. But the medicine did not work. However, previously whenever I experienced a runny nose and constant sneezing, one Cetirizine tablet helped.In fact, it resolved the problem. Could you please share your opinion on this, please, why the cetirizine did not work? Secondly, I may have had (but I am not sure at all) a possible HIV exposure around 10 months ago. I did not get tested. I have consulted few doctors online who said that the chances of HIV infection is quite less. Assuming I may have HIV, could it be the reason why the cetirizine did not work? I wish to mention here that I had high blood pressure for which I take medicines and last month when I checked, it was under control. ### Response: Firstly, I do not think it has any relation with HIV status and you should not worry about it. It seems you are quite worried and unconvinced about HIV status. So, I would advise you to get yourself checked. It will help in relieving your anxiety and fear. It is not at all related to HIV. You appear to have another viral infection now and I would suggest Tablet Paracetamol 500 mg whenever needed for your body aches, uneasiness and fever if develops. Also, instead of Cetirizine, you can have Tablet Allegra (Fexofenadine 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 am 33 years of age, 165 lbs. I have had anxiety, fatigue, gynecomastia, low libido, no morning hardness, and muscle loss. My lab results came back with my free testosterone level of 9.2 and testosterone level of 485, is this considered low T? ### Response: Hi. I have reviewed your query and can well understand your worries. Normal levels of testosterone range from 300 to 1200 mg/dL and can vary a bit with different laboratories. Yours is not that low but is on lower side for sure. Keeping in view all the symptoms you described, low-T can be suspected if not otherwise ruled out. Just for general knowledge, signs, and symptoms of low testosterone include a change in sleep patterns that may be insomnia or sleep pattern disturbances. Physical changes like increased body fat and reduced muscle mass or bulk. Sexual changes like reduced sexual desire, sexual dysfunction, or infertility. Emotional changes like decreased motivation, depression, lethargic. Worsening of sleep apnea if a patient already has it or if there are risk factors the patient will get sleep apnea possibly. Worsening of congestive heart failure in cardiac patients. Many of your symptoms overlap with low-T. You need further probing in this matter. Your treating physician would help you in this regard. Sometimes diabetes, infections, obesity or other factors may contribute to ending up with low-T. Your physician would rule them out for 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 was taking Oxra 5mg tablet for diabetes and due to which I had excessive urination. I got fungal infection on the skin of my penis with burning sensation and itching. I had got this problem two weeks ago when I was on Oxra. I consulted a skin specialist and he prescribed Itraconazole 200 mg for five days and Lulifin cream to apply twice a day. I took the whole course and all cleared up until after two weeks ago when I had sex with my wife. I started getting the burning sensation and by the next morning, it was itching badly. I then applied the Lulifin cream. Should I go back on the course of tablets too? Why has it recurred? I stopped the Oxra completely when I started the course. Currently, I am on Carbophage G 1 for diabetes. How can I be helped? ### Response: Candidal balanoposthitis is a very common fungal infection of the glans and prepuce of the penis. It is usually seen in poorly-controlled diabetics. Also the treatment course you have taken is incomplete. Usually, the antifungal cream needs to be applied daily for at least two weeks including strict sexual abstinence. The partner too would need treatment in case of any existing vaginal discharge. Kindly upload appropriate images of the present clinical lesions so that we could suggest treatment for you accordingly" "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 concerned because I have had a low WBC since after I had my son three years back. A year later, my WBC decreased to 4 and since then has continued to decrease but now I have a low granulocyte count of 1.7 which I have not had before. It is now 3.5 from recent CBC. My last draw was a year ago and it was 4.0. I have been as low as 3.6 in the past. I am a highly stressed person since after the birth of my son. I have been in school for my BSN and MSN and I am wondering this could be related to stress. My H+H is within normal limits with only a slight decrease in my HCT of 28.1. At the time of my CBC I was menstruating so I am attributing the low HCT to menstruation. The only symptom I have is fatigue. Otherwise, my PLT, RBC, HGB and other cell line are fine. Any advice would be greatly appreciated. Previously I have had anxiety and leukopenia. ### Response: Hello. According to the provided history, you are having low WBC count along with normal hemoglobin, platelet, and other values. But your WBC count is not much low and so not much alarming. Viral infection, hepatitis B, HIV, autoimmune disorder like SLE, enteric fever are some causes. According to examination, further workup can be planned according to need. But I need to check your differential WBC count and for that peripheral smear, examination report will be best. So provide your peripheral smear examination report to 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: I have a UTI with E. coli infection detected. My blood urea is 27 mg and the serum creatinine is 1.3 mg. My primary health doctor advised me to consult with a nephrologist to find out the reason behind the rise of creatinine level. He told me that the creatinine level is near borderline. I have back pain, waist pain, and discomfort in urethra, and a little foamy urine,Frankly speaking, we do not have any doctors in our area. There are no many doctors who are specialized in kidney disease. How should I have to maintain my health and what precaution needs to b taken care of? Please give me a suggestion. Am I in a danger zone? ### Response: Probable cause could be interstitial kidney injury or interstitial nephritis. E.coli (Escherichia coli) can cause both toxic and interstitial injury to kidneys but it is usually reversible. As your ultrasound is fine, there does not seem to be anything to worry. You need to repeat: After 14 days, they should be fine by then. Also, avoid sexual contact for next three weeks. Currently, no medicine is needed if you do not have any symptoms. No sexual activity. Increase fluid intake. There will be no medicines for two weeks. Follow up in 15 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 having ""mood disorder"" and under treatment for around nine years. The doctor said that the medicines are to be taken lifelong. Now prescribed Valporil CR-300 and LithoSun SR tablets (both 1-0-1). If I come to Ayurveda, can I stop these medicines within some time? While visiting an astrologist, he recommended me to take ""Manasamitra vatakam"" tablets along with Saraswata Ghritam for 21 days. My query is, can the above Ayurveda tablet be used along with the other allopathic medicines? Will there be any side effects? In what proportion is it to be used? ### Response: As you have this problem from a very long time, suddenly stopping the allopathic medicines may lead to worsening of the problem. So, follow the advice of your psychiatrist. Along with the allopathic medicines you can take Ayurvedic medicine. But keep some time gap between your medicines. The ayurvedic medicines recommended to you are good and you can take it as per your physician\s advise. But initially, take under supervision and in case of any problem visit your physician. Along with medicines, try to stabilize your mood by doing meditation and breathing exercises like Pranayam and Anulom vilom daily. Walk daily for at least 30 to 60 minutes. Adopt a new hobby like dancing or painting, etc. Learn new things. These things will help you in managing your mood" "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 flown very often in the last few years. I forgot to wear earplugs and slept on a few flights recently. On the last two trips, I had multiple flights connecting. I noticed my ears did not stop popping after a few days. Since my last flight, my right ear has not cleared up. It used to be at night my ear would pop and get better during the day. Now my right ear has lost hearing, I would estimate about 50% and fluctuates between 50% to 75% during the day. When it is totally silent, I think I hear this tone in my right ear. I do not have headaches and can sleep fine. I have gingivitis and bleeding gums, and no other health issues. I was wondering if my ear is infected or not. I know whatever I have is connected to my frequent flying every two months for the last five years. I always wore earplugs and never had this before but forgot the last trip. Should I take antibiotic drops? I definitely have mucus in my sinus and I am not sneezing or coughing in any major way just and not sure if I am infected or not. Would antibiotic drops help me rule out infection? ### Response: Hello. Simply it is a eustachian tube dysfunction. Ear infection which needs an antibiotic must be accompanied by ear pain. I think that you need an anti-edematous and anti-inflammatory like Alphintern tablets or Reparil tablets three times daily for a week plus corticosteroid tablets in the dose of 1 mg for each 1 kg of your body weight daily. For example, if you are 70 kg you need 70 mg of corticosteroid per day for 10 days.The most popular corticosteroid is called Prednisone tablets. Chewing gum will be useful for 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 have a white blister on the scrotum for the past one year which is painless. ### Response: I have seen your query. With your descriptions, it seems you have developed a sebaceous cyst. Please get a review with pictures for better evaluation and the best possible treatment for your concerns." "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 all started with leg pain some two years ago. At that time my vitamin D3 level was only 8. Then, I took Uprise-D3 60000 weekly dose for two months. I was cured and fine. But after six months, the problem started again. I did my blood tests again and it was 30. I started taking vitamin D3 again and got about 70% relief. Three months later, my vitamin D3 level was 66. But when I stopped taking vitamin D3, the symptoms occurred again. Kindly help. My uric acid is 7.6 and calcium level is 10.5. ### Response: It appears that you have myalgia. Usually, vitamin D has to be taken along with calcium supplements even if the calcium levels are normal. Also, 50000 IU of vitamin D can cause muscle pain. Dehy" "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 took GABA supplement and I am unable to sleep. If I fall asleep, I am only sleeping for a few hours, and then I am wacking up. I did not start experiencing this issue until I took the GABA supplement. ### Response: Hello. GABA (Gamma-aminobutyric acid) supplements can both, make one go to sleep and keep awake. As for now, I suggest you wait for a few hours until the effect of the medicine wears off. I suggest you do not take the GABA supplements by yourself." "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 erectile dysfunction with no apparent cause. Blood test and ECG are fine.I have never had ED. My sex drive is usually not even too much. For the past eight months, my sex drive is non-existent. I also have no morning erections. Factors that play a role are that I broke up with my wife and also eight months ago, I had serious accessory nerve operation that failed to fix my trapezius palsy, but I think these areas are physically too far apart. But maybe depression? I have not been able to think myself to be turned on. I have tried Zinc, Magnesium ZMA vitamin supplements which seemed to help for one week and I got hard morning erections. However, it stopped working. I have also tried Ginseng which does work as well as Tadalafil prescription works too. I can stimulate the penis with no medication too and ejaculate, but I usually have to look at porn (which I do not do often do because I have no libido, whatsoever). I have failed to have sex with three girls now because of lack of desire. I want to physically get it up, but it does not get up. I have ED, and I simply cannot get it up to beautiful women which is horrible.I have slight pain in both testicles which is I think because I have not masturbated. Feels like blue balls which are there when a man gets turned on but does not cum, so it hurts a little. No lumps are there on or in the testicles or anywhere else. No STDs of which I am sure because I had only five partners of which my ex-wife now was for last four years. All were protected sex. All tests came back normal. Only ECG said signs of hypertrophy but compared to ECG three years ago, not with any significant change so I doubt this is a reason. Also, note that the testosterone levels are fine. I usually get my eight hours of sleep but this may be because of sleep apnea. I never feel too rested. ### Response: Relax and do not worry. ED (erectile dysfunction) can be because of mainly two causes: Basically, we need to differentiate between the two as treatments for both are different. Your reports are fine (attachment removed to protect patient identity) They do not suggest any hormonal problems. I would like to have you one more test which is penile doppler with vasoactive substance injection (Papaverine). This will test whether the flow of blood in your penis is adequate or not. I feel you have a psychological cause because of your relationship with your wife and other stressful events. Moreover, it has formed a loop as now you are in the fear that every time it will not erect. So, I feel it is basically a psychological 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 brush my teeth a minimum of twice, if not, once a day but my teeth have a yellow look to them. Is there anything I can use at home to help get them white. I have heard that charcoal tooth paste makes teeth white. Is this true or can you recommend something? ### Response: I got your chief complaint and your concern is esthetics. Yes, there is kind of toothpaste containing carbon or charcoal which can remove stains. But there are variable opinions regarding their use. I suggest you if you are more concerned about esthetics use alternative toothpaste like Glodent (containing Bromelain, Papain, Flouride, Xylitol) daily for one month. This toothpaste can remove stains and whiten teeth. But so for tooth esthetics is considered, there are treatment modalities available like bleaching, scaling, and polishing." "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 is 25 years old and she had her period on the 14th of last month. On the 1st of this month, while having intercourse, unfortunately, the condom broke. She had taken I-pill within two hours. Can you please advise if the tablet will work or not? ### Response: Hello. I have gone through your history and understand your concerns. As you had I-pill, the chances of pregnancy are not there in your case. Delayed menses, if any, are due to hormonal imbalance caused by I-pill. Just wait and watch for your menses." "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 had unprotected vaginal sex single exposure with a girl. Nine months later, I found she is HIV positive. My question: I have read that after a certain window period time (three months after getting negative) is conclusive and even after (six months) confirmation is definitely negative. But, why are all these other people saying you can go years without showing positive and that is really freaking me out big time. Is it true that it takes years to come up positive or does it only take six months to know it 100 %? What is true? Also, there is a doctor who says no test is 100 % reliable. I am still 15 months post exposure. HIV RNA PCR qualitative all are negative. 20 months post exposure, HIV-Alere combo test result is negative. Any further test is needed?I am negative now. Will my result change in the future? What is 100 % window period? Please clarify my doubts. ### Response: For this question, it is based on the test you do. HIV enters the body on day-0, and goes to the nearest lymph node and starts replication by day-7. This is when, p24 antigens (core proteins of HIV virus) get detected and in turn, the body starts defense and produces HIV antibodies, and these get tested positive in 15 to 23 days. But, due to neutralization of antigens by antibodies, as per theory, testing after 23 days up to 28 days may give false negatives (<0.001%). So, getting a fourth generation HIV test after 28 days is confirmation by 99 %. Yes, not only in medical, but in any field, 100 % is not possible. And taking medico legality, no one gives you 100 % cure. No further test is needed. You are negative by 99.99 %. A change in result is unlikely. You will stay negative forever. The window period is a period where lab tests cannot detect the presence of infection by tests" "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 knee joint pain issue. We consulted a specialist a month back, he said that the cartilage in the knee joint has become less in one side of the joint and he suggested few medicines for pain relief and cartilage renewal namely, Calcium (Celedol -100, Jointac C2, and Osteodon). I read about Cartilage type-II that it helps very well in cartilage improvement and pain relief. I just want to ask you whether we can use this Cartilage type-II capsules along with the above-mentioned medicines for fast recovery of the cartilage? Or should we use only Cartilage type-II capsules without using \ Jointac C2? ### Response: Hello. Whatever you use, whether cartilage supplements or Glucosamine, it will not help in moderate to severe osteoarthritis. Only in the very early stages of OA, it helps. \ If she is not diabetic, I suggest she can take intra-articular steroids or if affordable, intra-articular viscosupplementation. Weight reduction also helps. If X-ray shows advanced stage, only joint replacement 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 got hit on my cheek by a rock while doing some work. The area under my eye swole up and caused me to have a black eye. Now a whole one year two months later, I still feel the bruising of under eye similar to the look of a black eye. Is there a certain term for this? ### Response: Hello. The certain term for this is the black eye that you have told yourself. This is a particular term (black eye) used for trauma to eye area resulting in blood collection around it. Another term used for it is raccoon eyes or panda eyes as it forms a complete ring around the eye. Because the eye area is very thin, the blood gets accumulated in collagen tissue and takes a long time to clear it up." "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 month, I did a health check-up and everything was fine. Later, I had my cycle a little heavy compared to my regular one. I felt quite weak. I went for an ECG in a local diagnostic center. It showed tachycardia and an early transition posterior infarct. I am very prone to anxiety. Please tell me what to do as I am going crazy. ### Response: From the limited details on this case that I have, it seems you are worried about the finding on the EKG (electrocardiogram) as early transition infarct of the posterior wall. Hope this helps. Please feel free to ask me if you need further assistance. I would be happy to help" "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 sick for two weeks with flu and now I have parotid gland infection (swelling) on the right side of my face which is getting bigger on the second day of antibiotics. Kindly tell me what has to be done. The ultrasound and complete blood count were checked. ### Response: Hello. I have seen your symptom details and reports (attachment removed to protect patient identity). Your reports show enlarged parotid gland with a cyst in the gland. This is due to parotitis. Usually, this kind of swelling will reduce in size with medication only. This may take four to six weeks of treatment. If the swelling is not reducing in size even after four weeks, it may require aspiration of the cyst. Your swelling size is probabling increasing because of incomplete treatment. There could be another possibility of stone formation in the parotid gland. You need to undergo X-ray to rule out the stone in the parotid duct or parotid gland" "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 gag reflex, which is really bad. I am going to the dentist next week, and I might even get braces. Do you know how I can get rid of my gagging reflex? ### Response: Gagging is very common. Do not be scared or tensed, as it can be controlled. Wish you good health and happiness. Keep me updated with the improvements" "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 unprotected sex with my wife on the fourth day of her menses and she took I-pill within 24 hours. The next day also we had unprotected sex and she again took an I-pill. After eight days, she bled and eight days later again she bled. She should get her menses by now, but still she did not get. We checked home pregnancy kit and it was negative. What could be the reason for delayed menses? ### Response: She has already bled twice this month and that means to say that she has already done with her periods, though before actual date. So, now she will not have her periods. Moreover, you said that the urine pregnancy test is negative and so there is nothing to worry about. Just wait for the next month periods. Do not hurry and take any further medications. She will be alright. One more thing I would like to suggest you. If you have intercourse within 10 days of periods, then you need not take emergency pills as it is the safe period where there are no chances of pregnancy." "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 age is 23 years and on the seventh day of my period. I had intercourse for the first time at 11 AM. Then, I had a sudden bleeding spot starting and I took I-pill at 6 PM. I have started nausea, feeling like vomiting, and next morning chills with fever, and weakness. So., I am worried about pregnancy. Any chance there is pregnancy? ### Response: Hello. As you said it is your first time having intercourse, you observed bleeding and then after an emergency pill, you had vomiting and then fever and chill. After the first time of penetrative vaginal sex, there Is hymen rupture that causes bleeding after sex. That could be a bit different in amount from person to person. After first sex, you may have some symptoms. Those can be exaggerated by hormonal emergency pills and differ from person to person. As you have taken I-pill already if it is taken in the right dosage, then least chances of pregnancy actually. Pregnancy is expected more likely in the fertileperiod with unprotected sex than in the rest of the cycle. And after I-pill, it is least likely." "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 Balaguluchyadi thailam be used for muscle knots or pain in the forearm? ### Response: Majority of thailam will relieve pain. But we should find out the reason for the pain. If it is because of gout, definitely your pain will be cured with this oil. It would be better if you explain your problem in detail with reports if you have any." "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 a painless pimple protruding on my penis skin. I am concerned about STD. I carried out blood tests and it shows herpes. Kindly suggest some cream. ### Response: Hello. Herpes genitalis usually presents with well-defined erosions or polycyclic lesions. The lesions are usually associated with pain or a burning sensation. Treatment is with oral antivirals. You complain of painless bumps which are unlikely to be herpes. It seems more like it could be viral warts. You may ask me a query along with a clear digital photograph of the lesions for a confirmatory diagnosis." "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 heard that edging helps to maintain sexual excitement for an extended period. Is it true? ### Response: Hi. Yes, edging helps to maintain sexual excitement for an extended period. If you are hyper-excited and anxious, then there may be an early discharge, and you will have an incomplete orgasm. Try to distract yourself during sex, and this will surely help you to extend the time. For some time, you can use condoms, and this will also increase the time." "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 1.7 years. He had rickets sometimes back and was put on supplements for six months. Upon taking him for review, alkaline phosphatase was extremely high but calcium level was okay and was referred to an endocrinologist. Upon doing several laboratory tests, TSH was okay, PTH was low, vitamin D levels were fine and wrist X-ray was normal. The boy cannot walk and does not look as if he will soon. When standing, he bends his legs at knee point and also clenches his fists when grasping. From the looks, he seems okay. Please help. ### Response: Rickets can be due to vitamin D deficiency or hypophosphatemia. You did not tell me the phosphate level in blood of your child. The hypophosphatemic form of rickets is resistant to vitamin D supplement. As X-ray is normal, this is a remote possibility in your child. Alkaline phosphatase is very commonly found to be high in growing child. But it is also high in rickets. With treatment, ALP comes to within reference range. I suggest you continue with the Vitamin D and Calcium supplementation and get a phosphate level in your child\s blood. Do not worry if minor deformities are present. Because these deformities will disappear as the child grows. But if the child cannot walk properly despite having a normal X-ray, and normal phosphate level, then consult with an orthopedic consultant. He will help your child by suggesting some good orthoses. I suggest you do a repeat PTH test and to do a serum phosphate level. Also, continue the Calcium and Vitamin D supplementation. Inadequate treatment. PTH, serum phosphate. Vitamin D resistant rickets, hypophosphatemic rickets." "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: Since a long time now, my voice sounds blocked all the time, even when I do not have the flu. Recently, I visited the doctor, and he told me that I need to take my adenoids out after three months. But, I was wondering whether there is a 100 % chance that my voice will sound perfectly normal, post the surgery or is there a chance it will not work? ### Response: Nasal voice can occur due to an adenoid enlargement. Do revert if you require any further support. Happy to help 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: Is coconut oil bad for the skin? A few years ago coconut oil was all the rage. We were told to slather it from head to toe for miraculous benefits. My questions are, What are the pros of using products that contain coconut oil on your skin? What are some potential cons? What skin types can benefit most from coconut oil? What skin types should stay away from it? How do you recommend using coconut oil in one\s routine to reap benefits and avoid breakouts? If someone wants to use natural coconut oil on their face, what kind do you recommend using (i.e. unrefined, organic, etc.)? ### Response: Hi. It is saturated oil and frequently used in skin, hairs or cooking purposes. This oil has health-promoting properties. It contains several fatty acids that have benefits to skin health as well. Now we will discuss some more about coconut oil step by step. Coconut oil contains several fatty acids which of them lauric acid and myristic acid are very common. These fatty acids have antimicrobial properties which help to protect the skin against harmful microns. Coconut oil also has anti-inflammatory properties. It helps to protect the skin from inflammation, contact dermatitis, eczema or other inflammatory conditions. It also helps to nourish and moisturize the skin. Coconut oil does not contain protein or carbohy" "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 noticed a small triangular bald spot in my beard three weeks ago. It was likely alopecia areata. Saw my dermatologist last week, she said it was likely folliculitis. I have had folliculitis before in the same area and it was much different. She is the doctor. So I accepted and moved on. One small spot that has some hair growing back, small thin white hair. Yesterday, I noticed what appeared to be a bald spot in my pubic hair above the penis. When I trimmed the hair back, it revealed a quarter sized bald spot and a smaller dime sized spot. I am not sure how long they may have been there as they were somewhat masked by a longer pubic hair. So, now I have what I believe to be three spots, two below abdomen and one on beard. My concern is more of them spreading than the current spots.I am now thinking back about the annual checkup that I had with my GP six months back. I advised him that in the past year the amount of semen I produce has gone down drastically. I thought it may be a testosterone issue. He advised it was likely a result of my vasectomy the year before. Also as a part of my visit, my WBC was lower than normal, outside of the range by a couple. He was not concerned about that either.My question is whether any of these things are related: decrease in semen, low WBC, and alopecia in pubic area or all separate issues? I see no reason to go back to the dermatologist as my new spots are hidden. Based on these separate facts, is there any likelihood they are related and is there any reason to see a doctor? ### Response: Alopecia areata is an immune disorder and is separated from folliculitis and it has nothing to do with your semen count and low WBC. Nevertheless, please send me a few good quality photographs taken in a natural light." "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 done RNA PCR test. The report showed that the target was not detected in the collected serum. HIV RNA was detected below, within and above the linear range of the assay. Can we conclude that the virus has entered into the body? After one week, I got western blot test also done. That is showing negative. Please suggest what my next step should be? ### Response: Hi. Kindly mention the kind of exposure you had, whether it was protected, the duration since the exposure and the timing of the test you have undergone with respect to the exposure. Are you experiencing any symptoms since the exposure? Western blot is a second line test and can be considered accurate beyond four weeks of exposure" "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 48 year old female. History of malnutrition caused by stomach issues that still have not been officially diagnosed but I am told I may have Crohn\s. I have chronic pain and seeing a pain specialist for stomach and migraine-related pain. My symptoms are:Severe fatigue.Body aches.Headache on and off.Postnasal drip.Mild sore throat.Shortness of breath.Upper back pain on the left side when I breathe deeply.When I had similar symptoms in fall, I was diagnosed at urgent care with bronchitis. I was given a breathing treatment, inhaler, and antibiotics. I started feeling a little better, then it came back in winter. I have felt poorly since then, but not this bad. ### Response: Calprotectin is a simple non-invasive stool test that can exclude Crohn\s disease. Regarding your stomach pain, I suggest that you take Controloc 40 mg (Pantoprazole) once daily at morning. It is very effective. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Regarding your chest problem, I am afraid that you have another episode of bronchitis that will require chest X-ray and some blood tests to confirm. As for your back pain and muscle ache, I suggest local Voltragen gel and deep heat creams" "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 26 years old and now 36 weeks pregnant. I just noticed my stool appeared as a mixture of white and brown long particles. I never had white poop in such lengths. My scan reports were normal a month ago. Is there any problem to worry? Is there any threat to the baby? Should I visit the doctor urgently? Please help. ### Response: Hi. Passage of white or brown particles in stool does not harm baby and there is no need to be alarmed. You can visit a physician or gastroenterologist for a physical evaluation, to confirm the nature of the problem and take treatment if required. If there are no other stomach symptoms, that visit too is not an emergency. If you have white string in stools along with other symptoms like loose stools or vomiting and pain in abdomen/fever, you need to visit a doctor as early as possible." "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 16 years old female. I urge to pee quite often. I have a sharp pain in my vagina when I pee. I have the urge to pee frequently. But when I go to the toilet, I do not have the urge to pee. Is this due to UTI or STD? ### Response: These symptoms are common in both STD (sexually transmitted diseases) and UTI (urinary tract infections). If you do not have vaginal discharge or any history of unprotected sex, then UTI is the cause. You can confirm the diagnosis with the following tests. You can do urine microscopy and routine examination soon. You can do a vaginal swab for microscopy and culture." "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 very depressed due to stomach gurgling noises at work, during the meeting, office training, etc. l have been facing this from my college. I am not able to concentrate on anything for the past four years. As soon I as I enter the office I feel very uncomfortable. During meeting while sitting in a small quiet room, I feel very stressed and wanted to break everything and run out. Please help me overcome this. ### Response: Hello. When you are saying stomach growling noises, you are probably referring to borborygmi. This is a normal process which happens to everybody when gas travels through the intestines. In some people, it can appear more prominent, especially if one is hungry or after meals. Are these noises, embarrassing you when it can be audible to others? Or are you referring to something else? Borborygmi can be controlled by making some dietary changes. Avoid gassy foods." "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: What does it mean if a swab test (just the Q tip inserted into the vagina) is very painful? More details about the presenting complaint: I have been bleeding nonstop for months, even while on Progesterone. And have heavy discharge with a bad smell. I went to the doctor to test for infection. Current medications include Progesterone and the past medications of the same issue include birth controls. ### Response: You are likely to have mixed vaginosis infection both bacterial and fungal which can easily cause cervicitis and is the likely reason you are bleeding since then. More so the infection causes vaginal walls to inflame and hence the pain on insertion. You shall require a course or oral antibiotics along with antifungal vaginal pessaries for complete treatment. Please discuss with your gynecologist and take an informed decision." "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 days ago I just had sex like thing. It means my penis touched vagina and proper sex did not happen. My sperm came out but my penis was covered with a double layered condom. Now, I am suffering from fever and cough. ### Response: Hello. Went through your post, as you have mentioned that you had used a condom, it is not possible that you could get an infection that is related to that sexual encounter" "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 pain in my lower tooth whenever I go to sleep. Due to lockdown, I am unable to consult the dentist. Can you please tell me any tablet that I can use in the meantime. ### Response: Sorry for the pain you are bearing because of the prevailing situation. As you have already mentioned there is a cavity and when it reaches up to the pulp there develops an irreversible stage which generally is more painful during night time as we sleep. I think your tooth has reached the stage of irreversible pulpitis and a root canal treatment is now must in order to save the remaining tooth. So go for it as soon as the situation in your area gets better. For now, take Amoxicillin clavulanate 500 mg (thrice daily) for five days, Paracetamol 500 mg to thrice daily SOS. Do not take Paracetamol when there is no pain but do complete the Amoxicillin course. Additionally, you can take any one for gastritis if you have a tendency to develop gastritis with antibiotics. You can take PAN-D (Pantoprazole) or Omez (Omeprazole). Take them on empty stomach. Do salt water rinse regularly. You can apply clove oil at the site, it is a good anti-inflammatory. Maintain good oral hygiene regularly, but for sure get it treated. Avoid eating from the affected side until it gets treated or even if you eat make sure nothing gets lodged in that tooth. Do mouth rinses with plain water regularly so that there is no food stuck. 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 pretty sure that I have retrograde ejaculation because when I ejaculate it does not come out at the same moment of ejaculation, but it does come out seconds later and when I urinate there is some sperm. I also have male Incontinence and bedwetting problem since I was young and I am now 24 years old and a couple of times this year I found it hard to urinate, I felt like my bladder was numbed or something. So I went to a urologist and I had my testicles tested because I had pain there and thought it was the reason for all this. He gave me antibiotics I also did an ultrasound on my testicles and to check my kidney stones but everything was fine and after the antibiotics nothing change but the testicular pain.My urologist said he wants to do a TURP (transurethral resection of the prostate) but I do not know anything about the operation and he told me I will feel pain and I am scared of that but I also do not know why he wants to do this operation. I searched online and it says mercury retrograde might be from multiple sclerosis, week bladder muscle, problem with the nerves, a previous operation (does not apply to me) or medication side effect (does not apply to me).So I am not sure what to do? I want to check for multiple sclerosis and also look at my bladder muscles? Could it be a problem in the prostate? And is TURP necessary? I want a urologist who really wants to find out what is with me instead of just doing a test and not listening to what I am saying and then tell me to come back a month later. I have more than one problem and I want to know what is causing all this? ### Response: Hello. I think that there is an obstruction in your prostate gland. Prostate gland store semen. That is why he wants to do this procedure. TURP stands for transurethral resection of the prostate. You must go for it. If you have further questions, do follow-up." "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 took an HIV CMIA test on 26th day after a sexual encounter. The test result is negative. I had protected sex but I saw some blood on the inner parts of my partner. And also at the time I was having two pimples on my penis at the end and not on the tip. I am concern about that. Is an HIV test on 26th day conclusive? ### Response: Hi. HIV negative test report at 26th day post-exposure is quite assuring, but, a confirmatory HIV antibody test is further required at three months of last exposure. There are no specific symptoms by which we can diagnose HIV. The complaints which you are having could be due to multiple reasons and do not necessarily means HIV. Is there any fever as well? If so, please send the temperature record. Please revert with the reports." "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 taking Unwanted 72, my wife got down within five days. But, her menses started again after five days though her actual time of menses not yet come. Why? ### Response: Hi. Unwanted 72 is an emergency contraceptive pill containing high amount of progesterone. These medicines have a severe side effect of heavy or irregular bleeding. Your wife had the same side effect. Please check her hemoglobin levels; she might turn anemic if she bleeds much. Continue taking iron pills. It might take one or two cycles to get her periods to get regular again. So, preferably maintain a regular regime with condoms or oral contraceptive pills like Novelon, Ovral L, etc., rather than an emergency contraceptive. They are way safer." "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 18 years old female and sexually not active. A month back, I woke up and peed straight up blood. I went to the ER and was diagnosed a bladder infection/UTI. I was prescribed Bactrim and the next day woke up with a rash. It turns out I was allergic. So, the next day I started a new medicine and took it for a few days. The blood stopped, but I felt pain, so I went back to the ER. They told me my UTI was gone and to stop taking the medicine. A few days later, I saw blood when I wiped after peeing, but it looks like it was in my discharge. It went on a few times, and I went back to the ER three days ago and said that I was peeing blood again. So, I am worried. I have not gotten my period this month, and no, I am not pregnant. I am a virgin. They said it was not a UTI and I was fine. I have had no pain or anything. Just now I peed and when I wiped there was blood in my discharge. It is not a lot but still freaks me out. I cannot tell if it is my period or something else. I have never had this happen before. My mother said that it is spotting but makes no sense to me. ### Response: Hello. This is likely to be irregular shedding which can often occur in adolescence by mid-cycle in girls with secondary progesterone deficiency due to either delayed ovulation or stress-induced hormonal imbalances. You need to get a serum progesterone level done and if it is less than 21ng/dl by day 21 of your cycle, then you may need cyclical progesterone therapy" "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 teeth are getting deposited with something which gets removed after scaling but, soon develops after 20 days. This situation has taken place twice. I do not have soft drinks, coffee, and chocolates. I am very upset about this situation. Please help. ### Response: Scaling is a temporary solution. You should maintain your oral health. As I have seen in pictures, there is stain deposition in your back teeth (attachment removed to protect patient identity). There are several reasons for stains, most common is smoking, fail to brush at night, not changing the brush for every two months, ignoring the brushing of back side teeth. Brush twice daily (especially night brushing), flossing, avoid smoking and gutkha paan. Make your teeth free from any deposition. Change brush every two months. If you follow these instructions, you do not need any scaling for several years. The most important thing is proper brushing technique. All surface of teeth should be involved, and prolonged brushing is not required." "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 here. I had a toenail injury last month (cause: fell down, toe landing first onto the floor, which made the nail get loosened). I did go to the hospital to get it treated. The doctor cut off half of my nail, cleaned and dressed it, and kept re-visiting to get the dressing changed. The doctor said that I could stop re-visiting. And then she told me that the nail would have to be removed again after it grows back fully. But, I am hesitant and kind of rejecting to do so.After a month, the nail is not loose anymore, but the nail seems to be growing outwards, and between the nail and the nail bed, there is a gap (kind of like a hollow gap inside). Should I just wait until the nail fully grows back? Should I cut it? What should I do? I am really worried that it will not grow and it will completely fall off once I start wearing shoes. Please note: I am going on a horse riding and hiking camp the next month. Just in case if it does not grow back by then, what should I do or wear to protect it? ### Response: I understand your worry. I think you need to follow your doctor\s advice (get the nail removed surgically), as it seems that the nail is detached from its bed. But get the procedure done only by a surgeon or a dermatologist. And get it done as soon as possible, because the earlier you get it done, the more the chances are that your nail will grow back before next month. 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: Yesterday we had a consultation with an eye doctor for my kid.After diagnosis the doctor said ""kid\s eyeball size is quite big"".He also said left and right eye have ""-4"" power (not cylindrical) and retina is good.He also added that, at this stage we cannot do any thing and asked us to come back after 6 months.He said the power may go tentatively up to ""-6"".Above all he said that spectacles is also optional.Please suggest me what to do now, as I do not want my kid\s eye power even more.Do we have any other approaches to control this?Will swinging of eyes be controlled on its own after some time? ### Response: Hello. I reviewed your history. Do write back to an eye care ophthalmologist online after consulting your pediatric ophthalmologist so that we can plan the next treatment" "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 17 years old. I had sex with my partner on the 24th day of the menustruation cycle. I used Today vaginal pill before intercourse. On the next day i.e. 25th day, within 30 hours, I also took i-pill to be sure not to be pregnant. Now my period which was on due is still missing. What are the chances of my pregnancy? What should I do to terminate it, if I am pregnant? Kindly help me out. ### Response: Hello. I have reviewed your query thoroughly. I-pill or emergency contraceptive pills have very minimal chance of failure if taken immediately after intercourse within 24 hours and chances of failure gradually increase after that even if taken within 72 hours. There is about one to two percent chance of failure of an emergency pill or i-pill in your case. Based on the dates given by you, today must be 8 days following the date of the intercourse. In that case, to find out if you are pregnant, you can get a serum beta hCG (human chorionic gonadotrophin) testing done. For the urine pregnancy tests to show the result if pregnant, it must be at least 10 to 14 days following intercourse. If you want to know urgently whether you are pregnant, you can get serum beta hCG testing. If you can wait another week, you can get a urine pregnancy testing, which if positive must be followed up by ultrasound imaging. Only after then and after consulting an obstetrician, should the abortion be planned under guidance. Furthermore, if you are sexually active regularly, it is better to choose other regular contraceptive methods after consulting an obstetrician and gynecologist instead of i-pill. I-pills are meant to be taken only in case of unexpected accidental unprotected sex, but not on a regular basis." "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 problem in one cord and it is for about a month now. I was given Defcort and antibiotic for a week. Persisting for little over a month now. ### Response: Hi. Since how long you have been having this problem? As per the picture, it has been there on only one cord. If it is early stages, conservative management can be tried. Did your doctor tell you about it? One month duration is a bit less to decide on surgery I feel. You should go for conservative treatment. Conservative treatment means antireflux and antacid measures along with control of allergy. Dietary precautions are to be taken. Absolute voice rest should be maintained." "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 an abscess on my balls. It is reddish and painful, but not much. I have jock itch right now. I saw terrific images on the internet, but it is not like that. Please help. ### Response: Hi. Please put up two to three clear photos of the affected area for proper evaluation and guidance. Revert back with the photos 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: Abnormal t-wave. High QRS Voltage. Abnormal Qtc. Pulse 60. Two readings were taken. Marfan syndrome present. Male 33 years old, 180 lbs, 6.1 feet tall. Chest tightness, heart palpitations, fast heartbeat, fluttering, fatigue, inverted sternum since birth (abdominal area protrudes, not due to fat but possibly due to chest deformity, sunken in). Do you see signs of ischemia, what could be wrong based on these readings? ### Response: I have gone through the ECG and images (attachment removed to protect patient identity). The abnormally high QRS voltage could be due to the chest wall deformity and thus the heart being closer to the chest wall than usual. Hence, the recording electrodes recording higher voltages from the heart muscle. The QT also seems normal. You need to get an echo done to diagnose these conditions" "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 did a dual test. I am worried right now, please help. Gestational age is 12 weeks and 6 days, crown-rump length 64.8 mm, nuchal translucency MoM 1.7 mm, nasal bone is seen, hCG, free beta 60.47, PAPP-A 6020. Method: ECLIA (fully automated electrochemiluminescence system). I have attached the report. Disorder screen positive cut off: trisomy 21 (Down)\t1:250, trisomy 18/23\t1:250. ### Response: I can understand your concern. According to your test results (attachment removed to protect patient identity), negative factors are: PAPP-A levels are elevated. Beta hCG levels are low. Positive factors are your age is below 30 years and nuchal translucency is normal. Now the possible steps can be followed are as a dual test can be performed till 14 weeks, better to repeat the test after 48 hours preferably in a standard laboratory. If the results fall in a normal range, repeat the ultrasound after one week. If everything is normal, you can continue the pregnancy. If on repetition also test gives screen positive, the possibility of the chromosomal disorder is more and you may need to terminate the pregnancy after confirming with your doctor." "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 high blood pressure since last 10 years. I take medicine every day twice but my BP remains same 150/100. I take Starpress XL 0 (at night), CTDT-0.25 (during day). Gender- female, age- 48 years. I have cholesterol little bit high. So I take Rosuvastatin, but ECG is normal. I have also my TSH level high. I daily take Eltroxin 50. ### Response: Hi. Your BP (blood pressure) is not controlled with beta-blocker (Starpress) and a diuretic (CTD). I advice you to do a renal function test and a renal doppler. The cause of your high BP can be from renal pathology. It should be ruled out. The second thing is that if both above things are normal, some changes in the medicine is needed. For now, you can add Amlodipine 5 mg OD. Secondary HTN (hypertension). RFT, renal color doppler, blood sugar (FBS, PPBS), electrolytes (Na,K). Essential vs secondary HTN. HTN, hypothyroidism, hypercholesterolemia. Exercise, low salt diet, reduce stress if any." "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 is 5 months pregnant. She is treated in one of the reputed hospitals. She has been advised to take Feronia -XT and Cal 360 tablets. Over last three to four days she is having cough in the night time and she is afraid to use any tablets or tonic. Kindly suggest which tablet or tonic she should take. ### Response: Hi. Blood test to check for hemoglobin level, total count and differential count. Cough in pregnancy. Revert back after the investigations to 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 37 years old. I have discomfort and mild pain in the right eye since last four days. The doctor has advised taking Nevanac ophthalmic suspension 0.1 suspension, and Maxmoist eye drops for dry eye. He has advised to take Nevanac one drop four times daily in both eyes, and Maxmoist eye drops only in right eye one drop four times a day. But after using Nevanac suspension I feel pain in my left eye which was not before. I have headache after using this suspension. Is it the side effects of Nevanac suspension? Should I discontinue Nevanac? I have myopia. My power is -3.75 in left eye and -2.75 in the right eye. I have myopia since 20 years. ### Response: Hello. No, Nevanac (Nepafenac) does not have such side effects. But, I suggest you reduce the frequency of Nevanac to twice daily after 15 days and then to once at bedtime after next 15 days. You said you are wearing -2.75 in the right and -3.75 in left. -0.50 at 60 degrees in right and -0.50 at 14 degrees in left. If that is not incorporated in your glasses please include it because not using cylin" "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 born half blind in one eye. I have been through a stressful few months and it has all caught up with me now with headaches and anxiety-like symptoms, etc. I noticed during this time, that my \x80\x9cgood eye\x80\x9d became hazy/blurry and became quite sensitive to light. This has gone back to normal vision. I noticed that it is now affecting my \x80\x9cbad eye.\x80\x9d I woke up a few days ago quite dizzy and did not know what was going on. I am wondering if it happened then? As I have gone my whole life like this so maybe my body is confused? I am also worried because I am unsure of whether the vision in the \x80\x9cbad eye\x80\x9d will return to its normal state. This makes me dizzy at times and I think it gets worse when I am nervous about it which might be why I get dizzy? ### Response: The symptoms of photophobia and blurry vision points out to the following possibilities: Given that there is a history of congenital impairment of vision in one eye, this tips the diagnosis towards glaucoma or corneal dystrophy. Nepafenac eye" "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 experiencing pain on my right shoulder for a couple of weeks. I have the pain only when I move. When I raise my hands up and throwing anything overhead, I have the pain. The pain is at the front of my shoulder, and I can put the finger on the spot that is sore. I am taking Paracetamol for the shoulder pain. ### Response: Keep icing the painful area frequently. The pain in the shoulder could be a muscle strain or a spasm after a prolonged period of compression possibly due to lying over that shoulder. It can be an AC joint (acromioclavicular joint) strain. Massage the area gently. Gentle stretching of the shoulder will help you feel comfortable." "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 taking Larin Fe as a birth control pill. It is a combined monophasic pill with three weeks of active pills and one week of inactive pills. I currently started pill packs a week back but wanted to change it to a weekend to avoid weekend withdrawal bleeding. How can I do so without losing the effectiveness of the pill? My idea was to wait until my placebo week which starts on a weekday and then to take the placebos only up until weekend and start a new pack then. Would this work without changing the effectiveness of my pill? ### Response: Hi. You can stop the active pill on Wednesday instead. Take placebo pill on Thursday, Friday, Saturday and start a new pack from Sunday. The plan of preponding periods is bewildering to the body. It might take you a few (2 to 3) cycles to tune your periods in a new cycle. Repeat the same thing in the next cycle by stopping the active pills one day prior, that is, 20th day, while starting the new pack on Sundays every time. So in four cycles, your dates will be as per your schedule with stable efficacy of the pills too. I hope, I could help you with your query. Please revert back, if want a shorter alternative." "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 done an eye test recently, and I found that I need a cylindrical correction too. Earlier I used spectacles only with spherical correction. My test results show 6/18, -1.25 DC \xc3\x97 95, 6/6 and 6/9, -0.25/-0.75 \xc3\x97 75, 6/6. I would like to know whether my eye power is too weak. Is there any other way available to correct cylindrical power? ### Response: The cylinder power is low, and there is nothing to worry. As there is astigmatism, the glasses have to be worn at all times. You do not need to wear glasses if you do not have symptoms like eyestrain or a headache. But if you have eyestrain and headache, you need to wear glasses. The power is low, so surgical treatment is not necessary. Contact lenses work very well, but for astigmatism, there will be mild discomfort in contact lens users. For a cosmetic concern, contact lenses can be worn after a proper fit." "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 it safe or risk to my healing process, if I smoke marijuana following a root canal treatment? ### Response: Hi. It is not safe to smoke marijuana after a root canal treatment. It can increase the pain in the root canal treated tooth. It delays the healing process, and it causes pain. If there is a pain, you can consider taking medications prescribed by your dentist. Stop smoking marijuana, and it is not good for your oral health now. Avoid smoking marijuana, and it is good for your health." "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 trying to conceive since 9/11/2014, which is when I stopped birth control pills and started prenatal vitamins.My cycles before BCP (Birth Control Pills) were always regular, about 30 days +/- 1 day with a 7 day period.And on BCP, my cycles were always 28 days, with a 5 day period.When I stopped BCP, I had a 5 day period, which began my first cycle of 31 days.The next cycle began with a 6 day period and the cycle lasted 37 days.Then this current cycle, which began with a four day period, a bit lighter than normal.I am currently on CD 27 and I believe I ovulated 3-4 days ago.So, the problem here is that I start spotting on CD 25, along with light cramping.It was only a very little bit of light brown blood, so I did not think much of it.Yesterday, CD 26, I had a little more throughout the day, then quite a bit right before bed.This morning, I am still spotting but much heavier than the past two days, and am starting to get a little alarmed by this.The blood is still brown. Any ideas on why this is happening, presumably 3-4 days past ovulation?Is this cause for concern? I have never spotted ever before.Also, I started taking Vitex at the beginning of this cycle in hopes of shortening my cycle a bit. ### Response: This could be ovulation bleeding. Usually it may take about 6 months to conceive after stopping the birth control pills. But your cycle has become irregular after stopping the pills and it is difficult to predict the ovulation time now. If spotting does not stop or if you experience pain, then you should get an internal scan done to see the cause of spotting. There is possibility of DUB (Dysfunctional Uterine Bleeding) or ectopic pregnancy or threatened abortion. It can be seen once your period date is over. Or you may get beta HCG levels tested to confirm this along with the scan (TVS - Transvaginal Scan). If everything is fine, then you may take progesterone support in the second half of cycle to clear this. Revert back with the reports to 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 injured urinary bladder and the left side ureter during hysterectomy surgery by laparoscopy. Then, cystoscopy and nephrostomy were done. A catheter is used. Can surgery be done again? ### Response: I have gone through your query and the reports of your surgery (attachment removed to protect patient identity). There has been an inadvertent injury to your left ureter and bladder. The details of the bladder injury are not clear in the summary given, but should most likely be repaired. The nephrostomy done will help in maintaining the function of the left kidney, until it is safe to do surgery again. You will need surgery to repair the injury to the ureter, usually done after 3 to 6 weeks. The results of this surgery are usually very good when performed by a trained urologist. Once the surgery is successful, the nephrostomy can be removed." "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 went to the dentist three weeks ago and had some pain in my top molar and there turned out to be a cavity which I had filled and fixed but a few days later I started to feel the same pain in the tooth and went back to the dentist and he said he could not find anything wrong. I have this flap feeling on the top tooth and it is causing discomfort and pain to that area but nobody can tell me what is wrong with it. I think I may have a crack or some type of nerve ending there and it is really bothering me. ### Response: Hello. I understand your concern. The possible causes of pain in your teeth which are filled could be multiple. A thorough checkup is required to reach a right diagnosis. However, if you find your current dentist is not able to help you out, visit another local dentist and tell your concerns. If you have an X-ray of the tooth, please upload it and I can help you rule out some of the causes" "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 18 year old girl and I am starting to notice little moles all over my body. Nothing unusual or worrisome. My mother and grandmother are also covered in moles so I guess I should have expected it. My question is, is there a way that I can prevent them from coming in or at least slow down the process? I am most concerned about the ones on my face. I have a number of them under and around both of my eyes. They are still in the ""beginning stages"" I guess. They have not risen and you can only tell if you get close to me. But I am afraid that over time they will grow in and be harder to look over. ### Response: I saw your clinical picture (attachment removed to protect patient identity). These are not moles. These are called dermatosis papulosa nigra (DPN). It a genetic condition, runs in families. These have to be removed individually. Options are: Schedule an appointment with a dermatologist for this procedure. I am very sorry there is no measure to prevent it from appearing since it is a genetic condition. However, gentle facial scrubs may help some individuals" "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 23 year old male, a third-year medical student. For the past seven days, I have had an increased urgency and frequency to urinate. I can go even more than 30 times a day - majority of these times, I feel an increased urgency. However, when I go, only a small amount or drops come out. For the past two to three days, the urgency kind of feels to be getting worse, I feel as if I will not be able to hold it. However, I am still able to as there is no leaking. There is no burning or irritation or any discharge. No recent sexual encounters and no other associated symptoms. I take Coveram 10/10 for essential hypertension and Valdoxan 25 because I also do suffer from anxiety. I have been under stress lately as I was doing my exams this past week and finished today. I have done a few tests at my family doctor: Last week I did a dipstick which was normal apart from +1 protein. Voiding bladder US was normal (450 mL pre voiding, 45 mL post voiding). An initial urine culture was normal according to my doctor. Yesterday, I performed another dipstick and urine culture. The dipstick was normal, and early urine microscopy showed 10 to 100 white cell count. We are waiting for the cultures to return. Due to the result of the white cell count, my doctor said it would be worth a try to undergo a 5-day course of antibiotics (Keflex).Today is my third day of antibiotic treatment, symptoms are largely the same. Today, I attempted to hold my bladder. It felt fine in the morning but as the day went on, my symptoms returned and I am finding it harder to hold my bladder. Also, for the first time, I tried going for a run. The entire time I felt a heaviness in my bladder and felt a strong urge to urinate, even though I went before my run began. What do you think could be going on? My doctor believes that it is either a UTI, or most likely, a hypersensitive bladder due to exam stress. However, there have been days where I have not felt stress at all yet symptoms have continued. I am really worried as I want to go back to work in five days and I do not think I will be able to manage the way things are at the moment. My family doctor does think this will settle down now that I have finished exams. Do you think there is a chance it could? I have mentioned this query to another doctor online, and he believed it may be due to an overactive bladder. However, since I am relatively young to receive this diagnosis, I wanted a second opinion, if that is alright. Do you think this could be OAB? I am worried that it could be something serious, like multiple sclerosis. One and a half years ago, I had an episode of sudden onset numbness in one arm and fearing the same thing, I ended up having an MRI of my brain and lumbar spine which both came back negative. Do you think this could be MS? ### Response: Hello. Relax and do not worry. As per your symptoms, it looks like overactive bladder only. Do you have any problem with the flow of urine? Or hesitation? Anyhow, as you are taking antibiotics better finish the course. I would like you to: Here are the answer to your questions. It is better if you consult a urologist so that, he can explain you in detail. Anyhow, I will be ready to help anytime." "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 regarding my eyes. I use computer up to 18 hours daily. I want to protect my eyes form damage as well. So let me know if any type of glasses is available. If so, then what is the name and characteristics of lenses used for protection from computer screen? ### Response: If you are working for so long. In this, the blinking rate of eyes is reduced due to constantly staring at the screen which can 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 am a 53 year old female. My periods have been delayed for two weeks. Till now they are normally regular. Could it be the early onset of menopause or they will eventually come? ### Response: Hello. If you have been regular with your menses these years and this is the first episode at 53 years of age when the menses have been delayed by two weeks, the causes can be a possible initiation of perimenopausal stage where menses are often delayed for a month or two and slowly tend to stop in next one to two years. Perimenopausal stage can be verified with the hormonal FSH (follicle stimulating hormone) and LH (Luteinizing hormone) levels which if high shall indicate an onset of perimenopausal stage. However, it is suggested that pregnancy should anyways be ruled out and if negative then you can wait naturally for your menses to resume. Hence, try maintaining a menstrual calendar and keep a mark for your dates, duration of flow and quantity to evaluate the possible onset of a perimenopausal state." "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 31-year-old female. I think I have pinworms. My butt (perineal and anus area) kept vibrating like a cellphone, about once every two seconds, all day. I started taking probiotics and now it is not as constant, but happens many times a day still. I researched it, and some people say it could be worms. I took Reese\s Pinworm medicine and there were a few small half to one-inch white worms. My anus itches every now and then. Two days in a row it was very itchy. But it is not extra itchy at night, which is supposed to be the main symptom. I do feel them especially at night and it disgusts me.Do you think the cellphone-like vibrating is because of the worms? I am very disgusted, upset, and terrified. I think I got it from eating kale and spinach that I did not wash. I do work in a school, too. I heard apple cider vinegar is supposed to create an uninviting atmosphere for them. Does that mean if I drink it they will start coming out of me in various places, and alive or will I just poop them out?And garlic and carrots, would I just poop them out dead after eating these? I want to take lots of things to be rid of them, but do not want to see anything come out except my anus, and must be dead. I took the medicine only for four days. Will they take a while to go away? ### Response: I understand your concern. I will advise not to use the apple cider vinegar, but garlic and carrots can be taken, and they will help in further elimination of the pinworms. It will come out only through your anus, and not through anywhere else. You have taken the pinworm solution, so that complete elimination may take around a week. Since there was almost immediate evacuation the next day, it is a good sign and it will keep coming out. I will also advise you to take Mebendazole 150 mg separately, and that will also help in the treatment. It can be taken as a single dose at bedtime. This excessive itching could be due to the concentration of the organisms in the tract and it will slowly get better. You have already taken medicine and a course of Mebendazole will further help in the treatment." "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 28 year old man. My girlfriend left me last month and I am going through severe heart pains and anxiety. My heart pounds and beats very loudly. I cannot concentrate on anything. I am having this constant urge to call her and I am not able to control myself. Due to my constant calling, she threatened me to change her number. But, still I feel like I should call her. I feel as if my hands and legs pulling me to pick the telephone and call her. I am becoming like mad. She said I have turned psycho and she cannot trust my mental condition. I forced her to be with me and she said she hates me and threatened me. I was not like this before, rejection turned me into a psycho. We used to talk daily on phone and I was really addicted to her. Now, she informed me that she is getting married. I am going through disbelief and lot of pain. I feel as if I am useless. I feel anger. I feel guilt. I feel why did this happen with my life? I cannot sleep properly. I am currently at home after my MBA and will be joining my job in some days, but I do not feel motivated. Please help. ### Response: Hi. All the very best. Have a bright future. Try to follow my suggestions and take medication for 14 days. It will definitely help you. Review after two weeks to a psychiatrist 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: These are my nail picture. Are they normal? I think they are little dark. My mom says I had this kind of nails from childhood. I am physically active gymmer for last two years. I play cricket at the professional level. Just want to confirm and get peace of mind. I had full body blood test last year and all went alright. My hemoglobin is 16. ### Response: I saw your pictures (attachment removed to protect patient identity). ) twice daily after bath on affected nails. No further evaluation is required" "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 28 years old. I got married before three months. From that day onward, I am unable to maintain an erection. My penis is not erect. I had a habit of masturbation before my marriage. Please suggest. ### Response: Hi. I have gone through your problem, and I can understand your concern. The erection problem occurs mostly due to psychological issues such as stress and anxiety in your age. However, medical conditions such as diabetes, hypertension, thyroid dysfunction or local pathology must be ruled out. These medications are avoided when taking medicines for any cardiac illness." "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: As suggested by most of the doctor marrying a girl with the same blood group will not cause any problems, in my case the blood group is A+ve. She is my maternal uncle\s daughter. She is a close relative. Can our marriage create a reduced genetic pool? Can I marry the girl? Will I have kids if I marry her? Will I have a future kid without genetic defects? What are tests needed to be done if I want to marry the girl in close relation first or second order? As I have read reduced genetic pool can create abnormalities as common genes which are suppressed may become active in the next generation. Please guide in this issue. ### Response: As you want to marry within your related family, I would suggest that you get yourself and your fiance genetically tested to estimate the risks based on both your genetic profiles. This will greatly help you with determining the chances of the child having genetic defects" "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 taking 4 mg of Xanax a day to treat severe panic attack syndrome and associated high levels of general anxiety for 15 years. My doctor arrived at the 4 mg per day amount gradually and it works very well along with CBT from a therapist. Before two months, when I received the medication from the pharmacy it was for 3 mg /day. I asked them to double check and that was the quantity that my doctor had written. I call his office and the office manager said that she would ask him about it. When I called the next day she said that he did not make a mistake and I asked for an explanation and was told that he did not give one.I started to feel sick a few days later and panic attacks actually started to increase the day that I talk to his office manager. I suffered minor but disruptive withdrawal symptoms physically and mentally for about two weeks and then they subsided but panic attacks continued to occur at random every day and my GAD symptoms increased to the point where CBT methods were not working.Then last month, the script was back to 4 mg per day normal dosage. I thought yes, back to normal. But again this month the script was back down to 3 mg per day which means I am going to experience a minor hell again.I am a defense and aerospace engineer who works on a contract basis through an agency and the client had noticed a drop in my performance before month but back to normal last month, now they are going to see it again and I will probably lose the contract job. I also started online system engineer classes and I am freaking out over being able to handle the exams and homework as I typically work on the class at night and am now without my evening dose. I again asked for an explanation and was not given any.My question is a 25% cut in dosage physically dangerous and I am well aware of the strong psychological addition issues, so will this settle down before my career and social life and general well being take a hit and I revert to hiding in my apartment with my dog and my employer and friends will give up on me. ### Response: There are a few clarifications and advice that I need to make. A reduction by 25% is unlikely to be physically dangerous but the 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 40 years old male, obese, non-smoking, non-alcoholic, non-diabetic. My lipids and blood pressure are controlled with Rosuvastatin 5 mg and Olmesartan 20 mg. My query is that I walk regularly brisk and my pulse goes up to 145 and 150 without any breathlessness and recovery is also good as it drops around 25 points within one minute. Does this mean my heart does not have plaque and I am safe? After 150 pulse, slight discomfort or maybe anxiety but no breathlessness. I am very scared to do TMT test but also anxious to know that if I am able to touch 150 pulse without any issue that means my heart is in perfect condition? ### Response: Hello. Yes, if your heart rate is going above 150 without any chest pain or heaviness then the probability of significant blockages (more than 60 to 70 percent) is very low. However, this or even TMT will not help to rule out plaquing. TMT does not help in the diagnosis or ruling out plaquing as blood supply to the heart is not decreased even at very high heart rate. For plaques, CT coronary angiography is a good investigation. Although not absolutely necessary in you, you may undergo screening CT angiography or TMT in a few years just be on safer side considering the risk factors. Rest continue with a healthy lifestyle and medicines." "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 60-year-old mother weighs 67 kg and is with a height of 5.2 feet. She is taking Eltroxin 50 mcg for hypothyroidism, Olmezest 20 mg for hypertension, Gemcal D3 and Kondro OD for osteoarthritis of the knee joints and Folvite for mild anemia with a hemoglobin of 10.6. Since the past one month, she reported mild to moderate pain in the middle portion of her waist joint. She had taken three to four Ultracet tablets, applied ointment, and a hot bag.Although the pain is reduced, the waist joint is not that flexible as one month before. When we spoke this to our orthopedic doctor, he advised starting the spinal exercise in addition to her daily quadriceps and hamstring exercises. I request you to share some details on what exact exercise is suitable for her waist pain, some video or image link on how to do that and the number of times she needs to do it. She currently does 30 times of quadriceps exercise twice daily and five times of hamstring exercises twice daily. Please help. ### Response: Hello. She needs to do trunk rotation exercises, slow and rhythmic rotation to each side of the body left and right. Repeat them twice a day for a count of 15 times each. She needs to do cat and camel exercise. Ask your mother to come to a qua" "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 got a cavity last year. I have left it untreated. It hurt really bad a year ago and stopped, but is not occurring again. I have not gone to the dentist because I do not want to make my parents spend the money. So, I have just been dealing with it. But it hurts really bad. Is there anything I can do? ### Response: I have gone through your question. I can understand your concern. For time being, you can get the pain relief from this infectious tooth. Take the following medication tablet Amoxicillin-clavulanic acid 625 twice daily for five days. Ketorol DT, only if the pain is there. But, your real problem is acute pulpitis because of an exposed cavity. It will be causing recurrent infections if you will not treat it. For treatment, get a root canal treatment done as soon as possible otherwise you may need to get it removed with a year or so" "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 23 years old. I have started consuming gutkha/pan masala one year before but not consistently. Today, I noticed a small white spot beneath my tongue and a white area inside my cheek. I am very much worried about this. Please help me. ### Response: Hi. It must be the tobacco pouch keratosis. That means your mouth has started reacting to it. At this stage, if you leave it, it will heal and there will be no problem but in case you continue, it may lead to the leukoplakia which has high potential to transfer into cancer. Leave tobacco chewing this time, you will be happy. Otherwise, it may be dangerous in the future. Also, take a multivitamin and eat carrots one or two daily. You will be fine in three to four months." "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 sister ate a bottle full of thyroid pills. She feels so weak and nervous every day. And she gets angry and her body temperature is always too warm and I searched the effect of too much of thyroid pills. Her age is 18 what should we do now? ### Response: Hi. Please visit the emergency department of any hospital and get a stomach wash done. The symptoms she is exhibiting is that of hyperthyroidism for which treatment is needed. It will increase heart rate, cause diarrhea, tremors of hand, anxiety, and agitation. Do not waste time. Take her to the nearest hospital urgently." "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 know an orthopedist opinion about my mother\s situation. She had femur plasmacytoma 20 years ago and 4 prostheses, because she had many infections after the operations. She remained with her external popliteus paralyzed. Now, she began to feel his knee mobile, and she could not walk because of it. There are some noises too. A few doctors said she needs Megasystem-C Link prosthesis, which would totally replace her hip and knee. What is your advice? Is there any intermediate option, like replacing only the actual prosthesis and adding pieces of bone? We heard that, in case of choosing the Megasystem-C, that can lead to amputation. So, we are looking for a second opinion. I have attached the radiograph links, please check. ### Response: Hello. The entire femur seen is grossly osteoporotic and the knee is showing evidence of osteoarthritis though I could not see the knee in the AP view. She needs a knee replacement but with the large hip prosthesis and very weak bone stock, I would support the use of a total femoral replacement. This, in reality, would need the whole femur to be removed but is not equivalent to amputation. The knee would have to be a constrained variety of her knee ligaments." "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: over the past 20 hours ive had constant lightheadedness/vertigo, and during the day today ive gradually started feeling nauseous (no vomiting), abdominal pain/cramping, headache, neck stiffness. in the past week ive had some abdominal pain on/off and acid reflux, as well as headaches and general soreness in my neck and shoulders. i am only 20mg of dexamfetamine (10mg in the morning and 10mg at midday) for adhd. i have fibromyalgia and chronic fatigue syndrome, and ibs but these symptoms don't feel similar to what i usually experience. no other medications.ive been trying to drink water and eat crackers but the nausea and abdominal pain makes it difficult. i havent noticed any fever, but i did have chills come and go with some sweating - but didnt feel feverish. ### Response: it could be subclinical inflammation and or infection like a stomach bug. to amphe along with a" "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 mom is a glaucoma patient for the last 10 years. She has been on medications like eye drops including Azopt, Ganfort, Alphagan, Vigamox, and prior to them Cosopt (which did not suit her). She has gone through retina eye laser and also has been injected in both her eyes almost 22 times for retinal leakage as well, has also gone through cataract eye surgery 16 years ago. At the moment her eye pressure remains between 21 to 24. The doctor says implants are necessary as she can see very less now. Given her eye condition is sensitive, a doctor has suggested that it is best to operate her with Ahmed valve implant, however, it has its own risks. I wanted to know if it is better to try the latest option, called MIGS (minimally invasive glaucoma surgery) like Xen Gel Stent and InnFocus Microshunt as it has near to no complications. I want to get an opinion about this before thinking about Ahmed valve. ### Response: Hello. I am very sorry to hear about your mother\s eyes. I suspect that she must have undergone the retina laser and the injections for a condition called as diabetic retinopathy. I feel that most likely it is a complication of diabetic retinopathy that might have caused a high pressure in her eyes. Xen gel stent is currently FDA approved for refractory glaucoma not caused by diabetic neovascularization and Inn focus micro shunt is currently being tested for long term side effects and usefulness in such situations. I must be clear in letting you know that neovascular glaucoma is a very adamant disease to treat and the treatment may not be straightforward and may require multiple procedures and reviews with the treating doctor, yet the most often agreed upon surgery, across most hospitals in the world is currently Ahmed glaucoma valve, along with of course the laser and injections. In case you need further clarification or if your mother is not a diabetic, please send a scanned copy of all her doctors records and prescriptions. I will do my best in helping you understand the situation." "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 type 1 diabetic and have been injecting insulin every day for years already. With this current quarantine going on, I gained some weight which made me worry. Although my BMI says that I am on the normal side, it still made me upset because the belly, arms, and legs have gotten bigger. So I started doing minimal resistance training and changed my eating habits for three weeks already. I noticed that my legs look leaner but my upper body is still the same. This made me anxious because it might have something to do with my insulin medications and I cannot go to an actual dietician since they were still on quarantine so I thought someone might be able to help me online. I am hoping to hear from you. This would really be a big help to my overall health for the rest of my life. ### Response: Hi. Yes, insulin might result in some weight gain, but if you are keeping a check on your calories and include a good amount of non-starchy food including whole grain, fresh whole fruits, and vegetables will help you to shed some fat. Keep a check on your exercise minutes, you can easily do 150 minutes of aerobic exercise per week which includes walking, bicycling, and other forms of moderate muscle strengthening exercises. Just keep in mind that your sugar level must not go down, do not reduce your insulin dosage. Also never skip a meal, if you skip a meal you will tend to indulge more calories in the next meal. Include more protein rich food, protein, and fiber rich meals will bring early satiety and will easily help build in more muscles than fat. 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 unable to bear weight on my healed ankle. I had a fracture of the same ankle four years ago. This problem has been there since six months. Climbing stairs is a problem. I get pain inside my bone, sharp stabbing pain and some burning sensation. This stabbing pain stays for a week or so with no movement and goes away after a week of rest, but returns when I climb stairs (put weight on the ankle). The bone is feeling sore all the time. Please advice. The x-ray and MRI reports are normal. ### Response: Hello. You have mentioned that you sustained an ankle fracture around four years ago and now you have persistent symptoms in the same ankle joint. Previous injury. 1. X-rays (digital) of the affected ankle - anteroposterior and lateral views.2. MRI of the affected ankle which you have already done.3. Recent blood tests especially serum vitamin D and B12 levels, serum uric acid levels, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP).4. A clinical picture of your affected ankle. Will decide after relevant investigations. Follow up with investigations to an orthopaedician and traumatologist 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 a chronic right shoulder pain, especially when lifting up an arm or moving arm sideways. I have discomfort when resting on my right side in bed. Also feeling a slightly loose shoulder or detached arm when rotating the arm, and the occasional feeling of nerve pinching, although no paralyzing pain. I would appreciate if you could kindly review my right shoulder MRI images, for a second opinion. I have had this issue for many years, but it appeared when exercising or under heavy restraint. Presently, it only takes a swift or unconscious movement or light load to feel discomfort. I have started with Aceclofenac 100 mg twice a day, one week ago, as per doctor\xb4s advice, although he mentioned that it was not standard practice for chronic cases. ### Response: Hi. Your shoulder MRI (attachment removed to protect patient identity) is not showing any serious concerns but there are some areas which might be causing mild pain and discomfort during movements. In the coronal images, there is likely early degenerative changes in the distal supraspinatus tendon which shows mild thinning of the muscle tendon. There is slightly decreased fat between the acromion and supraspinatus tendon and it can cause mild pain and discomfort with lifting the arm" "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 29 years old man, currently having issues with my penis. So it has been exactly one week where I was doing foreskin stretching while erection during taking a shower three days straight, due to a very tight foreskin. I noticed very dull pain the second day which went from the front left side of the penis head to back pelvic floor area. I also noticed the veins on my penis is inflamed swollen. How can I cure this soon? I was concerned and decided to masturbate to check my semen, which was good (no blood). The penis skin is good and no bruising showing, just the swollen veins. I was forcing the foreskin back and do not know if I hit the vein, or etc. Please help. ### Response: Hi. I can understand your concern about your symptoms. Since it is an acute one, it can be due to phimosis. Do you have any of the following issues: Itching, any discharge, pain, swelling, irritation, redness, disruption in the flow of urine, difficulty passing urine, irritation while passing urine, painful masturbation. Kindly send a picture for better understanding. At present, painkillers will help you. for further management, share more details." "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 stretch marks. Why these appear? And how it can be prevented. Please give me an idea of avoiding this disease. ### Response: Hello. Stretch marks can have causes that are not due to underlying disease. Examples include pregnancy, weight gain in obesity, growth spurts in teenagers, medication side effects, or a rapid increase in muscle size through weightlifting. You can prevent the stretch marks by avoiding immediate changes in weight and by avoiding all the situations as told here to prevent marks." "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 pain in my mouth. It is like sensitivity pain. I cannot say it is pain exactly, it is irritating a lot. No pain in teeth. It is feeling like itching in my gums (middle of the teeth). Please tell me what can I do. ### Response: According to the characteristics you have mentioned, it seems that you have a mild gum infection. Do not worry it is common and not a big problem. You can follow some instructions given. Brush twice a day. Using floss at least once a day. Gum massage with gum ointment. Use antiseptic mouthwash or lukewarm water with a pinch of salt to rinse your mouth. Avoid too much cold or too hot food. You need a professional dental cleaning so see your dentist (attachment removed to protect patient identity). Poor oral hygiene. Clinical examination. Gingivitis, periodontitis. Generalized gingivitis. Oral prophylaxis. Avoid too hot and cold food." "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 33-year-old male, healthy, and have no current or previous skin conditions.1) I am about to start utilizing Tretinoin 0.025 % to apply to my face to get a head start and keep fine lines and wrinkles at bay. There is a product that is a moisturizer that comes with Vitamin C and has glycolic acid, would that be ok to use after applying Tretinoin at nights. ### Response: Hello. Both Tretinoin and glycolic acid work by exfoliating the superficial layers of skin. When applied together, they have the potential to irritate the surface for the same reason. But obviously, it also matters glycolic acid is in what concentration 1 or 2 % should not increase irritation as Tretinoin you are using is of low concentration. But a higher concentration might irritate the skin. If you do not feel any anger or extreme stinging or burning sensation, it is an indication that you should not use them together. If no such problem with the usage you can continue. But be sure to use photoprotection while you are on Tretinoin or glycolic acid." "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 daughter is 6.5 years old. When she was 1, she had a seizure for a couple of times in two years, for which she took medicine and now she is off from medicine for the last three years. Now recently she was diagnosed with adenoids for which we are going homeopathy. My concern is she is right now 112 cm tall and 21 kg weight. I find her too short compared to her friends, my wife is only 5 feet tall and I myself is 5\7"". Is this the reason she is not growing, since last 4 to 5 months her height is the same, or due to adenoids or medication which she took in the past?What should we do regarding her height? I want her to be at least 5\4"", up to what age girls height can grow? She takes Pediasure, two eggs in terms of protein every day and four days a week swimming, is there anything special I can do? Kindly advise. ### Response: Here are certain points of advise I would like to give you. Weight is absolutely normal for her age as per growth charts. If the child\s height had to be affected by adenoids the weight also would be effected but it is not. Girls grow in height up to the age of 14 to 16 years. The final height of the child should be close to 5 feet, 2 inches considering the parent\s height. The current age of the child is 6 years so you have a time period of 8 to 9 years for height growth. There is no exercise or supplement specifically for height. However, it has been noted that chil" "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 daughter is 6 years old. She has a stomach ache. Her stools are a little watery. Please tell me a solution to this problem. ### Response: Watery stools imply stomach infection. That is why she has stomach pain. Give her plenty of oral liquids like ORS, coconut water. Avoid sugary juices or liquids (they increase loose stools). If the child is dull or not taking adequate liquids or passing very less urine, please consult the doctor immediately as it implies that she is much dehy" "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 month, I was given a Depo shot to stop intermenstrual bleeding that started before six months after Provera tablets did not work. Unable to do a pap smear because of the bleeding. Transvaginal Ultrasound revealed tiny (1x1.3cm) uterine fibroid, three hemorrhagic cysts, and a heterogeneous endometrial cavity. Earlier, I passed clots that look like blood mixed with chicken meat. I am terrified. Is this a side effect or do I need to go to the ER? Please help. ### Response: Hi. I can understand your concern. According to your description, the possibilities are hormonal imbalance leading to thickened endometrium and menstrual irregularities. If there is any possibility of pregnancy, please go for a urine pregnancy test once to rule out missed abortion. If the bleeding with passage of possible endometrial tissue persists better to go for dilatation and curettage once. With this, the possible cause your problem can be identified and sometimes curettage by removing abnormal endometriotic tissue may cure the problem and may regularize next menstrual cycles. 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 had my flu injection a week back. And ever since I have been really ill. I have had cold sweats and very high temperature. I have not eaten anything as I am sick. I am drinking plenty but still in bed and have no strength. I have had this flu injection every year but have never felt like this. ### Response: Hello. Usually, the flu vaccine is very safe and no adverse effects occur in most of the patients. But unfortunately, your symptoms suggest side effects of the flu shot. It can be managed according to a predominant presentation. You can be prescribed Ibuprofen for pain and fever relief. If rash or congestion associated, then decongestant can be prescribed. Avoid the intake of excess spicy foods." "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 a course of antibiotics, I have developed severe dry eyes, dry mouth, and photosensitivity. No tears are coming from my eyes. I think I have developed Sjogren\s syndrome. Is there any treatment for Sjogren\s? I am wating for the test. The antibiotics are long gone, but all the things I mentioned above are still present. Please answer. ### Response: Hello. I went through your query. You have not mentioned which antibiotics you have taken. I do not think that you have Sjogren\s. Regards" "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: No one is diabetic in my whole family. My sugar levels are fluctuating. My sugar levels in the past three months were 110 mg/dl, 107 mg/dl and 122 mg/dl for pre-lunch and post-lunch were 83 mg/dl, 120 mg/dl and 172 mg/dl respectively. I have never taken any medicine for diabetes. ### Response: You are not a diabetic, but some of your reports need further follow up. You seem to be in a healthy weight range. A better indicator of your blood sugar levels will be glycosylated hemoglobin (HbA1C). This is a blood test and can be done at any time of the day. This will give us a good overview of your sugar control in the last three months. I suggest you go to a reputed laboratory for your tests because laboratory errors are very common. Kindly come back and follow up with your HbA1C levels, then we can discuss further. In the meantime, do not forget to eat healthily and exercise regularly" "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 got a stroke but I do not know how to explain it. Twice I was bleeding along with the stroke. One type of bleeding was chronic and the other one was acute. I would like to know which type of bleeding is dangerous? And also explain the reason for the same. ### Response: Hi. An acute hemorrhage is for a short duration but very dangerous. The reason being a sudden build up of pressure in the brain. In case of chronic bleeding it is not so dangerous but it will remain for a long period. In this case there is a gradual increase of pressure in the brain. Patient goes to a doctor only when the bleeding is significant in case of stroke. I would like to have a look of your MRI brain scan to get a detailed view of your bleeding. If you are feeling better then no need to worry." "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 31 years old. I have gaps between my teeth. Can it be closed? By which process can it be closed? ### Response: I have gone through the image (attachment removed to protect patient identity). We can try composite filling or veneer or porcelain veneers. But, it will make your teeth look broader and will affect your esthetics, as the gaps are generalized in the front teeth. Hence, I would suggest leaving it just like that as it does not look so odd. But, you can consult your nearby dentist. The doctor can examine your soft and hard tissues and conclude it in a better way as my advice is based only on the image of your teeth. For the gap in the midline (between two central incisors), a composite restoration can be 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 on the day before yesterday and took I-pill yesterday. Is there any problem? ### Response: You have taken an emergency pill within 72 hours of intercourse, so there is no chance of pregnancy. The I-pill will be effective for 72 hours of intercourse" "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 on Effexor 187 mg and Trazodone 50 mg at night for depression and anxiety. My depression and anxiety have been worse, and I did not want to keep going up on with more medicines. So I tried Ashwagandha 600 mg in the morning and have seen a great deal of help in my mood and anxiety. I have not even considered if it is safe with my medication. Kindly advice. ### Response: You may take Ashwagandha 600 mg (morning and night), Centella Asiatica (morning and night) as a supportive therapy. There must be one hour gap between modern" "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 it ever appropriate to prescribe stimulant medication after an episode of psychosis? I am a patient that has done well on them in the past and is struggling to mange my ADHD without them. The psychosis happened last year during a period of social isolation. ### Response: Hello. You have raised a very pertinent question. Stimulant medication can raise the risk of relapse in psychotic symptoms. If psychotic symptoms were clearly treatment-emergent, generally it is not advisable to try stimulants again. If ADHD symptoms are problematic, you can discuss with your doctor about trying non-stimulant options like Intuniv (Guanfacine XR). Also, try to follow behavioral strategies to manage ADHD symptoms." "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 developed tinnitus after using a nasal spray Sudafed, please assist. Not on any medication, hearing is fine. I was suffering slightly with dizziness prior to the tinnitus four months back which had cleared by then. ### Response: I just went through the complaints that you been having. This sounds like peripheral vertigo and this is how people usually present with. The treatment management part, take a tablet called Betahistine 16 milligrams twice daily for three days followed by once a day for three days and stop." "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 21 and suffering from tinnitus from last four months. The sound in the ears is not constant. It is changing. Sometimes, it is loud enough that I can hear it even in a crowded place and sometimes so low I cannot detect in a normal environment and the most important of all with a loud noise like train horn it is taking a peak and when the sound goes off it comes back to normal. My doctor told me this is due to cold and prescribed some antibiotics. But it did not work. So he told me to visit an ENT specialist. After visiting an ENT specialist, he told me my ears are fine but I should do an audiogram. And also given me some antibiotics. There was no hearing loss in the audiogram. And the medicines also did not work. Then I again visited the doctor. This time he told me there is nothing to worry about and sent me back home. What I want to ask is, if there are any other tests that could detect why this is happening and how this could be treated? ### Response: Hello. You are suffering from fluctuating tinnitus for four months as you have said. Tinnitus (ringing sensation in the ear) may be due to problems of the ear or problems not related to the ear. Ear problems causing tinnitus are generally associated with hearing loss. But that is ruled out in your case as your audiogram is normal. Some investigations need to be carried out: I would suggest you go for the investigations as suggested. If no cause is found, you should go for tinnitus retraining therapy. An audiologist may help. Avoid loud sounds, have a diet comprising of green vegetables and fruits containing beta-carotene (mango, papaya, etc.)" "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 35 year old male. I weigh 68 Kg and my height 5\5"". I am in a healthy status. History:No episodes of herpes except chickenpox in childhood.No infection of HIV - clinically tested every 6 months since last 7 years.I am straight and only 1 relationship with spouse.Both me and my spouse are not having HIV - clinically tested.I had bacterial/fungal infection with pus and redness in the genital area and so blood test was done.I recently got tested and the report is as follows:HIV -ve.HSV-1 IgG 4.5 +ve.HSV-1 IgM 0.29 -ve.HSV-2 IgG 0.45 -ve.HSV-2 IgM 0.69 -ve.HSV-1 is mostly a non-genital infection. I have not had any episode of HSV-1 type herpes in my life. I have never had HSV-1 type herpes anywhere in the body.How can blood show HSV-1 IgG positive without any symptoms?Doctor (dermatologist) says it is because of past infection and there is no present infection.Doctor told that I should take antiviral dose Acyclovir for 20days for HSV-1 IgG past infection. Is it useful to take antiviral dose for past HSV-1 type infection? Will it reduce the IgG level in blood? Is HSV-1 IgG showing a false positive result?Question 1 : Should I take Acyclovir medicine for HSV-1 IgG positive results? (Blood test done on 20th January 2015) Question 2 : Should I retest for HSV-1? Question 3 : Is HSV-1 transmitted via intercourse or sexual contacts? Question 4: Is HSV-1 a life threatening disease? Question 5 : Does HSV-1 positive at present means that I had infected with HSV-1 3 or 4 months back (but no symptoms at present)? Question 6 : Various herbs like monolaurin, a coconut ingredient are proven to flush out/kill HSV-1 virus from nerves, how far is this trustworthy? Please explain. ### Response: I shall answer your questions one by one. 1. As you have mentioned that you do not have any symptoms at the moment, there is no need to take Acyclovir. 2. A repeat test can be done just for your reassurance. Chances of false positive result is there with every test due to technical errors. 3. HSV-1 is primarily not transmitted through sexual intercourse, but kissing or oral sex can cause transmission to partners. 4. Except encephalitis, HSV-1 causes no life threatening diseases. 5. A positive IgG means exposure to the virus anytime during your entire life. IgM shows present infection. You might have had a sub-clinical infection earlier, which is very common. 6. The herbs do not work and there is no data to support this. Hope this relieves your anxiety. Revert back to a dermatologist online for further follow up" "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 both my thyroid glands removed eight years ago, and a small amount was left (in the size of half of my small nail). Since then, I am getting my blood test done every year, which comes back normal. I do not understand this as everybody needs two thyroid glands to work properly, and a small amount of the gland is not enough to do the job. I suffer from tiredness, weight gain, and insomnia over these years. ### Response: Hello. It is not the size of the thyroid gland, but it is the function that matters. In most of the thyroid gland removal, the left over gland will start hyper functioning and hence will take over the body function. So, if your blood work is normal means that a small part of the thyroid is working well. Now coming to your problem, it might be due to either calcium or vitamin D deficiency which can happen because of your thyroid removal. I advise you to get serum D3 and calcium levels tested. Revert back with reports. I advise you to get serum lipid profile. Serum Cortisol. FBS (fasting blood sugar), and PPBS (postprandial blood sugar)." "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 like my urinary meatus has changed over a longer period of time. It is sometimes red and irritated and I know this sounds weird but I think it has gotten longer. More specifically, in my opinion, there are cracks or tears that get especially visible when I have an erection. Kindly help. ### Response: Relax and do not worry. I have seen images sent by you (attachment removed to protect patient identity). As per me, the size of meatus is absolutely normal. I think" "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 a girl has sex 2 or 3 days before her periods without any precautions, should she be given preventives or would there be any fear of her being pregnant? ### Response: If the woman is regularly menstruating, meaning she has regular monthly interval of 28 to 32 days, she will not get pregnant three days prior to having sex. Her ovulation would have happened midcycle and that would be her fertile cycle, it will be within days 10 to 20 days of the cycle. So assuming that she menstruated at day 28 interval, then her three days prior would be day 25, and if it is 32 day interval, it would be day 29. She will not get pregnant at that time." "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 36 year old female. I am overweight. I have BP problem since a year. I was initially taking Cilacar 5 mg. Later the dose of the medicine was increased to 10 mg. I experienced dizziness and vague pain in left hand and severe burpings. Previously, during my root canal treatment when local anesthesia was given, I experienced dizziness and some discomfort in my chest. An angiogram was done, and it was normal. Another cardiologist after seeing my ECGs suggested that I may have WPW (Wolff-Parkinson-White) syndrome. I have had anxiety attacks two or three times. What is your opinion? I am hereby attaching my reports. ### Response: Hi. I have carefully reviewed your health query and can well establish how worrisome this situation has been for you. It is always troublesome for patients when it comes to the heart\s health. 1. Fasting lipid profile.2. Serum electrolytes.3. Echocardiogram. Revert back with the reports to 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: I had HPV warts 25 years ago. A recent bout with Fordyce on lips and a large amount on the scrotum and penile shaft. What should I do? ### Response: I have gone through your case. In my opinion, Fordyce spots are non-infectious lesions and are not sexually transmitted diseases. These are painless spots which occur in the area of sebaceous glands. It has no corelation with your previous HPV infection. Usually, it does not require any treatment. If cosmetically unacceptable, then pulsed dye laser or cautery are options." "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 getting ejaculated early within 8 to 10 shots. Semen quantity is also less than before. I am a married male of age 30, my height 5\5"" feet and weight 65 kg. ### Response: Hi. A lot of males when start doing sexual intercourse suffer issues like early ejaculation. This occurs because of a lack of experience and over-excitation. But with time your timing will improve and you will start to have pleasure in sex. Paroxetine can be used to delay the time and this will help 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 getting my wisdom teeth out and was told I will be under IV sedation, but I did not sign a consent to that, just anesthesia. So, I called and asked them about it. They said I will be asleep, but if they ask me to raise my hand, I will be able to do that. What on earth are they giving me? I want to be asleep during the entire procedure. Will IV sedation do that? ### Response: Hello. I understand your concern. The type of sedation your dentist has recommended for you is ""conscious sedation"" in which you will be at minimal consciousness and not completely asleep. You could respond to verbal and physical stimuli. This type of sedation helps you reduce the discomfort, pain, and anxiety during and after the procedure. Unlike general anesthesia in which you will be completely unconscious, this type of sedation is pretty safe and does not cause any side effects as such. For minor procedures like extraction of wisdom teeth, general anesthesia is not recommended. You will be comfortable in IV sedation" "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 16 years old. I have started taking a protein supplement since yesterday. I passed black stools this morning. Is this black color because of the protein powder? ### Response: Hi. Protein supplements do not cause black stools. Black stools, also known as melena, occur if there is bleeding in the upper gastrointestinal tract. There are chances of black stools if you take medications like Pepto-Bismol or Iron supplements. So, if you are not on Pepto-Bismol or Iron supplements and if there are persistent black stools which is sticky, bulky and offensive, then it requires immediate attention. Get an upper gastrointestinal endoscopy and share your reports." "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 32 year old female, and I weigh 57 kg. I am work in a bank, which keeps me out of home from 9 AM to 7 PM. I was diagnosed with PCOS, and I have a 1.5 mm intramural fibroid on the posterior wall of the uterus since two years. I am taking Glyciphage SR 500 since then, and it has kept my period as well as ovulation regular. My menstrual cycle is 28 to 31 days now. My husband is 33 years old, and he weighs 72 kg, and his job keeps him away from home for 12 hours. He is suffering from erectile dysfunction from last year. His semen analysis revealed slow sperm, and he has been on Edon and Maxoza since three months.We went for IUI last month, and my husband has 10 million motile sperm count. The fertility specialist at the clinic told it is too low for IUI and suggested IVF with ICSI since IUI is only time and money loss. Is it necessary to do IVF with ICSI in our case? Since I have PCOS, can I suffer from OHSS during IVF? I am a working woman, do I need to take long breaks from the job while going IVF treatment? Can I go for single embryo transfer? Is bed rest needed after embryo transfer or during the entire IVF procedure? ### Response: Hi. It is not necessary to go for IVF (in vitro fertilization). IVF has more success rate than IUI (intrauterine insemination) during infertility. I suggest trying IUI few more times, but chances of success are less. So, you have to take the decision." "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 fell over seven weeks ago at a running competition (at the end of a race), and had subsequent knee pain, swelling and difficulty walking. I then proceeded to have an X-ray which ruled out any fractures and then an MRI which showed a partial PCL tear. I have been having physiotherapy on it since including leg strengthening exercises. However, severe pain still persists, no improvement from the pain felt two weeks post-injury. Does this indicate it is not healing? ### Response: Hello. The pain indicates that you might give some more time for it to heal properly. Do not be in a hurry to start up your exercises. Partial PCL (posterior cruciate ligament) tear recovers well with exercises. So, you do not worry. Keep working towards pain reduction first before starting off any exercise routine. Work for range of movement in your knee. Once you attain pain-free movement with complete or at least considerable pain-free range, you can start off next level of rehabilitation. Till then, work on the recruitment of muscles and maintain whatever you have. Hope this is helpful for 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 had chest pain. In my 2D echo report, septum jerky is given. What does is it mean? The doctor said the heart is fine. ### Response: Hi. The echo is reassuring. A jerky septum means that there is slight dyssynchrony between the septum and the other left ventricle walls. Such thing is usually seen in left bundle branch block which needs to be confirmed on an ECG. If the ECG shows normal sinus rhythm, then nothing to worry about. The rest of the echo is reassuring. Please keep BP under well control to less than 130 mmHg." "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: From the past 10 years, I am suffering from an allergy. The doctors informed that due to allergy there is an excess histamine produced in my body. My allergic symptoms are nasal congestion, sneezing, anxiety, frequent throat infection, shortness of breath, and some kind of discomfort. I am having these symptoms from past 10 years. The doctors told it is due to not maintaining hygiene and low immunity. I am making lifestyle changes and yoga to get rid of allergy. But monthly three to four days, I need to do presentations in my office, and due to the allergy, the quality of my work goes down. Presently, I am using some herbal medicines, that is, turmeric for reduction of histamine and it works a little and reduces a few symptoms. I am requesting you to provide me the tablet for reduction of excess histamine in the body or medicine to prevent the production of histamine in the body. If histamine level is normal in my body, I can experience calmness and happiness. But if histamine levels are increased due to allergy, I feel some kind of discomfort. So to avoid discomfort asking medicine to reduce histamine levels. ### Response: I can understand your concerns. Having allergy can cause a lot of discomfort in life, affect the quality of life, and result in anxiety and depression eventually. But, you need not worry. We have solutions for allergy. Revert with more information to 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: I am having skin problems for the two months where pimples are like faint and after it disappears that spot becomes black. Please help. ### Response: I will help you with your problem. You are having acne vulgaris which is the most common skin condition of your age. Generally, the eruptions on healing leave a mild dark spot. If the eruptions are manipulated by picking them or squeezing them, they leave darker spots on healing. In your case, if you are having oily skin, you should use Ahaglow S facewash four to five times a day. This will prevent oily skin which is one of the main causes of the acne. For the treatment of the eruptions, you should use Deriva CMS gel on the eruptions at night daily. Also take tablet Azithromycin 500 mg three days a week for 1 month (3 days daily dose, then 4 days gap, then repeat). The dark spots, if persist after the course of treatment, can be treated by other creams then. Acne vulgaris. As mentioned above." "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: Whenever I yawn sometimes it feels like I pulled something, and on my bottom jaw I push on it and something goes up. ### Response: Your upper and lower jaw are connected with a joint called temperomandibular joint. Similarly we have elbow joint and knee joint. The lower jaw is movable only because of this joint. So whenever you yawn, sounds like that joint is rubbing high and that is why you feel that something is going up. You might be able to hear a clicking noise as well if I am not wrong. If you are feeling sore at your joint every time after yawning, please visit a GP and he or she might give you a script for this like a muscle relaxant." "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 18 years old male. I have been suffering from nightfall for one and a half years. I feel dizzy, tired, and have no concentration. Please suggest me a good medicine to cure it. Is NFcure capsules a good option in curing it? ### Response: Hello. The very first advice is not to worry about the nightfall. According to Ayurveda and Siddha, it is due to the excess heat in gonads." "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 prescribed Lymecycline for my skin. I am only in week one and my skin seems to have slightly worsened, with a really big hard lump on one side of my face. Do they work by drawing the impurities to the surface initially, and is my reaction normal? ### Response: Worsening of acne is not because of Lymecycline as the medicine takes time to start its action. It is simply the closed comedones which are converting into active pimples" "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 my braces for three or four weeks I suppose to get spikes because my tongue thrusting I was wondering do I get the spikes when I go to my next visit? When will do I get the rubber bands and power chain? I hope you can tell me some more information I am looking forward to. ### Response: Hello. The time at which the tongue crib appliance is placed is usually in earlier visits at the start of treatment. However, this decision depends on a multitude of factors, along with your orthodontist treatment approach. It varies with each orthodontist. Also, elastics and e-chain are used for many different purposes like correction of bite, closing spaces, aiding in alignment, retraction, etc. So again, it depends on what tooth movement your teeth require. The simplest way of knowing is to ask your orthodontist for these details." "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: Hello,I noticed rashes forming from groin and spreading up to stomach and chest area.I have attached the reports and photos here, kindly go through it. ### Response: I have gone through your reports and photos (attachment removed to protect patient identity) in detail. It appears to be due to scabies or fungal infection. I would like to know the following details: Revert back with these details 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 took my mother to a dentist. She hit the tooth hard with a hammer and chisel to remove the second molar of upper jaw. She has experience as a dentist for 30 years; still she does not wear gloves. I am wondering, is this practice safe? My mother cried during the procedure, but the dentist told it will not pain. My mother cried because of fear. I am looking forward to hear from you. ### Response: Hello. Getting a tooth removed is a terrifying experience for all. Ideally, the procedure should be explained to the patient beforehand. Infection control is very important for the safety of both the dentist and the patient. A dentist must wear gloves and face mask before any treatment. As far as using a hammer and a chisel, these are the instruments usually present in dental clinic. They are a part of the dental instruments used for teeth extractions, especially in difficult cases. Although, a local anesthetic injection is given prior to removing a tooth, anxious patients may need more than one injection. Also, while the local anesthetic is good for numbing the area, patients can still feel the pressure sensation during tooth removal. In the end, it all comes down to proper communication with your patient and constant reassurance during the procedure." "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 made an STD test, and the doctor said that I have antibodies for herpes type 1 but not infected with the virus, exposed. Does this mean I am infected, and will these antibodies transferred to my partner or will disappear with time? I have attached the report. For mycoplasma, it is already treated. ### Response: The report says you have already infected with herpes. Did you have any unprotected sex with anyone? There are chances you can have an outbreak - symptoms of herpes. During the outbreak, if you have sexual contact, you can infect your partner. Once herpes is positive, it is always positive." "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 epilepsy patient. I got seizure before three weeks. There was a brain trauma nine months back. The CT and MRI showed only tumor and no other problem. Last week, the EEG report showed normal. How to find whether the seizure is caused by the tumor or by the trauma or both? ### Response: Hi. I read your query and understand your concerns. The establishment of the cause depends on the clinical history and location of the tumor as well as trauma. The nature of seizure varies from different areas of the brain. After identification of the affected area, we can know the exact cause of the seizure in most cases. I request you to post videos of any seizure event along with CT scan, MRI scan, and EEG report. I will be glad to assist you. Revert with more information to 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: About 13 years ago, I had an abscess on the right upper first and second molars. The Endodontist has done root canal treatment in these teeth and crowns were placed after the treatment. Recently, I experienced pain around the gums in the second molar and there is a pain radiating to the head. I went to my dentist. He examined and took an X-ray which looked fine. The crown was removed and cleaned by the Hygienist with a Listerine or Peroxide mix. There were food particles and they cleared the food particles present in the crown. My dentist advised me to take tablet Zyrtec every day. The teeth still have a dull type of pain. Could it be an issue of the crown that has not been shown on the X-ray or there is any allergies? ### Response: Hello. It could be mostly due to food impaction causing infection below the crown. So, the dentist might have tried to clean it. If you have X-ray of the teeth please attach it for examination. This pain is definitely not an allergy. Use warm salt water gargle twice a day for a week or two. There will be a relief. If still, the pain persists or increases in future then, you have an option including extraction of the teeth or replacing the crown with a new one causing no food impaction below the crown. You need to take antibiotics for a week if the gums are irritating and if there is a pain" "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 26 year old male, and I get severe pain in the backbone and the surrounding area. What could it be? ### Response: I need to know the following things: Revert to an orthopaedician online with the details, the pain can be a \Mechanical Pain,\ or it can be \Neuropathic PIVD (prolapsed intervertebral disc).\" "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: This is the report of Double Marker test of my wife:Corrected MoM and calculated risks:fb-hCG 165 ng/ml 3.82 Corr. MoMPAPP-A 1.84 mlU/ml o.45 Corr. MoMUltrasound data:Nuchal translucency 1.00 mmCRL 60 mm 0.64 MoMGestational age by CRL 12+ 2 Nasal bone presentGestational age on the day of serum taking 12+ 2Risk at term:Biochem. risk +NT 1:356 (below cut off).Double test >1:50 (above cut off).Age risk 1:1515.Trisomy 13/18 +NT. ### Response: Hello." "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 on a holiday. I wish to delay my period. Kindly advice. ### Response: Please mention your last menstrual period date. Ideally, menses can be delayed safely and effectively by starting progesterone only pills from day 21 of your cycle daily till as long as you wish to delay your menses but advisably not more than 15 days. If started later, on just a few days before the expected date of menses, then there are high chances that complete cessation of bleeding may not occur and you may experience irregular spotting in between the course of medications. Hence it is important to learn about your last menstrual date. You can use tablet 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: Recently, I was diagnosed to have iron deficiency anemia. My primary doctor thinks this is due to heavy menstrual bleeding. Therefore, he advised me to see the gynecologist. I never thought I had heavy periods. What is the actual definition of heavy menstrual bleeding? My period always last for seven 7 days and the first 2 or 3 days will be heavier with some clots. I have to get up during the night once to change the pad only in the first two nights. I usually use about 25 to 30 pads during my periods. Can this be considered as heavy bleeding? For me, this is normal. I have always been this way. My laboratory report showed hemoglobin 8.5, hematocrit 29.7, MCV 66, MCH 19, MCHC 28.6, RDW 18.9, UIBC 430, serum iron 15 and iron saturation and ferritin 3. In addition, I am not sexually active and I am still a virgin. I have never been to the gynecologist and really do not know what to expect. What kind of examination the doctor will perform? How should I prepare for the visit? Please visit. ### Response: 1. Serum TSH and PRL.2. Ultrasound lower abdomen. Menorrhagia with anemia. Tranexamic acid with Iron supplements. Revert back with the reports to 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: My wife is 13 weeks and 5 days pregnant at present. She vomits in the mornings, and she has continuous light stomach pain. Once or twice a day, she has intense stomach pain for 5 to 7 minutes. She takes Doxinate tablet once a day. Is this type of pain common in pregnancy? Can she take Doxinate throughout her pregnancy? Will Digene help in these type of stomach pain and is it safe during pregnancy? ### Response: Hi. How are you doing? Hope I have clarified your query, and do write back. All the best" "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 I have had an open heart surgery, how long should I take Warfarin for? ### Response: It depends upon the cause for which the surgery is being done, and what open heart surgery is being done. And if you have any indication for long-term anticoagulation like atrial fibrillation (abnormal heartbeat). I can provide you more insights only after knowing the complete details. Revert back to a cardiologist online for further help" "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: Hi,My hands are extremely rough since childhood. I am 17 years old now. I have tried almost everything to get rid of this problem. I also have so many lines on my palm and fingers. Suggest me some treatment. ### Response: Hello. Hyperlinearity (lines in the palm and fingers) of palms is a feature of a condition called atopic dermatitis. I would suggest you to use a moisturizer twice daily upon the" "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 dentist went for a crown for my molar because my molar was too sensitive. Now the sensitivity has reduced but not gone completely. My crown was fixed before two years. What can I do? ### Response: Crowning the tooth could not be a solution for sensitivity, and moreover, you say that you still feel the tooth to be sensitive. There is a high chance that the molar with the crown is not the culprit. Also, the sensitivity could be for two reasons. 1. Enamel wear exposing the next layer of the tooth(dentin). 2. Initial stages of tooth decay. Hence, my advice for you is to get a complete oral check done, and I suspect tooth decay in any teeth opposing the molar you mentioned. On the other hand, treatment options for sensitivity as in reason are, either switching on to an anti-sensitive toothpaste or applying anti-sensitive gels or creams on the tooth surfaces." "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 24-year-male. My nose is growing towards the left side, and I want to know about rhinoplasty. ### Response: Hello. You said that your nose is growing towards the left side. For your information nose does not grow after the age of 16 years. If you are right then you need to show your nose to a plastic surgeon to check whether there is any pathology or not which is unlikely. Nose can be deviated to the right or left side and it can be corrected by rhinoplasty. Rhinoplasty corrects your dorsum and deviation of nose. You have to discuss with your plastic surgeon. After surgery there will be swelling which will settle in few weeks. 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 and my fiancee do use condoms but sometimes condoms cause me pain due to size issues. So, we get into an intercourse without it. Basically, I never came inside her but I wanted to get educated about the facts like how to avoid pregnancy if I came inside her? I mean what should be our first step? Even if I pull out, is there any chances that she will get pregnant? Which condom is a perfect fit for starters like us? Is there any natural ways too to make sure no sperm left inside? ### Response: I shall answer your query in the order that you have asked. If you have had unprotected sex and have come inside her, and she is in her unsafe period, then the next best step to avoid pregnancy would be for her to opt for an emergency contraceptive pill like an I-pill or an Unwanted 72 pill within 72 hours of intercourse to avoid unplanned pregnancy. So chances shall remain unless you ensure pre-cum control as well. The condom size is mentioned on the pack and one can decide that based on his penile length and thickness at full erection. There are standard size condoms available but that is completely user\s preference. Natural ways like washing with water immediately or wiping with tissues do not help much, but if you can opt for a spermicidal vaginal cream before initiating intercourse mixed with a vaginal lubricant like KY jelly, then chances of pregnancy can be substantially decreased even with an unprotected intercourse episode. But you cannot ensure even after cleaning post ejaculation that the vaginal cavity has been cleaned off of all sperms completely." "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 husband is away from the past one and half years due to his work. I visited him for 15 days. I had my normal periods there on the 31st of last month. Since I got a bit anxious about getting pregnant, I had four I-pills in these two weeks for protection. I then returned back on the 15th of this month. I had very scanty periods between the 24th to the 28th. And that is it. I had no periods after that until today. I have checked for pregnancy four times and it always showed negative. I do not have any pregnancy symptoms as well. I am leading a normal life. At times, I feel some cramps in the lower part of my stomach. I have already visited my doctor. She suggested I take Regestrone 5 mg, two tablets a day for five days. But, I still did not get my periods. Kindly advice me for the same. ### Response: After you have finished taking tablet Regestrone (Norethisterone), you will have to wait for 15 days to get your periods. If you do not get it in 15 days, you have to repeat the urine pregnancy test and visit your gynecologist. Please do not take emergency contraceptive pills so casually. It is not to be used as a regular method of contraception and it is not to be used more than once a month. Have patience. Everything is gonna be alright" "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: Are you supposed to feel heartbeat on the right side of your chest? I hear heartbeats on both right and left side of my chest and I feel that I have two hearts. Give me your advice. ### Response: You could feel the extra heartbeat, if you are having palpitations. Palpitation can occur in many conditions. It is mostly due to stress or anemia. It can also occur in some cardiac conditions which can be diagnosed only with a proper history of your symptoms, your family history and a thorough cardiac and general clinical evaluation. There is a rare condition called dextrocardia, where the heart or any other abdominal organs may naturally be on the opposite side. This condition can be diagnosed only after a physical examination, and if necessary need an x-ray or a scan. If you have any further questions revert back to 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: Six weeks ago, I started to get muscle twitches all over my body and tingling sensations in my skin. This is still happening. I visited my GP four weeks ago who immediately prescribed anti-depressants. I have suffered from health anxiety for the last seven years. It comes in waves. The GP did not even check me over and told me not to worry as he had no concern. I am worrying about motor neuron disease. However, deep down this is unlikely because someone with this illness could not go to the gym (run and push weights). I would like an opinion from an expert. ### Response: I read carefully your question and would explain that your symptoms are not typical of motor neuron disease. You are right to say that this disorder is associated with other symptoms besides muscle twitching. From the other hand it does not cause sensibility problems or tingling. Coming to this point, I would recommend performing some tests to investigate for possible causes: Nerve conduction studies may be needed. You should discuss with your doctor on the above tests" "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 2.6 years old son is suffering from cold, cough, and sneezing from three days, and yesterday night, he developed a fever. I am giving him Levolin syrup 5 ml, and for fever, I had given Babygesic 1.5 ml. Is Levolin for both cold and cough, as well as sneezing? ### Response: Avoid cold beverages, use nasal" "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: Dear Doctor,My mother is 50 years old. According to the report, She has got: Fatty changes in the liver.Bulky uterus with fibroid.Blood sugar 201.0mg/dL.Kindly interpret the report. ### Response: Hi. Diagnosis (according to available information):Fibroid Uterus, Type II Diabetes Mellitus. Further information required: With respect to the above diagnosis, the treatment plan is as follows, Consult a general surgeon online for further help" "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 20 years old and I have myopia (-3,50 ). I always avoided smoking, lived a healthy lifestyle and ate a balanced diet but my vision just got worse. I just became worried about my vision. What else can I do to stop this progress? ### Response: I understand your concerns. I want to assure you that such myopic progression is quite common at a young age such as in your case. This is mainly because of the exponential growth and development of all the parts of your body at this stage of life. I can confirm that this has nothing to do with the diet you eat. Over a period of time, this growth will cease, and your eye power will stabilize. One suggestion to reduce progression is to avoid excessive near work like reading books, using smartphones, fine near work like jewelry or watchmaking, etc. 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 66 year old healthy male. I have tinnitus since two years. MRI is normal except for age-related gray area. But of late, any outside sound like flushing toilet increases the volume of tinnitus. Left ear 6/10 and right ear 4/10. The sound is the insect cricket sound. Moreover, since two weeks, I have serious sleep problems. It happened after my exposure to music played by a bus in which I traveled for five hours. That night, the sleeping problems started. Further, as I complained stiff calf muscle and a bit of pins and needle in the legs, especially after sitting in the bathroom, a nerve conduction study was taken. Before that, a VEMP test was done. Please give your opinion on those test results. Some local doctor yesterday suggested to take Niterest 0.5 mg tablet for sleeping and a relative who is a doctor suggested Melatonin 0.3 mg without any combination can be taken as it is also good for both sleep and tinnitus. Please kindly forward your opinion. ### Response: Hello. I would like to know some details about your problem: Regarding sleep disturbance: As you mentioned that your MRI brain was normal, there may be a possibility that tinnitus could be related to some ear pathology. For tinnitus, I suggest you consult an ENT specialist. Revert with more information to 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: Hi,I sprained my ankle while playing soccer. The ball hit the outside of my foot, causing my ankle to turn inward, and it popped few times. I also landed on it sideways in the same position. They took me to the hospital, where they told it was a moderate sprain. At first, it hurt to walk, but it did not hurt the following days. The doctor put me on crutches and a splint, which I only used for a day. It has been a week since I sprained it, there is still the pain in the top part of the ankle. The swelling went from none, to swollen to little swelling. I can play on it, but sometimes I feel pain. I have gone to my chiropractor twice, and it is still very tender around the top part of the ankle and the side of the leg, where those ligaments go upward. There is still slight pain while pointing my foot and turning it outward.My main concern is when I am sitting with my legs on the table, and when I try turning my ankle inward, I feel as though something in my ankle is shifting (like something is dislocated). My chiropractor tried adjusting the ankle, and it popped, but it did not affect the dislocated feeling. I have asked other people who I know have sprained their ankle, but they said they have never felt that. Should I be concerned? I am currently taking Advil. ### Response: So I think, it is not the matter to worry. Hope this helps you and get back if you have any doubts" "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 stray dog came near my 3 years and eight months old toddler. Its mouth was very near his hand. I do not know if it licked his hand or not but I just got worried. He has no open bleeding wound but yes mosquito bite sites and many minute abrasions because of playing. In the last two years, he has been given a tetanus shot also. I do not know what to do. I did not see the dog licking his hand but was very close to his hand, maybe for sniffing it came near.The dog looked fine, not overactive or underactive. It was a stray dog, so cannot watch it also. Please suggest what to do. Such incidents wherein a dog comes near or sniffs might happen in the future also and with kids, you cannot be sure if they were licked or not. ### Response: Just licking on unbroken skin comes under category-1 exposure. Here no vaccination is needed. But if licking was on abraded skin then better to get vaccinated. If you are not sure about licking on the abraded skin and if dog not traceable than better to get vaccinated for rabies. Once the child is vaccinated, it protects the child for many years. But still, after completion of five doses, a booster after one year can be taken" "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: The left side of my tongue has been hurting for a few days, and there is a white raised line on it. What do you think it could be? The image is attached. ### Response: I have seen the image (attachment removed to protect patient identity). Hope your doubt is cleared." "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 grandmother is 83 years old and has been suffering from a mild form of glaucoma for three years now. When we consulted doctors earlier they suggested using eye drops than surgery. So we have been using Travo Z and Tear Drops daily and she is also able to see properly. Since one week she is experiencing pain in her eyes and has trouble looking at the light directly. Her eyes have also turned reddish. Please help. ### Response: Hello. Has she got operated for cataract? Any previous record of vision please share the latest one. Also, share the glaucoma test reports in which she was diagnosed as glaucoma and share the photo of eyes." "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 hard-working man in my mid-60s. Two years ago a 15 lb street light fell on my head, a 10 feet drop. Since then I have been having a problem with my ear, a dimmed echo in my head when I speak and frequent high pitched ringing that leads to aggravating headaches. This could not be solved by the doctors and nothing was found in any tests such as MRI, and CT.Unfortunately, it is been a real struggle. I do not sleep well, and it is burdening my life. Is that a known problem? Could it be treated? Any help and advice could make a big difference. ### Response: Tinnitus is often described as a ringing in the ears like roaring, clicking, hissing, or buzzing which cannot be attributed to an external source. Post-traumatic tinnitus usually follows head and neck injuries. Do you have tinnitus in both the ears or in one ear? Any history of hearing loss? Any triggers like exposure to loud noise? Does loud noise or loud music hurt you? Well, for treating your tinnitus other causes for tinnitus need to be ruled out. Compacted ear wax. Management involves a multidisciplinary approach. Good to know your CT (computed tomography) and MRI (magnetic resonance imaging) being absolutely normal. I would suggest you go to an ENT specialist for audiometry to see for any hearing loss. Ear wax removal if any." "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 with itching like eczema around my private parts for the last two years. Please help. ### Response: I have read your query in detail and do understand your concern. You could be suffering from a fungal infection. However, your symptoms may also be due to eczema.A picture and detailed history will be needed to differentiate between the two. 1. Proper oral and topical medicine for one to two months will completely cure your disease.2. A course of oral and topical antifungal medicine like Fluconazole or Terbinafine is usually prescribed to cure one of these disease.3. Do not use any over-the-counter medication over this area as it may be containing certain ingredients which may increase the problem. 1. Wear loose cotton clothing especially when at home.2. Revert back with picture 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: My sperm count is 64 M/mL, motility 60 %, rapid linear progressive 15 %, sluggish linear progressive 15 %, forward progressive 30 %, morphology normal 35 % and abnormal 65 %. Are these values normal? ### Response: Are there any pus cells or WBC\s (white blood cells) in the sample report? Also, is the fructose test positive? Please share the complete report as an attachment." "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 sinusitis patient. But I do not face any breathing problems. And I am just 21 year old. Is Corona dangerous for sinusitis patients? Please tell me I really want to know. ### Response: Hi. Corona is dangerous for each and everyone one of us. However, there are few conditions where the patient\s body immunity is on the lower side. One such condition is recurrent allergy associated sinusitis. You may be completely asymptomatic, but in general patients probe for allergy and associated sinusitis do have a slightly higher risk for acquiring any infection for that matter. It is always better to take adequate care and precautionary measures must be followed at all costs failing which you not only expose yourself but expose others as well. Make sure that the sinusitis and related symptoms are treated in an effective manner. I have not gone into the treatment for sinusitis as your question was very specific regarding the lethality of Coronavirus in patients with sinusitis. 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 seronegative inflammatory arthritis with ana positive. Joint pain especially at right knee shoulder joints MTP IP joints. Unbearable in the night for the last three months relieved with NSAID (non-steroidal anti-inflammatory drugs) patient cannot walk chairbound with in situ catheters for more than four years. I am taking Ultracet if pain unbearable, few days back I have taken Injection Kenacort 60 mg IM on the advice of rheumatologist with some relief, but again pain resurfaced. Apart from that patient is on Apixaben 2.5 daily, Mirabeg 50, Soliton 20 and Donezepil 5, Vitamin C 1 gm daily. No BP, and DM issue. I am taking inhaler Laba with corticosteroid for long. ### Response: Hello. I have gone through your reports and history (attachment removed to protect patient identity). There seems to be some inflammation going on in the blood reports and with a diagnosis of previous arthritis, it looks like it is coming back again." "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 want to know about body lift surgery procedure. I have lost weight of 50 kilograms. I want to get a full body life. How many surgeries do I need? How are they divided? How much time does it take for recovery? ### Response: Post weight loss people go for many procedures to reduce the overhanging and sagging skin all around. Basically, the procedures include, circumferential lower body lift, breast lift, upper roll lift, arms and thigh lift, butt lift and facelift. These can be divided into two or three sessions depending upon your requirement and the body status. We recommend three weeks to six weeks of a time period in between two sittings. You will feel relieved when all the skin is gone. You will get a rejuvenated body for yourself" "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 experiencing severe lower back and left hip pain and spasms. I have a history of a slight disk herniation at L5-S1 with no nerve impingement. I believe this flare-up began two weeks ago when I attended my first chiropractic visit. The pain became so severe, I broke down and went to a different chiropractor for possible help. The pain was so severe that I got nausea, sweat, and almost passed out in the waiting area. The pain was better since yesterday. The new chiropractor thinks my right hip was tilted forward, causing the muscles on the left to get spasm and be in pain. Please help. ### Response: Hello. I understand your concern and suggest to do the following. Take analgesics, and muscle relaxants. Apply hot packs, and Diclofenac gel locally where you feel any tenderness. Either lie in bed or stand. Sit for short durations only, less than 20 minutes at a stretch and that too with your back supported. I would advise against any manipulation by your chiropractor till your spasms subside though, you can have massages of the muscles in spasm. If all this fails to help in the next couple of weeks get a repeat MRI (magnetic resonance imaging) if there are new leg symptoms like numbness, weakness, or shooting pain below the knee. 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: What is the meaning of HSG test? The uterine tubes are patent bilaterally. There is bilateral spontaneous contrast m\xc3\xa9dium spillage into the peritoneal cavity. The contrast filled uterine cavity demonstrates normal morphology with a central immobile smooth spherical filling defect. ### Response: HSG is hysterosalpingogram, X-ray while spilling contrast from the cervix to see patency of tubes. Due to infection, endometriosis and infertility issues, tubes could be blocked. So, to check the patency of tubes this test is advised. This report (attachment removed to protect patient identity) shows normal or healthy, patent tubes. No abnormality." "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 Pericoronitis (swelling and pain behind the wisdom tooth). I went to the dentist yesterday and he cleaned my mouth and gave me antibiotics (Penicillin V) and Ibuprofen 600. I have been taking the antibiotics for two days now and I do not feel an improvement. Is this normal? How long does it normally take until it starts getting better? Should I go back to my dentist tomorrow? I take Ibuprofen but it only lasts for two to three hours. I am also using Chlorhexamed forte. ### Response: I understand your concern. The loosely attached swollen gums over the wisdom tooth is called as pericoronitis. The age of eruption of wisdom teeth is from 17 to 21 years. Beyond that, if the wisdom tooth has not erupted or half erupted gives out pain or swelling, it is highly likely to be locked inside the jaw. Since they are the last ones to erupt, most of them do not get enough space to erupt and tries anyways and this causes jaw pain, swelling and sometimes the surrounding structures like same side temple, ear and throat also gives out pain. This wisdom tooth is called an impacted tooth. During the first visit, antibiotics and painkillers will be prescribed. The swelling will come down eventually but if that is impacted, it may not come down. Please visit your dentist and get an x-ray of your wisdom tooth to check whether there is enough space for it to erupt and to check whether it is erupting in the right direction. Taking painkillers and antibiotics will help to control pain and swelling but if the tooth is impacted, this will not be a permanent solution. You may require wisdom tooth removal. 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 and my fiancee were doing foreplay and I touched my penis and then fingered her (my hands are slightly wet) but I touched only penis skin, not tip and did not ejaculate at that time. Then I ejaculated on her butt and then I wiped off the sperm with a towel. Is there a chance of pregnancy? If some drops of semen had fallen by chance on her outer vagina and due to fingering also? Her periods were finished on 16th and we had this on 18th and today is 19th. Do I need to give her a pill or not? Kindly help. ### Response: Firstly, your apprehension and concern are completely understandable. But the fact that you both were involved in sex after two days post her menses had stopped simply puts her in her safe period when chances of pregnancy are minimal as ovulation had not taken place. Secondly, there was no ejaculation involved before you fingered her and also you touched just the prepuce skin before fingering, again decreases her chances of pregnancy. Thirdly, you ejaculated over her butt and before the sperm could trickle to her vagina, you wiped it off. In this case as well, chances of pregnancy are minimal and do not qualify for any need for an emergency contraceptive pill within 72 hours of sex. As there was no unprotected intercourse involved, so you can be sure that there are no chances of pregnancy in this situation." "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 white tiny particles on penis skin and itching forehead skin. What is the cause? What is the solution? I am currently applying Candid B. ### Response: Hello. I have noted your concern and I have viewed the image (attachment removed to protect patient identity). You have Fordyce spots. These are sebaceous glands without an opening and appear as yellowish white granules on prepuce undersurface. It is just a sometimes concern and does not require any intervention. Itching may be due to a yeast infection. I suggest you take oral Fluconazole 150 mg tablet once a day for three days. Topically, you may continue with Candid B (Beclometasone and Clotrimazole) cream, twice daily for a week" "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 penis size is 4 inches when erect but all my friends have a length of 5.5 to 6. I feel embarrassed in front of my fiancee. Can I increase it to 6 inches because I think that nothing is impossible? Is there any way? I also suffered erectile dysfunction and premature ejaculation. The sex time is only one minute. ### Response: Hi. I have read and understood your problem. There is no medically proven treatment to increase the penis size. It cannot be increased, unless you have hormonal problems like if the serum (blood) testosterone and LH are low. Size of the penis varies from person to person, like other physical features like height, etc. On an average, it ranges from 3.5 inches to 5.5 inches on erection. If your penis is within this range on erection, then do not worry. If your penis is smaller, then you can do hormone tests. , which is harmful, so most people have wrong ideas about penis size." "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 2-year-old son has hard motions. He has just had his circumcision surgery. My friends advised me to apply Lignocaine Hydrochloride gel between his buttocks. By mistake, I applied more. I am very much worried. I hope it is not harmful. Please advice. ### Response: Lignocaine (Lidocaine Topical) gel is a local anesthetic so even if you have applied more there is nothing to worry. If he is having constipation, I suggest you give him syrup Looz (Lactulose) 10 mL twice daily. This is a stool softener and you can give him until his stools become soft. You can stop it after four to five 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: After suffering with groin pain, I had a double operation 12 weeks ago. During the operation, I had a repair of left side inguinal hernia and right hand hydrocele. I am now in more pain than I was before the operation. My testicle thorns with pain constantly and I have stabbing pain on hernia side. It feels like someone is sticking a bottle in me. I am struggling to walk very far, climb stairs and drive. I am unable to have a sex life. Is it normal to do both operations at the same time? Can you explain any possible cause for pain? ### Response: Hi. Pain can be due to entrapment of a nerve like ileoinguinal or ileohypogastric nerves which run with the spermatic cords or it could be also present if there is improper repair with subsequent breakdown of the repair and subsequent herniation of the bowel content into the inguinal ring or it can be from infection of the operation site. 12 weeks is quite a long time for surgical pains to have disappeared. You will need to do an abdominal pelvic ultrasound scan to see if there is any reccurence or failure of the surgery or if there is entrapment of visceral content." "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: What is colon cleansing? Colon hydrotherapy has been advised, and how effective is the procedure? I have chronic constipation. ### Response: As colon can normally expel waste colon cleansing is not needed. It can disrupt normal bowel flora. However, in the fecal impact, it can be used but only under medical supervision. Causes for constipation is inadequate water intake, the insufficient fiber in the diet, resisting urge to have bowel movements. So" "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 mom is 56 years old. She is a patient of hypertension, diabetes, and mild nephropathy. BP 140/80, pulse 96/ min, creatinine 1.3, fasting sugar 125, postprandial 157. From a few months, my mother is suffering from chest pain. The doctor told it is chronic stable angina. All other tests are done like Na, K, hemoglobin, urea, and uric acid. The reports are quite fine. Our family doctor suggests me to take angiography. So, what should I do now? Please suggest. She is taking the following medicines: Aciloc RD, Glimmy 2, Nexovas, Telmikaa40, Febugood 40, Lipikind 10 and Glypten 20. ### Response: Hello. With these kidney function tests, she can perform the coronary angiography. I agree with her doctor\s recommendation because this would help identify possible coronary artery stenosis and also perform angioplasty, if necessary. Another test which can help investigate the presence of coronary ischemia is Dobutamine cardiac stress test. If this test results positive, the next step would be performing a coronary angiography" "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 taking a low dose of combined birth control medication (Femme 20/100) containing 21 hormone tablets and 7 placebo tablets. I was on a higher dose of contraceptive medication (Microgynon 30). Microgynon 30 was switched to lower dose pill because of severe PMS type symptoms. Currently, I am taking Ritalin 60 mg per day in 3 x 20 mg intervals, Abilify 300 mg depot injection monthly, Femme 20/100 contraceptive pill and Clonazepam 2 mg twice a day as needed. I had unprotected sex on day 6 of inactive pill. I forgot to take active pills on day 1, 3 and 4. But, I had 2 pills on day 2 and had unprotected intercourse. I am concerned about the possibility of pregnancy. It is now day 5 and I am regular on my pill. Am I at risk for a possible pregnancy due to missing so many hormonal pills? Also, what should I do from this point onwards? Should I continue as normal or begin a new packet entirely? ### Response: Hi. Since you have missed three pills, you are not protected for this cycle for further intercourse. But, you were protected in earlier intercourse. To keep your cycle regular continue the present pack, but take extra precaution during this cycle. Use condoms. You can also use a Morning-after pill, not more than once in this cycle." "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: Me and my partner had unprotected sex, and she took I-pill within 72 hours (but after 24 hours), and now after 8 to 9 days of taking the pill, she is having mild cramps similar to period and also mild bleeding (just a few spots), but the discharge is brownish in color, and this is the third day with cramps, although the bleeding is very less. Is it side effect of the pill or is it implantation bleeding? And when can she expect her normal periods? ### Response: I have read your concern. Spotting or sometimes profuse bleeding accompanied with cramps are most common side effects after taking the emergency pill. This is due to the high-level hormones (Progesterone) contained in the pill. However, this is difficult to differentiation from implantation bleeding. The only way you can identify it is taking a pregnancy test since it has been more than eight days since your last contact and if you are pregnant then it would have turned out positive by now by using a simple home pregnancy test kit." "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 14 years old. He got a seizure before 15 days during sleep for 10 to 15 minutes. His EEG and MRI are normal. His doctor suggested two options. They are either we can wait for the second attack or go for treatment Val-Cr 300 for three to four years. Kindly give your opinion. ### Response: Hi. I have gone through the query. A person can develop two seizures without regaining consciousness in between or one episode of status epilepticus lasting for more than five minutes. Seizures occurring for 15 minutes requires treatment, and it needs evaluation like EEG (electroencephalography), MRI brain (magnetic resonance imaging), serum calcium and electrolytes, and blood glucose." "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 do a couple of sports to have some hip flexibility. I am pretty flexible, and I can do right and left splits. But when doing the center split, I get a stopping pain in my outer hip with no stretch in my inner thigh. If I rotate my knees back and hips forward, I can do more stretch, but there is also a slight stop. What is this and can it be worked? Will stretching help to release that stopping pain or am I anatomically incapable of doing a middle split? There is pain only when I am doing a center split. How to fix it? I do a lot of kicking, and I do not want to injure myself. ### Response: There are many factors, other than tight inner thigh muscles that limit the split especially center split. Bony restriction in the hip joint, as the hip joint bone gets jammed into socket because of extreme coxa vara angle (angulation between the neck and shaft of the thigh bone) leading to restrictions in movement. These jams will not happen when you do a side split as there is slight rotation occurring in the joint and allows the action to happen. Other reason could be ligamentous (pubofemoral ligament) limitation as the ligament tightens and it limits the further movement. This ligament realigns and will relax while doing forward and side split. So, it will not restrict your movement other than center split. You can try tilting your pelvis forward so that there can be some relief with limitation in both the 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 31 year old female. My first trimester NT and double marker test showed a very low risk of 1:3690 for DS and 1:100000 for two other abnormalities. During the second-trimester anomaly scan, the doctor found two markers, CP cyst and mild RPD 4 mm and 4.5 mm. I have given blood for NIPT but did not get any results. I am at 23 weeks now and stressing out and getting really depressed. I have no family history of abnormalities. Is there a need to worry? ### Response: Hello. I have gone through your question and understand the concerns. Hope you found the answer helpful." "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 complicated migraines, simple partial seizures and are controlled by Lamictal. I have a long time pain from sound intake and it has worsened into my face. Other sensory triggers the pain. It has become just way too much to handle. I sought advice from friends and groups and nurses, that have trigeminal neuralgia and they suggest Carbamazepine.I learned it lowers Lamictal. I contacted pharmacy that said many will test blood serum of Lamictal and then add Carbamazepine and adjust Lamictal to therapeutic levels.My doctor is a bit concerned. She is not a pain doctor or neurologist. I am waiting to see one. But my condition makes it hard to travel in a car. My doctor asked I seek advice. Do you agree that checking the serum and adjusting is fine to do, in order to take Carbamazepine?The second option is Oxcarbazepine. In your experience is it a good pain drug for TN and does it mess up Lamictal? I found a study that said it did not.I was thinking I could start it now while I wait on Lamictal levels. And see if it helps. Just really struggling. Pain cream not helping much in certain places. My old neurologist wanted me to lower Glutamate as much as I could and suggested Namenda at one point. I know many people are on two and three drugs. I hope to try injections for the pain soon. Do you have any suggestions? ### Response: Firstly, we need to be sure if your pain is really Trigeminal neuralgia (TN) as there can be other causes of facial pain like idiopathic facial pain, Post-herpetic neuralgia. Sometimes dental causes of facial pain can mimic TN. Trigeminal neuralgia has sharp, shooting episodes of pain in any distribution of the trigeminal nerve. Pain is mostly along one side of pain and lasts for a few seconds. Pain can be triggered by brushing teeth, cold air, chewing of food. Mostly there is no baseline pain." "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: This query is regarding my husband\s health. Three months back, my husband underwent surgery for pituitary macroadenoma. He was advised Hisone steroid tablet for three months. But he has a headache on and off. He has gained 9 kg in three months, though he eats very little. Yesterday, we took the third month follow up MRI scan and I wanted to share below findings in the MRI report.Post-operative changes noted in sphenoid sinus and sellar fossa.Pituitary stalk mildly deviated to the left side.No evidence of enhancing residual and recurrent tumor seen.Polypoidal mucosal thickening noted in bilateral maxillary, ethmoidal, and right frontal sinuses.Also when I look at the scan films, near the pituitary gland few residual part of the tumor is seen. I am requesting you to have a look at my query and respond me how the report looks like. I am more anxious to know about this. Please help me to understand the current status of my husband\s health. ### Response: The MRI (attachment removed to protect patient identity) does not show a residual or recurrent tumor as per what you have written as part of the MRI report. The so-called \residual tumour\ which you have interpreted, may be postoperative changes which is common after pituitary surgery. If the four points that you have written is what was written on the report, then you should not worry. Meet your operating surgeon for further advice regarding Hisone which may cause weight gain. Best wishes" "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 tell me within how many days angiography must be done after a heart attack? ### Response: After a heart attack, angiography should be done within the first 24 hours. But, if it is not done and if the patient is on thrombolytic medicines like streptokinase medicine, and no symptoms, then it can be delayed. There is no exact time, but it is better to get it done as soon as possible. Hope this helps you and get back if you have any doubts" "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 many years of health problems including severe joint pain, inability to lose weight, chronic fatigue, transient pains, and abdominal pains that seem to come and go in cycles sometimes lasting for days or even months. I have a medical phobia, so have not been to the doctor unless it was an emergency. But over 20 years ago I ended up going to the ER and had several tests. I was told I had lupus, osteoarthritis, PCOS, and thyroid issues. I have tried to treat myself and pain naturally over the years with a healthy lifestyle and natural aids, but the pain finally became so bad over the last couple of years that I have gone to some appointments.I was referred to a rhuematologist that did blood work and said I was fine except low vitamin D. I told the new doctor about the early diagnosis and she said it was probably wrong but she would run blood test anyway. When the test results came back, she said I did not have an autoimmune problem and I was fine except that I had low Vitamin D. I have a copy of the test results that look like there are some problems to me and based on her reviews and my personal experience with my health, I would very much like a second opinion. I am taking Xanax when needed. Some tests are attached. I have also had an MRI that showed osteitis pubis, fatty liver, and mild bladder inflammation. ### Response: I have gone through your history and blood reports. (attachment removed to protect patient identity). I found a few abnormalities which I would like to ask a few more details on and also some more questions pertaining to your problem which would help us reach a conclusive diagnosis." "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 broke a foot blister with a pin and the skin appeared intact. I disinfected it and put a dressing. But it hurts when I walk. Is this normal? ### Response: You have broken the blister with the pin and I would recommend you not to do that in the future as it is a non-sterile method of doing so and can cause infections in that area. As foot is the dependent part of the body and all your body weight is on it so even a small blister will be painful during walking, standing, etc., for a few days until the blister heals. Blister. Foot blister- local trauma. Tablet Paracetamol one tablet twice daily, Betadine ointment for local application, tablet Augmentin 625 (Amoxicillin and Clavulanic acid) twice daily for five days. Proper foot hygiene. Regular" "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: There is a white patch on my tongue that started out as a red, inflamed taste bud. It is very painful, and the patch has got bigger. ### Response: Hi. Your history is not clear. If the patch is severely painful and if it is present for two to three days, it can be an aphthous ulcer. If it is having a history of more than a week, it can be a fungal infection. I would recommend you an antifungal Candid mouth paint (Clotrimazole). Use it two to three times daily. Do not eat after applying it for at least 10 minutes. Also do salt gargles twice daily and take multivitamins for a month" "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 having big rashes every night and they disappear in the morning. Sometimes, I wake up with a swollen lip, I went to the hospital and they gave me an allergy injection and some drugs Promethazine and Prednisolone tablets. They stopped and I stopped taking the drugs. Now they are back. I am a female, age 21 years. ### Response: Yes, this is the condition called urticaria. That can be acute or may be chronic. , that can cause it. Most of the cases are idiopathic that is the reasons are not known. The most important thing in its treatment is to look for trigger factors that are causing it like what type of food do you eat? Certain foods like egg, meat, junk food, etc., can cause it, taking any" "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 20 year old female and had sex for the first time. I took Regestrone to delay my periods because I planned to get intimate the same day as my periods. I took them for three to four days before my expected period date and had the tablet two to three times a day. Last dose I had it just the night before having sex. I had sex many times the next night but with protection and took an i-pill to be sure. Next week got light periods that were very painful. But ignored it thinking it was because of hormonal imbalance. Both of us were affected by flu and it turned into a stomach infection with alternate periods of diarrhea and constipation that was accompanied with mild nausea but had no vomiting. I became very weak and then eventually recovered by taking Pantocid, Digene and Zandu pancharishta. I am six days overdue and had slight back pain, nausea and increased urination. I do have migraine issues as well as I am quite obese with a BMI of 33.8. I got two home pregnancy tests done and both of them turned out to be negative. However, I still have not got my periods yet and I have been insisted to check for PCOS and get an ultrasound done. I am worried if the ultrasound shows that I am pregnant. I have gained about 4 kg. Is it possible to get a false negative six weeks after having sex? What can I do to get my periods early? Please advice. ### Response: It is impossible for a urine pregnancy test to show false negative six weeks after sex. Delay in periods may be as a result of anovulation due to stress or infection as well as because of gaining weight. For regular ovulation and to avoid hormonal imbalance, it is advisable to maintain your weight. Healthy BMI (body mass index) is essential for our overall health as well as reproductive health. No pregnancy will be seen in ultrasound when a urine pregnancy test is negative. If you had regular periods previously, you can wait for a week for the start of menses." "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: Should I get a permanent retainer months after braces and use of a removable retainer? Part of my overbite has returned since I got my braces off due to tongue thrusting. Partly because I never wore my retainers as much as I should have. Can I get a permanent retainer at this point? Or is it too late? ### Response: First of all, you should wear your retainer regularly. Ideal position of teeth or occlusion which is obtained with the help of orthodontic treatment is maintained by regular use of orthodontic retainer. Use of orthodontic retainer is equally important and is part of orthodontic treatment. As per your description, you have tongue thrust, so it should be corrected otherwise it will be a cause of relapse after successful orthodontic treatment. As you have stated that your bite has relapsed, so if you use permanent retainer then it will retain faulty occlusion. This is what you can see about changes. But as the bite has relapsed, definitely there must have some other changes or movement of teeth happened (you have not uploaded any image of your concern area), that you cannot see but being expert in that field we can see. So for any kind of second opinion one has to check clinically or at least have an image of your concern area. So kindly upload an image of your concern area or teeth for appropriate treatment planning." "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 having intercourse with my husband, I had taken Unwanted 72 within 12 hours of intercourse. But, I missed my periods and got pregnant. Now, my question is will this ECP damage the fetus in any way? I also want to let you know that six months back, I had an abortion as my child was very low. Kindly suggest me, is it safe to continue my pregnancy with all these problems? ### Response: Hello. I have gone through your history and understand your concerns. Yes, you can continue the pregnancy after taking I-pill as it will not be harmful to your baby. But, yes if you had an abortion within one year, it may affect your health. So, take proper healthy and nutritious diet. Kindly give more information about your abortion, if it was medical or surgical. Hope you found it useful. Feel free to ask more information" "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 38-year-old male, 174 cm tall and weight is 73 kg. I have been having puffed up nipples since long and can feel slight hardness under the nipple surface. It is painless and there is no discharge. I suspect gynecomastia. I can provide you photographs. Need your advice on treatment. ### Response: You have bilateral grade II gynecomastia. Medical treatment, diet and exercise cannot reverse it. The correction will require liposuction with gland excision. It is a day care procedure. You can get discharged on the same 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 a 31-year-old female. My right eye is red and very sensitive to light. It is painful while I move the eyeballs. Center of the eye is paining with irritation. ### Response: A couple of things come to mind when an eye presents like you described red, painful, photophobic. The first one is an eye inflammation, officially called an anterior uveitis. This is usually an isolated incident. It is considered idiopathic, which is just a fancy way of saying we do not know what causes it. If there is a history of this happening before sometimes lab work is ordered to rule out various diseases. Those might include things like Crohn\s disease or Sarcoidosis or Spondyloarthritis. For an anterior uveitis there is nothing over the counter (OTC) to treat it. A visit to an eye doctor to confirm this tentative diagnosis is in order. If you are a contact lens wearer this could be a corneal ulcer, those present the same way as an anterior uveitis. Anterior uveitis. Again, there is nothing over the counter for this. And we need to be careful with steroid" "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 did a test. I got my results that my erection transmitter is 2.99, testosterone is 4.459. vitamins E, K, and C are also slightly low. Could this be the reason I have premature ejaculation? At times, I also have a weak erection after one ejaculation. ### Response: The premature ejaculation occurs due to anxiety and hyperexcitation in most individuals. Altered testosterone levels are not the cause of early discharge. The" "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 wart on my foot. I used highly acidic vinegar on it. It burnt and became worse. I used ancient oil on it and it swelled and now it looks like a big black-brown in color. It is not recovering. What should I do? ### Response: Hello. You have burnt the superficial skin over the foot by applying the acid. The wart can be simply treated by co2 laser or cryotherapy like good treatment option. Now over burnt skin, you can apply moisturizer. No other specific treatment needs to be done. I suggest you consult a dermatologist for detailed 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: My wife was pregnant last year, but a miscarriage occurred. We consulted our gynecologist and he suggested we have a TORCH test. The result of TORCH was rubella IgG 270.30 and IgM 0.42, and CMV IgG 118.60 and IgM 0.26. We are unable to understand the report. Is this hike in the value of Rubella IgG and CMV IgG the cause of miscarriage? Please guide us. ### Response: Hello. How are you doing? Hope I have clarified your query. Do write back if you have any more queries. All the best" "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 recently chipped the top of one of my teeth off, it is quite sharp and hurts when I eat certain things (sugary things it seems). The part that came off was very thin but I am worried my tooth could become more sensitive and more could break off so I would really like to fix this in some way. What is the best way to go about this? ### Response: Hi. The sensitivity is because of the exposure of the second layer of the tooth (dentin). It can be easily cured by using anti-sensitive toothpastes. Replace this toothpaste for night brushing and you will find best results in two weeks. You have also mentioned that the edges of the broken tooth is sharp and hurts you. For this you should visit a nearby dentist where the edges of the tooth will be rounded off to smoothen the surfaces. If the chipped portion is quite big to be replaced, it can be done with tooth coloured resin type filling materials which mimic the natural tooth to 90 %." "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 daughter has skin lesions that started last year. They are on one side of the body. Initially, she got eczema kind small red rashes for which we applied Corticosteroid and later we observed whitish patches developing on those spots. Initially, the GP thought it could be tinea versicolor and suspected it could also be vitiligo.He referred us to a skin specialist and initially, the skin specialist thought it could be hypopigmentation and after a month, in the next appointment, she thought it could be vitiligo and started with Tacrolimus and Corticosteroid cream.Even before we started applying this Tacrolimus, we saw some repigmentation in some areas but it was slow repigmentation. We were confused as is it vitiligo or not and also as we are applying strong creams for a 6-year-old girl. Any long-term issues?We want to have a second opinion. I live in a city where it is very difficult to get skin specialist appointments. They give for every three to six months. Could you please help us in diagnosing the skin patches and treatment? I can send in the photos. I uploaded the photos:They all are on one side of the body (right side).On the hand, it started four months ago with a small white patch and gradually increased to the size and then we are seeing some repigmentation slowly very slowly to normal skin color.On the chest also, it started around the same time this year and not increased and stable.On the neck, it started early last month and it is not that whitish (like little less brownish).As said, the doctors diagnosed differently (postinflammatory hypopigmentation, tinea versicolor and finally vitiligo) so far and we are confused. Could you please look into this and help us?In all these spots, we applied Corticosteroid last year for eczema (hand, neck, chest and back) at the same spots where the white patches started and then grown big now. The only spot where we have not applied Corticosteroid but observed white patch is on the eye. We started seeing a white patch on the right eye as well from the last three weeks. ### Response: I have gone through your history and clinical photographs (attachment removed to protect patient identity). From the present situation, it looks to be vitiligo. Since it is on one side of the body, it can be called as segmental vitiligo also. Tacrolimus is the right medication. Wood\s lamp examination helps to diagnose vitiligo. Yes, in some places, there is repigmentation which is a good sign. Did anyone in the family have vitiligo? Revert with more information to 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: My 6-year-old child is having asthma and is coughing in the night. He uses a nebulizer. I am giving him normal saline. Please help. ### Response: Hello. Since your child is having an asthmatic cough, I suggest you give Asthalin (Salbutamol/Albuterol) nebulization and Budecort (Budesonide) nebulization along with an oral cough syrup with Salbutamol or Levosalbutamol. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. Just giving normal saline will not help. If the wheezing is heavy consult your pediatrician" "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 good health with occasional atrial fibrillation. Last night, I had a flare up of atrial fibrillation and my resting heart rate was 130 beats per minute which happened a few hours ago. My normal resting heart rate is 70 beats per minute. I am taking Magnesium and Potassium. ### Response: Hi. Atrial fibrillation occurring in this age group needs evaluation like an echocardiogram, cardiac stress test, coronary angiography to rule out coronary artery disease. Next, I guess you do not have any other diseases like diabetes, hypertension, or stroke. If not, then you do not have to take blood thinners. Usually, atrial fibrillation is not a life-threatening disease, but it can cause troubles. Regarding management, you should be treated with beta blockers like Metoprolol to keep your heart rate under control. Alternatively, you can take tablet Flecainide, whenever your atrial fibrillation recurs, as a pocket pill." "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 protein shake for three weeks, around five scoops a day. Since then I get a pulsation in my buttocks and legs. This also causes dizziness most of the time. If I eat too much this problem gets worse. Drinking a lot of water helps but it is not sorting out the problem. I was advised to see a toxicologist for this problem as someone said to me that it could have given me protein toxicity.Anything I eat with high protein like chicken, lamb, fish, etc., makes this problem go worse. I also tried to stop eating that for a bit. It did help a little but again it did not sort out the problem. I have tried taking Detox as well.I am suffering through this problem for the last one year. I have been running around my gp. I am really fed up with this problem. All blood tests were done and everything normal. I have also tried taking vitamin C it did help a lot. But I experienced some pains around my kidney area so I stopped taking that too. This shake has definitely done something to me and nothing was helpful. I have tried a lot to find a toxicologist because I think who is the right person to help me with this issue. Could you please suggest me the correct medication for this problem as it is messing me up and stopping me from work as well? Please help. ### Response: After going through your question I feel that you are really worried about the ill effects of protein shake. Let me assure you that a protein shake is perfectly safe even if you have taken in large quantities as mentioned. The fact that even after three weeks it has not altered your renal function or liver function itself is the proof that you need not worry about the toxic effect of the protein shake. Just bring down your weight. It will ease your problem a lot. Do not worry. You will be all right." "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 low levels of vitamin B12. I have to take vitamin B12. Every time, when I take them, I get a terrible spine pain, and I feel very tired. Please help. ### Response: Hi. Your symptoms are related to vitamin B12 adverse effects. I would like to know your vitamin B12 plasma levels. You can take it as an injection once a month." "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 now seven weeks pregnant. The issue is my hCG at 18 DPO was 664, and then at 22 DPO was 2002, and then a week after the last measure, it was 3900 (different lab). It has not doubled properly. I had a scan at 6 weeks 3 days approx. and fetus measuring around 5 mm with HR of 120, was told its good and measured 6 weeks. Do I still have a chance at a normal pregnancy or will I miscarry due to hCG not doubling as they should? ### Response: Hello There is a good chance that you may continue the pregnancy, simply because the initial doubling of hCG from 664 to 2002 was evident and indicated adequate placentation. Ideally, the serum beta hCG levels should rise by 63 to 65 % in 46 hours. So, as can be seen, that they are and to add further, the fetal heart rate has arrived. The heart rate is low with known standards (140-160 bpm), but nevertheless, this is an ongoing pregnancy and you should be placed on Progesterone support for the next four weeks to allow better placentation. You may get a repeat scan done after two weeks to check for fetal viability and growth. Regards" "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 pain and sometimes heavy bleeding during or after sex and I can only do certain positions where I can tolerate the pain. I have already been tested and I am negative for STDs. I also have really heavy periods to the point that I cannot wear tampons because they do not work. What is going on with me? ### Response: You need to get a pap smear test and a per speculum examination done to rule out cervical erosions or cervicitis which are the most common cause of post-coital bleeding in reproductive age group women. The element of infection present can cause pain during menses and also a pelvic inflammatory disease which can be a cause for heavy menstruation." "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 issues with sleeping. I am exhausted all day every day, sleep 6 to 9 hours every night and take 2 to 3 hours nap every day. I am unable to control falling asleep. I am not on any medications. ### Response: The reasons for sleepiness could be many. Firstly, could be related to the deficiency in vitamins in body or iron deficiency. This can be easily tested by blood tests. Secondly, hormonal changes can cause sleepiness, like low functioning thyroid gland, which can also be checked on the blood test. Thirdly, sleep issues like sleep apnea or insomnia can cause daytime sleepiness which will require clinical assessment and sleep study. Finally, low mood or depression commonly causes sleepiness and feeling of exhaustion." "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 hit my forearm yesterday and there is a hard lump now where it was hit. It does not hurt to move my arm or pick things up but does hurt if any pressure is put near the lump. It does not sound like a fracture, does it? I do not want to go to the doctor\s office as everyone is sick and \xc3\x8d have two small children. Please help. I have attached photographs for your reference. ### Response: I have gone through the attachments (attachment removed to protect patient identity). It does not seem like a fracture. I would like to know few things for clarity" "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 suffer from cold, restlessness and body pain. During every winter season, I will get sick starting with a cold. Currently, I am taking Arsenicum album 30 and Aconite 30. Kindly suggest me a homeopathy medicine. ### Response: You can start taking Aconite 200 five pills in the morning, noon and evening. If you have Aconite 30, then you can take it at an interval of 15 to 20 minutes until the cold gets reduced. Take it four times a day. Take Rhus tox 200 in the morning, noon and night. Have warm milk with turmeric powder and ginger powder. You can also take one spoonful mixture of honey, crushed ginger, and turmeric powder for three to four times a day. This home remedy helps to give a fast recovery. Follow up after a week to decide the duration of treatment." "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 went for an HIV test at six weeks after low-risk exposure and get false positive. At eight weeks both fourth generation and HIV RNA PCR are negative. At 9 and 10 weeks rapid test is negative. At 12 weeks HIV RNA PCR is negative. Is it conclusive? My doctor told me no need for further tests. ### Response: To answer your query, I want to give reference of published research that, Although the reported sensitivity and specificity of fourth generation tests are more than 99% in numerous studies, there are several instances of discordance between screening and confirmatory techniques (Liu P et al. AIDS Research and Therapy 2016 13:1). False positivity can be due to user error or cross contamination, if there is ongoing some other illness eg. malaria, or if there is a history of blood transfusion, autoimmune diseases. A positive test result always needs to be routinely confirmed using a different type of test or testing kit. Fourth generation tests are more than 95% accurate at six weeks and this needs to be confirmed after three months with a second test. If the test in your case has been performed at three months after the exposure and is giving negative results, and you have not had another risk, you do not have HIV. Your fourth generation test and RNA PCR at 9 and 10 weeks and further 12 weeks negative RNA PCR, suffices to rule out infection. If you still have apprehension, get a repeat HIV antibody test at six months of exposure, no need to repeat it in between. Take precautions in the future (consistent and correct condom usage). 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 24 years old. Three months ago, I got viral conjuctivitis after two weeks everything was fine but eyes got blurred then my doctor recommended me Tobramycin + Fluorometholone acetate suspension and Tear Naturale Forte. Then after using it for one month my vision was clear but then doctor changed eye drops to Tobarest-F and Tear Naturale Forte. Now my vision is getting blurred again. What should I do? Now I have no other problem such as redness, itching, etc., just blurry vision is there. Please help. ### Response: I have seen the picture. (attachment removed to protect patient identity). You are having post-viral SPK (superficial punctuate keratitis) in your eyes. It is a very common condition after viral conjunctivitis. It is that small whitish scar marks on the cornea which leads to blurred vision. It will take time to resolve." "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 week I took three pregnancy tests and all three came back positive. This morning I woke up and was cramping and bleeding like I would with my normal period only a little lighter. Is this something to be concerned about? ### Response: Hi. If you are pregnant and the pregnancy test is positive, then bleeding after workup means there is threatened abortion. This is the initial phase of abortion, you should do rest in bed, consult a gynecologist personally for a scan for fetal well being. Over exercises. Ultrasound of lower abdomen for fetal well being. Start tablet Duphastone 10 mg twice a day, and tablet Folic acid 5 mg once a day for 15 days. Injection hCG 5000 IU intramuscularly stat and weekly for three months. Avoid sex and exercising." "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 want to know how bad or serious is type II (Galassi) arachnoid cyst located on the left temporal lobe? Can it be responsible for mood fluctuations, depression and/or panic attacks?There are no clear symptoms, but only mild depression (also had recent changes in life and my father died) and anxiety. No strong pain, only a minor one when my heart pounds fast. But I have to pay attention in order to feel it, it is very subtle. I am currently taking mild anti-stress natural medication and a quarter tablet of Betaloc-ZOK 50 mg in the evening to lower my pulse. I have done my MRI also. ### Response: There are no clear evidence in the literature favoring arachnoid cyst as a primary cause of any psychiatric disturbances. Having said that its size does affect the lobe functions if it is compressing it. So basically if you have symptoms that are not responding to the medical line of treatment then only you should opt for a surgical option." "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 see a black dot that has not gone away since yesterday does not move when I rub my eye or blink. It is more significant than floaters I usually see. It seems to move when I jiggle my eye a lot and moves slowly down after I shake my eye. ### Response: The fact that it is moving confirms that is also a floater but maybe newly acquired. Your age does not seem to put you in any danger of systemic diseases unless there is a family history of some genetic diseases. Marijuana does not seem to be the cause either. However, there is an increasing number of articles waiving about some side effects of CBD (Cannabidiol) products. I would suggest you visit the ophthalmologist for a more detailed evaluation to be on the safe side." "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 the adult palate narrow or change shape due to age or stress or hormonal factors? ### Response: Yes, definitely. Age changes occur in all our body, including our bone shape and density changes. The bone depth and density decrease with age in our jaws, causing gaps in our teeth, exposing more of our root part of teeth sometimes and it includes narrowing of the palate too. This is troublesome for patients wearing dentures as denture size alters by deepening of the palate. Stay happy and blessed." "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 weird rash on my foot. That has been persistently itchy, peeling and building. It does not burn, but it is unappetizing to look at. I do take Lyderm for it. It seems to stop the itching, but not the spreading of the rash. It has been on my leg for a year now. Please help. ### Response: This is most probably stasis dermatitis (attachment removed to protect patient identity), which occurs in people with poor circulation and in serious cases may develop into ulcers. Stasis dermatitis is common in people above 50, especially if have heart diseases or overweight or sit for prolonged periods of time. The symptoms include skin discoloration, itching, scaling and ulcers." "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: \x80\x8bI have sharp pain in the right eye since yesterday evening. Also, I wore a fresh pair contact lens last evening. And I did not wear a contact lens for almost two months. The pain started two hours after wearing contact lens and I went to a marriage function and there were many people with conjunctivitis. There is mild swelling and redness of the right upper eyelid since today morning after I woke up, but no watering and itching. ### Response: Hello. I reviewed your history and the photo attached to the question. (attachment removed to protect patient identity). It seems like inflammatory swelling of the upper eyelid, most commonly in the form of hordeolum." "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 33 years old and got ovulation spotting on 27th of last month, after this I tried to conceive. My period date is 11th of this month. I faced many leg cramps and abdominal pain in the period, also the period was light as usual and got frequent motion after the period. I am feeling irritated with many smells. On 24th again I got some spotting (ovulation day). I did a pregnancy test but it is negative. I am messed up. Can I be pregnant in this scenario? My doctor prescribed Deviry 10 mg for 10 days. Please suggest me is that medicine is safe if I get pregnant? ### Response: It is not always that you will be surely pregnant if you had sex during ovulation. It is also not 100 % that there is bleeding when there is ovulation. Spotting can be due to other reasons and can be the sign of irregular endometrium due to hormonal imbalance. Consult a nearby gynecologist and do take proper consultation and counseling session about pregnancy and its treatment performa. You may need to do some basic investigation to find out whether there is any problem or not. Whether you are ovulating or not during the mid-cycle and confirming it by ultrasound. You can take a repeat urine pregnancy test after eight more 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: My last exposure was protected but I am not sure about whether the vaginal fluid touched or not since I was drunk that time. After that, I went to an HIV specialist and he suggested me HIV DNA PCR test at 66 days period. The result is HIV 1 not detected.Then at 83 days, tridot rapid test is negative. 88-day tridot rapid test negative. 93-day tridot non-reactive. 99-day tridot (immuno filtration) antibodies 1 and 2 nonreactive. Then I took HbsAg, HCV, VRD total all are non-reactive.Is it enough for HIV testing? Is DNA PCR at 66 days (in window ) period useful? Is tridot test useful or not?In the window period time, I used fever tablets, antibiotics, and Levocetirizine many days. Will it affect my window period? Please give me brief information. I have a family and a child. Can I have sex with my wife without protection? Next test needed or not? ### Response: It is great that you have been found negative for HIV and other STIs (sexually transmitted infection). All the tests which you had taken for HIV were highly sensitive and specific and gives accurate results. It is unlikely for antibiotics and other medications which you had taken for fever could affect the result. Window period is the time taken for antibodies to develop after infection and then get detected by a particular test. The length of the window period varies between individuals. There are recommendations and I also suggest my patients to repeat the test at six months of last exposure. Testing at three and six months of possible exposure can detect almost all HIV infections. You can take precautions (consistently and correctively using a condom) with your wife until the time you are undergoing tests. 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: Hi,I am approaching you since I am concerned about a situation regarding which I am very embarrassed. I am a 43 year old female. I am normally healthy. I am 178cm tall and I weigh 75kg. Around 9-12 months ago, I started to suffer from anal itching.It is rather intense at night, after passing stools and during/after having intercourse or anal masturbation.I also have few lumps on my anal ring that seem to grow outside of my anal opening as an extended piece of flesh.They are very sensitive but they are odd and it really troubles me.I fear that my problem started as a result of anal masturbation and anal sex.I feel very ashamed to say this. I was using anal toys and hand and I am afraid that during these years I myself have created problems to my health and I do not know how to fix it.I do not have constipation and my stool is normal.I pass motion once a day and I have no abdominal pain while passing stools.Sometimes when I have anal sex I start bleeding from my rectum for a few seconds and then it stops.It does not bleed when I pass stools or any other time.I have not attained menopause even though my period seems to be every 6-7 weeks these days.I would appreciate if you can help me understand how to treat this issue and what should I do (i.e, special diet, special creams, instructions on how to clean the area etc.)Help me please, I am looking for a very discreet way to handle my situation since I am too concerned about talking with my spouse. ### Response: I read your entire history and have understood your concern. I also understand your hesitation in discussing your problems with anyone. Lastly, no good doctor will ever judge you for anything you do in your personal life. So do not feel ashamed in consulting one and getting the growths removed. Revert back with the reports 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 had unprotected sex on my infertile day, but I was quite scared, so I took post-pill a week later I had another unprotected sex this time in my fertile days but did not receive the post-pill immediately next day I saw a slight spotting which prompted me into taking the emergency pill. Now a week later, I have been bleeding for two days. I hope this is not a sign of pregnancy. Please help me understand it better. ### Response: Ideally, the emergency contraceptive pill is to be taken within 72 hours of last intercourse to be effective 99 %. It is of no importance if taken after a week. This rules out pregnancy as you had a 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 have been getting sores and things that look like blood blisters in my mouth for around six months. I had a swab test and blood work was done to rule out HSV. It came back negative. However, there is still a chance it could be HSV as it takes three to six months to show up in your blood. I am concerned. This is completely out of the normal for me. I do not smoke, drink moderately a few times a week, eat healthily and exercise. Any ideas? Would oral or genital herpes look like this in the mouth? Could it be mouth cancer? ### Response: Your concern may be oral lichen planus which is an autoimmune issue which is treatable. Or this can be aphthous stomatitis which are oral ulcers and they are also treatable. They flare due to low immunity of any reason, low iron in the blood, B12 deficiency, stress, overthinking, etc. Thirdly, it can be oral herpes which will have multiple ulcers rather than your presentation. The lesion might not be any oral cancer by the pictures (attachment removed to protect patient identity)" "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 an echocardiogram and ECG diagnose restrictive cardiomyopathy because I have had like three of them but I am still confused? All I have is just some premature ventricular contractions. ### Response: Hello. Yes, usually echo is sufficient to diagnose restrictive cardiomyopathy if findings are clearcut and the observer is sufficiently confident in the findings. So, your echo report must have mentioned all those findings. ECG is nonspecific, it may just point towards it but will not give a definitive diagnosis. However, an ECG may be helpful in confirming premature contractions which you are suspecting or sometimes may need Holter" "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 2 and a half years old and has very jagged (crescent-shaped) front teeth. I have brought him to two dentists.One said it appeared to be an enamel deficiency and the other said it was due to him grinding his teeth. I have never seen or heard him grind. ### Response: I have read through your complaint and the relevant details. I also saw the picture attached (attachment removed to protect patient identity). This is definitely not because of teeth grinding because the features of the tooth say it all. This could be something called as Hutchinson\s incisors with the clear crescent shape of the teeth. There is a high possibility of his back teeth (molars) having a similar shape. If that is so, please check with a general physician if the child has any other abnormalities in the internal organs including rhinitis and rashes. Because Hutchinson\s incisors is a sign of congenital syphilis (birth defect). Mostly, in syphilitic infections, permanent teeth will be affected. But here, considering your son\s age it is the milk teeth that are affected. Hence, it could be as simple as enamel deficiencies which were already diagnosed. If infections are ruled out, then you need not worry about the enamel malformation because once the permanent teeth erupt, it will be resolved automatically. After a consultation with the general physician, you might choose to get the teeth filled by a dentist for cosmetic reasons" "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 did some EKGs on a portable device and they all said not abnormal. Would just like an expert to look them over to make sure they agree and it is correct? I just started Citalopram 10 mg for about five days and now on 20 mg daily for the past two days. Saw that it could cause a QT prolongation. So, just wanted to make sure this was not occurring. ### Response: Hello. After carefully reviewing your uploaded ECG recordings, I would like to assure you that your QTc interval is not more 440 ms, which is not dangerous or life-threatening for a female patient. Coming to this point, you are not actually at an increased risk of cardiac arrhythmia under your current therapy (Citalopram). In addition, I would recommend to frequently control your ECG (at least every three months) coupled with blood electrolytes levels and avoid any potential adverse events induced by this therapy." "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 40 mg of Fluoxetine. For the past four days, I was put up from 30 mg to 40 mg as my 20 mg stopped working after three years. While on the 30 mg, my symptoms got better for a couple weeks and then I went back down to where I was, in the beginning, feeling extremely depressed, anxious and completely awful. I was wondering why this happened? ### Response: Fluoxetine 20 mg OD is the usual dose prescribed in managing depression and anxiety. Sometimes Fluoxetine dose needs to be increased to 40 mg OD if the previous dose is no longer effective. You have been on 40 mg for the past four days. You may be aware that you need to wait for at least 2 to 4 weeks to see the maximum therapeutic response. In addition to medication, you will benefit from counseling, CBT to manage your emotional difficulties. Discuss with your GP, CMHT in case you have not had taking therapy before. Try to exercise daily. Even brisk walking outdoors for 30 minutes daily can help to improve your mood and lower anxiety. In case, if you do not get better even on Fluoxetine 40 mg OD. Kindly consult with your doctor. You may need a reassessment of your symptoms and sometimes alternative SSRI needs to be considered." "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 24 year old male weighing 221 lbs. I felt a fluttering in my chest yesterday for the first time, which only lasted for five seconds and I felt short of breath. I got an ECG, x-ray, CBC and HbA1c done today. I am worried about my ECG being abnormal. I am scared that there could be something wrong and I have no other symptoms besides shortness of breath. ### Response: Hello. Do not worry because the probability of any serious illness at this age is low. However, these are probably an arrhythmia like atrial fibrillation or PVC (premature ventricular contraction), which are not a serious condition. These can cause all your symptoms and can be managed with medicine. Revert with the reports to 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: I would like an opinion on my X-ray if it shows any signs of a stress fracture in the heel. I took up running and increased it too fast.It hurts to walk on the sides of the heel. Pressing on either side of the heel hurts a lot. There is swelling but no bruising.The swelling is decreasing now but the pain is not. I want to know what I am dealing with. I cannot see the GP for another week or so. ### Response: I have viewed your X-rays (attachment removed to protect patient identity) and there is no feature to suggest a stress fracture in the calcaneum bone and bones in the heel area. It is possible that you have a soft tissue or tendon abnormality which can cause you the pain in the heel area. If there is no significant improvement in the pain over the coming week, then you can discuss an MRI ankle joint scan to know about the soft tissues or any subtle bone edema in the calcaneum. This information is not available in the X-ray picture. Since your doctor is not available for a week, I suggest you decrease your running and apply a muscle relaxant spray or ointment over the hurting area. You can also apply an ice pack to decrease any inflammation in the area" "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 28-year-old female. I have always had a small, raised, symmetrical mole on the right side of my chin. It has always been very benign and had a hair growing out of it that I consistently plucked. About two weeks ago, I noticed a small, shiny whiteish bump on the mole and called my dermatologist. Because of the holidays, I could not get an appointment anytime soon and still have another week to wait. Over the last couple of days, the mole has gotten bigger though it has stayed symmetrical and is still slightly smaller than a pencil eraser. It is slightly more raised and it stings to touch. I also realized that it has been a month or two since I had to pluck any hair. None has grown.I have had a zit on this mole a couple times but this does not really look like the previous moles. I am conscious it could be another more severe zit or maybe a cyst but I am very nervous that it is cancer. I had a couple of moles removed in childhood that were not quite suspicious but that the dermatologist removed just to be safe. My mother has had several basal cell cancers removed. I spent many summers in my youth outside and am worried that this is melanoma or nodular melanoma even though it is not dark. ### Response: I have noted your concern and I have viewed the images (attachment removed to protect patient identity). It looks to be a pretty benign nevus to me. Well defined, uniform colored, small, rough to oval, and symmetrical. I think the nevus perhaps has an ingrown hair and the resulting inflammation has caused it to swell up and sting a little. I suggest you apply a topical antibiotic either Neosporin ointment or Mupirocin 2 % ointment, twice daily for a few days. Regards" "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 27-year-old female. I am experiencing sharp pain in the area below my left breast and near the rib cage. Could it be something serious? ### Response: I have read your query carefully, before any prescription I want to know few things, 1. The exact location of pain? 2. Type of pain like sharp, cutting, and duration of pain? 3. Any previous history of any disease? 4. Hypertension and diabetes? 5. Current medication?" "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 began presenting last fall with some chronic fatigue. The initial blood work showed low iron saturation without anemia. I have attached reports of the same. There were other endocrine-related findings as well. In the course of various endocrine-related treatments and corresponding blood work, I began iron supplementation in the form of ferrous sulfate 143 mg daily. I began this before the blood work was done. So, you can see that that the levels have increased. Subsequent testing, a month later, showed a decline despite continuing treatment. Most recently, you can see that the levels are back up. Note that the ferritin levels began a bit low around 27 ng/mL and had increased to 30 ng/mL.I have received a wide range of conflicting advice about whether low iron levels in the absence of anemia can cause fatigue. I have also received a range of conflicting advice about whether to continue iron supplementation. One doctor told me to continue taking the iron until the ferritin is up around 50 or so. Another said that would be unnecessary and to discontinue it and wait for three months to re-measure the blood work. It is all quite puzzling. Please help me to understand iron\s role, if any, in fatigue in the absence of anemia. And help me to then understand the rationale for treatment or lack thereof. And finally, please give me some sense of when iron toxicity emerges in terms of blood work measurements and at what frequency one needs to check the iron levels during any supplementation. ### Response: Hello. You can consult an endocrinologist or a neurologist based on your reports, but iron medication need not be continued as per my opinion" "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 migraine for the past five years. I took Sibelium for four years, but it caused me to put on so much weight. So, I stopped taking it. Now, I have a migraine again. What should I do? ### Response: I have gone through your query and understand your concerns. Hope you found the answer helpful. Do get back to me for further queries" "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 just had a sinus lift graft and implants placed. The dentist has prescribed 500 mg of Levofloxacin every 12 hours for 10 days, plus Augmentin, plus Ibuprofen and Dexamethasone. My question is whether the Levofloxacin is necessary and why is it such a high dose? I have read it should not be taken with Ibuprofen and Dexamethasone. My dentist said it is fine, but I am very worried as I have heard this antibiotic is very toxic. What is your advice concerning this issue, please? ### Response: Hello. In usual cases here, we just give Augmentin (Amoxicillin and Clavulanic acid) 625 mg twice a day for a week or two which is more than enough and Levofloxacin is not required. Maybe your dentist is being extra sure that you do not get any infection at the site. The dosage is fine, and if your dentist is an experienced one, you should go with his prescription. Taking just one course of Levofloxacin is not going to harm you in any significant manner" "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 given Medroxyprogesterone. Today is my last day but I have not got my period. My doctor suggested PCOS. What shall I do next? ### Response: Hi. I have read and understood your problem. So, you wait for a week. Oral contraceptives are a good choice for PCOS (polycystic ovarian syn" "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 sore throat for the past 15 days. I tried taking all the medicines. But there is no use. I had also done four tests for HIV in this period. I had protected sex. All the results came negative. Why do I have a sore throat? If I am doing another HIV test, do I need to test with the morning blood? ### Response: Hi. First, there is no need to give a morning sample for HIV test. Second, a sore throat is due to infection and may not always be due to HIV. Simply check for any redness (congestion) of tonsils or surrounding area to rule out any infection. A sore throat can occur due to a viral, or a bacterial infection and the causes are numerous. A viral infection may present with body pain, while a bacterial infection will have a high-grade fever. So try to rule out any congestion in the throat. Take tablet Amoxiclav (Amoxicillin with Clavulanic acid) three times a day for seven 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 taking rabies vaccination. Right now I have completed two doses of my injection. My question is if I get another bite during my vaccination do I have to restart my rabies course from starting or should I continue the same course? ### Response: I can understand your concern. According to your statement, you are taking rabies vaccination and you have already completed two doses of rabies vaccine. Now you want to know what will you do if you get another bite during your vaccination. And the answer is simple there is nothing to be worried. Just complete your rabies vaccination schedule. No need to start the vaccination from the first dose again. So you should complete your current schedule and rest of the doses of rabies vaccination should be given." "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 since I can remember, a runny nose, especially in the morning. Not uncommonly there are streaks of blood. Quite often also post-nasal drip. At times, I have itchy runny eyes. My doctor has prescribed an ointment Otocomb which sometimes help. In the past few months, I have noticed a sore in my inside of the left nostril. It feels like it runs neatly along the rise or cartilage. It sometimes forms a scab that I pick at. I am worried that it is not improving. ### Response: Hello. What you are explaining is consistent with chronic allergic rhinitis and chronic sinusitis. I wanted to know if you have ever tried a nasal spray and if yes for how long? Which one and did it help? Do you have pets? Did you have patch testing ever?" "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 13-year-old male. I tried this relatively cheap BleachBright StarBright Dual-Action whitening pen. After using it I noticed white spots forming all over my teeth. It was the weirdest thing. I have always had white spots on and off throughout my life, but after using this, within five minutes I had a bunch of them appearing. Is this an allergic reaction? How do you recommend I get rid of them? Should I consult my dentist? Should I continue using my whitening pen? Of note, I am currently on Guanfacine. ### Response: As per your symptoms, the white spots on the teeth are due to hypocalcified areas that are areas of poor mineralization. Bleaching makes them more pronounced and they can further stand out on the teeth. It is not an allergic reaction but this has happened due to a more clear appearance of hypocalcified areas. Please do not use your whitening pen further and for any cosmetic dental treatment, it will be better to consult a cosmetic dentist. Regards" "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 back pain for the last 12 years. I had an l5 s1 disc herniation and later diagnosed with severe lumbar spinal stenosis at l4 l5 as well. My back pain is more critical than the leg pain. However, I have persistent calf and foot spasms and cramping (especially in bed and at night). I am able to exercise and lift heavy objects, but not able to walk more than a mile at a time. I believe the stenosis is more of an issue right now than the disc herniation, and my MRI confirms the disc is not as bad as it was years ago.I have done physical therapy, acupuncture, chiropractor, and epidural injections, but, my lower back pain remains an issue (especially when standing and walking for a long time). My doctors recommend a laminectomy, though I am scared that surgery may leave me in worse shape than I currently am. Can I have some advice? Should I go through with the laminectomy, or should I deal with the back pain since I have built a high tolerance for pain and can do most (but not all) activities? ### Response: Hello. You are quite aware of the condition and have managed to live with the issue, but as you say, you cannot walk not than a mile, but it does not seem to be your main issue. If you required to walk longer, then laminectomy will be the solution, but you need to get relief from back pain. I will hazard a guess that this is from local instability, faceted, or discal. I will say that because that is usually the reason for back pain in patients with disc issues. Lumbar canal stenosis will not often give rise to back pain. I will recommend that you discuss this with your doctor and perhaps go for laminectomy and pedicle screw stabilization as this will help relieve both issues." "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 47 years old female. Before a year, I went to the ER with pain during breathing. My D dimer was elevated at 700 ng/mL. CT scan was negative for a clot. Then I have done two subsequent D dimer tests, and both the ranges were elevated. The values are 521 ng/mL and 707 ng/mL. I am taking tablet Armour for hypothyroidism and a multivitamin tablet. ### Response: D dimer is a fibrin degraded product, and it is elevated in case of thrombosis usually like pulmonary embolism, deep vein thrombosis. For this, the investigation is done in the form of 2D echocardiography and color doppler of the leg. But you had investigated with CT scan angiography as mentioned in the history (attachment removed to protect patient identity) and it is considered as the preferred test to detect pulmonary embolism. So pulmonary embolism seems less likely. Calf vein color doppler is done to check deep vein thrombosis. Specific false definite causes for D dimer include pregnancy, inflammation, liver disease, any previous surgery. Also, you can check your coagulation profile through PT (prothrombin time), aPTT (activated partial thromboplastin time), BT (bleeding time)" "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 26 years old. I got married recently. After having intercourse with my husband, I feel too much pain in my vagina and also burning sensation while urinating. I also feel frequent urination. Is this urinary tract infection? Please suggest some medicine. ### Response: Hi. You are right. You have symptoms of urinary tract infection (UTI). Please get a urine culture and sensitivity done. We can start the appropriate antibiotic then. Meanwhile, have plenty of water of about 10-15 glasses a day to flush out the toxins." "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 abuses me a lot and eats a lot. He is really aggressive. He also has some memory problem due to over consumption of alcohol. Unless we give food he starts destroying things. So, I think he is suffering from bipolar disorder. What should I do? ### Response: Increase appetite, aggressive behavior and destroying things are symptoms of bipolar mania. But, in bipolar mania there is decrease need for sleep. So, it may be bipolar mania. To make a definite diagnosis, I need to know more details about his behavior. Revert back with the answers to the above questions to a psychologist counsellor 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 mom accidentally dropped the Lulifin lotion into my eyes. Is there any first aid treatment or should I contact the doctor? Please tell me. I am scared. ### Response: Lulifin is an antifungal lotion. You should immediately do an eye wash with clean water, and continue this for at least 20 to 30 minutes. Please remember that if your vision is affected then it is better to see an eye doctor." "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 tooth decay for the past five weeks and it is causing a lot of pain. Please help. ### Response: Your tooth enamel chipped off, exposing dentin and inner layers of the tooth. This might have opened root nerves too and that is why you are having pain. Start taking tablet Brufen 400 mg twice a day for three days. If the pain gets relieved by it, it means there is no deep infection and tooth may be restored by filling. But if pain persists after leaving medication it means root is exposed and now root canal treatment is the only option you are left with. I can tell exactly if you can provide me with a radiograph. Stay happy and blessed." "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 R related words in speaking, I practiced a lot, but problems remains the same. Kindly suggest any specific medicine or exercise for the same. ### Response: Hello. First of all, I hope you consulted a speech therapist. Because he can help you correctly and quickly than you can do it by yourself. R sound of the retroflex is the sound where the tongue performs a vibrating motion to produce the sound R. For correcting the sound you first need to start practicing with the placement of the tongue then you progress to vibrate it. If you are finding it challenging to understand, consult a proper speech therapist as you need to practice the first steps to articulate. You first need to produce individual sound and then words. 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: From the past five days, I am sending my 21 month old son to a daycare. For the first three days, they allowed me inside the campus. Since I was close by, he was playing well. But, from the last two days, they are not allowing me inside and hence he is crying a lot. Today he was a bit fine but, not actually enjoying. Will it affect my child\s health? Will it create any psychological problem in him? I have heard that the cortisol hormone levels will be changed. Is that true? My in-laws are not staying with us. So, I have to either send him to the day care or I will have to send him to my in-laws\. Which is the best option? ### Response: I have gone through your query and understood your concern. Yes, it is true that the child may suffer from some psychological problems when not staying with the parents or the regular care giver as it occurs in some foster homes. But, as you mentioned that it is only for a few hours every day, it does not affect significantly. Make sure you are available to the child after your office hours and then take proper care of him physically and emotionally. So, it is not a problem. After a few days in the daycare, if you observe some changes in the baby, you may assume that the baby is not comfortable there. But, in the initial days, it is normal for him to behave like this as the baby has anxiety from the unknown surroundings and people. You can wait for a few days or weeks to see if the baby is comfortable in that place and then decide. Regards" "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 missed period for four months. This has happened before and my period came normally for one to two years after. There is no pain and no medications for that. No symptoms or chances of being pregnant. Please suggest. ### Response: Hello. Irregular periods can be due to many reasons. A little bit more information will help in making the right diagnosis. May I know when you had your first periods? Have you lost or gained weight recently? Any change in lifestyle or stress recently? Are you having any pimples, hair growth in face, chin, etc? All the above reasons can contribute to irregular periods." "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 had a fall following which it was diagnosed two fractures in the hip joints in front and back. She lives in an area which does not have excellent medical facilities. Hence we thought to take your opinion. Please look at the attached X-ray, prescribed medicine, and let me know your views on the situation. Also, her bone density is extremely low, I do not have her last report, but when did three years ago, it came to be very low.The proposed diagnosis by the doctor, says minor fracture, and since it is in the hip area, plaster cannot be done. Currently, there is a stand provided to support and asked for complete bed rest. However, she is moving to use the washroom for stool. Please suggest if the course of treatment is fine and also how significant is the fracture. ### Response: I have gone through your questions and the attached reports (attachment removed to protect patient identity). Your mother has a hip fracture which is mildly displaced. The best treatment would be to get the surgery done and get the fracture as early as possible so that she may be able to walk early. Only taking rest and medicines would not guarantee that the fracture would unite and may lead to further complications. However, there are 50 % chances that this fracture may heal without surgery. But there is no guarantee. So I would suggest surgery for faster recovery." "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 two weeks of LMP, I had mild cramps and non-stop light vaginal bleeding, it lasted for three days. I experienced non-stop light vaginal bleeding, once again after this month periods. This morning, I started to have light bleeding again. Given my concerns, I had bloodwork this week; my blood counts are normal; my thyroid, hormones and pituitary gland levels are all normal; and I am not on birth control. However, my urinalysis revealed that my erythrocyte is 25, my leukocyte esterase is 0.3 mg/L, and my eGFR is 88. Plus, my ferritin is 10.Initially, my doctor believed my abnormal bleeding between my periods was due to a hormone imbalance but we now know that it is obviously not the case. Can this be due to gynecological cancers? I am only 32, I am healthy, I am not on birth control, I am not pregnant, I am not on hormones, and the possibility of having cancer makes no sense to me. I would appreciate talking to someone because I am terrified. ### Response: Overall looks like normal. There is no ultrasound scan which is required if you having irregular bleeding. Secondly there are 100s of hormones producing and out of which we can do tests of few only. So cannot say by 100 % that it is not hormonal issue. Irregular menses can be due to other reasons also like starvation, environmental factors, stress, eating habit. There are some food nutrients which may have effects like hormones or may acts against hormones. Do one ultrasound scan. And may require dilatation and curattage and send endometrium to rule out endometrial cancer." "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 protected sex before two years. As I recall she was on the top and then later I was on top of her. During the act, my condom slipped, but there was no exposure to my bare penis. I could not achieve an erection, so she removed the condom and applied lotion on my penis. My question is,1. Can her vaginal fluids enter my exposed penis as she applied lotion, making me infective (unknown status)?2. I had two p24 tests done at four and nine weeks. Both came negative. Should I go to 12 weeks or is this conclusive? Is there any chance of turning negative to positive?3. I feel swollen lymph node in my neck which occurred close to 12 weeks now. Am I HIV infective? Please help with your reply, and I am getting stressed. ### Response: Hello. Answers to your queries are, 1)This is not a likely situation of entry of HIV through the vaginal fluid. Acquisition of HIV in this scenario is non-existent. Your fears are unwanted. 2) It is good that your p24 test is negative at four and nine weeks. Majority of the individuals (approximately 97 %) turned positive after an HIV exposure in two to eight weeks, and a very few take six months for the test to become positive. As per the recommendations and I also suggest you undertake a repeat HIV antibody test at three months and if negative then at six months. You need not repeat it in between. 3) Enlargements of lymph nodes can be in multiple conditions. Get it evaluated. Lymph node biopsy helps in establishing the diagnosis. I hope your queries are answered, but if you still have, feel free to ask." "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 inside part of my right elbow has been sore and swollen for five months. Flexing my arm out and wrist up and turning my arm from side to side aggravates things quite badly. Pain is worse at night time. When I push my three fingers and thumb together I get radiating pain down my forearm into my inside part of my elbow. Ultrasound showed all is good, but something is going on. It is hard to use my arm for any strength activities. My GP and physiotherapist have told it is not tendinitis. I took Ibuprofen and Voltarin Samuel gel but made no difference to the pain. ### Response: Sorry to hear about your suffering. Swollen sore elbow could be due to many causes like: Please provide me with more details in order to identify the cause: Please provide me with a clear photo of the elbow. Send me X-ray of the elbow if already 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 am a 49-year-old woman. I am suffering from severe anemia (iron and B12 deficiency). This might be the result of prolonged malnutrition over the past few years. The problem is that I have developed extreme sensitivity to most of the drugs, medication, treatment. In the past, there were many instances of adverse reactions by taking medicines of Iron composition. These include restlessness, breathing problem, and diarrhea. About five years ago, upon the doctor's advice and supervision, I was fed intravenously through saline bottle with some Iron injection to it. Immediately in about 15 minutes after the procedure, I experienced shortness of breath, burning sensation in muscles, swelling of legs, fatigue, and diarrhea. It subsided when I was given an antidote by the doctor immediately. From then onwards I was reluctant to take any of my medicines and undergo any treatment. I just focussed on improving my diet. Recently upon doctor's advice, I took some medical tests and the reports were serum ferritin: 3.0 ng/mL, vitamin B12: 129 pg/mL, TSH: 0.02 \xb5IU/mL (but T3/T4 tests are fine), iron: 15 \xb5g/dL, TIBC: 527 \xb5g/dL, hemoglobin 7.7 g/dL, vitamin D: 18.39 ng/mL. I was also informed that I developed food allergy to some foods. Lately, I am experiencing a headache with activity, unexplained generalized weakness, fatigue most of the time. According to the doctor, I am in a very critical position and should be immediately treated with Iron injections, blood transfusion, etc. But, I am really worried as my body will not be able to take these treatments (as I faced adverse reactions in the past). Are there any medical procedures or treatments on which I can rely upon ensuring that they will not have any adverse effects after the treatment. Please help me. ### Response: You are having Iron injection allergy. Hence, it is better to avoid. But sometimes, we have to take decision according to benefit to risk ratio. In your case benefit could be more because severe anemia should be treated. (Your ferritin is also very low). So, blood transfusion or Iron injection might be needed in your case if severe anemia is present as per provided history. I suggest you consult a Hematologist for examination and accordingly further management" "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 observed that my left testicle is lower than the right. I examined myself but found no lump. I am not experiencing any pain either. Is this normal? ### Response: Hi. You need not worry since this condition is quite normal. Because of the late descent of left testis into the scrotum, the left testis is generally placed at a lower level compared to the right. This is totally normal and not harmful. This, by no means, will affect your sexual life. Consult a urologist online if you have further queries regarding the same" "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 infection in my tooth and swelling in the gums. Can I take an antibiotic to clear the infection? ### Response: Yes, you can take antibiotics. Take Augmentin (Amoxicillin and Clavulanic acid) or Penicillin. Take three times a day for a week. Get an early appointment with your dentist for an examination. If you are willing to save the tooth, go for root canal treatment if it is possible or else go for extraction of the infected tooth" "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: How can I figure out my conception date? My last menstrual period was three months back. I had my dating ultrasound and it put the GA at 9 weeks and 3 days. Also there was a CRL measurement of 26.96. My due date based on LMP and ultrasound are different. Please answer. Also how many ""safe"" days are there after a period? ### Response: Hello. First of let me tell you that if your menses is coming every month with 2-3 days here or there then it is absolutely normal cycle. Now in normal cycle ovulation occurs in the middle of the cycle (around 12-18th day of cycle) when conception can actually happen. First 8 and last 8 days of your cycle are safe period in normal menses as there is no chance of pregnancy thus safe. Now pregnancy can happen in regular and irregular cycle both. And it is far more difficult to calculate the actual date of conception. Other than that it is easy to remember last date of menses and easy for calculation, so we are calculating pregnancy from last day of menses. In technical terms there are two age of pregnancy one is gestational age and other is embryonic age. Embryonic age is actual age from conception and gestational age is from last day of menstruation. So do not get confused. Lastly if your pregnancy is growing well that I can assume by your history then no need to worry and the due date according to last menstrual period is the date. Now what is importance of this date? It means if delivery pain starts near this date then let it happen. Do not interfere and if it does not start till date then induce pain with some method of induction." "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 got my periods today for the second time in 10 days. The last time I got it, there was less flow comparatively. On 30th, I had unprotected sex and had an I-pill immediately. Can you please tell me if there is anything harmful? ### Response: I have reviewed your query and can understand how worried you are about your health. I want to add that it seems to be due to hormonal imbalance caused by the contraceptive pill. Emotional distress also adds up to the situation. As of this time, it seems nothing wrong. You just keep up with daily routine and do not bother much about this issue. When we take pills that contain hormones, it interferes with the natural body hormones. This may sometimes cause breakthrough bleeding too. Hope it helps. Kindly be advised, if you do not want a pregnancy, use barrier contraception. It saves from STDs too. Regards" "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 36 year old male and my wife is 28 years old. I have been suffering from azoospermia and have been in touch with different doctors for the last eight to 10 months. I have done many tests and everyone is ending up with a suggestion of testicular biopsy. My wife is not in favor of this and both of us would like to go for other tests before going for a biopsy. I am attaching all the reports. Can you please let me know whether there is any hope of the sperm coming back? Please suggest. I had four cycles of chemotherapy six years back and now I am completely cured. ### Response: Hello. I read your query and reviewed the attached reports of USG and semen analysis (attachment removed to protect patient identity). I hope this helps you. Feel free to write back to me if you have more questions. /ask-a-doctor-online/an" "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 wondering if an anesthesiologist would mind getting interviewed. I am writing a research paper and could not contact any anesthesiologist around me. Below are the questions I need an answer.1. How many years have you been a part of this profession? 2.\tAbout how many times a month do you administer anesthesia to a pregnant mother in labor? 3.\tRegarding the previous question, what kind of anesthetic is used? (GA, LA, or RA) 4.\tHave you heard of transmitting the anesthetic agent through the placenta, from mother to child? 5.\tIs there any information you could provide for the above? 6. About how many times a month do you administer anesthesia to infants for surgery related procedures? 7.\tRegarding the previous question, what kind of anesthetic is used? (GA, LA, or RA) 8.\tWhat kind of chemical compound is used in the hospital's anesthetic? 9.\tDoes this hospital use an anesthetic \x80\x9cCocktail\x80\x9d (mixing drugs with anesthesia)? 10.\tWhat information can you provide about the issue of neurological degeneration in infants who have been exposed to anesthesia either during surgery or birthing? 11.\tWhat kind of introductory do you give your patients about the anesthesia they are about to receive? 12.\tHave you ever had a follow up with any infant patients later in life? (adolescent age) 13.\tIs there any more information that you believe could help me better understand this topic? ### Response: I am glad to answer your queries. Responses are by the question numbers: 1.I have been working as an anesthesiologist for the past 8 years. 2.I would administer anesthesia for around 15-20 caesarean sections per month. 3. In my practice RA is the choice of anesthesia for the pregnant mother under going C section." "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 weeks ago I went to the doctor with an open skin wound on my face. I was cultured as it looked like Staph infection and given antibiotics. I ended up putting raw, unfiltered honey on the wound and it cleared up in the next three days. There is only a small red scar now. The culture came back as positive for Nocardia. I have no fever, shortness of breath or any other symptoms to speak of. I have set an appointment with infectious disease specialist by next week. As the wound got healed, could it still be in my blood? Do I need to do anything before my visit? Should I push to be seen earlier? ### Response: Hi. I can understand your concern, but I require some more information." "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 58 years old. I have some very minor tingle in my right second toe. I am very healthy with no medicines and no other symptoms. It started with unilateral tinnitus. MRI of the spine showed moderate to severe stenosis spine. I do exercise, and running, and my neurologist says this might be normal. I had a concussion when I was 17 and spent a day in the hospital.My MRI brain is obviously abnormal with white matter. What is the likelihood of MS? I had an MRI in 2015 and said chronic microvascular changes. MRI of a couple of weeks ago said no tumor on auditory nerves. Please explain. ### Response: I understand your concern and would explain that your MRI findings (head and spine) fulfill the radiological criteria of MS (multiple sclerosis). There are many old lesions in the head and spine and there is a new lesion in the left parietal lobe, which explains the tingling in the right toes. Although you have no past medical history for paralysis or limb numbness and weakness, these brain lesions are compatible with MS. I recommend discussing with your neurologist about that. As there is a new lesion (with light contrast enhancement), steroids would help to relieve the tingling in the right toes. Regarding the mild spinal canal stenosis, it does not explain the spinal cord lesions in the upper levels which are probably related to MS. I recommend performing a spinal tap in order to examine your cerebrospinal fluid and visual evoked potentials. 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: For the past one year I have been suffering from seemingly unexplainable symptoms, which have been getting progressively worse.I have been through a series of medical examinations which did not find anything. My doctors are clueless and I am desperate. I hope you may have some suggestions.Symptoms:Persistent unbearable fatigue which is worst in the morning and afternoon, worsens after eating a meal, after standing up and after drinking coffee. It gets better after lying down with legs raised and after stretching the neck and after drinking alcohol. Otherwise the fatigue prevents me from doing most normal daily activities. I can barely sit and watch videos, eat and use the toilet. I am not able to do any other work. While sitting I fall asleep during the daytime.Resting and intention tremor (while rotating the wrists).Sluggish memory, fairly frequent memory lapses (forgetting my friends names). Clumsiness - when pressing buttons on the computer or microwave I often miss the button and while opening drawers or doors I grasp air instead of the handle, etc.Eye coordination problems - while reading my eyes jump over words thereby making me misread words for something else or just omit words.Cognitive difficulty - with mental arithmetics and planning and I often mispronounce words or use different words than the appropriate one in a sentence during speech.Post-void urinary dribbling and frequent defecation.Flashes of past memory like dreams while awake, euphoria turning into nausea and extreme tiredness afterwards.Pain in the neck, muscle cramps and stiffness in the neck and TMJ area. (I have had orthodontic treatment for the past 2.5 years for correcting underbite). Slightly dislocated coccyx.Pain and pressure behind the eyes, urge to blink often.Tests done and reports:MRI scan of the brain: normal.Thyroid function tests, Liver Function Tests (LFT), serum electrolytes, vitamin B12, kidney function tests: normal.Glucose blood test: normal.Lyme disease: no abnormalities.Gluten intolerance: no abnormalities.Complete Blood Count: no abnormalities.Urine microscopy: no abnormalities.Psychiatrist: no abnormalities, except worry about my health.No hypotension or orthostatic hypotension.Sleep study: no hypoxia or sleep apnea.No papilledema and nystagmus.Plantar reflex - flexion, negative Romberg\s sign.Symmetrical reflexes.No family history of any disease, no childhood history, no epilepsy, no drugs ever taken.Serum C-reactive protein level, serum vitamin B12, serum ACE level, serum folate, complement C3, complement C4, ESR (Erythrocyte Sedimentation Rate) are within normal range.Could all of these be caused by anxiety disorder/ depression?What all tests would you recommend to rule out all possible underlying neurological conditions? What is the most probable condition I am suffering from? ### Response: Hi. All the symptoms which you have mentioned cannot be explained on the basis of anxiety disorder or depression. The points against anxiety and depression are resting and action tremors, problems with eye coordination and the memory lapses that you are experiencing. You have already undergone almost all required tests in neurology. But a few more tests are necessary: Complete neurological examination by a neurologist - this is the most important test. Screening for heavy metals. At this stage, I am not able to make a provisional diagnosis for you but there is a possibility of Synucleinopathy (group of disorders associated with abnormal deposition of synuclein), if your age is beyond 50 years.Revert back with the reports to 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 am having bloating and incomplete bowel movements for the past six to seven months. There is a light pain in my left abdominal area for the past two days. Please let me know the reason behind this. ### Response: I read your query. As you mentioned, you have a problem of bloating and incomplete bowel evacuation for some time. You also have abdominal pain that can be due to gas. To avoid this, follow the instructions mentioned below: I hope you have understood my suggestions. Regards" "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 husband and I will be using a surrogate to have kids. My husband is kell positive (heterozygous). What are the risks to this that the surrogate would need to be aware of? ### Response: Hello. Few points include: 1. As per medical facts, the first pregnancy remains silent. In your case surrogate is kell negative it means her body is still not exposed to kell antigens which are good, so this pregnancy will be safe. 2. As the husband is heterozygous, it means he has only a 50 % chance of having baby kell positive. In the rest 50 %, there is no risk of complications. So, theoretically, this pregnancy should go silent without complications. But then surrogate will be exposed to kell antigen from your husband, she should be aware of this risk which can create trouble in future pregnancies if the male is kell positive." "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 sister is 18 years old, and she has never had periods. Recently, we did a test which said, 46, XY (20), 20 cells were counted, all cells showed 46 chromosomes. Small chromosomal anomalies and small clonal population may not be detected using the standard methods employed. Could you please explain what does it mean? What can be done for her? Will she be able to have kids? ### Response: Hi. How are you doing? This is a tough condition to explain, but let me try. 46 chromosomes mean the total number of chromosomes is normal. For a normal female, the sex chromosome should be ""XX"". ""XY"" means male. So, your sibling who is looking as or phenotypically female is actually or genotypically a male." "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 low energy for a few days now. I have done a blood test, and I have a ferritin level of 10 ng/mL. After taking supplements, my ferritin got increased to 16 ng/mL. But, still, I suffer from weakness. My doctor advised me to have an iron infusion to raise my levels. I still have low energy, and it is affecting my daily life. Can I take an infusion now? Can it help me? Please suggest. ### Response: It also depends on the level of hemoglobin. There are no additional benefits seen while having an infusion. It gives a rapid rise in hemoglobin. If you have responded to oral treatment, then it is not necessary. Please send your blood reports soon. If everything is fine, then do a thyroid test." "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 33 year old female. I got my cavity filled two days back. Now, it hurts when I drink cold stuff. Is there anything I can do? ### Response: Hello. In case there is no relief, you need to visit your dentist again to get an X-ray of the tooth done or maybe get a refilling with a different filling material. Hope it helps you. Regards" "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 period was on 24th last month and it went for a regular five days. I had sex on that Friday after my period was over, had Ipill the next day. Again had sex on Wednesday, had Ipill on Thursday and from Thursday, I am getting a brown discharge, a little bit of cramps. Am I pregnant? Because he did not discharge inside me, so I cannot be pregnant but I am scared of pre-cum, but I took Ipill. Still I am getting a brown discharge, please help. When can I expect my next period (on the date or delayed)? ### Response: You have taken Ipill after sexual relation. So the chance of getting pregnant is very less. The brown discharge could be due to the frequent use of Ipill. The excess Ipill intake is not advisable for health. You can use precaution next time. Your next period might be delayed for a week as Ipill contains high dose Progesterone. If your next period gets delayed for more than a week then rule out pregnancy by urine hCG card test." "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 missed my period last month and after the first late day I took a pregnancy test and it said not pregnant. So I waited for a few more days to go by to take another and it said positive so from that day I scheduled a follow-up appointment and when I went to get an ultrasound they told me that there was nothing there. So she predicted that I may be early, so she used the camera and she still did not see anything. She told me to undergo a urine test and it came out negative meaning I am not pregnant. I left there and took another test at home and it said negative. It has been a whole month and I still do not have my period. What could be wrong with my body? ### Response: Hi. Have you done the blood pregnancy test (hCG)? It could have been a chemical pregnancy meaning non-viable early pregnancy. You will get periods after you stop the medicine. The bleeding might start by 4 to 14 days. Did the radiologist mention the endometrial thickness?" "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 68-year-old male. I am currently on Gluformin G2 Forte for diabetes, Cinod-N 10/2.5 for BP and Olmezest 20. My lab report is from last week.HbA1c - 6.8.Uric acid - 7.41.Fructosamine - 299.7.eGFR - 83.APO B / APO A1 Ratio (APO B/A1) - 1.1.SGOT- 54.6.SGPT 59.9.Lipoprotein (A) LP (A) - 30.8.TSH - 6.07.Uri albumin/creatinine ratio (UA/C) - 68.5.25-OH Vitamin D (total) - 20.17.Any advice, please? ### Response: Hello. Your HbA1c is in good control and the other parameters are within the normal range. ACR is slightly high. You need to recheck the albumin-creatinine ratio after three months. Please repeat your uric acid levels after two weeks. If it is still high, you may need medication. In the meantime, continue all the medicines as you are taking. There is no need to worry. Do check your BP regularly and fasting blood sugar after two weeks and follow-up, please. As you are 68 years old, you need to take Aspirin tablet 75 mg for cardioprotection. Please add that to your regular medicine. I suggest tablet Ecosprin 75 mg one tablet once daily. Consult your specialist doctor, discuss with him or her and start taking the medicines 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 am newly married, and we both are first timers. We tried penetration a lot of times, but the moment I come close to her, I lose the erection. Also, I am ejaculating within 20 seconds. I do not have any health issue and morning erection is positive. ### Response: Hi. You seem to be reporting of premature ejaculation. It is very common among this age group during the initial part of sex life. I will explain, try to engage more in foreplay during sex like for at least 20 minutes. During intercourse try to go very slow, when you feel that you are about to come, stop and slow down for a minute and then continue. By this way, you can prevent rapid release. You may need medicine temporarily. Use it when required like one hour before sex and maximum once per day. Kindly avoid heavy food before taking a tablet. There are no major side effects except a mild headache rarely. And, you should not be having any cardiac problems. Do a thyroid function test (TSH) to rule out thyroid disorders. I suggest tablet Tadalafil when needed, and the problem will gradually improve." "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 26 years old and recently I have started having issues maintaining an erection. I have no issues on my own but once with my partner, I experience shortness of breath and it just does not stay up. Any help is greatly appreciated. ### Response: Relax and do not worry. Do you have an erection in sleep? Do you smoke? Do you have a family history of medical illness? Occasionally, erection problem may happen to everyone. In your case, I think it is because of performance anxiety as there is no problem when you are alone. So I think you need to just relax and do not feel pressure. No tests required now. If required, you can take Sildenafil 25 mg one hour before intercourse" "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: Dear Doctor,I am a 29 year old female suffering from PCOD, taking medicines from past 1 year. But still it has not reduced. I was into Metformin and Folic acid. At the same time I have also taken medicines for conception (i.e, clomiphene).Follicar study has been conducted for four times and only once the egg ruptured, but I did not conceive.From december onwards the follicles are not maturing upto required level.Again during February and March my doctor put me on K-35 as my periods during past 1 year were not regular and still are irregular (I have to take tablet Norgest thrice daily for 5 days and then periods come).Recently I have consulted another doctor, she has prescribed me to stop taking Metformin and instead to start on APCOD sachet (Myo-inositol) and Safegest D (dehydroepiandrosterone) and during periods Adova (Anastrozole).But I have not yet started the medicines. I am a bit confused, whether should I totally stop Metformin and start with these new drugs? ### Response: Hi. Metformin is a very effective medicine in PCOD (Polycystic Ovarian Disease) treatment. All these effects are helpful in the treatment of PCOD. But as you say it is not effective in your case; you can start these above mentioned medications instead of metformin. But use of myo-inositol in PCOD is not very clear. You should consult an expert gynaecologist for your treatment. If you have further questions, feel free to ask 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: My prostate-specific antigen (PSA) value has got increased by 30 % from 0.8 ng/mL to 1.1 ng/mL. I am in testosterone replacement therapy also. Please advice. ### Response: Hi. The absolute PSA (prostate-specific antigen) level is in the range where it is not of much concern. But the rise in PSA is bothersome if it rises more than 0.75 ng/mL per year. For a young patient like you, even this rise in rate needs to be assessed. Testosterone replacement can also be a cause of this rise. Please mention about the reason for taking testosterone replacement therapy." "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 A1c is 5.4 and my fasting glucose is 107 and I was taking 800 mg of Seroquel which is a medication for paranoid schizophrenia and is known for causing diabetes and high blood sugar and five minutes after taking a 400 mg pill, one day my sugar went over 200 and the next day five minutes after taking a 400 mg pill, my sugar went up to 495. So, I stopped the Seroquel. According to my A1c, I am a nondiabetic, according to my fasting glucose, I am a pre-diabetic, and according to those two high blood sugar readings, I am a serious diabetic. Those are three different diagnoses. But those two high readings could have just been because of the Seroquel because I have never had high readings like that other than when I was taking the Seroquel and I was taking a high dose. A lot of people only take 100 to 200 mg, but I was taking 800 mg. So, do you think I am a diabetic or do you think it was just the Seroquel that caused the two high readings? ### Response: Hello. Quetiapine (Seroquel) in such high doses may produce hyperglycemia. So, try to reduce the dosage after consulting your doctor." "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 38 weeks pregnant (38 weeks and 2 days). I took an ultrasound today.My report shows:Biparietal diameter 8.93 cm (36w 1d)Head circumference 32.17 cm (36w 2d)Abdominal circumference 31.65 cm (35w 4d)Femoral length 6.98 cm (35w 6d)Average age of gestation based on today\s scan: 36 weeksEstimated fetal weight: 2765 grams.I just want to ask if I need to be worried, as my doctor said the baby is small. Is there any problem for the baby because I am on 38 weeks 2 days now, but base on my ultrasound the baby is 36 weeks. ### Response: The growth of the child is two weeks smaller for 38 weeks but corresponding to its ultrasound age, the weight of the baby is fine. There is a likelihood that you may have had an irregularity in your menses earlier and your ovulation may have been delayed and leading to late conception. However, best would be to undertake a biophysical profile and an umbilical artery doppler, MCA Doppler studies (middle cerebral artery) to look for cause for decreased supply to the fetus (if at all). If these parameters are normal, then your dates are probably wrong or you have had delayed ovulation and fertilization because fetus would then be considered growing and pregnancy can be continued and followed up with serial ultrasounds. But nevertheless, even if dates are not good, still it is advisable that one should go with your dates as at 38 weeks and deliver the child by 41 weeks, considering the child has matured and the average fetal weight is also good. 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 had low B 12 in the past (135 ngl) and seven years back had injections via my GP. These finished five years back. Recently have had symptoms come back and had my B12 checked and it was low, 265, but in the recommended range, however, I do take a supplement with B12 in it which would have pushed my level up a bit. My symptoms are fatigue, pins, and needles in hands and feet, slow cognition. Should I be receiving injections again? ### Response: Hello. The fatigue and pins and needle sensation are suggestive of B12 deficiency-induced neuropathy. Your B12 is within the limit but borderline deficiency. I suggest you take B12 injection again as you did earlier. However, your detailed neurological evaluation also should be done. You can consult nearby physician for detailed evaluation and get prescription accordingly." "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 about my voice. As a kid, I had a raspy voice the entire time until puberty. After I hit puberty, I do not think my parents noticed anything, but people have said I sound like Kermit the frog or that I need to stop mumbling. The problem I have is that I have to try quite hard to speak in a normal tone, and I am extremely self-conscious about the way I sound. I breathed through my mouth my entire life until I had a septoplasty three years back. Now I can breathe through one nostril, which I guess is 60 % open, while the other one is always 100 % blocked. What is happening, that is making me sound like this? I know I was not meant to sound this way, there has to be something causing some problem. Any idea or suggestion will be appreciated. ### Response: If your nose is blocked then you may have nasal polyps or some nasopharyngeal mass like adenoid or may have deviated nasal septum. For that, an endoscopy or CT scan is required. It may alter the voice. After ruling out these possibilities, you can consult a speech therapist. According to me, you should meet an ENT specialist and get a nasal endoscopy and laryngoscopy done. Following which, a CT scan can be done, if 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: My daughter is 6 years old. About 10 to 11 months back we saw a very very small dark black colored dot on her side of the tongue. But now there are 4 to 5 similar sized dot around her tongue on both sides. The size has not grown. But it is just that new location has emerged. Lately she is continuously touching her tongue and her tip of tongue appears red. She says she feels like there is a hair on her tongue and there is some sensation on her tongue. I do not know if she is able to correctly describe her feeling. I am more worried about the black spots. Rest she is absolutely fine. Please advice. ### Response: These are hyperpigmented macules. Most of the time these are asymptomatic. The cause can be hereditary or acquired (nutritional or poor hygiene or local trauma-thermal or mechanical to tongue). Diagnosis based on current images: mucosal lentigines or melanotic macule. My advice is to keep observation for new lesions. Take tablet Zincovit (Ascorbic acid and Biotin) one tablet daily. Maintain good hygiene. Do not panic about these lesions" "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 34 year old male. I had anxiety issues since childhood. I have been jumping from one idea to another for a long time but it has been three years I have an issue with frequent urination. It started in a bad time for me when I was obsessing that I have HIV. No burning, just slight urethra burning. I went to a urologist. He told me nothing was wrong, maybe an overactive bladder. I go to the toilet every two hours or three. I never knew what was wrong, but I started to obsess over it and it got worse to a place that my mind is in urination 24/7. I almost gave up until I went on a vacation and during that vacation, I forgot about it totally. The frequency was gone and even the burning urethra. Also, I had to remove my wisdom teeth and when I did, I was so occupied thinking about it that I forgot about urination and I noticed that I do not use the bathroom like I used to. But, I got back obsessing about it again and it got to a point that I urinate a lot of high volumes every hour. It comes suddenly and goes on its own. I use to get those episodes every few months when I had stress but since I got the fear it might never go away I get it almost daily now. I do not know what to do. Can anxiety cause polyuria like this clear urine when I am stressed? ### Response: Hello. I read your query and understand your concerns. First of all, I like to state that the stress and anxiety can affect almost every organ of the body and polyuria is not an exception. In other words, yes the stress can cause almost all the symptoms narrated in your query. Secondly, I would like to assure you that this is only stress and nothing more. The statement is based on the following facts: I hope this answers 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 got red patches on my nose after using chemically made facial products while using Retin-A ointment. I have attached pictures. In that, I have used Cerave ointment for healing the marks. Now, I discontinued using Retin-A 0.025 % ointment. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). Retin-A (Tretinoin) makes the skin sensitive and a scrub or facial may cause dermatitis like this. I suggest you use a moderately potent topical steroid cream like Fluticasone propionate 0.05 % cream or Mometasone furoate 0.1 % cream, twice daily for a week. It will get fine" "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 76-year-old father had urinary infection last month with a high number of pus cells. The infection started with fever and shivering and slight pain with urination. The doctor prescribed Oflox 200 mg twice a day. After that, he was also prescribed ultrasound scanning. In the scanning, it showed that his prostate was minimally enlarged.After antibiotic treatment and based on the ultrasound report, the doctor prescribed Urimax 0.4 mg once per day. The urine culture was also normal. After starting the treatment, the flow of urine is normal now and sometimes little out of control and early. Why is he passing urine a little early even before reaching the toilet? ### Response: This urgency and leak of urine are age-related. I can suggest him a medicine but it might cause some postvoid residual urine and more chance of infection. If the problem is very severe, only then give him the medicine. I suggest tablet Soliten (Solifenacin) 5 mg morning and evening for seven days and see the response. Consult your specialist doctor, discuss with him or her and with their consent take the medicine. If it is not severe and if it is manageable then I think do not start him on any treatment. Also, ask him to reduce fluid intake after 6 p.m. Daily fluid intake should be around two liters. Regards" "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 24-year-old male with no health problem except for my problem with premature ejaculation and no second erection. It is very frustrating to last 2 to 3 minutes in the preliminary and then my desire goes down. I had a problem with internet porn where I can have as many erections as I want. I am one month free now but premature ejaculation has always been there. I also cannot hold my pee for a long time. If this can be associated with the problem, I am begging for help beacause it is ruining me and my relationship. I am taking corticosteroids for autoimmune disease. ### Response: Hi. Premature ejaculation is usually unable to hold ejaculation for more than one minute after vaginal penetration. So 2 to 3 minutes is not premature ejaculation. An average time is five minutes. Peeing after ejaculation is not abnormal. You can do meditation, or Kegel exercise, that will benefit you after 12 weeks. If you want to take medication then Fluoxetine with Sildenafil 1 to 2 hours prior to sexual activity will certainly help 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 51-year-old female. I got sick about a month ago and I went to urgent care. My left kidney was swollen and I had an infection. I have a 2-cm kidney stone and they put a stent in.I do not want to have surgery. I am scared that the use of natural remedies can hurt the stent or move the stone to block where I go to pee. I had a CAT scan at urgent care.Will they use local anesthesia for this instead of general or something else? Can the kidney stones come out from behind? I have diabetes. Can lemons and olive oil help treat this? Currently, I am on Metformin, Aspirin, Simvastatin, and Lisinopril. ### Response: A 2-cm kidney stone is a fairly large one and it will definitely require surgery. I cannot recommend using any natural remedies for a stone of this size though they will not affect the stent. The stone, however, can move to cause obstruction again, but this is unlikely if the stent remains in position. The surgery has to be done under general anesthesia. The procedure used varies based on the location of the stone and your treating urologist. I would have to have a look at the CT (computed tomography) scan images before I can make a plan. I would recommend you to go ahead with the surgery as that gives you the best chance of getting your stone removed" "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 in a little trouble. Summer has started where I live, and I am addicted to playing cricket, whatever the weather or climate be. From last two weeks, I have noticed that my face color has become darker due to the sun. So, I am a little confused about which sunblock cream to use. I need your suggestion on which cream to use. I do not understand the concept of SPF 25, 30, 50 and 60. ### Response: Hi. Sun protection factor or SPF blocks damaging UV rays, which are responsible for skin aging, darkening, sunburn, and malignancy. I would advise you to use sunscreens that are a multi-spectrum or broad spectrum, which blocks both UV-A and UV-B rays. Select Sunscreen according to SPF value. SPF number not less than 30 and not more than 50 will serve the purpose. While going to play, you may apply a generous layer of SPF 50, and for the routine purpose, you may use SPF 30. Have a nice and safe game" "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 32 years old and I am going to get married after two months. I am doing masturbation rubbing penis in bed for many years. Will this affect my sexual life after marriage? Can it lead to erectile dysfunction and other issues? ### Response: I read your query and understand your concerns. I would like to inform you that masturbation is completely harmless process and not associated with any ill-effects. Infact almost 95 % of the men do masturbation in their life time and nothing is wrong with self-stimulation. You can get assured that masturbation is not going to affect your sex life in any way." "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: Positive ANA, weak positive Smith through childhood or teens. Monitored for lupus by pediatric rheumatologist but never really exhibited symptoms. I have abnormal beta 2 glycoprotein that puts me at risk for blood clots. Was told in high school to take Baby Aspirin every day. I am now 28.Recently had full lab tests done for the first time in many years. Platelet count: 402 (had physical labs done three years ago and it was 432), protein: 8.9, ABS lymphocytes: 3.2. I went back to look through all my labs from my teenage years from a rheumatologist. I saw and I never had high protein. Also, my platelets were usually normal so I think the elevated thing is more recent? But it has gone down from 423 three years ago.I show no active signs and lupus and never truly did. I was always just monitored. I have a copper IUD and occasionally take my Aspirin. When I take it often, I bruise super easily. Just concerned mainly about the protein level. I have read about leukemia and other blood cancers. I was fasting for more than 12 hours and drank no water (I hardly ever do). All other labs are normal in the metabolic panel and CBC with auto diff. ### Response: Hello. The elevated high total protein does not indicate malignancy only. It could be due to some temporary infective etiology as well. Your all other parameters do not indicate any blood cancer. If you have a history of positive beta 2 glycoproteins as mentioned in the above description then you have to repeat your beta 2 glycoprotein estimation again after 12 weeks. The positive Smith antigen points towards lupus. If asymptomatic, then no need for treatment and only monitoring can be done. However, you can repeat your Smith antibody estimation again to exclude the possibility of lupus. You can investigate with anti-ds DNA estimation as well to exclude SLE. If beta 2 glycoprotein result comes negative in the repeat test, then no need to take Aspirin. The occasional Aspirin ingestion has no value and not indicated. You can consult nearby hematologist for detailed 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 have a spot on inside vagina. Please help. ### Response: Hi. This is a fungal infection (attachment removed to protect patient identity). Take tablet Fluconazole 150 mg twice a week, tablet Ciprobid (Ciprofloxacin) 500 mg twice a day for five days, tablet Levocetirizine one tablet twice a day for five days. Saline douch. No sex" "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 baby just turned 6 months. I gave him Nan Optipro One for his 1st to 6 months, now I gave him the follow up milk which is Nan Optipro Two. After two days of drinking, he is suddenly having diarrhea now (five times a day). I tried reaching out for a pediatrician in our area but they are not accepting the appointments. He is also irritated because of his blooming teeth and he is eating oatmeal with banana puree. I wanted to ask if it is just his tummy adjusting or is there any underlying problem? ### Response: I appreciate your concern regarding your child. I would like to advise that transition can cause diarrhea but it should settle within four to five days. If it does not then we should change the feed." "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 disc desiccation. There is a pain in my right leg while walking. ### Response: In Ayurvedic Panchakarma therapy, there is a procedure named kati basti, which is helpful in this problem and your treating Ayurvedic physician will also prescribe you oral medications while performing this procedure. It is a noninvasive procedure done with the help of medicated Ayurvedic oils. You can visit a nearby Ayurvedic hospital or Panchakarma center and ask for the details." "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 regular contraceptive pill and an emergency contraceptive pill. I-pill is an emergency contraceptive pill. What is the difference between them? Which one is taken after unprotected sex to avoid pregnancy? ### Response: A regular pill has to be taken regularly for 21 days daily without any gap, and then they are stopped for a week (for periods). Again, they are retaken for 21 days. It can be taken for two to three years together. At that time, you have to avoid pregnancy. I-pill has to be consumed within 72 hours of unprotected intercourse. All these are low dose pills with minimum side effects." "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: Diffusion-weighted images, ADC maps, and postcontrast sequences were also performed.Findings:There is mild cerebral volume loss and ex vacuo dilatation of ventricular system. There are scattered punctate foci of increased signal intensity within the periventricular and deep subcortical white matter on the T2/flair sequences which are nonspecific. However, they are most likely secondary to chronic small vessel disease. There is no evidence of restricted diffusion to suggest an acute infarct, midline shift or mass effect. There are no blood products on the gradient-echo images.Normal intracranial flow-voids are seen.The visualized paranasal sinuses are clear.There is no pathologic enhancement identified.Degenerative changes are noted within the upper cervical spine.Impression:1. No acute intracranial process.2. Mild cerebral atrophy and mild chronic small vessel disease.3. No pathologic enhancement identified.What should I do and how concerned should I be? I am 70 years old and my BP and cholesterol are controlled. How concerned should I be? ### Response: Your MRI shows mild cerebral atrophy with some small vessel disease changes. I would like to know about your memory, speech, gait and urinary symptoms. Are there any abnormalities? These changes are much common at the age of 70 but still, you have to take some precautions. Life style modifications like regular sleep and healthy foods like low sugar, low fat, high fiber, and protein will do. Do exercise 45 minutes regularly. It is good that your BP and cholesterol are under control. Keep a watch on it. Check your blood sugar at least yearly and if raised then control it. Do regular meditation and yoga." "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 period is a little late, just only a day. But, I have been having many pregnancy symptoms. I masturbated yesterday (penetration and clitoral stimulation to orgasm) and a considerable amount of blood came out. Some blood flushed itself out for some time and I am clear now. What does this mean? Before, I was worried that I was pregnant, but that blood was too much to be spotted from implantation I think. Was it period blood as I masturbated roughly? I had a bit of cramping today. ### Response: It may be your period bleeding or may be bleeding due to masturbation. For that have to check clinically for any sign of vaginal tear or just bleeding from your uterus. If you have a doubt that last month had sex and can be pregnant, then do a urine pregnancy test. If negative, then you are not pregnant and it was either your period or bleeding due to masturbation. Cramping also can be due to your menstruation, as it may be going on and you will bleed in short time. In case of laceration of the vagina while masturbation also, you will get cramps. If bleeding is not there, then it is difficult to say the cause. But, forget everything and just do a urine pregnancy test in case of doubt. Other things are normal as you are not bleeding 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: So I never had acne on the back, maybe one or two single, but after visiting this massage center, which I know was a big mistake, my lower back is full of acne. I tried a couple of ointments, did not work. Cortisone helped a little, but not really. I think I need oral back up, any suggestions? ### Response: Hello. Apply Adapalene and Benzoyl peroxide 2.5 % combination gel at bedtime over the back. Do not apply Cortisone cream (steroid). It can lead to worsening of the condition. Clinical photographs would have helped." "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: 55 years old male with complaint of ptosis on the right eye having diabetes for the past 10 to 12 years. FBS yesterday taken was 165 mg/dl. Ocular movement normal on left side but adduction limited in affected side. He is suspected to have third nerve palsy. What all medical intervention can be possible to get normal? ### Response: Hello. I recommend performing a brain MRI. If normal (which means that is a peripheral nerve damage) I would recommend starting low dose Steroids for 20 days, Vitamin B complex supplements, Alpha lipoic acid 1200 mg daily. In case of pain in the eye, Gabapentin or Pregabalin can be helpful." "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: Hi,My age is 29 years. Yesterday I drank ice cold water in the afternoon. Since today morning I am feeling pain in the throat, body pain and laziness. Please suggest medicine for the same. ### Response: Start tablet Azithromycin 500mg once a day for three days after meals. Take tablet Paracetamol 500mg thrice daily for the pain relief." "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 my Mirena IUD removed today. I have had regular cycles the entire five years of having it. How soon can I conceive? ### Response: Hi. How are you doing? Hope I have clarified your query, do write back. All the best" "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 25 year old woman. I like my skin tone very much. But, I have pigmented skin. I see a lot of discoloration in my face, near my eyes and near mouth. I have consulted a dermatologist and he recommended Vichy cream overnight, which helped me a lot in getting an even skin. But, the wrinkles around my eyes are still there, which make me look aged. I have very much deep tan on my hands, neck and feet area. Please suggest me some body lotion to get even skin tone. I have been using cucumber on my eyes religiously but still no results. Hence, I am requesting for a dermatology recommended eye, face and also body cream. If u can suggest something for daily routine also would be great. I have a dry sensitive skin. I am using Emolene moisturizer and Neutrogena sun block which works well on my skin. I am using Vichy cream at night. Should I include anything more to get even skin? What facial can I go for? Please help. ### Response: I have gone through your history and seen the photographs (attachment removed to protect patient identity) you have attached. 1. Hormonal.2. Genetic.3. Sun induced. Perioral and periorbital pigmentation. Revert back after four weeks for follow up 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: Hi, I have gradually developed unilateral ptosis, is there any cream or non surgical way to cure it. My eyes were fine till about a year ago, gradually my right eyelid started to droop and is getting worse day by day. ### Response: Hello As you have send me images of your both eye I can see there is ptosis in your eyes right eye it is looking more compare to left eye. As you told it started a year ago and not from birth so it can be apponeurotic ptosis but we have to take exact measurements for ptosis and we have to compare both eyes. There is no medical treatment for any kind of ptosis. LPS weakness Ptosis measurements Ice pack test AchR-AbThyroid profile MEDApponeurotic ptosisMyesthenia gravis Ptosis Depending upon ptosis measurements and lab test 5 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: My age is 24 years. I have scrotum skin problem. Kindly advice. ### Response: Hello. I understand your concern, but there are no attached photographs in your message. Kindly send a picture of the affected area to help you better. I need to see the affected area to assess the condition and to suggest the appropriate diagnosis and treatment. Please send the picture of the affected area." "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 dentist convinced me to replace my metal filling with a nonmetal filling. After doing it, I got sensitivity to hot food and liquid. Then I went to visit my dentist. She took an X-ray and said the filling (she replaced) was close to the nerve. She suggested a specialist. He told me that I might need a root canal for that tooth. Is this normal? I had a previous root canal done to some other tooth, which got infected. Finally, I got pulled it out. ### Response: Hi. I have gone through your query. If the X-ray shows that the filling or cavity is approximating or involving pulp, you will definitely need a root canal as just a filling will cause pain and infection in future. Maybe the doctor would have given a temporary filling just in case if the cavity was approximating pulp so that if you are asymptomatic for minimum one month, you can go for permanent filling. Since you have symptoms, it is better to go for a root canal. Do not worry, you will be fine. Make sure you get a cap (crown) after root canal and maintain it properly" "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 exotropia squint in my right eye from the last 10 to 12 years. Presently I have a very low vision in that eye and near and far vision is blurry. I consulted an ophthalmologist and he recommended a LASIK surgery and after that a squint correction surgery a month later. Should I go for that? I am attaching my prescription for your reference. ### Response: I have gone through your images (attachment removed to protect patient identity). You can proceed with the LASIK surgery and the squint correction as advised but please keep the following in mind: Do discuss with your doctor regarding these points" "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: Me and my wife got an annual blood test done. Few of my wife\s results are off the radar. She is 30 years old, and she had a mild cough when the tests were done. She becomes tired very easily. In the attached hemogram report, her monocytes are 0 and ESR is 80. Rest of the tests including thyroid, liver function tests, ECG, and lipid profile seem to be normal. Is this a cause for concern? ### Response: I can understand your concern, but after a detailed evaluation of your wife\s reports (attachment removed to protect patient identity), I would say there is nothing to worry. As soon as you get the reports, please send it to me for evaluation. Revert with more information to a general 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: My lower molar root canal was done a year back. After that, a metal-ceramic cap was placed. A few months later, my cap was replaced with zirconia supreme because of throbbing below the cap. My dentist advised that because of metal there may be a possibility of some allergic reaction. So, I should replace the cap. Now just two weeks back, I replaced but now I have a bulge in the jaw with pain. ### Response: Hello. Zirconia, no doubt, it is the best in all caps. But, there is no reason to replace a metal cap. Your jaw pain is may be due to forceful removal of cap and trimming of teeth, etc. Visit the dentist for genuine advice. Not all metal crowns create allergies. It is once in a blue moon thing. Do not worry, you will be fine but at least use your cap for at least five years." "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 suffer from anxiety, and I was never diagnosed with any other mental health problems before. I am not taking medication for anxiety due to fear of drugs. My family members present on my maternal side have a generalized anxiety disorder.Recently, my anxiety became high due to some personal events. A few weeks ago, something triggered my mind, and I was harming one of my child in my mind. After that, my thoughts got escalated, and it became like a daily thing. I am unable to forget these thoughts. My doctor prescribed me Zoloft 25 mg for anxiety, and I started taking it. Will Zoloft help me to come out from these thoughts? ### Response: I can understand your situation. Anxiety disorders are common psychiatric disorders with significant prevalence in the general population. Yes, Zoloft (Sertraline) will help you to beat anxiety, and the thoughts of killing your son come under an obsessive fear, which is again a sort of anxiety disorder. Do not worry and you will get better." "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 cousin who is gay and her and her partner just recently adopted a child and I am fearing for that child\s future because of the problems it could face as an adult which is they have a greater chance of committing suicide, suffer from obesity and depression, become dependant on drugs. ### Response: Hello. I understand your concern and worries. You are right in saying that a child needs the love and affection of both parents but at the same time, it is just love and affection which matters the most. The person who is giving it becomes secondary. The point is if the child is being brought up with love, affection, care, understanding, and support, he or she will adjust with environment easily, will develop good coping skills and good caring parents are more important than the gender of parents. Parental counseling can be done. Good care, support, understanding, nurturance of the child." "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 mom is 83 years old. She had a bad fall 1.5 years ago and suffered with a head injury with little internal bleeding and a broken arm. While in hospital, she contracted C.diff and has had several recurring bouts with it. She has had a transplant and so far she is doing well with no recurrence. She also has a fistula near the rectum from an abscess. They put in a tube to keep it open and flowing. She has always had bouts of constipation and diarrhea for years before the accident. Her cognitive functions have been diminishing. One of my brothers is living with her and care taking her for full time.She is very weak, but can walk with the aid of a walker. Before the accident, she was fine. But, she may have shown a few signs of slight memory issues and balance prior to the accident as well. Our main issue right now is loose stools with some fecal incontinence. The doctor said that the fecal incontinence is because of a weak rectum that will not hold back fecal matter. Also, the fistula is always draining. When her stools are normal, she has good energy and cognitive function. When she has loose stools, she is very weak and can hardly stand or walk. Her cognitive function is a lot worse. She gets very confused about daily items and memory issues.We are looking for supplements to keep her regular and avoid the loose stool episodes. These are recurring every other week. Being so weak at the time of an episode, the toilet and the surrounding area get very filthy. She has little control and not able to clean herself properly. Her diet is pretty good. We are trying to keep dairy items away, limiting sugar and some carbohydrates as best as we can.We are giving her Metamucil when she has loose stools as well as some ammonium. This seems to have very limited success. She is on a blood pressure medicine as well as on Coumadin. So, we have to watch for interactions between everything. Regarding supplements, right now she is taking Alpha-GPC, Prevagen and multivitamins B for cognitive help, Fish oil, turmeric and Centrum multivitamins.Any help or suggestions to prevent the loose stools without creating constipation would be appreciated. I would also like to increase her core energy, so she will feel more like moving around. We have a physical therapist at once a week. ### Response: I appreciate you seeking help for your mother. Well, after having gone through the case history as described, it seems her fecal incontinence is mostly of neurological origin. In the given context, I would advise that she would be clinically examined by a neuro physician first and treatment recommended appropriately. Also, self-administration of any supplementation should be avoided. For her cognitive, memory, weakness issues and health balance you can include a BRAT (banana, rice, apple, toast) diet, which will likely help improve her present diarrhea or fecal incontinence issue. WHO (World Health Organization) recommended electrolyte" "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: Respected doctor,My father is suffering from a chronic liver disease. I have attached his case summary with this query. He is in the ICU for the last four days. As per the doctor, my father may remain in this state for an indefinite period of time because his liver is not functioning. So, I want to get a second opinion and want to know, whether there is a way to revive his liver and make it function properly. ### Response: Hi. As per the records, he is suffering from stage-3 liver disease, that is an end-stage liver disease. His current problems need to be medically supported. This will result in temporary improvement of his condition. However, issues like infection, blood loss, fluid accumulation in the body, etc., will be frequent from now. The definite treatment ahead is liver transplantation. If you are ready to proceed with evaluation and transplant, then I would suggest considering treatment at a transplant center. Else, medical optimization, which is going on now will be alright. Was an endoscopy done for him? Also blood, abdominal fluid, and urine culture tests? If yes, please send them across. Hope your queries have been cleared. Do review if you have any further queries" "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 on Depot injection and I missed the shot for over 10 days now. I have not started bleeding yet. When I was on the shot before, I bled when I get off the shot. Now, how would I know if I am pregnant? ### Response: Serum beta hCG. 1. Post progesterone amenorrhea.2. Intrauterine or ectopic pregnancy. Routine cyclical contraceptive. Revert back with the reports to 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: My partner and I had sex two months back. She got her period that month but she missed her period for this month. She took an I-pill after we had sex. Could this be her pregnancy? Please help. ### Response: Basically, she should get SB hCG (serial beta human chorionic gonadotropin) to rule out pregnancy even if you had an intercourse for once or twice in this month (maybe in the fertile period). If SB hCG is negative then hormonal imbalance due to I-pill could have occurred. So, get a gynecological ultrasound to look for endometrial thickness and to rule out any ovarian cysts or abnormalities. I suggest you get a thyroid profile, serum prolactin, fasting blood sugar, and a fasting insulin" "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 lot of black spots on my face and upper back due to the popping of pimples. To where it is darkening my skin making me uncomfortable with myself. I have been clueless about the medication I should use that would help my situation. ### Response: Hi. I have gone through your case. The pigmentation which you are having will take at least 2 to 3 months to recover (attachment removed to protect patient identity). Please mix Azelaic acid and Vitamin C cream in equal amount and apply on lesion at night for two hours only. Do not rub on your whole face. Take both creams in a small amount. Each one about the size of a pea will be enough for the whole face." "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 pregnant for one month. I got to know it when I missed my periods on a fourth of date. I had sex with my husband after an eighth of date. Then I did the pregnancy test 3 to 4 times and it was positive. Then I tried natural abortion methods like having food for natural abortion but it did not work. It was 4 to 5 days for it now. I want to take the abortion pill. Can I take the abortion pill without doing any test? Or use the abortion kit at home? I only take the Omega site tables as the doctor said and completed that course 15 days ago. ### Response: Firstly, if this is an unplanned pregnancy then you may consider termination. But it is important to learn the location of pregnancy first, whether it is intrauterine or an ectopic pregnancy (pregnancy outside the uterus). This is because in that case, you cannot undertake abortion by MTP (medical termination of pregnancy) pills. Hence, an ultrasound pelvis is a must to establish the location of pregnancy first. Secondly, it would also estimate the period of gestation and if less than nine weeks then you can opt for termination of pregnancy by the medical method under a gynecologist supervision safely" "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 unstable sacroiliac joint that gives me pain, which is relieved by adjustment for a few days. My doctor tells me it is not stabilized, but may become that way sometime in the future, but now needs frequent treatments. What should I do? Is there any stretching exercise that will free up the joint? Any other advice? ### Response: Hello. In my opinion, I would like you to do glute stabilization exercises as those exercises will help you stabilize your pelvis, and thereby your back and SI joint. Along with those stabilization exercises, some simple hip mobility exercises will help you reduce the load on the lower back. Simple exercises like bridging clamshell will help to strengthen gluteus along with step up. Stretching for gluteus and piriformis hip iR stretch will help maintain hip mobility" "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 done a tooth extraction before three days. I am agitated that I may have a dry socket. On the third day, after the extraction, I have an increased pain on the extracted site. ### Response: Use warm salt water gargle twice a day for a week or two to get some relief. Get some antibiotics and painkillers for a week. Do not touch the area with brush or hands or tongue. If the pain is increased, then consult your dentist soon for cleaning and debriding" "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: Dear doctor,For four days, I have very watery diarrhea, cramps, and nausea. Vomiting only twice. Yesterday, I was prescribed Levofloxacin 500 mg for four days. Now, after 24 hours of taking the first pill, there is no improvement. Diarrhea is 20 times a day very watery. I take electrolytes and lots of liquids. The blood test showed a bacterial infection. Stool test was normal. So my questions are: When usually antibiotics start working? Is Levofloxacin a good medicine for this kind of diarrhea? ### Response: From what you mentioned, most likely you have acute gastroenteritis. Ciprofloxacin is a very good antibiotic for gastroenteritis. You have to complete a four-day course at least. It may take few days before you see a good result. I suggest: Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. I hope I answered all your questions." "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 want to consult about my skin condition that happens annually. Every year, my hands has this condition where it will itch and form rashes with liquid inside then skin itself. Most of the time, it starts on December then end on February, however it differs every year. This year it started on March and up to now. I experience this every year, as in yearly so I assumed it is normal. It is not hereditary, I assume, because none of my family members is experiencing it other than me.My mother told me that maybe it is because of cold weather which I agreed. It is there for the past 11 years. I have never consulted any professionals about it since it does not look severe. However, I am curious what is this condition called. ### Response: Seasonal itch and swelling over the exterior parts of the palms, soles ear, nose occur due to a type of cold allergy called perniosis orchilblains. Lesions for increased itchy sweling occurs mainly during the start of cold weather and end of the cold weather when there is temperature change in the environment. I am not sure which part you are living in as you have not mention. Treatment for this is avoidance of cold exposure, wearing warm clothes. Calcium dobesilate gel twice daily. Diltiazem 30 mg tablet BD for 2 weeks during the lesions. For itching you use Loratadine10 mg once daily for two weeks or whenever there is itching. Apply aloevera moisturizing cream over the hands multiple times with rubbing of the hands and feet and the parts so that good circulation bring warm blood flows into those area." "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 phlegm with blood just now without coughing. He does not have chest pain and a fast heartbeat. Before a day, he also had a headache and hot temperature. Yesterday, he poked his nose with his finger at night. This morning, he had phlegm coming with a portion of blood. Does it require medical attention? Does spitting phlegm with blood is an alarming one? Please suggest. ### Response: Hi. A possible diagnosis can be lung cancer. For it, your partner must be a smoker for 15 to 20 years or over 50 years so that he can spit blood continuously. If your partner does not have these conditions, then you must be calm. Respiratory tract infection can also be a cause for having phlegm with blood. A headache and fever will also support the diagnosis. Poking the nose with a finger can also be a cause for having phlegm with blood because blood can pass from the back of the nose to the pharynx. On considering the age, it is necessary to rule out malignant pathology. If the bleeding is not continuous, then there is no need to get tensed. In addition to bleeding, if your partner has a fever, headache, and cough, then respiratory tract infection will be a probable diagnosis. You can consult a family doctor for evaluation and treatment. If there is a continuation of bleeding and if your partner is a smoker, then it is necessary to do a chest X-ray." "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 31 year old female. Height is 5\3"" and weight 71 kg. I have normal skin. I have started developing fine lines on my face. Just recently I have developed a slight depression in the form of a line starting from under the inner side of the eye running down the cheek (photo attached). I think this is the beginning of cheek sagging. Is this premature aging? Can this be reverted with non-invasive techniques like topical anti-aging serums, facials, massages or exercises?Someone suggested me to use Retinol-A, which I have started using and is suiting me well. I have read a lot about the benefits of topical retinoid, vitamin E and C serum. Please suggest the best ones as I have heard that most of the available vitamin C serums in the market are useless as they oxidize easily and do not penetrate the skin. I have seen some videos of facial exercises online. Do you think they are effective? Also let me know how often should I get facials and which one is for anti-aging? I am also trying to put down weight. In this process I will naturally lose some fat from my face as well, but I do not want my facial skin to become loose. What should I do for this? ### Response: I have read your details and examined your picture (attachment removed to protect patient identity) carefully. I have the following suggestions for you which I am sure will specifically help you significantly in the long run." "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 47 today. I went to my primary doctor three years ago with low libido and poor quality erections. Blood work came back as total testosterone 381 and A1c 6.9. Started exercising and lost weight and inches, 198 lbs to 178, 38-inch waist to 32. Symptoms still persisted. The doctor started me on Clomid 50 mg three times per week.Testosterone shot up to 900\s but symptoms persisted although Cialis helped with erection quality, still low libido. Will attach a note with test and A1c results during this time. So, I stopped taking the Clomid in March this year and had my physical last week.The doctor says my testosterone is 570, A1c is 6.0 and everything else looks good. He says since I still have symptoms, that I have testosterone resistance. His analogy was; like diabetics, their bodies produce insulin but just does not know what to do with it.So, his treatment recommendation is TRT testosterone replacement therapy along with Clomid. I am hesitant because I feel this therapy is overused nowadays, and I feel pretty good except my libido.Sought a second opinion today from my urologist, he seemed disinterested in me doing that but said if I try a few injections it would not hurt me, then advised me to run this by an endocrinologist.So I guess in summary:Do you believe that testosterone resistance is a valid diagnosis?If I do try the TRT, can I stop after a few weeks or a few injections and get back to the way I am right now with no permanent issues?Should I just start the Clomid again, or just keep using the Cialis and keep working out and trying to clean up my diet more?Any other thoughts and advise would be appreciated. ### Response: I have a couple of questions for you: Testosterone resistance is a phenomenon that occurs due to a genetic defect and would have caused problems with puberty and would not appear now in adulthood. Clomid (Clomifene) gave a very good response. I would not advise TRT. The low libido could be due to a variety of other issues and likely not a result of testosterone levels. If the thought is resistance then there would be resistance to exogenous therapy too. Why do we think a chemical would be better than the body's natural testosterone. You are thinking right, eat better. I would recommend reducing animal food consumption which have high sex steroids and these can act as endocrine disrupters. A plant-based diet is recommended to reduce these endocrine disrupters and lower inflammation in the body" "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 baby is 3.5 months old. In my house, they are saying to give urai marundhu is it safe to give? As my daughter is licking her fingers, my mom wants to keep castor oil or neem oil, is it safe to keep it on her finger? ### Response: Hello. Urai mathirai or marunthu is safe but advisable only after six months. In case of emergency, you can give within six months. Kids will not lick their fingers as they tend to suck only. Either the kid needs milk, or it may feel insecure in the prolonged absence of mother say more than half an hour. It is a normal phenomenon, so do not worry about that. Do not keep neem oil at this stage." "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: To start, I have bipolar disorder type II, social and generalized anxiety disorders. Previously, I failed to SSRI medications such as Zoloft, Prozac, Lexapro. I tried Lithium, Depakote, and Carbamazepine with no success. However currently, I take 50 mg of Lamictal and 75 mg Venlafaxine. This treatment kind fits me because I have lessened anxiety levels for sure. It is my first week on Venlafaxine XR. And the second week on Lamictal. In a few days we will increase Lamictal to 100 mg and after two weeks to 200 mg. I also take Tranxene 10 mg if needed, as well as Olanzapine 10 mg. How come I responded to Venlafaxine XR so fast, when I did not respond to SSRI? I lack energy and motivation, should I increase Venlafaxine XR to 150? If so, will it have more effects on my anxiety and depressive episode? ### Response: It is good to know that you are responding to your current medication. Venlafaxine XR is an SNRI (serotonin-norepinephrine reuptake inhibitors) which can be helpful when SSRIs (selective serotonin reuptake inhibitors) have not been effective. I note that you have been tried on different SSRIs and mood stabilizers before with no success. It is positive that you have found Venlafaxine XR 75 mg to lessen your anxiety. I will advise to continue with the titration regimen suggested by your prescribing doctor. Do not rush to increase the dose to 150 mg as titration needs to be carefully considered after weighing up your response and any side effects. As you are also on increasing dose of Lamictal it makes sense to do the titration gradually. Have regular follow up with your prescribing doctor as you are on multiple medications and need to monitor. Along with medication, I hope you are also having therapy/counseling to manage your health. 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: One year back, while sitting on a chair in office I felt as if my back got stuck and was unable to move. I took two painkillers and managed to sit there for a while, but after two to three hours the pain started radiating to leg. I was diagnosed with moderate disc herniation at L4-L5 and L5-S1. I was advised to take bed rest for three months and felt better after five months. Then I got some manipulation done with my lower back and my condition got worse. After that I had slight pain in my tail bone while walking and the pain got worse when I sit for five minutes. It got radiated to hips, thighs and it was worse when I stood up from a sitting position. Then I left with no option except bed rest for another four months that is a total nine months of bed rest. After that I suddenly started walking two to three hours a day in a stretch and started doing some exercises. After few days of getting my body too much into motion I felt my upper back getting stuck and again was unable to move and the pain radiated to my wrist and hand. Then had bed rest for another 10 days and felt a bit better. But, still in pain and resumed with two to three hours of brisk walking and exercises. I noticed that many joints in my body were making cracking sound while I walk or move my body and they were continuous. They are not going away no matter how much I move that joint, the cracking sound will repeat infinite times whenever I move my body. The cracking sound is mostly from lower and upper back, shoulder, ankle, foot fingers, knees also make that cracking sound and it is painful as well. Cracking sound in knees are felt more when I start walking after being in rest state and frequency of cracking sound reduces after walking for two to three minutes.I got my ESR and CRP checked. They are normal, but there is a slight increase in lymphocytes and RBC. Now, I have been suffering from this continuous cracking sounds and pain in almost all my joints for more than a month now. I also suffer from severe pain in tail bone area. Also suffers from some sensation loss (not persistent) in left side of my upper left leg, pain in groin area (but not anymore), pain in lower back and upper back. Also a few days back a physiotherapist did some manipulation, which again increased my problem and after that when I wake up in morning both my hands are badly at asleep. Doctors say that discs are hydrated and it is rather some other thing which is causing me problems but are unable to diagnose. The amount of rest I have taken and all those manipulations have gone through have only done badly rather than doing any good. I am only 27 years old and unable to do simple tasks like sitting for five minutes. Please help me, what could be the possible reason for all this.I had some back pain three years ago. My lifestyle is also not good. I do not used to any exercise or walk earlier, only sitting on a chair in front of a computer for 10-11 hours. I have also gained weight of 15 kg in 10 months. Right now, I am taking only Vitamin D3 supplement. I am attaching all my reports for your reference. ### Response: Hello. I have gone through your reports (attachment removed to protect patient identity), but you need to provide me the following details so that I can help you better. Revert back with the asked information to a family 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 concern that I have angle-closure glaucoma. I took a strong sleeping pill called Trazodone one night and woke up with a decreased vision in the right eye. My left eye became bad three weeks later. It has now been three months with no improvement. Fundus and other clinical examinations are normal. However, an OCT showed nerve fiber thinning and ganglion cell thinning. ### Response: I reviewed your reports with patience. OCT (optical coherence tomography) of optic nerve head is normal. Your vision, color vision, visual field, and intraocular pressure are normal. I do not think you have any glaucoma. Please feel free to ask your queries." "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 left ear hurts. If i press the back of my ear, it would really hurt. Sometimes it feels itchy and throbbing. Also, it feels like it\s clogged inside. Last month my other felt like this too, I had to take medication for it. ### Response: Hi! There are only 3 possibilities with the complaints you have mentioned. 1. Impacted wax in the left ear which is causing pain and a blocked feeling For this, you can use wax solvents which liquify the wax and resolve the issue 2. Infection involving your outer ear, which can be the cause of itching and pain 3. Eustachian tube catarrh which is associated with allergy and usually does present with only feeling of pain and blocked sensation The treatment you would have taken earlier using anti allergic would have been to treat the eustachian tube catarrh. You can consider taking a combination of paracetamol with fexofenadine / montelucast/levocetricine/ phenylephrine combination whichever is available 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: In left shoulder joint minimal fluid seen in the subcoracoid and subdeltoid bursa and also in bicep tendon. Finding symptoms of subcoracoid/ subdeltoid bursitis and mild biceps Tendinosis. ### Response: Hello. The report is suggestive of some impingement of shoulder joint with a mild fluid collection. I recommend you to not to load your shoulder for a while. I suggest: Hope this is helpful for 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 suffering from constipation since I was 13. I always have taken medicine for that, but nothing worked, and lately, I had not taken any medication. Do you think there is something wrong with me? ### Response: You seem to be suffering from chronic constipation. I would advise you the following: 1. To get a thyroid function test done as hypothyroidism might be the cause behind constipation that you are having. 2. To take laxative like Lactulose in the night only when you are severely constipated. 3. To increase fiber in the diet. If you have any further query, please ask. Hypothyroidism.Constitutional. Thyroid profile and fasting blood sugar. Hypothyroidism. Chronic constipation. Review with investigations." "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 some allergic symptom on my foot. First this was like a pimple with forming pus. After it burst, and started itching and it started forming in that place also. What is this? What is the medicine for this? ### Response: Hi. With the information given and photos provided, I assume that you are most probably having eczema. Eczema commonly presents like these morphology associated with itching. Please apply Excel-G cream [Clobetasol with Gentamycin] twice daily for 10 days and Deslor Desloratadine tablet once before sleep for 10 days. If you do not find any improvement, kindly review back to me for further advice. Tinea Pedis Excel-G cream twice daily for 10 days or tablet Desloratidine once daily for 10 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: A couple of my adult teeth feel loose. My gums are sore and bleed randomly as well as when I brush. Do I have gum disease? ### Response: As you say about your gum condition and oral health, I think you have a gum infection. But do not worry. It is common and curable. You need a dental appointment as soon as possible. He or she will examine clinically and advice treatment (deep oral prophylaxis, gingival flap surgery). You can follow some instructions like brush twice a day, make sure all surface of teeth is covered properly. Use a soft brush and change it every two months. Use medicated mouthwash containing Chlorhexidine twice a day or you can use lukewarm water with a pinch of salt to rinse your mouth. And make sure to confirm an appointment with the dentist. Poor oral hygiene. Clinical examination and dental X-ray. Gingivitis, periodontitis. Periodontitis. Oral prophylaxis." "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: The patient met with an accident. She is 47 years old. In the accident, she had a collar bone fracture and a hit in the back of the brain. The back of the head is bulging and some spots are observed in the brain CT scan. I have attached the head CT scan report for your reference. Please help. ### Response: I have gone through your query with diligence and would like you to know that I am here to help you. Revert back with the answer to the above question to a neuro 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 am an 18-year-old female. I have a cold with chest pain, fatigue and difficulty breathing for three days up till now, without physically consulting a doctor. I have had pneumonia last year and I am afraid that I might get again as I am starting to show some symptoms of pneumonia. Should I be concerned? ### Response: Just saw your letter that you been having a difficulty breathing and you are concerned about pneumonia. I would like to get some more information in terms of fever, difficulty breathing, bringing up sputum. Is it yellow color or white color. If you are having all the symptoms you have to get chest X-ray and medications. We will have to take Paracetamol 650 mg three times a day, antibiotics Amoxicillin-Clavulanic acid 625 milligrams twice daily for five days and take a tablet Fexofenadine 120 milligram at night for five days. In addition, you can take tablet Pantocid 40 mg 30 minutes before food for five days. Despite all this medication, if you continue to have a fever and the symptoms are not better, seek medical attention from a nearby doctor." "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: Hi doctor.I had Pantocid HP after doctor advice and had loose motion 4-5 times. For stopping loose motion what shall I do? For past six days I am taking Pantocid HP kit. No problem except loose motion of about 5-6 times and some weakness.I am taking Bifilac HP one tablet daily and a vitamin capsule. How long loose motion will happen as it is a 14 days course. I know this is a side effect.Can I take electrol powder (ORS) and coconut water? Should I follow any food restriction except spicy food? ### Response: Hi. I have seen your reports (attachment removed to protect patient identity). Pantocid HP kit contains Pantoprazole, Amoxicillin and Clarithromycin and is used in the treatment of gastritis by Helicobacter pylori bacteria. Pantoprazole reduces acid secretion while the other two kill bacteria. Loose motion is a common side effect of Amoxicillin and Clarithromycin. I will suggest you to take Bifilac (probiotic) 3 times a day. That may prevent loose motion from antibiotic and also to replenish your gut flora. Take this after consultation with your physician. I also suggest you to take Imosac M (combination of Loperamide 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: Something broke off from one of my teeth, and I would like to know what was it that broke and what I should do about it (if anything). I think it might have been tartar or cementum, but I do not know. They are hard and off whitish (a little yellowing). They are the same as that material that appears roughly along the bottom edges of my lower incisors. I think they are either tartar or cementum, but I do not know. Please let me know what you think they are and what my options are. ### Response: Hello. I have been through your query and I can understand your concern. It seems the broken part is tartar (calculus) which gets accumulated over teeth mainly lower inner side of the front teeth. From the images, (attachment removed to protect patient identity) it seems you are undergoing orthodontic treatment. During orthodontic treatment, the accumulation of tartar is common. You need to take extra care while brushing and cleaning the teeth. I would advise you to have a visit to the dental clinic and get an oral prophylaxis and cleaning done. Moreover, I would like to advise you to maintain good oral hygiene and use mouthwashes." "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 33 year old healthy male. Last month, I had an unfortunate sexual exposure (condom\s head broke off). I quickly pulled out and washed the genital area with a bathing soap. After few days, I started having a slight itching sensation in the penis. I visited a urologist and he asked me to undergo urine routine and culture tests. The urine culture report did not show any bacterial growth, but the urine routine showed some abnormalities. I have attached those two reports. On subsequent visit, the doctor prescribed me a 10 day antibiotic course (Microdox LBX 100 mg) to be taken twice a day. In addition to that, he also asked me to wash the penis with Betadine Povidone-iodine solution twice a day. The antibiotic course got over two days back. But since then, I have been noticing a slight burning sensation after passing urine, especially during morning and afternoon hours. Today, there is a slight pain in the penis. I checked the area, but did not find any abnormality. Please help in resolving this issue. ### Response: I have gone through your reports and I can understand your concern (attachment removed to protect patient identity). Revert back with the reports to a urologist 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 suffer from bipolar 2 disorder as well as OCD and social anxiety disorder. I have tried almost all SSRIs, and SNRIs and neither of them have worked for me (for the last 2 1/2 years). I believe that I have treatment-resistant depression because all the medicines are not working. Currently, I am taking 20 mg of Paroxetine (although I already took 40 mg a few months ago, so I already increased the dose as well), 900 mg of Lithium and 1.5 mg of Risperidone. What should I do? ### Response: Hello. I can understand that it can be frustrating if the medicines you have tried so far have not been effective. Have you been on the maximum doses of each medicine before trying another? There are medication options like add-on Bupropion, which can be considered by your psychiatrist if the low mood is a significant issue. Any medication changes have to be done carefully under monitoring as you are already on a different psychotropic medication. More importantly, have you received any psychological therapy like CBT along with your medication? Combination of CBT and medication is likely to be more effective than medication alone. Especially for OCD and anxiety, CBT has a strong response rate. Also make sure that you follow the necessary lifestyle modifications like eating healthy, have a sleep routine, and exercise regularly. 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: My bottom teeth were drilled for a root canal but after drilling doctor told that my teeth have a split and he filled that hole with a cavity. From the past one year, my gum was swollen and bad smell is coming out from that teeth. From the past one month, I have had bumps on my back of tongue and white coat. Is this a cause of diseased teeth? Currently, I am on Esoz 40 and Telmekind H. ### Response: Hi I have read your complaint and the relevant details. My first question would be did you not visit back the dentist after the filling has been done? Because you are already informed that it has a split deep under which means the treatment cannot be just a filling. I wonder why the treatment was ceased half-way. The ideal treatment plan for a split or fractured tooth should be as follows: Now the swelling in the gum and the bad odor is because the tooth got decayed heavily and it is over a year. This is called necrosis similar to a dead tooth. The burning sensation and the white coating on the side of your tongue are because of the rubbing of the tongue over the sharp edges of the tooth. Now the only choice is to remove the tooth and since the friction causing factor is removed the tongue will get back to normal in few days after extraction" "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 30-year-old woman. I am having OCD since I was 12 years old. I have a strong fear of an event that happened a couple of years ago when a psychiatrist told me that I have a borderline disorder and have no fantasy. I was trying to ask her for years to say me the opposite as a compulsion. She refused to do that, I am not sure if it is because she did not want to change her opinion or it is because she did not want to satisfy my compulsion. My mother was encouraging me to do these kinds of compulsions as she thought it is going to get worse. It was a bad thing as she was validating my fears in this way. I just realized these things now so I started to confront my fears about what the psychiatrist said to me. But I ran into another one which is about what if my mother is right and if I am confronting my fears it is going to get worse. What do you think? ### Response: My first question is whether you are currently on medication for OCD or not. If your obsessions are bothering you that much, first you need to start medications because the content of your obsessions is a second factor when it comes to treatment, first we need to focus on not having an obsession which will be possible with medication. Secondly about your compulsion to have a second opinion, what you can do is find a therapist which will help you and teach you techniques to overcome this need. CBT is a great tool in that way . Enabling an obsession is never a good idea, you need to learn ways to cope up with them without acting on 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: I am a 34 year old female. I have been having terrible anxiety the past month. I wake up feeling very uneasy and nervous. Almost shaky. I also feel like I literally cannot breathe. I have to take deep breaths constantly. I went to an urgent care and they tested for a blood clot in the lungs, but I was cleared. My doctor put me on Lexapro two months ago and I stopped taking it. But then the anxiety got so bad that I started again on it two weeks ago. My fear is that there is something wrong with my heart. I have had this before and chest pain. So, I have been to two different cardiologists. We did stress tests and echoes. I am afraid these doctors are blowing me off because I am active. Please advise. ### Response: Follow up with your physician and of course, you may consult me back anytime you need. I would be happy to assist. Hope it helps. Regards. for further queries 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: Dear doctor,I am a 21 year old male. I feel quite sad and depressed. I do not even want to perform daily routine. My life is monotonous. I get a lot of negative thoughts. I am so lazy and feel like I do not want to live. I am weak and I lack concentration. I do not feel like going out of my house. Suggest treatment for the same. ### Response: Symptoms that are commonly present in a depressed patient are: You are having almost all the symptoms of depression. Depression is the main problem for you. You need more focus on raising the mood and concentration with the help of medication. Antidepressants are very effective in such kind of symptoms and patients show improvement within a period of two weeks after starting the adequate dose of prescribed medication. If other than these symptoms you are having additional symptoms like hearing voices that others are not able to hear, seeing objects that are not visible to others and feeling suspicious out of proportion, then there is a possibility of depression with psychotic features of schizophrenia. You need immediate treatment before irreparable damage occurs to the brain. At this stage do the following:" "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 a left branch bundle block a few years back. I have been under the care of a cardiologist to make sure my heart is fine since then. I have done stress echos yearly or every two years since and have been told my heart is otherwise fine. I just had to switch the other doctor because of insurance and my new doctor says old stress echos are irrelevant, that only chemical or nuclear echos work in patients with lbbb. Is this true? I have a strong family history of heart disease, my father survived two heart attacks, mother survived double bypass and my maternal uncle died from a heart attack, all were smokers with high cholesterol and high blood pressure. I am a former smoker. I am a 43-year-old female. I have been exercising six days per week for over 20 years. My cholesterol is high 213 but HDL is 140 and triglycerides are low. I am a little put off by a nuclear stress echo and would prefer the regular exercise. But I want to know what this new doctor says is true? Then I guess I will have to go nuclear. I am currently taking Spironolactone 100 mg for acne, Omeprazole, and multivitamins. I just had an ultrasound of heart and EKG past monday. Doctor did not mention anything other than lbbb that was previously diagnosed. ### Response: Stress thallium is the best test to be done in you. I guess you did not have any symptoms like chest pain or heaviness during stress test and if so it will still suggest the absence of significant heart disease. In my opinion, there is not much difference between exercise echo and chemical stress echo and not invalid, but nuclear scans like stress thallium is certainly a better test. I would advise for a nuclear scan as it would be more informative. Anyhow, you should have a healthy lifestyle like avoiding fatty, oily and high calorie diet. Have a low salt diet and monitor your blood pressure regularly. Do regular exercises like brisk walking, jogging according to your capacity at least 30 minutes a day and 5 days a week. Eat lots of green leafy vegetables, fruits, and fish once or twice a week. Avoid meat, smoking, and alcohol if any. There should not be any abdominal fat deposition or obesity. Get your lipid profile and sugars tested once." "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 c-section with my first pregnancy 19 years ago. I have fallen in love with a wonderful man who does not have kids. I and my fiance have been discussing and are planning to have a baby. I am concerned if I am able to have a VBAC delivery with my second pregnancy since my first pregnancy resulted in an emergency C-section. Also, I am 48. What are the risks of pregnancy in women over 40? ### Response: Pregnancy at the age of 48 years definitely come with certain risks like an increased risk of chromosomal abnormalities due to the defective ovum being released. Also there may be a difficulty in the conception itself. VBAC (vaginal birth after cesarean) delivery has to take into a lot of factors into consideration like the cause for previous LSCS (lower segment cesarean section), the gestational age at which you had cesarean, the present baby weight, and if there is a spontaneous onset of labor or not and many other factors. I would suggest you go for an opinion from your gynaecologist before planning for a conception and take a pre-conceptional counselling so as to avoid any complications possible during pregnancy." "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 recurrent sore throat for the past seven months. I cannot drink, swallow, and my tongue is covered with a white layer. I have a dust allergy. I have a mild fever that goes to high fever as the time passes. There is malaise. I have vomiting often after I swallow. It is like a viscous sputum that blocks food from entering into the food canal. This time, I have swollen lymph nodes in my neck. The doctor examined me and told me there is no tonsillitis. I am taking Levofloxacin, Azithromycin, Ofloxacin, and Amoxicillin. ### Response: Hi. You are having an acute pharyngitis infection. You need to do the following tests: According to these reports, further treatment can be decided. Use salt water gargle done with warm water three times a day. Take one tablespoon of turmeric powder with milk daily. Vitamin C 500 mg can also be taken for a week. For the symptomatic relief of pain and congestion, Paracetamol and Levocetirizine can be taken. You can consult an Otorhinolaryngologist for the further 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: My wife has lung cancer PD-L1. I need your advice regarding the continuation of this therapy. Docetaxel and Nintedanib are suggested. I think it is too heavy. I would prefer immunotherapy, if possible. ### Response: " "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 lazy eye. My right eye (sph - 0.50 cyl -0.75 axis 10 degrees) and the left eye is fine. I am 24 years old. I am a web developer, I have to work in front of the computer screen more than 13 hours. Kindly answer the following:What should I do? Do I need to change my profession?Is it curable? What is the treatment?Is there any chance of getting other eye affected? ### Response: Are you facing any problem in vision? I do not think you will be having any problem with your vision. It does not seem to be lazy eye to me (attachment removed to protect patient identity). Your right eye has a slightly subnormal vision and that may not be even noticeable. Is your eye tilted? If not and still have any problem with your vision then get your retina examined. You need not change your profession at all. It will not do anything. Lazy eye is not curable at this age. No, another eye will not get affected by the lazy eye but yes can be involved in other diseases. Really want to know what symptoms exactly you are having because your power in the right eye is not that significant enough to use glasses" "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 terrible cough for weeks due to the flu. I decided to try Delsym 12 hour cough. It helped immensely, but the second day when I had it, I noticed a bit of restlessness and light sensitivity. I waited to take another dose and when I did take another dose, I took half of the recommended dose for adults. That was at 10 pm last night. Now, at almost 2 pm the next day and I am experiencing odd side effects. Sweaty palms, a bit of confusion, loss of attention, and light sensitivity. It feels like my eyes are dilated, but does not appear they are. Every day I take 20 mg of Vyvanse and 300 mg of Wellbutrin. ### Response: Sorry to hear about what you are going through. It is a rare but possible condition that can occur when Lisdexamfetamine (Vyvanse) is taken together with Dextromethorphan (Delsym). It can also occur with Lisdexamfetamine (Vyvanse) and Bupropion (Wellbutrin) are taken together due to" "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 28 years old and weigh 72 kgs. I am not married or pregnant.Recently, I have been having a problem of breast leakage and during intercourse, my boyfriend has also shared the same concern.It is embarrassing & alarming at the same time. What could be the reason? ### Response: This should be definitely investigated. I would advise you to do serum prolactin test first" "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 undergoing Q-switched laser treatment along with the use of Hydroquinone to treat my melasma. However, I would like to know if the use of stem cell creams can worsen the melasma by encouraging the growth of melanin? Currently, I am taking Tranexamic acid, Cipramil, Valdoxan. ### Response: Hello. Stem cells have higher doses of pigment in them. So, theoretically yes, the creams that stimulate stem cells may worsen melasma." "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 16 years old. He is suffering from constipation. What are the home remedies used to get rid of it? ### Response: Give him more fibrous diet like fruits such as papaya, vegetables such as radish, and whole grains. Avoid taking excessive caffeinated" "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 bad cavity, and I filled it. After doing it, I started to have pain on my jaws and the areas around the tooth. My dentist is not available for a few days. What can I do now? ### Response: Hi. I have gone through the query (attachment removed to protect patient identity). I can see high points. The uneven pressure on the tooth causes tenderness in your jaw. You have to reduce the high points present in the filling soon and make it as even. You can take Paracetamol 500 mg for the pain until you visit your dentist." "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: For ten years, my husband has been successfully using an extended wear bandage contact lens (monthly wear) to control the pain of aphakic bullous keratopathy in one eye. About seven months ago, he had an episode of foreign body pain in the eye which the contact lens could not control. His optometrist changed the type of lens after remarking that the lens appeared tight. Although the painful sensations have decreased, they are still present with more of a sore feeling now. His ophthalmologist suggested that he discontinue the Azopt drops he had been using in case the preservative was causing some corneal toxicity. His eye pressure without the drops has read at 18 and 20 on separate occasions, but he does have corneal edema which may affect the measurement. He has had high pressure in that eye previously, but it was mostly lowered by Cyclodiode treatment some eight years ago. The consultant said he had left him on the Azopt drops just as a precaution. My query is that if the bandage lens has worked so well for pain management for 10 years is it possible that it can continue to work? And if the Azopt drops and their preservative had caused some toxic reaction seven months ago, could that still be causing him to feel the discomfort? His consultant suggested out that he could have the eye removed to control the pain, but as he has what he feels is some slight, useful vision in that eye, he does not want to take such a drastic and life-changing step. In fact, he wants to pursue the least invasive course of action to relieve the pain he is getting. I would appreciate any advice you could give as he is in quite a bit of pain. ### Response: Hello. I reviewed your history. Bandage contact lenses are a proven and effective treatment option for pain relief in case of aphakic bullous keratopathy. Hence he can continue the same and I do not think these are responsible for the sore feeling of the eyes." "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 anal fissure. I am taking homeopathy for the past 25 days. It worked for the first 20 days, but for the past five days, my pain has increased significantly. Is it homeopathy aggravation or something else? ### Response: Hello Can you please mention the name of the homeopathic remedy taken? The increased pain after an immense relief can be due to two reasons. The first, the given remedy acted superficially hence you noticed immediate relief. However, since the action of remedy is not completed it stopped working at a certain point where you started getting pain again. The second reason is the aggravation of homeopathic remedy which occurs if the remedy is taken too often in large doses. It is important to know how many doses and in which potency the remedy was taken. If this is an aggravation of remedy, stop the remedy, the pain will subside slowly over the time. This remedy will help to reduce the aggravation. Also, it is important to know if the fissure has started to heal in the last 20 days or has it got worse. This can be determined by the physician who will perform the physical examination. Hence, I would advise you to consult a physician and get it checked." "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 30 years old male with HTN (Telmisartan 49 mg and CTD 6.25 mg) for past six years with a body weight of 80 kg. For some days I have noticed froth in urine and facial puffiness. I want your suggestion. My RFT was normal but I have not checked my urine for protein or USG abdomen. Can you please guide me regarding further management? ### Response: Hello. Your main concern is regarding facial puffiness. For that, you can do following investigations: According to cause specific treatment is given. Urine routine microscopic examination also can be 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 am 30 years old, female. I get cough problem during year end which never goes till next 3 to 4 months. I get a little bit of relaxation by medicine but not completely and again next year I feel the same problem. I have gone for X-ray, etc., and everything was fine. ### Response: Your cough seems related to the weather which gets worse during the winter season. This seems to be a kind of allergic bronchitis that is healed by increasing immunity. Lemon and ginger are the best natural ways to improve immunity or take a Vitamin C supplement. The cough will go with regular care and warm water treatment." "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 CBC (complete blood count) done yesterday and it came back with elevated WBC of 13500, with neutrophils 9000 (more or less), ESR 36, and close to normal lymphocytes. My urine sample was negative. I had a severe eye infection that lasted about 10 days and started clearing up really nicely yesterday. When I had the blood work done, I was crying for an hour due to unrelated massive stress factors. I have severe anxiety and I am going through a rough time, I am hardly ever at ease. I am mentioning this because I read stress can be a factor.I am worried because my levels are elevated and I show no signs of infection apart from the eye (which still has a little pus). I do not go out due to COVID-19 at all. Food is delivered and handled in a very safe way, packages are disinfected and I have no contact with anyone. I am puzzled as to where an infection could come from. My doctor thinks it is a bacterial infection and has put me on antibiotics. I am very worried about cancer. Should I be? ### Response: Hello. Following is my opinion for your asked question. Your total count and neutrophils are elevated. So it could be due to bacterial infection or stress as per provided history. You can complete the course of antibiotics. Meanwhile, try to reduce stress and anxiety by yoga, exercise, breathing exercises, etc. You can be prescribed anti-anxiety medication for stress. It does not seem to be cancer according to history provided. However, kindly attach your all reports so that I can check it and can give you detailed comments." "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 daughter who is 2.8 years old cried hard before two weeks and developed a hoarse voice the next day. It subsided in about three days. Before a week, I remember her throwing tantrums and crying hard for every small thing and again developed a hoarse voice. I gave warm water and honey, and it has subsided a lot.Sometimes her voice sounds normal, and when she screams or cries, I can still feel her voice is a little hoarse. Is this hoarseness due to crying or could be any other infection? I read that hoarseness could occur due to cancer. I am a paranoid mother who gets scared after reading the stuff. She does not have any cold, cough and eats normally.In spite of her hoarse voice, she is taking ice creams and cold stuff. If the hoarseness is due to any serious medical condition, would she have any accompanying symptoms? My main concern is cancer. What would be the symptoms of laryngeal cancer other than hoarseness? She is a very adamant kid and still screams if things do not go her way. Suggest remedies to get rid of hoarseness. Please remove my anxiety towards cancer. ### Response: Hello. Relax do not worry. She does not have laryngeal cancer (vocal cord cancer), it is a vocal cord abuse. It is due to screaming she is having hoarseness of voice, so it is temporary. Give her warm water and if she can gargle then let her do it with salt water gargle. Based on your history I can understand that she has a minor behavior issue, typical of a toddler. When she starts screaming then try to divert her attention, so you can stop her screaming. A positive note is that the child forgets quickly and so you can do it. If you still have some queries, then please visit ENT doctor and get her vocal cord checked." "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 43-year-old female. I have bloating and loose stools for the past two days. There is no cramping and vomiting. I do not have any other issues. Please advice. ### Response: Most likely, you are suffering from viral diarrhea. Take a combination of Pantoprazole and Domperidone once daily for three days. Take a probiotic like capsule Vizylac (Folic acid and Lactobacillus sporegenes) twice a day for three 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 attaching a picture of a mark. Can you tell me if this is a melanoma? It has been that size for a long time but, it looks a little weird. ### Response: Hello. From your description and the given picture (attachment removed to protect patient identity), it seems you have a mole or melanocytic nevus. They are considered benign melanomas and nothing actively needs to be done for them. If the mole shows a sudden increase in size, differential pigmentation, bleeding, irregular borders, etc., then you may go for a skin biopsy." "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 child is 15 months old. He is not standing well. He does crawl and pulls up his knees. When I try to stand him up, he is reluctant and seems to be scared and cries when standing. I am worried. Should I be concerned? Do I need to check his hips? Had appointments with a doctor and he never identified any physiological problems. ### Response: Most babies take their first steps by their first birthday. Most toddlers have walking unaided, often with uneven steps. Do not worry, if your baby takes a little longer time. You should stimulate the child to get them walking regularly. It will help. You should get the child clinically examined by a Pediatrician. CNS (central nervous system) examination is required to be done to rule out any pathological cause. Visit a Pediatrician for a clinical 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: Diagnosed with varicocele grade 2. I have a lot of queries. Can it be treated? Will varicocele affect my sexual life? Will it lead to infertility (what are the percentages of chances) or is it controversial? Will sexual activity complicate my varicocele? Should I avoid sexual intercourse? Can I go to the gym? ### Response: Varicocele needs operation is two cases only. If it causes too much discomfort or pain or as a treatment of infertility. Not every varicocele causes infertility or problem in sexual life. Only if infertility occurs then varicocele treatment is needed. There is no fixed percent cases but chances are low. You can go to the gym, no problem in that. You should do repeat sonography after three months to check for the status of varicocele. You should also do a semen analysis to get an idea of your fertility status." "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 57-year-old male and the results of my recent annual resting echo showed the following:Tri-leaflet aortic valve with well-compensated moderate regurgitation (2-3/4) as well as mild aortic sclerosis but no stenosis.Normal size left ventricle (130 mL) and no evidence of hypertrophy or remodeling. Low normal systolic function with an ejection fraction of 54.A normal right ventricle size and function.Mildly dilated left atrium.Mildly dilated aortic root (41 mm) and ascending aorta (41 mm).In addition, it is noted that my resting ejection fraction last year was 64 and my stress echo taken this year (for atypical chest pain) was 62. My cardiologist says all my echo parameters are stable and he does not want to see me for another year. Despite my cardiologist reassuring me and I having nothing to worry about, I remain a little concerned about the drop in my ejection fraction from last year to this year. Should I be worried about this or is it still in the normal range? ### Response: Hello. So, due to all the above reasons, I think this borderline value of ejection fraction is due to a measurement variation. At this stage of regurgitation, it only needs monitoring. Surgery is considered in case of severe regurgitation, significantly enlarged ventricles along with low ejection fraction. So, no need to worry and the future plan should be monitoring with echoes. Hope this helps you. Get back if you have any doubts." "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 urinate a lot, almost 32 times a day. When I urinate and come back, after a while, I can feel some urine passes my urinary tract, and I have to urinate again. Can you prescribe some tablets? ### Response: We call this as urinary incontinence in medical language. There are so many possibilities which can be responsible for this. Most probably your urinary bladder may fail to empty properly due to weakness of bladder muscle. For this condition, you have to get a USG (ultrasonography) done, where I want the detail about post-void residual volume. It means an ultrasonologist will take scan one before urinating and another after passing the urine in which he will mention the volume of post-void residual urine (PVU). If the volume retention is moderate, then we have to strengthen your pelvic floor muscle with some exercise and believe me it gives an excellent result and I had, treated so many patients with that exercise. Another possibility is decreased blood concentration of ADH (anti-diuretic hormones) which is, responsible for concentrating the urine and lack of this hormone is responsible for frequent urination. The last but not least, I would advise to get your blood sugar level done (both- fasting and two hours after a meal). As you know, without knowing the cause, nobody can prescribe you the medicine as it can be dangerous for you. So I will suggest you to follow my advice, get these two tests done, and send it back to me for proper evaluation and treatment of your problem." "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: The patient is oxygen dependent because of pleurodesis since 1 month. She is suffering from breathlessness after talc pleurodesis. She has metastatic breast cancer with distant spread to the lung and liver. There is residual pleural effusion along with bilateral lower lobe consolidation. She has pleurodesis related inflammation, interstitial pneumonia as well as interstitial lung disease due to pleural disease showing ground glass opacification. She has talc related leg injury. Patient is currently on tablet Methylprednisolone 16 mg every day. Along with this, she is taking tablet Mucinac 600 mg daily thrice a day. Blood reports, current x-rays and CT scans are attached for your reference. His CT chest is suggestive of patchy areas of consolidation along with bilateral pleural effusion. Doctors are not sure about the reason for breathlessness. I need your valuable opinion to treat this breathlessness. Kindly help. ### Response: Hello. I have read all the reports (attachment removed to protect patient identity) including your CT scan. It is very sad to be in such a situation with multiple problems." "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: The imaging of the neck region was done and some lesions were detected. The operation of lower jaw and neck region was done followed by chemotherapy and radiotherapy and it was stated that things will settle to normal. During routine checkup, some swelling in neck region was detected and FNAC was done, which shows metastatic poorly differentiated squamous cell carcinoma, and after that full-body scan was performed. The reports are attached. Kindly look into it as the second opinion is required. ### Response: I am sorry to know the recurrence of cancer. (attachment removed to protect patient identity). You got diagnosed with squamous cell carcinoma in buccal mucosa of the left oral cavity in December 2019 which was operated. Then you received chemotherapy and radiation therapy and now on routine evaluation, there are some new lesions coming up in the thyroid and neck. So basically there are two sites of new lesions now, in parotid and around it one more lymph node. So please undergo a biopsy of this lesion from parotid to see if it is same cancer as before or a new second primary cancer. If it is confirmed as same cancer as before, it will be operated and taken out and also few more lymph nodes on the same side of the neck followed by chemotherapy. If a second primary cancer, then treatment can be different depending upon what type of cancer it is (on biopsy). So your first step is biopsy." "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 tetanus shot last year around June. I had another minor mishap on the road with a small injury (cleaned with antiseptic). Do I need another tetanus shot now? ### Response: Hello. The last year\s dose is not going to give you any protection now. If any one of the following has happened during the injury, you will need tetanus followup: I advise you to take the tetanus injection (tetanus toxoid vaccine) as soon as possible. Even though the application of antiseptic negates the chances of acquiring an infection to a large extent, it is better to have the shot for safety purpose. You should ideally take tetanus injection within 24 hours, as it will not have any protective effect when taken beyond that period." "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 hepatitis B transmitted by saliva? Hepatitis B virus is just detected in my body. My viral load is 1.5 * 10^5 count/mL. Is it possible for me to get totally cure for this disease? If it is possible how much time will it take to get totally cured? ### Response: Hepatitis B can be transmitted by sharing needles, the blood of infected persons, unprotected sexual activity, and saliva. Acute infection is not usually treated as body overcomes the virus but chronic infection may require treatment with the combination of medications for up to 12 months. The cure rate is high. The decision of treatment depends on the HBV (hepatitis B vaccine) markers as well as ALT (alanine transaminase) level. I suggest you do your labs and have your HBV markers and ALT done. Consult your physician" "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 36 years old. I have depression, illness, and taking treatments for about 16 years. Now, taking Veniz XR 37.5, Thyronorm 50 mcg, both in the morning and Veniz XR 37.5, 75 both are evening. Feeling fatigue and anorexia. I do not like doing work, feel restlessness, and intensely angry. These symptoms are feeling compulsive looking in the smartphone, porn sites, and porn stars detail, and masturbate two to three times daily. Now, while looking on erotic porn stars videos, heartbeat and anxiety are high. Is it porn addiction? And what are the symptoms of porn addiction? Porn addiction and intense anxiety have any relation? Please answer me. ### Response: When we are in anxiety and depression, our mind is stressed, it needs something which could increase secretion of a chemical called dopamine in our brain. This chemical uplift the mood. Doing masturbation or any kind of sexual activity increases this chemical in the brain. I would advise you to consult psychiatrist so that your medications can be adjusted. Once you are better you would automatically decrease all these increased sexual behavior. Thyroid stimulating hormone. Medicines need to be adjusted. Sleep well, eat a healthy diet, follow a routine." "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 just received results back from a blood test that says my red blood cell count is quite high. I am a 35-year-old female and I am a smoker (between 4 to 7 a day). I began to get headaches, dizzy spells, nausea, fatigue, and itchiness all over the past five weeks. I do not know whether or not a miscarriage could count towards what is going on or not but I would like to know what it is I should do. My doctor just said to quit smoking and come back in 12 weeks for another test. ### Response: Hello. High RBC (red blood cells) count can be due to the smoking habit. In smoking, oxygen delivery to tissue is decreased. So RBC is elevated by increase erythropoietin. A headache and dizziness in your case also seem to be due to smoking. So, it is advisable to stop smoking immediately. To rule out miscarriage, you can investigate with ultrasonography of pelvis and urine hCG card test." "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 want to know about piles. For the past two days, I am having little bit pain in the anus. I want to know if it is piles or not. ### Response: I have checked the attached photo (attachment removed to protect patient identity). Most probably it is an early degree of piles. Piles is a condition where the congested veins along with the covering mucosal layer protrude from the anus. It has four degrees, the first three are treated conservatively and the fourth is surgical. It causes pain with defecation and bleeds sometimes. You have to treat constipation if it is present" "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 writing for my daughter, staying away from us, with her husband. She is 30 years, 5 feet 1 inch and 63 kg, working in the IT sector. She is married for the last three years and seriously trying for conception from a year. She missed her period once in the beginning of this year. During her obstetrics consultation, beta hCG was done. It was repeated after two days. A transvaginal ultrasound scan was done and repeated after 10 days. The end result was diagnosed as a blighted ovum. So, it was evacuated by D and C.Our daughter is of normal build and nutrition. Her menstrual history was normal since the beginning in terms of cycle, duration, and flow. But, one month after D and C, she did not have her period. On the doctor's advice, she took some medicines and bleeding occurred. She was known hypothyroid. So, she was taking Thyroxin 50 or 75 to keep the TSH near about 2.5 Uiu/ml. Her Hb % and sugar are within the normal range.Again, she tried to conceive since three months ago along with Aspirin and folic acid. She missed her period last month. Her beta hCG was 9.20 mIu/ mL. It was repeated after two days. It came down to 1 Miu/ml suggestive of \chemical pregnancy\. This time, after a few days, a spontaneous jelly-like bleeding occurred for two days. I would like to add that her husband requires to take Penegra 50 mg tab before a performance. Our daughter is immunized with triple antigen, polio, MMR, chickenpox and hepatitis B vaccine in childhood. The transvaginal scan (done at a later phase of the first conception) showed normal anatomical and physiological pattern of the ovary and uterus to me at least (report attached).Two consecutive miscarriages brought great disappointment to all. Presently, the doctor told her to take Aspirin 150 mg, folic acid, and Vitamin B12 combination tablet and to try for pregnancy again. I want your valuable opinion regarding subsequent management or the right line of treatment and suggestions or tests (if any) to get a successful pregnancy and healthy baby. ### Response: Hello. I have gone through your daughter\s reports (attachment removed to protect patient identity). Hope this helps. Regards." "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 31 year old male. My eardrum burst after coming down with the flu. It has been leaking this watery bloody substance. This happened about four hours ago. I was in pain till it burst. Seems like all the pressure went away and was a huge relief. My question is do I let it heal on its own or should I go see a doctor? ### Response: Small perforations of tympanic membrane heal on their own, particularly if traumatic. However, you say that it happened after a flu. You may need to see an otolaryngologist to determine if you have any infection in the middle ear. If otitis media is present you will need a prescription medication to treat that. For now, do not put anything in your ear. While taking a bath, make sure no water gets in. 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 reduced smoking. From past 30 days, I have only smoked maybe 10 to 12 cigarettes and trying to quit smoking. I had a dry cough but it was gone but sometimes I do a cough maybe three to four times in whole 24 hours. But while brushing my teeth today I was cleaning my tongue, I coughed up blood in my spit and then I went to really polluted area dust and smoke of burning tier. I was not able to breathe. Literally not able to breathe. So, I came home on purpose I coughed blood again and that cough was really from inside. I am scared is this lung cancer? But no pain in chest not breathless while running or anything. I am totally fine. No weight loss, I feel hungry. I am totally fine. Please help. ### Response: I understand your concerns. Coughing up bloody sputum could be caused by many conditions like bronchitis, pneumonia, TB (tuberculosis), or lung cancer. Unfortunately, all these conditions are exacerbated by smoking. Your age, how much do you smoke and for how long? Have you experienced fever recently? Any phlegm? The cough you experienced is due to chronic bronchitis which is very common for smokers. Coughing could be a simple cause of spitting blood. ( sputum with blood streaks). I suggest that you perform chest X-ray to exclude the serious conditions of coughing up bloody sputum. Send me the X-ray for interpretation)." "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 26 year old male. When I am with my friends (male), an image of kissing that friend pops into my head sometimes. Though I am not attracted to boys, what could be the reason for this? Please help. ### Response: Hello. Your symptoms are suggestive of OCD (obsessive compulsive disorder). The popping of an image is called an obsession, if it is repetitive, automatic, intrusive and senseless. It induces significant uneasiness or anxiety. The first thing is to understand that you are not turning gay, and do not worry that your orientation may change. Consult a psychiatrist for detailed evaluation and proper treatment." "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 as if I may have a neurodegenerative disease. My symptoms are as follows:More forgetful than normal.Battle to find the right words.I get very bad pains and pressure in my brain.When driving, I battle with judging my following distance.Please, could you provide any tests that I could take? If it is a neurodegenerative disease, what is the progression rate, that is, the timeline between each stage? ### Response: First, only based on these symptoms, it is difficult to say with certainty. I would like to ask if you have any medical problem as of now, and taking any medicine, or using any substance of abuse. These symptoms could be due to: So, to reach a diagnosis, you need to undergo few investigations including full blood count, blood sugar, thyroid function test, B12 and folate level, CT or MRI brain, liver and renal function test. There are psychological tests such as MMSE (mini-mental state examination), or Hamilton depression rating scale (to find the level of depression), ADAS - Cog to find the level of cognition. I recommend that you consult a psychiatrist in person for a detailed evaluation. The timeline for neurodegenerative diseases is different for each disease and also vary considerably in different people, like Alzheimer disease progresses in 5 years to a decade while prion disease progression is very rapid. Similarly, neurodegenerative diseases secondary to medical conditions are reversible or at least stagnant once appropriate treatment is taken" "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 lower back pain for the last couple of years. It all started after I lifted a stone at a cricket ground. A little amount of physiotherapy helped after the doctor\s advice. I have consulted three doctors in two years and a doctor advised MRI this week. My doctor is out until next week and I am very anxious to understand the MRI report. Kindly help me understand the report. ### Response: I have gone through the attachments (attachment removed to protect patient identity). Your MRI (magnetic resonance imaging) is showing herniation of an intervertebral disc that is displaced from its position and impinging in the nerve. However, this is only an MRI impression. MRI is a sensitive investigation that picks up clinically insignificant findings so it is important to get clinically examined and see if these findings reported by MRI are actually the reason for pain or not. Secondly, whether the condition requires surgical management or will it be treated by conservative treatment alone" "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 23 years old and just learned about transillumination of the scrotum. I did the exam on myself and my right testicle does not glow when the light is shinned under. I cannot feel any lumps on palpation. Should I get additional examination? ### Response: It is very nice to know the effect of health education imparted to you. On self-examination, if there is a normal smooth contour of testes, uniform consistency, no lump or heavy mass felt, then no need for further 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 fell off the bike. I took X-rays and the doctor is telling me that both elbows are broken. As a non-professional, I cannot see if it is really broken. I do not have any pain if I am not stretching the elbow too much. Are both elbows really broken? And if yes, do I have to wear the cast for 2 to 3 weeks? ### Response: Hello. There are fractures in both elbows but that is where a detailed description is needed (attachment removed to protect patient identity). If you look at the radial head and neck area (the bone in the elbow that is on the outside or thumb side and had a round appearance at the top). Look carefully and trace the bone upwards towards the elbow joint and you will notice a subtle fracture which is in its place in both views or undisplaced. You do not need a plaster. Only a sling and mobilize as pain allows. Ice the elbow for pain relief and some of the counter painkillers. Avoid wrenching and twisting activities for 3 to 4 weeks as they may be more painful" "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 question about the ketone diet. I honestly do not understand the benefits of a ketone diet, what are they? Is a ketone diet good for those who are diabetic? ### Response: It aids in weight loss. Reduces acne. It may help reduce the risk of cancer, improves heart health, may protect brain functioning, potentially reduces seizures, improves health in women with PCOS. Longer use of ketogenic diet is not good for the diabetic patient" "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 flossed by a tooth where a filling almost came out and my tooth and gum have been hurting all night. Also have a tooth that is by this molar that fell or chipped out. I do not know if it is an abscess or an exposed nerve in my molar that is right behind it. Took Tylenol 2 every 6 hours twice. It did not help. Used Benzocaine on the area. Helped 20 %. Do not feel comfortable using it at home. ### Response: Hello. Is the pain sharp or dull? Any gum swelling? If the pain is sharp, lancinating and referring to the same side jaw, temple, ear or throat, then this could be from the tooth with the chipped out filling. Most chipped out fillings expose the underlying nerve which causes severe pain. Ideally an X-ray is required to determine the depth of the cavity and to check for nerve involvement. If the nerve is involved, a root canal treatment and crown procedure will be done to save that tooth. If the pain is from the gums and is dull in nature, this could be an accidental gum injury due to flossing or there is a chance of the attempted food deposit to get deeply pushed into the gums causing this pain. If this is the case, a deep localized scaling should be performed under local anaesthesia to relieve any deeply wedged food deposit. A clinical examination and X-ray is required to diagnose the cause of this pain. I see that taking painkillers and topical anaesthetic in this situation were not much of help to you. Please visit your nearby dentist immediately and get the root cause identified. Meanwhile, try warm saline mouth rinses and avoid hot, spicy foods which may aggravate your pain." "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 polycystic ovary syndrome and my periods get delayed sometimes. From the past four days, I am having pain in my left pelvic area. I got an ultrasound done, and it shows 4.5 cm cyst in my right ovary. Why am I having pain on my left side when the cyst is on the right? Could this pain be due to the cyst? ### Response: Hi. The pain that you are experiencing is not due to the ovarian cyst, as the cyst is on the right side and pain is on the left side. This pain might be caused by an infection or any other pathology. So, I suggest you repeat an ultrasound of the pelvis if the pain is severe. I wanted to know the type of cyst you have, When was the ultrasound done? You will require a repeat ultrasound after three months, to know whether the size of the cyst is same or if it is increasing. Revert with more information to 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: My 4 years son had a cough for two days. Now his cough is fine but now he has a high fever on the head side but his hands are ice cold. He is telling pain sometimes in hands and some times in feet. What is the cause? Please explain. ### Response: From the description, it seems your son is having an upper respiratory infection. If he is playful and active in between fever it may be a simple infection which will subside by its own. You can give Paracetamol during the fever spikes. If his fever is lasting for more than three days, then you have to do a blood test including complete blood counts and may go for antibiotics after consulting a doctor in person. Pain can be part of the infection." "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 is indifferent to child health issues. She controls the child with threatening words. The child cannot cry or weep even with an extreme reprimand by her. She makes the child sleep under extreme pressure. Sometimes, the child wets the bed. She then becomes furious with him. All this has led him to be a withdrawn child and always compromising. Please suggest me. ### Response: Hi. So, you need to explain these things to your wife and with the help of yourself/psychiatrist/psychologist, she may be able to change her behavior. She can also be relieved from the stress that she is feeling now. To reduce the demand for care by her, other facilities such as day care or housekeeper can be made use of. Provide the emotional support she needs. Encourage her to take training for planning and meeting the needs of chil" "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 taking Effexor XR 300 mg for depression. It has been working really well. My psychiatrist has now prescribed me Strattera for ADHD. I am about to start 25 mg and work my way upto 80 mg over a few weeks. Strattera and Effexor both seem to inhibit Norepinephrine reuptake. Is it safe to take this combination? I know my psychiatrist knows what he is doing, but I wanted to get a second opinion from others. ### Response: You may know that Effexor XR is effective against depression and Strattera is used to manage ADHD. Sometimes both are prescribed together when you have ADHD along with depression. Your psychiatrist is following a safe approach of starting on a low dose of Strattera (Atomoxetine) and gradually titrating up the dose depending on your response and tolerability. Continue regular review appointment with your prescribing psychiatrist while the dose of Strattera is being titrated up. If there is any side effect, it can be picked up early and dose adjusted accordingly." "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 diabetic and hypertensive and have neuro problems. I want you to look at my MRI reports and advice me accordingly. I have attached the reports. ### Response: I have gone through the attachments (attachment removed to protect patient identity). The MRI (magnetic resonance imaging) report says that there are chronic ischemic changes suggestive of small vessel ischemia. These changes are usually seen in people with underlying diabetes and hypertension and represent longstanding nature of two conditions. The only way to prevent further progression of the changes is strict control of diabetes and hypertension. These changes in the brain will not lead to any disability. However, you should understand that you are at increased risk of stroke and hence strict control of diabetes and hypertension is essential" "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 got EBV test done. My result was IgG positive and IgM negative. What does this mean? Is it life threatening like HIV? Is it contagious? Please guide. ### Response: Hi. IgM (immunoglobulin M) negative and IgG (immunoglobulin G) positive means that you do not have acute infection, but may be a carrier of Epstein-Barr virus (EBV) which is not as dangerous as HIV (human immunodeficiency virus) and can be easily treated. You may develop symptoms of sore throat, swollen glands, fever, rashes, abdominal pain, cough and runny nose. Symptoms generally last for between a week and a month although it can recur when the body is under stress. Treatment in chil" "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 periods suddenly stopped after a few hours. Then, it started again the next day and stopped again. I had unprotected sex six days before my periods started. Could I be pregnant? Please reply as soon as possible. ### Response: If your menses have started after your sexual episode, then it is unlikely that you would be pregnant at all. There is endometrial shedding occurring and hence, you would not be pregnant. However, you may get a serum beta hCG test done to confirm. If the hCG levels are less than 5 ng/dl, then you are not pregnant at all." "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 quite afraid of needles. I get anxious even thinking about blood tests. I fainted once while taking blood test. Please suggest me to overcome fear. I have to get blood tests done but I am extremely anxious. ### Response: Hi. Needle phobia is quite common and it has different types like vasovagal syncope attack which you have encountered earlier. You can try local anesthetic cream when a needle is to be inserted so that pain associated with needle prick is not felt. A psychotherapy called CBT is also effective. In this, a systematic desensitization is done and maladaptive emotion and thought are challenged and corrected." "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: Our baby is 16 days old and is suffering from jaundice. Both mom and son have same B positive blood group. TSH level is normal and vitamin D oral drop is given. I have attached the bilirubin test report for your reference. Does breastfeeding affect jaundice in any way? Please advise us. ### Response: I have seen the reports that you have attached (attachment removed to protect patient identity). Revert back with the report to a paediatrician 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: A few days back, a brown spot appeared halfway on my thigh. By the same night, it grew and it was black. In less than 24 hours. Small brown spot turned black and grew in just a few hours. It is flat. I am writing this a week later. The edges are flaky now. It has a slightly rough texture but the edges are peeling in not picking it. Do you think it could be melanoma? I am brown in complexion but had an aunt who died of skin cancer. ### Response: The bigger brown patch is cafe-au-lait macule and the small one is probably an atypical nevus (attachment removed to protect patient identity). That is not melanoma clinically to me. Melanoma is very rare at a young age like in your case and obviously very rare in brown skin color. You are doing good that you are doing skin biopsy for tissue diagnosis so that no confusion is left but it is less likely to be melanoma." "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 unprotected sex and taken a pill after the sex. I did not get any bleeding after taking a pill. Then, I had unprotected sex again after six days. Shall I take Unwanted 72 today that is, after three days of last unprotected sex? ### Response: Hi. If you have not crossed 72 hours of intercourse, then please take an emergency contraceptive pill. However, if you have already crossed 72 hours of intercourse, then there is no help for taking the medication. In case of doubt, you can get a urine pregnancy test done with early morning urine sample to ensure that your not pregnant. Do not take any medications without an expert advice. Just get your urine pregnancy test done and get back to me with the reports." "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 3-year-old son weighing 19 kg seems to develop running nose along with nasal congestion today afternoon. He also seems to have some amount of breathing difficulty today while sleeping, although he does not have any background in asthma.I have some questions:I have given him Zyrtec (Cetirizine) syrup 3.5 mL today late evening, which probably makes him feel a little better. Also, I am planning to give the same twice daily for tomorrow and day after unless something else comes up. Is this a correct medicine? Is the dosage 3.5 mL BD correct for his age and weight?We have a nasoclear nasal spray, however, he is extremely reluctant in taking it. Is there anything else we could do for his nasal congestion? Also, usually he develops some amount of throat pain the next day. Is something like 5 mL of \Ibugesic Plus\ or \Calpol 250\ fine for that?Is it fine to give him curd, fruit juice (orange, pomegranate) or fruits (apple, banana) during his sickness?Please advise if any of the above is not recommended.Since the last few days, he used to sleep a little in the late afternoon. He wakes up late and as a result, takes fruit juice (orange) and fruits like banana little late in the evening. Is this a probable cause ofsickness?He has taken his flu vaccine appointment in two days. Given he is sick and in case it continues for a couple of days, will it be appropriate to give the vaccine?What is the preferred time for the flu vaccine? Should we give flu vaccine now or wait for some more time? ### Response: The dose of Cetirizine is fine and you can give it for two days more and see. If there is no improvement then kindly do a physical examination. Nasoclear nasal spray can be easily used in form of spray be inserting the tip into the nostril and pressing it. The child can be taught to do himself. Giving plain steam can be an alternate option. Calpol (Paracetamol) can be given if there is throat pain or fever. Ibugesic plus (Ibuprofen and Paracetamol) syrup can be used for high fever. Salt water gargling will help with throat pain. Consult your specialist doctor, discuss with him or her and with their consent take the above medicines. Fresh fruit juices which are at room temperature can be given any time. Giving curd depends if that triggers cold in him when given. It is better to avoid flu vaccination for now. You can plan it after one week. This time of the year is fine to take flu vaccination. Generally, it is recommended to take in in the latter months of the year. There have been major outbreaks even during summer. Hence it is better to protect your child" "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 had my third blood transfusion a week back. However, it is a week later, and I still feel unwell. Is this normal or what should I do? I feel tired and weak with zero energy. ### Response: Hello. For severe anemia, you had given a blood transfusion. The clinical improvement depends upon hemoglobin value. Usually, if your weakness is due to anemia then with normalization of hemoglobin level, symptoms will improve. If no improvement, then other causes for weakness need to be searched like low vitamin D, low calcium, electrolyte dost urban, liver and kidney disease, etc." "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 22 years old, and I am a mother of four months old baby. Recently, I have got infected with chicken pox. Does breast milk transfer chicken pox to the baby? Do I need to take special care of my baby? Can I do breastfeeding now? Does it affect my child? Please help. ### Response: Hi. A mother who contracts chickenpox can do breastfeeding. Any vesicles present on the breast should be covered to minimize the risk of transmission. There is no evidence shown the presence of the varicella-zoster virus (Chickenpox) in breastmilk. Hence breastfeeding is safe. Breast milk does not transfer chickenpox to the baby. The doctor may prescribe Acyclovir 800 mg five times a day if you are seen within 24 hours of rash onset. It reduces the time to have full crusting of lesions and reduces the number of lesions. Acyclovir can be taken during breastfeeding. It is safe to take. Keep your nails short to minimize the damage from scratching." "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 nausea every time and every day after eating. I cannot eat my food. I drink only water. I am feeling tired always. My stomach hurts me so much. Why do I have a feeling of nausea after eating? Why do I throw up after eating? ### Response: I have gone through the attachment (attachment removed to protect patient identity). Your BMI (body mass index) is in borderline. It is normal. I can understand your concern regarding vomiting. It can occur due to various reasons. Gastritis can also be a reason for having nausea and vomiting. Take food at regular intervals and avoid skipping breakfast, lunch or dinner. Follow a diet schedule. Avoid eating oily, fried and spicy foods. Take plenty of oral fluids. You may also need to take antacid and antiemetic if it is required." "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 got gallstone and prostate enlargement and the PSA is 8. Abnormalities are noted in the lung parenchyma or pleura, but no pulmonary nodules seen. Also abnormalities are seen in neck and mediastinum. When I have cold, cough does not stop itself. I drink some water and I think while working. I joined the art of living ayurveda course and the doctor give me Haritaki, Yashtimadhu, Deva vati, Hingvastak, Triphala, and Maha triphala ghrita when I had colonitis 8-10 years back and it was cured. Presently, I am having Harnalidge for prostate enlargement. So, could you also give me an advise on ayurveda medicine for the gallstone and prostate enlargement problems this time. ### Response: Hi. If you take these medicines regularly both your problems will be taken care of definitely. Revert back after a month to an ayurveda 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 have taken Clonil 10 mg, Olonex 25 mg, Valprid and Serlift 50 mg only at night for two days for depression. After the second day, in the morning, I fainted and heartbeat were excessively fast along with muscle of all over body feeling warm. I stopped taking them since then but my body is weak and I feel a tremor, shaking hands and today also heartbeat is getting fast with little nervousness. It is the fourth day today. Please help. ### Response: All the symptoms you described could be due to anxiety disorder per se and not because of medicines as they are out of your system now. Sometimes there are few problems when medicines are started but they usually go spontaneously within 2 to 3 days. Medicine dosage can also be adjusted accordingly. So, stopping the treatment is not a good option. In my opinion, you shall consult the treating psychiatrist and start treatment with dosage change as per the current situation. Remember, every problem has a solution. You just need to try solving it and help is just a step away" "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 severe ear pain in my left ear. Today is the third day and I cannot hear properly. It resulted due to pricking my ear. ### Response: Hi. After reading what your complaints are, I think two possibilities are there which can lead to the symptoms you are perceiving. It could be that you already had an underlying infection of the middle ear which can lead to an earache and pricking was incidental or that fiddling with ear may have lead to infection of the external ear canal which could lead to symptoms. I would like to know if you had a common cold and running nose or pharyngitis before an earache and decreased hearing appeared. Is there any discharge from the ear? Does moving your pinna cause any pain? In either cases, you need an antibiotic and analgesics. If you had any history of cold, you need decongestants as well. URTI (upper respiratory tract infection). 1. AOM (acute otitis media).2. Otitis externa." "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 developed a small cut on my foreskin during an intercourse with my wife. Did not realise it initially but was feeling uncomfortable while passing urine. I washed it and left it unattended for a few days and abstained from having intercourse for some time. It had reduced. I did masturbate a few times and felt a little discomfort though there was not any pain. I recently had an intercourse with my wife and the cut seems to have become fresh again. I took a break from intercourse and masturbation for the past 10 days and started using Fusee B cream for the past one week on the cut before going to sleep. Sometimes during erection, the cut seems to become a little fresh. ### Response: This appears to be a tear in or near the frenulum. This may continue to recur as healing will cause scarring and further contraction, while sexual activity will stretch and tear it again. You should see a surgeon or urologist if this does not heal. A minor surgery called frenuloplasty may be 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: Dear doctor,I want to know the interpretation of my lab test for hepatitis. These are: HBsAg 5638.62 reactive, anti HBs 0.00 nonreactive, anti HAV IgG (reverse) 1.06 reactive, anti HCV 0.520 nonreactive, SGPT 19 (ref value is less than or equal to 41 U/L). The liver ultrasound: right mid hepatic length 6.10 cm, left mid hepatic length 7.2 cm, sonographically normal sized liver. Note: I have a schedule for other tests which are HBV DNA-PCR (viral load) and fibroscan for chronic HBV, normal SGPT. Hoping for your prompt reply. ### Response: Hello. You have hepatitis B infection. You need to get your HBV DNA quantitative level and depending on that, start antiviral treatment from your treating physician. Nothing to worry. If well treated, you can have a good control of the liver disease. Hope your queries have been cleared." "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 pregnancy test is negative. But my period is not coming. I checked my pregnancy five times with pregnancy kit. Every time it shows negative. But my period has not started. I take Regesterone 5 mg for three days. I took my last dose two days before but not yet got my periods. So what should I do now? ### Response: Since your urine pregnancy test is negative, there is nothing to worry about. The delay could be because of hormonal changes. After taking Regesterone it will take a week or so to get your periods. So relax and do not worry. Wait for a week or so and if you do not get periods by then get yourself checked by a gynecologist and get a pelvic scan done to rule out the exact cause. Do get back to me with reports so that I can guide you further on." "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 bump on my labia , it does not hurt and it is not too big but I have had one before so because it is reoccurring. I am a bit nervous. It is close to where I shave so I am hoping it is just a dull razor issue or a pimple but the fact that I had it before is concerning to me. I have not tried to pop it and it does not look like it is filled with pus or anything, it is also flesh colored.I know it is hard to give me a diagnosis since you cannot see me, but I was wondering for some insight on what this could be because I know self-diagnosing myself is not the right thing to do. I do plan on seeing a doctor but seeing with the virus going on right now I cannot make an appointment so this is my only hope to get some kind of answer to ease my mind for the time being. ### Response: Hi. I can understand your concern. According to your history, there is a possibility that the lesion you described could be a Bartholin,s cyst. But as you mentioned by direct examination only we can make the exact diagnosis. You can take a sitz bath with lukewarm water and with few ml of disinfectant liquid like Dettol. With this the symptoms of inflammation can be relieved and size of the lesion can be decreased. You can do this twice a day for three days. If the lesion persists or recurs you may need to consult a local gynecologist for examination and 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: So for the past couple of weeks, I have been very itchy and will break out in little bumps. I went to the doctor to find out if it was an allergic reaction or something else but they were not very helpful. They prescribed me Desonide for the breakouts. I have been using it but it has not helped with the itching. I also talked to a pharmacist and she asked if I had ever had experience with eczema and I did when I was a baby, but I thought I had grown out of it. She recommended me taking Claritin for the itching and using a moisturizing lotion and to continue using the Desonide. I have been doing this for a couple of days and I am still itching like crazy. I do not know what else to do. ### Response: Hello. I have read your query. Profuse itching over your body leading to a little red bumps could be an urticaria or an allergic reaction. Since it is from two weeks it can be acute urticaria. Urticaria uaually comes down in 24 - 48 hours to appear in other areas. These can also be called as hives. Complete blood count along with differential countIgE (immunoglobulin E). Acute urticaria. Anti-pruritic creams like Sarna or Ritch cream. Can use steroid like Mometosone if the itching is persistent over the area." "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 want to quit smoking. Is it possible to quit cigarette smoking within three weeks time? What are the side effect after quitting cigarette smoking?Is Nicotex recommended by medical council? ### Response: Hi. Yes, you can certainly quit cigarettes within three weeks. Because, smoking habit is more about self-control and determination than anything else. Also, medical council does not recommend any one particular brand or medicine. It recognizes that Nicotex (chewing gum with Nicotine) is legal and in my personal opinion, it is a very helpful substitute for quitting smoking. There are no side effects after quitting smoking. Once you quit smoking, you will only have an urge to pick up the cigarette again, but this you should be able to fight using Nicotex. Also, this is not going to be an easy path. So, I recommend you to have a social support from your group of friends and family. Also, give a strong reason to yourself while fighting the urge to smoke. It is an excellent step towards a better way of life." "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 daughter is 11 years old, height is 5\2"" and weight is 45 kg. She started her periods eight months back. It was normal till two months back. After which, she got her periods twice with a gap of 10 days and duration of 9 to 10 days. Same continued next month also. The next month we had been to a gynecologist and she has asked us to do a couple of tests and scan which came out normal. She has Iron, vitamin B12, serum ferritin and vitamin D deficiency so gave supplements for the same. Again we went to her around fifteen days later as bleeding was still continuing. She prescribed Trapic for three days and the bleeding stopped but is back again. Today we had gone to the doctor. She has prescribed Regestrone 5 mg thrice a day for a week twice a day and once a day for a week. Please advice. I am concerned about weight gain and other side effects. ### Response: Hello. I have gone through your history and understand your concern. As she is bleeding we have to give progesterone to stop it because in her age mostly cycles are anovulatory and deficiency of progesterone may cause bleeding. Do not worry much about weight gain" "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 22-year-old male. Is there any treatment in ayurveda for pancreatitis? I had six recurrent pancreatic attacks in the last three years. Please help. ### Response: As you are aware, there are many reasons for repeated pancreatitis - that including alcohol consumption, some viral infections, autoimmune, etc. 1. Karisalai karpam tablet or Heptowin tablets, 2 morning - 2 noon - 2 evening after food. This is pure herbal. 2. Kaasukatti tablets, 2 pills morning - 2 noon - 2 evening after food. This tablet is chewable or can swallow with water. This is also pure herbal. 3. Kantha chendooram 100 mg mix with honey and" "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 used to take treatments for facial hair removal using a laser, microdermabrasion, and chemical peeling. I did these treatments before two years. My skin has become worse now. I have more dead cells in my skin, and I have darker looking skin. Even my lips have turned dark. My entire upper lip is black. I do not know the reason behind this problem. Do I have this problem due to the laser treatment or due to hormonal imbalance?I am taking medication for thyroid, which is normal now. I am taking Metformin for hormone regulation. I have facial hairs, and it grows faster. I have facial hair above the lips and chin. I use a razor to clear it. Please prescribe me ointments or creams to reduce the problem. ### Response: Hi. You are having hormonal issues. It could be the reason for having pigmentation and excess hair growth. Please mention about the steps taken to maintain the skin. Please send the images of the darkened portion of the skin. I can suggest some remedies after looking at the present condition." "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 54 years male, having erectile dysfunction and diabetic for the last three years with HbA1c value 8. Can you please prescribe the dose of Sildenafil? ### Response: Erectile dysfunction can be due to many conditions including psychological and underlying like diabetes, hypertension, thyroid dysfunction, atherosclerotic disease and some medicine such as antipsychotic, some antihypertensives. So you need to be evaluated to find the cause of erectile dysfunction. These are prescription 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: Today I got clot after using abortion kit, but no periods. Before going to the doctor, I got two days period in that also I got clots. I am unable to understand my situation. Please help. ### Response: Following the intake of proper dosage of abortion kit, complete abortion occurs in more than 95 % of cases. Bleeding following consumption of abortion kit is variable, sometimes heavy with passages of clots, tissues sometimes it may be like menstrual bleeding. The bleeding may persist up to two weeks. You must get a USG lower abdomen done to exclude any retained pregnancy of conception." "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 46-year-old female. I have a problem with my tooth. There is an abscess and my dentist is always fully booked. Can you help me? ### Response: Hello. I have gone through your query. For an abscessed tooth, you have two options. One is endodontic treatment, and the other is the removal of the tooth involved in the abscess formation. Now, the treatment plan depends on the condition of the tooth crown. If the crown is in a good condition then you will be treated through a root canal treatment and if the crown portion is decayed or damaged grossly then you will undergo extraction of the same. It is necessary before the treatment. Take this medication only if you are not allergic to any of these and only if you are physically fit and not going through any condition like pregnancy, etc. Consult your specialist doctor, discuss with him or her and start taking the 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 complained of neck and shoulder pain. It was diagnosed to be muscle spasm by a doctor. X-ray has been taken. I was given cream and Muscadol tablets. I used ice and some exercise. It worked over 90 % but the problem is I feel pain after sitting on a chair for 10 minutes continually. It goes away when I lay on my back. Any suggestion please? Note it is an old problem approximately four years. Also, nine years back, I suffered from neck stiffness. ### Response: Hello. Your young age makes arthritis (wear and tear) unlikely. And you did not mention any history of traumatic injuries to your neck. The issue seems to be postural as the pain appears after sitting up and resolves on lying down. It would be useful to check the Xrays to confirm there are no bony issues. You will then need to have your desk and chair adjusted to allow support for your neck. There are also some neck braces that you can use for added support. I hope you find this answer helpful. Please let me know if you have any further questions" "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 it normal to poop and urinate often during implantation bleeding? ### Response: Hi. There is no relation of implantation bleeding with frequent urination and defecation. Implantation bleeding usually occurs about 9th day after ovulation, and no bowel symptoms accompany 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: I am a 51-year-old woman with an eight-month history of:persistent fever.shortness of breath on exertion.suffocation feeling.barking cough, sometimes productive cough with yellow sputumraised resting heart rate.tachycardia and palpitations with mild exertion.I am status post sudden onset of joint pain/headaches, adipose-derived stem cells, and rapid atrial fibrillation. I have done p-ANCA test with a background of positive Lyme testing with positive babesia and equivocal mycoplasma pneumonia. I am worried about having vasculitis. I would like to know how is vasculitis diagnosed and if I fit the symptom picture? I am currently on doxycycline 100 mg a day. ### Response: The manifestations of vasculitis in general are: Investigations will reveal high ESR (erythrocyte sedimentation rate), positive CRP (C-reactive protein), high platelet count, protein in urine along with RBCs (red blood cells). The other manifestations depend on the type of vasculitis. However, you do not seem to have manifestations of vasculitis" "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 28 years old. I got pregnant three months back. At 1.5 months, I went for a regular check-up. Everything came normal except for my TSH level, which came out to be 5.57. I have not gone for thyroid test before. Doctor gave me 50 mg Thyronorm to be taken daily as she termed it hypothyroidism. After one month when tests are done again, TSH came out to be 1.67, but anti-TPO antibodies are present and 278. Please explain what does this mean? Do I have to take medication life long? Does it have any harmful effects on my kids, I am expecting twins. Doctor asked me to continue medication even after delivery. What does it mean? ### Response: Hello. Elevated levels of anti-TPO antibodies indicate you have autoimmune thyroiditis. Do not worry about these terminologies, what it shows is you may have the disease even after the delivery. But that does not mean that you need to take medications life long. It can become normal by itself also." "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 41-year-old, healthy female, average height and weight. I recently had a CBC which was concerning to me. The WBC count was slightly low at 3.78 (reference range starts at 4.16) and the ANC was 1.08 x 103/uL. All the rest of the CBC was entirely normal. No immature granulocytes, etc., and lymphocyte count normal (although obviously percentage was higher at 55 %). I recently completed a short course of Ciprofloxacin for a tooth issue (about 3 to 4 days prior to blood draw). Also had a mild stomach flu about two weeks ago. Only other medication is Wellbutrin. Should I be very concerned about cancer, etc? I have been feeling hotter at night recently, but I have also been under a tremendous amount of stress. I recently was laid off and I am having trouble finding a job. ### Response: I have seen your attached report here (attachment removed to protect patient identity). It is not suggestive of any cancer. Your Hb (hemoglobin), HCT (hematocrit), RBC (red blood cells) and platelet count all within range. You had mentioned the history of flu which can lead a temporary decrease in WBC count may be by bone marrow suppression or relative decrease because of increased lymphocytes. Immature cells are not present so I do not think you have to worry about that. Repeat CBC (complete blood count) after few days. It will be normal if not then will investigate 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: I had sex with protection and even took an I-pill within 24 hours. But the next day I had bleeding. I do not know if it is the period or the I-pill side effect. Along with that, I have a headache also. I am dealing with PCOS at the same time. What are the chances of getting pregnant despite all this? I feel a bit dizzy as well. ### Response: The chance of pregnancy is almost zero. There is no need to worry. Dizziness might be due to stress" "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 25, female suffering from intestinal tuberculosis and got operated three years back. Now I am undergoing medical treatment for that but I was experiencing huge hairfall and I got a good and effective solution from here. I am totally satisfied but I have one more query about my skin, I am getting too much pimples and glow is totally vanished. ### Response: Hi. Are you on any medications at present? If yes, please mention the 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 am suffering from low-grade fever, hair loss, and extreme tiredness. There is pain and burning sensation in my stomach along with loss of appetite and weight gain. I got my ANA test done and it came positive. My ESR level has increased. All my other test results found to be negative. Please help. ### Response: I went through your reports (attachment removed to protect patient\s identity) and observed that there is no autoimmune disease present. Since you have been suffering from multiple joint pains for the past one year, you should have tested for rheumatoid arthritis (RA) factor and got done ASO (Anti-streptolysin O) titer. ANA (anti-nuclear autoantibodies) can be elevated even in slight fever, hence no need to worry for the same. Did you get affected by chikungunya anytime before? It has been mentioned that your 3D reports are normal. Please do attach those reports for my reference. I would suggest you to kindly get the following tests 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 have depression, anxiety, fast heartbeat, excess sweating, low energy, IBS with diarrhea from the last 15 years. I have taken so many allopathic medicine and showed to so many psychiatrist but no real effect. Now I am really confused that which treatment should I follow for long term.1. Treatment 1- Tablet Nexito forte + Toficalm 100 in morning and evening and Libotryp in night. Taken in two months duration.2. Treatment 2 - Tablet Nexito + Clonazepam 0.5 in morning and evening and Mirtazapine 15 mg in night- three months duration.3. Tablet Nexito forte + Pronol 10 mg in morning and evening and Prestiq 50 mg in night for 2.5 years.Please suggest which treatment should I take for my present condition as every treatment creates some problem. Which treatment has lower side effect? Please suggest as I want to get rid of my depression and anxiety completely and am unable to focus on my work. Please help. ### Response: Each" "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 has been two years since marriage but I have never felt sexually attracted to my wife, no matter what I do. I have tried Viagra and ayurvedic medicines to increase sexual drive but no results. My parents had compelled me into this marriage. Since I never had sex before marriage, they said that couple gets automatically attracted towards each other no matter what feeling they have towards each other before marriage. I tried sex several times. Erection is maintained for a few minutes that also after thinking about some other girl but ejaculation never happens. Now for the last five months, even erection is not happening. I was diagnosed with hypothyroidism last year but that is under control now. I was also diagnosed with increased prolactin levels recently and I am currently taking medicines for that. I think the problem is more psychological. Please advise me what to do. I am currently on Thyronorm 100 mg per day and Cabgolin 0.25 mg per week. Please help. ### Response: Hello. Hypothyroidism and high prolactin explain a few symptoms that you are suffering from. So before jumping to conclusion that it is psychological, I would suggest you that further investigation is required such as serum testosterone, serum LH (luteinizing hormone) and FSH (follicle-stimulating hormone). You may also need sonography of testes and visualization of the duct to see if they are blocked or not and also prostate if it is enlarged or not. Most often psychological anejaculation is situational and not permanent or complete, while you mentioned that you never had it. So I recommend that you consult a urologist for your symptoms and get investigated properly to find the cause of your problem. It is a treatable condition and can be treated accordingly. If the investigation comes normal then you can think that this is due to psychological in origin. Then counseling and sex therapy will be helpful." "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 very depressed. I am so tired of being tired and fatigue all the time. I have low self-esteem because I am over-weight but I love life. I love my family, my kids, my husband. They love me. I cannot get a job to help pay bills. No one is calling me back. I am so depressed and down every day all day. ### Response: Hi. As you are suffering from depression, you need the help of a psychiatrist. In such condition, SSRI such as Fluoxetine and psychotherapy are helpful. Also, regular exercise is very important as it helps in both hypertension and depression." "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 26-year-old male. I had protected sex with a sex worker a month back. I used one condom, she gave oral sex and post that had vaginal sex for 5 minutes. Once I finished off, I went to the bathroom and got cleaned off. I could not see any tear as such on the condom. I just washed my penis and got back home. The same night after 2 hours I pulled my foreskin behind to clean my penis with soap. The frenulum got too tight and tore. It started bleeding. I washed my penis and let it heal for 2 weeks.What are the chances of getting HIV from what had happened? I do not have any symptoms. Just had fever for a day and now I have a common cold. On the 15th-day post exposure (yesterday), I went for the HIV PCR RNA yesterday. The results are yet to come. Will the torn frenulum give chance for HIV virus to get in after 2 hours? I am feeling very anxious and stressed out. I really need your guidance. Please suggest what I need to do to rule out HIV and live a normal life. Please help. ### Response: The chances of transmission of HIV with given description is almost nil. The HIV test is likely to be negative. If the test is negative, it is almost conclusive provided there is no further risk exposure. The chance of test result coming positive later is almost nil. You can go for HIV antibodies tests after 3 months exposure to have final conclusive results to relieve your anxiety" "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 dull aching pain just above the back of my left knee (near the hamstring) and in my left buttock on occasions for about five weeks now. I am normally fine sitting but hurts when standing still or walking. Could it be a hamstring strain or sciatica? ### Response: You lie down on your back, stretch your legs straigh, then lift your left lower limb up without bending knee joint. If you get severe pulling pain from buttock to whole leg, then it is sciatica. This test is called (SLR) straight leg raising test. Hamstring muscle pain in the back of the thigh and lower buttock when walking, straightening the leg, or bending over. Do the SLR test to know there is sciatica or not." "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 26-year-old male with a weight of 85 kg and a height of 5 feet 10 inches. Recently, I was not able to get an erection while doing sex and was also ejaculating very soon. This happened two days ago with my current partner while we were having sex for the first time and also with my ex-partner some six months ago. It is very disturbing and takes a mental toll on me. Earlier, I had a pretty healthy and regular sex life. Please help. ### Response: Hello. Poor erection in most individuals occurs due to psychological reasons. But sometimes hormonal issues, diabetes, hypertension also worsen the problem." "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 very bad pain on the back left roof of my mouth. My left top and bottom teeth, jaw and the left side of my tongue is really sore. I felt that there is a hard lump, which feels like a bone and it is excruciating to touch it. It hurts to swallow, yawn and makes my ear pop. The bump is back of the teeth, like near next to my tonsil. I have had cough, cold and sinus symptoms for a couple weeks and it is almost better now. My current medications include birth control pills, Topamax, Trileptal and Vyvanse. ### Response: I understand your concern and it appears as you are having, For both the above conditions you have to consult your ENT doctor (ear, nose and throat specialist) for examination and treatment as surgical intervention may be required to treat it. In the meantime, you can take tablet Paracetamol, antibiotics (preferably broad spectrum) and have adequate fluid orally. Do warm saline gargle at least two to three times a 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 had braces years ago due to my bite being the wrong way round. I then have had retainers to wear at night for a few years. I think the retainers are giving me ulcers. I want to stop wearing them. Will my bite go back the wrong way if I do not wear them? ### Response: Hi. Yes, your bite may go back to a previous alignment if you will not wear retainers properly. This will cause your whole treatment to relapse and it would be bad. Things you can do is you can put some oral gel at ulcer in the daytime and at least wear for 2 to 3 hours for a week so that ulcer may heal up and then come back to 14 hours of wearing from the next week. If some wire is hurting you and creating ulcer, get it fixed from your dentist and then start wearing. If you cannot go to dentist urgently chew some chewing gum and put it on the point where it is causing the ulcer and wear it. Or you may put a tiny piece of moldable wax too at that point. It will not hurt that bad then and you can wear it. But do wear it somehow. Stay happy and blessed." "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 slight shiny red blister or sore on the side of my shaft. I get occasionally some white discharge and a smell from it. There is no pain. What can be the diagnosis? ### Response: I have viewed the image (attachment removed to protect patient identity). Is there any recent history of intake 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: I am 64 years old and I just had my first prostate biopsy. Out of 10 samples, only one contained cancer. Gleason 6 (3+3). DRE normal. PSA 4.4. PSA has gone up and down over four years with 4.5 the highest, 3.75 lowest. Recent 4K score 9%. Recent PCA3 17%. I was relieved with biopsy, but urologist wants to do a follow-up MRI to rule out any hidden cancers.Why did not he do this before biopsy? Is this insurance related? By the way, my prostate measured 60 grams. I am an active healthy guy. I take Simvastatin for cholesterol and Losartan 100 mg for blood pressure. I just want your advice on why MRI is indicated. ### Response: Hello. If no foci then you do not require anything at present just follow up with PSA (prostate-specific antigen). If there are other foci which are malignant then you may require surgery depending on the stage of disease and hence MRI. MRI can be done pre or post biopsy. If your biopsy had shown aggressive tumor then MRI could have been avoided and you would have required surgery directly. So, he did not do an MRI before. So it is better for you to undergo MRI as you require active surveillance." "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 extremely emotional. I cannot control my feelings and always feel like a victim. How can I be more responsible and in control without constantly feeling hurt? ### Response: Hi. First of all, I appreciate you for your strength to be able to recognize your own nonhelpful thoughts and behavior. It takes a lot of courage. Self-victimization often is seen with people who have had a childhood in a nonnurturing or dysfunctional family. It can also be a part of a personality disorder, what you can do is find a therapist, a counselor and start taking sessions so you can work on your impulsivity and the therapist will further help you recognize your subconscious thought patterns leading you to behave and feel this way. You can find a counselor in your city or there are many online sites providing the facility. If you cannot do that either, start with journaling, keep a mood journal and start writing what happened and what made you feel bad or when you reacted in a wrong way, what went through your mind. If you do this regularly, you will be able to recognize patterns in your behavior and situation which is your triggers, which you can avoid." "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 26 years old and delivered my baby four months ago. I feel very stressed out nowadays. After my delivery, I started hating my post-pregnancy body. My baby is four months old and I have not lost even half kg. I am trying to lose my weight but nothing is working. ### Response: Pregnancy and motherhood involve changes in both body and mind for a woman. Be proud of it. It is too early to think of weight loss, especially when you are feeding your baby. Give some time for your body to come back to normalcy. A healthy, balanced diet and mild exercise are important to ensure the well being of both of you. Do not go for crash diet or strenuous exercise now as it can weaken your body. Enjoy your motherhood to its fullest. You can review with me for regular follow up." "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 PCOS. I want to know what happens to all these unreleased follicle eggs on ovaries? Why I have spotting after the period? And how can Yasmin help me? If it prevents ovulation so the number of follicle eggs would increase? What are the side effects once I get off Yasmin pills? Can you answer me with an explanation, please? ### Response: Hello. The unreleased follicles are multiple and tiny and small as the follicular phase is very long. FSH hormone is very high. They are all unripe and immature but one of them grows till ovulation (takes a long time in PCOS patients) and other undergo apoptosis, that is get dissolved. Some women experience spotting at the time of ovulation but not necessarily it could be due to ovulation. It could be mainly because of hormonal imbalances. I myself prescribe Yasmin to PCOS patients and works wonderfully as it is a low dose hormonal pill. It regularizes the menstrual cycle, the follicular phase becomes 14 days and luteal phase becomes 14 days, periods come on the exact date. It has Estrogen and Progesterone component which is active and it mimics like normal body rhythm (how it normally should be) unlike what imbalances happens in PCOS and corrects them. Spotting does not occur. The number of follicles do not increase even if it inhibits ovulation by a complex mechanism but the follicular phase which is very long in PCOS patients gets corrected thereby leading to normal FSH levels. Side effects on stopping Yasmin are again irregular or delayed periods and hirsutism may increase as male hormone an" "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 with my partner last month, after the third day of my periods. There was no intercourse and also we used condoms. My period date was 2nd of this month but did not get my period. Then I consumed Primolut N for three days thrice daily. Today is the 8th day after the last dose. I have back pain, cramps, and also abdominal pain. I also ate papaya this week. I also did a home pregnancy test but the results are negative. But I do not understand why periods are not coming. I am very tensed. Is there any chance to get pregnant? Please help. ### Response: If you had sex on the third day of menses then there is no chance of pregnancy. Periods can be delayed due to stress. And even due to taking Primolut N. You need to wait for five more days. I think the period should come in these five days. Do not worry as the pregnancy test is also negative." "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 27-year-old male. My weight is 255 lb, and I am a smoker. I suffer from panic attack, anxiety, and fear of cancer for six years. Right now I have been spending all my day reading about brain tumor because I think I have it since I have all the symptoms.Two weeks ago I had a panic attack where I felt I could not breathe, and feeling fainting. After that day, my ears started hurting a little bit, and I started feeling lightheaded, which is very hard to explain. My head feels like I am drunk but it is not spinning. I have not slept for days.I had this problem before when I had anxiety issues, and I went in urgent care, where they checked my ear and I did not have ear infection. The doctor said your neck muscle feels irritated and sore. He said it could be due to it or allergies. And he prescribed me nasal spray to use, but when I used that, I experience terrible headache with neck pain.After two days, I had the feeling that I am about to pass out again, so I decided to go in the ER. I told the doctor I need MRI and may have a brain tumor, and she said I could not do MRI on you without doing a blood test, ECG, and some tests where she makes me walk in a straight line and, etc. My blood test and ECG came back 100 % good. My doctor said there is no need for an MRI. I doubt that how she knows I do not have brain cancer?She gave me some pills for allergies, but I am not taking it because I think I have a brain tumor. I am a painter, and I paint houses, and I work 14 hours a day. I do not feel any tiredness just this feeling in my head is killing me. Do I have a brain tumor and am I going to die within a year? I do not have a loss of appetite or anything, and I am just really thinking that I have a brain tumor. What do you think my problem is? ### Response: Hello. Possibly you are very anxious with thoughts of having a brain tumor. It may be part and parcel of your previous anxiety problem, which might have increased recently. I suggest you consultant a psychiatrist for anxiety issues. For relieving your current thoughts and anxiety, you can get an MRI brain. Otherwise, your thoughts will keep on making you restless. The doctor might have said of not having a tumor because you do not have a different kind of symptom. Still, you can get MRI done, to relieve these thoughts. But for further management, you should meet a psychiatrist. T3, T4, TSH, serum vitamin B12. Anxiety disorder. Daily exercises in form of jogging and yoga." "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 57 years old male. I am facing weakness and high fever and body pain symptoms for a while now. Upon doing some routine tests with a local clinic, the test values are as below:RBC count- 5.48.Hemoglobin- 8.16.Hematocrit- 28.9.MCV- 52.71.MCH- 14.88.MCHC- 28.24.RC distribution width- 13.01.Total WBC- 3.18.Neutrophils- 29.1.Lymphocytes- 55.43.Eosiniphilis- 0.4.Monocytes- 13.66.Basophils- 1.4.Platelet - 405.MPV- 6.86.What do the above values signify? In addition to this, my iron is 18.22 and my TIBC is 300.72, ferritin is 213.00. Had colon surgery for colitis nine years back. Currently, I am taking Panadol, Ferroglobin. ### Response: Fever, weakness, and lymphocytosis in CBC are suggestive of viral infection. Your physical examination should be done first that includes lymph nodes, spleen, liver palpation, auscultation, etc. Investigate with peripheral smear examination report as well. According to the physical examination, if needed, the doctor will suggest doing further investigation. If a sore throat, abdominal pain or any other specific symptoms present then inform about that. After recovery from fever, iron tablets needed to recover from anemia. Provide peripheral smear examination report once done. Consult a physician for 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: My wife is three months pregnant, so we went for a scan to check for Down\s syndrome and the baby\s brain growth. I have attached the scan report. Please suggest if everything is fine, as we did not see our normal doctor. ### Response: Nice to hear from you. I have seen the scan report (attachment removed to protect patient identity). The scan is absolutely fine. Hope I have clarified your query, do write back." "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 (55 years) got sugar results fasting 172, and pp 136. What can be the explanation (higher fasting value)? What treatment course to be followed? ### Response: Hello. I just read your query about your wife and it seems that she has an impaired fasting blood sugar and that she must have her HbA1c checked to be sure whether she has a need to take medications for diabetes or not. Exercise by way of walking for 30 minutes daily. Impaired fasting glucose means that she can develop diabetes in the near future if she is not already diabetic." "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 two milk teeth in my mouth in the upper part. There are two adult teeth on top of that as visible from the x-ray. I wanted to know if I start the procedure now, how long it takes to pull the two adult teeth down and remove the baby teeth? ### Response: There are retained teeth and impacted permanent canines (attachment removed to protect patient identity). As your age is concerned, it is a complicated procedure to move them orthodontically after extraction. Still, I think you consult an orthodontist that will decide the treatment plan. Usually, it will take one year or more to move them to the desired location after milk teeth are extracted, followed by the orthodontic procedure." "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 17 years old and I usually suffer from chest pain, and burping after eating something or drinking. I do not know what is this, sometimes shortness of breath occurs for a short period of time. I am a little worried about this. When I searched this on google there were things like GERD, acid reflux, heart attack, and all. Can you please help me out with this problem? ### Response: Hi. I see you are worried about your chest pain. Do not worry, your symptoms particularly relating to food connects your chest pain to a gastric related problem. And it fits into GERD (gastroesophageal reflux disease) in which there will be acid reflux, which in turn causes pain due to intolerance of food pipe to the acid. GERD. Tablet Pantoprazole + Levosulpiride 1 tablet twice daily half an hour before food for two weeks, syrup Sucralfate + Oxetacaine 10 ml one hour before food three times a day for two weeks. Avoid spicy food. Avoid heavy meals. Do not lie down immediately after taking food." "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 diagnosed with chronic rhinitis by an ENT doctor. I cannot sleep at night and barely eat anymore because I cannot taste or smell anything. My nose is always stuffy. I tried Neti pot, sinus irrigator, herbs, and steam inhalation. I cannot seem to find anything that helps except steroids. I used Carticosteroid nasal spray and Methylprednisalone 4 mg, but those are terrible to keep using. I lost hope. What to do? ### Response: I understand your problem. It can be a bothersome problem in your case. If you could show me the findings of the nasal endoscopy it will be useful for me to make a decisive diagnosis. You may also do nasal odor tests to confirm the loss of sense of smell and let us know the results of the same. Nextly, the use of corticosteroid nasal sprays are not bad at all. They are very helpful in resolving nasal inflammation and accompanying rhinitis. You may use them as per your doctors advice, we also regularly advise patients to use those. As to using oral steroids, you do not use those continuously for a long duration. Also, try taking saline nasal sprays once a while." "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 sister is 16 years old and extremely worried about her breasts. There is no development in them at all, what so ever. There is no breast bump, they are the same size as they were when she was 5. She has had her period for two years and has pubic hair. What is wrong with her breasts? Could estrogen help in any way? It gets her down so much and it is all she can think about when she wakes up and when she goes to sleep. It makes her cry herself to sleep every single night and wake up wishing she had breasts. She feels horrible like this. She feels like a boy. Please help her. She is desperate. She went to a doctor but they were absolutely no help. ### Response: Hello. I just read your query and I can empathize with you. Sometimes, a girl\s breast can develop a bit later than most of the other girls her age. You said that she is 16 and got her periods two years ago. That means at the age of 14 years. So, it was later than most girls her age. So, naturally, her breast can grow later too. There is nothing to worry about. There are many options. Firstly, we have to know whether all her hormones are normal or not and treat accordingly. Secondly, we can always have a breast implant surgery if nothing works on the medical side. Ask her to eat a well-balanced diet. Stop worrying" "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 uncircumcised and never had sex. I masturbate three to four times a month. For about a week there is an issue which I think is inside my penis. It feels uncomfortable like a vein is swollen or hurt. There is mild irritation but nothing abnormal while urinating or masturbating. I have no clue what is the issue. I am unable to describe it I guess. It gives a very mild pain or rather I will say discomfort. It is annoying now, the same feeling every time like the vein got hurt or swollen. Please help. ### Response: If possible send me images so that I can see and suggest you properly. It might be because of violent masturbation. I suggest you to avoid masturbation for two weeks. I will give medicines after I see the images." "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 aged 72, weight 65 kg, is a diabetic type 2 for the past six years, hypertensive for the past two years, is suffering from moderate tricuspid regurgitation, aortic valve sclerosis, and pulmonary hypertension for the past two years. Her systolic function is good and there is no diastolic dysfunction.No drugs are prescribed for AS or TR. For hypertension, she was prescribed Telmisartan 40 one tablet per day with which her BP is about 145-150/90-85. Diabetes is under control. Other parameters are normal. Whether the present medication is adequate or she needs further medication such as Tadalafil to treat PAH. Any medication for TR? Please advise. ### Response: On the face of diabetes and hypertension with raised cholesterol and LDL, I suggest you add tablet Rosuvas (Rosuvastatin) one tablet daily after dinner. Consult your doctor. I think the dose of anti-diabetes medicine could be adjusted to reduce his blood sugar level to reduce further to near the desired level along with BP medicine dose to adjust to achieve BP around 130/80. Regarding PAH and other valvular diseases, your Cardiologists will decide after going through different parameters." "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 had unprotected sex and after that took an I-pill within an hour. After 6 to 7 days, she had spotting for 2 to 3 days. It is almost six days up. There is no clue for periods and she is also suffering from cramp, vomiting and nausea. But we have taken test for almost four times. It is always negative. ### Response: I can understand your concern. As she took emergency contraceptive pill within one hour, the possibility of pregnancy is less. As she disturbed natural cycle by taking pill, now it may some time for regularization of cycles. And next period may come after one month of spotting. Cramps, nausea may be due to some other causes like infection either vaginal or gastric, renal related, etc. Clinical examination and ultrasound will help in finding out the possible cause of the problem and treatment can be taken accordingly." "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 on 0.5 mg Xanax for one month. As per my psychiatrist, I went cold turkey from the dose. After eight days I started having mild hallucinations such as a knock on the door, smells, and visual disturbances. I went back to 0.25 mg (on day 10). Will the hallucinations stop if I continue on the 0.25 mg and how slow of a taper should I do from 0.25 mg? I am sensitive to medication changes. I am on Lexapro 10 mg and Trazadone 150 mg. ### Response: Hello. I can understand your concern related to Xanax (Alprazolam). Usually, Xanax has a half-life of around 12 hours and is fully eliminated from the body in about four days. Thankfully, you have only been on a lower dose of Xanax 0.5 mg for a month. So there is a less chance of dependence and 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 21 years old. Last month, I was experiencing some ringing sounds in my ears, with dizziness. It triggered my health anxiety. I convinced myself that I have MS. Now after a month, my dizziness is gone. But I have new symptoms like joints making crackling sounds (especially in my hips and shoulders). My arms and calf muscles are tight sometimes, and they hurt a lot. My hips make a loud popping sound sometimes which I have never heard it before. If I swing my leg in a circular motion, it makes a loud pop. It causes my whole body to vibrate. I am panic, and I am afraid of going to the doctor. Currently, I am taking Magnesium 200 mg daily. ### Response: Hi. You are suffering from generalized anxiety disorder. Your joint symptoms may occur due to vitamin D deficiency. I suggest you do a blood vitamin D level and a complete blood count. Multiple sclerosis does not happen with joint symptoms. It is a disease though commonly seen in young females, often manifest with limb weakness and cramping in one of the limbs. Multiple sclerosis can present with vertigo in case of brainstem involvement. But, it seems to be a remote possibility in your case. I suggest you take an anxiolytic for your symptoms. If the vitamin D level is found to be low, you may need a vitamin D supplementation." "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 taking 100 mg of Zoloft for a number of years. On 14th, my doctor added another 50 mg which I take at bedtime. For the past few days, I have been experiencing severe insomnia and can rarely sleep for more than an hour at a time. In addition, I have begun taking 25 mg of Seroquel three times a day. Could the increase in Zoloft three weeks ago be causing this recent bout of insomnia? If yes, how long after my doctor returns to the old dosage before this side effect diminishes? ### Response: The increase of the dose of Zoloft (Sertraline) can cause sleep problem, as you are facing currently. To manage this, you can change the time from night to morning or afternoon. If you altogether stop night doses of Zoloft (return back to 100 mg per day), then this sleep issue will me resolve within four to five days. Another way to manage sleep is to take Seroquel (Quetiapine) 25 mg in morning and 50 mg at night time. By this, your sleep will be normal as Seroquel has sedative property. Try to manage adequate sleep hygiene, like do not sleep during daytime, no coffee after 5 PM, no alcohol, etc" "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 abscess in my gums. I went to the hospital yesterday and they prescribed me 500 mg Penicillin to be taken four times a day. I started the Penicillin at 10 AM yesterday. The abscess has caused my face to swell. Overnight, the swelling has spread to the area around my eye. I do not have any pain unless I poke around at my cheek. I can still see out of the eye, but it is uncomfortable. I am, however, extremely scared by the swelling around my eye and was wondering if I should return to the hospital and possibly inquire about an IV antibiotic or should I just wait it out with the oral antibiotic? ### Response: Hello. You also need to consult a dentist as soon as possible, and the tooth should either undergo a root canal treatment or extraction, depending on the condition of the tooth. Hope this helps. Regards" "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 16-year-old daughter is having inflammation of skin behind her inner tooth, the last one may be wisdom tooth. She has intense pain and is not able to move her jaw properly while eating food. This started two days ago. She had vomiting and stomach pain three days back. She was having allopathy medicines for that which she has now completed. She now has acidity problems. Kindly advice medicines. I have attached photos for your reference. ### Response: Hello. I have gone through the attachments (attachment removed to protect patient identity). Yes, it looks like inflammation of the gum flap.over the wisdom tooth. This condition is known as pericoronitis.The wisdom tooth, however, looks misaligned and impacted but for confirmation, an X-ray should be done.I can also see an abscess over the mucosa." "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 doing a frozen embryo transfer cycle, is it absolutely necessary to use progesterone in oil shots or will the suppositories work the same? ### Response: Hello. How are you doing? Hope I have clarified your query. Do write back. All the best" "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 28 years old and suffering from facet hypertrophy. I have continuous lower back pain. I cannot stand for more than five minutes. I am taking Nuroday daily. I would like to know the treatment. ### Response: Degenerative disc disease. MRI spine and x-rays of the affected part of spine. Revert back with the reports to an orthopaedician and traumatologist 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: This question is about my 36-year-old brother. He was having a fever on and off since one month and lower back ache since last three days. We did his NCCT KUB to rule out stone but the radiologist saw pleural effusion and did a contrast CT abdomen and chest. The radiologist said it is suggestive of TB. Please look at the report and guide us. Also, tell if chances of lymphoma or any cancer. ### Response: Hi. Sorry to hear about your brother\s symptoms. I have checked the attached reports thoroughly (attachment removed to protect patient identity), the pleural effusion and the enlarged lymph nodes could be due to many causes, although TB is the most likely diagnosis. In order to confirm the diagnosis, we need to take a sample from this effusion and analyze it. Analysing the morning phlegm for TB bacteria is required. In case the diagnosis is confirmed, a combination of antibiotics is required for six months. In case the effusion increased and causes shortness of breath, removal of the fluid by a needle will be required. Lymphoma could be the cause, but less likely. Analysis of the effusion will confirm the diagnosis" "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: Today, my hand is tingly off and on. It is my entire hand, but it especially seems to affect my pinky finger. My other hand does not have this issue, and it does not affect any other part of my body. The tingling feeling has come and gone for two hours. Is there any way for me to tell if it is serious or not? ### Response: Hello. I went through your post. Tingling sensation in any part is due to nerve irritation supplying the area. However, none is serious and can be managed easily. So, no need to worry. You should check your vitamin D level and B12 level. These deficiencies can also cause tingling." "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: Recently, I did a series of blood tests to check my pre-existing G6PD deficiency. The results showed low G6PD levels of 0.4 units/gram of hemoglobin. I have read that anything below 10 % of the normal range can cause hemolytic anemia. Please suggest. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). But clinical correlation is needed in your case. I suggest you investigate with CBC, reticulocyte count estimation, and peripheral smear examination to check whether there is a presence of hemolysis or not. If there is no hemolytic episode, then there is no need to worry. In G6PD deficiency, you have to be alert when you have typhoid and pneumonia. It can lead to oxidative damage and can result in hemolysis." "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 I play football again after retinal tear? It has been seven months after eye laser and I have been great, no more flashing lights for few months and no vision problems. ### Response: I, unfortunately, have to say no. The fact that you have had a retinal tear which had to be treated by laser tells me that you are at future risk of another tear. The tear by itself can progress to retinal detachment and can permanently decrease the visual acuity of your eye even after treatment. Please avoid all contact sports and attend follow-ups as instructed by your ophthalmologist. Anomalous PVD (posterior vitreous detachment). 1. Indirect ophthalmoscopy. 2. B-scan ultrasound. 1. Retinal hole. 2. Retinal degeneration. Retinal tear post laser. Observation. Avoid contact sports.-" "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: Which toothpowder or toothpaste do you people prefer for a yellowish teeth to make them white. I am using Patanjali toothpowder this time and I have done scaling also. ### Response: Using toothpowder is not good for teeth as toothpowder contains a higher amount of abrasives and will abrade your teeth. When teeth get more and more abraded it gets more yellower day by day due to loss of enamel and exposure of dentin, which is more yellowish than enamel. Colgate toothpaste is enough for normal brushing two times a day, along with scaling every six months if possible. Slight yellowish teeth are normal. Do not use mouthwashes and toothpowder and strong toothpaste like Sensodyne or Sensodent." "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: ### Response: Hope this report finds you in good health. Based on your query, my opinion is as follows: In the report (attachment removed to protect patient identity), there is no mention of an encapsulation. Usually in classical papillary carcinoma as you had, there is no capsule often seen. Only in follicular variant of papillary carcinoma, capsule is commonly described. At present, there is no need to worry about capsule. Only in follicular carcinoma, we are worried about capsular breach or invasion. In classical papillary carcinoma, we do not bother about capsule." "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 clotted blood whenever I go for cleaning the nose from the last few days. After every four hours, my nose is choking. ### Response: Use Solspre nasal spray (Sodium chloride) two to three puffs every few hours. These days due to weather change and pollution, extreme" "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 28 years old, and I am suffering from blood pressure and high cholesterol. I am taking Telvas H 40 and Rozustat daily. I am taking two garlic cloves with warm water. Yesterday, when I checked my BP, it was 140/70 mmHg. Is it normal or high? ### Response: It is a borderline reading, and you need to check it frequently. Have a low salt diet and monitor your blood pressure regularly thrice a day for one week. Then follow it once or twice a week. If the BP (blood pressure) is persistently more than 140/90 mmHg, then the medicines have to be hiked. Do regular exercises like brisk walking, jogging according to your capacity at least 30 minutes a day and five days a week." "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 30 years old female. I have tiny red spots on the uvula. I can see a small vertical bulge behind my uvula on the pharyngeal wall. I am very concerned. What could be the bulge? ### Response: Hi. The picture is not clear (attachment removed to protect patient identity). This bulge can be enlarged adenoid" "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 suffering from jaw pain and stiffness for a while now which can sometimes result in a headache and pain in the ears. I also can hear my jaws pop when I open my mouth wide. I visited a dentist regarding this issue and after an X-ray, it was concluded that I have a dislocated TMJ. However, the dentist said that I will most probably always be able to not open my mouth too wide and my jaws will almost always pop despite medication and physiotherapy. I have a hard time believing that this is incurable. Is my dentist right to say that it cannot be cured? ### Response: Hi. There is always a cause associated with it, that can be one of the following: In case you have one of the above-mentioned conditions associated or night clinching of teeth, you will be cured. Your doctor may be wrong. TMJ-associated conditions can be treated and managed with better prognosis." "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 35 years old lady having horrible pain in my anus while passing motion. It is intolerable. I am applying Anovate cream but still, it is not helping. Please advice. ### Response: Hi. I have read your problem carefully. Though history is incomplete, I think you are suffering probably from anal fissure. I need to know if there is any bleeding per rectum or anything coming out from the rectum during defecation. It occurs mostly in a female. The main cause behind it is chronic constipation (passing hard stool chronically). You need to follow the following: Taking adequate water, adequate vegetable, and fruits. Taking hip bath 3 to 4 times daily, warm water in a bowl, add 3 to 4 spoons of Betadine solution and sit on warm water for 10 minutes. Take stool softener, syrup Osmolax 3 to 4 spoon 3 to 4 times daily for 7 to 10 days. If not improved within 2 to 3 days, consult with a surgeon immediately." "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: Hey doctor how do you do? To be honest am not fine !! When we come to ma point i have a symptoms like going to toilet many times in a day and also farting much times in a day(over 100 times ). Am from poor family Once I tried in hospital but because of money I Can\t continued .It tooks many years and influenced me for isolation of social lifes even if from school.now i am a 2nd year university student and i have many ideas what i want to do but I can\t please help me !! ### Response: I am sorry to hear that you have been such distressful times. I really hope with the following advise your problem solve for rest of your life. Well you it is not uncommon to have fart and burping. Since these are the normal.process of body of emitting gases which are produced in the small bowel. However, excessive gases are produced in someone who have problem with two things. 1. The corbohydtates are the major compotent of our diet approx. 70% of diet we take it is corbohy" "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 15 months of unprotected sex, I went for HIV test called Comb AIDS test but, the result came back negative for both HIV-1 and 2. Again after three months, I redid the test, but even this time, the result was negative. I was not satisfied, so I went for ELISA test, and again the results came back negative. I consulted two general physicians, who told me that I do not have HIV. But, I am still worried because of the symptoms that I have. I am a male, who weighs 62 kg, and I am 6 feet tall.The symptoms i\m having are:severe weakness,ulcers in mouth and tongue,fatigue,pain in legs while sleeping,itching in the private part,occasional sore throat,occasional itching and pain in ears,and black spots on my back.I remember having loose motions after a week of unprotected sex. At that time, the doctor told me that I have food poisoning, and I was alright after taking medicines. Are these HIV tests done by me reliable? Was the loose motion caused due to HIV? Is it possible that my immune system was so weak to detect antibodies during my HIV test? Should I go for another test such as PCR RNA test? Please help me, I am worried. Your kind response will be appreciated. ### Response: Hi. The test kits used to diagnose HIV are highly sensitive and specific and gives accurate results. The majority of the people who are infected with HIV (human immunodeficiency virus) develop antibodies by three months, and even in the rare instances of late seroconversions, they develop HIV antibodies by six months. You can rely on your HIV screening test results. If there had been no other exposure other than that, you do not require any further test. The symptoms which you mentioned could be due to various reasons and cannot be attributed to HIV. In fact, there are no specific symptoms or signs which can lead to the diagnosis of HIV. As per the above information, you are HIV negative. Just relax. Hope your query is answered, but if you have any other query, please do not hesitate to ask or call anytime. Best wishes" "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 pain in my right side of the face between the temple and cheekbone. I am getting a stabbing pain when I press there. I am also suffering from sinus and taking Sinarest and antibiotic. What can I do? ### Response: Hi. Do you have a CT scan of your paranasal sinus (PNS)? If you have sinusitis, then you have to continue antibiotic and decongestant for at least a week. Chronic sinusitis has to be operated and acute can be cured with medicines. The pain between your temple and cheek is a very vague symptom. This pain cannot be due to maxillary sinusitis. Revert back with the report to 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: My whole body gets itchy after sex. Earlier it used to be random, but now it is almost every time. My face, neck, chest, legs, even hands, and arms are involved. I am 29 years old. ### Response: According to your statement, you are suffering from allergy just after sex. You did not mention here whether your partner uses condoms or not. You may be allergic to the condoms or any added ingredient like spermicide that you or your partner used. Although it is possible to be allergic to any type of condoms. Latex is the main common culprit. Between 1-6% people of your race are allergic or sensitive to latex like you. Again, spermicide are commonly used in gels, suppositories, and lubricants. Nonoxynol-9 is the most common active ingredient in spermicide is known to cause irritation or allergy to some people especially when used frequently. By using skin prick test, RAST test, etc, it can be determined which ingredient is responsible for your allergic reaction. Latex causing allergy will be subsided with one to four days. Your partner can use condoms of latex-free ingredients. You can also take anti-allergic medication too." "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: Today my mother-in-law was diagnosed with breast cancer stage 4. She is having a fracture in the hip bone for two days and was admitted in hospital for that. Later, it was diagnosed as cancer. They are planning to do surgery for fracture and after that chemotherapy. Now she is unable to walk or sit. Is there any risk in doing surgery at this stage 4 of cancer? What are the treatment for this stage? What is the prognosis? Please give us a reply. ### Response: Hi. She needs PET-CT whole body scan to establish the sites of metastasis involved all over the body. Breast cancer only with bone metastasis has a good prognosis. She needs six cycles of chemotherapy first and then reassessment. Surgery is indicated for spine or bone for fixation of fracture and local radiotherapy. Surgery or radiation for breast is not warranted at present. If the spread involves liver, lung or brain other than bone, then prognosis will be bad." "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 (aged 70) is suffering from coughing and light fever (varying between 99 to 101) for the past 10 days now. Medical tests (attached) do not seem to reveal anything, and the prescribed medicines (see below) do not improve things. Coughing is now also accompanied by wheezing sometimes, and is at the peak during the dawn hours and causes extreme difficulty in sleeping.Since my mother and I have a slight problem of asthma, is there any chance he might be suffering from the same? I have to take Asthalin/Foracort Rotacaps occasionally which immediately relieves the coughing. Would it be advisable for him to try Asthalin/Foracort when he faces wheezing?Any other suggestions/remedies?Do note that he takes regular medicines for maintaining his blood pressure: Olmax-AM and Prazopress-XL).Medicines taken so far:Five days:MoxClav-625 (1x2).Ebast DC (1x2).Ibugesic Plus (1x3).Zevit (1x1). Another two days:Imunocin (1x2).Esoga-RD (1x1).Syrup Cyp-L (1x3).Surbex XT (1x1).Ibugesic Plus (1x1).Syp Tossex DMR (1x1). ### Response: I have gone through the reports (attachment removed to protect patient identity). It appears to be bronchitis, likely viral. Has his fever settled now or still continuing? Wheezing and coughing may continue for some more days up to one to three weeks. Yes, he can and he should use the inhaler. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Initially, he should have MDI (metered dose inhaler) or Rotahaler Asthalin (Salbutamol/ Albuterol) two puffs or one Rotacap whenever needed, up to four to six times a day. If coughing and shortness of breath are not relieved then he should also have Foracort (Formoterol and Budesonide) two times a day. He should also have tablet Montair LC (Monteleukast and Levocetirizine) once a day at bedtime for 10 days. If there is no improvement in fever for another four to five days, then he should have chest X-ray to find out the other cause of his fever. Hope this helps you and get back if you have any doubts" "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 54-year-old mother has a problem with breathing. She faces challenges in breathing mostly in the summer and monsoon season. She is taking an inhaler for the last three years. Please help. ### Response: Hello. It seems your mother is having an airways disease probably asthma. It usually aggravates in monsoon seasons. She needs to follow certain precautions. She has to avoid aggravating factors like exposure to cold, foods and avoiding dust. Regards" "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 got one of my wisdom teeth taken out a week back. My stitches came out and now there is a big hole where the tooth was extracted. My dentist gave me nothing, not cleaning tools at all. I am just freaking out because their office is closed. What should I do about the giant hole? It hurts a lot. My breathe stinks and taste is bad as well. ### Response: You need to start taking antibiotics like Augmentin 625 mg and a painkiller. Also, use warm salt water gargling three times a day. Do not touch the area. And wait it out till you can see a dentist nearby. In such condition it takes time for full healing of the area, thus you have to be patient, get the wound cleaned and debrided by your dentist as soon as possible." "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 going to be 6 months next week and weighs about 6.54 Kg, birth weight was 3.03 Kg. Is weight fine? I am giving him Formula with room temperature unboiled water. Is that a problem? Can incorrect mixing of powder with room temperature water a problem for weight gain? He did not roll to tummy until now. He just moves clockwise when lying on the bed. ### Response: Hello. Weight for age is fine. Please use filtered and clean boiled water to avoid infections. Incorrect mixing will lead to improper concentration of the product and may cause either indigestion or reduced nutritional content of the Formula. Hence, always mix in concentration as per instruction of the Formula. It is alright for a 6-month-old child to start moving clockwise at this age." "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 back pain and after an examination with ultrasonography in the KUB region, a 2.8 mm calculus was found in the right kidney and a 2.6 mm calculus in the left. I consulted a urologist, who suggested further examination. I have attached the reports of the same. I have no other health issues except for high BP. The details of my blood report are shown in the medical prescription. Here, I would like to add that I had already gone through cystography to remove the stone from the left and right ureter on two different occasions. Now my questions are, is it curable without any surgery? Is there any health risk if I travel abroad in this condition? What is your suggestion to get rid of this problem? Do you think that surgery is required? Do I need further tests? My PSA is 1.69 and uric acid is 6.5. ### Response: I have gone through your history and your prescription (attachment removed to protect patient identity)" "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 20-year-old male. I have been using Melacare cream for four months, and I stopped using it for a few days. My face becomes so dull and dark in complexion. Now I am using Kojivit gel. Please advise me is kojivit gel safe? How to use it, and how many days it requires to cure the dull skin and become fairer again? Please give advice. ### Response: Hello. It is not meant for regular use. This cream is a prescription product and should never be used without dermatologist advice. Dermatologist commonly prescribes it for facial hyperpigmentation and melasma. However, it should never be used as a regular fairness cream and in any case, not for more than two to three months. Since the steroid content of this cream can cause various side effects like acne, photosensitivity, skin thinning, and telangiectasia and facial hair growth (hirsutism), which is especially troublesome in females. I would suggest that you use a broad-spectrum sunscreen throughout the day. At night you could use Glyco-A (glycolic acid cream) or Kojic (Kojic acid cream) to obtain the desired results of brighter complexion and even tone. You could also opt for a few peeling sessions from a dermatologist, e.g., yellow peel (Retinol CT peel) or glycolic peel or lactic acid peel." "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 is suffering from a bipolar disorder. When he gets annoyed, he makes a loud noise. I feel nervous about this. Why is this happening to me? This past month, I have had so much work to do and due to this, I have lack of sleep too. I am not on any supplements or vitamins. Kindly suggest me what should I do. ### Response: From what I can understand, you seem to be depressed because of two reasons. One reason is your father\s behavior and the other is your stress from work. People with bipolar disorder are hard to accept as their moods change a lot. This is because they are not on proper medications. Understanding your father will be very helpful in your situation. You need to exercise a lot" "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 18 years old female. I have got cut myself accidentally with broken glass from an old picture frame. I am concerned that I may contract tetanus. The cuts are minor. Currently, I am taking birth control medication and anxiety medication. ### Response: Hi. You have a cut from a glass of some frame. Hence, you have to clean the wound with an available antiseptic solution like Betadine or Dettol whichever is available. You can consult a general surgeon for the examination of the cut. To be on the safer side, you can get an injection of tetanus toxoid for developing immunity against 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: I am a 25-year-old woman. Three years ago, I had a root canal, and it fell out today now. It is a hole, and the tooth around the gums do I need to get it looked at also is there anything I can do at home to make sure nothing gets infected inside of the hole. ### Response: Yes, you need to get that remaining part called root stump extracted. There must be a hole in which chances of food lodgement are there. After you get it extracted, you will have two options after wound healing, and you can either go for an implant or a prosthodontic bridge. So no point keeping the root only. Do revert back for more queries." "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 cervical pain radiating to the right shoulder, neck, and arm until fingers. I have this problem for the past eight months and I am currently on medications for diabetics. ### Response: Hello. The symptoms that you have described point towards cervical disc issues with a small disc and bone (osteophyte) that is irritating to the right-sided nerve at C5-6 level as mentioned in the MRI reports. Usually, such cases heal within 6-8 weeks. On and off pain is common. But persistent pain in the arm and hand is nagging and decreases productivity especially if it is a dominant hand. We need to take MRI films to interpret the severity of the disc problem, know the handedness, know the exact location of the pain and if associated with tingling or numbness, and any weakness in the hand or arm. Until then do warm water fomentation. Apply pain killer gel locally over the neck and arm. Avoid lifting weights or jerks to the neck, and avoid bad roads." "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 thyroid problems for the past five to six years. At present, I am taking tablet Thyronorm 25 mcg. For the past one month, I have low energy levels along with stiffness and pain in the muscles, especially in the upper back and neck. So I got my blood tested for vitamin D and thyroid profile. The results are attached. TSH is out of range, and vitamin D seems to be very low. ### Response: Hi. I went through your reports (attachment removed to protect patient identity). I have noticed that your TSH (thyroid stimulating hormone) level is very high. It indicates that your thyroid hormones levels are not in the sufficient range. Hence, we need to increase the dose of Thyronorm. I recommend you to take tablet Thyronorm 50 mcg (Thyroxine) every morning in the empty stomach daily. Also, your vitamin D levels are also low. I recommend you to start taking Vitamin D supplements. Take capsule D-Rise 60K (Vitamin D3) one tablet weekly once for three months. Once your thyroid and vitamin levels get normalized, your low energy levels and muscle stiffness will get relieved. Repeat TSH after two months." "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 concerned because I have a growth on the corner of my eye that you can see when you pull my eyelid to the side. It has been there for a long time. I do not even remember the first time I noticed it. It is a pinkish color. It does not move with my eye so it does not seem like it is attached. I also have been getting a lot of floaters. It has been there for at least six to seven years. ### Response: The swelling that I can see in the photo of yours (attachment removed to protect patient identity) can be one of the two things: Given that it has been there with you for seven years, tells me that it is a benign swelling. You will need to see a doctor about the swelling if: Regarding the floaters, I suggest you see a doctor as soon as you can. They are suggestive of posterior segment disorders and will need to be examined after dilating your pupils" "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 red, scaly patches all over my body. I consulted a doctor and he said it as Pityriasis rosea. I took treatment for a month, but I guess they are enlarged. Now, I have completely stopped medicines. I took Averzine 25, L-Cet 5 mg, applied Propynate, Clobivax and Galderma. Another doctor says that I need to do a skin test to confirm psoriasis. I have attached the prescription here and the test is yet to take. Right now, I am applying an ayurveda cream Sorion topical and taking ayurveda medicines. I have also attached my recent blood test report. Please suggest any medications and right action. ### Response: Hi. I have gone through your investigation reports and they are normal (attachment removed to protect patient identity). I have seen your images and it is psoriasis only. Yes, a skin biopsy should be done to have documentation for the future. It is a very small procedure. The small skin sample will be taken from the lesion. Your dermatologist prescribed Methotrexate and it is a test dose given to you. Subsequently, if needed the dose of Methotrexate will be increased depending on your response. You have started on the right treatment. Along with oral the topical medications given to you will help. Also, narrow band UVB therapy (ultraviolet B) called as phototherapy works well in case of psoriasis. If your doctor has this facility, then ask him when you visit next time. Because, it will take time to resolve only with medication." "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 helped my cousin move and I hurt my back now. My left leg hurts by the knee and I feel a pressure on my chest, those hurt more than my back does. ### Response: Can you be more precise about where exactly does it pain? And what is the nature of the pain? If this pain is dull aching in the knee then should be muscular. Because heavy work most of the muscle lands in DOMS and the pain arrives. Regarding pain in the chest, it should be muscle catch as many times muscles are not flexible at certain regions and so does the catch happen. Use hot water fermentation over the painful areas like the chest, knee, and lower back. After two days, you can try doing simple exercises. Like breathing exercises for the chest muscles, leg raise for the core muscles and knee press for knee muscle strengthening. Heavyweight lifting. Muscle spasm. Exercise." "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 18 year old male. I am 5 feet 5 inches tall and weigh 46 kg. I have been masturbating for the past 6 years and now I am sick. If I masturbate now for 5 to 6 times per month then I get jaundice. I have this problem since 3 years. I am suffering from night fall. Sometimes, it happens 3 times a week sometime 2 and 1. I cannot control my ejaculation. It happens within 30 second or less than a minute. I ejaculate 3 times in a day. Sometimes, semen also comes out in urine. Before I used to masturbate 4 times a week, but now for past two years I masturbate 2 times sometimes 3 times. These days I had little pain in my penis. I use both hand and pillow to masturbate. I also watch porn videos. Before I used to watch a lot, but from now I had minimized it. Nearly five months, I have been facing lots of health issues like jaundice, loss of appetite, weight loss, stomach problem, pneumonia and weakness. I have taken treatment for these, but jaundice is not getting cured. Now, I am suffering from pneumonia and under treatment.Before 6 years or before masturbation I had no history of health issues. But after masturbation life is like a hell. Before I was addicted to masturbation, but now I am trying to control. When I masturbate then the day after pimples comes out in my face but from 1 year it has started to come on my chest and back. I search in the internet that masturbation do not cause any harm and it is completely natural and safe. But, this is not working on me. So, please help me to get rid of these problems. I want to masturbate and do not want to quit. So, please give me a way so that I can masturbate and stay healthy. My penis size is 5 inch long and foreskin is completely out. I get easily erected. I have attached the pictures of my penis. I am not very comfortable in sharing this, hence not discussed with anyone. ### Response: Hello. I read your query and understand your concerns. Revert back with the investigation reports to 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 have been having tiny random muscle twitching all over my body which seems like a constant thing at bottom of my feet, in both legs, both forearms, and even my stomach for almost two months now. I am scared of ALS diagnosis. I do not have any muscle weaknesses or balancing problems. I can lift 40 lbs dumbells with no problem and still do push-ups and other exercises with no problems and sprint and run without falling or tripping.I have had some sort of issue for almost a year where it feels like I am not getting a satisfying breath from time to time so I bought a spo2 meter and my O2 level fluctuates between 95%-98% with an average of 97% most of the time.I am just freaking out because everything I search for comes back to ALS. I even watched a similar story last night and I had a panic attack afterward. I guess I am just looking for a little reassurance to calm down. ### Response: Hello. I read carefully your question and would explain that your symptoms do not seem to be related to ALS (amyotrophic lateral sclerosis). As long as there is no progression, no weakness, no muscle wasting, there is no reason to panic about ALS. I would recommend performing some tests: 1. Thyroid hormone levels. 2. Blood electrolytes. 3. Vitamin B12 and vitamin D plasma levels. 4. Complete blood count, PCR (polymerase chain reaction), ESR (erythrocyte sedimentation rate) for inflammation. Nerve conduction studies would help to completely exclude ALS and thus put your mind to peace. I recommend discussing with your doctor on the above tests. 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 a 70 year old male. I just moved to a new area and found a new ophthalmologist, and he said my optic disc was smaller than normal, and he recommended a visual field test, to get a baseline, should it be needed for the future. I called my ophthalmologist for the previous two decades, and he said he never bothered to look at my optic disc. From what I can find on the internet, a field vision test is used to check the progression of glaucoma, among other things, but not to diagnose it. My new ophthalmologist gave a diagnosis of low tension glaucoma, stage unspecified. He did not start treating me for it. When I questioned the diagnosis, he explained that the visual field test is the only way to diagnose it. I hate testing for the sake of testing. I am finding some articles on the internet that support the idea that a field vision test can be overused and a waste of time for a variety of reasons, including the management of glaucoma. My peripheral vision, as best I can tell is fine. I can certainly look straight ahead, cover one eye and see an object at 90 degrees. The doctor did no vision testing in his office. He only saw what he thought was a smaller than normal optic disc. He admitted this could be perfectly normal for me. My manual and online computer tests show no loss of peripheral vision. Do I really need this test? ### Response: The spectrum of the disc and the cup size is hugely variable in people. The size of the optic disc is not the only determining factor. The size of the cup, average rim size and pattern, nerve fiber pattern, and intraocular pressure, are together taken into consideration before conclusively making a diagnosis of glaucoma." "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 met a guy. I decided not to have sex as I do not know him. He gave me protected oral (blow job) with a condom. Also, I fingured his anus two minutes with vaseline by putting nitrile gloves. That is all and he also sucked my nipples. We did not have anal sex. There was little masturbation before oral. But it has been a week and I am having diarrhea. I am very scared. Do you think I got exposed to HIV? Please help. I never did anal sex due to fear of HIV. Please help. ### Response: Hi. It is unlikely to acquire HIV without exchange of body fluids. In your case, masturbation and oral sex have very minimal chance for such. Your diarrhea could be due to other infections" "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 32-year-old software engineer. My lens power in the right eye is -1.75 and left eye is -1.25. I use computer around 12 hours a day and all day I sit under a fan. From a couple of months, my eyes are dry. From past three months, daily I am taking one omega-3 tablet, which is making things little better. I am using Refresh Tears three times a day, but the effect stays for less time. Should I use any gel instead of Refresh tears which effect might stay longer? At the outer corner of my eyelid at nights, I can find something sticky which is making the eyes uncomfortable. These sticky things appear at the end of the day. The main issues are as follows:Dry eyes.Sticky at the outer end of eyelids.Eye irritation.Kindly let me know what needs to be done to overcome these three issues. I request suggestion on two of the following things:Thin fully loaded with blue-cut lens and features are protect eyes from blue rays from phones, premium anti-glare, UV 4000 protection. If I use this lens does it help my eyes?Moist Acuvue. Features are water content 58 %, the lens material is etafilcon A, extremely soft and comfortable and lacreon technology involved. If I use contact lens instead of the lens would it help the eyes in any way?Do you recommend lens or contact lens? Awaiting for your reply at the earliest. ### Response: I recommend you to use spectacle only. Antiglare, blue cut glasses help you on computer screen work to some extent. It will help to relieve from UV light from LED lights. If" "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 mom is suffering from skin disease for the last two months on her palms and bottom part of her legs. She has an itchy feel from inside and usually her hands are getting tight and dry. The upper layer of her palm skin is coming out in patches. Please guide me with the pictures attached. ### Response: Hi. I have seen the pictures (attachment removed to protect patient identity) and the given history of your mother. Certain general measures have to be followed such as:" "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 weighs 71 kg and I am 6.3 feet tall. My TSH was 0.35, and six months later it is 0.73. T3 is 4.9 and T4 is 14.4, which is steady and normal. As I understand it, with low TSH and normal T3 and T4, I am subclinical hyperthyroid, right? My symptoms are anxiety, sweating, weight loss, recurring infections, forgetfulness, really dark and red circles under my eyes. My mother and a great aunt had Graves\ disease, I also have a family history of hyperparathyroidism. Any advice is most welcome. ### Response: Yes, you are right about that, you have subclinical hyperthyroidism. Hope you find my advice of some benefit. Good luck" "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 cold sore, and I put Zovirax on, and a few hours later, it is tingly. My cold sore has blistered and fully formed is the tingly feeling meaning it is going away? ### Response: Hello. I have gone through your history, and according to me, you are suffering from herpes virus infection. Most of the patients experience a tingling sensation before the appearance of blisters, but this is soon followed by painful ulceration. This lasts for 7 to 10 days. You have mentioned the application of Zovirax cream on the cold sore, but that is not very effective. Instead, you should take tablet Acyclovir 400 mg three times a day for five days. I would recommend you to send me your photographs as I would like to confirm the diagnosis." "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 a routine checkup done. Please check the attached reports, and let me know if everything is fine. ### Response: I had seen your report (attachment removed to protect patient identity). Hope your concern is solved. Consult your physician for examination and prescription" "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 ago, I was suffering from UTI and followed by vaginal dryness. Right now, I feel occasional sharp pain in my vagina, which subsides after a while. Also, I am getting pain during intercourse. I wanted to know the ways to treat this vaginal dryness. I had urine and culture test for UTI. ### Response: Hi. Pain can be due to cystitis or recurrence of UTI (urinary tract infection). It indicates inadequate exposure to estrogen (hormone), which can be due to many causes." "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 got some red patches on my buttocks, penis, and scrotum. It is too itchy. I consulted a doctor and he diagnosed it as scabies and advised to use Lindane Lotion. I used it for three days but the redness has not gone. The itchiness has reduced but not gone completely. My doctor is currently out of city. Can you suggest me what should I do? ### Response: Hello. Yes, it is nodular scabies. Now do not apply Lindane lotion. Consider the application of Flutibact cream twice daily for seven days. (Fluticasone and Mupirocin). Tablet Levocetirizine 10 mg at bedtime. It takes time for nodular lesions (inflammation) to subside. For future reference, if one has scabies consider a single application of Permethrin 5 % cream below the neck overnight. Do not use it 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 had sex on the first day of my period which was on 28th two months ago. As it was unprotected, I took the morning after pill within 24 hours. My next period was expected on 28th last month but it has not come yet. I have also done home pregnancy tests three times - the first one after one week of missed period, and the rest two after one week of the first test. All came negative. It has been 42 days now. Should I take the Misoprostol kit? Please note my current medication: Medroxyprogesterone acetate 10 mg. ### Response: As the pregnancy test is negative, there is no need to consider Misoprostol kit at all. The delay can be a side effect of the morning after pill in itself which is quite common where the next one or two cycles are delayed or get regular. I believe you are already on 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: I dislocated my right ankle before 14 years and had an operation after one year. Ever since then I have a sheer sharp pain go up to my Achilles tendon lasting for 20 seconds. What causes it? Recently, it is getting worse and swelling has formed around the tendon and there is pain around the heel and tendon. I am having pain around the ankle joint as well. Sometimes, I cannot walk on it. It sometimes gets cold then, very warm with a tingling sensation. What could it be? ### Response: Hello. You appear to be suffering from Haglund deformity, which is otherwise called Achillestendo insertional tendonitis. It happens from overuse and consists of inflammation and swelling of the Achilles insertion. It is not related to your ankle injury earlier. Treatment usually is pain killers, anti-inflammatory, cold compresses, stretching exercises and sometimes use of a small heel in your shoe to relax. Your ankle pain is possibly due to arthritis resulting from the injury. The treatment depends on the age and the severity of the injury. If you are having pain in the front of the ankle, first you need to get an x-ray to study your ankle. Further treatment depends on the radiological findings and the severity of arthritis. Let me know when you get an x-ray 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 am quite allergic to dogs, cats, and pretty much anything with fur, which exacerbated my asthma, sneezing, and itchy eyes. I am hoping to get a job at home health, but many people have dogs and cats. Is there anything that could be done for me to enable to work in home health? Furthermore, my kids would love a little doggy at some point, if possible. ### Response: Is your allergy based on your assessment or has any allergy testing been done? The best way to prevent allergy is to avoid the requisite allergens altogether. We even suggest a change of profession and change of place to our patients. In that case, I feel you should not be wanting that job or the dog in your house. But before that, we can check for allergies either by skin prick testing or blood immunocap testing. Skin prick testing is more authentic and specific than blood testing." "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 dark line in my toenail for a long time, since I was a kid I realize that, but never came into my mind that could be dangerous. The same happened to my fingernail many years after I became an adult. I would like to know if it is something serious and should I care about it? ### Response: I have seen your query and examined your given picture. (attachment removed to protect patient identity). It seems you have developed melanonychia. The cause of this are many such as inflammatory nail diseases like lichen planus, racial, nevus in nailbed and rarely melanoma. You need to go for nail biopsy for confirmation." "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: Now I am six weeks pregnant. I had two miscarriages before. I have some spotting and brown discharge with clots seen continuous from the fifth week to now. Two days before I went for scanning and a perfect heartbeat was seen, no subchorionic hemorrhage was there. But still, small spotting and clots were seen. What is the reason for this? And will it affect the fetus? Any birth defects? Or any problems? Please answer. Will it end with miscarriage? I have one other doubt, that whether trisomy or other chromosomal abnormalities of the fetus can be identified? How to identify? And which stage of pregnancy it can identify? ### Response: Please take Progesterone supplements and adequate rest. If properly treated and taken good supplements, miscarriage will be prevented. Trisomy and chromosomal anomalies can be detected by 12 to 13 weeks and for the rest of the development details can be found on TIFFA scan (targetted imaging for fetal anomalies) around 20 weeks. However, if you have a doubt then get 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: I am a female in my 20s. I have been having obsessive worries, so please do not judge my rather paranoid concerns, since I cannot get them off my mind. A week ago, during a night out, I received a kiss on the cheek by a male stranger, and also gave him a kiss on his cheek. Initially, I was not alert because I thought the person was a friend of my friend\s, but later I realized that he was a total stranger, who was acting weird and asking everyone in the nightclub for a kiss on the cheek. For some reasons, I kept thinking that this weird person had some sort of contagious disease and was just desperate to pass the disease to as many people as possible. About three days later, I started having symptoms similar to those of a cold. I felt tired and had a runny nose. I stopped feeling tired after two days, but the runny nose has not completely stopped until today, which is four days later from the start of the symptoms. From my own knowledge and some researching, I learned that early HIV symptoms include flu-like symptoms. And although I did not have any a sore throat, fever or swollen lymph nodes, my runny nose has been worrying me and making me have thoughts that I may have contacted HIV from the weird stranger. From my memory, when he and I exchanged kisses on the cheek, his lips, and cheeks, as well as my lips and cheeks, did not have any open cuts or sores, so I have almost zero chance of HIV exposure. However, I cannot seem to put my mind at ease, as I have been having obsessive worries for about three days. Therefore, I want to seek consultation from a professional. Please give me some advice, so I can get some peace of mind. ### Response: Hello. As you have mentioned, there were no cuts in his and your lip, then 80 % problem is solved. Touch and light kiss do not transfer HIV. Saliva is their least chance of transmission, which is not known or does not have a reported case though. So, this is just a quick response, nothing else. The common cold is very common in your place. Do not worry. Take tablet Montek FX (Montelukast and Fexofenadine) one at night for three to five days. There is no HIV contamination" "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: Hello,I've been having symptoms for a long time now, about 6 years. Something constant that I feel is a \x80\x9cpressure\x80\x9d or imbalance on the upper left side of my body. I get brainfog frequently. Other symptoms come and go. Sometimes my upper rib feels tight when inhaling, sometimes I get dizzy and heart races/palpates. I've had some exams done recently and found out I have an inflamed supraspinatus tendon. Since that, Ive tried doing exercises and stretches but they haven\t helped that much. I've even tried palpating the tendon but it doesnt even feel tender. Recently I've tried doing some neck stretches and the next day my upper left shoulder went almost completely numb. One thing I feel I have to mention is before these symptoms starting appearing, I had an incident at the gym where I pushed too hard doing an exercise and something happened that my vision went dark and I had constant pain on shoulder/neck area for a few weeks.I apologize for the wall of text but I'm at a standstill. Whatever this is, it's keeping me from being able to function in everyday life. I'm currently a shell of my former self. ### Response: Hello, After going through the detail you provided, its clearly a symptom of jerk you felt at the gym while excercise. i advice you to stop doing any excercise related to shoulder or neck. take accelofenac paracetamol tablet twice a day fir 3 days and consult in person with any physiotherapist near you. you need personal attention and proper treatment. a physiotherapist will guide you during this time on how to perform excercise properly during pain and if needed he will apply IFT and ULTRASOUND to reduce pain and for relaxing muscles. stay safe." "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 jaundice for last one month. My current bilirubin is 3.1, SGPT 72.4, SGOT 45.8. Can I join the office after four days of bed rest? ### Response: Hello. To answer your question specifically, it is not advisable to go back to work. I have seen your LFT blood reports which are not elevated too high (attachment removed to protect patient identity). I would like to know if you had done any other blood test, urine test or ultrasound abdomen because in jaundice, it is important to treat the underlying cause for it. It might be due to alcohol consumption, smoking habits, liver disorders such as acute or chronic hepatitis, etc. Some complications of jaundice you have to be aware are anemia, bleeding, chronic hepatitis, etc. If you are not vaccinated for hepatitis B or C, please take those vaccines also. If you are taking any tablets for this jaundice, please continue it. If you have not seen any doctor so far, I would highly recommend you to see a doctor first. Try to avoid alcohol or smoking habits, if you are used to it at once. I would recommend you to undergo a further investigation to know the root cause for your abnormal LFT blood test. Alcohol, smoking, acute hepatitis. CBC, urine analysis routine, urine ketones, serum electrolytes, ultrasound abdomen, X-ray chest, and abdomen. Acute hepatitis, fatty liver. Acute hepatitis. I would suggest treatment after seeing the further blood tests advised. Avoid alcohol and smoking strictly. Try to follow up after doing the above investigation advised and list any complaints if you have." "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 gums near the area where the wisdom tooth should grow started feeling painful, but not much. Whenever I chew near that area, it would hurt. I thought of myself, it is probably because my wisdom tooth is coming out (as there was a sort of bulge where my wisdom tooth should come out). The next day, I noticed that the gums near the area where the wisdom tooth should grow started swelling around the tooth before it. And while looking into the mouth, I poked the swollen area accidentally, and pus came out of the swollen gums. What is that? Should I consult a dentist or just taking medicines is enough? If so, what medicine would you prescribe? ### Response: Hello. It seems like your wisdom tooth is on the way, but wisdom tooth does not erupt easily. They will take time and phases to erupt, so you will have to face this pain and swelling in some phases, maybe accompanied by fever even. Do salt water gargling. I would suggest to continue with warm water, and salt rinse five to six times daily, it will help you. I will not advise you to take painkillers. You can take an anti-inflammatory for the time being, Aceclofenac-P 500 mg twice daily for three days. Maintain good oral hygiene and rinse off your mouth after every meal. Follow up after three 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: Is high intake of protein powder helpful or harmful to the health? And what is considered as too much protein? ### Response: The recommended dietary intake of protein is 30% of your total calorie or food intake, which means 30% of what you eat should be proteins. If it exceeds 45 or 50%, then it can cause problems, especially to your kidneys. High protein powders can be used if you have protein deficiency or if your normal diet does not supply adequate protein. If you are asking this for bodybuilding purpose, then taking a very limited quantity over a short period is considered to be fine." "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 the right varicocele, which is 4 mm in size due to which I have very mild pain in the right testis. Do you think this can be treated by yoga in any way or if yoga can help in controlling this? ### Response: First of all, you need to undergo examination and need to take medicine for the immediate arrest of the problem. You can try yoga asanas like suryanamaskar, bridge pose, straight leg raising, dhanurasana in a slow manner. Deep breathing exercises and pranayam can help." "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 non-itchy but painful penis rash. I am a 47-year-old unmarried, not-sexually active, uncircumcised male, 5'10\x80\x9d, 190 pounds. I have a history of ulcerative colitis (which seems to be hereditary). This was corrected 12 years back when I received a total colectomy and pouch replacement (that is bowel removed, and new bowel constructed out of small intestine). That seems all good. For some time (five years), I have experienced a very slight pain or irritation at the base of the glans of my penis. Friction (eg., masturbation) would make it sore, but it was very slight. Some redness in the skin just below the glans, but not always. Did not even consider this a problem (and it might not be the problem, I am just mentioning it).Six months back the glans of my penis became inflamed. This was the start of my problems. No bumps, no itchiness, no scaling skin. Just redness on the bottom half of the glans, and also the tip. It got very sore. If it was never touched, it does not hurt at all. However, it rubs the underwear during the day, and that can be very painful. Not always, but most of the time. The pain can be excruciating. I want to emphasize that the rash has never been itchy. Urinating causes no pain. I consulted my family physician and he did not know what it was but said he could treat it like a yeast infection. So he prescribed some antifungal cream with 1 % Hydrocortisone (Clotrimaderm) and when that did not do anything, suggested the 1 % HC might be getting in the way, so prescribed straight anti-fungal over the counter anti-fungal cream (all the creams I have used twice a day). No help. The 1 % HC did relieve some (a little) of the pain but did not actually fix anything.Thinking maybe the problem was not fungal, but perhaps bacterial, my doctor then prescribed Polysporin ointment. I quite by accident bought the version of Polysporin with Lidocaine. The Polysporin also did not fix the problem, but the Lidocaine brought some relief! The pain was lessened, but as I said, the problem was not fixed. I used Lidocaine for two weeks before going back to the doctor to let him know the problem remained. He then recommended a urologist, so I got a referral to a urologist. The urologist did not know what it was but suggested two possibilities: go see a dermatologist or get a circumcision. My family doctor did not think the circumcision would help, so he referred me to a dermatologist. The dermatologist said the rash was non-contagious and non-cancerous. He prescribed me four creams which I was to try, in sequence one at a time, for a week at a time, and let him know which helped. They were Ketoderm 2 %, Fucidin 2 %, Noritate 1 %, and Hydroval. I tried each of these as directed. None of these helped. The ones with some HC 1 % relieved some of the pain, but the rash is currently as bad or worse than when the problem started. The dermatologist said there was nothing else he could do, and recommended I get another appointment with a different urologist. The dermatologist did a swab and sent it to the lab, and it came back negative. He also had earlier said it was not an STI.As you can imagine, I am not very encouraged. My doctor does not seem to know what is up, and neither does the urologist or dermatologist. Can you give me some suggestions as to the cause and the remedy for my rash? ### Response: Hi. Depending on the symptoms you have mentioned, and all the treatment you have taken with no much help, I can list few possibilities though it is difficult to comment without seeing the picture. Since it is bothering you for few months, I strongly feel this condition would need shave biopsy of skin to know the exact nature of the problem so that treatment can be targeted for the cause instead of treating it with antibacterial or antifungal or topical steroids. Hope your blood glucose is within normal limits, if not it strongly favors candidal balanitis which may not respond to only topical anti-fungal but needs oral antifungal medicine" "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: Dear doctor,I am a 19 year old male. From the last three years, I have been facing the symptoms of Patulous Eustachian Tube with the eustachian tubes partially open few times in a day. My own voice becomes distorted and sounds like it is coming from a vacuum.Breath sounds are enhanced and swallowing and chewing becomes disturbingly loud as they vibrate inside my own ears. I had previously consulted a doctor and after following his medication there was a temporary relief but after 3 to 4 months, those symptoms have again started occurring but not severe and, it occurs for a short time and when I suck air by closing my mouth and nose, the heaviness of sound diminishes.The problem with my left ear is more severe than the right one and left ear shows disturbing signs more frequently. Please help. ### Response: Hi. I feel a naso and otoendoscopy is first necessary to confirm the diagnosis. The condition is not dangerous unless it leads to some middle ear problem. If you can manage by doing a manoeuvre like how you described, it might help in symptom control and you may not need any intervention. Tuboplasty can be done for this condition but the diagnosis has to be established and assessed before attempting anything." "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 know how and which product is safe for my skin to look lighter. My facial skin does not look like how it used to, and I do not like it. Please help. ### Response: Hello" "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 11 year old son fainted at soccer practice and was taken to the hospital. His heart had an extra beat. The bloodwork showed that his troponin level was slightly elevated. He is not on any medications. Is there a way of stabilizing troponin levels? ### Response: Elevated troponin may occur due to the involvement of heart, lungs, and kidneys. They occur in blood as a response to trauma to the heart muscles. Slightly elevated troponin may or may not be related to a heart condition. The only way to stabilize it is to avoid the condition which makes it appear. If your son is having any symptoms related to the heart like chest pain, or difficulty in breathing he should get evaluated for a heart condition" "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 2 months old and he is suffering with dry cough over the last 3 days. We consulted local doctor and he advised TA-65 capsule which can be taken by mixing one capsule in 10 cc of distilled water. He advised to use 2 mL of this mixture for 3 days. My question is how exactly does TA-65 work for cough? ### Response: Your kid is probably suffering from some throat infection or lung infection (respiratory infection). TA - 65 is a telomerase activator, it comes in capsule form. It is used to boost immune system, skin and given for sexual improvement. I advice you to not to give this medicine to a child. You should probably consult a different pediatrician there as rest of medication like antibiotics or medicated nebulization or any investigation needed. It cannot be advised without examining the child. Viral infection of respiratory tract. 1. CBP (complete blood picture).2. CRP (C-reactive protein).3. Chest x-ray if required. 1. Upper respiratory infection.2. Bronchiolitis. 1) Kufril LS" "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 recently diagnosed with polycythemia due to increased red cell count of 5.28x10^12/L, HCT 0.466, and hemoglobin of 161 g/l. I stopped smoking two weeks ago. Six months ago, when I started to smoke, I smoke only four cigarettes per day. Would the high red cell count be a case of secondary polycythemia, or would it be due to smoking? If so, would my red cell count decrease after a month after I have smoked? Also, in this situation, would I need to take a low dose aspirin before a long haul flight (12 hours)? ### Response: You have polycythemia. It can be primary or secondary polycythemia. The primary polycythemia is the cancer of bone marrow, which means myeloproliferative neoplasm. However your total WBC count and platelet count within range. So the chance of primary polycythemia less. You have an excess smoking history. Thus smoking can lead to secondary polycythemia, which is a pure benign condition. Smoking can decrease oxygen level in blood and so compensatorily more red blood cells produced. You have to stop smoking to cure your secondary polycythemia. If you stop smoking than gradually your CBC (complete blood count) will be normal. You may need not to use aspirin as per my opinion. I hope I have answered your question. Let me know if I can assist 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: I am a 26-year-old boy. I am suffering from stomach pain, cramps, and gastric problem. Before six years when I eat some food I got still more inflammation, pain, and cramps. The first year when I reported in the hospital I came to know that I have gastric ulcer, so I took the medication, and I got cured in about five months.But I am severely suffering from the same kind of cramps and pains for almost six years. Now when I went to the hospital, they said everything is normal. But the thing is I did not know that masturbation or any sexual feelings may cause it and I have never discussed about my sex life to doctors.Usually, I masturbate five to six times in a week continuously (not every week of the month). During this time I noticed whenever I do masturbation I get pains and cramps immediately after ejaculation. There are few days when I masturbate I get some relief to those pains and cramps. This is because I think I am not holding my breath while I masturbate. The problem now is my pain and cramps is still for six years. Please help me to come out of this painful life. ### Response: I can understand your concern for your symptoms. The cramps, and pain during and after masturbation can be due to, 1. Renal calculi, do you have any abdominal pain? 2. Urinary tract infection may be a reason. Do you have burning or increased urination? 3. Epididymitis causing scrotal pain. 4. Diabetic neuropathy can cause such pain. Please get it confirmed by blood sugar test. 5. Improper methods of masturbation can also cause pain. I hope I have answered your query. If you have further doubts, I would be happy to help 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 inner muscle is hurting in my upper right leg. I can touch and feel a small round lump at my upper leg joint. I am having it for the past three days. Today, I am feeling more pain. Please help. ### Response: I have gone through your query and can understand your health concern. Revert back with the x-ray reports 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: I have a vomit, loose motion, fever, and body ache. I want to know what kind of fever I have. What are the medicines I can use? And what are the health tips I can follow? ### Response: Hello. I will surely help you out. From the symptoms, you have described you most probably have food poisoning. So for vomiting and nausea you need Ondansetron or Domperidone. For fever, Paracetamol will suffice and for body ache, you should have Diclofenac with Ranitidine. Also, antibiotics need to be started. Empirical antibiotics are Ofloxacin and Ornidazole but for definite antibiotic stool culture and sensitivity is required. There is no specific type of fever in food poisoning but for details, you can visit a nearby hospital and get your work up done and attending doctor will help you out with more details." "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 right abdominal pain since last five days. I am not getting relief after taking medicines also. My ultrasound says that the gallbladder is distended with a 6.8 mm calculus at the gallbladder neck. The gallbladder wall is 5.6 mm and appears thickened. The gallbladder is filled with sludge. According to the report, I have acute cholecystitis with cholelithiasis. Do I need a surgery? Or can it be cured by medicines? ### Response: Hi. Hope that helps. Follow-up if you need more information or leave a feedback if you like" "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 know the first aid for burns. Should we run every type of burn under cold water and for how long? Shall we put butter, milk, toothpaste and/or lavender oil on a burn as people believe these things to be true? Does it depend on the severity of the burn, or is this a terrible idea? If someone\s clothes or jewelry are stuck to them after or as a result of the burn, do you take them off or leave them? When is a burn considered serious enough to require either emergency treatment or follow-up medical treatment? What should be done immediately after a burn whether from heat, chemicals or electricity? How long does it take for a burn to heal and how often do they leave a scar? Is sunburn a kind of burn? ### Response: I have gone through all your queries and the answers are: Burns should not be run under cold water. Water with room temperature will be fine. It should be done only for a few minutes until the pain eases for minor burns. Butter, milk or lavender oil are effective and can be used, as most of them are alkaline and alleviate the burning sensation. If someone\s cloth or jewelry stuck to them, immediately take off them. Burn involving facial areas or head and neck or genitalia or any burn involving more than 20 percent are serious and should be dealt in an emergency. If burn happens wash with normal saline and apply Silver Sulfadiazine cream. Consult a local doctor immediately. Healing depends on the level of burning, either restricted to epidermis or dermis or subcutaneous tissue. If upper-level epidermis is involved it takes two weeks to heal. Deep involvement will take longer duration to heal and may leave a scar. Sunburn is a first-degree burn in most 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 have anxiety and panic disorder for the past five years, for which I was taking antidepressants. I have stopped taking antidepressants for more than eight months as I started feeling well. I drink alcohol occasionally. Is there any chance of anxiety disorder relapsing? Can I drink occasionally? ### Response: Hi. It is good that you do not have any symptoms even after stopping the medicines eight months back. There is always a chance that panic disorder and anxiety relapse. So you have to be careful and watchful that if any previous symptoms reappear or any new symptoms arise, then you have to consult your psychiatrist as soon as possible. Alcohol per se does not cause these symptoms if used occasionally and in lower quantity (within safe limit). However, the chances are high if the intake is increased. If you become dependent on it or use more alcohol, then alcohol-related medical conditions can arise and may complicate the situation. Also, do regular follow-ups, so that early sign and symptoms are recognized and dealt accordingly." "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 make a diagnosis of autoimmune or other thyroid disease based on the information?I was treated. My theory is I have autoimmune thyrotoxicosis or Graves\ disease. I was taking Lithium for cluster migraine prevention. When I discontinued Lithium I become very anxious in line with Graves\ hyperthyroidism. I have sore shins eleven eye orbits photophobia, grittiness, lid lag during attaches and lid retraction reflex with sudden upgaze. It became worse a few months back with a flare after influenza leading me to the hospital with 110 beats/min heart rate at rest, fever, dehydration, and exhaustion. My eyes have proptosis when flaring especially the right eye. You can see sclera above the iris. Paternal grandmother had Graves\, severely blood work trends for last six years, creatine 110 always up, EGFE at 60. The urologist thought due to exogenous testosterone due to hypogonadism (injection 100 mg/week qua eight years).Elevated HDL cholesterol, high triglycerides, high monocytes, and either high or very low neutrophils, and eosinophils. May have thalassemia minor, high RBC hematocrit always. Iron low. Magnesium elevated always. Portable for TBII antibodies level 4 cut off 10. During Lithium treatment, my thyroid TSH was 9 and the T3 and T4 in the normal range. The trend has been lower and lower TSH in low normal to 7. Now the lowest but average 1.0. I have had recent TSH and TBII done no result yet but will be first off Lithium. I began self-prescribing Methimazole due to the active thyroid anxiety now gone after Lithium stopped. It is taken over. I have positive TPO antibodies. No thyroid scan ultrasounds biopsies, etc. No eye or skin diagnosis. Is this eye skin signs definitive plus blood work of Graves\. Blood work trend is high free T3 13 average T4 low normal TSH (always while on Lithium and testosterone with LH suppressed diagnosed as result of therapy) ### Response: The diagnosis is correct viz hyperthyroid Graves\ disease. You certainly need Methimazole for this as well as a thyroid surgery. You should not take Lithium for prolonged use. However, bearing in mind the side effects it has. But I understand you also need it for your grittiness and mood behaviour. You should speak to an endocrinologist regarding the surgery for the same and hopefully, you can go off both Lithium and Methimazole. The other medications do not matter here. Considering your age and family history, thyroid toxicosis could set in. So I would recommend you get it operated." "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 can barely open my mouth up to three fingers space. Is it bad or normal? I have never noticed this before, only recently I happen to see this. I chew tobacco. Is that causing it? Is it serious? ### Response: Hi. Your problem is very common amongst regular tobacco chewers. I appreciate you got aware, and it is never too late for a new start. So, live an addiction-free life. Do not worry. You will be fine." "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 as manic-depressive (now bipolar 1) 43 years back. For many years I was on Lithium and then subsequently on Haloperidol. Then, I switched over to Valproate 18 years back. The results of the Lithium and Haloperidol were polydipsia and TD. TD was treated with Quetiapine, and over many years it almost got eliminated. Polydipsia was treated with Amiloride HCTZ and Telmisartan. So, now it is reduced to three liters daily. Now, I am on Lamotrigine and Oxcarbazepine. There are no side-effects. For sleep, I use Melatonin and Asenapine 2.5 mg. Can you recommend a better treatment protocol which I can try out for all the four problems?. ### Response: Hi" "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 suffering with acidity or acid reflux from the past one year. My scan report says fatty liver and I also have polyps in my gall bladder. Past few months I also seem to have had constipation and hemorrhoids. ### Response: I need few more details to help you better: 1. Have you got your cardiac evaluation done? 2. Are you getting relief on Razo (attachment removed to protect patient identity)? 3. Any thyroid or diabetes problems? 4. Any other medications you are taking? 5. Are you overweight? Revert with the asked details for better help." "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 27 year old female. I have been diagnosed with Eagle syndrome last year. I do not know which type it is, whether it is affecting nerves or arteries but I can feel the pain which is so tough to bear and my face is getting dull day by day. Please reply soon. ### Response: There are some medications that can help decrease the dullness sensation such as Neuroton ampoule (nerve multivitamins). I suggest taking just one injection every three days. Anti-inflammatory medicine such as Brufen tablets can be taken twice daily. The second option is nonsteroidal anti-inflammatory injection around the stylohyoid ligament. The third choice is a surgical shortening of the elongated styloid process" "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 13 years old. He has grade-1 fatty liver. SGPT 149 and SGOT 70. His cholesterol is also high at 230 and triglyceride is 200. LDL 140. Blood pressure around 150/87 but varies a lot and comes down to 125/80. Pulse is always above 90. His height is good around 5 feet 7 inches and weight 84 kgs. Looks overweight. He exercises around 45 minutes five days a week and eats junk only twice a week. Please advice. What should I do about the above? ### Response: Hi. In the long run, if not controlled then there is a high risk of developing complications, like diabetes and heart problems. The best suggestion I can give is to see a good endocrinologist and follow up with him, as he needs to be tested for hormones like cortisol, thyroid, an" "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: This query is for my dad who is 75 years. In the last two months, one week he has been housebound and the initial one month, he was completely bedridden. He slipped twice on the first day. That is how it all started. His right leg could not carry the weight of his body. He is approx 110 kg, 6 feet tall. He has had this problem for the last 30 years but he had never been bedridden and the medication worked. He is also diabetic, taking medication for the heart - Eliquis 2.5 mg to reduce the risk of formation of blood clots and he also has varicose veins.On the first day after this started, he took medication himself as per his last prescription. It did not work and after four days, we called the same doctor home who prescribed Insulin, Zocef CV 500 twice 10 days, Levoflox 500 one a day for 10 days and Daflon twice for 15 days. He said to give it nine days before a follow-up.However, after five days since there was no relief and it had started oozing or edema which he noticed when he was sitting up when two visitors came over. The next day, we called another doctor, a diabetologist, as the previous doctor, then said to visit a vascular surgeon as he could not do anything about the oozing. This doctor completely changed the medicines prescribing Linospan 600 twice, Ceftum 500 twice, Chymoral Forte twice along with two other ointments Nadoxin and Betadine and dressing the wounds. This gave immediate relief. He continued the medication for two weeks till the next follow by the same doctor.By this time, the wounds (characterized by oozing, discoloration, swelling) had completely healed except a small hole at the ankle. This time, the doctor prescribed Doxy 100 twice for two weeks and Orni O twice for seven days along with the same ointments. After the end of two weeks, he continued this for a further 10 days after which he was prescribed Dalacin 300 mg for seven days. He took this for around 12 days. Since the last 10 days, he has been taking his own medication - Zocef CV 500, Levoflox 500 and Daflon and at present, he is back to Dalacin 300 since the last two days.He is averse to being admitted to a hospital for the fear of amputation and because he does not want to be admitted to a hospital. He prefers to be treated at home. 10 days ago, my mom also went to our family doctor, who on seeing the pics of the leg said that as per his opinion it required immediate hospitalization and recommended a color doppler of both lower limbs both arterial and venous. My dad cannot walk to get this test done. Please advice. Especially since he is not able to walk beyond the bed to the dining table and for not more than five minutes.Also, particularly why does the leg get swollen off and on now? After taking the antibiotics for so long (now 67 days), does it mean that there is some internal problem? How can it be diagnosed? ### Response: Hello. He needs to be seen by a podiatric surgeon, or a surgeon who deals with foot care. Being an elderly diabetic with limb swelling, it is always safe to get a Doppler (both arterial and venous) of the limbs done. Arterial doppler rules out any block or reduced flow and possibility of pre-gangrene (evolving tissue loss). Venous Doppler rules out varicose veins (which he already has) and also deep vein thrombosis (obstruction of deep veins which is dangerous). This can change the current line of management. Antibiotics can be stopped if there is no evidence of active infection and proper limb care is given. Some general measures you have to follow: You can add some flow modulators like Trental (Pentoxifylline 400 mg twice daily) which can improve blood flow. Consult your specialist doctor, discuss with him or her and start taking the medicines 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 been very sick with a cold for the past five days and just yesterday I got an ear infection. It did not hurt that much but my ear was so blocked that it was highly uncomfortable. Today I noticed some drainage, which I immediately looked up and saw that it meant a broken eardrum and I should contact a doctor immediately, but after about an hour or two of drainage, my ear is unblocked and hurts less than it did before. What is happening and what should I do? ### Response: Because of cold, you must be having some ear infection as well. Due to recurrent cold, your eustachian tube is blocked and caused reduce ventilation of ear and hence there was pus formation in the ear. This continues pus formation has broken the tympanic membrane and came outside yesterday. You may consult an ENT specialist who can examine your ear and you need a course of antibiotics and anti-inflammatories for seven days. Also you should take decongestants for five 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 had a wisdom tooth and an adjacent molar removed two days ago. Everything has healed nicely except a very painful white spot in the very back of my cheek next to the extraction site. What could this be? I have attached photographs for your reference. ### Response: Hello. I have gone through the attachment (attachment removed to protect patient identity) By looking at the picture, it looks like an oral ulcer to me. You need not worry, it sometimes takes more than a week to heal up completely. You can start with Hexidine (Chlorhexidine Gluconate) mouthwash like for at least three to four times a day for a week. You can discontinue it after a week. Along with this, you need to take Becosules Z (vitamin B complex) with zinc for 10 days one capsule a day. Consult your specialist doctor, discuss with him or her and with their consent take the above medicines. If the problem persists even after 10 days then you need to visit your dentist for further investigation" "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: What are the initial and common symptoms of rabies? Is there any risk of overdose with rabies vaccines? I have taken 10 in four months. ### Response: First of all one rabies vaccine will give protection for around ten years, no need of revaccination if you get vaccinated once and later get bitten by a stray dog later in next ten years. For some unknown reason even if you are vaccinated more than once no problem since it is a protein subunit vaccine and side effects are limited" "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 feeling depressed, life is getting hopeless. I am very religious and I have racing thoughts about death and about life thereafter. I have been having decreased social interactions, isolation from others, curiosity, sad, a big sex desire, really wanting to die so that I can see what comes after death, and sometimes a faking sickness. Kindly help me. I am on Focalin. ### Response: You seem to be suffering from BPD (borderline personality disorder). You can take help from a psychologist to deal with the behavior problem and the psychiatrist can help you deal with the depressive disorder, hypersexual desire and the anger issues. This will affect your behavior. You must visit a psychologist to evaluate your personality" "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 I try to have unprotected sex every weekend, would this increase the chances of me getting pregnant? I am taking my prenatal Vitamins. I am trying my best to get pregnant. What should I do? My period goes 28 to 40 days. ### Response: If your periods are regular, then there is more chance of pregnancy when you have sex in the middle of the cycle. But when your periods are irregular then it is very difficult to predict ovulation time. But it is in the middle of the cycle only if ovulation is happening. Because you may have menses without ovulation, so you may have to take treatment for conceiving if you have irregular periods. But as your age is just 19 years, so try for at least a year. And if no pregnancy, then go for treatment. Every weekend is not the proper plan if you are planning for pregnancy. There is less chance of pregnancy than a normal couple. Keep that in mind and do not panic early that pregnancy is not happening." "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: On one of the molar bumps of a wisdom tooth, there is a fade to white with a hole at the top that is not discolored at all. It almost looks like an animated drawing of a volcano. What is this? Could it be a cavity and if so how can you tell whether it is or is not reversible? ### Response: I have gone through your question. I can understand your concern. It is mostly reversible (attachment removed to protect patient identity) and depends upon your oral higeine. We can arrest the carries at till this stage only on the smooth surface because the plaque does not get accumulated on it. For that fluoridated tooth paste is sufficient. In your case, we cannot arrest it only by using fluoride supplements because there is a shallow depression. So you have to get it filled. Make sure there must not be any high point after filling. So you need to visit a nearest dentist to get it filled, there is nothing to worry about. Your oral hygiene is good and I think this had happened because of the malocclusion of this cusp in relation with the upper one. It is getting too long and we have to manage time too." "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 did not realize my surgery would be so soon. I have been taking Ashwagandha and an Omega 3 supplement. I am having an enlarged lymph node removed in my neck under general anesthesia as an outpatient procedure. Will it be safe to undergo this procedure under anesthesia in a few days? I heard this might interfere with the effectiveness of the anesthesia. ### Response: Hi. Removal of a lymph node is not an extensive surgery. So, no need to worry much. As far as anesthetic risk is concerned, you may face the following problems because of your high BMI (body mass index). Ashwagandha is a herbal" "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 cholesterol and triglyceride levels are elevated. But, they were the same in my previous checkup reports too. I am a bit reluctant to take medication because of the side effects. My father has both cardiac and diabetic issues. I am doing exercise regularly and my intake of sugar is also under control. I do not smoke, but drink 3 pegs only on Saturdays. Can you please let me know why my cholesterol levels are still high? Is it too high to take medicines? Is there any side effect with the medicines? What precaution do I need to take in my lifestyle? I know that the long-term elevated levels of cholesterol is risky. Please help me. ### Response: Your vitamin D levels, thyroid levels and HbA1c are quite good. Regarding your high cholesterol, it may be due to hereditary and food related. You have a high risk of coronary artery disease as you have a positive family history and high cholesterol. If you have any severe muscle pain report to a physician. It is a rare side effect theoretically. Consult your doctor, discuss with him or her and take the medicine with 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 pain in both legs when I walk fast. There is a fatty lump in both legs, not painful when pressed. ### Response: Hi. I would suggest getting a test called the ankle-brachial index (ABI). This is not done at laboratory but some doctor or especially a surgeon can do in his office. Those test will test if you have any vascular insufficiency. If positive, you might need to be started on some medication to help in pain. Also get blood lipid profile, vitamin D levels stat on capsule Vitamin D 50,000 units, one capsule every week for six weeks, then tablet Vitamin D 400 units 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: I am 39 years old. I have hypothyroidism for the past 11 years, and I am taking one tablet Thyronorm 50 mcg every day. A recent test shows T3 with 129.35 ng/dL, T4 of 8.99 \xb5g/dl, TSH of 2.65 mIU/ml. Now, I have severe hair loss and dry skin. Please advise me. ### Response: I have gone through the query. You have hypothyroidism and hair loss. Since your thyroid function test is perfectly normal, there is no need to change your dosage of Thyronorm. But for your hair fall, I would suggest you check your vitamin D levels, serum ferritin, and hemoglobin levels. Then we will review them again." "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: This is for my son. We have got his blood tests done. He is on Thyronorm 500 mcg one tablet per day in the morning. Off late, he is having mood swings. Sometimes he seems to be active and sometimes too tired. He sleeps a lot maybe about nine hours in the night. In holidays, he tries to sleep in the afternoon also. He is about 5 feet 10 inches and weight 90 kgs. His age is 29. I checked his nails and bottom of the feet and they seem to be fine. There are no cracks, etc. He has no numbness in the feet or in the body. For the past few days, he is having a dry cough for which he is taking a cough syrup. ### Response: I just read your query about your son and it appears that your son has hypothyroidism and vitamin D deficiency. The combination of hypothyroidism and severe vitamin D deficiency can give rise to the symptoms that you have mentioned. I suggest that you give him tablet Vitamin D 50000 IU once weekly after lunchtime for three months. Give him tablet Calcium 500 mg once daily after lunch as well. Continue Thyronorm at the same dose. Hope you find my advice beneficial. Good luck" "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 went to the dentist four days ago and now I am noticing a sore bump behind my last molar on the right side of my mouth. ### Response: The probable diagnosis is pericoronitis. As per your symptoms, the sore bump behind the last molar tooth can be either due to an abscess formation that can be due to an injury or it can be due to an erupting wisdom tooth that might be putting pressure over the gums. Another cause can be inflammation of the gum flap in that area caused due to food accumulation between the gum flap and the wisdom tooth. For confirmation, a clinical examination and an X-ray is needed. I suggest antibiotics like Augmentin (Amoxicillin and Potassium Clavulanate) and anti-inflammatory painkillers like Ibuprofen can help. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. Application of numbing gel containing Lignocaine (Lidocaine Topical) over the bump will also help. Warm saline gargle and an antiseptic mouthwash gargle can also be used. You need to avoid hard foods to prevent irritation of the area, keep the area clean, and maintain meticulous oral hygiene. Follow up with the X-ray" "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 21 years old and my menstrual cycle is generally of 30 days. Last month I had sex with my boyfriend on just after 2 days of my periods. Though we used condoms but I felt as if it was leaking so to be double sure I took one Unwanted 72 in 23 hours. Now, I am 13 days late for my periods. I am getting muscle cramps and whenever I rush to the washroom to see I just find white liquid discharge. I have no other specific symptoms. I took two home pregnancy tests and both are negative. I am afraid. Can I be pregnant? If yes then how can I abort? And if no then why am I not getting my periods? Please help. ### Response: Hello. If yes, then the date of the 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 had severe cough and mucus formation which was in yellow. The doctor had prescribed antibiotics, Salbutamol tablet and allergy tablets. Now that cough has reduced but I feel some heaviness at the back right hand side and when waking up in the morning. While I had visited the doctor they had adviced me to take an X-ray. Later they said there is slight pneumonia and to continue antibiotics (Azithromycin) for five days. Also, I have completed my antibiotics dose for four days, still left with one more day. Cough is not there currently and better. I am attaching X-ray that was taken for your advice. Would like to have a second opinion on the X-ray report. ### Response: Hello. In attached X-ray report (attachment removed to protect patient identity), there is presence of slight consolidation in right side. So, it is suggestive of pneumonia like infection. For that, you need to complete antibiotic course. If clinically improved well, then no need for further work up." "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 is 21 years old and suffers from anxiety. He feels like it is getting in the way of his daily activities and interactions with people. He used to get attacks more often but that is a lot better now. He decided to start taking L-Theanine pills or supplements. I would like to know more about these pills. How safe are they? How long or often should they be taken? He currently takes them with caffeine (200 mg of supplement for every 100 mg of caffeine) average of 400 mg L-Theanine a day. Could they become addictive? Does it have any side effects? What more should we know? ### Response: L-Theanine is an amino acid synthesized from tea. It helps with reducing stress and anxiety and induces a sense of calmness by increasing serotonin and dopamine in the brain which are the feel-good chemicals. As such, it is a supplement and not a medicine per se, so there are no fixed guidelines issued by any regulatory authorities. Normally people do get relief with 200 to 600 mg. Since it is synthesized from a stimulant (tea) it is advised not to combine with other stimulants like caffeine. It can increase anxiety once the effect of caffeine wears off. Apart from that, there are no side effects as such and not really addictive. If the anxiety issues are troubling, it would be advisable to visit a local psychiatrist and take a short course of SSRI (selective serotonin reuptake inhibitors) class of medicines which will help with this problem. Also, consider doing deep breathing exercises or yoga or meditation." "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 stroke two weeks ago. Today morning, when I got up off the table, I nearly fell twice and had trouble speaking. My BP was 220/110 mmHg. They took me to ER and the telemetry unit. I got an MRI with contrast this morning. Am I having a stroke? ### Response: Hi. I read your query with keen interest and understand your concerns. The onset of problems in the early morning, blood pressure in a range which can cause stroke and difficulty in speaking along with two falls point towards the high possibility of stroke. The above things can present in both hemorrhagic as well as ischemic stroke affecting the left side of your brain. I must acknowledge that post-menopausal age and recent history of stroke adds to the risk of stroke and I do not think we should take it lightly. Kindly post your recent MRI reports to 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 mouth stinks very badly. What shall I do? ### Response: You must get the cause identified. Treating the root cause will give a permanent solution for bad breath. If the halitosis remains even after the use of mouthwash for two weeks, consult a dentist online for further treatment." "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 about HPV. I am a 28-year-old male with one genital wart and I wanted to know if this is for life? Will this keep coming back every so often? What are the best ways to get rid of the wart and a way to prevent them from coming back? I also read that the immune system plays a big part in clearing the virus. I was thinking about taking medical mushrooms and Inosine Pranabox for immune boosting. ### Response: Warts are treatable. Kindly always attach the picture of the lesion for reference. It is not necessary that warts come and go. Once you are treated properly it does not mean you have to suffer from it again and again. It is human papilloma viral infection. This virus has 150 types because our immunity has to fight with this. That is why it is very important that our immune system should be healthy. The best treatment for genital wart is cryotherapy. Other can be CO2 laser. Sometimes a small wart can shed off itself but that depends upon the type of the wart. To boost your immunity you can use Zinc preparation. It has a role in preventing further warts. Genital wart. Cryotherapy for wart. Use Zinc preparation to prevent 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: I have a question concerning a failed medical abortion. I have read the odds and they do not look good. I am 11 weeks pregnant and my medical abortion failed. I started having second thoughts about keeping the baby since this happened but I am also concerned for malformations and any other issues that may come up due to the medication. I have a surgical abortion scheduled and I am starting to get nervous. I just wanted some thoughts on what my odds are if I decided to keep this baby. I know the first trimester is very delicate and I feel like I have already messed this up. I did not realize I was pregnant either so there has been a bit of alcohol consumption plus I take about 1 mg of Alprazolam a day. If you can help me sway my decision either way. I am okay with the abortion. I just feel like I had a second chance or I am being punished. ### Response: Hello. If you have been given tablet Mifepristone 200 mg during the medical abortion process then there is no point continuing the pregnancy as it can cause congenital anomalies in the foetus, however, if only Misoprostol was used then you can contemplate continuation." "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: There are many desiccant packs in the bottle of ovacure medicine? Can I throw them after opening the bottle? I am scared of eating it with the medicine. ### Response: The desiccant packs are used to keep the tablets moisture-free. Once opened, they might attract moisture and stick together which may alter its molecule or spoil it. You can keep the packs inside, there is no harm in 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: I have been suffering from a condition known as pruritus ani for almost a year. It gives me uncomfortable itching around the anal area. I have tried creams, seen a doctor and a colorectal specialist, taken Metamucil and sitz baths. I did pretty much everything, but the problem persists. Some days are better than others, but the problem has never entirely gone away, and I cannot take it anymore. Is there any way that this condition can be cured once and for all? I want my normal life back. Please help me. ### Response: I can understand your concerns regarding pruritus ani as I have analyzed each detail that you have provided. I have managed lots of cases with a matching condition and feel that you too will make good use of the information and suggestions. First, please get your stool tests done on three consecutive days. For now, no steroid creams need to be used. If you are using one, taper that off slowly till you are comfortable without one. It might lead to a temporary increase in discomfort, but it is an absolute requirement. You can have sufficient antiallergics like Levocetirizine once or twice a day to neutralize itching completely. The affected area need not be touched, and for that, the above medication helps a lot plus there is a useful contribution from one\s determination too. Deworm your GI system with Albendazole or another suitable agent about which you can get advice from your physician. I am sure the problem can be managed even though it might not be possible to do so in a matter of days. The key to treatment is to let the skin heal, remove any cause of irritation, and break the cycle of itch and scratch, which is bound to have resulted in thickening of the affected skin." "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 wondering if you could shed some light on something for me. I recently had my newborn daughter and something looks off. The doctor at the hospital said it was her hairline and I wanted your input. In the middle of her head it is brown and normal looking but on each side of the brown it is definitely lighter in color and less hair. I have uploaded a picture for you to look at. My husband\s hairline is also like that but where his hairline cuts back there is no hair whatsoever. The second picture is of my husband\s hairline for a comparison. ### Response: Hi. You have got a beautiful daughter there. Please do not worry about the widows peak (attachment removed to protect pataient identity). It is too early to comment on it. It will be clearly noticed by the time the child becomes a year old. Frankly speaking even if there is a widows peak or for that matter any anomaly relating to the hair, there is nothing that can be done right now at this age group. So, please stop thinking about it and watch as the child grows. Whatever it is, it will be clearly distinguishable by the age of one year and by that age something can be done about it. Also, if you are very anxious I would advice a visit to the dermatologist who can examine the child thoroughly (as the examination in photo and person differs) and guide you on the issue." "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 24 years old woman. My weight is 95 kg and height 165. I have irregular periods, ovulation problem. I consulted a doctor, she says hormonal problem, I have not produced an ovum, so the ovulation has stopped. ### Response: Your condition is known as PCOD (polycystic ovarian disease). It has the following features: Ovarian follicles are not fully functional and they do not produce the adequate hormone. This disease also has insulin resistance (a hormone which decreases glucose by increasing its breakdown) which leads to an increase in weight of the patient. Your doctor might be giving you a course of oral contraceptive pills for irregular menses. You should focus on weight loss by a healthy diet and exercise. Your weight loss will increase insulin sensitivity in your body. Please think about marriage and pregnancy before 30 years because PCOD is commonly associated with infertility. Infertility has better results if diagnosed and treated at an earlier age." "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 woke this morning and cleared my throat and there was blood in my saliva and then later some in the saliva in my mouth. I have gum disease and my top back teeth, gums are tender. Could that have caused the bleeding? ### Response: Yes, gum disease can cause such oral bleeding. You should first get your teeth and gums cleaned by a dentist. Apply an oral antibiotic gel over gums. Use warm salt water gargle twice a day for a week. Sometimes gum surgeries may be needed to remove infections and heal the gums in severe 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: For the past two days, I had painful sex. It feels like it is going to tear down there. It became unbearable, and it is hurting a lot. ### Response: Hi. It seems like you have some vaginal infection or lack of lubrication or foreplay which is causing the problem. Proper foreplay and adequate lubrication will help you get relief from the pain. However, if you have a doubt then get yourself checked by a gynecologist and get a vaginal swab test done. Avoid having sex till then. Wear cotton panties and loose lowers. Maintain personal hygiene and take plenty of fluids. Wash your private parts with normal tap water every time when you use a washroom. Avoid using vaginal douches and creams" "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: Hello,I\m looking and would like to discuss my treatment options for my conditions.I\ve bipolar disorder II, social and generalised anxiety disorders, panic attacks and agoraphobia due to it.In past, I used escitalopram, venlafaxine, fluoxetine, sertraline, lithium, depakote, quetiapine, risperidone, anxiolytics. Venlafaxine was effective but had to discontinue it due to high blood pressure it caused. Other treatments mentioned didn\t work for me. Anxiolytics worked, but now i don\t have such options to continue this treatment because I\m getting used to Tranxene.Currently I\m taking Lamictal 200 mg and 10 mg olanzapine.I am afraid to go out from my flat, I am constantly alarmed, nervous, anxious, can\t eat because of constant lump in my throat. Anxiety is debilitating, I can\t work outside my home. At work I get so anxious that I have to take some free days from work, if I don\t do that, I vomit from this anxiety.1) Can duloxetine be effective? Is it common that it can increase pulse and blood pressure as Venlafaxine did?2) How long does it take for escitalopram to take effect?3) Can prozac decrease anxiety?4) Is paroxetine an good option for me? ### Response: you should continue medications on which you are stable at present. 1)duloxetine may be good option for you. it does not increases blood pressure. 2)tablet escitalopram takes around 4 weeks for full effect after starting medications. 3) yup,prozac can decrease anxiety but it belongs to same group as tablet escitalopram. 4) yup,paroxetine is good anti anxiety but tablet escitalopram is better than tablet paroxetine. you should follow below advice which can help your anxiety. hope you get your answer" "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 4 months old, and one eye is slightly more open than the other (ever since he was born). I feel like the eyelid of the eye that does not open as wide might be swollen and there is also an angel\s kiss on that eyelid. It also has an extra crease on the outside of the eyelid. Is that ptosis or something else? It does not cover his pupil and does not seem to affect his vision. ### Response: I have seen the photos. (attachment removed to protect patient identity). From the photos, I can see a few variations from the normal anatomy in both upper lids. There is an extra fold of skin over the upper lid of the right eye, this is called epiblepharon in medical terminology. My advice to you is Regarding the left eye, wait and watch for another year. Congenital ptosis does require surgery to correct it, but the ideal time to operate would be when the patient is 3-4 years old. This is because we can get more accurate measurements for the surgery then, and the child will also be able to tolerate the procedure. Also, the upper eyelid" "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 parents are diabetic and living in a village where non-treated water is consumed daily for everything other than drinking which is rich in minerals, algal blooms, dirt, etc. Suggest me a toothpaste which is better considering this kind of locality. Their gums are bleeding and experiencing spongy gums. ### Response: om. Frankly speaking, toothpaste is just an external application, and it does not make any difference based on the brand. Toothpaste does not have any therapeutic effects as portrayed in advertisements. When you say they have spongy gums that bleed easily, it might be an indication of vitamin C deficiency. If they do not have any allergies or any other health conditions or medications, they can take a course of Vitamin C 100 mg tablets once a day for one month and see if it helps. If not, please consult a doctor in their locality, who can suggest appropriate treatment after examination. If they have any other health conditions or allergies or if they are taking any other medications, they need to talk to their doctor before starting Vitamin C therapy. In the meantime, I suggest they use soft toothbrushes." "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: There are soft wart-like lesions in my left groin region. A picture is attached for your reference. It is itchy on and off and it is mildly painful. Is this a genital wart? ### Response: I have gone through your query and the image attached (attachment removed to protect patient identity). Yes, they seem like warts. Regards" "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 25 year old male. My teeth are not in perfect shape. What should I do? Should I go for braces? Please advise about all possible options. ### Response: Hello. By looking at the picture of your teeth (attachment removed to protect patient identity), you seem to be having spaced dentition with some malalignment. The best possible solution for this is to get the orthodontic treatment or braces done. This would be the permanent solution. One more treatment could be individual crowns on each teeth to close the gap which is not as time taking as braces but it requires cutting of the tooth structure. So, considering your age, the best and safest treatment is braces." "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 baby is 9 months old. His measles vaccine is pending and he got chickenpox just 10 days before. Is it safe to give measles vaccine today? ### Response: Hello. Chickenpox and measles are similar kind of diseases, categorized as viral infections with a rash. In such a scenario, it is better to give measles vaccine one month after full recovery from chickenpox. It is not a problem to give measles vaccine after a month. Until then see that your child is not exposed in public places, or other kids with infection do not come near him. Nowadays, the vaccination schedule has changed to MMR, instead of measles vaccine at 9 months." "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 too much pain in teeth and also getting tiny small type holes in teeth. I am a male, 18 years old. ### Response: Holes in teeth indicate cavities. If you are having severe pain in teeth this may indicate you are suffering from pulpitis and you need root canal treatment from your dentist. Meanwhile, start with the following medicines. Take Augmentin 625 mg two times a day, Gramex 400 mg (Metronidazole) two times a day, Ibuprofen 400 mg three times a day at every eight hours for three days. Take all these medicines for five days. This will relieve your pain for a while and visit your dentist as soon as possible for treatment. Stay happy and blessed." "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 33 years old male. I have a B12 level of 1800 pg/mL and SGOT of 80 U/L. My SGOT level is within range. I have never taken B12 supplements. Please suggest. ### Response: Hi. Do not be scared. Repeat the tests soon. A raised B12 can happen due to laboratory error. Even after that, if you have SGOT (aspartate transaminase) above SGPT (alanine transaminase), you should do a USG (ultrasound) abdomen. A raised SGOT above SGPT of about 2:1 ratio suggests an alcoholic liver disease. A chronically elevated SGOT above SGPT can also occur due to nonhepatic causes like hypothyroidism and in some myopathies (muscle illness). You should get your tests repeated along with serum TSH levels, complete blood count and kidney function tests. Serum B12 is metabolized in the liver, and its excess is excreted through kidneys." "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: For the past two years, I have experienced lower back pain coupled with what I think to be an abnormal inward curvature of my spine. I recently went to a pediatrician and the doctor brushed it off saying there is nothing wrong with my spine. No one believes me even though I have showed them and complained about the pain. I have looked online and found what I think to be the problem (lumbar lordosis or anterior pelvic tilt). My back causes me a great deal of pain and embarrass me by making my butt stick out. Please help. ### Response: The cause of your back pain is overactive erector spine muscles. These muscles support the back in all the activities. Due to a reduction in their flexibility, they are not able to take up high impact activities like running or jumping, while the low impact activities like daily chores are pain-free. During high impact activities the stress which should have been taken up by the muscles now falls on the inner structures that are not made for it, and so there is a sharp shooting pain felt. Treatment is as follows: Things to remember: Do the Cobra Stretch as mentioned above before and after workout and also as the last thing in the night, just before going to bed" "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 daughter is suffering from abdominal pain due to gallbladder problem. She is suffering from stomach pain for the past one year. It has aggravated recently. She gets pain when she eats green leafy vegetables or fatty foods. She had an antibiotic for a month. Doctors have told that water has formed around her gallbladder along with infection. CT scan, HIDA scan, color Doppler and endoscopy tests all are normal. Is there any dysfunction of gallbladder seen in HIDA test? Or cystic duct syndrome? Is gallbladder surgery compulsory? Please help me. ### Response: Hi. The report says that she has a component of decreased gallbladder motility associated with polycystic changes in ovaries (PCOD). Now, we need to get LFT (liver function tests) done. Did she had pain as well as fever or jaundice? At present, is she symptomatic? Or asymptomatic? Kindly provide details of her weight. Obesity is associated with cystic changes in ovaries. Surgery is not compulsory in this case." "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 this lichen planus? I also have white spots and stains on my genitals and inside my mouth. I have attached pictures for your reference. I had alopecia areata in the past. ### Response: I have gone through the attachments (attachment removed to protect patient identity). Yes, it is lichen planus. There will be itchy red to violaceous small bumps over the skin and on the mucosal surfaces like mouth and penis. It will have a whitish lacy pattern. It affects the mouth, genitals, inner aspect of wrists, forearm, outer aspect of legs, nails, sometimes palms and soles as well. Do not scratch. If you scratch you will get new bumps along the line of scratch. This is called Koebnerization. It is an idiopathic condition and the exact cause of this is not known. This is mostly triggered by infections, certain medicines, chemicals, and dental amalgam made of mercury. You need treatment in the form of creams and oral tablets which require blood work before prescribing oral medicines. Kindly meet your dermatologist for your complete physical examination to access the extent of involvement" "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 the past couple of days my vagina smells like rotten eggs. I have never been sexually active, but I use tampons. I do not have any other symptoms, like burning, itching, discharge, etc. What could this be? ### Response: Hi. How are you doing? The possible causes are: Hope I have clarified your queries, do write back. All the best" "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 26 year old male. I am 5 feet and 9 inches tall and weigh 250 pounds. I have been feeling dizzy for one week and there is a little pressure on my head and ears. I did a blood test and EKG and all came good. I am attaching these reports. I am really scared that it could be a brain tumor even though I do not have a family history of brain tumor. I do have an anxiety disorder and have been in stress for a month now. I do not know if that is causing my dizziness. I smoke one pack of cigarette a day. ### Response: Hello. I have gone through all the reports (attachment removed to protect patient identity). They are all normal" "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 tried teeth cleaning, I avoided non-veg foods and beverage drinks, which produce gas, and I am eating a balanced diet. My bad breath problem is since for the past five years till now, so in this period I realize that I have a white layer on my tongue and when I smell my tongue then I feel very bad breath. Also, I have a hole on my throat back of the tongue, and something comes through that way like thick water and when I smell it so bad.Another is when I eat something, then that smell lasts for a long time. What to do? I have been spent more money to avoid bad breath, so give me a suggestion to get rid of it. Bad breath is the main reason for my unsuccessfulness. Sometimes thinking about this problem, I become depreciate. I needed your help. ### Response: The white coating on your tongue is mostly due to bacteria and debris. All this must be causing bad breath. Clean or scrape your tongue regularly, maintain proper oral hygiene," "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: Dear doctor,I am 47, 5 feet 6 inch, 78 kg. I had gone through master health check up on the 29th. Found some abnormality in liver function. A:G ratio 1.83, SGPT/ALT 121, SGOT/AST 62, triglyceride 336, total cholesterol 195, TC/HDL 5.42. Please advise me suitable medicine/treatment. ### Response: Hi. The attached reports (attachment removed to protect patient identity) show mild variation in liver enzymes. This looks like a fatty liver disease. To complete the evaluation, you need to get an ultrasound scan of the abdomen to assess the liver. Regarding approach, it includes diet modification, regular physical activity, and medicines" "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: Girl\s father is dumb and deaf affected. If I marry that girl (affected person\s daughter), will the child born to us also be affected? And I am not dumb and deaf. Please help me to decide to marry her or not. ### Response: Hi. I understand your concern. Congenital deafness and mutism has a genetic effect and may pass to future generation but incidences are very less as compared to other congenital and genetic diseases. You may marry with girls concern. Deafness and mutism in the next generation are due to so many factors. So deafness of father should not be criteria for rejection of daughter for marriage. Now a days deaf and mutism is very easily managed by cochlear implants and few agencies are sponsoring the surgical costs as well. So need not worry and go ahead." "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 unmarried woman. My plan is to get into marriage life after two years. Currently, I have been taking Isotretinoin for the past 20 days. I have heard that it may cause infertility in women. Does Isotretinoin cause future birth defect? Will it affect my future pregnancy? ### Response: Actually, it is known that Isotretinoin can cause severe birth defects in the baby if taken during pregnancy. So, you must not take it, if you are pregnant. And if you have taken, then some doctor will advice termination also in early pregnancy. But, there is no study done specifically to find correlation between Isotretinoin and infertility. And if done, then there is no correlation found significantly. So, you can use Isotretinoin if you are not pregnant. If you are planning for pregnancy, then stop using at least two to three months before. If you have acne and you are taking treatment for that, then let me tell you that try to lose some weight if possible. It will also decrease your problem. As far as future pregnancy is concerned, do not take Isotretinoin in pregnancy and stop before pregnancy." "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 25 years old and I weigh 75 kg. To cure my persistent moderate body acne and KP of past 10 years which was not responding well with topical treatment, the dermatologist put me on Isotretinoin course starting with a dose of 5 mg. Along with this, he has also prescribed AHA Revitalizing Lotion 20% (Glycolic Acid) to help with the acne scars and the KP bumps, Salyzap body spray and Spongy-Sal for washing. Is it okay to use this AHA Lotion while on Isotretinoin? I ask this because it said in the pamphlet that no cosmetic procedures can be had on the skin while on this medication. Please help. ### Response: Hello. Regarding the dose of Isotretinoin, it can go up to 20 mg easily. With regards to Glycolic Acid 20% lotion, I will suggest you use it for short period first then increase it slowly. Concomitant use of Isotretinoin and Glycolic Acid 20% will be ideal although there is a relative contraindication for use of both simultaneously. But we perform Peels with even Glycolic acid 35% to 50% with Isotretinoin and we do not have any side effects. Because we give Isotretinoin in lower doses and you are taking just 5 mg which is very low. So, I do not see any problem. Consult your specialist doctor, discuss with him or her and with their consent take the medicine" "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 on 13th of last month (last period was 31st before). The condom burst inside me and cum went inside. So after five to six hours I took unwanted 72. Then from 17th to 22nd there was bleeding and cramps. But now it is about one month and I did not get my periods. Is there any chance I am pregnant? ### Response: Yes, there is some chance. Do urine pregnancy tests. If the test comes positive then there is pregnancy. And if the test comes negative then it is disturbed menses due to emergency pills. Here are some detailed explanations: Unwanted 72 is an emergency contraceptive pill and it can disturb your menses. It can disturb the cycle for two to three cycles. You may have irregular periods or delayed periods also. At the same time, it is not 10% effective to prevent pregnancy. There is some chance of failure even if taken within the time period. You have periods on Jan 31st and have intercourse on 13 Feb which is almost near ovulation period. that does not mean period. After that, it is almost a month. So do a urine pregnancy test for confirmation. If it is negative, then you can take tablet Primoult N daily for five days and then wait for periods. It should come in 10 days after the last tablet. In case if the test comes positive then you are pregnant and you can continue or terminate pregnancy. Do" "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 smoker for 29 years, about half-pack a day. I just went through a chest CT scan yesterday. Can you help me to review the Dicom image files to see if everything is fine? ### Response: Hi. Review of given CT chest scan images (attachment removed to protect patient identity): There is no obvious focal lesion in the lungs. There is mild hyperinflated lungs with concerns for early changes due to emphysema. This is not a serious problem. However, you might like to alter your smoking habits and decrease the chances of further lung changes." "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 17 years old and getting white hairs. They are white near the scalp and black in the tip. What to do? ### Response: Hello. As you are only 17 years old, the primary cause behind it might be genetic as your parents or grand parents may have white hairs at an early stage. The other possible causes might include poor nutrition, improper lifestyle, stress, etc. White hairs mean lack of melanin, the coloring pigment in hairs. Once the hair that grows white, there are fewer chances to revert them back to normal black color. But, you can stop further graying of hairs. First of all add foods like figs, curry leaves, raisins, fresh fruits, and vegetables in your diet." "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 girlfriend has been taking Microgynon 30 for two months, with two packages back to back. She took Microgynon for suppressing severe PMS. The medicine successfully suppressed the PMS, but there seem to be some side effects. She experienced some spotting for a week, and the other doctor told me that it is normal for a microgynon-taker.Her actual period started the very next day after stoppage of spotting (which is late for two weeks), and it has been lasting for 18 days. In the beginning, the volume is lower than average, but red blood is visible. In recent days, the volume keeps increasing, and it gets me worried about whether some issues are occurring. Should I take her to a gynecologist for a check-up or it is entirely reasonable for a microgynon-taker?We did not have any sexual intercourse before and in the case for an extremely rare accident, she took a pregnancy test, the result was negative. Therefore, pregnancy could be eliminated. She finished her second package of Microgynon around 6/4, and the next day, the blood volume started to increase. One more question, she has a third package of Microgynon and the gynecologist we saw said that she should begin the third package when the second period stops. Is this correct? ### Response: Hello. Your doctor is right in saying that this is normal with the medicine you are taking. Microgynon is progesterone. It is a hormone which builds up and helps in the growth of the inner layer or lining of the uterus called endometrium. Due to overgrowth sometimes the endometrium sheds off and appears as vaginal bleeding or periods. She must take some iron supplements and wear a panty liner." "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 18 year old boy. I have teeth pain and sensitivity whenever I drink something cold or hot. Why does it occur? I also have stains on my teeth. I do not smoke or drink alcohol, but my teeth do not look white. How can I improve the colour of my teeth? Also, why do I get the smell of whatever I eat in my breath? ### Response: You are suffering from halitosis. You must be having sensitive teeth, hence having pain or cold or hot sensation. I suggest using Sensodyne toothpaste. Try using Orahex (Chlorhexidine) gargles twice daily for bad breath. Slight staining is normal, it has to be noted only when you get more stains in your 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: I recently took a CBC. My RBC count is 5.74, hemoglobin is 17.2, hematocrit is 51.5, platelet count is 131, lymphocytes are 47 and other elements are normal. Could you please suggest possible reasons for this? Is there a way I could approach this? ### Response: Hello. Hereby, I am giving you my opinion regarding your case. Your platelet count is slightly low and lymphocytes are high. It can be seen in viral infection. But provide your clinical complaint if present and send full CBC report for giving more comment" "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 fell on my face and cracked my right front tooth right in the middle, horizontally. You cannot see the crack with your bare eyes, but if you shine a light from the back of my tooth, you will see it correctly. It goes from the right to the left, and it stops two millimeters before the next tooth. I was scared, so I asked many dentists before going to an actual appointment myself.They said it was fine, that it is only on the outer layer. Then, I went to an actual dentist myself, and they did an X-ray test on it. Nothing appeared, and said I would be fine, but gave me no further details. I was still left wondering, is there any way the rest of the tooth will fall out eventually because it is very slightly sensitive to change in temperature. ### Response: It is one of the most common complaints in routine dental practice. The fracture (hairline crack) might be only in the superficial structure (more likely in enamel than in dentin) of the tooth and not in the pulp (since it does not hurt). It requires minimal attention, and no specific care is mandatory. You may use desensitizing gel (with potassium nitrate) for brushing and also for a massage before having hot, cold, sweet, and sour stuff. 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 very anxious I might have acquired HIV. Two weeks ago, I deep kissed a man I had just met whose serological status I do not know. During our kiss, I tasted some blood coming from a cut in his lip. I just mixed that small amount with saliva and swallowed it. 34 hours later, I started a PEP regimen out of worry, which I am still keeping up with. Two weeks later, I am now suffering from a 38 celsius fever for three days, with fatigue and night sweats and recently an enlarged painless lymph node in my neck. No sore throat, no sneezing nor coughing. I am even suffering from daily insomnia which I think is both because of my anxiety and a side effect of my PEP regimen. Please help me understand my HIV risk and what I should do next. ### Response: Hello. Is it possible for you to investigate your partner? Any other kind of exposure like penovaginal, peno-anal, or oral? Looking forward to your response in order to help you. Revert with more information to an HIV AIDS 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 want to show my echocardiogram, to know if I have diastolic dysfunction or not. I can see that the velocity is high, but the report says normal. I am not an expert, but I have read that, if E/A ratio is higher than 1.5, then it is a problem. Please help, I am worried. ### Response: Hello. In order to diagnose a person to have diastolic dysfunction, there are factors that have to be met. Like ejection fraction more than 45%, the presence of diastolic stiffness, and heart failure symptoms, with changes in some laboratory test indexes. E/A ratio greater than 1.5, is not a criterion for diastolic dysfunction, it is not a gold standard. E/A ratio up to 2.33 is considered normal for people below 23 years." "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 18 years old and I once in my lifetime applied toothpaste on my bottom eyelid trying to help with the dark circles I had but then I had an irritation there and the next morning I had a scab which later fell off and left an indentation on my end eye that looks like an ugly wrinkle. Can this be treated to remove the wrinkle with a cream? Because this small indentation is causing other wrinkles near it. Please help with a depth answer. It would mean a lot. ### Response: I understand your concern. The indentation below the eyelids as I can see the picture (attachment removed to protect patient identity) could have been due to two things. Toothpaste that you had applied might have caused contact dermatitis and in turn skin thinning in that area. The other reason could be that there is loss of tissue under the lower eyelid skin. You could use Vitamin C serum under the eyes. This helps you lighten dark circles as well as minimize indentation. If the indentation and wrinkles are too loose, you can get fillers done from your dermatologist. Contact dermatitis, tissue atrophy None As described above Avoid frequent rubbing of eyes and use of harsh products" "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 21-year-old male. I have Fordyce spots on my private areas and on the corners of my upper lip. Can you give me a cure? My problem has remained consistent since the last seven to eight years. It does not pain or itches or none of such problems. I just feel upset whenever I look down at them and badly want to cure it. When I touch the spots on the downside of my penis it feels like some kind of tight hard mass inside, but it pains when I try to squeeze them out all in vain. Two-three spots get bigger in size sometimes and remain so for quite a long time and some new spots also arise intermittently. It is very awkward to see them feel the masses inside and these spots are only on the downside of my penis and not on the upper side. And my BP is normal as I last checked up some days ago. I have no problem with sugar level or any cholesterol issue. ### Response: Fordyce spots are sebaceous glands. It is a normal variant, harmless. I totally understand your frustration. Unfortunately, this condition has limited treatment options and cure is difficult to assure. Co2 (carbon dioxide) laser is one option, it removes the spot but there can be potential for scarring. Another option is oral Isotretinoin capsule. Isotretinoin is vitamin A derivative, it is used in acne and it shrinks the sebaceous glands. I am very sorry to say, even with Isotretinoin, cure cannot be guaranteed." "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 believe I am having a few genital warts, for which I tried some home remedies as well as wart freeze away recently. Why there is redness around them? What are the possible ways to get rid of it? ### Response: Hello. Yes, those are genital warts (attachment removed to protect patient identity). It is an STD caused by HPV infection. Surrounding redness is perhaps due to irritation to the home remedies that you have used. If I were the treating doctor, I would suggest either electrocautery or freeze with liquid nitrogen for these warts." "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 36 years old male with 167 cm height. Weight is 73 kg. I am in good health. Practicing yoga four days a week. Two days walking or jogging like 8000 steps. Daily walking for office and routine is 4000 steps. Sitting job. I have a gastric problem for last six months. Release gas from stomach 10 times a day average (fart). Very difficult to manage in meeting time. No smelling but it sounds. No stomach pain. No problem in toilets. My diet is the same as the previous. Nothing has changed. I am a vegetarian. I drink water 3 liters a day. Wake up in the morning 6 to 6.30 AM and have a breakfast by 8, lunch by 1 o\clock and evening snacks by 5 (light food) and dinner 9 to 9.30. Sleep by 10.30 to 10.45. Yoga 7.20 PM to 8.30 PM. Please guide me. ### Response: Passing fart up to 10 times a day is normal. For you, I suggest you take a good amount of water and dietary fibers. Hopefully, that should improve your symptoms. If you are having constipation, treating it may improve your problem." "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 daughter has pleural infection in lungs. When she was 2 years, decortication was done by open surgery. Now she is four years old. 3 days back she got fever. Though after taking antibiotic her fever subsided, x-ray report showed mild cardiomegaly with bilateral perihilar congestion. Is there again a chance for fluid to get gathered inside her lungs? What should we do for the same? Please advice. ### Response: I can understand your concerns. Pleural fluid collection occurs when infection persists for long time and is not responding to antibiotics. Pleural fluid collection in past does not increases the chances of collection at a later age. This time, x- ray (attachment removed to protect patient identity) shows mild cardiomegaly and perihilar congestion. This is not related in any way to lung infection and fluid collection. I suggest you to do an echocardiogram, to see what is the cause for cardiomegaly. Further treatment will depend on echocardiography report." "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 losing my hair day by day. Can I use Finasteride? I have hydrocele. Is it related to my testosterone? ### Response: Please do not go to Finasteride straight away. First, the cause and the pattern of your hair loss have to be assessed. Then, treatment can be planned. Have a consultation with a dermatologist for physical evaluation and get your problem assessed. 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 got round dark spots on face. It was light initially and became darker later on. Give me advice on how to remove it. ### Response: Hi. It looks like seborrheic keratosis (attachment removed to protect patient identity)." "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: How accurate are early ultrasounds at determining gestational age and conception? Based on my 6th-week scan I am 23 weeks today means I conceived around December 25th. Is it possible that I actually conceived around December 5th and baby is measuring small? (I have had six ultrasounds and the baby has never measured more than 2 days off from the date given at my 6-week scan) even though my last period last came on November 28th she has never measured on track for that. ### Response: The first-trimester ultrasound scans done before 12 weeks are the most accurate ones in the assessment of gestational age with an error of only + /- 5 to 7 days in the assessment of gestational age. So they are used for obstetric dating and determination of expected date of delivery. Moreover, if you have done 6 ultrasounds and the date calculated from each of them corroborates and does not lag behind then probably your baby is growing well and it is not small as you apprehend. In case of any discrepancy the date from dating scan at 6 weeks are accurate and to be considered. It is a probability that you actually conceived in later part of the cycle which leads to this discrepancy between the date and USG." "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: What is polyclonal hypergammaglobulinemia? Can it be related to leukemia? ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). Polyclonal hypergammaglobulinemia is an increase in antibody level in the blood in response to infection. If you have lymphoma or leukemia then, the result can be in monoclonal nature. Monoclonal means the same type of antibody forms. But the result does not show a monoclonal nature. So there is no need to worry. Here the result is in polyclonal nature. It suggests towards infective etiology more." "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: Over six months I have had what was thought to be an epidermoid cyst at the end of the right side of my nose. I have taken antibiotics on a regular basis as there is redness, swelling and tenderness in the area when inflamed. Approximately 2 weeks ago this cyst on my nose became very inflamed or infected. I was experiencing headache, sore neck, painful and uncomfortable nose and facial pressure (swelling), pressure in my ears and dry infected eye that too right side consequently. I visited GP and had CT scan of paranasal sinuses. I hope you could provide me the explanation for the below sentence, which I am unable to understand. The nasal septum deviates towards the right associated with a large right sided bony spur which abuts the right middle turbinate. Pneumatization of the left middle turbinate (concha bullosa) noted. In simple terms what does this mean? What is the likely recommended action for this? Are these comments and findings consistent with the symptoms I have experienced? ### Response: Due to retained secretions in the paranasal sinuses there is infection and headache. Nasal septum deviation to the right means that the central bone of your nose is not straight and is bent towards the right side. A surgical procedure called septoplasty is done to correct the deviated nasal septum. It is an intranasal operative procedure may be performed under local or general anesthesia. Turbinates are bony structures that project from the side of the nose that function to humidify and warm the air. Concha bullosa is presence of an air cell inside the turbinate. The middle turbinates have an inner core of thin, single-layered bone covered with the normal nasal membranes. Occasionally that bone can get pneumatized and results in a much bulkier structure. This will lead to blockage of breathing passages as well as obstruction of sinus" "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 my niece with red islands or patches on the tongue surface. Her age is 23 months. This is there for the past one year. ### Response: Hello. These patches are related to vitamin B deficiency and gastric discomfort. Sometimes, they also have superadded infection of bacterial or fungal origin. I would advise you to start a Multivitamin syrup, deworm the child and apply Candid mouth paint for 4 to 5 days. Syrup A to Z 5 ml once daily for 30 days, syrup Zentel 10 ml single Stat dose, Enterogermina suspension 5 ml twice daily for three days. Candid mouth paint local application for 4 to 5 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 had my last periods two months back. Last month, I and my fiance got intimate, though we did not have intercourse, he fingered me after touching himself, so to be safe I took I-pill next day. A week later, I had bleeding for three days. Since then I did not have my periods till date. I have taken six home pregnancy tests which were all negative. What can be the cause of delayed periods, can I still be pregnant? If not can I take Meprate tablets to start my periods? ### Response: I have read your message. If it was just fingering then no chance of pregnancy at all. As you said that you had bleeding, the next period is expected to be around the same date of next month. Actually, with I-pill, periods get disturbed for 1 to 2 cycles. I would suggest you wait for 4 to 5 days, your periods will come. If you are still worried then do blood test serum BhCG. If its value is less than 5 then definitely you are not pregnant and you can simply wait for menses. You can take Meprate as well for periods to come if BhCG comes out negative." "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 31 years old and a mother of 7 months old baby. Recently, I have got infected with herpes zoster virus on my back. It is a small patch above my waist. Doctor told me to stop breastfeeding for a week. But, my baby is exclusively breastfed till now and not taking bottle feed after several attempts. My question is should I completely stop breastfeeding? Will breast milk transfer chickenpox virus? I am eagerly waiting for your response. ### Response: Hi. I can understand your concern. If you have chickenpox or herpes zoster virus infection and you are breastfeeding, then your baby does not get infected with the chickenpox virus through your breast milk. However, if you still have blisters on your skin, then it is possible your baby could develop chickenpox if they come into direct contact with your chickenpox or herpes zoster blisters. Chickenpox virus does not spread through breast milk. It only spreads by skin contact. Since the patch is on your waist and not on any other body part, I think you can breastfeed your child." "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 said that ""oral absorption of isotretinoin is enhanced when given with a high-fat meal."" My meal, while on Accutane just has normal fat. Does it affect the absorption? ### Response: Hi. Yes, absorption of Accutane (Isotretinoin) is enhanced with a high-fat meal, but it does not keep increasing with an increase in the fat intake. So, if your diet contains a moderate amount of fat, it is enough for the absorption of Accutane." "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 tooth extraction done nine days ago top left #14 and my gums are still swollen. It looks like a white blister around the extraction site. My dentist will not listen to me and the pain I am in. Is it something I should worry about? It is causing pain too. ### Response: Hello. Your swollen gum and white blister on extraction site can be a canker sore (small and shallow ulcer) which can be treated with medicine and oral hygiene. This could have happened due to improper oral hygiene and using some pointed object (toothpick, etc.) to the extraction site. Grave disease supports mouth ulcer as well." "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 eosinophils are increased to 7. It is very difficult to breathe. An effective treatment to eosinophilia may be communicated. ### Response: High eosinophils are found in conditions with allergic reactions. I would recommend you to please see your doctor and if your chest is congested, they would help you with antibiotics, short steroids, anti-allergic, and nebulizer. If you are asymptomatic with just mild cough, a short course of two weeks with antiallergics like a combination of Levocetirizine and Montelukast works wonders." "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 had mild chest pain. The doctor did an angiogram, and they told there is a block in the blood pumping vessel and it is closed. We planned for placing a stent. The next day, the doctor tested again and told the blood vessel is opened and it is normal. So, the stent was not placed. After a few days, my father had pain below the heart which was on the rib side, and he told something is holding in the heart. So, again we went to the cardiologist. The doctor examined him and said he is fine and there is nothing to worry. Whenever he got this pain, we consulted the cardiologist, and he said there is no problem in the heart. He got this pain for about three times till now. Again, we tested for a gastric problem and a neurological problem. That was also fine after the examination. But, still he is experiencing the same pain, and he is willing to do angiogram now. I cannot understand the problem. Please suggest. ### Response: Your cardiologist would have done ECG (electrocardiogram), echocardiogram, and TMT (treadmill test). If all these three tests are normal, then the cardiac problem is unlikely to occur. If this pain is not increased during walking or any other physical activity, then it is not from the heart. Usually, heart attack pain increase during physical activity. It can be a muscular, or anxiety or microvascular angina. If he is in discomfort, you can go for an angiogram on your will" "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 32-year-old, male, 105 kg, 6 feet in height. Recently, I have been diagnosed with diabetes. I am not on any medication. I am strictly controlling food and doing regular aerobic exercises. My one hour postprandial BG is always around 200. ### Response: Hi. Please update your FBS (fasting blood sugar) and HbA1c (glycosylated hemoglobin). Anyway, your sugar values are high. So, you have to take the necessary precautions to prevent the progression of the disease. First is adequate exercise. Daily do aerobic exercise for at least 30 minutes, then comes diet control. Avoid oily food. Increase amount of leafy vegetables. Reduce salt intake. It is better to add" "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 I take Testosterone cypionate and Trenbolone enanthate, while on high blood pressure medication Benicar 20 mg? ### Response: Hello. If you have low testosterone and have been given a prescription for using testosterone, after consulting an endocrinologist you can take it. But always remember you should not have very high doses of testosterone since hypertension already puts the cardiac system under some risk for development of coronary artery disease in the future. Even though nothing has been reported scientifically, but doctors believe there is an indirect association between high testosterone and cardiac ailments. As you know men are prone to more heart attacks. So it is better to take it lower doses if it is required medically." "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 vaginal opening is white in color and it itches a lot around that area. It has been like this only for the past 4 to 5 days. ### Response: The presence of itching over the vaginal opening with white discoloration is a possible indication of vulval candidiasis or fungal infection which can be treated with local and oral antifungals, but before starting any medicines, please get it confirmed by a local examination by your gynecologist or you may send a picture of the lesion for diagnosis and further advise." "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: Dear doctor,I had protected vaginal sex (with little lube) with a prostitute. Although the condom did not break or tear, I feel there could have been some vaginal secretions from her. Since it was my first time, I did not last long and released early, but there was no leakage from the condom, which is how I confirmed there is no tear. But, the entire condom does not cover my penis, which worried me if some tiny secretion could have entered into the condom. There are no cuts or sores around my penis area. Forgive my frankness, but does moist nipple mean anything related to HIV? Also, what are the chances for, if there were any vaginal secretions near the penis base, on wiping (using a tissue) is it possible for the virus to enter through the penis? I am sorry for asking such a long question, but this was my first experience, and what happens next will decide my fate. I am willing to take the test, but I think I need to wait for the three-month window period right? Please advise doctor. ### Response: Hello. I have noted your concern. If the condom was of a proper size and well-fitted, there is no chance of vaginal fluids going inside from the base. Therefore, a protected vaginal sex is safe as far as risk of HIV is concerned. Yes, a rapid HIV screening test is considered reliable and conclusive after a window period of three months. Regards." "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 gallbladder mass and jaundice. Please help. ### Response: I have gone through the above reports (attachment removed to protect patient identity). Before going further, I would like to know a few details, 1. What is the general condition of the patient? 2. Any other illness like diabetes, hypertension, and, kidney problems? As per reports, it looks like gall bladder cancer. It is locally advanced probably unresectable because of jaundice. I would like to see films and patient myself though. If the general condition is good and bilirubin comes down to normal, we can start chemotherapy and also look for the possibility of surgery after four cycles of chemotherapy. Both surgeon and medical oncologist should see a patient decide a proper line of treatment. If the disease is metastatic, then there are no roles of surgery and only chemotherapy is advised. It helps in controlling the disease for the time being. If the condition of the patient is not good, then only palliative care is advised. If you have any further questions, I would be happy to help." "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: How likely is a CAT scan to show a lung cancer if a pleural effusion is present? My husband has a pleural effusion and has had four CT scans, none of which show any suspicious mass. Cytology records are inconclusive. I am wondering if the presence of the pleural effusion limits the visibility of a potential tumor? What about in the presence of a middle lobe collapse, could that be hiding a tumor? He has right side pain, short of breath, and was admitted to hospital and fluid drained. ### Response: Detection of tumor on CAT (computed tomography) scan has nearly 85 to 90 percent efficacy which further increases to 95 percent in post-contrast studies. The pleasurable effusion can be due to numerous causes and in your case due to mucous plugging causing lung lobe collapse-tumor need to be the cause always so do not be apprehensive about that. Any heterogenous abnormal enhancement can be a tumor seen in contrast scan which is not present in your scan." "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 2 year 9 months old daughter was tested and she has an egg white allergy. She ate scrambled eggs accidentally. Should I worry? Is it a problem if the egg is scrambled? Please, can you advise? ### Response: Do not worry. However, please watch for symptoms of allergy like hives and severe itching and in worst case scenario breathlessness. If breathlessness occurs, it is best to rush the child to the nearest hospital. The other symptoms are mostly controlled by syrup Allegra (3.5 ml) for two such doses spaced 12 hours apart." "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: The level of anti-TPO antibodies is 492. The doctors say it is a state of euthyroid. I am worried about my prognosis. I am a medical student, can I still become a surgeon? ### Response: Going by the details you have provided you have euthyroid. This means that you do have normal TSH with normal T4 and T3. The most common cause is autoimmune thyroid disease, which is confirmed by positive anti-TPO (anti-Thyroid Peroxidase) antibodies. Positive anti-TPO means you have these antibodies in your body which act against the thyroid cells. Most often this is a progressive disease. As of today, we do not have treatment against autoimmunity. Therefore, we replace thyroid hormone in the form of Thyroxine. With TSH near 10 and strongly positive antibodies, I suggest you get your TSH done after 6 weeks. If normal, there is nothing to worry. Apart from the destruction of thyroid cells, anti-TPO antibodies do not cause any other harm. Disease per se is harmless if TSH is kept normal. Keep track of TSH and treat it accordingly. This will never affect your future, and you can continue your studies without fear of not becoming a surgeon. You will become a surgeon, all the best." "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 ate my dinner yesterday, and a bit of my molar tooth fell out from my mouth. I do not know whether it is a filling or an actual tooth. Around the area, I also had a lot of solid white bumps sticking out of the tooth. It looked like plaques. I am scared of dentists. I do not know what to do. Please help me. ### Response: Hi. It can be a fractured crown of the tooth due to a cavity. You should get an X-ray done to know whether it needs root canal treatment or it needs a simple filling. Please send a picture of it to guide you further and to make a diagnosis. It is better to get it filled as soon as possible. Do not be afraid of dentists." "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 watery eye and I feel something is there in my eye since last week. It was really bad during the weekend and I found a white spot in the eye. I went to an ophthalmologist and he just had a look through the machine. He said it could be marginal keratitis and gave me drops and cream. Uncomfortable feeling and watery eye have gone, but, the spot is still there. That spot is in the cornea and I can see a white line in the white (cornea) also. What can it be? And if it is keratitis, when will the spot disappear? I am really worried. ### Response: Can you name the medicines that your doctor prescribed? Marginal keratitis is not a disease to be taken lightly. The white spot will lighten as the healing begins but will not completely vanish. Send me the pictures of the doctor\s file and the medications prescribed" "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 days ago I was diagnosed with UTI infection. I was put on antibiotics, and the ER doctor sent my urine for a culture. My doctor told me that Klebsiella pneumoniae is present in my urine culture and referred me to a specialist. What does it mean? I am 23 years old and sexually active. Will this bacteria cause harm? This year I have had about four UTIs, which is not normal for me. I am done taking the course of antibiotics. I was given a five-day course. Could this be because the antibiotics are not treating it? Is this curable? Is it contagious? Should I stay away from sexual activity? I am trying to get pregnant. Please help. ### Response: Hi. UTI - urinary tract infection caused by Klebsiella takes longer to get treated. But, once cleared it should not come back. I would suggest you carry out ultrasound examination of your abdomen to rule out upper UTI, fasting blood glucose levels to rule out diabetes and carry out culture sensitivity of the organism. Antibiotics will surely clear your infection. It is not contagious but can occur in the sexually active individual due to more chances of mucosal injury. I would advise you take a good quantity of water: Ensure water intake of 2 to 3 liters per day. It will provide a good output of urine. The high output will clear urine infection by flushing action." "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 65-year-old white male and tested negative for HIV 1 and 2 in a one-time test three to four years ago. I am not sure if it was a third or fourth generation test. I tested negative with a fourth generation test four months back because I thought I might be having some symptoms. And I remembered the flu-like illness about six months after exposure.I weighed 204 kg three months back and now I weigh 191 kg. I have worried a lot (pacing the floor, sleep loss) for past five months, took Paxil, and realized my worry could account for some weight loss. Shortly, after the test, I had the following symptoms:I started having a small patch of 8 to 10 pinpoint sized pink-light red dots under the skin of my left wrist that have been there for two to three weeks.I also had a smooth, flat spot about 3/8 inch in diameter that appeared on the back of my right hand about a week ago, that has now faded to a pinkish brown. I have read about Kaposi sarcoma being a definer of AIDS, but do not understand how that could happen with a non-reactive fourth generation test four months back.Three months back, I had sinus type headaches multiple times that would sometimes be severe. After three rounds of antibiotics and a CT scan two months back that showed shadowing in a sinus, my ENT doctor just told me this week that there is something in my sphenoid sinus. He is treating it with a rinse for inflammation for three weeks before I see him again. I have had blood in my mucous from my nose for past three months. It dries out in my nose and causes blood almost every time I pick at it. The ENT doctor said that the lining of my nose had been worn down from this, but did not seem concerned about it. I do mess with it a lot, and blow my nose a lot.My PSA elevated quickly in the last six months, going from 1.2 to 3.5. A biopsy two months back showed an early cancer in one of the 12 regions biopsied.I had a lithotripsy on an 8 mm kidney stone this month and I am still passing dark urine. I was told that I do have several small stones still in each kidney. I have had multiple stones over the years.I have a swelling sensation all the way around my waist down into my groin at times that has been there for about two months, but no noticeable swelling. Several doctors have felt in my abdomen and detected nothing abnormal. A CT scan with no contrast 10 days ago showed no abnormalities other than a little swelling in the right kidney where the 8 mm stone was blocking the passage into the ureter. A CT with contrast five months back was normal except for showing stones. But I have microscopic blood in my urine since then.My vital signs have consistently been normal for past five months, including temperature, BP and oxygen. I know I am getting old and some of these symptoms happen with age. But it is driving me crazy that so much has happened since my negative fourth generation test which is supposed to detect antibodies may not be conclusive after three to four years of exposure. I had Zoloft 100 mg daily earlier but currently, on Paxil 40 mg and Propranolol 60 mg daily.After nearly four years of exposure and a negative antibody test four months back, would that test have detected antibodies if I were in a stage of HIV or AIDS? Do you think it was conclusive? Or is there another test I should have done? I have read about an HIV RNA test, but it says early detection. I understand that it detects more than the antibodies. What are your thoughts on my next step? ### Response: Your test done before four months is certainly conclusive and final. A three months intervening period/window period between risk exposure and a fourth generation HIV screening test is good enough for it to be considered conclusive. 95 % of those infected with HIV will have detectable antibodies by four weeks and by 12 weeks, or three months 100 % of HIV infected individual will have detectable antibodies. Antibodies once formed will remain detectable by screening tests. In fact, antibody based HIV screening tests are the gold standard tests for the diagnosis of infection whereas an HIV RNA PCR test is more commonly utilized as a measure of response to antiretroviral therapy in HIV AIDS patients rather than as a diagnostic or screening test" "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 strange feeling in my left testicle. I ordered a vacuum penile pump, and I used it only for two days. After that, I threw it away fearing an injury, as it turned my urine red. After five days, I went to a doctor, because I had a strange feeling in my testes, but I did not have pain. The doctor gave me tablet Diclofenac 100 mg and Cystone tablet. I started taking these tablets, but after two days, I have pain in my left testis and pubic area. I also had pain on the base of my penis and erection problem. So, I went back to the same doctor, who gave me Paracetamol and Nimesulide. I got a little relief, but after a month, I still have little pain. My testes are red, and I have pain in my pubic bone area. My erection is normal now. Is this because of the injury from the penile pump? I am attaching my ultrasound report. What should I do? Please help. ### Response: I have seen the attached ultrasound (attachment removed to protect patient identity)" "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 LMP date was a month back. Yesterday, I took a pregnancy test and it came positive. Today also I repeated the test and it is also positive but in the afternoon I had dark brown little bleeding like spotting. What does it mean? Am I pregnant or not? ### Response: As your urine pregnancy test is positive twice after your missed periods, it indicates that you are pregnant. The bleed that you are confusing with your menses is likely to be darkish brown in color unlike normal menses and likely to be an implantation bleed post pregnancy. If you wish to be conclusive, then you may get a serum beta hCG test done. If the hCG levels are more than 5mIU then you are surely pregnant." "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 27 weeks pregnant now and by scan two weeks back and the doctor says the baby is IUGR due to placental insufficiency. She said to terminate the pregnancy but I feel baby movement and heart rate. Also, I am pre-eclamptic and diabetic but sugar is controlled. Tell me what can I do. Any treatment or way to have a healthy baby and near to due date?IUD 18 weeks, fifth-week pregnancy due to no fetal heart rate, so DNE was done. Currently, I am taking Duphaston 10 mg BD, Asgard 75 mg OD, Glucophage 500 mg TDS, and Aldomet 250 mg QID two tablets. ### Response: Hi. It would be better if you can send me your ultrasound report. You have the previous history of stillbirth around 19 weeks." "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 uneven skin complexion and dark skin. Can you please tell me any cream or foods that improve my skin and skin color? ### Response: I understand that you have an uneven and dark complexion. Also, while going out in the sun please use a sunscreen with SPF 50 to prevent the tanning of your skin. Apply a moisturizing skin cream with vitamin E in it during nights after a face wash or bath. These are general measures that will help you. If you have any specific questions, please do not hesitate to get back to me with a photo of your skin problem. I would be happy to help." "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 it possible for the knees and shoulder or spine growth plates to be open, once the hip and ankle growth plates have closed? ### Response: Hello. It depends upon the age. Because on an average if the hip and ankle growth plates have fused then the knees, shoulder, and spine follow it and close in the next six months of the onset of fusion of the hip and ankle growth plates." "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 done my TSH test recently and the result is 6.0 but my doctor did not suggest any medication. What should I do now? I am having many problems like weakness, gaining weight, dizziness, trembling, back pain, and waist pain. My skin is getting pale and dry day by day. I remain frightened all the time. I also get a problem while breathing sometimes and my blood pressure gets high like 120/90 or 130/80 mmHg and it becomes normal again. I am having these problems for five years. Sometimes they show up high and sometimes they become normal. I sleep a lot. Please help. ### Response: I just read your query as to why your doctor does not want to prescribe any medication for your raised TSH (thyroid-stimulating hormone). Well, in my opinion, he is right because your TSH is a bit high but not above 10 when we need to prescribe treatment for the same. Your symptoms which you have described are mainly due to the anxiety and depression which you have for a long time and you already took medicines for the same. These medicines which you mentioned are also partially responsible for the weight gain and side effects. They are currently not related to thyroid issues. The TSH is not so high that it would give rise to these symptoms. Well, I would suggest you follow up with a good psychiatrist in your area for these symptoms. Also, I would suggest you do complete blood count and repeat thyroid function tests in three months. 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: My 9 month old baby boy is having some issue in the left eye. Before a week, suddenly one day, I saw his left eye half red and then it slowly subsided. But now, there is some little part of his left eye seems to be permanently reddish and some part of his eye pupil edge looks whitish. I am worried about that whitish grey part of the eye pupil edge. I am attaching an eye close up photo of him that is continuous for the last one week. Could you please help me know if there is anything serious or underlying disease or it can be treated easily? ### Response: Hello. I have gone through the image (attachment removed to protect patient identity). It looks like an allergic reaction. I suggest the following: Consult your specialist doctor, discuss with him or her and start taking the medicines 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 am a 16-year-old guy. My height is 168 cm. My weight is 65kg. My father\s height is 178 cm and my mother\s height is 164 cm. I wanted to ask to can I consume Oxandrolone? Is it safe for me? Also, how can I increase my height in this stage? ### Response: Your height is almost the average of your parents. At 15-17 years in males growth plates close and then there is no increase in height possible after that. You are almost in that age. Do you have any other symptoms of impaired secondary sexual characteristics? You can have bone age checked if you want to confirm it. Oxandarolone is an anabolic steroid. It increases weight an not height. Some people using Oxan" "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: Does Ayurvedic massage help to remove toxins from the tissues? Do they help to remove toxins from the body through the skin? Which organs are used to eliminate the toxins from the body? ### Response: Ayurvedic massage loosens the toxins from the body, and by a steam bath, it will get eliminated from the body in the form of sweat. The therapy used to remove toxins from the body is called panchakarma which includes five procedures. First one is called Vamana karma which is also known as medical emesis. Virechan is one of the panchakarma therapy where the toxins are eliminated in the form of loose motion. Basti is the other form of panchakarma therapy where different types of enema are used. Nasya is a kind of panchakarma treatment where the oil is poured in the nostrils. Raktamokshan is a procedure of bloodletting. These therapies will help to remove toxins from the body through mouth, anus, skin, and nostrils in the form of motion, vomiting, sweating, cough, and bleeding." "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 moved, so I do not have an OB or internist to ask these questions. I did my yearly mammogram in 3D for the first time. I did bring my past images, but they were not in 3D. I got a call back for calcifications of the right breast, and it was recommended that I get three additional images. I am anxious because I thought that 3D was meant to see calcifications very well. But, they said the report is very vague, it did not mention the size, shape, or pattern of the calcifications. Do I need to worry? I was adopted, so I do not know my family history. I have had cysts in that area before. ### Response: Hi. I saw your mammogram report (attachment removed to protect patient identity). I hope this will reduce your tension to some extent" "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 unprotected sex last March but took emergency contraceptive afterward. Six days after, I had the bleeding associated with the emergency contraceptive. Two weeks after that, in the first week of April, I had my period for six days (my usual period lasts five to seven days). In May, I had five days of the period although the last two days were only very light bleeding.Now I was due for my period four days ago, but I still have not got it. What are the chances that I am pregnant and if not should I be worried about my late period? ### Response: As you have missed your menses now by four days and if you have been sexually active during this cycle as well, then you must rule out pregnancy first with a home urine pregnancy test kit. If negative, then the delay is most likely stress-induced and you should wait for at least five days to allow menses to start naturally. If not, then you would need an ultrasound pelvis to check for endometrial thickness which if more than 8 mm. You can be offered a 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 have a hypothetical question. Suppose I was one of the rare people who is incapable of producing antibodies to HIV-2. What would you expect my CD4 count to be after four years? And how sick would I be? ### Response: Hello. I have noted your concern. Antibodies against HIV are not a very effective defense against this virus and though they may initially contribute in keeping the virus under check they eventually fail to do so. So your CD4 count would be lower than if you had antibodies against HIV and obviously it would imply that there would be a greater risk of opportunistic infections. Regards" "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: ### Response: Hi. I am a Urologist and I have performed urethroplasties. But, excision and primary anastomosis is the procedure of choice only in short segment urethral strictures and they occur in the majority of traumatic urethral strictures that occur in the proximal urethra. Such a stricture in distal urethra is rare. However, I had to do excision and primary anastomosis in an iatrogenic distal penile urethral injury, wherein the surgeon had badly damaged distal penile urethra during an attempt to dilate the distal urethra. I was called intraoperative. The urethral plate was badly damaged in that case for only 1 cm. I did excise that part and anastomosed end to end and the result was excellent and there was no postoperative chordee (bending). Other than this case, I have not done any EPA in distal urethra." "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 threadlike protrusion near the opening of the anus. It is paining the whole day. There is no blood during defecation. Please give a remedy. ### Response: Hi. The threadlike growth in the anus seems like a small anal tag, that is, just a skin tag. Usually, it will have an underlying anal fissure, that is, crack in the skin near the anal opening, that causes pain. I suggest you take the following medicines: Please review with me after three days or earlier if the symptoms worsen. You can take a picture of the area if possible, for better understanding. Good luck." "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 you perforated your rectum from anal sex, would you know within five hours? I am feeling more gas than usual. ### Response: I read your query and understand your concerns. In my opinion, any tear involving mucosa can be known to the individual within seconds rather than hours. I mean to say that if there is perforation of rectum you will know it within seconds and five hours are not required. The symptoms often include excruciating pain at the affected part and tearing sensation. 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: Can you tell me, do all the diabetics develop diabetic neuropathy? My relative is 25 and just got diagnosed with type 2 diabetics. Will she definitely develop neuropathy. Can you also tell me the estimates of the number of diabetics developing it? She is diabetic but is not a BP patient. ### Response: Almost all the people having diabetes will sometime during the course of the disease will develop diabetic neuropathy. The reason is damage to microvasculature (small blood vessels supplying the nerves) get affected. Even with fairly well controlled diabetes this does happen. In case if the control is poor then severity increases rapidly. Hence it is very essential to achieve a strict glucose control all through out the course of the disease." "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 tested negative for ANA but positive for anti-dsDNA. My GP diagnosed me with ankylosing spondylitis when I have many symptoms of lupus just not the rash. My sister also has lupus and did not test positive for ANA. She has seronegative lupus. I am under the impression that anti-dsDNA has nothing to do with ankylosing spondylitis. Is that correct?I am currently taking Gabapentin, Tizanidine, Naproxen, Levothyroxine. ### Response: You are right. Anti-dsDNA antibodies are specific for SLE (systemic lupus erythematosus), especially if the titers are high. Ankylosing spondylitis does not give you any kind of antibodies. Anti-smith antibodies are the most highly specific antibodies for lupus, but only a small percentage of people with lupus have them. Did you get that test? But it is strange that your ANA (antinuclear antibody) was negative. Anti-dsDNA is a type of ANA. I believe it is a false positive. A normal sedimentation rate essentially rules out inflammatory pathology. Lupus is an inflammatory disease. To begin with, we need to know more about your symptoms. SLE is diagnosed based on the symptoms and signs along with laboratory tests. It is not diagnosed just on the basis of an antibody test. You can get false positive tests (positive test in the absence of disease). So please get back to me with details of your symptoms. Based on the information you gave, I do not think you have lupus. There are no blood tests that can diagnose ankylosing spondylitis (AS). HLA-B27 is more common in people with AS, but it is not diagnostic. AS diagnosis needs clinical and radiological criteria. 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 a fluttering feeling in the chest regularly and have had an ECG done showing PVCs. Is the attached ECG a cause for concern? ### Response: I have gone through the ECG test result, and all seems normal. Nothing significant to be disturbed about. PVCs (premature ventricular contraction) are very common among the healthy population." "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 done my C1 and C2 surgery with screw fixation. After three months, my head is little flexible to move down and backward but not left and right (the surgery moto is not to turn my head). But for the past one week, I am facing that my neck is very stiff and my right shoulder feels like very tight and weight (sometimes I get pain). Because of this, my total head feels like very tight and with this, I am not able to move my head down (but can move backward). After I consulted with my doctor and took an X-ray and checking that there is no fault in my screw fixation, that is perfect and he gave me some tablets too. But still, I am facing neck, right shoulder (starting from neck till shoulder knee) stiffness. ### Response: Hi. Your X-ray looks fine (attachment removed to protect patient identity). So, nothing to worry. Yes, you can travel but if you have pain and stiffness, then you need to use a soft cervical collar-size depending on your neck length, or it can be adjustable. If you do a sitting job, then you should get up once every 15 to 20 minutes and take a small walk for two minutes everytime. For the lower back, you need to do McKenzie back extension exercises (cautiously under the guidance of a physiotherapist, as the neck should not get a lot of strain while exercising)." "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: What can be done for low calcium in a thyroid patient? ### Response: Is it possible you can do histopathology of thyroid gland to rule out? You have many metabolic disorders that you need correction (attachment removed to protect patient identity). Relative hypocalcemiaThyoid Disorder Histopatholgy of thyroid and parathyroid GlandMRI Thyroid GlandCollor Dopller Thyroid Gland Relative HypocalcemiaThyroid Carcinomatous change Thyroiditis Tab Zecal MAX1 Tab po od 1 monthSalt added foodSyp Potklor 10 mlPo bd with glass of juice SteroidChemotherapy With report" "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 facing a toothache problem, especially at night times. There is higher pain from the last three days. Please suggest me a solution for toothache problem. ### Response: Hello. As you are describing it as night pain it looks like the infection in your tooth has reached pulp and now requires root canal treatment. Please get an X-ray done and send the photo of the X-ray as soon as possible. For now, you may take the following medications for three days: Amoxicillin clavulanate 625 mg, twice a day, Paracetamol 500 mg thrice a day, only when pain is there, otherwise take only Amoxicillin clavulanate tablets. Revert back with X-ray. Follow up after two days. Follow up after two 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: Will without thyroid gland reduce lifespan? Is Levothyroxine harmful to liver and kidney? Is synthetic Levothyroxine mechanism different from the original? How T4 converts to T3? What is the side effect? Can I marry someone? I am a lady. Will I conceive? I have no cancer after nodule operation. I have a suspicious follicular adenoma. ### Response: I just read your query and I would like to answer your questions one by one. No, being without thyroid gland will not reduce lifespan. No, Levothyroxine is not harmful to liver and kidney. Synthetic Levothyroxine mechanism is not different from the original. T4 converts to T3 by an enzyme present in the body. There ae no side effects. And of course, you can marry someone and conceive if you are on correct treatment." "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 26 year old female. My face tone looks uneven and very dull. Can I use Kojivit gel to improve my skin tone along with clearmin soap? Is clearmin soap good? Or please suggest any other soap. ### Response: Hi. You may continue the use of Kojivit gel, which has Kojic acid. However, I would recommend you to replace Kojivit gel with Vitamin-C based creams. The soap you have mentioned is fine, but make sure you are following a good facial routine, which means cleansing, toning, and moisturizing. I would better recommend a face wash which is more gentle and hygienic than soap. You may try Cetaphil face wash and moisturizer depending upon your skin type, and you can also tone your skin with rose water sprays regularly. As per recent research, Vitamin-K based creams work much better for skin moisturizing along with improving the blood supply and regenerating the broken capillaries, which are responsible for dullness over some time." "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 19, exercise regularly and eat healthy, yet my blood pressure is always very high at the doctor. He says this is only because of my anxiety disorder. It has been as high as 168/110 before. He did a physical and CBC, thyroid, glucose, and kidney function test and they all came back normal. Does this rule out secondary hypertension? ### Response: Hi. A renal function test will not be helpful in this case. An MRI or ultrasound of the kidneys would be required to rule out a possibility of adult polycystic kidney disease. Also, I would like to know if either of your parents has hypertension or autosomal dominant adult polycystic kidneys." "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 husband abused me emotionally and physically for five years. He feels very low, sad and feels negative towards everything. He has self-pity. It happens for a few days to few weeks. After that, he starts having anger. Finding fault in everything especially in me. He has the habit of doing emotional abuse which again goes on for a few days. On following it, he becomes aggressive and then there is physical abuse too. Then, he becomes ordinary. He is a very loving, and a caring spouse. He is dependent on me. Then again the whole thing gets repeated. What is happening to him? He had taken Fluoxetine for eight months before 15 years. ### Response: Hi. Your husband may have depression or anger outburst problem. If your husband is abusing any substance like alcohol or cannabis, it can also cause the above issues. Your husband needs face to face psychiatrist consultation. His symptoms can be controlled with medication and need to stop abusing alcohol or cannabis. Try to find out if your husband has any social, financial or work problems. Help him. You must spend quality time with him. You must take dinner or at least a one-time food together. Try to go for walk together daily after dinner or early morning for 30 to 40 minutes. Give him surprises or try to make him happy. Fluoxetine is one of the right options for your husband. It will help him to manage the depression and anger outburst" "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 Abilify (2 mg) help me get off 37.5 mg Effexor? That is what my psychiatrist prescribed. ### Response: Hello. You are taking a minimum dose of Effexor on alternate days, and it is relatively easier to get off from this dose. Abilify is Aripiprazole and is an antipsychotic" "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 35-yearold female and do not have children. I have two intramural fibroids of 2.5 cm in size, putting pressure on the cavity.Doctor suggested laparoscopic myomectomy along with the removal of chocolate cysts on the ovary. I want a second opinion.Is surgery necessary? How long should I wait to conceive after surgery?Is reduction of the size of tumor necessary before surgery? ### Response: Hello. I have gone through your history and understood your concern. It is better to go for surgery because it will increase the chances of pregnancy, and it is better to reduce the size of the tumor because it causes pressure on the uterine cavity. You can wait for 3 months after surgery to conceive again." "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 an unprotected sex, and then after 18 days, 40 days, 90 days, I had an HIV 1 and 2 antibody test including p24 (combo test). All four times it was negative index value around the same of .016. I have read about immunodeficiency people developing late antibody. I am really stressed out that am I having pre-existing immunodeficiency. I have never been hospitalized for any medical reason, and I do not fall sick very soon, like I get fever once in two years. Please advise what to do. Should I test again? ### Response: Hello. If you go again and get tested and then also if it is below 1.0, you are not at all infected with HIV. As per your statement, you had no complaints till test. If you felt sick, then it might be a problem. For any sickness due to low immunity, do not have any assumption or prediction as it is not fine. So do not go for any test. Try to boost up your immunity with a healthy diet, morning walk, some outdoor activity." "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: Do you have experience with FAS/FASD? Can prenatal exposure to alcohol cause a short columella? Is this common in those with the affected face? ### Response: Alcohol is a known teratogen for the human fetus. Consumption of alcohol during pregnancy is associated with abnormalities in the fetus. The problems can occur in many systems, most importantly facial changes, heart abnormalities, kidney abnormalities and neurological (structural or functional) abnormalities. Three findings are common in facial abnormalities: 1. Smooth philtrum (a groove seen from the bottom of the nose to the upper lip will look flat). 2. Thin upper lip. 3. Narrow palpebral fissures of eyes. Short collumella can be an associated feature, but that alone cannot be used to label the diagnosis as fetal alcohol syn" "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 run over by a car four months ago. I got an MRI and the doctors said all my ligaments and meniscus look fine. However, my kneecap is dented in, slightly swollen above the cap. If I overuse my knee, the whole leg swells. I have been going to wound care doctors for four months for this. I have constant pain shoot up to my hip and every five to 10 minutes the knee burns and starts shooting pain all over to the point where I want to cry. I cannot feel the pain on the skin and the meat on the right side of my left knee but it still hurts when I move. I have attached the films for your reference. Is there anything else that can be wrong with it? I feel the doctor has not correctly diagnosed the condition. ### Response: I have seen the films (attachment removed to protect patient identity)" "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 19 years old. I had sex with my partner two days ago. We were protected. He told me that he even pulled out on time. But, it was our first time, and hence we were clumsy and all. And now I am kind of paranoid about getting pregnant. I have looked up other options which suggest taking a birth control pill, but since it has other side effects too, I am not actually in favor of taking it. My period is in two weeks, and since the symptoms of pregnancy and PMS are almost the same, I am worried. Maybe it is just because it was the first time but still, should I take a pill? Or should I just leave the situation as it is? ### Response: Since there was no ejaculation, there is no chance of pregnancy. But, if you have a doubt then take an emergency contraceptive pill within 72 hours of intercourse. There is no chance of pregnancy. However, if you have a doubt then get 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: I am a 19 year old boy and I have myopia (2.5 approximately in both the eyes) and I am wearing glasses since two and a half years. Now, I am thinking to quit glasses. What best can I do to reduce the power and quit glasses completely? ### Response: Hello. Myopia is a refractive error. The change in your refractive correction should be checked every six months to note any progression/improvement. Even a fundus examination is necessary. The refractive correction needed can be given either via spectacles or contact lenses. Giving up on glasses will not help. It can further increase the refractive error. If you are not comfortable with glasses, you could switch to options like contact lenses." "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 kind of flap in my mouth since three weeks in the inner left cheek near the saliva hole. At the beginning, it was bright red with light pain when I put my tongue on it, and now, the flap is the same color than the rest of my mouth and painless. What should I do? ### Response: In the absence of pain, it seems to be a case of fibroma, a non-benign lesion and you need not worry about that. This can be due to trauma, bite or sharp tooth or broken tooth in the area. However, I need to rule out the possibility of stone in duct and tooth. Can you answer these questions: Do you feel any pain on chewing or during eating in any part of the mouth or gland? Is there any pain when you bite? Do you have any carious tooth in the region? Do you have any history of biting in that region? Any other problem for which you are taking medicines?" "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: What is the treatment of mania? ### Response: Hi." "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 my mother\s ultrasound done today. She is a 39-year-old anemia patient admitted to the hospital. She has hypothyroidism from the last 12 years and is overweighed and obese. Her ultrasound shows 19 cm liver from the mid-clavicular line with increased echogenicity. Is this something of concern? If yes then what has to be done? ### Response: I have reviewed the ultrasound report (attachment removed to protect patient identity) and I can say that she has hepatosplenomegaly probably due to fatty liver disease. This is why to my opinion she needs to do liver enzyme tests like AST, ALT, GGT and alkaline phosphatase, blood work too. It is important to lose weight and to avoid fatty foods." "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 29 years old, male, unmarried. I was doing masturbation for 10 years. I became so addicted to it that every day I was doing it and sometimes I am doing it more than once a day. I know it is dangerous to my health. So, in between, I have controlled for some time and then I break my rule myself. This time, I have decided I will do it only once a month and decided to not watch any sexual videos. I had ASD issue in heart, it has been closed by device last month. Now I am alright but having Aspirin tablet once a day by doctor\s prescription. Nowadays, my sperm automatically comes out (I could see in my inner). And my semen amount has become very low and decreased in density. Nowadays it looks like water. I am afraid because within six months my marriage. I know I have done a very big mistake. Please help me. And I promise I will not do this again. ### Response: I would like to tell you that masturbation is a safe and healthy habit. Most of the males masturbate and this is normal. Masturbation does not cause any weakness or loss of fertility or any other harmful effects. Even if you masturbate daily even then that is normal. You have stopped masturbation and are not engaged in sexual intercourse with anyone so spontaneous leak or nocturnal emissions will occur normally. This is a normal physiological response of the body to get rid of the semen formed in the body. This is not a reason for weakness. Everything is in your head only. You can masturbate once to twice a week and in some days the problem will be solved and the concentration of semen will become better. No need to worry about that. Just remember this is normal and you have not made any mistake" "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 filling done last week on my distal lateral incisor. It was pretty sensitive for a few days but it dissipated. This morning, after I brushed and flossed, the sensitivity to cold air returned and was getting progressively worse with throbbing and a headache. I took four 200 mg Ibuprofen which is stopping the throbbing. Is sensitivity like this normal? No allergies, no medications, 5\3\\ height, weight 115. ### Response: Hi. I have gone through your question. I can understand your concern. I think there is a breach or dislodging of filling. You need to visit the dentist again and get a dental X-ray (IOPAR) done. It is reversible pulpitis and you will feel pain and sensitivity. Use fluoridated toothpaste and take Aceclofenac 200 mg twice daily till you visit the dentist." "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: Please find the attached echo reports of my 18 days old baby boy. Please review and give your feedback. ### Response: Hi. I have gone through the echocardiogram reports (attachment removed to protect patient identity). 1. Normal breastfeeding and monitoring of symptoms.2. Keep close contact with pediatricians." "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 and I had unprotected sex yesterday. Her period also started yesterday. It was the first day of her period. She took an I-pill after seven hours. Today also, she was bleeding and again we had unprotected sex. Her period cycle is of 24 to 27 days cycle. Will she get pregnant? Please help us. ### Response: I have gone through your history and understand your concerns. As you had I-pill, the chances of pregnancy are not there in your case. But as you had unprotected sex after I-pill, then the chance of pregnancy is again there but as she is in her menses, there is almost no chance of pregnancy" "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 23 year old male who has just returned home from a year\s trip to a country known for high rates of pollution. I am currently experiencing shortness of breath (no coughing) and excessive burping. I will try to provide you as much detail as possible. When I went, I did not have any symptoms. Three months had passed with no problem. Then I slowly started to become tired while working out and eventually at the five-month mark I was exhausted. The main symptoms I had were fatigue (unable to exercise at all), shortness of breath, pain/discomfort in the upper back, and excessive burping. Now after returning (been back for two weeks), I only have shortness of breath and burping. I still feel some discomfort in upper back but not as severe. I went to the ER and got a chest X-ray and blood work (I have listed the tests), all came back fine. So as of now I do not know what to think and I am debating whether to return there as it is known for its high pollution rate in most cities, and at times it seemed that my symptoms fluctuated with the pollution level. I do not know what to think about the shortness of breath. It feels as though I need to take deeper breaths. I am able to exercise again though. I am currently using Omeprazole for the burping. I have been using it for almost two weeks and it is not helping at all. I also have antacid and digestive enzymes that I use occasionally. What are your suggestions for tests I should take or in general? I honestly want to know if it would be a good idea to return given the information I have provided. ### Response: In case all your investigations are normal then you probably have acute bronchitis or associated anxiety. In your case scenario, my suggestion would be antiallergic like Levocetirizine and Montelukast once daily. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. I hope it 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 hypertensive and diabetic, FBS 100 to 110, PPBS 120 to 130, HbA1c 5.3 (last measured), taking Glyciphage 1 gm, Telmisartan 40, and Amlodipine 5 mg. Clinical BP 150/100, just after clinic 125/78, at home 115/75. Fatty liver II, prostrate 25 CC (no problem urinating, no burning sensation, etc.,), lipids are under control.I would like to know how to reduce the fatty liver condition from II to I. Is any medicine available? I had suffered from hepatitis two times during childhood at 7 and 10 years of age. No smoking and drinking at all. No pain in the abdomen. The problem faced now are that for the past few days, I am suffering from excessive gas, bloating, and discomfort in the neck and food pipe, as if some air is trapped which is expelled as burps at times and relieved after I took PudinHara and Raciper plus (given to my wife when she was suffering from IBS). No difficulty swallowing food. But a light pain in the neck which is relieved with flushing out the air. Please advise for medication. I had experienced this condition in the past also say 2 to 3 years back and that time it was good using Omez for few days. I am having microalbuminuria sometimes. It is below (UACR values). ### Response: Hi. For the treatment of fatty liver, first of all, I need to know your liver function test. If you have your recent LFT report please attach it. If not done yet, please get it done and write 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: I have found out that there is possible, though less likely to be infected by HIV through tattooing if done carefully and professionally with the equipment either sterilized or new. What I am anxious about is that my fiance got a tattoo done yesterday, unprofessionally (it was done by a local tattoo artist in our village who gives tattoos at the artist's own home). My fiance had his parent\s consent before he got this tattoo. But, young as we are, we are not yet aware of the risks of this unprofessional method of tattooing. This morning, my mother warned me about the risks of getting HIV through the tattoo.I am concerned because I was an eye-witness of the process, the artist just drafted the design with a pen. I saw the artist pour the ink from the bottle to a cup that has obviously been used before. I just found out today that new needles should be used, and I am troubled because I did not see the artist change the needles before he gave my fiance his tattoo. While tattooing the artist is wiping off the blood and extra ink off of my fiance's skin with wet cotton (he just used tap water in a basin). Lastly, when the tattoo was done, he wiped Petroleum jelly over the area. Now, I am very anxious because months ago I found out that HIV and AIDS are very common in our area.These are my questions. Is it possible that my fiance might have acquired HIV through the tattoo process because of the unsterilized and reused equipment? How high is the risk of him being infected? Should I advise him to get an HIV test? And if yes, what specific type of test and when should he get the test? What other health issues are more likely acquired by my fiance after the tattoo session? ### Response: I understand your concern. Firstly, stop worrying. There is a solution to your problem. It is true that unsterile needles used for tattooing can lead to the spread of certain blood-borne infections. HIV virus is quite unstable outside the human body, so it is less likely for the virus to have been active on the needles, but we cannot rule out the chance of him acquiring the infection. HIV virus does not usually show up on blood tests very soon. The best thing to do is to talk to your doctor about the exposure and your fiance can take post-exposure prophylaxis. Some medicines will be given that will help to prevent infection in people who might have been exposed to the virus. There may be a risk of other blood-borne infections like hepatitis B, hepatitis C, tuberculosis or Staphylococcus aureus. These can be prevented by taking appropriate treatment. Please talk to your doctor. I hope that 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 a 33 year old female. I have acne on my face. After delivery, I put on weight (74 kg) and today I am 66 kg. I have used hormonal tablets for six months till February due to periods problem. Now, I am not using any tablets and my periods are regular. Almost for four months, I am facing acne problem. My skin also looks so dull and dead. Please suggest. ### Response: Hi. Do not worry. Acne in your case is due to the hormonal changes which occurred due to the medicines you took in February and due to childbirth. But, just relax, it may take some time, like up to four months, but it will be fine. Apply Skinoren cream (Azelaic acid) in very little amount only on the pimple or dark spots only at night. Take very little amount. You will experience slight peeling of your skin but do not panic. Use Cetaphil cleanser. Use for three weeks" "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 major depressive illness,sleep deprivation,anxiety attacks,heavy breathing ,fatigue and exhaustion.i am a doctor myself, and currently taking Petril 0.5mg. I need help. ### Response: - I note that you are taking Petril 0.5 mgs ( clonazepam). Petril is good for short term management of stress , anxiety and help you to calm down. As you know it is not recommended for long term use due to risk of dependence and tolerance. You can use petril occasionally as needed for upto 4 weeks - If depression and anxiety symptoms are severe and persistent, you will benefit by taking SSRIs ( like Fluoxetine, Sertraline or Escitalopram). - In addition to medication, make lifestyle changes to improve your mood. Regular exercise helps. Try walking for atleast 20-30 mins daily. Talk to a trusted family member /friend about any ongoing difficulties. If feasible, consider CBT which will be helpful to manage and prevent relapse of depression & anxiety 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 a 66-year-old male with no hypertension and non-diabetic. Since many years I have the dry eye problems and have been using Refresh tears drops or Refresh Liquigel. Last year, I developed frequent twitching of eyes and eye specialist prescribed the same eye drops and fish oil 1200 mg that contains 360 mg of omega 3. Since then, the dry syndrome improved a lot. I am continuing to take the fish oil one gel a day soon after lunch. My eye pressure is normal (L 14 R 17) and no glaucoma. I have mild cataract formation in my right eye and I am advised to wait for another year for its removal. I use only reading glasses. However, one and a half years ago, one eye doctor who checked me for the change of eyeglasses suspected that I may have an open-angle problem and graded it as grade II. But in later check up with another doctor, it was ruled out. My cornea is fine and nerves are fine too. My height is 172 cm and weight 68 to 70 Kg.Current problem and symptoms are as follows:I have again twitching (not as frequent as it was during last year).Dryness in both eyes.Burning sensation especially during or after computer work.Mild pain on eyebrow area (occasionally).No discharge in both eye and no redness except one mild blast in the right eye extreme left the bottom corner.Normal Vision.No problem in eye rotation.Concerns:I am using the refresh eye drops for more than five years. Will it be a problem?Using GenTeal gel continuously for past two months. Will this be of any problem?Taking one capsule a day of fish oil (1200 mg of which 360 mg are omega 3). Will that be good as I am taking it for more than seven months now? Can I continue to take this? Seeking advise for improvement of my present condition or symptoms as mentioned above. ### Response: Hi. You seem to be suffering from what we call myokymia. It is a benign twitching of the eyelids. The other know factors which cause and aggravate it are" "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 one ear plugged completely with limited to no hearing on that side. I have been to the doctor and received Amoxicillin and steroids for it as well as Ciprodex ear drops and a Bromide nasal spray but my ear is still plugged. I woke up last week with this condition and debilitating vertigo as well. This is the first time I have had such debilitating vertigo in general. I went to urgent care and received a shot of Zofran to stop the nausea and purging. The dizziness has tamed down a bit, but still, I get woozy when I turn my head or look up and down. I am worried about the lasting condition of my ear and would love some help as I have not been to an Otolaryngologist yet. ### Response: Your ear bulging is mostly because of eustachian tube dysfunction and middle ear inflammation. Chewing gums may help in opening the obstructive eustachian tube too. Now about vertigo, it is now related to certain positions as looking up or down. So, this type of vertigo is related to your inner ear. Many" "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 low fever since yesterday. My TLC is 7100/cmm. In urine report pus cells are 2 to 4 hpf, epithelial cells are 1 to 2 hpf. Everything else is absent and normal. What infection could it be? What medicine to take? ### Response: Hello. It seems to be a typical result. Have you any other symptoms besides low fever? If you have pain, difficulty, or burning sensation during urinating, it may be a urinary infection, and the urine analysis is not done properly. It must be done with the first urine of the morning and the middle portion of the complete amount if you have not other symptoms, it may cause a common simple viral infection. Nothing to be worried about. I would recommend you to have another complete blood count with formula and fibrinogen and CRP included, and a urine test too after a few days. Meanwhile, have a light diet with plenty of liquids and vitamins. Antipyretics are only to control the temperature if it goes high." "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 got married 2 days before. My penis got erected while doing foreplay. However, after some time penis gets loosen and become small. So, could not penetrate my penis. Is there any issue in my health? Or is this due to first time fear? How to approach this? Please advice. ### Response: Since you got proper erection during foreplay and there is no history of difficulty in erection it was the result of performance anxiety. This generally occurs in first timers and especially in young age. I do not think you need to be concerned at this level as occasional failure is rule rather than exception. Almost all men report such problem in erection psychologically on certain occasions without suffering from any disorder." "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 27-year-old female, and I have mild, cystic acne for the past five years. Yesterday, I got prescribed with Accutane 20 mg per day, and my weight is 50 kilograms. If everything is fine, I will be taking it for the next ten months. I know that taking Isotretinoin can cause idiopathic intracranial hypertension and I also take Tetracycline. I have heard that both should not be taken at the same time.I have been taking 100 mg Tetracycline for the past one week (seven days). I took my last pill yesterday evening. How long is the wash-out period of Tetracycline is? If I take 100 mg Tetracycline per day for seven days, when can I start taking Isotretinoin? Taking after 24-hour is enough? ### Response: There should be a time gap of seven days between stopping tetracycline and starting Isotretinoin. Monitor your fasting lipid profile and liver function test. While on Isotretinoin, you should not conceive. There should be a gap of six months after stopping Isotretinoin." "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 20 year old male suffering from long term constipation and gas problem for around 1.5 years. I have consulted many doctors and they usually suggest digestion tonics and tablets. One of them suggested me to do regular exercise and morning walk but that also did not help much. I have strictly banned myself from eating junk or street food over 6-7 months. My weight has not much increased in this period instead I have gained fat in my belly part. Main problem which I face in day to day life is constipation which includes less regular motion and sometimes no motion for two to three days. I always feel stomach bloating. Other problems are acidity or acid reflux, feeling of tiredness, less motivation to work, dry skin, dandruff in hair and hair fall. Occasionally I feel sleepy and there is some joint and muscular pain. Seven months ago, I had stone in my kidney. It was removed by surgery using PCNL technique. Also four years back, I had appendicectomy. ### Response: Functional. Thyroid and blood sugar. Acid peptic disease. IBS. Revert back after 10 days of starting the medicines to 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: My two year old son has eye power.RightS C A-1.50 -1.00 169-1.50 -1.00. 171-1.50 -1.00. 171-1.50. -1.00. 171.LeftS C A2.00. 0.75. 1491.75. 0.75. 1401.75. 0.75. 1391.75. 0.75. 140Does he need glasses? Which type of eye power? Will his number reduce when he grows? He squints a little. ### Response: Hello. I have gone through the reports (attachment removed to protect patient identity). The retinoscopy that has been done is the final refractive error. The automatic refractometer readings that you have mentioned are in negative but retinoscopy that has been mentioned is in +3.0. Your child is esotropic, that is inward-deviated eyes. So, we will subtract 1 for atropine. The final refractive error is plus 2 in both eyes. The frame should be plastic, squarish, lightweight and cover both eyes easily. These glasses will serve two purposes. One, it will help your child see clearly and two it will straighten his eyes. You have to get four to six monthly checkup. As he comes of age, surgery can be done for squint" "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 bad throat maybe because of change in weather as I am traveling. It is like flu with a bad throat and with a blocked nose. Also, my spit is in green color now. Can I take antibiotics? Is it bacterial or viral? I m attaching a picture of my spit. Also, I am on Metformin for weight loss and I am a prediabetic. Please help. ### Response: Hello. If it has just started now you can take antibiotics. I suggest you take tablet Azithromycin 500 mg once daily for four to five days and tablet Hicet DC (Cetirizine and Phenylephrine) one at night for three 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 have some small white spots on my skin of the legs, from the past two years. I was taking homeopathic medicines for it. From the past six to seven months, some new patches are coming on my face. These spots are spreading fast, and it has become a serious issue. Kindly suggest some quick and efficient treatment. ### Response: It is vitiligo and since new patches are appearing it is called unstable vitiligo. How many patches are there over your body other than your neck? I suggest you try using the following: You should consider visiting a dermatologist because treatment for vitiligo takes time for repigmentation and since new patches are appearing, oral steroid or Azathioprine can be considered after examination and blood investigations. Please visit a dermatologist, and it is better to take treatment at this stage before other body parts are involved." "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: Hello. Does having low (and high) blood levels have anything to do with overly oily skin, burning lips, a painful throat and thrush? I\ve been feeling these symptoms for 3 months and I can\t take it anymore. I\m getting a blood test done this week; which levels should I particularly make sure are tested?I\m looking forward to your reply. ### Response: Hi! There could be multiple factors involved over here as a result of which these symptoms are occurring. I would recommend you to perform the following tests mentioned below All these tests have a purpose and can detect any underlying abnormality that\s there in the body. In addition, please do get the above mentioned tests done so that we can treat you in a specific and precise manner. There is nothing that you need to worry as things will fall in place once we treat the etiology of the problem in concern. I hope I have answered your query in detail. If there is anything more you want to ask or enquire, please do let us know and we will get back you ASAP. Warm regards." "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, 18 years old, 5 feet. I weigh 50 kg. I am having a problem with my wisdom teeth. They are impacted and causing me a lot of pain. ### Response: I understand the pain you are experiencing due to impacted wisdom teeth. These teeth should be removed to alleviate the pain. They are removed by surgical procedure mostly under local anesthesia. Sometimes they are done under conscious sedation also. It would be great if you could send me the X-rays pictures. I could diagnose and let you know the difficulty in removal. For pain reduction, you can continue the same medication. Kindly rinse your mouth using salt in lukewarm water frequently around 4 to 5 times daily till the wisdom teeth are extracted." "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 just wondering how long germs would live on in a liquid lipstick? Around five weeks ago I had a vomiting bug, most likely gastro. I went out on Saturday night and wore a liquid lipstick, and was sick on Sunday. Will these germs still be living in the liquid lipstick and make me sick again or will they have died. Also, if I shared my liquid lipstick with someone who potentially had a cold sore, I am not sure if they get them or not, would those germs live in the liquid lipstick? ### Response: I understand your concern. There is exactly not much research done on how long bacteria or viruses could survive in a liquid lipstick. If you have had a gastrointestinal infection, and if your lipstick came in contact with your saliva, the microbes could have gone into the lipstick. How long they survive in the lipstick, and how fast they multiply, largely depends on what kind of chemicals were used in the making of the lipstick. Moreover, different microbes need different kinds of growth environment, so it is hard to comment on that. I would advise you to avoid using cosmetics when you are sick. Regarding sharing of your lipstick, it is never a great idea to share your cosmetics with others. Cosmetics should be used as personal items, just like you would use your toothbrush. Sharing cosmetics can lead to the spread of skin infections. If you think you have shared cosmetics with someone you think might have some kind of infection, I would advise you to dispose it, and buy something new. 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 18 years old and I do not know what is wrong with me. I think I have severe depression and anxiety, but obviously, that cannot be 100 % accurate. The thing is, I think I am depressed, but there are times where I feel on top of the world. Maybe I have bipolar disorder? I do not know. I have been researching a lot lately and I have watched videos of people experiencing a maniac episode and I feel like sometimes I act like that. I am not sure though. It would really help if I could talk to a professional, but I am scared of asking my parents to see one. I know they would probably say yes and accept me but I have just always been closed off. So, now I am here. Please help. ### Response: Ideally, you should collect the courage to tell your problem to parents because you are still very young. If not comfortable with parents some close relative or friend or free helpline. Making the diagnosis of depression, the symptoms must present for at least two weeks regularly. Sometimes we see someone close to us suffering from any disease and try to find or check yourself for these symptoms, remain anxious with their thought, later that thought can lead to depression. One more easy way to decide is to ask yourself whether normal functioning is hampered. If the answer is yes you should go to a psychiatrist as early as possible. Again saying that taking help from the parent is the best option in front of you. Do not be afraid of the treatment. It is very simple and easy to treat depression nowadays." "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 age is 23 years and I am a student. Since the past one year, I find my handwriting to be abnormal. In other words, I am not able to write in a way that I used to before. I earlier thought that this was because of lack of constant practice. However, even after continuously writing for one or two months I am finding it very difficult to write legibly. My handwriting used to be good but now I am almost scribbling. Also, I am finding it very difficult to write in a legible and understandable manner and end up straining too much. I find my colleagues being able to write faster but I am very very slow; it was not like this earlier. Is this a nervous issue or is it normal and temporary age-related issue? Please suggest me a remedy. ### Response: Hello. In most cases, this is normal. There is nothing to worry as such. However, I would recommend you go for vitamin B12 levels and thyroid test. Get the tests done and write back with results. Revert with more information to 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 a health and exercise question. I am 24 years old and I weigh 293 lbs, 5\9"". I have polymyositis. I started a new workout today. I did five pushups, five reps, five squats, eight reps, 20 standing stiff leg ups, seven reps, five flys, eight rep, 10 curls, 10 reps using two eight lbs gallons of water. Not all at once, alternating between arms and legs. I wanted to know if it was fine for a starting workout. I also had 151 grams of protein so far today and one gallon of water to drink. Is this fine for a starting plan? ### Response: Hi. Having polymyositis, you should start with a fewer resistance exercise and more of stretching exercises to improve flexibility. Yes, the exercise plan you made is fine for a good start. But maintain the muscle length through stretching exercises before initiation of the workout. Protein content increased by 250 gms per day and one gallon of water. Take equal amount of rest in between the sessions. It helps the recovery of muscle soreness. It can include aerobic exercises. Count your heart beats to increase the time period." "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 unprotected sex. I took Plan B (72 hours) pill almost right after, four hours later. I consulted with the pharmacist on the phone but she sounded careless and told me it was safe to use. I am too young. The main question is I do not know if I should even call this vaginal sex because he did not cum and we decided to call it off after three minutes because we were scared of the consequences. But I took the pills anyway, just in case. Can you help me? ### Response: Plan B is an emergency contraceptive to be taken in case of male ejaculation inside vagina. If you have already taken the medicine, nothing much can be done right now. I hope you have attained menarche, so then you should get your periods in the next two weeks. The next period might be a bit irregular due to the pill effect. If there was no ejaculation or pre-cum, there is no chance of pregnancy." "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 passing stool yesterday, I noticed bright red blood on the toilet paper after wiping. Now today after passing stool, I noticed a bit of bright red blood on the toilet seat, but not in the stool and a bit when wiping. I am suffering from a bit of pain when this happens, and the bleeding stops quickly after and only occurs again after passing stool. I believe that I either have an anal fissure or hemorrhoids. So my question is, will this heal on its own? If yes, then how long will it take to recover? Is this likely to get worse, or what can I expect over the next few days? Should I purchase Anusol to help it heal? ### Response: I can understand your concern. Your symptoms are consistent with anal fissure. Yes, fissure will heal on its own, provided it will get a proper environment. An anal fissure can be prevented by avoiding constipation. Because constipation will produce more pressure on the inner wall of the anal canal, which worsens the fissure. I suggest you try taking medication for pain, apply local anesthetic ointment for quick pain relief, anti-inflammatory medication, and sitz bath to reduce the swelling. Consult your specialist doctor, discuss with him or her and start taking the medications after their consent. Consult a general surgeon and get clinically evaluated" "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 27 years old, and I have 1.6 months old baby. After my delivery, I am getting scared for everything. If something bad had happened to anyone, I am scared to talk with that people am thinking that it will happen to me also. If I love to buy any product while taking am thinking that if I take some bad will happen to me like that I am thinking. ### Response: Hello. Please do not worry. After delivery, for any woman, it is common to have a hormonal imbalance which could cause anxiety and depression symptoms. More over, the trauma associated with the childbirth also could trigger anxiety and depression. But both of the anxiety and depression conditions are normal and they are for a short time. Your symptoms should clear within three months." "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: Are implant supported bridges good? Will they cause bad breath in the long term? I have dental bridges in my four front teeth for about eight years, but now it is causing bad odor. ### Response: Implant supported bridge is an extremely good option for replacement of missing teeth. Implant is the best treatment option in dentistry and it is a lifelong treatment option. It stays for ur whole life without causing any problem. Once osseointegration has taken place successfully it acts extremely perfect. But you have to maintain your oral hygiene nicely. You have to use electric brushes for maintaining your implant and you have to visit the dentist every year for follow up for scaling and polishing, just for maintaining your oral hygiene. Go for It. It is the best treatment option if you are healthy systemically. Patients suffering from high blood pressure or diabetes might have some problems. So your dentist will decide what is best in those conditions after all the blood tests, OPG, and CBCT (will decide your bone condition) diagnosis. 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 been sick for the past five days. I woke up with very red swollen gums and roof of my mouth. I have white pockets in my throat. I went to the doctor and they think it is streptococcal throat but were not sure about my gums. Could this be linked? Should I be worried? I have never had problems with my teeth or gums. I just had a cleaning done three months ago and everything was perfect. Please help. ### Response: Got your complaint and checked your attachment photograph (attachment removed to protect patient identity). This is a case of gingivitis brought by streptococcus bacteria. Though it is rarest finding that the bacteria causing sore throat can cause gingivitis. I suggest the treatment tablet Ornidazole 200 mg BD for five days. Chlorhexidine 0.1 \x84\x85 BD for 15 days. You will get relief in a couple of days. Do not worry." "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 21 year old male, and I have pain in the ear from today afternoon. I do not have any liquid discharge from the ear, but the pain is increasing with passing time. At night, the pain is very intense.I can hear all voices clearly, but my ear is paining a lot. I do not understand the reason for the pain, as I have never experienced such a pain in my life. What is the reason behind this tremendous pain? Is it an emergency? Please answer as soon as possible. I have already taken steam inhalation for this, but I did not get any relief. ### Response: Your ear pain is probably due to a middle ear infection with Eustachian tube blockage. Did you suffer from any nasal congestion or throat infection in the recent past? I suggest taking Paracetamol for pain and follow-up with the required information, so that I can suggest accordingly. Revert with more information to 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 always had tiny and small bumps on my penis head, from the time I started noticing my penis. But today I saw some white and tiny dot like bumps. Is it any kind of STD? I had intercourse with a sex worker five weeks ago. It was protected and I kept checking my condom after every three or four strokes. I am totally aware of STD and HIV risk and I used a branded condom non-expired one. I stretched it hard to see for any holes or tears and did not see any. When I tried to insert, it broke and at that very second, I heard a popping sound and was out of her. It will be about one or two seconds and not more than that. I am not sure did it go in or not but I did not feel anything when the condom broke.I went to the doctor HIV specialist and she told me I do not have any risk for HIV. I would like to have your view on this. I have attached the picture. ### Response: First of all, there is no risk of HIV. Secondly, the tiny bump can be a healed ulcer. Third, to be honest, a condom will not protect from HIV. The size of the virus is far small than microscope holes in the condom. Condom promotion is done to prevent STD (sexually transmitted disease) which may cause an increased chance of HIV transmission. Test for TPPA (Treponema pallidum particle agglutination assay). Injection Benzathine penicillin 2.4 mu deep intramuscular. Stay away from unprotected sexual activity." "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 25-year-old male. I am straight but yesterday I had anal sex with my friend. I feel I took wrong decision. It is remembering me a lot. I want to forget that. My mind is not concentrating now. Kindly help. ### Response: Hello. If it has been done against your wish, you can take legal help. Some time accident happens. Forget it like a nightmare or just an accident." "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 28 year old female, I would like to know if multiple sclerosis is hereditary? My dad has it, and I am very nervous to inherit this disease. I have had two brain MRI\s that have been normal, except for an incidental finding of a pineal gland cyst. I continue to worry about inheriting multiple sclerosis. I am a medical coder. So, I spend a great deal of time in front of the computer. This affects my vision, and I experience back and thigh pain. I am hoping this is due to sitting down all day. I also have a slight hand tremor. However, I am a very anxious person, and I type fast all day long. I wonder if typing all day could cause a hand tremor?I am very active and energetic. I exercise 5 days a week for an hour doing treadmill and stair climbing. I spent a great deal of time this weekend hunched over painting. I am wondering if this is what is causing my current thigh and back pain? I am also due to start my periods anytime. I am still worrying about inheriting multiple sclerosis. What are your thoughts on the possibility of still having multiple sclerosis with two negative brain MRI\s? ### Response: I understand your concern. It is clear that you are not having MS (Multiple sclerosis) as of date. None of your symptoms are typical of multiple sclerosis. Back and thigh pain is posture related and tremors are anxiety related. Repeated MRI\s being normal further rules out this disease. Agreed that multiple sclerosis can be hereditary. If one of the parents is having multiple sclerosis, chances of the offspring having multiple sclerosis are 1 in 50. Since you are having no symptoms and your brain MRI is normal, you need not worry about it. Please be assured that you are fine." "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 here to get help for rebound nasal congestion. Two years ago, I started using Oxymetazoline nasal spray for mild allergy. I continued using it because I thought my allergy is persistent. Recently, I realized that my problem is not an allergy but addiction to nasal spray. My symptoms are severe nasal congestion which requires using nasal spray four to five times. I have no typical symptoms of an allergy, like a runny nose, watery eyes, or irritation. Above all, I become very upset and anxious if I do not use the nasal spray. I tried to stop the usage of nasal spray, and somewhat successful. But at times my congestion is severe and it seriously affects my activities including sleeping. It would be great if you can suggest some alternative for nasal decongestants. I am a 29 year old male, who is under treatment for mild hyperuricemia. ### Response: Hello. You suffer from a condition called as rhinitis medicamentosa. As you have rightly understood, it is due to the prolonged uninhibited use of nasal decongestants. Repeated use of the same causes decongestion temporarily followed by rebound congestion inside the nose. The action of these decongestants is by vasodilation, which lasts for a short duration, followed by reflex constriction of vessels which causes congestion again. This problem causes nose block. It is totally different from an allergy, which has specific symptoms as rightly pointed out by 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 developed pancreatic disease.I have been worsening the condition by taking the triggers (heavy food and alcohol).Last April and July I could manage with a strict diet to bring the inflammation and enzyme levels down.I am maintaining a low fat diet and I have reduced the amount of alcohol I consume. Then I was doing fine.Two weeks ago, I had a heavy meal and too much alcohol and got an acute attack.I was hospitalized and now I feel better as I strictly follow the diet. The MRI scan which I took last week (1st August) shows an improvement than the CT scan taken in the month of July.I am taking the following as maintenance medications:Metoprolol 50mg twice a day and Irbesartan 150 mg once a day for hypertension.Escitalopram 10mg once 1 day for anxiety.Pantoprazole 40mg twice a day for my acidity issue.Pancreatin 650mg 3 times a day with meals.I have the following questions:Is there really no medicine to help the pancreas for complete healing or will I have this issue for my entire life?Are there any supplements like vitamins, minerals etc., apart from healthy living that would protect my pancreas?Do I have chronic pancreatitis? ### Response: Hi. I have gone through your history and investigations.You are hypertensive, under medication for the same. You are also under medication for anxiety, gastritis and reflux.You are having acute attacks of pancreatitis (inflammation of the pancreas). If you continue taking heavy meals and alcohol, it might result in chronic pancreatitis, which in turn will cause irreversible changes in the pancreas.There is no medicine which can prevent pancreatitis if you continue taking alcohol and fatty fried meals. I would suggest you to continue the medicines that you are taking and follow these instructions very strictly." "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 have sex after a heart attack? ### Response: This is a very common question among heart attack patients. I would explain that there is not a specific time to return to your sexual life after a heart attack. It depends on the individual basis of physical activity. It is usually recommended to start sexual intercourse when the patient is also able to perform a moderate physical activity (climbing a pair of stairs, walking 100 meters, etc.). An exercise cardiac stress test can be performed, just to be sure that the patient can afford to perform a moderate physical activity." "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 extreme lower back pain. ### Response: I need more information about your symptoms, duration, intensity with time of the day and with movements, any relieving factors, and treatment sought and the effects, any leg symptoms and radiation of pain to the leg, and any bowel complaints like loss of control of urine." "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 operated for cryptorchidism when I was nine years. My left testicle is 3.5 by 2.5 cm. I feel this is too small.Please suggest tablets to increase its size. I have epididymal cysts 7 cm long in both testicles. I have burning sensation and numbness and pain. Suggest tablets for this as well.Some days ago I put Flexabenz or Chlorobenzene and Linseed oil cream for joint pain by mistake on my right testicle side, but I washed it immediately. Will it cause any damage or shrinkage of my right testicle? I am worried.Also, I have white spots called elevated Meissner\s corpuscles on the left side of the urethral opening on the glans penis. I have elevated lunar and semilunar elevated papillae on inner foreskin. I have white spots on inner foreskin also.I have numbness, loss of sensation, itching and burning sensation on both glans and inner foreskin. Please suggest medicines for all these.Please do not suggest topical gels or creams. I am scared of those. Please suggest only tablets. ### Response: The normal size of an adult testis is 3 by 4 cm with an approximate volume of 12 to 19 cc. Patients with a history of cryptorchidism may have a slightly smaller size of the testis at adult stage. However, the size of the testis does not matter as long as the semen functional tests are normal. Moreover, there are no medicines available to increase the size of a small testis. In your case, the size is just borderline and nothing to worry. I would advise you get a semen analysis done to see the functioning of the testis. Also, the spots that you have mentioned are physiological and represent the oil glands on the genitalia. They do not warrant any treatment. With regards to the use of Chlorobenzene and other oils, they can at times lead to an allergic contact dermatitis. But otherwise, do not affect the testicular size" "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 regarding the Schwarz appliance. I have been wearing it for a couple of weeks now, and I have noticed that, on expanding the upper palate, the palate has come down and it became less shallow. Why is it so? Is it a good thing to have the palate coming down? How should be the palate usually, when you are not wearing the retainer? Shallow or more flat? Please suggest. ### Response: As a part of our body, palate comes in many shapes and sizes. It may be deeper, more shallow, flatter and it may include a torus palatinus. This appliance, which, you are using now, modifies your palate and it helps to erase some orthodontic problems. As long as the age is concerned, when the body growth ends, the palate gains a standard size, and this application can make it flatter than it is used to be. You can consult your orthodontist and check it whether everything is fine." "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 19 years old. I had sex four months before and ovulated on the second day after having sex. I got periods on the next month for four days, and after five days of my periods I got a Nexplanon birth control, and the doctor gave me a negative pregnancy test. I then had a period of 14 days in the next month and I am still spotting.I am just wondering if there is any way for me to be pregnant? I have not had sex since then. But I am paranoid that I am pregnant I cannot afford an abortion. Also, I cannot even afford to go to the doctor or have a way to buy a pregnancy test. For the past couple of days, I have felt movement, but it could be gas.I have also been having sharp pains in my lower abdomen for a while especially when sneezing or coughing hard. I always had very painful and heavy periods associated with sharp pains while pooping on period. The birth control has helped by stopping my period, but I still get the sharp pains randomly. Kindly advice. ### Response: No, you are not pregnant as your pregnancy test was negative at the time you got Nexplanon implant, and you did not have had sex afterward. So calm down now and give relief to yourself. Your periods have reduced due to the effect of Nexplanon as it is a contraceptive as well as it also reduces blood loss during periods and some women get reduced bleeding or absent bleeding in the very start of the implantation. Your periods will slowly return to normal. So do not have to worry about pregnancy now. And secondly all of the symptoms you told are pointing towards anxiety, and you need some stress reliever. The problem with passing stools may be due to the lack of fiber in your diet. I hope it has helped you. If you require any further queries, please do not hesitate to contact 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 4 years old son is suffering from stomach pain from the last eight to nine days. He mostly complain about that in the evening time or after mid night. If I massage his stomach he feels relaxed. He underwent an ultrasound along with appendix and some other blood tests including TB. All reports are fine. No complaint of loose motion. He is feeling down from a couple of days and not eating properly. Suddenly he starts to complain of pain in the stomach. But the pain does not remain all day. Even in the school, he sits with his head down in free time. Please advise me on what is the problem and remedies for the cure?He is currently taking Duphalac, Drotin DS, Zentel, and Metrogyl. ### Response: Hi. I have seen the reports. (attachment removed to protect patient identity). The on and off stomach pain is due to constipation. The scan report says few fecaliths are present which means hard stools that are not cleared. I feel this is the reason." "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 tooth extracted, and it resulted in the perforated sinus. I was on antibiotics Amoxicillin for seven days before and three days after the extraction. I took all the medicines on the sixth day I got a bad sinus infection. I went to my primary care doctor she put me on Amoxicillin once again. She told me to go back to the dentist if there is no improvement.I went back to the dentist, and she prescribed Augmentin and advised to go to an oral surgeon, and he confirmed the sinus perforation. He told me it was healing and told me to stay on antibiotics come back in two weeks for follow-up. After six days on Augmentin, I am still having bad headaches in the front by my eye and a lot of sinus pressure. I am taking the Augmentin, Sudafed, Off Brand Flonase, Tylenol, Ibuprofen 800, and Asprin alternating. Should I be taking another type of antibiotics, or do you feel the Augmentin is working? ### Response: Did you get a CT scan done to see the size of the fistula? It\s called an oro-antral fistula. If it is big then it may have to be corrected surgically. Additionally if the infection is not healing one can give a thorough antral wash and wash out the contents of the sinus in an operation theatre under anesthesia which will help in bringing down the load of infection and help the antibiotics act. Since you have taken amoxicillin/augmentin for quite some time, I also feel the antibiotic can be changed into a stronger one with a broader action, say like Levofloxacin and Metronidazole." "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 using a high dosage of krill oil to combat concentration problems. It seems to work on the cell membrane and it appears to improve the electrical signaling because electrical signals pass the cell membrane. However, if I improve the electrical signaling, will this impact the heart? Will my heart pump stronger if the electrical signals from the brain to the heart become stronger? Do I need to monitor my blood pressure for example? Or does the krill oil only work on the brain\s electrical signaling and not the heart? ### Response: Hello. I passed carefully through your concern and would like to explain that krill oil is a good source of omega-3 fatty acids, which have proven beneficial to the brain and nerve endings activity. But, it shows only mild beneficial effects on the heart. Anyway, it has no adverse cardiac properties and you should not be concerned about any cardiac issues while using krill oil. It will not significantly affect your blood pressure or heart rate. You may follow a normal daily activity without any need to monitor specific cardiac parameters or blood tests." "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 it safe to take Vyvanse 100 mg for ADHD symptoms? ### Response: Vyvanse (Lisdexamfetamine) is a stimulant. I basically do not approve giving stimulants to target ADHD (attention-deficit hyperactivity disorder) symptoms. And the dosage 100 mg is way above safe dosing range. One side effect to watch out for is motor tics or involuntary movements when you take such a dose. The occurrence of this side effect is dose-dependent and if it occurs, it means that you are using above the therapeutic dose. Consult a psychiatrist online before taking such a dose" "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 36 year old, otherwise healthy (as far as I know) female.I was a smoker earlier. No history of heart disease.My mother has COPD, but has been a long time smoker. Two and a half weeks ago, I went on a hayride with my sons.I have a short stature. To get on and off the hayride, I literally had to pull myself up onto the trailer. (Imagine pulling yourself out of a swimming pool).The next morning, I woke up with chest soreness.I had pain in the upper left chest area, a few inches to the left of sternum.That was a radiating pain over the breast towards armpit.Pain worsened on bending over.Also, I could locate very tender spots when pressing on the area with fingers.I had no pain during regular breathing, but very deep breaths caused pain to worsen (from the left of sternum radiating across and to the left breast). Over the past two and a half weeks, pain has improved, but still not completely subsided.Most of the pain (while bending) is gone, but I still have tender areas across upper left chest when poking around with finger (trigger points?).I have some minor discomfort on taking deep breath, but greatly improved from what it was.And now pain is just in an area to the left of my left breast.Now, pain is mostly towards armpit area and may be slightly radiating to the upper, bottom side of arm.I do not have much pain as it was in the beginning, but more of soreness.It is not constant, it occurs mostly just when I move in a certain way or tense my chest.Also I am noticing upper left back discomfort, not really pain. Local FNP suspects strained muscle. No x-rays were done.I have no cough, no shortness of breath, no loss of appetite, no indigestion or heartburn.Otherwise I feel fine. My concern is that I still have some pain and discomfort after almost 3 weeks.Shouldn\t a muscle strain be healed by now?I am a bit concerned as it may be something more serious than a strained muscle, perhaps pleurisy or costochondritis? ### Response: You are right, muscular pain will not last so long. Start taking analgesic and hot fomentation 2-3 times a day for the painful region. Use a thoracic belt to restrict movements of the affected part. Get a chest x-ray done immediately and revert back to a general practitioner 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 feel itchy on my vulvar. I am not sure if I am having this vestibular papillomatosis or yeast infection. It does not feel pain or sore if I leave it there, only itchiness. If I scratch it too much due to the itchiness, it will feel sore and a little pain. ### Response: Is there any discharge like curd or any other kind is there as well? Because discharge sometimes causes itching and first we have to do the simpler treatments and if they are not prolonging relief only then we progress towards complex problems like you mentioned. Now what you can do is to take a single dose of tablet Canestein 150 mg to treat this itching as itching is most commonly associated with yeast. And secondly, some other general measures are associated with hygiene like washing the area with plain water as many times as possible and avoid using any cosmetics there and also wear only cotton rich undergarments. These measures will also help in relieving your itching." "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 mom had fibroid in her uterus and got it removed last week. Please see the reports attached and let me know what it is. ### Response: Hello. The report says that the fibroid was not malignant or cancerous (attachment removed to protect patient identity). It is a type of cellular growth due to long-term hormonal stimulation. Leiomyomas are benign monoclonal tumors arising from the smooth muscle cells of the myometrium. Metaplasia is normal cells at abnormal location. The treatment is correct that is the idea of operation and she should do fine." "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 25 years old and my weight is 83 kg, height is 163 cm. I am having Hashimoto\s and PCOD for last six months. Can I take Navaka Guggulu tablets? Can you suggest the dosage? Currently, I am taking tablet Thyronorm 150 mg and Thyrocal thrice weekly. ### Response: Hi. I can understand your concern. This is the condition of hypothyroidism. It leads to PCOD (polycystic ovarian disease). It can be managed through ayurvedic medicines and Yoga practices. It will take three to four months to recover. You can take Navaka Guggulu two tablet twice a day with warm water after meals. You can also take Hyponid two tablet twice a day along with Navaka Guggulu. Do regular Kapalbhati and Mandukasana. Pranayama like anuloma vilom, nadi sodhan, bhramari and ujjaai. It is very effective in such kind of issues and helps in quick healing" "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 unprotected sex weeks before and I took i-pill the next day. My periods are due on 18th of every month but 14 days after taking i-pill, I had two to three drops of blood and did not get proper periods. Again after one and a half weeks, I thought I am having periods, but just two to three drops of blood. Last night, we had protected sex but when my partner ejected out, he ejaculated on his hand. The condom did not get torn though. I am really scared now. Should I eat the i-pill again? ### Response: I have gone through your history and understand your concern. I will try my best to help you. If no spillage of semen inside the vagina and no touching of the vagina with his semen in hand then no need of taking i-pill. And the menstrual irregularities through which you are going is the side effect of i-pill. But still to be on the safer side take a pregnancy test and if the test is negative no problem." "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 experiencing pain around the bone of the little finger. It is just below the end of the finger, near the joint of the bone joining the palm. I did an X-ray and no crack was shown. I play cricket. So, I experienced this after taking a catch two months ago. It pains every time I take a catch, and me being an import and fielder, I cannot evade fielding. I took six weeks of rest, and still experienced the same pain. I took pain killers and even applied some gel, but nothing has helped so far. ### Response: Hello. This professional advice provided by me stands subject to the actual examination of the report or image and is based entirely on inputs provided to me. It should be correlated with the clinical findings" "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 my baby last week. After coming off IV painkillers for the C-section, the doctor prescribed Percocet. On the third day after giving birth, my depression returned as it was before. Is it safe to take Percocet, Zoloft, Lithium, and Wellbutrin-XL? It seemed like the depression came back right when I started taking Percocet but it could also be PPD. I am not sure how am I getting PPD with all my current medications. ### Response: It will be better to stop all the above medications except Zoloft (Sertraline) and Lamictal (Lamotrigine). Zoloft and Lamictal cause very rare and mild side effects. Pregnancy may cause depression. You need family support and emotional care after pregnancy. You can take psychotherapy counseling sessions" "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 4-year-old child has caries on teeth. Since one year we observed pus in the gums above the front tooth. This pus frequently appears with mild pain and disappears within no time. We consulted a doctor who prescribed antibiotic Mox Kid for a week. After using this, again pus was found in the next 10 days.It is in the same place frequently observed. Please advise. ### Response: I can see in attached pictures (attachment removed to protect patient identity), actually, there are multiple apical infections. I suggest you please ask your dentist for dental X-ray, to find out the number of injected teeth and I think you need root canal treatment followed by gum treatment. Please do not worry it is common in early childhood and known as rampant caries. Generally occurs due to bottle feeding, more sugar-containing food, poor oral hygiene. Prolonged use of antibiotic is not good for child health, a dental procedure done in dental office and medication is the best way to treat this type of problem. Pedodontist is a specialist for child dental problem so I suggest you please see an experienced pedodontist for your baby. Get well soon." "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 road accident and fractured my right thumb. It happened three weeks back and was administered a spica cast the next day of injury. After an X-ray, the doctor suggested that the cast can be removed in a few days. I want to understand, how long before I can resume my normal activities like driving or riding a motorcycle, etc. Also, I was strength training regularly before the accident, when is it advisable to lift heavy weights again? ### Response: It is a bony mallet injury. You need to wear the splint on for eight weeks totally, a mallet thumb splint. Do not remove the splint for eight weeks. Repeat X-rays after eight weeks of injury and splint application. And then after eight weeks, you will require physiotherapy for mobilization as you are expected to have the stiffness of that joint. Heavy weight lifting can be done after six months of the date of injury" "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 burning like pain on the upper back of my body between the shoulder bones. It happens almost every day after sitting for long or when I lie down for quite some time. What could this be? ### Response: Hello. The burning sensation in the upper back could be due to chronic bad posture and imbalance of the chest and back musculature strength. I recommend you to kindly check your posture and maintain it. Do some retraction exercises to help your upper back and neck. Sometimes this issue can accompany with neck stiffness as well. Do a lot of icing on your upper back and take frequent breaks. Regards" "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 white bump on my penis for the past three months. It did not cause any pain when I touched it, and when I tried to remove it in the shower, it did not budge. It is single and there was nothing else resembling it that showed up on my penis. It showed up maybe a day or two after sexual contact with my girlfriend. I am not sure if it is an STD.Today, during the shower I realized it was not there anymore. It either fell off or shrank, I have not been paying much attention to it the last couple days so I am not really sure. I am attaching a picture of what it looked like when I had it, and what it looks like now. It does not look like any STDs I have seen online, so I am at a loss as to what it could have been. Any help would be appreciated. ### Response: The lesion is not looking like an STD (sexually transmitted disease). From your history, it is asymptomatic and pain free. Whitish concretions can form due to the collection of subpreputial discharge or it can be Fordyce\s spot. Wart can be asymptotic and go for spontaneous resolution. But it would have spread by now. Apply Mupirocin ointment on the spot. Clean the area with mild soap. Observe next time. If it is forming again please consult with your doctor and remove it and give for biopsy along with blood tests for STD for reassurance." "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 finger had a drop of precum, and I touched my partner's vagina indirectly through her cotton panties. Will she get pregnant? ### Response: Hello. I can understand the concern. Precum or pre-ejaculatory fluid also contains sperm to make a female pregnant. If your sperm has reached inside her vagina by any probability, there are chances of pregnancy. Also to be noted she should be in her fertile period (10 to 15 days from her last menstrual period) to get pregnant. If you are anxious, and if it is within 24 hours you can go for an emergency contraceptive pill (I pill). I hope I have answered your query. If you have further doubts, I would be happy to help 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 beta thalassemia minor, but my wife is not. Recently my 5-year daughter was diagnosed with beta-thalassemia major (heterozygous). She is active and playful. No problem reported yet, but her Hb level is between 7.8 to 8.8 from starting. Her spleen is enlarged as diagnosed in USG. Will she be transfusion dependent? Please advice. ### Response: If you are having thalassemia minor and your wife is thalassemia negative than there is no chance of acquiring thalassemia major in your child.So your wife must also have thalassemia minor if your child is thalassemia major. Your child\s attached report suggestive of thalassemia major (attachment removed to protect patient identity). The only treatment in thalassemia major is either bone marrow transplantation or regular blood transfusion to maintain hemoglobin level within range. So your child might need a routine blood transfusion to maintain hemoglobin within range. She can be given an iron tablet, but it will not work in your child case as she has thalassemia major. I am sorry to say, but your child will need a blood transfusion for the treatment of low hemoglobin. You can consult nearby good hematologist or the place where bone marrow transplantation facility is available, which is a curative treatment for thalassemia major. But it is costly treatment. I hope I have answered well of your question in detail. I will guide you further if 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 am on birth control pill Femilon for the last three months and I have followed 21/7 regime from the last three months. I got my last two periods on the 6th and 7th pill-free days respectively. And now I have advised to follow 21/5 day regime by my gynecologist for proper efficacy of pill. I am still being confused, that I have to continue 21/7 regime or 21/5? My gynecologist said to me do not think about your menses just follow 21/5 regime whether menses come or not. So I want to ask is it normal to lost menses for two to three months, because I feel that if my menses came on 6th or 7th pill-free day on 21/7regime, then if follow 21/5 then I have to start my pack on the 6th day after five pill-free days. And if my menses will not come in these five days then after starting the new pack my menses will not start still a month, is it normal? What I have to do? ### Response: How are you doing? I would sincerely advise you to keep having pill in the 21 pills, 7 pill free cycles. This will avoid all the confusion. Hormone control will be the same if you take 7 pill-free or 5 pill-free cycle. So I would say you just follow the three weeks pills and one week pill-free cycle." "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 diabetic patient for two years and currently entered the third month of pregnancy. And till now, I did not consult any doctor. Is my baby safe? I am taking iron, calcium, and zinc tablets for six months. Please tell me about the precautions and healthy tips. ### Response: Hello. First of all, diabetes with pregnancy is a high risk pregnancy. The blood sugars should be checked before getting pregnant. In case a woman gets pregnant with high blood sugar levels, then there can be a risk of miscarriages, and certain congenital disabilities in the baby. Please check your blood glucose levels and HbA1c level to see for your glycemic control. Also, I am assuming you are taking folic acid supplements because that is a vitamin that helps prevent certain birth defects (neural tube defects - in other words brain and spine defects) in the baby. It would have been good if you had mentioned the medications that you been taking for your diabetes to check if you could continue them, also if any dose modifications are required. Because pregnancy-induced hormonal changes can disturb the glucose control as the pregnancy advances and it needs close monitoring. Please get back to me with the necessary details so that I can help you better and guide you through your pregnancy. I hope this helps. Have a great 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: My 2-month-old baby girl child is suffering from cold for the past four days. There is a very little bit of coughing occasionally. There are some wheeziness from the nose also. She is moving her neck very often to both sides. I used Mucolite drops eight drops BD, Etolin PD syrup - 1.5 ml BD, and saline nasal drops. I used Sinarest AF drop for two days and stopped now. Please suggest to me is there any need for a diagnostic check up? What these symptoms could be? ### Response: I just want to know a few more information. Is your daughter feeding well? Does she sleep well? Did you notice any change in her breathing pattern like fast breathing? If she is feeding well, sleeps well and no breathing difficulty, then it is a simple common cold for which no medication is required at this age. The only thing is to keep the nostrils clean and open." "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 being treated for chronic prostatitis rebounce. It is now the third day I am taking Tavanik (Levofloxacin) 500 mg a day. I am taking it the same time each day among other medications. One of them is Vigantol 1000 I.E. My doctor told me to take Tavanik at least one hour after and before other medications. I think I have errored and might have taken Vigantol soon after Tavanik. Any problem with that? ### Response: I have gone through your query, your doctor had suggested you take Levofloxacin before any other medication as the absorption will be better. Unless you took both the medication together, even if you had spaced them by 30 minutes you should be fine. There is nothing to be concerned. But I would suggest you space the medication properly from now, because in chronic prostatitis, the more the" "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 heard that Pericoronitis could cause Ludwig syndrome, which can interfere with breathing. I heard this happens when the lower wisdom tooth is infected. Can this still happen if the upper wisdom tooth is infected? My upper left wisdom tooth is infected. However, I am treating it with antibiotics and warm saltwater. ### Response: Hello. I can understand your concern regarding dental health. First of all, I would like to tell you that Ludwig\s angina is not associated with the infection of the upper wisdom tooth. It is associated with infection or pericoronitis of lower partially erupted wisdom tooth. So, if you are having pain in partially erupted lower tooth, then consult an oral surgeon for according advice. And it is good that you are taking care of your upper infected teeth by taking antibiotics and warm saltwater. But, this is not enough for this type of infection. You must consult your dentist to check the condition of the present infection and an x-ray investigation of the same tooth to rule out the spread of infection to the end of the root and for the needful treatment and also for antibiotics dosage. I hope this helps. X-ray of upper infected wisdom tooth." "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 and my girlfriend had unprotected sex 10 days before. She took Unwanted 72 on next day and had periods on the same day which was also her due date for menstruation. She was facing a problem that her periods was not clear but it lasted for four days. Is there any chance of pregnancy? Is it fine to have light bleeding after taking the pill? ### Response: Hello. Unwanted 72 is an emergency contraception pill. If taken within 72 hours, it is effective up to 95 % to prevent pregnancy. Also, she got the periods on the same day. All factors are against the pregnancy to occur. It is very unlikely to get a pregnancy in your case. Light bleeding is common after taking the pill." "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 know if speech and vocal issues can be linked to early-onset hearing loss or hearing problems. I am wondering if our diagnosis of vocal nodules from vocal abuse actually is stemming from overcompensating to hear at a normal volume. ### Response: Hello. Well, the development of speech is definitely related to hearing. Early-onset hearing loss does impair development of speech as it is known that congenitally deaf are also mute. Regarding the other part, vocal abuse is in fact the only cause of vocal nodules. So technically yes those who are hard of hearing may develop vocal nodules because of inability to modulate their voice, the association has not been stated too frequently not that I know of but yes the voice regulation is definitely impaired." "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 left hand and occasionally part of my left side of the body tends to vibrate. It started three months back. I do not have any pain or other problems. I can eat, walk, drive and do my job at ease. I am a 44 year old male. I do not have the habit of smoking or drinking alcohol. Six months back I got my blood and urine test. Results of the same have been attached for your reference. Since two years, I have high blood pressure and I am taking Amlodac 5 one tablet a day. Do I have any problem with liver or kidney? Do I need any more tests? Please guide. ### Response: I have gone through your query and can understand your health concern. Your reports are normal (attachment removed to protect patient identity). Revert back after the investigations to a general 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: Is Stenson duct normal in the mouth? They are located right next to the upper second molar on each side of the cheeks. Mine do not hurt and my doctor told me to rinse my mouth with salt water every day and they will go away. They are very annoying because you can feel them with your tongue. I do not know if other people have them in their mouth but I was just wondering if this is a normal thing. Please help and is there any way to get them out of your mouth? ### Response: Hi. Normally, the ducts are not felt by the patient or individual. Sometimes this can happen as in your case. It is not any pathological condition it is a normal anatomical defect that happens one in thousands. Yes, you do not need any treatment for it, in case you handled in for too many years. Now you have a problem with it, you can visit an oral surgeon, with simple minor surgery you can get rid of them any time. After checking your image (attachment removed to protect patient identity), I think you must not worry about it. My opinion will be do not think too much about it. It does not need any treatment. You may also take over-the-counter antibiotics for five days if it is infected." "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 week I and my partner had a romance, I did everything expect for the penetration of my penis into her vagina. At last, I was masturbating outisde with my hands, when the sperm came out it spills out over her legs and also near to her vagina. So we got scared that if sperm spill over was only outside her vagina.Incase, if the spillage over her vagina was only outside means will it cause pregnancy? If it causes pregnancy means what are all the symptoms immediately or with in a week? If in case pregnancy means how to stop now? Please tell us if there is any solution for our safer side to keep us without fear. When the period will stop incase of pregnancy? Please help. ### Response: Pregnancy can happen rarely in the scenario you described. There will not be any immediate symptoms of pregnancy. The earliest symptom is missing the next expected period. You cannot do anything to stop the pregnancy right now. If she misses her period, she can confirm pregnancy at home by doing a urine pregnancy test. If pregnancy is confirmed, you can consult a gynecologist for abortion through medicines. In case, she becomes pregnant, she will miss her next expected period. Remember one thing, pregnancy is very rare (most unlikely) in the scenario you described, so there is no need to fear. Just wait for her next period and things will become clear by then." "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 suffering from urge and incontinence of urine for the past four years. My USG is showing first grade BPH with about 50 ml to 75 ml of PV retention of urine. PSA is within normal range. The routine urine examination also reveals nothing abnormal and on culture sample, found sterile. I have been taking Tamsulosin 0.4 mg and Dutasteride 0.05 mg tablets OD as per doctor's prescription. There is relief in the passage of urine but the urge and incontinence still persist. At times I feel irritation in the pelvic region. Please help me with your valuable guidance in this context. ### Response: Hi. I have gone through your query. It is usual to have some degree of urgency in BPH (benign prostatic hyperplasia), but if it continues to persist even after your urinary stream improves, then one should make sure that there is no UTI or chronic prostate infection causing the symptoms. If both are negative, a urodynamic study will show whether you actually have an irritable bladder. If yes, then bladder relaxants can be added provided that your residual urine on ultrasound is not more than 50 to 60 ml." "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 17 months old daughter booked in for grommets and adenoidectomy due to fluid in middle ear and recurrent ear infections. We are flying two weeks after the procedure. We will be visiting a place with bad air pollution. Will she be more at risk of respiratory infection with no adenoids? ### Response: At a place with bad air pollution, one\s respiratory mucosa tends to get excoriated and irritated due to the harmful contents in the air. This can make the area supple and raw and more prone to bacteria and viruses in the surroundings. Having removed adenoids does not make your kid very susceptible to respiratory infections although theoretically adenoids are supposed to help contain infection by acting as a portal of immunity for harmful organisms entering through nose and throat. But at two weeks post surgery, the area will still be slightly raw and healing would not be complete. Hence, that can cause more susceptibility to environmental pathogens. I suggest you take a good course of antibiotics post surgery and during the hospital stay. Take a course of antibiotics for the baby with you and start when you feel she is developing an infection during your trip. Avoid areas of frank dust and pollution. Stay away from direct cold winds and Aircon air. If feasible put a face mask for the baby. The mother also should stay healthy as much as possible and follow all precautions to not develop an infection or allergy." "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 33-year-old male with no significant medical history aside from essential tremors treated with Inderal 120 mg, and anxiety treated with Venlafaxine 75 mg. Three months before, I consulted an ENT doctor because of an unilateral (right) tonsil enlargement. I am attaching a photo of what it looked like at that moment. Upon clinical examination, my doctor was not worried and suggested to monitor the volume of the tonsil in the upcoming year. I had underwent adenoidectomy during childhood.In the last few months, I have noticed that the same tonsil has gained in volume and now appears round, red and more swollen than before. It is not painful when I swallow, but I have the sensation that something is stuck in my throat (most probably a collateral effect of edema). I am attaching another photo of what it looks like today. I do not feel any lumps in my neck. I have an appointment to see my ENT again, but it is only in one month from now. Being a big fan of catching things early I am a bit worried about waiting another month. Could you please give me your opinion? ### Response: Hello. The two tonsils are unevenly enlarged. Whereas it is usually not any abnormal growth, we can say conclusively only after biopsy. I suggest you discuss with the doctor about the option of tonsillectomy and histopathological examination of the sample. Meanwhile you should get some Benzydamine gargles and check if the symptoms resolve." "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 37-year-old unmarried female, with no sexual activity. I have been experiencing problem in periods that I have got the period twice a month in the last month, without any pain, and scanty period. My FSH is 8.29 miu/ml, LH is 7.69 miu/ml, prolactin 7.6 ng/ml, testosterone, total 18.6 ng/dl, TSH ultrasensitive 4.470 uiU/ ml. Usually my cycle is 35 days, with three to five days period, and I experience pain too. I am worried because I am getting married soon and becoming infertile. I want to have my own babies. I have attached my today\s blood reports (third day of period). ### Response: I have seen the reports (attachment removed to protect patient identity). Your hormone levels are normal. I would like to know more about your menstrual cycle. Is it this month or every month you are getting frequent periods? I would like to get you a ultrasound pelvis 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 have a little mole on my neck that seems to have got swollen and inflamed. It happened about nine weeks ago. I think my necklace may have irritated it. The swelling has gone down. But, the mole seems different and red around the outside. I saw a dermatologist in a person who told me that it is not a concern and it will get healed soon by itself. But, it has been a few weeks now, it is still red and not back to normal. ### Response: Hi. I have gone through your pictures (attachment removed to protect patient identity). It seems like an irritated mole. There is nothing serious about the condition. I suggest you apply a topical antibiotic such as Neosporin (Neomycin) ointment or Mupirocin 2 % ointment, twice 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: I hope you will read it thoroughly and answer every query. I am a 30 years old male. It all started with itchy scalp ten months back this summer. But, I was not concerned much, since it was just itchy and some bumps like mosquito bites (not more than two to three) and some swelling as well. Since it was summer, I was sweating. Sometimes, the whole scalp would itch and sometimes only the bumps. It continued for some months. Later, itching of the scalp subsided and bumps size has decreased. But since three to four months, I can feel pimple like things on my scalp and they ache sometimes. When they started, they would disappear on their own in less than a week. But now, even after so many months, I can feel some more (not more than two at a time) pimples. I doubt whether it could be folliculitis. I have not had a haircut since ten months, just because I thought the itching could be contagious. So, I better not go for a haircut and spread it to others. There are two to three bumps on my face as well. One was hurting earlier, but it is all itchy and the other two are only itchy. I would like to state it again that they do not itch all the time and one that aches do not hurt at all the time. Also, I felt a pimple like thing on my butt. It disappeared in a week. It was not very painful. I have had folliculitis till I was 25. So, I know how much it pains and itches. I thought it could be folliculitis. My father had a boil and got better in two weeks and everything was fine. So, I thought maybe the spread of same bacteria. Getting pimples on my butt have become regular. They come and go and they appeared on my face only after that. We are a family of four. I have OCD as well and cannot tolerate these skin diseases. I wash my hands and taps touched by him every time he touches them. The only thing that I share is the bathroom tap and latrine tap and also latrine bucket. Apart from them, I do not touch anything from him.When I try to touch the pimple like things on my butt, I cannot feel them. They do not appear to be there. Also, before the pimple like things started to appear, I had some scratchy and cracked elbows (pictures included) and it was painful. I was scared and thought it is somehow related to that boil. It healed in two weeks. This happened four months back. From then on only all pimple like things started appearing in the same month. Unfortunately, I do not have the picture. And the ones on the face and scalp are covered with hair, so there is no way I can click it.Now, my question is whether I can go for a haircut and beard trimming? I have not trimmed my hair since five months, all because of these reasons to not spread it to others and myself. I will use electric shaver to trim my beard. How can I have my haircut without spreading it to others? My hairs are now getting twisted and unmanageable, since I have not covered them either. My social life has suffered a lot because of it. And, what is it (disease) that has taken away my freedom, social life and confidence? Also, what can I use to disinfect my electric shaver, the blades, nail cutter and other such things? What I do is soak in boiling water for 30 minutes and then wash it with dish gel and dettol. I am waiting for your answers. ### Response: Hi. I have checked your photos (attachments removed to protect patient identity). It is better you go for haircut and shave or trim beard. It may be due to folliculitis or fungal infection by the description. You can get it examined by a doctor or dermatologist for physical evaluation and diagnosis. You need not worry about spreading infection to others. You can use separate trimmer for yourself or get it done by a barber with separate trimmer. The disinfection method you are following should be fine. You can use topical antibiotic cream like Mupirocin (T-bact) if pus filled lesions are present. Do not worry about transmission of diseases. You can wash your hands with soap and water after using washroom. You can use moisturizing soap or Cetaphil cleanser. Apply moisturizing cream like Ponds or Cetraben cream. Main ingredients of this cream are (White soft paraffin and Light Liquid paraffin)." "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: There have been problems between me and my family due to which I have got a migraine. I do not want to do my family business but I am forced to do so. I have lost interest in talking to anyone. I was not allowed to do masters even though I was good in my course. I am not allowed to do anything that I want in terms of my professional career is concerned. I feel helpless and do not know what to do next. I have fought, cried, pleaded. But they do not let me do anything. Just because my father\s business is flourishing and he has money, does it mean even I have to do the same? ### Response: I think there is a definite factor for your stress and that stress is due to the conflict with your father. They are not letting you complete your studies or they want you to join their business, these are different things. You have to clear in your mind about your current academic status and future career related to your studies and compare this thing with the business, and have a healthy discussion with your father or have conflict resolution counseling where you and your father would attend the session to have fruitful results." "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 acne on my left nostril and left arm. They were small and itchy. When I scratched, blood came out and the area has become red. Even after four days, there is redness with some bulging. There is some inflammation and itching as well. Sometimes, there is also a sensation of itching throughout the body, but there is no soreness or acne on my body except my left nostril and left arm. I am currently on Sarna lotion and Atarax 25 mg. ### Response: Hello. Was it just acne or may be some insect bite? Because, in acne there will not be any itching. So, I think it is some insect bite and the same thing happened to another part of the body. Due to scratching you further triggered the inflammation. I suggest the following treatment. Consult a specialist doctor, discuss with him or her and take the medicine with 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: My wife\s and mine blood groups are the same. Both of our blood group is B. Will there be any problem in our married life? ### Response: Hi. There are two major blood group systems. You have not mentioned the Rh grouping. You both have the same blood group and can conceive without any fear. There is no worry regarding same blood group. The point that should be kept in mind is if your wife has a negative group and the child is Rh positive, then to prevent hemolysis in the second child, an anti-D injection is given. It is good that you are alert regarding pre-conception counseling. You and your wife need to do CBC (complete blood count) with PS (peripheral smear). I am advising this because if there are microcytic hypochromic red blood cells and the RBC mass is high, then HPLC (high-performance liquid chromatography) should be done to rule out hemoglobinopathy, especially thalassemia minor. If you both are thalassemia minor, then fetus amniocentesis needs to be done to rule out thalassemia major in the baby. Hope your concern is solved." "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 26 years old bodybuilder, who weighs 220 lbs and 5.9 feet tall. I masturbate from the past 14 years, and recently I was doing it excessively, up to eight times a day. I never had sex before, and I am afraid of failing in my future relation due to this amount of masturbation. Sometimes, I have a weak erection, but when I stop for one or two days, it becomes stronger. I have some drops of urine come out after I finish urinating. I feel I will have a weak erection or premature ejaculation during sex. What do I have to do to avoid that? Do I have to stop masturbation completely? What test or examination can I do to evaluate my sexual performance before I have sex? ### Response: Masturbation is the most harmless of all sexual acts. No fear of STDs (sexually transmitted disease) or pregnancy" "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 want to ask what is the best medicine for allergy? I have hives on my body and so itchy when I scratch them it turns painful. I even have them on my soles and palm. I am currently on Loratadine. ### Response: Hi. Itching with hives has various causes. Treatment of it is mostly according to the cause. Another treatment is symptomatic. Loratadine is antihistaminic and antiallergic medicine. In your case of itching with hives, you can take Desloratadine with Montelukast (Dazit M) or Fexofenadine with Montelukast (Allegra M). But to search for the cause of itching with hives will be more beneficial." "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 know how to get stress relief from work. ### Response: Hello. I have gone through your question and I understand your concerns but it seems that the stress you are experiencing is affecting how you function during your daily life. This raises the possibility of getting into depression if it was not managed probably. Unfortunately most triggers stressful situations are things that we cannot control as work environment, However, it is possible to control how you feel and handle these triggers in order to keep your psychological health. First, try to identify these triggers and write them down. Mark those that can be avoided and try to avoid them. Mark the ones that cannot be avoided and start to apply cognitive thinking. In the meanwhile, try to start meditation or yoga and engage in social activities." "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 days back, I had a severe pain in my right ear. One fine evening, the pain went severe starting from the head till the chin. I had visited an ENT doctor who removed a lot of earwax through EUM suction procedure. Since then, I got relief from the pain. But, I feel my right ear is slightly blocked compared to my left one. I again visited the ENT doctor who said my ear is clear and there is nothing that I should worry about. Can you suggest any other remedy to follow? I am worried if this block would stay permanent. I had a cold that has now resulted in a dry cough with phlegm. I will be traveling abroad in two days. ### Response: Hello. Do revert back if you need any further help. Let us know the progress with medicines. If doing the tests, please share the reports" "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 daughter of 3 years old. Recently since four days, I have noticed on her face a small patches more of like skin allergy. I am attaching her picture which shows her allergy on the left upper lips and cheeks. Kindly advise ointment for her, as we live out of the country. So you are requested to prescribe an ointment. I have used Derma due ointment and even virgin coconut oil but there is no use. ### Response: Hello. I have seen the pictures. (attachment removed to protect patient identity). Apply sunscreen like Photostable regularly twice daily over the face eg, at 8:00 AM and 12:00 PM. Apply any moisturizer repeatedly." "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: Everytime I have sex I get a vaginal tear. I did not have sex or wear a tampon for 10 weeks to let it heal. I had sex again last night and it tore again. I do not have an issue with lubrication, so I am not sure what to do. ### Response: Hello. , and sometimes it may also be caused by the use of recreational medicine like Viagara by the partner. Vaginal tears could be superficial and deep. Superficial tears usually result after having sex and they usually heal by themselves in few hours to 1 to 2 days and then usually do not bleed heavily. Deeper cuts usually occur during childbirth. As you mentioned that it took 10 days to heal your previous tear then it sounds alarming. Was there any heavy bleeding or pus coming through it? And how long have you been facing this problem? Can I have a look at any picture of tear? I would suggest you that if you do not have any issues with lubrication (which is the most common cause of vaginal tear during sex) then you must get yourself assessed by the local doctor and get tear examined to determine the actual cause and appropriate treatment." "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 white rashes or patches have grown up on the upper portion of the palm, behind and the left side of the neck and arms. They itch when they become dry. I applied Candid B for a few weeks but could not get rid of it. It has been quite a long time with this. ### Response: Hello. The photos are not clear. (attachment removed to protect patient identity). It shows a lichenified lesion on the dorsum of the foot and hypopigmented lesions on dorsum of hand, neck and in other site lesions are not shown. Duration, presence of allergies, occupation, etc., is not clear in your query. It may be due to allergic contact dermatitis going for lichenification and hypopigmentation. Try with steroid creams like Flutivate (Fluticasone) cream. Take antioxidant capsules like Oxidon or Oxivit, and Cetirizine when itching. Avoid allergens and rubbing friction. Consult a dermatologist if it does not respond. Else get back with photos of all lesions and details." "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 body rocks back and forth very very slightly. I was using my laptop and had my finger resting when I felt my finger moving back and forth barely noticeable by eye unless you were looking for it. I looked at my finger and I see it moving slightly back and forth and then noticed a very weird feeling of me rocking but barely noticeable. I uncrossed my legs and still felt like I was rocking. I am not leaning against something and not it is just my head rocking. What does this mean? I am currently on Lamotrigine 50 mg daily. ### Response: First of all, we need to make sure whether this rocking movement is happening, or it is just your feeling. So I advise you to ask someone to observe you and confirm whether that kind of movement is happening or not. If it is confirmed that the rocking movement is there, it indicates that there is some problem in your brain (cerebellum). It could also be due to the side effects of Lamotrigine. You have two options: 1. Either discuss with your doctor and ask for an alternative to Lamotrigine. If your symptoms disappear two weeks after stopping Lamotrigine, then it means your problem was due to the side effect of Lamotrigine. 2. Get MRI (magnetic resonance imaging) brain and revert back with the report. 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: Hi,I am a 20 year old female. My height is 5\5"" and my weight is 140 lbs. I experience mild numbness and also sharp pain where the wisdom tooth was removed 2 years ago, thereby making it hard to eat. Why is this happening? ### Response: Hi. Possible reasons for the numbness and sharp pain could be: Investigations Required: Treatment Plan: Revert back with the reports to 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: There is optic disc asymmetry 0.5 and 0.7. Normal vision is 6 by 5. I am 30 years old male. Normal BP. I have a complaint of severe headache migraine like when a headache starts, there is swelling around the eye. What can this asymmetry be due to? Can this be glaucoma? ### Response: I have gone through what you have mentioned. There are several causes which cause an asymmetry of optic cup to disc ratio, but glaucoma is the main disease that we try to rule out as it sometimes manifests without any pain and hence can go undetected. Migraine headaches are due to blood flow abnormalities in the region of the face and inside the cranium (skull bone). Hence, there is a chance that this eyelid swelling could be due to a migraine. My advice to you is: 1. Since you have been detected to have optic disc asymmetry, kindly follow up with your ophthalmologist every six months or as instructed by him or her. You may also be offered additional testing to confirm if your disc asymmetry needs to be treated or if it should just be monitored. 2. Continue with your anti-migraine medication and watch for any changes in your eyelid puffiness. In case there are changes such as longer duration or if you have an itchy sensation or feel like rubbing your eyelid, then please bring it to the notice of your ophthalmologist." "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: Could you please take a look at this mole? I had it for ages and it has not changed, but it always bothers me. It is more of a reddish color than brown and I have a couple of them. I visited a dermatologist and she said it as fine. I was just wondering for the tiny dots in the mole? I think she may have said hair follicles or pores or something. I was just concerned if it was a mole with two colors as in the ABCDE signs. Sorry, I get a bit paranoid about my skin. I have sent you pictures with and without flash for your reference. ### Response: Hello. I appreciate that you are so aware and concerned. I went through the pictures (attachment removed to protect patient identity) and I find them completely harmless for 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: My partner is 48 years old, and her weight is 65 kilograms. She has RBC of 5.6 mcL, Hb of 15.3 g/dL, and creatinine of 0.9 mg/dL. The urine report shows white cells of 60 to 80 WBCs per high power field. There are traces of proteins, leucocytes, and epithelial cells also. ### Response: Your partner has urinary tract infection. She needs to do a urine culture and sensitivity. Meanwhile, get examined by a gynecologist to know the local source of infection. If she is symptomatic, with fever or burning micturition, then she needs to take a course of antibiotics." "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 21-year-old female. I have a polycystic ovarian syndrome. Ever since 14 years right now I am taking medication such as Provera (Medroxyprogesterone) 10 mg x 5 doses OD if ever I would miss my menstruation since I have an irregular menstrual cycle. My problem is how to have safe sex with my partner? Which method should I use? Yes, we use condoms, but I do not want to use pills. Is there any other method like a calendar method I can use? Please help me. ### Response: Hello. The best option is low dose contraceptive pills it will help to regularise your periods. Try to control weight by diet and exercise to prevent PCOS." "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 three miscarriages. I did TORCH test twice. Now that I went to my doctor she told me not to get pregnant since my rubella IgG tests came out to be reactive. In the first TORCH test, my rubella IgG value was 65.1. In the second TORCH test, my rubella IgG value was 277. I did the second TORCH test after 16 months. My doctor said that getting pregnant would be risky. Also, there is a higher chance of miscarriage. ### Response: Hello. Do not worry. With recurrent miscarriage, you do not require to go for TORCH test as it is responsible for sporadic losses and not a recurrent one. Have you been immunized against rubella in childhood by receiving MMR at 16 to 18 months? The levels of 277 suggest that you are immune and to know whether you had a recent infection or not then avidity testing is done for that. Please state at what period of pregnancy you had an abortion and what test and medication have been given so far. Few important tests should be done to know the cause of recurrent miscarriage. Is there any family or past history of thrombosis in the family? We need to rule out congenital or acquired thrombophilias. First get all these tests done and review with reports and I suggest you be put on some medicines while planning a pregnancy after three months" "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 38 year old male. I started taking Ashwagandha 500 mg per day, a few months ago, and it improved my memory, attention, etc. But after a month, I began to have night sweats, agitation, weird sensations in the neck area and protruding eyes. I have read that Ashwagandha is excess pitta, I am new to ayurveda but also converted because Ashwagandha works wonders for me. I have some symptoms of overactive thyroid from it, but I really cannot quit it, because it has made me feel so good.It has improved my life considerably. I suffer from OCD combined with BDD (body dysmorphic disorder) and depression. I am not producing enough serotonin, and my receptors for serotonin are also dysfunctional. In the last ten years, I have tried to keep myself aloft without psychiatric medication. Because it was not successful in my case, and they have some unwanted secondary effects. I take Omega 3, Vitamin E, Vitamin C, Zinc, Vitamin D, Inositol, 5-HTP and lately Ashwagandha, and I cannot have a decent life without these supplements. I will never quit Ashwagandha again; I really cannot live without it. I have tried ghee, but it is not cooling enough. I also tried taking Shatavari and Bacopa, but I have some weird feeling, so it is not working. I also tried Triphala and Amla for a month but was also feeling weird from it so gave it up. Now I take Ashwagandha on alternate days. Please help me adjust the warming effects of Ashwagandha. ### Response: Hello. I can understand your concern. I have carefully read all the details provided by you and here is the solution." "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 having consistently a very low resting pulse, between 50 and 58 and I do not know if this is a sign of a problem. I do not have any other issues besides nausea sometimes. I am 39 years old and overweight (BMI 32.9). Should I be worried? ### Response: This resting pulse is perfectly normal in healthy peoples. This pulse will rise once you exert. Rise in heart rate with exercise and fall during rest is a normal phenomenon that is controlled by our autonomic nervous system. In healthy persons, it even falls in 40s during sleep. So, nothing to worry. The only thing that I would like to ask you is whether you have any symptoms such as dizziness during low pulse rate? Another thing is ECG (electrocardiogram). I want to see your ECG to see whether it is a sinus rhythm or is there any block. As your cardiac workup is done and is normal, I do not think you need any more work up but if there are occasional symptoms associated with low pulse rate as graying of vision, dizziness, etc, I would advise you to have a Holter monitoring done for 24 to 48 hours to see rise and fall of heart rate during daily activities including sleep. If you have no symptoms, just relax and do not worry." "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 husband is 33 years old with a weight of 95 kg and 5 feet 9 inches height. He has been having pain in his scrotum and testis area for the past 6 to 7 years after every 2 to 3 days whenever he does not masturbate or does not have sexual intercourse. If he masturbates daily or has sex daily, the pain does not come but if he misses it for even two days the pain and heaviness come back which goes away only after ejaculation. We got married almost one and a half years back but he has been having this problem for a long time. He says it all started after a few years back whenever he would get aroused after watching porn and could not masturbate. He has not consulted any doctor yet. What could be the reason for his problem? I am worried. That pain and heaviness sometimes make walking difficult for him. ### Response: Hello. I can understand your concern. He has persistent testicular pain which develops usually when he does not masturbate or have sex. If the pain is persistent and is severe then that should be evaluated. The causes should be ruled out in order to make the diagnosis. Infection in testis should be ruled out first. Though any granuloma, torsion are other rare possibilities. Non-specific testicular pain is seen in a lot of individuals. His urine and semen analysis should be done. Scrotal ultrasound should also be done. This will grossly rule out possible causes. A prophylactic antibiotic course can be given if there is any mild infection or there are pus cells in semen. Doxycycline can be given for at least four weeks. This should solve the problem. If the problem persists and all investigations come normal, then that pain could be due to some psychological reasons." "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 penis gets swollen after sex for the past two months. I have itching and pain during sex. I will send you the picture of my swollen penis. ### Response: I have gone through the picture (attachment removed to protect patient identity). The swollen penis with itching can be due to balanitis with inflammation in penis and glans. If the swelling is painful, use a topical steroid cream. If needed, use a topical antifungal. You can consult a dermatologist or urologist for examination and get the prescription accordingly." "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 been diagnosed with 8.5 uric acid and recently underwent a hysterectomy. Which medicine should she take for uric acid? ### Response: Hello. High uric acid will require diet modification followed by medical treatment if not controlled by diet. You can start diet modification like, 1. Have adequate fluid intake. 2." "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 and my fiancee have ureaplasma parvum (DNA analysis). I have no symptoms, she has a little excreta. Should we take antibiotics or not? ### Response: Hi. I have gone through your query. Men usually do not get significant symptoms in this infection. Women usually get some whitish discharge, not very significant. It would be best to get it treated and both of you would need treatment as it can be sexually transmitted. However, it is completely curable. I would suggest you visit your local urologist for a clinical examination before any treatment." "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 took Benzodiazepine Alprazolam for insomnia for 2 months for a total dose of 30 mg, while stupidly attending college parties and binge drinking once a week during the period (I have never taken the pill on the day I was drinking). I did not take the drug every day and after roughly two months I quit the drug altogether, the withdrawal, that I did not recognize at the time, kicked in (Extreme tinnitus, sweating, heart racing, heightened anxiety). I went to ENT doctor and she gave me two Dexamethasone injections in 3 days (I think 8 mg). I developed during these 3 days a major loss of short term and then long term memory, trouble finding words, trouble learning in general. The physical symptoms of the steroids and benzo withdrawal went away in 2 weeks. It has now been a month since I feel physically fine, but the cognitive issues persist and they do not get better at all. I have been to a psychiatrist because I felt overwhelmed that Iam not going to be able to finish school in such a state and she gave me Escitalopram thinking it could be psychological, but there is no improvement in cognition after a months use.Does that combination have that drastic side-effects and could it caused a chemical or structural problem in brain? What can I do to return somewhere close to my old self? I am 24 years old. ### Response: Doing so can cause additive" "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 high blood pressure for the last three years. During discomfort, the reading comes around 140-148/90-98 mmHg. In normal times, it is 120/80 mmHg. Presently, I have been taking Cilacar 10 in the morning after breakfast and Ecosprin AV 75 at night as suggested by my doctor. I am taking Cilacar since nine months and started Ecosprin just five to six months back. Earlier, I was taking Telma 40. But, my high BP has not cured fully. Sometimes, particularly in the evening due to the anxiety I feel some discomfort and uneasiness in the left chest. But, I do not have any pain. I am getting sleep only after some struggle for an hour or two. But after deep sleep, I feel relieved. My blood sugar level, lipid profile and last ECG report were fine. My doctor did not advise for echo or any further test. I have attached my latest blood report. I do not smoke and drink. But, inactive lifestyle due to sitting in front of a computer for hours. Please suggest some alternate or additional medicine to cure my hypertension and anxiety. ### Response: Hi. You have hypertension (high blood pressure), which is out of control occasionally during episodes of anxiety. The baseline BP control is fine. I would suggest adding a new medicine, tablet Concor 2.5 mg (Bisoprolol) once daily at 8 AM. Consult your specialist doctor, discuss with him or her and take the medicine with consent. Let me encourage you to develop a more healthy lifestyle. One practical suggestion would be to join a good gym and have a trainer. You should start with elliptical trainer and treadmill. You need to change your sedentary lifestyle and that in turn will help you to decrease the number of medicines. Also, having a personal trainer will help you to have a sustainable activity program." "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 date of the period was last month. Usually, I have an improper cycle (one month miss). We had intercourse after almost a month and I took Ipill on the third evening. Please help. ### Response: I read your message. Actually, chances of pregnancy are negligible as you have irregular cycles. As you said you took Ipill on the third evening, so in the next 3 to 4 days you should expect your periods. If in case of periods does not occur, then do a blood test (serum BhCG ) around 11th to 12th 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 a 19-year-old female. I have been having bad headaches for about six months now. They happen in very specific areas (top right of my head, top left of the neck). I could probably trace a quarter-sized circle around the area of pain. The pain radiates down the side of my face and even into my neck and sometimes affects my vision. They hurt terribly. I thought I was having an aneurysm. I get the pain only once in a week or two. They usually were gone within the hour, and I am better with Excedrin Migraine, but sometimes the pain comes back. I do not drink alcohol, caffeine, smoke, or take any medication regularly. The pain does not seem to happen at a particular time of day or during my menstrual cycle. Please help. ### Response: Hello. From your symptoms, I feel that you are suffering from Migraine. A migraine is a form of headache which most commonly affects young females. It gets worse when you have stress, lack of sleep, or gets triggered by some particular food or smell. But the problem is, there is no test to confirm Migraine, it is a clinical diagnosis. Also, diagnosis can be confirmed if you respond to Migraine treatment very well. My suggestion is to start your Migraine treatment. You observe for two weeks, if you are finding a good relief, then you shall continue the same medications, and it would confirm Migraine as your diagnosis. But in these two weeks, if there is no improvement, then we shall evaluate for certain other causes like cervical radiculopathy, trigeminal Neuralgia, etc. So start tablet Sibelium (Flunarizine) 10 mg every night after dinner for one month. 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 take Quetiapine XR 400mg. How can I gradually withdraw? ### Response: Quetiapine is an atypical antipsychotic, with a half-life of less than 24 hours. It has a benefit of not causing extrapyramidal side effects. However, it can cause sedation, postural hypotension, and urinary complaints. As you are taking 400 mg XR formulation of Quetiapine, you can taper it by 100 mg every 2 days until you reach a dose of 100 mg, when you reach 50 mg, take 50mg for one more day and then stop. However, if you are taking Quetiapine for some psychotic conditions or acute mania/ BPAD (Bipolar Affective Disorder), I would suggest you to consult your treating psychiatrist before tapering your medications, as at times unsupervised tapering can lead to the reappearance of the symptoms." "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 five years old now. He was having a partial obstruction issue when he was three years old. It got cleared without a surgery. He has never complained to us about a stomach pain or any difficulty in the stomach. But he does not have a weight gain. He is 16 kilograms now. He is very active. But he starts to have sweating within a minute when compared to others. He gets a headache when he sits under an AC, or he gets cold. He had mothers milk only for 40 days. Later he took regular powdered milk. As parents, these things concern us a little bit. Please advice. ### Response: Hi. Your child\s weight is fine for his age. There is nothing to worry. Give him a balanced, nutritious diet regularly. A headache during cold is a common association. It goes away after a resolution of cold. If it is persistent, then there is a need to worry. Some kids sweat more due to the anxiety situations they face." "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 an MRV done. In the report, it said my right internal jugular vein was not visualized at the skull base. What could this possibly mean? It was never followed upon. I get terrible headaches. ### Response: Hi. The internal jugular vein carries blood from the brain and neck area to the heart. There are many reasons for the non-visualization of the internal jugular vein on MRV and the causes can be technical due to slow flow of blood or can be due to a mild compression of the vein due to a secondary cause. Rarely it can be from a thrombus in the lumen of the vein. If the MRV of the brain and rest of the internal jugular vein is normal, then the non-visualization is likely due to technical reasons and is artefactual. If you are having headaches, then it is better to talk to your doctors and get a neck venous Doppler done to rule out any external compression of the vein or any luminal thrombosis of chronic nature." "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 AF for six years. Tried DCC and got sinus rhythm for 12 months, then back to AF six months ago. My echo showed serious left atrium dilation (more than 200% i.e. 180 ml compared to the normal 60 ml) and mild ventricular dilation. 24 hour tape ranges from tachycardia of up to 120 and bradycardia with up to two seven second pauses per night, but it was stable before one year. My ejection fraction is normal (60%). I have booked to have an ablation. Could you please describe what is the level of risk to life of such serious dilations, and what can be done to get them back to normal? ### Response: I had gone through your query. So as ablation can prevent AF (atrial fibrillation) but the return of atrial size to normal is unlikely. The risk due to atrial dilation in AF is due to the formation of blood clots inside left atrial appendage and chance of embolism producing a stroke. We normally perform transesophageal echocardiogram to rule out the presence of thrombus before considering for DCC (direct current cardioversion). So if the size is more than 4.5 cms and some consider more than 5.5 cms there is a need for anticoagulation (blood thinners) to prevent thte stroke. Some may consider left atrial appendage closure device or surgical removal so that the chance of stroke decreases. So you need to discuss these issues with your consultant cardiologist who is planning ablation. 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 28 years old, and I am suffering from pain starting from spinal to upper neck for three years. Sometimes BP is little high and that BP was 150/90 four to seven times BP up but now it is normal, but I have still suffered in the neck to upper head pain, discomfort on the left side like my heart is pressed and left shoulder and left leg. Now average BP is 85/125 to 90/130. LDL is 126, and HDL is 43. ### Response: Hello. The pain you are describing is not cardiac pain. Cardiac pain is accompanied by symptoms like shortness of breath, palpitations, etc. You have cervical radiculopathy this can cause pain to radiate to other parts of the body. I advise you to take tablet Ibuprofen 400 mg two times daily for five to seven days and gently trying to exercise your neck by moving it around. If you do not get relieved in a week, see a physician for a physical check-up." "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 25 years old. My total testosterone was low. It was 400 ng/dL. This was on last Friday after a very intense week with insufficient sleep and no exercise. My question is, am I stuck with this? How can I improve this to any value within the normal range? ### Response: I have read and understood your problem. However, I would like you to answer few questions so that I can help you better" "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 problem of nose block for the past one month and I suspect this as sinus. I have done a CT scan. Please advise on treatment. ### Response: Hello. You have allergic rhinitis along with a benign nasal polyp which is usually seen in patients with prolonged allergic rhinitis. You have also sinusitis associated with it. Polyps are usually removed surgically. I suggest taking Augmentin (Amoxycillin and Clavulanic acid) 625 mg twice daily, Pantoprazole once daily, Montelukast with Levocetirizine once daily. Take all these for five days and it will reduce your symptoms. Symptoms due to polyp can be relieved surgically. Consult an ENT surgeon." "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 used to run about five km and do cycling about 6 km. I got a calf pain six months ago, though it would get normal in a few days, the pain persists, the MRI shows nothing. The doctors tell everything is fine, but the pain is too much, could not even walk for a few mins continuously. The pain is exactly on the outer part of the left calf muscle where I could feel it in a particular position like a small line. But the sickness spreads over the entire calf. ### Response: It would be nice if you can share the MRI reports with us so we can comment accurately. In general, without the MRI, I suspect this to be a muscle injury, which is healing slowly. As MRI too have limitations, we have to follow the clinical signs and symptoms and treat according to the clinical symptoms. This sounds to me as a muscle injury, due to which there is a muscle imbalance. I will advise undergoing muscle re-education, and muscle balance board training, which can help correct the actual action of the muscle and a proper torque can be applied with the contraction of the muscles. Later a graded practice of the lower limb will be good. If the nature of the pain is burning, tingling, radiating, and numbing, etc., that we may have to look out for any nerve root entrapment and treat accordingly. Please share the MRI reports if possible." "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 consulted a counsellor suggested by my probation officer and discovered that I have extreme post-traumatic stress disorder, anxiety, and depression, etc. I wonder if any of this could be related to the trouble I have got myself into. When I get very overwhelmed with emotion or stress, I tend to black out completely but still functioning, and I come back to normal after a few minutes, but I have no memory of what I have done during those minutes.In my whole life, I had a lot of bad things that have happened to me and my family, but I have never dealt with them. This past year a lot of bad personal situations have happened, and now I am starting to notice the blackouts. What can I do? ### Response: Hello. You should get yourself investigated for the blackouts and memory problems you face. First, you should consult a neurologist for that. Once every other neurological issue are cleared, then only we can diagnose whether it as related to your anxiety, depression or PTSD (post-traumatic stress disorder) if so then it is psychogenic. In most cases, a psychogenic blackout is an involuntary reaction of the brain to pressure or distress. Psychogenic blackouts sometimes develop after people have experienced ill-treatment or trauma and such conditions are treatable and curable. But we need to identify the severity of anxiety and PTSD and then the treatment slowly starts with medicines, psychotherapy and relaxation therapy. You can be cured completely, but it takes some time. Consult a psychologist or psychiatrist." "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 facing this below for more than 15 days. My lower and upper wisdom teeth are erupting. The lower teeth are erupting and gum got swelling and pain. There is swelling nearby the last molar teeth and feeling pain. I have a feeling of throat infection and sometimes pain in the throat, neck and Jaw. I have no fever but inside the tongue I found red blisters. I need your advice.Already I am taking Loxoprofen sodium 60 mg for one week, and Azithromycin for about three days. ### Response: First of all please do not worry. I went through your query and I am a specialist dealing with third molars. I can understand what kind of pain and discomfort you have been through. I will guide you to relieve all your pain. These teeth are impacted and they will not come out normally and will cause discomfort repeatedly. I will prescribe better medicines kindly get them you will be fine. Visit your dentists office once the lockdown gets over to extraction. For now, I need you to do Warm saline gargle two to three times a day (if hypertensive avoid salt, use Betadine gargle). Avoid sticky or sweet food. Maintain oral hygiene. Avoid direct heat (warm cloths from outside). Take the medications as prescribed. Impacted third molars. Pericoronitis. Follow up after seven 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 35 year old male. I cheated on my wife and I am really scared that I may have HIV. When I say scared, I mean night terrors, huge anxiety, and no appetite (lost 15 pounds in three weeks). I cannot work and it is all I think about. The circumstances are as follows. I performed oral sex on a female. I then fingered her and then masturbated myself with the same hand. I have asked a few professionals and they say I am only at risk theoretically but have no real risk of contracting HIV. However, my body tells me differently. I have had a sore throat for 20 days, no appetite, pain where my liver and spleen are, weakness in my legs that come and go and a hint of nausea every now and then. I have night sweats that awaken me but they are accompanied by panic. My heart feels like it is going to burst. My tongue and mouth burn, but I think that is acid-related because my breath is awful, no matter how much I brush. I had an Alere combo HIV test at 25 days and that was negative. I have never had a fever, rash, swollen nodes, or any of the common symptoms. My questions are what is my real risk of contracting HIV? The health department said I do not need to retest and that 25 days was enough time for accurate results with that type of test. Is that true? Could this all be anxiety and guilt? ### Response: I understand that you are worried but it is not the end of the world. 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 an occupational therapist, and my client\s mother would not let me talk to her neurologist even though I need to script some equipment. So I wanted to ask general questions, the client is 12 years old and has hydrocephalus and had many many surgeries as her shunts keep becoming blocked. She now has the most significant possible VP shunt in her brain, and recently (a couple of weeks ago) had a bleed after surgery, but that has been treated now, and she is going well.The client also has uncontrollable absence seizures, a chromosomal disorder, intellectual disability, connective tissue issues, hand deformity, and recently diagnosed tuberous sclerosis (skin and possibly in the brain). The client\s mother would like me to complete a funding application for them to get a hospital bed at home, as the daughter (client) is currently sleeping upright with pillows.She said sleeping upright helps the shunt drain. I have not been able to find any research around this, and have also read about something that says over drainage can be an issue. Did you have any thoughts about this issue? Or if it is really client specific and I do need to contact her neurologist or neurosurgeon. ### Response: Hello. I read your question carefully and would explain the upright position (head of the bed 45 degrees) can help reduce the intracranial pressure. So, I agree with the patient that she feels better in this position. Regarding the medication, I would recommend Diamox and Furosemide to help reduce intracranial pressure. I would suggest Valproate or Levetiracetam. I hope you will find this answer helpful. I remain at your disposal for any further questions whenever you need." "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 writing this on behalf of my wife, who is 56 years old. She has been suffering from severe low back pain since last 8 to 10 years and left shoulder joint pain since last one year. Please find the enclosed reports, for your kind perusal. We shall be grateful for your valuable opinion and advice about further treatment and management, at your earliest convenience. ### Response: I have gone through your query and reports (attachment removed to protect patient identity) with diligence and would like you to know that I am here to help you. She has got cervical spondylosis. This probably causes the shoulder pain rather than a problem in the shoulder. Avoiding forward bending will help relieve her pain. For that: There is a disc prolapse which causes back pain. Surgery is needed for this" "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: Cervix radiation treatment fears me. How will it affect my sexual life, attracting the opposite sex, pheromones, sex drive, sexual stamina, and my attraction for others? ### Response: Hello. Radiation therapy leads to a lot of sexual adverse effects and poor quality of life. Also, radiation may affect the length or caliber of the vagina and decreased vaginal lubrication and elasticity and can adversely affect sexual function. However, some of the side effects will alleviate with time and hormonal replacement therapy. For fertility preservation, there are options available. So overall, radiation has significantly higher incidence of sexual dysfunction as compared to surgery or chemotherapy. Higher incidence of pelvic pain and pain during sex. Also, there will be higher incidence of bowel dysfunction, higher incidence of urinary incontinence. 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 a 30 year old female. For the past few weeks, I have had an unrelenting back pain between my shoulder blades. I also have a sharp, tearing chest pain above my left breast area or along my sternum on my right side. The sharp pain will last a few minutes, then stop. At times, it radiates to my shoulder. When it happens, my pulse and blood pressure increase for a few minutes and I feel short of breath. What could this be? I had PE ten years ago but the pain was not quite the same. ### Response: After reviewing your health query, I want to add that there may be anything from a list of possibilities. So, as the next best step, you need to consult your PCP (primary care physician) and get referrals to consultations for a pulmonologist, a cardiologist and/or a gastroenterologist. Your PCP is capable of ruling out at the preliminary level on his own. He would refer you either to all of the aforementioned specialists or only one of them as he feels comfortable with. Once ruled out, we can better assist you and this hopefully will all be managed accordingly. Hope this helps. Please feel free to ask me more if you need further assistance." "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 experiencing ED issue. I am not able to achieve full erections while sex. There is no previous history of this issue. Kindly advice the further action to be taken. ### Response: Relax and do not worry" "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 took a tablet to extend my period during my wedding. After that, I got a scanty one in the same month and took an i-pill end the end of the month. I got my next period within a few days. It was heavy for the first two days and I felt so tired. Again after twelve days, I had bleeding for four days.The next cycle started. I took an i-pill on that month also. Last week I took another i-pill and it started bleeding after four days. It is very heavy. Am I getting an early period or just bleeding or something else? ### Response: Hi. You are probably taking the i-pill again and again which is not right. It has caused hormonal imbalance and disturbed the cycles. It is meant to be taken once only for emergency reasons and not after every unprotected sex. If you take the i-pill before ovulation, then your cycle is likely to get shortened and you get your periods early. But if you happen to take it after ovulation, then the cycle will be prolonged. It will be better if you take regular combined contraceptive pills for 21 days if you want contraception for a few months. This will also regularise your cycles and also control bleeding. However, it will be better if you get one check-up done and get a scan done to see is there any other cause for heavy bleeding." "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 lesion on my left leg from the past 15 years. I have never shown it to a doctor. I am attaching a picture of the lesion. ### Response: Hi. I have seen the picture (attachment removed to protect patient identity). I can narrow the diagnosis with the help of further information. Revert with 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 am 30 years old male suffering from coccydynia for many years due to injury. I fell back on cement at that time. X-ray showed a hairline fracture. The doctor said it will heal. Use donut cushion but the pain did not relieve. My pain symptoms are localized pain only at coccyx area. I cannot sit directly on the surface with coccyx wedge cushion can sit for 30 minutes. Recently, I underwent dynamic coccyx X-rays and lumbar spine along with coccyx. MRI reports say mild retrolisthesis at the sacrococcygeal joint along with obtuse anterior angulation (120\xb0) which is mildly increasing in sitting compared to standing. I have undergone physiotherapy, external and internal manipulation, a steroid with numbing agent injection directly on the coccyx painful area without live X-ray alternative medicine, no relief. So, by seeing my reports please reply what is my coccyx condition name, whether it is hypermobile or rigid. Surgery is the only solution or can I try proper chiropractic adjustments which I did not get done or ganglion impair block and RF ablation, Prolo or PRP injections are useful in my case which is chronic? Please reply in detail. ### Response: Your condition is called coccydynia and usually, most of the patients improve with conservative treatment. You have also taken steroid injections which might have had given you relief for a few days. (Not mentioned in history but I am assuming). Surgery for the same is mostly not required. You can try for PRP injection. PRP (platelet-rich plasma) has been seen to cause healing as compared to steroid injections which only cause suppression of inflammation" "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: Dear doctor,I am undergoing a spinal anesthesia on the 11th for an inguinal hernia condition that I have. However, during a party with friends, I accidentally took a 5 mg Cialis tablet. I have heard that this may create complications in anesthesia. I am really tensed whether to go ahead with the surgery or not. Can you please guide me? I am hesitant to tell this to the doctor in front of my family. So please advice me. ### Response: I read your query regarding the spinal anesthesia. The Cialis tablet should not have any effect for the procedure on the 11th. Even spinal anaesthesia guidelines is for stoppage of such" "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 56 years old and I am suffering from hyposmia since a month, which appeared after a cold with fever and inflammation. I have been prescribed Flixonase nasal 400 microgram/unit dose nasal drops.I used Flixonase twice daily for about 10 days.At this point I am not sick and inflammation has gone. I do not take any medication and I am healthy.The opthalmologist did a visual check and told me that I he could not see any sign of swelling, it was a very superficial check, just look up with the light.I will describe how I feel my hyposmia:I do not have a total loss of smell.I can smell some things slightly, other things very slightly, and other things I cannot smell at all. I have noticed that sometimes, more or less one time at every two days, I can recover a lot of my smell sense for a short time, sometimes 30 minutes to an hour followed with worsening of my smell sense. As for example, yesterday I could smell and taste my lunch and I could smell many others things like the rain outside the house.Sometimes I have worsening of my hyposmia and when it occurs I cannot smell many things. After a while I recover some of my smell sense more or less to the level before (not the normal level).Last night, my smell sense got worse but stabilized overnight. This morning it again got worse.The same is happening with the intensity of odors, it improves and worsens along the day. It just happens.Do you have any idea of what is going on?Are those signs of recovery or indications that I am losing the sense of smell? ### Response: I understand your concern. I would like to tell you that for the sense of smell we have got a sensory mucosa at the top of interior of nasal cavity and it is called olfactory area." "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 26 years old. I am diagnosed with hypothyroid about four years ago. I started from 0.25 mcg Levothyroxine, and now taking levothyroxine 0.75 mcg. Recently, I lost 4 pounds which is very bad because I am 5.6 tall and my weight is 116 pounds. I feel weak and dizzy very often. I also have irregular heavy periods and symptoms of having too much male hormone (too much hair on legs, bikini, etc, severe acne especially a week before expected period). Since one year my periods cycle became longer, before it used to be 28 days and now it is 38 days.I am also worried because of low insulin and pretty normal glucose. What does it mean? May it be because I am on gluten-free diet for two years? Please also look at my sex hormones prolactin looks too high, and I am not sure about testosterone. ### Response: I just read your query and the detailed information you have mentioned in the attached reports. (attachment removed to protect patient identity). The thyroid function is good and you must take your medicine regularly as usual. Do not worry about the insulin levels it is a good thing, it means you are perfectly normal. Your prolactin levels are the ones that you should be worried about as they are the ones causing your irregular periods. They need treatment. I would suggest that you take tablet Cabergoline 0.25 mg orally twice a week for two weeks and then repeat your serum prolactin levels. Your testosterone levels are within normal limits and perfectly normal as well. 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: My ACTH level is 43 and my cortisol level is 23.9. I am 25 years old and my weight is 237 lbs with a height of 5\4"". What could be the problem? I am currently under Nuva ring 0.3 mg and vitamin D 50,000 units once a week. ### Response: I have gone through your lab reports. (attachment removed to protect patient identity). I need to know what was the reason and why these tests were done in the first place? What were your symptoms and complaints? And also why Nuva ring was started? Kindly get back with the answers so that I can make the best possible diagnosis for 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: Hello ! Can you please review my blood test? My concern are low level of ferritin, high level of B12 and Urine WBC is very high. ### Response: The low ferritn , Low Mcv could be suggestive of early iron deficiency anemia. The common cause for high B12 include supplement intake , Liver disease or Kidney disease. Your liver & kidney profile reports are normal.So don\t worry about that. If you have any history of supplement intake than mention it.B12 excreted by urine , so might need not to worry about that.High Non Veg food also sometime can cause elevated B12. For low ferritin no need of any treatment.Repeat your serum ferritin & serum iron after few days. The WBC in urine could be due to urinary tract infection.For that investigate further with urine culture report.Meanwhile take more water & cranberry juice extract tablet.Attach the urine culture report once done. Hope this will help you Regards" "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 continuous pain, sensation in the whole right half of my body with an epicenter of this chronic pain somewhat near to my last rib, backside, in right side near to corner end of lung or near to liver. This chronic pain started with a fever eight and half years back since then it has been with me. Sometimes it soars for 10-15 days once in six months. Symptoms are chronic pain, cough and sore throat, pain in the jaw, pain in the eye (burning sensation) like some inflammation starts in right half of my body, fever due to this cough, sore throat (not high but 99-100), the repetitive urge of micturition in worse days. The situation worsens when micturition get delayed due to sleep, in travel or class or meeting, etc.I consulted with a urologist three years back, and he suggested me to go for a cystoscopy, in which I got confirmed as having IC (PBS) (please see reports in images attached). I had Elmiron 100 mg for two months after getting diagnosed three years back. The reports and previous consultation I am attaching herewith. Nowadays it gives me the same pain, but my concern is why it is limited to the right side of the body only? Is there anything we have not diagnosed so far? ### Response: Hello. I have seen your reports (attachment removed to protect patient identity) and I have some questions for you. Again it is a diagnosis of exclusion. I would suggest you start on tablet Soliten (Solifenacin) 5 mg morning and evening for seven days and see how do you feel. Somewhere in your reports, you have mentioned that you have RBC in urine? If that is there, then it is not normal. So do the urine routine and microscopy test." "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 27 years old, and I have been suffering from OCD and health anxiety for many years. For about a year now I have been having arrhythmia (mostly extrasystoles) they have been chiefly eased up since I started my new job, but something has been going on. I have been feeling angina for over a month now with the occasional extrasystole, and I cannot focus on my job, I had an ECG done five months ago, and it revealed that everything was going perfect. But I did a new ECG two days ago, and now I am super concerned and can only go to the cardiologist tomorrow. It revealed ischemia in the inferior wall, I believe from what I see, the V1. Is this from all the emotional stress I have been through? What can make me calm down and think it is nothing too serious? ### Response: Regarding your concern, I would explain that it is necessary a direct review of your ECG recordings to accurately judge the clinical importance." "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 these dark spots and wrinkles behind my neck. I am a little chubby but what should I do to remove them? It does not burn or anything. I have had KT for more than two years. Is there a way to remove the wrinkles and the dark spots? ### Response: Hi. Kindly let me know your age. With increasing body weight there is an increase in pigmentation in body folds plus wrinkles as you are saying. Try to maintain your body weight in good and healthy limits. It will improve dark spots and wrinkles. For dark spots apply Vitamin C cream at one time and Retinoid cream at night time. Adapalene gel applies at alternate nights on the neck area. Apply Vitamin C cream BD (morning and evening). Use sunblock of 60. Protection from sunlight." "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 woke up suddenly at 1\o clock in the night to urinate. I have a burning sensation after that. I woke up once an hour until about 5 am and having the same problem. There was only little urination, and the burning sensation started to decrease after each time I urinate. At around 4 am, I noticed light pink spotting on the toilet paper after the first wipe. It has occurred all day and at 6 pm the burning has almost completely disappeared. I am due for my period in seven days and I had unprotected sex eight and 13 days ago. A little concerned, I had UTI in the past and never had any spotting. I have googled, possible implantation bleeding, and took an EPT two days ago, and it turned out negative. I want a little more possible explanation. ### Response: This can well be an implantation bleed considering you have had unprotected sex recently unless proven otherwise. The EPT (early pregnancy test) test is not sensitive enough during the cycle at all, and can only detect the hCG levels on the seventh day post missed period. The pregnancy can be rather confirmed with a blood serum beta hCG level, which if found to be raised indicates pregnancy. You need to furnish details about your LMP (last menstrual period) and regularity of cycles to comment 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 right eye occasionally gets swollen. I do not have any pain, itchiness or watery eyes. But this comes like once in every three months or four months. It would be there only for one day and gets better later. I initially assumed it to be because of body heat since I get this only for one day. It was very difficult to get an appointment with a doctor on that day to show my eyes. However, I continue to have this problem. I researched on the internet (because it is highly impossible to meet a medical practitioner here) and I understood that the cause might be because my right eye tear duct is getting blocked, although it is my assumption as the place between my nose and right eye corner gets swollen. A day or two before the swelling starts my right eye gets a bit teary and I feel like rubbing the right eye often. It would be nice if you could advise what could be the reason for this and whether I should immediately consult a practitioner here. ### Response: Hi. From what you have told about your condition and the photos of yours, I suspect you may be having a benign disease called blepharochalasis. It is quite frequent in your age group and follows the same pattern of on and off swelling of eyelids just like you have told. There are as of now no good tests to confirm this condition nor any proven treatment measures for this. However, I would advise you to avoid stress and being too emotional at times as these are known to cause attacks of blepharochalasis." "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 unprotected sex 10 days back and then took Unwanted 72 after four hours. I have not got any withdrawal bleeding yet. What does it mean? When should I take the pregnancy test? Also, I am a patient of PCOD. ### Response: You have rightly taken the emergency contraceptive pill within 72 hours of unprotected intercourse. If the hCG levels are less than 3 mIU then you are pregnancy safe else you are pregnant. If the test is negative then you can safely wait for the menses to return for at least two weeks and then, can get an ultrasound pelvis done to check for endometrial thickness and post that if the endometrial thickness is more than 9 mm then you can opt for a 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, and I recently saw a scary movie, where a man used a turkey baster to insert semen into a woman\s vagina. This scared me very much, and I remember one time I fell asleep on a couch in a study room. If someone did something like this to me while I was asleep, it would have woken me up, right? ### Response: Hi. I read your query and understand your concerns. I hope this helps you. Feel free to write back to me if you have more questions." "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 32-year-old male. Recently, I had sex with my partner. After 20 days, I got a severe stomach infection, and I am undergoing treatment. I am responding well, but specific food causes loose stools (not sure if it is because of food). After 40 days, I started to get a slight throat infection with cold. I am scared of getting HIV. Please suggest. ### Response: Hi. There are many reasons for having loose stools. Even, anxiety cause increased motility, and it results in diarrhea. Coming to a sore throat, it may occur due to a viral cause. You can get tested with fourth generation test as you have already crossed 28 days and the test result will be conclusive for diagnosing HIV. You can continue your treatment. Kindly share your treatment details for further analysis." "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: Please tell me whether L-Lysine is safe to take every day or not. ### Response: Yes, it is safe to take it daily upto 5 gm. It has shown positive effects in depression, wound healing and is good for skin and hair as well. Excess can cause gastric upset." "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 10-year-old daughter just found out she has grade 3 spondylolisthesis. I am assuming she is done ever playing sports again? ### Response: Hi. I do not think there will be any problem in playing sports when she grows up if she takes adequate precautions. Spondylitis is not a disease. It is not curable. If she takes proper care and does some exercises she will definitely recover. You should also consult some physiotherapist for this problem. Also, she should take a good proper and balanced diet that is rich in Calcium, Proteins, Vitamins, and Minerals that provide adequate nutrition to the body and hence proper growth that can help in the curing of the problem." "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: Hi,I am suffering from balanitis since last month. I am using an antifungal cream (candid B) to avoid it. Till the time I use antifungal cream all rashes/infection disapper, but once I stop applying the cream all symptoms start again. Sympoms are: Red skin around head of penis and itchiness after 1-2 days of red skin. ### Response: Have you ever been diagnosed by a doctor because balanitis has several other causes as well and fungal infection is one of them. Get a fasting and post prandial blood sugar done and please send me a few details: These answers will help me come to a diagnosis and treat you properly." "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 working as a design engineer. I work more than ten hours per day in front of the computer. Last two months ago I have pain in my right leg while walking and irritating buds while sitting on the right side. So I went to doctor. He took MRI and says I have disc bulge L4 L5 and it presses the nerve root. The doctor prescribed some anti-inflammation tablet and take physiotherapy for ten days and take rest some days. I finished my physiotherapy and I do exercise twice a day suggest by the physiotherapist. I take rest in bed for one month, but my pain not reduced. I consulted some ortho specialist they said bulge is very small only no need to worry. Now I have some shoulder pain and nerve pain in my right hand. While sleeping I feel numbness in my baby finger and ring finger from the wrist on both hands. I am confused now is it the only disc problem or something nerve problem? I have taken medication for erectile dysfunction for two months ago. The doctor prescribed one month medicine but I took two weeks only later I scared of my leg pain and I stopped medicine. ### Response: The numbness in your small finger is related to a pinched nerve in the elbow, probably related to a wrong position during sleeping. It is not related to the bulging disc in the lumbar vertebral column. I would just recommend performing a nerve conduction study if the numbness persists. In the meantime, I would recommend avoiding pressure on the elbow during sleeping or on the desk" "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 has been detected with glaucoma. The problem started about two months back. There is some irritation in eyes and vision is hampered in one eye. I wanted to get an opinion on how serious. What should be done? Do we need to take urgent action? Can we cure it completely? ### Response: Hi. The thing with glaucoma is that it is a progressive condition and we can arrest its progress to a level that it does not cause further damage. The vision loss that has already been done by the disease is not reversible. Our goal here is to lower the pressure to such a level so that it does not cause further damage." "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: What are the clothing items that are low-key bad for your health? A rundown of items of clothing that are actually bad for your health like some shapewear, unsupportive flats, jeans that are too tight, etc. ### Response: HelIo. I will explain about skin-tight clothes like jeans. First they cause excessive sweating which might lead to frequent folliculitis and fungal skin infections. Secondly, if they are very tight and have Lycra in them it can lead to vascular compromise. Thirdly, if the fabric is rough they may abrade the skin. Shapewear can be harmful if worn for a prolonged period." "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 2-year and 8-month-old daughter is having a cold and cough for the last two weeks. Earlier I gave her Maxtra and Levolin for five days. She had a cough for two to three days and it got settled. But, the cold was still there. So, I gave her Xyzal for three days with improvement in the cold and now again the cough has started. She is coughing in every 30-minute interval. What shall I do? Previously, she was down with typhoid fever one year ago and the immunity is very low now. ### Response: Do not panic. I suggest you give her some Mucolitic (Carbocisteine) syrup and an antiallergic or an antihistaminic syrup. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. In case there is an associated fever, consider an evaluation with a pediatrician before starting any antibiotics" "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 18 weeks old second daughter was diagnosed to have congenital glaucoma with aniridia and corneal opacities bilaterally at birth for which she underwent bilateral trabeculectomy within 15 days of birth. She achieved peripheral clearance of cornea in both the eyes within few days of surgery after which there is not much improvement. Her photophobia has reduced now and she is attracted by lights, reflective surfaces, hanging toys in the baby gym, musical toys, etc. Her other milestones are normal except reaching for toys which she does occasionally. Her eye movements seem to be coordinated, at times shake while trying to fix.At 14 weeks of age, EUA was done after which doctors advised to wait for further corneal clearance as she does not require any surgical intervention for glaucoma right now and procedures like PKP has guarded prognosis till two years of age. Her IOP was variable during EUA but the corneal diameter and axial length of the globe were within normal range. She has a tongue tie, anteriorly placed anus, mild redundant periumbilical skin. Echocardiography and USG abdomen done were normal. We are planning to do a genetic test for her. There is no family history of such illness. We parents are E.N.T specialists practicing in India.I was 37 years old during my delivery and obstetric history was uneventful. Amniocentesis done during pregnancy showed normal FISH report. I would like to know about the prognosis of the disease, availability of advanced treatment options and about any early intervention services required for her. Currently, she is taking Timolol and Dorzolamide eye drops BD, Atropine eye drops and steroid eye drops OD. ### Response: It is a good sign that glaucoma is under control and cornea has started clearing out. But the main problem here is to stop development of amblyopia which is basically a state where due to prolong blurring of vision brain. I am of an opinion that if we wait for two years chances of amblyopia are too high. You can consult a specialist for the management. Let me tell you in advance, chances of corneal transplant in infants is low and that too combined with glaucoma makes. Prognosis is poor" "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 total bilirubin level of 27.20 mmol/L and direct bilirubin of 12.20 mmol/L. Is it fine for my profession? ### Response: Hi. I have reviewed your query and your bilirubin level is high. You need to get your bilirubin level within the normal range. Sugar cane juice and apple juice can be taken more. Avoid heavy strenuous activities until your bilirubin level comes under control." "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 daughter just turned 9. She has been complaining about lower abdomen cramps, and I have noticed a few things changing. Is it possible that she is getting ready to start something and should we be prepared? She is only 9, but I have heard of other little girls starting puberty earlier, and with myself, I did not begin that wonderful stage until I was 14. ### Response: Hi. I can well understand your concern. It is not too young for her to get started with the signs of puberty. Usually, girls start puberty between 9 and 14 years. And she has started at 9; this is fine and in range. I will instead ask you to confirm about her pubic hair and breast development. I am sorry to ask, but we have to take the scenario as a whole. It is because pelvic inflammatory disease alone may cause such pains, and in that case, pubic hair and breasts will say no we are not ready to be mature yet. 1. Start of puberty.2. Pelvic inflammatory disease.3. Gastrointestinal problems. Puberty.PID.GIT issues." "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 59 year old father has hypertension from the past nine years and acidity problem. He got an acute MI last month. Prior to this, from past 10 days, he was suffering from a low blood pressure and our family doctor asked him to stop the BP tablet for a few days. At morning 5 AM, he got high acidity and chest pain, but we thought it was acidity and gave him Rantac and other home remedies. But, he started sweating and got severe pain in the chest. We took him to a nearby hospital and the doctor immediately did the angiography and found the main coronary artery was 100 % blocked which had to be stented immediately. But, he said it is very risky as you have reached late. The damage has already happened. He processed with the angioplasty. There were a total of three blockages on the left side. Two were done via balloon and the 100 % blockage one was stented. Post the surgery, on the next day, my dad started feeling high acidity, big burps, and heaviness in the chest and his heart rate was very high. From then, we were in the hospital for ten days until his heart rate and BP and other things got normal. He had little breathlessness also.Post returning home, he felt very weak and again a week later, he got readmitted for low blood pressure as my dad fainted at home and we checked the BP was very low and hence we got him to the hospital. The doctors admitted him to the ICCU and started giving fluids to bring up his BP. The doctors said low BP was due to dehydration as my father had gone for motions thrice that particular morning and since the intake of fluids is restricted to 1.5 liters max.Previous medication when we got discharged: Cardivas, Ivabrad, Ecosprin, Brilinta, Restyl for sleep and now since my dad complained of breathlessness, they have changed the medication and now they have discontinued Cardivas completely and increased the dose of Ivabrad and asked to stop Brilinta and take Prax 10 mg. My query is should one discontinue Cardivas abruptly in between? Also, his heart rate is very fluctuating and at times his respiratory rate also reaches 25 to 30 at times. And his LVEF on the day of discharge was 30 to 35 % but on the day when he got readmitted his LVEF was 25 to 30 %. Is the heart muscle becoming too weak? What could be the reason for the same? Please advice. ### Response: Your father presented to the hospital late after the episode of acute MI (myocardial infarction) with a total occlusion of LAD. So, before intervention itself, a major part of his anterior heart muscle was damaged. Even after angioplasty, his LVEF deteriorated and your father is now suffering from heart failure with reduced ejection fraction. Ideally, according to the recent ESC guidelines, the medicines should be: And fluid intake 1.5L/ day. So beta blocker must be continued at a reduced dose and to be adjusted with Ivabradine. Send a recent ECG of your father to evaluate whether he is a candidate for CRT or ICD implantation" "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 65 years old. She has been diagnosed with initial first stage cataract in right eye majorly. I want to know is surgery necessary now, or is there a way out through medications to cure it? ### Response: Hello. A cataract is a gradual opacification of a natural lens. It increases with advancing age. An early cataract causes a change in glasses number and vision corrected simply by glasses until the cataract is significant, and vision is not improved even with glasses. Secondly, cataract surgery timing depends upon patient visual needs. If the cataract is affecting patients daily routine activities, then surgery is advised. If she is fine in daily life and has not any problem in daily life, she can wait. She can revisit eye doctor when she feels further deterioration of vision, and her eye doctor will tell you the stage of cataract. If she is diabetic control her blood sugar level and blood pressure. You are most welcome for any queries." "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 has pulmonary hypertension after ASD closure surgery. Kindly advice. ### Response: Did the pulmonary hypertension occur only after ASD closure? Before closure was there pulmonary hypertension? The treatment depends on the severity of hypertension. So, is her pulmonary hypertension mild moderate or severe? If you cannot tell about severity, kindly upload the reports so that I can go through and advise better." "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 has glaucoma problem. Presently, he is using Xalacom eye drops but still does not have any changes. Please, I would like you to advise any other drugs to manage his case. ### Response: Hello. You have mentioned that there are no changes. What changes are you exactly referring to? I will try to explain the essentials of glaucoma treatment to you so that you will be in a better position to understand how the treatment works. Glaucoma is also a long" "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 is six weeks and five days pregnant. In the fourth week, she got pain in the stomach and back. So, there were two ultrasound reports. The first was taken in five weeks and six days where the gestational sac was 2.33 cm with no heartbeats found.The second ultrasound was six weeks and five days. In this ultrasound, the doctor said there was no heartbeat. He said for abortion. What should I do? Shall I send you the ultrasound reports? Please help. ### Response: Hello. This looks mostly look like a missed abortion. Usually by six weeks or later, the heartbeat appears on the scan provided. You seem to have regular periods" "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: Small red dots started to come beneath the skin on my ankles several years ago. They do not itch and you cannot feel them when you touch the skin. It seems to be worse at the end of the workday and after wearing boots. It used to be on one side but now it is covering both ankles, part of feet and occasionally a couple on the lower leg. They do not blanch when pressed. I am on no medication and vegan, although they appeared before I made that switch two years ago. ### Response: Hi. It seems like capillaritis. That is inflammation of capillaries. It can appear after prolonged exercise and stays there without any symptoms. In other vascular problems, individuals have some sort of symptoms like pain, itching, etc. Capillaritis is not the condition to be afraid of. Sometimes it gets better itself and no treatment is a better option. Just do not stand or exercise for too long. When you are sitting put support under your feet. Do not let them in hanging position." "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: Please explain the relationship between a sinus problem and pregnancy. Does sinus infection be a reliable sign of pregnancy? Why does pregnancy trigger sinus issues in some women? ### Response: A lot of women have an increase in sinus congestion during pregnancy. It happens due to the increased level of estrogen during pregnancy which tends to cause vasodilation generally. Hence, they have improved blood flow through the nasal and sinus passages. It leads to symptoms such as runny or blocked nasal passages, congested sinuses, and even sinusitis. It is not a reliable sign of early pregnancy. This symptom comes along with other symptoms to indicate pregnancy. Some women who tend to have sinusitis may not be able to tell it. Women who are not usually prone to sinusitis may have it as a positive sign of pregnancy with few other symptoms." "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 issue is related to skin color. Of late I have been observing that there is a change in the color (white) at the shaft (penis) as well as the skin below. Which is there for quite some time and is increasing now. However, there is no pain or itching or any other issue. I just wanted to know the reasons and treatment required. ### Response: You probably had a condition called phimosis, which ruptured during sexual activity. The traumatic rupture heals by fibrosis which is white in color. Except for cosmetic issue, it is not going to affect you. Skin darkening procedures can be sought from a Dermatologist. If you still have phimosis consult a Urologist for single day procedure. It relieves pain during sex due to phimosis." "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: For three years I have been at home as a caretaker for my child. Mostly I feel exhausted and boredom every day morning. Now, I plan to go for a job. But, I have a fear of facing an interview. Please help. ### Response: Hi. I first wish to appreciate the love and dedication you have shown towards your family, by staying away from work for three years." "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 age is 17 years. A part of my upper lip is swollen. There is no pain in it. What might be the cause for it? ### Response: Hi. The swelling of upper lip might be due to allergy, insect bite, or a small trauma. You can take anti-allergy medications to reduce the swelling. I suggest taking tablet Allegra (Fexofenadine) 120 mg has to be taken, one tablet in the morning and a half at night. The total dose in a day should be 180 mg. Consult a specialist doctor, discuss with him or her and start taking the medicine with their consent. If the swelling persists even after taking the medications, consult a family 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: My daughter woke up with a rash on her chest and back and has gotten worse. She was put into an antibiotic a couple of days ago Amoxicillin, so I do not thinks she is allergic since it has been days, no other known allergies. I think it might be roseola any opinion? She is 13 months, it is very spotted all over, no fever and she is acting normal, had a fever a couple of days ago of 102, 103. ### Response: It appears to be a case of viral rash, and the details available and neither can not diagnose the specific viral type is it of much significance. As your daughter does not have any significant symptoms besides the rash, she does not need any active intervention for the moment. Hopefully, the rash shall subside in next four to five days. If the rash does not subside in next five to six days or she develops any new significant symptoms (fever, cough, low appetite, vomitings, etc.) then it is advisable to have a check-up by a doctor." "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 PCOS and irregular periods. My doctor prescribed me Diane-35 for 21 days. The last day of the pill was fifteen days before. I did not get my periods till date. I did a home pregnancy test, and it is negative. Though it is unlikely I can be pregnant, I wanted to know how long to wait for the periods to come with Diane-35? Please clarify. ### Response: Hello. Diane-35 is taken for 21 consecutive days with seven days off. The next cycle is started after seven days off on the eighth day, irrespective of the periods. Though in majority of cases there are periods in those seven days, rarely there may not be periods. Hope your other investigations, mainly CBC (complete blood count), blood sugar, TSH (thyroid stimulating hormone) and Prolactin are normal." "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 3.5 years old. We live in a place which has a lot of dust along with cold weather. My son has been suffering from regular cold cough problems since he turned 1, on an average three times in a month. Sometimes, the gap is longer when we are too careful and maybe the weather is stable. Starts with a runny nose, then cough, coughing is too much when he lies down, at night and early morning. Many times he also gets fever.We have visited several doctors and have been told it is RAD, we still do not know what is he allergic to, could be dust. In the past 2.5 years, he has regularly (when suffering) taken Allegra/Cetrizine, Nasivion drops, finished several bottles of Beta2, Salbutamol, Asthaline syrups, Paracetamol, sometimes but less of Azithromycin when it is throat infection, once or twice taken Kidpred also, also he has taken Montelukast 4 mg for certain intervals like taken for a few months and stopped and again taken.Three weeks back he got cough, we went to pediatric pulmonologist and were advised to start Budecort 200 inhaler twice a day for a year. Also, Asthaline inhaler three times a day for a week but still has cough. Allegra for a week along with Montair 4 mg. We did not start Budecort but started with Asthaline inhaler, Montelukast and Allegra. It improved and third week again he has got cold and cough but intensity is little less.My question is should we start Budecort 200 inhaler for a year and stop Montelukast? Or should we not start Budecort right now and continue with Montelukast for some time and check if it works? Or should we give both Budecort and Montelukast? Also is it fine to start with Asthaline inhalers whenever he gets cough? Lastly is there any way which we can find out what things he is allergic to? Or a list of common allergies? ### Response: Please note that Budecort inhaler is the medicine to prevent or reduce these instances and Asthalin is the emergency medicine to control sudden bouts. Hence, without fail you should start and continue using Budecort along with Montelukast and use Asthalin on SOS basis. As far as the question regarding allergy to certain items goes, it is best to observe the child for the same rather than doing umpteen number of tests just for finding the causative allergens. Any which ways the chances of you preventing the child from coming in contact with such an allergen would be less only. So do not worry much about the allergens point of view." "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 renal hypertension. I am on Cilaheart 20 BD. My BP is 160/100. My creatinine is 4.18 and urea is 104. Please help. ### Response: Hello. 1 mg thrice daily. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. These would be able to get your blood pressure well under control" "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\s creatinine is 2.7. Now BP is brought to normal. What food should I give and what to do? ### Response: First, you should get regular follow-ups with her doctor (nephrologist, cardiologist or even internal medicine specialist). Foods to avoid are salt, dark-colored colas, canned foods, orange, and orange juice, red rice, etc." "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 been put on Primolut N for 15 days for PCOD. I started the pills on last month and finished in 15 days. On the seventh day, I had sex with my husband. I got my period on the 21st day and had been asked to begin Diane 35 for 21 days on the fifth day of the cycle. I began taking Diane 35 on 25th of last month and the pack finished on 15th of next month. Today is the last day of the pill-free week but there is no bleeding yet. I had taken an emergency pill within an hour after the intercourse. There has been no sex after the last cycle. Should I worry about an unwanted pregnancy? Please help. ### Response: As you are on hormones externally induced as internal hormonal imbalance so having bleeding according to these hormones effects on the body. After finishing these tablets cyclically you will have 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 had a protected sex with my wife 10 days ago. In order to delay her periods, she consumed one tablet of Primolut N the same day before having sex. By mistake, I touched her vagina after touching my penis. To avoid any risk of pregnancy, she consumed Unwanted 72 within eight hours of having sex. It has been more than 10 days she has neither bled after consuming Unwanted 72 nor has she had her periods until now.What are the chances of pregnancy? It has already been 12 days. Is it possible to test for pregnancy now? If yes, kindly mention the name of the test and any precautionary measures to be taken before going through the test. ### Response: They are high dose hormonal pills which may cause delayed periods too. If your spouse has skipped her expected periods, she can check her urine pregnancy test with early morning urine sample to be sure if she is pregnant or not" "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 31 and I am going to marry a girl who is 33 years (two years elder to me). If we do not want to plan for a baby for one or two years after we get married, will she face any problems during pregnancy as she will be above 35 years? Also, will the baby have any problems growing up? ### Response: Hello. I went through your query and understand your anxiety. Actually, the chances of conception and having a healthy pregnancy decrease after the age of 30. So it is best advised medically to conceive sooner. Both your health and medical parameters will be able to establish better on your chances of having a healthy pregnancy later on. Personally, I have had patients conceive naturally or with minimum medical help even at 35 and 40 and have had successful pregnancies and healthy babies. But, statistics do show that as the quality of sperm and ovum decline with age, so does the chance of conception and healthy pregnancy. I hope this information has been beneficial. Let me know if I can help you in any other way" "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 is suffering from fever for past 11 days. On the first day, we got a Widal test done. It showed 1:40 S.typhi, but having a fever 103-104 degree Fahrenheit. Just three days back we confirmed 1:180 in Widal test. The doctor has advised Ceftum 500 mg bd. Now she is having fever of range 100-100.3 degree Fahrenheit at night time for about half an hour.Should she be admitted to the hospital or can continue Ceftum 500 for a few more days? ### Response: Typhoid should be treated with antibiotics for 14 days must. Otherwise, the bacteria remain in the gallbladder and cause recurrent infection. Now, if you feel that symptoms are not improving, she might require injectable antibiotics. It is better to get intravenous antibiotic first and then oral for a total of 14 days. Take her to the prescribing doctor for injectables ,if fever does not subside or symptoms do not improve or worsen" "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 24-year-old female and I was on the birth control pill Aviane for almost two years. I never had any negative symptoms and had an overall good experience but I decided to stop taking it after ending my relationship because I would no longer be sexually active. About four weeks after my withdrawal bleed, I had my first period again and everything seemed to go right back to normal. I have been off the pill for a year now, and my periods are totally regular, but I have noticed some slight differences. Before BC, my cervical mucus seemed to change throughout the month but now it stays the exact same. Thick and milky. Occasionally, it will be a little more watery, but it used to get that egg white consistency around ovulation and such. It does not seem to do that much anymore, if at all. Although I am pretty certain I still have ovulation pain around the middle of my cycle. Should I be worried? Did BC mess up my body? Or is that not cause for concern? Everything else is completely normal. My cycle is a perfect 28 days and my periods are back to how they were before. The only difference is that I used to still have some light spotting on day five, but now it is mostly gone by day four other than a bit of light spotting. I am not trying to conceive, but I was wondering if this was something I should be worried about. ### Response: Hello. Firstly, birth control pills do not have this kind of lasting effect which might be over or after a year, so the change in discharge is not because of pills. Secondly, changes in consistency of vaginal discharge over the cycle are totally normal. These changes are due to hormonal changes which are taking place in different phases of the cycle. Thirdly, if the discharge is not smelly, itchy or associated with any abdominal pain or painful voiding then it is nothing to worry about. If any of these problems arise, you have to seek expert advice then only. Another general advice is to use cotton undergarments and wash area frequently with plain water 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 want to leave cigarette smoking. So, please help me and give a solution. Is there any ayurvedic medicine available then please tell me. ### Response: There is no short cut to quit smoking. There are two methods you can try. The natural method. You decrease the number of cigarettes by 20 % each week till you reach to a point where you smoke only 4 to 5 cigarettes per day. Then reduce it by one each week. the other method is to substitute cigarettes with Nicotine chewing gums. These chewing gums are to be cheeked in the mouth like Khaini or Zarda. Along with it, start taking tablet Bupron XL 150." "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 age is 30 years old. Sometimes, I have an eye irritation. I have an earthworm image in front of eyes. Please help me to clear this issue. ### Response: Hello. I understand that you have two questions, one concerning occasional irritation and the second is regarding a linear worm like image floating in front of your eye. These will help reduce the irritation and are free of side effects. For the image of the worm, please visit an ophthalmologist to get your retina examined. A problem like this is usually associated with problems in the vitreous and retina. This process usually needs dilating" "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 34 years old and have an 8-year-old boy. I just got promoted and I am not happy with it. I am unable to handle the stress and pressure of the new role. I do not wish to do any work not at work and at home. I do not wish to go to the office and just pray that I should get sick or have an accident. I do not wish to stay at home also. I do not wish to live. I think I have panic attacks in the morning like I am unable to breathe, feel really low, cannot sleep at night. And the thing is all other people who are working in my current position are doing it very well. Why am I not able to handle it? I have the option to take reversal but am really scared. What would other people, my friends, my relatives think? I feel like my mind is going to explode. Also, now we are planning to have a baby. I am really terrified. ### Response: Hello. I have reviewed your query and here is my advise. Change in position at the workplace creates extra stress and new challenges. Your problem is obvious and temporary. You are having multiple responsibilities managing son and household works beautifully. There are few medicines also to overcome stress and depression. But still, I would advice you to wait for sometime. With time, you will build up the confidence to deal with these problems. Otherwise, SSRI (selective serotonin reuptake inhibitor) medicines would be the last option" "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 18-year-old girl. It had been quite noticeable for some time that I have had excessive hair loss, especially in my hairline. I am a ballet dancer and have been putting my hair in buns ever since I was little. Two years ago, I started training a full time course which meant I needed to put my hair in a bun every day with hairspray, and a lot of times I got home too late to wash it out. Now I am taking more caution but I have lost a lot of hair and my hairline has receded a lot. Is there anything I can do to reverse or help it? ### Response: From your description, it seems like it is traction alopecia that occurs due to excessive pressure on hair roots due to hair bun, etc. First thing is to make sure to relieve pressure from your hair roots. Use Minoxidil spray BD over the frontal area. Take biotin supplements BD for atleast three months. Follow up at one month." "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 bump in the throat. It is hard and not painful, and my mouth looks white, I looked on the internet and scared of mouth cancer. Please Help. Other symptoms I had was pain in throat for couple days, but that gone away quickly with gargling. I also have reflux (I am going to the specialist in two weeks). My tonsils are operated and I do not have one. Currently, I am taking Omeprazole. ### Response: The posterior pharyngeal wall has some enlarged and congested nodules (attachment removed to protect patient identity). Could be due to chronic pharyngitis. Continue the reflux medicine and when any pain is there take decongestant and Claritin (Loratadine)" "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 eyelids have become more hooded. ### Response: Hello. There can be a number of causes which could give rise to an appearance of a hooded eyelid. The most common of which are: 1. Eyelid bags (for which you may be using lid taping), although a reaction to the tape is possible, it is a rare occurrence. 2. Dermatochalasis which is caused by eyelid skin sagging down, this is benign and needs surgery like blepharoplasty. 3. 4. Epiblepharon which is an extra fold of skin since childhood. This also may need surgery. If you could attach a photo of your eyelids while closed and send me, I could probably be able to help you regarding the cause and treatment." "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 an opinion regarding my elder sister. She is 52 years old. She is diabetic and is suffering from severe vaginal pain for the last few weeks. While collection of pap smear, the swab was bloody and it was very painful for her. She is currently using Candid cream and Candid V6 tablet for vaginal insertion. I have attached the reports of pap smear and CEA - carcinoembryonic antigen serum test. Please help. ### Response: Hello. The reports of both pap smear and tumor markers are within normal limits and rules out any malignancy in terms of possible cervical cancer. However, the pain in vagina and blood tinge at her age, where she is likely menopausal, could be due to atrophic vaginitis. Revert back with the details to 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: My weight is 90 kg and height is 181 cm. I am a fighter by profession. Four days ago, after finishing three hours of outdoor training, I had severe lower flank pain on both sides. Since then, I am having frequent urination at an average of four times at night and 15 times during the day with some discomfort while urinating. I am also having excessive thirst, loss of appetite, general lethargy and fatigue. I am currently taking Cipro assuming it to be a UTI. ### Response: Hi. I can understand that you are worried about your health and the urinary system issues. 1. Urine culture.2. Complete blood count with erythrocyte sedimentation rate and electrolytes.3. Liver function tests.4. Renal function tests. Without testing, it is not so rational to have Cipro (Ciprofloxacin), but since you have started it is better to consult a local nephrologist for proper physical 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: Post plateletpheresis, my hand is turning bluish black day by day. It is spreading wider and a slight pain occurs in such areas. I have attached pictures of the same. Is this a safe sign? Please help me. ### Response: Based on your query and image (attachment removed to protect patient identity), my opinion is as follows: Revert back to a hematologist online for further follow up" "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 any problem if syrup Vitcofol is given along with syrup Zincovit to 1-year-old baby? ### Response: Hello. There is no harm in giving these both medications because both of them have a different mode of action but the important point to consider is that try to give one medicine at lunchtime and another one at dinner. Do not give them at the same time. These two medicines will effect this way properly when you give them with a time difference. One medicine is an iron supplement, and the other one is Vitamin B complex" "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 16-month-old presents with intermittent limb weakness, hemiplegia, gait disorder, dysphagia, intermittent ataxia, brisk reflexes, seizures, and intermittent hypotonia. There are sudden bouts of alternating limb paralysis. There is sudden difficulty with balance and walking with falls every few steps. The baby is seemingly dizzy. There is dysphagia with no etiology. There is a paroxysmal tonic upgaze. The doctor has prescribed Diamox for ataxia today. The baby has a normal CBC, CMP, and CSF. I also have attached the spinal and brain MRI images here. I need a second opinion. ### Response: I have gone through the images which you have sent (attachment removed to protect patient identity). Regards" "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 is schizophrenic. She is not medicated because she does not have health insurance. For the past five days, she has been talking to herself thinking she is having a conversation with others. For the last two days, she has been having episodes thinking that the imaginary people are putting snakes inside of her. I have taken her to emergency room 11 times but she leaves shortly after arriving because she is being told by the voices that she is not at a real hospital. I am worried that she might hurt herself not purposely but by accident since she truly believes the voices are putting snakes inside of her. I do not know what to do please let me know what to do? ### Response: Yes, those are symptoms of schizophrenia. It happens due to a chemical imbalance of certain neurotransmitters in the brain. Levels of dopamine are usually increased and medicines will help reduce the level and get it back to normal and restore the balance. Medicines like anti-psychotics are usually prescribed by psychiatrists. Please take her to a psychiatrist and get started on medicines. Most such patients, do not comply with medicines, so in that case, there are other options that you can discuss with your psychiatrist. Some medicines can be given in food or water or any beverage which are tasteless, colorless and odorless. Once her acute symptoms are reduced she should comply with medicines. Also, there are Depot injections that can be given once a month or two months." "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 both are 30 year old couple and we have been planning for a baby for more than a year. My wife has normal period and as per the medical report my semen is fine. We have visited a doctor in our locality and he advised cleaning of the uterus (D and C - dilation and curettage). Could you please advise if our treatment is going in the right direction? Should we go for cleaning of the uterus (D and C)? My wife\s current medications are JP Tone, Femitone, D3 Must, Norflox 400, Zentor 500 (Levofloxacin) and Tido (Tinidazole). Her past medication includes Ovares SR and Krimson. Please also check the medical reports and prescription attached. We have also undergone the following tests. Syphilis urine test, E.coli culture and sensitivity test, HIV transvaginal sonography, hormone tests - LH, FT4, TSH, prolactin, FSH, AMH and semen analysis. What should we do? ### Response: Hello. Please send me the complete reports to get better knowledge about your problem. A few suggestions based on the other information mentioned in the description are as follows. HSG. Primary infertility. Revert back with the reports to 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 46 years old. I am diabetic, and I have a high blood sugar level of 200 mg/dL. I also have a hernia problem. Currently, I am taking allopathic medicines, Glimepiride and Metformin. Please suggest. ### Response: Hi. If your blood sugar level is above 200 mg/dL, you may need a change in the dosage of your medication. You might need to increase the dosage of the existing medication, or you may require a new medication. You have not mentioned the exact dosage of Metformin and Glimepiride that you are currently taking. The medication and the dosage are decided by the doctor based on various factors like age, weight, previous medical history, duration of diabetes, other medical conditions, other medications and the condition of your vital organs. It may not be ideal to give you a prescription without doing a clinical examination and evaluation of laboratory parameters. Hence I suggest you meet your diabetologist for proper clinical assessment. For the hernia issue, it is essential to understand the stage of the disease. It helps to determine whether it needs conservative treatment or whether there is a need for surgery. It can be decided only by a qualified surgeon after a detailed clinical examination, and it involves various steps." "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 on Fluoxetine antidepressant drug for a few years. I just started to notice few change, but I do not know what to do. I am getting more headaches than normal, restless legs at night and hot sweat most of the day and night. Are my problems related to the drug? Can you prescribe any medicine for this? ### Response: Mild headaches and sweating are known side effects intrinsic to Fluoxetine. Usually this" "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: All my reports are normal for high BP. Presently, I am taking Tezlocbeta 50 since last six months. After that, I am suffering from so many problems like acidity. Presently, I feel anxiety for the past one month. Before one month, my doctor prescribed me Esopam 10 mg. After taking one tablet, I feel bad. After this, I am suffering from anxiety. Right now, I am taking Etizolam 0.25 mg, please suggest me what do. In starting time my blood pressure was 135/95 to 140/105. My doctor prescribed me Olmetrac AM, after a few months my blood pressure came 110/70. Again he changed Tezloc beta 50, before taking Esopam 10 mg. I have a gastric problem. ### Response: I have read your health related query. Glad all your blood reports are normal. I understand your concern. Right now what is important is to manage your blood pressure, once the blood pressure is maintained with medication your symptoms may start to reduce gradually. You must continue the treatment as advised by your doctor. Meanwhile continue treatment for anxiety too. Apart from anxiety treatment, try some relaxation techniques like meditation, aromatherapy massage. Avoid stress or stressful situations. Avoid too much coffee and tea and sugars. Try to go out for small mild walks. Try to be around people who care for you, spending time with family and friends. Try to take a break from work if that is leading to anxiety or any situation that can be a potential cause for anxiety. Visit your doctor regularly to follow up with blood pressure management." "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 45 years old. She got a hole in teeth and she is complaining of a toothache for three days and from yesterday, she developed swelling on the right half of the face. Is this any sort of emergency? ### Response: After going through your query and image sent by you (attachment removed to protect patient identity), this seems to be a case of severe infection inside the right tooth. Tooth decay has resulted in infection in the innermost part of the tooth called pulp that contains nerves and blood vessels. Deep dental caries. Intraoral periapical radiograph (X- ray). Acute periapical abscess or buccal space infection. Acute exacerbation of chronic periapical abscess. 1. Treatment can be planned after analyzing the X-ray.2. 3. If infection beneath the root is not in excess, then root canal treatment can be done.4. In case of excessive pus and infection, pus" "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 PCOD. My period is on the time but stays for 1 to 2 days and bleeding is very less. I am trying to conceive. The doctor gave me Dronis-30 and Rejumet tablet. My weight has also increased. Can I conceive? And two years ago the doctor gave me the Gardasil vaccine. I used Novelon two years ago but the period condition is the same. ### Response: Yes, definitely you can get pregnant. PCOS is a condition which can be easily reverted by diet, exercise, yoga, lifestyle modifications, and physical fitness. Get started with Folic acid supplements. Continue taking the medication as prescribed by your doctor. Try during your fertile period which is between 12 to 24 days of your periods. However, if you have a doubt then get 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: I have pain all over my body, positive ANA and CRP 1.9. My doctor thinks I have lupus even though all the rest of the tests were negative. She wants me to take anti-malaria drugs. I am worried she is treating me full force without the proper positive tests. ### Response: High levels of CRP means that there is an inflammation going on inside your body. What is inflammation? It is a process where our white blood cells who are our protectors are attacking foreign bacterial or viral cells. Sometimes these white cells may turn against our own cells leading to chronic inflammation. That is why you are feeling pain all over." "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 15 years and medium built. He recently has some concentration problem. What homeopathy medicine can I give him? Please suggest the recommended dose. ### Response: Hi. It is essential to understand the cause of a concentration problem. Based on the limited information provided here I can think of a few remedies. If your son has taken too much stress of his studies and due to which he is not able to perform well or unable to concentrate, then you can give him Kali Phos 6x two tablets twice a day for 15 days. If Kali Phos 6x is not available, then get Phos 30c three pills once a day in the evening for seven days. You can give him Five Phos 6x if he is generally not able to concentrate and the cause is not known. Five Phos 6x two tablets can be given twice a day for 15 days. It is very important to understand the details of his problem to prescribe any homeopathic remedy correctly. I hope he will feel better with this remedy. Let me know if you have any questions or else report back in 15 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 experiencing swelling of the gum on my molar and bleeding, as well as a bad taste in my mouth. I have a picture and it looks as though there might be some food stuck in my gum or even my wisdom tooth coming in. I am not entirely sure but I would like an opinion on the picture, if possible? ### Response: Hello. I can see in the attached picture (attachment removed to protect patient identity). There is an infection present in your last molar region, most probably it is due to third molar impaction and known as pericoronitis. Sometimes it is also due to abnormal cheek biting. You should avoid spicy and hot food. Make proper oral hygiene, you could also use salted water to rinse your mouth. Please see your dentist for a clinical examination and treatment. A dental X-ray should be taken." "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 heard that in nephrotic syndrome the filtering unit of kidney becomes larger and so protein comes in urine. I am a patient of cortisone dependent nephrotic syndrome over 15 years. Doctor says that about 95 percent of children will get cured at the age of 18. I am 17 years old now. When a child grows, does the filtering unit become smaller? And what happens to the remaining 5 percent? I have anemia, but otherwise normal. Only albumin comes in urine. I also heard that kidney biopsy is done for nephrotic syndrome. But no doctor advised me for biopsy. Do I have minimal change disease? ### Response: Yes, you have heard the things right. Due to increased pore there is protein in urine. The best treatment remains the Cortisone. In cases where there is no response to Cortisone as evidenced by persistence of albumin in urine, we need to shift those patients on Cyclophosphamide and Azathioprine. Renal biopsy can be performed but since you are on steroids the reports may be altered. You need to get C3 (complement component 3), C4 (complement component 4), ANA (antinuclear antibody), ANCA (antineutrophil cytoplasmic antibody) and urine protein to creatinine ratio." "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 50 years old male. I have middle back pain for the past eight years. It is usually in the middle right back between the shoulder blades. I have this pain when I stand for an extended period. Recently, I felt the pain radiating from my back into my chest. I think that I have a knot between my shoulder blades. It seems to get worse as the day progresses with stress and anxiety. After a recent treadmill run, I noticed a knot like a pain in my upper right back. It is accompanied by an urge to cough. Other new symptoms include throat clearing and occasional breathlessness on humid days.But all the pain gets relieved with rest and sleep. But it is worse throughout the day. My recent blood report showed WBC with 3800 per microliter, RBC with 5.06 million mcL, my hemoglobin is 154 g/dL, hematocrit showing 45 %, platelets with 145,000 platelets per microliter of blood. My EKG, echocardiogram, stress test and abdominal ultrasound were all normal. Ultrasound showed a fatty liver.My doctor advised me to do a chest X-ray. They found a small lesion on my left lung at the rib one area. He said it is nothing and recommended for a CT scan. I am living with full of anxiety. I read somewhere that 60 percent of lesions in men are cancer. Surely, I am not asking for a diagnosis. Can a small lesion have such ability to cause so much pain and discomfort? Is it possible to have advanced lung cancer? But my lungs look clear on the rest of the X-ray image. Is there anything else in the blood work or any other tests showing the possibility of cancer? I have no cough, wheezing, fever, loss of appetite, weight loss, and unexplained sweats. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). Your symptoms are not suggestive of cancer. It is a spinal cause which is causing the symptoms (spondylosis). The points which favor for the spinal cause is the long duration of symptoms, your sitting job, worsening as the day progresses, knot-like feeling and radiation to the chest (due to nerve compression). Malignancy will not stay for an extended period without causing any symptoms, and prolonged survival is not possible. With the absence of symptoms, it is too premature to consider it as malignancy. Usually, most of the lesions found incidentally on the chest X-ray are benign as they may indicate a fibrotic lesion of the old healed infection either clinical or subclinical. Also, your doctor has already seen it, and it reduces the chances of having a malignancy in you as they will have some features. So overall, the possibilities for malignancy are very less, and these symptoms are not correlating to 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: I have a doubt regarding pregnancy. I had unprotected sex with my girlfriend a few days back. As per my knowledge, there was no ejaculation of sperm and to be on the safer side, she took an I-pill six hours prior to sex. But, she has not got the period for this month yet. Is this due to pregnancy? Or should we wait some more days? Is the delay in her periods because of the I-pill? ### Response: You can wait for another two days for the menses to come. Many times a fluctuation of two to three days is seen even in the normal cycle. In case they are further delayed, then get a urine pregnancy test at home. If it is positive, then consult a gynecologist immediately. If negative, get a USG (ultrasound scan) done just to be sure as it will show gestational sac if there is pregnancy" "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 OCD (Obsessive Compulsive Disorder) since I was a child, and I did not know that I have this type of sickness until I read about it on internet. And now I am 27 years old. I need to ask you whether I can take a medicine by myself (Prozak or alternative). My symptoms are that I keep repeating certain words and sentences in my mind all the time from morning till evening or some pictures in my mind. And I cannot stop this thing at all. I am really tired of it.Please help me if I can take Prozak and what will be the dosage. Also is there anything I need to know before planning to stop the medicine? ### Response: First of all I would like to inform you that OCD like symptoms occur in various disorders other than OCD itself. And the management of different disorders varies according to etiology. Besides this which" "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 took a morning after pill about eight hours after my fiance\s condom broke. It has been a week and I started bleeding today. It was a heavy flow at first (blood-red) but it stopped after 24 hours (became light pink towards the end). I just want to know, am I pregnant or is there a possibility that I am? ### Response: Hello. You have taken I-pill (an emergency contraceptive pill that is hormonal medicine) that interferes normal cycle and prevent conception by preventing ovulation, fertilization, implantation. So it is normal. There are least chances of pregnancy. Next cycle could be irregular but as the body gets rid of the effect of medication, cycles will get back to normal." "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 41 year old male with height 5 feet10 and weight 84 kg. I am having a health situation for the last two years where the top of my feet (the area covered under the shoe) gets very sensitive to touch. Even a touch of the cotton pajama feels irritating. My left hand (below where we tie the watch) occasionally burns and has the same \sensitive to touch\ feel as the feet. Sometimes, I have felt the same kind of sensitivity on my nose-tip and edges of the lips. Recently, I am noticing that the finger pads on both the hands have become too sensitive to pressure and the reddish and painful mark remains for a long time even after applying a bit of effort like turning a key in the lock. I am attaching my blood test report from the last month. Kindly help me as this is a very irritating situation and I am finding it difficult to concentrate on work because of this. ### Response: Hello. I have gone through your reports (attachment removed to protect patient identity). Your uric acid is slightly increased. So, avoid red meat and recheck uric acid after three months. Most of your symptoms point to a neuropathy. So, you need to get a nerve conduction study done. It is done by a neurologist on an OPD basis. Low calcium levels can cause some of these symptoms. So, I suggest starting tablet Shelcal 500 mg (Calcium and Vitamin D3) once a day for three months. Consult your specialist doctor, discuss with him or her and start taking the medicine with their consent. Also, check serum vitamin D levels if symptoms do not improve in the month\s time" "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 28 year old male. I am married and have a child. But, my penis is small. It is 2 inches in the normal stage and 4.2 inches during erection. I do not have any sexual issue. I have a good erection and my wife is getting an orgasm. But, the issue is I cannot use the public toilets or swimming pool. I am depressed due to the penis size. Please advise good medicines to increase the size. ### Response: I read your query and understand your concerns. I hope this helps you. Feel free to write back to me if you have more questions" "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 with fiancee a month back. I gave her Unwanted 72 in 48 to 72 hours bracket. She had her periods 10 days back. Today she is experiencing some lactation and also suffering from typhoid. Is she pregnant. What to do? ### Response: Hello. The lactation could be due to high prolactin levels due to hyperprolactinemia which needs to be investigated with serum prolactin levels. However, the best way to rule out pregnancy if you are still anxious is to get a serum beta hCG test done. If the hCG levels are less than 5 mIU then she is surely not pregnant. The lactation is not a sign of pregnancy. This cycle, the menses can be delayed as she is suffering from typhoid, so stay apprised." "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 24-year-old male. My weight is 75 kilograms. I have a healthy diet. I have a habit of drinking alcohol once a month, and I do not have the habit of smoking. I checked my blood pressure, and it was 155 by 65 mmHg. Is it high? Please suggest. ### Response: You are slightly overweight. Your blood pressure is elevated. Still, a single elevated reading does not mean that you have hypertension. Taking repeated measurement for at least two to three times, and having your BP high at these measurements, may suggest that you are hypertensive. At your age, a normal BP should be below 120 by 80 mmHg. BP (blood pressure) is a dynamic parameter. It usually gets elevated after having an emotional upset, anxiety or physical exercise. Repeat your blood pressure measurement soon. Reduce taking salt in your diet. I also advise you do a blood test called lipid profile. An elevated cholesterol or triglyceride level can also cause high BP." "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: Dear doctor,I am a 32 year old female. I had HPV and LEEP 12 years ago. Now, I have the following symptoms:Bleeding during sex.Heavy periods.Extra painful abdomen pain.Heavy feeling of fatigue and headaches.Could I have cancer? ### Response: Hi. All the symptoms you have mentioned warrant a doctor visit with a full examination and Pap smear as a minimum, and colposcopy to be very sure. With your HPV and LEEP background, it is even more important that you get this done on priority. In all probability, it may be nothing, or early pre-cancer, but it is better to check and get treated. Consult an obstetrician and gynaecologist online for further queries" "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: Dear doctor,Which is the primary blood test for HIV? Is it fasting or nonfasting? I want to get tested for a routine checkup. ### Response: The recommended primary test for HIV detection is the fourth generation HIV rapid test. You need not be fasting for this test. If there is a recent exposure and the test result comes negative, a confirmatory test needs to be done at three months of last exposure. Please revert if you require any further information. Best wishes" "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 25-year-old female. I have scoliosis and my curve is around 25 degrees. I would truly appreciate if you can answer my queries. Can my scoliosis get worse over time?My right muscles tend to get knotted more often than my left muscles. Can scoliosis cause such problems?Can exercise be performed in the wrong posture worsen my scoliosis? ### Response: As you have achieved skeletal maturity and now have stopped growing with your curve only 25 degrees then the spontaneous increase in the curve is highly unusual. You will have to, however, monitor the curve. Scoliosis leads to muscle and structural imbalances and getting knotted on one side is not uncommon. You can, however, see a good physiotherapist who will be able to help" "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 dear daughter just completed 1 year yesterday and still on breastfeed (twice, a full day) along with normal food. She is lactose intolerant and was hypocalcemic (less calcium) by birth. Her doctor gave her OstoCalcium and retested after six months and she turned to be absolutely fine with calcium levels and other reports. The doctor advised going off the medicine.Now the complaint is; from last Friday, she was vomiting frequently three times. She was on breastfeed and her mother was having super acidity. On Saturday, we did not make her consume breastmilk and she was fine. On Sunday, we went for a wedding and while to and fro in the car she was vomiting.After that, there was no vomiting. She is very active but very restless (like throwing anything in hand, continuously trying to chew something specifically her own finger and looking to drink water more than normal, suddenly crying and then stops and starts behaving normally).Today, she did watery potty twice and we have her Peditrol ORS. What can be the issue? Please suggest, we are perplexed as the symptoms keep on changing each time. Is she teething? ### Response: Hello. Do not worry so much. What you are describing seems to be gastroenteritis. Continue the same medications which are going on. The matter should settle in two to three days. I suggest giving Enterogermina respule (probiotic vials), one respule twice a day for three to five days for faster action. Consult your child\s specialist doctor, discuss with him or her and start taking the medicines 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 had my lower wisdom tooth removed a month ago. It was infected and they said they had to break a bone and take it out. I had two stitches removed post 10 days of my surgery. Still, I have the sensitivity and light pain in the cheekbone area. Is this normal to have? How long will it take to cure? ### Response: After wisdom tooth removal, one generally has pain and little difficulty in chewing for a week or so. But, it is a month now and it should not be there. Is there sensitivity on the cheeks or the adjacent tooth? If it is on the tooth, you need to check for any cavity in the tooth adjacent to the wisdom tooth removed or during the time of removal of wisdom tooth slight luxation to the adjacent tooth can occur that is also normal. This can lead to a sensitivity in that tooth for a few days. You also need to check if there is any tingling sensation or not. Because in some cases, wisdom tooth is very near to the nerve supply of teeth of the lower jaw. This also leads to a problem This can be relieved over a period of time with medication. If possible do post an X-ray of your teeth so that I can let you know in detail if there is any problem with respect to the tooth" "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 want to have an opinion about my daughter\s (8 years old) chemotherapy treatment for B-cell acute lymphoblastic leukemia. I want to know that is it possible to start or continue chemotherapy at very low counts of WBC and WBC differential. ### Response: Your child is having B-cell acute lymphoblastic leukemia. In that case, to induce remission, induction chemotherapy should be given to restore normal bone marrow. After induction, maintenance chemotherapy also to be given. Your total count might be low because of chemotherapy but your daughter was having 87 % blast so chemotherapy should be given. You can investigate further with a molecular study of different translocation which reflects prognosis in case of ALL (acute lymphoblastic leukemia). So consult your hematooncologist for examination and under the guidance of the oncologist, chemotherapy should be given" "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 34 years old male. I am married. My weight is 85 kilograms, and the height is 5 feet. My resting BP is 130/80 mmHg, and pulse is 80 beats per minute. I do not have any tension at my home or the office, and I am very relaxed. I am suffering from left side chest pain along with upper back pain (left side only) with left shoulder and sometimes with left-hand pain. When I bend my head forwards, I feel tightness and pain in the upper body and left shoulder backside.I have light-headedness, fatigue, and feel drowsy all over the day while sitting or standing. I have the pain on the left side for about three years. I underwent almost all tests, and all are normal. But the pain persists. I underwent heart tests including CT angiography and MRI brain. All are normal. I am attaching my X-ray of cervical spine and ECG which I underwent two days back. Kindly suggest how to reduce my pain. ### Response: Hi. I have gone through your reports (attachment removed to protect patient identity). Your ECG is fine, and from the description of pain and test you underwent, it is a cervical pain. In the cervical X-ray, there is a straightening of the spine which is the cause for your pain. You should undergo further test like MRI (magnetic resonance imaging) of the cervical spine for the confirmation of diagnosis and the extent of disease. Also, vitamin D test should be done. You need neck physiotherapy, including traction and cervical belt which is better starting after MRI. Also, you should use local Diclofenac gel for the pain relief. Hot water fomentation can be done. Also, you need to take tablet Pregaba M 75 mg (Pregabalin with Mecobalamin) at bedtime, which is a nerve stabilizer and they help in symptoms control. Also, take tablet Flexon MR (Chlorzoxazone with Ibuprofen and Paracetamol) whenever needed up to two times a day for the pain relief. You should visit an Orthopedician to get relieved." "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 was young I used to lick my lips a lot causing a red line above my lips and under my nose. One day I went out and came back with a permanent blackness above my upper lip (not my skin color). It lools like I have a mustache. Please help. ### Response: Well, we would be able to help you the most if you are able to provide us with a clinical photograph of your condition. Based on the brief history you have provided to us, you seem to be suffering from Lip-lick cheilitis induced post-inflammatory hyperpigmentation. In simple words, your habit of licking lips too often in childhood made the skin surrounding the lips (called vermillion border of the lips) too sensitive that it developed red lines and made it vulnerable to sun-induced pigmentation. One episode of having stayed out may have resulted in the tanning of the sensitive lip area resulting in pigmentation. To prevent it from becoming darker, you should immediately start using a broad-spectrum sunscreen with an SPF (sun protection factor) of 40+ at least twice a day, every day, irrespective of your outdoor exposure. I am sure you will be able to procure a sunscreen from the pharmacy. For further details about ideal sun protection, you may read the sun protection information posted on our website. Additionally, use a good moisturizer over the lip and surrounding skin at least twice a day. To reduce the established pigmentation, a mild depigmenting cream may be needed. However, to suggest the ideal depigmenting cream for your condition, I would need to see the photograph of your pigmentation." "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 want a review of EMG analysis to reassure it to be unlikely ALS onset. My knee and arm reflexes were normal, as were the strength tests. Does ""good recruitment"" in the presence of atrial fibrillation and occasional positive waves point away from ALS or MND? In those cases, would not the recruitment be reduced? The interpretation was mild S1 radiculopathy. ### Response: I read your query and understand your concerns. I hope this answers you. Feel free to write back to me if you have more questions" "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 provide me with your opinion on a white patch under my tongue. It does not rub off and just noticed it a few days ago. I am currently on Losartan 100 mg. ### Response: I understand your concern and saw your clinical pictures. (attachment removed to protect patient identity). These pictures look a little blurred and a clearer picture will make the diagnosis easier. Generally, anti-hypertensive" "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 girlfriend is B- group and I am O+ group. Is it advisable for us to get married or give birth? ### Response: Yes, the blood group is not at all barrier in your marriage. Your wife is Rh negative, so will be given anti-D immunoglobulin injection during pregnancy at 28th and 34th week of gestation to prevent hemolytic disease of the newborn. So do not worry about that. I will suggest you one investigation before doing marriage that is Hb electrophoresis by HPLC (high-performance liquid chromatography) method to rule out hemoglobinopathy which should be done before marriage" "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 coming in loose stool for the past one year but I do not feel any pain. What is the reason? ### Response: Hi. Blood in stool is not a normal condition as you are having the problem for one year. It should be investigated in detail and the following work-up will be useful. Rectal, anal area examination, stool routine microscopic examination, proctoscopy examination, colonoscopy, if needed. If needed during colonoscopy, biopsy taken from the abnormal area if found for histopathology examination. This work-up will be helpful to rule out causes for blood in stool like a polyp, proctitis, piles, colitis, diverticulitis, any growth, if present, etc. If the color of blood in stool is of brown-red color than bleeding is from the upper gastrointestinal tract. If colour is bright red then the cause for bleeding is from the lower gastrointestinal tract. So, from your provided history, this work-up should be done and above causes should be ruled out. One diagnosis cannot be given. Consult general surgeon or gastroenterologist for examination and above work up and according to cause identified further treatment plan can be decided." "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 hole in the middle of my tooth and the top of my tooth. I do not have any other symptoms. The only medication I am taking is a multivitamin. What should I do? ### Response: Hello. As per the explanation, it looks like a tooth decay but does not look deep. So my suggestion is to consult a dentist and get evaluated and if the decay is superficial then filling of the tooth with a tooth-colored filling material will prevent further decaying. Investigation to be done are to take a tooth X-ray for confirmation of the severity of decay. Probable diagnosis is dental caries. Preventive measures include brushing your teeth twice a day, use antiseptic mouthwash gargle and a get a dental checkup done every six months. Follow up with the X-ray results." "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 Wellbutrin XL 150 mg per I am going to put up to 300 mg before I do so. Our pharmacy is currently out of 300 mg. They do have a generic brand which I do not like. In cases such as this, is it fine to take 2 doses of the 150 mg to make up the 300 mg? Or is that not possible? ### Response: Wellbutrin XL ( Bupropion XL) can be increased to 300 mg XL once daily in the morning after you have been taking Wellbutrin XL for at least four days. The dose has to be increased gradually to minimize the risk of side effects like seizures. If Wellbutrin XL 300 mg is not available in the pharmacy, you can potentially take two doses of Wellbutrin XL 150 mg, taken together as once daily in the morning (giving you an effective dose of 300 mg once daily). Both pills should be swallowed as a whole and not crushed or chewed. You can switch to Wellbutrin XL 300 mg once it becomes available. Another easier option will be to try generic Bupropion XL 300 mg tablets as they contain the same active ingredient. I note that you mentioned you do not like it. Is it the medication effect or taste which is not to your liking? If you feel strongly against the generic version, you can take Wellbutrin XL preparation itself. Whichever option you choose, kindly discuss with your prescribing doctor as some pharmacies will not dispense unless the preparation and dosage are clearly mentioned in the prescription. It is important to have regular follow-ups with your prescribing doctor once the dosage is increased so that benefits and any potential side effects can be monitored. 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: My mother is having parkinson disease for the past 8 years. She is taking Syndopa 275 mg 3/4 five times a day, but still she is not feeling good. Any alternative? ### Response: Hello. I understand your concern. Based on what stage of her disease she is in, there are quite a few alternatives available for parkinsonism. The first line of management is obviously the one that the doctor has given to you, Syndopa (a combination of Levodopa and Carbidopa). If this combination is not very effective then, a combination of Levodopa and a Dopamine agonist such as Bromocriptine, or Ropinirole, or Pramiprexole can be given." "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 age is 36 years and weight is 86 kg. Recently, I observed that my fasting blood sugar was 125. All my LDL and HDL cholesterol levels are in control. So, the doctor suggested me take Glycomet SR 500 after dinner and asked me to follow for three months. So I have one doubt like in case my fasting sugar level goes down and when it is in control, can I stop this tablet or I need to take lifelong? Please suggest. ### Response: Yes, so if your sugar levels are less than 100 mg/dl without taking medication, your doctor probably might wean you off. But the condition is that it should stay in the normal range without medication. Right now, your sugar is in the normal range due to the medication. So make sure your doctor knows when you are having low sugar so he can taper it down. But mostly once the medication has started, it continues. It all depends on how good you can control your sugar with a healthy lifestyle and regular medication (if taking any)" "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: The head of my penis is itchy and there are few red spots in certain areas on the head. This has been happening for the past week or so. I have stopped applying soap to the area and I wash it with lukewarm water twice a day and apply Candid-B thereafter. The itchiness went away after three to four days but as I stopped doing that, the itching has been back.Initially, I had some pain while retracting my foreskin and my foreskin was kind of swollen but there was no pain and swelling. At times, I find a white substance around the foreskin when I try to retract it. Should I continue applying Candid-B for few more days? And what other precautions should I take so that it does not happen in the future? ### Response: Hello. With your description, I feel you are suffering from a fungal infection of your genitalia. Kindly stop Candid-B cream (Beclometasone Topical and Clotrimazole Topical). It has steroids in it. This gives you temporary relief from itching but promotes fungal growth. However, I cannot precisely diagnose your condition without having seen your clinical picture. I would suggest you attach a clinical picture along with your 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: I am currently 26 years old. My testicles used to hang low. I mainly think it was due to over masturbation. Five years back I got water in my testicles. The doctor said that it was due to the balls rubbing while sitting and he gave me medicine. I got well, but my right testicle got small to the size of a peanut, and it has been like this for the past four years. I am worried. I do not feel any pain though. ### Response: I think you may have varicocele which are dilated veins of the testis. Varicocele causes small size testis. I suggest you get ultrasound scrotum done. It will give the reason for small size testis" "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 is 5 weeks and 6 days pregnant. The doctor diagnosed that the baby has a heartbeat of 110 bpm and there is a chance of abortion. Please advise. ### Response: If the heartbeat is present, though it is 110 bpm which is less, we cannot definitely say that the heartbeat of the fetus would stop. But a close follow up and repeat scan is required after a week to keep a watch on the heartbeat of the fetus. Missed abortion a condition where the dead fetus remains inside the uterus without being expelled from the uterus would ensue once the heartbeat stops. There are no intrauterine medications to stabilize the heartbeat. Consult an obstetrician and gynaecologist online for further follow up" "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 dentist told me I have a tooth infection, but did not seem too worried and said I could wait until next month to extract it as that is when I will have insurance. This was a week ago. Since then I have been having moderate sinus headaches. Is this something that I should be worried about? There is a gross taste in my mouth from the tooth as well. ### Response: Hi. I had gone through your question, I can understand your concern. In case there are such symptoms, you need to take a course of antibiotics and you can wait till next month and if the symptoms are not so much you can wait as you do. In case you need any medication or treatment for any particular symptoms, mention it in next query. You can also use mouthwash Chlorhexidine." "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 numbness in my right side of the face and right arm and right hand. Blood pressure is normal. ### Response: Is it sudden onset or gradually develops from last many days. If it is gradual and it is there since long time period, then it is most probably spondylosis both cervical spine. It is a spine problem where you get numbness, pain, and other symptoms due to compression of nerves between spine. Do you have any history of trauma to your spine, does this pain increase on neck movement, is it associated with tingling, needles and pins sensation, if yes then it further supports the diagnosis. You will need vitamin D level, X-ray cervical spine, spine AP/lateral view and further may need MRI if X-rays are not informative. The treatment for this is physiotherapy to release the nerve compression, traction, cervical collar, medicine and if none helps, then surgery. Till the time you can have tablet Neurobion forte once a day which is a nerve vitamin. You need to visit a neurologist for all these investigations. If the problem is suddenly and of short duration, then it can be a minor stroke and needs further investigation." "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 38-year-old cholesterol patient. I have suffered this problem for the last five years. Now, I checked up my uric acid report. My uric acid report is between 1 to 7 range and sometimes 8.99. I have muscle pain in the hand and legs. I feel sometimes my cholesterol medicine can increase the uric acid. I am currently on Rozat 10 mg, Evion, Vitamin E, Prolomet 25 mg. Please help. ### Response: The main line of treatment for all the above problems is to have a healthy lifestyle and medicine to keep cholesterol and uric acid levels under control. Mild muscle aches are side effects of cholesterol medicine. You can discuss this issue with your physician who can adjust the dose or change the medicine which can suit you better" "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 33 years old male. I traveled by train for 12 hours and came sleeping, then I developed a headache. Now, suddenly I am having one eyeball misalignment and dual vision. No other symptoms. Please help. ### Response: Hi. You are experiencing sudden squint. Please get blood pressure checked now. The double vision right now is not an emergency but if you have high BP, that has to be taken care of. If you do not have a BP instrument, kindly tell me if you have these signs. Dizziness, headache at the back of your head, slurred speech. If you have these signs, please visit an emergency ward of a hospital nearby. The eye problem can be taken care of in the morning." "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 issue is concerned with my oral health. My teeth have been yellowish for the past five years, and also I have problems of bad breath. Now I am 19, and it feels really painful as I even cannot smile in front of others. I am afraid to laugh and to talk. I need a cure for this. It is now affecting my mental health too as I get depressed at times thinking of this. Please help. ### Response: Hello. Why did you never visit a dentist for your problem? Your problem is calculus formed on the teeth and gums which contains millions of bacteria, that is why you have bad breath, and you have yellowish teeth. Go to a dentist immediately and get your teeth cleaned. Otherwise, the calculus may eat your gums, and your teeth will become loose. Do not delay, do it quickly, and message me after you get your teeth cleaned. I will tell you some remedies to keep your oral health in good condition." "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 three miscarriages, my doctor suggested me for torch test and it came out positive with high values of rubella IgG 272, toxoplasma IgG 78.6 and CMV IgG 12.1 and herpes IgG 46.1. My doctor gave me Acylex 200 mg two times a day for two months and advised us to not try for a baby for two months. After two months medicine course, I did this test again today and again it is positive with rubella IgG 223, toxoplasma IgG 101, CMV IgG is 13.6 and herpes IgG is 47.9. We cannot understand the reports. My uterus, ovaries, hormones, everything is fine. Please tell me when we can plan a pregnancy? And what are the chances of miscarriage again because of torch test positive results? All torch test IgM values are normal. ### Response: I have gone through your case summary. Please tell me about the miscarriage at what time of gestation did they occur. Have you got an ultrasound done in those previous pregnancies? Was any shadow of the baby seen at that time? Was heartbeat seen in the baby? Next is your TORCH test. First of all, it is not responsible for recurrent miscarriages. All high values of IgG suggest that you are immune and now nothing is to be done. If we want to know a fresh infection, then only IgM or avidity testing is required. Did you have any history of fever, sore throat or any eruptions on your skin at the time of first miscarriage? Now, just do not bother about these tests. The important test required to be done. Get all these tests and accordingly, she can plan a pregnancy after another month. Pre-conceptionally, she should take tablet Folvite 1 mg and tablet Ecosprin 75 mg once a day. Could be anti-phospholipid antibody syn" "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 about plastic surgery to remove excess skin. About six months back I got sleeve gastrectomy and lost over 100 lbs. I was 372, now I am 257. I have a lot of excess skin around my abdominal area. Now I have seen stories about getting skin removal and also losing more weight. How does skin removal surgery work exactly? What do the surgeons recommend? ### Response: Hello. That is a really good change you have got after the surgery. Definitely, you can go for the excess skin removal surgeries, which includes tummy tuck, brachioplasty, thigh lift, butt lift and mastopexy to get the skin in good shape. But we do recommend that the weight reduction should come to a static position and maintained for around six months to proceed with the skin excision procedures. That will help in avoiding the same procedures again due to skin laxity with further weight reduction" "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 huge inner pain in stool going place, anus. It happens after every 10 months. Please suggest what has to be done. I am male, 40. ### Response: Burning while defecation could be due to anal fissure. The anal fissure is a break or a crack in the mucosal lining of the anal canal. You better see a gastroenterologist and get a PR examination and sigmoidoscopy test done. Treatment consists of taking stool softeners like Pegfibre 4 tsp at bed time with a glass of water. Ointment Diltigesic locally thrice a day. Hot sitz bath for 15 to 20 minutes twice a 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 have social phobia. I have this problem from my childhood. Till now, I have not visited any doctor. I am explaining my common issues. Please go through it and please suggest me. I dislike being introduced to other people. I find hard to go outside. I cannot be confident in front of other people. I hesitate to go through crowds. I have a fear to go to parties. I have a fear to have eye contact. I cannot concentrate on my work. I find it hard to socialize with other people.I feel hard to talk in front of other people. I feel anxious when I go to social ceremonies or functions. I generally want to stay silent always. I have a fear to talk with others. It makes me depressed. I have a fear to give a speech in front of other people. My mind is going blank, and I am very nervous. Please give me useful advice. ### Response: Hi. I have gone through your problem, and I can understand your concern. You have social phobia and anxiety disorder. You need to consult a psychiatrist soon as depression and avoidant personality disorder are difficult to differentiate from a social anxiety disorder. In social phobia, SSRI (selective serotonin reuptake inhibitor) and psychotherapy such as cognitive retraining, homework assignment, and desensitization are helpful." "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 husband is 32 years old and he got his first depressive episode five years back due to business stress. After that he is undergoing depressive episodes every year. He becomes fine after taking anti-depressants and does all his work normally. But again after few days depression repeats. He is kept on Lamitor 200 mg all these years. Is there a permanent solution to this problem? ### Response: It means it is a recurrent depressive disorder. Lamitor (Lamotrigine) is a mood stabilizer. So continue it. If illness worsens, start an antidepressant. There is no permanent solution for it. Only keep positivity in your life. Do meditation daily. Read good inspirational books" "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 37 year old female. I am facing pimples problem in and around my nose area on my face. Now, in winters, my skin is getting very dry and also getting white. I want to know which face cream suits me for dry skin. ### Response: Hope you are doing well. At your age, pimples are very unlikely. Pimples seen after 30 years of age is called adult acne, most of the times it is because of a hormonal cause. I am really sorry, I cannot suggest medicines for pimples without seeing your clinical picture. This is because I am not sure if it is pimples, as there are many conditions which mimic pimples. However, I would like to mention few skin care tips for pimples" "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 25 years old. I have been diagnosed with PCOS 3 years ago. I was on the pill till around this year however due to a few issues and after removing my gall bladder due to gall stones my GP advised I stop my pill. My periods have been on and off however I have not actually bled as such. There is just continuous dark brown discharge for a few days but no red flowing blood. What could this be and how do I go about treating it? ### Response: Hello. If you have been on pills for PCOD for more than 3 years now and yet your hormones remain uncontrolled and menses have not been regularized, then there is definitely something wrong in the treatment protocol or you may not be following the lifestyle changes which you may have been advised to follow. It is best to stop pills for at least 3 months after such a long treatment already and switch to lifestyle changes now for results. If pregnancy is not a concern lately, then the pills can be avoided. However darkish brown blood indicates irregular shedding and this could be due to isolated progesterone deficiency, which can be evaluated by your serum progesterone levels. However immediate control of bleed can be achieved with antifibrinolytics. You may discuss it with your treating gynecologist. Please feel free to discuss this further in detail. Regards." "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 63 years old. Her weight is 60 kg and her height is 5\2\\. For the last two-three days, she was getting an eye burn. Yesterday, she felt like a sand particle inside her left eye. Also, dropping of the eyelid. So today we started putting some over the counter eye drop. While putting drop we noticed a black mark inside the white of her eye. Is it a matter of concern? ### Response: I have seen the picture. (attachment removed to protect patient identity). This appears to be a mole. By seeing her eyelids it appears a bit swollen so can be a mild infection." "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 just done with HIV-1 and HIV-2 test. Can you help me understand the report? Result is 0.03. Notes given regarding this test are this is a chemiluminescent enzyme (CLIA) for simultaneous qualitative detection of antibodies to HIV 1 and 2. A negative result does not exclude the possibility of exposure to or infection with HIV 1 and 2. A positive result is not a diagnosis of AIDS. Supplemental testing such as immunoblot should be done for confirmation. Specimens containing mouse monoclonal antibodies or heterophile antibodies can give falsely elevated or depressed values. ### Response: Hi. In CLIA (Clinical Laboratory Improvement Assessment) test result, a value greater than 1 is considered reactive (positive). Your result is 0.03, which is less than 1. Hence, it is non-reactive (negative). In HIV (Human immunodeficiency virus) testing, it is very important to know how long it has been since your suspected exposure to infection.It can take up to 3 months from the time of exposure, for the virus to be detected in blood. If it has been more than 3 months since your suspected exposure, your result confirms that you do not have HIV infection. In case it is less than 3 months since suspected exposure, I advise you to repeat the test after 3 months of exposure." "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 33 year old male. I have had chronic constipation since my childhood. The doctors said that my gastric motility is a bit under-par. To rule out any physical damage, I went through colonoscopy three years ago. The reports only mentioned small hemorrhoids. I was on a brief course of antacids and laxatives after that, which gave me temporary relief. Constipation had reduced considerably by the end of last year. However, I have been experiencing acid reflux since early this year. This is the first time that I have had regular episodes of reflux. So, I did my endoscopy four months back. It revealed ulcers in the esophagus near the sphincter (GERD). It also revealed a small sliding hiatus hernia. No metaplasia seen in biopsy. The doctors said that since I am a young patient, surgery is not recommended. They said I have to rely on lifestyle modifications and antacids. Currently, I am taking Nexpro RD 20 mg capsules and Riflux Forte syrup. I have cut down on spicy food, and also have altered my meal times since the past one and a half months.The acid reflux has reduced by 60 to 70 % since the lifestyle change. However, I still experience some really disturbing symptoms: stinging chest pain at both the breast bones (especially after meals), occasional back-ache, frequent shortness of breath after meals, huge bouts of burping (with the feeling that air is trapped around the diaphragm), and overall fatigue. Regarding chest pain, I have undergone ECG, 2D echo, stress test, and troponin. All tests normal. The cardiologist has ruled out any cardiac problem. However, he has prescribed 2.5 mg of Nebicard SM to control my palpitations. He has already tapered the dose from 5 mg to 2.5 mg, I believe he will take me off the medicine soon. I need help to know what can I do to improve my symptoms. ### Response: Your treatment till date is on the right track and I appreciate your adherence to the same. You have a small hiatus hernia, which is not an abnormal finding always. The reflux of acid from the stomach to the esophagus (chest) is causing your current symptoms including the small ulcers. Now you can deal the problem with few dietary and non-medical tips. Please consider the following tests too. Hope I have cleared you doubts to your satisfaction. You can review with the reports when it is done and revert as needed if any fresh queries" "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 query is regarding my relative who is suffering from carcinoma of cervix. I would kindly request you to advise us regarding the stage of cancer based on the biopsy, MRI and CT scan report which I have attached here for your reference. In her MRI report, there is a feature suggestive of carcinoma of the cervix with parametrial extension. In CT scan it gives an impression of bulky cervix with parametrial fat stranding along with a few subcentimeter sized parenchymal and subpleural nodes in the bilateral lower lobes. I would like to know whether the above mentioned reports are sufficient to identify the stage of cancer? She even advised to get vaginal examination done. Is a PET scan necessary in this case in order to get a clear view than CT scan? Kindly guide us. ### Response: Hi. I would like to assure you that everything is going to be fine soon. I have thoroughly gone through your case and the reports (attachment removed to protect patient identity) and can well understand your genuine concerns. 1. She has got cervical carcinoma.2. It is a well differentiated type of adenocarcinoma that is an invasive cancer. This is a less common type of cancer compared to the squamous carcinoma.3. According to the staging systems devised for cervical cancers (AJCC-American Joint Committee on Cancer, TNM- tumor, lymph node and metastasis and FIGO - International Federation of Gynecology and Obstetrics), the tumor in this patient had spread to the distant organs. Thus it shows the lung metastasis.4. It falls into stage IV of the cervical cancer.5. Consult her treating physician for clinical correlation as it is very important, since I do not have the complete case in front of me. 1. No need of PET scan in this case.2. Vagina is normal on MRI of pelvis, so no need to worry for vaginal 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: I have been under medications for hypertension for the past five years. I am currently taking Zilance 40 and Ciplar 10. The random blood pressure reading is 140/100 and goes to around 160/100 at times. The current symptoms include excessive sweating, palpitations, anxiety, headaches, flushing, and fatigue. My ECG and kidney renal doppler tests are normal. Today, I have been prescribed Metanephrine and VMA 24-hours urine tests by the cardiologist. I am also on anti-psychotic medications for depression for the past 10 years. I need your advice and guidance on the tests prescribed above as I read on the internet that the tests are meant to detect a type of tumor. ### Response: Urinary VMA (vanillylmandelic acid) and Metanephrine tests are done to detect Pheochromocytoma, a kind of tumor, that causes hypertension in young persons, as well as facial flushing, headaches, and palpitations. Though it is rare, it is better to rule out pheochromocytoma in young hypertensives. But honestly speaking, I do not feel that your hypertension is because of pheochromocytoma. The more likely cause is excessive anxiety and depression. So, go for tests and continue your antihypertensive medication" "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 got blood work for recurrent chest pain. All was normal but my D-dimer was 1.28 ug/ml (normal below 0.50). Chest CT with contrast normal, doppler u/s both legs normal, abdomen/pelvic CT, as well as abdominal ultrasound normal. The doctor says do not worry about D-dimer but it was normal range a year ago. I had a hysterectomy, endometriosis excision or fallopian tubes removed five months ago and it resulted in an abscess and sepsis. I was hospitalized for a week but recovered. I have Hashimoto\s but no treatment because my TSH is in a normal range. Should I continue to pursue the D-dimer? Currently, I am taking Lexapro 10 mg daily. ### Response: I think we should retest D-dimer may be after few weeks, three to four weeks. This is to see the trend and confirm the elevated levels. The usual causes for elevation include DVT (deep vein thrombosis), pulmonary embolism, infection, stroke, trauma and rarely some cancerous conditions. Also, D-dimer rises with age. But, all your investigations are negative so ruling out the major and important causes for elevated D-dimer. I guess at this moment, you are totally asymptomatic, right? No fever or any evidence of infection, etc. The elevation from previous infection five months back should have settled by this time. You have undergone all possible test to rule out the causes for elevated D-dimer so I think there is no need to worry about it at this moment. So overall, I think, we should repeat the test after three to four weeks. Also, see if you have any symptoms or let me know if suffered from recent infection or 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: My son in law is HIV positive. His HIV PCR count is 46,938. He has been prescribed Tenvir. I want to know can he be ever cured? My daughter is married to him for only three months now and she is also pregnant. I would like to know if there is any medicine or ayurvedic treatment to get him completely cured. ### Response: No, there is no treatment available for HIV (human immunodeficiency virus) and your daughter needs to get tested as she might have caught the infection by sexual intercourse. If your daughter is infected then there is a possibility that she passes the infection to her child" "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 doctor recommended I get an MRI of the prostate and kidney. I have visible blood in the urine after exercise. We suspect it is a result of prostate laser surgery several years ago, but the doctor wants to rule out other sources of bleeding. I am okay with MRI\s but will not agree to get an injection of Gadolinium contrast after reading the latest study showing long-term retention of this toxic material in the body.Ultrasound: I also read there is a new, safer contrast media using some type of ""microbubbles"" for use with ultrasound to detect blood flow. Questions:From a diagnostic perspective, is it absolutely necessary to use contrast with the MRI\s?Would ultrasound with contrast be of diagnostic value? I appreciate any suggestions. It is very difficult for a patient to get knowledgeable answers to these types of questions.I had prostate laser surgery several years ago to improve urine flow with large prostate BPH. After surgery, I had visible blood in urine for nearly two months. Since then, I have been experiencing bleeding after exercise (for example, 5K run, tennis, basketball, etc.). Bleeding usually ends in few hours but recently experienced greater duration of bleeding. ### Response: Hi. Prostate MRI is one of the best noninvasive techniques to asses any condition of the prostate. Gadolinium is a contrast material used for better delineation of any suspected lesions. The chances of adverse effects are higher in people who have a kidney condition. However, you may proceed with a plain MRI of the prostate to get a basic idea of any lesion of the prostate and there is research showing that Gadolinium contrast is not absolutely needed for prostate MRI. b for evaluation of prostate. Transrectal ultrasound prostate may be done without contrast but gives less information than an MRI scan. You may also get PSA (prostate-specific antigen) levels done and get tested for any urine infection. Regards" "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 a BP of 99/68 good in case of stage-4 cirrhosis and liver failure? I am currently on Dopamine, Potassium chloride and Albumin human 25. ### Response: Overall, it is a good one. Hope this helps you and get back if you have any doubts" "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 a headache along with congestion and confusion as well as an ear pain like if there is some pressure on it. I am not sure if this is an allergy like sinusitis because I barely have any other symptoms than I mentioned above.Sometimes, I feel a dry throat, but I think that is due to taking less fluids. I had this a few weeks before and had a stuffy nose. I got well in the middle, but it came back. I will mention the environmental conditions that I am currently living in. The weather is really dry and cold air blows mostly.Since there have been barely any rain in the past weeks, as well as there is a high proportion of pollen and pollution in the area as well. I have been to the doctor during the initial days of this problem, she prescribed me an antihistamine (Loratadine).But, I just took it for a day as I felt anxious and had panic attacks, which I believed happened due to its adverse effects.Currently, I am relying on the home remedies like steam inhalation and use of warm cloth on ears to relieve the ear pain. I need an urgent help to cure this because it is killing my productivity and preventing me to think and work efficiently. I am a high school student who will be having mid-year examinations in a couple of weeks. ### Response: Hi. From what you describe, it sounds like you may have an ear infection. In the initial stages of an ear infection, there will be severe ear pain, a feeling of blocked sensation in the ear, decreased hearing, fever and this usually happens along with a severe cold or sinusitis. In case of an ear infection, you will need antibiotics, which you can get after visiting an ENT surgeon for examination. I suggest the following medicines to help you. Consult your doctor, discuss with him or her and take the medicine with consent. Apart from these medicines you need to do steam inhalation thrice a 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: If X-ray is clear and the person is having a good appetite and no fatigue but the person is spitting up blood with phlegm not always. Sometimes the phelgm is white and sometimes black and sometimes traces of blood in phlegm. No chest pain, no shortness of breath. Is anything to worry? Is there any chance of lungs cancer after clear X-ray. ### Response: I have read your issues. Coughing up blood can be a symptom of many diseases like throat or chest infection, tuberculosis, bronchiectasis (a disease where your windpipes are damaged) or lung cancer. A detailed history of complaints and your reports are needed to determine the reason. If you are below 40 years and coughing up blood only for a few days, it is likely a chest infection or tuberculosis (TB). If age is above 40 and a smoker, we need to consider the possibility of cancer. If coughing blood is for months to years, bronchiectasis is the likely cause. If X-ray is normal, TB and cancer become less likely. I would suggest you get a sputum exam for TB, blood tests CBC (complete blood count) and ESR (erythrocyte sedimentation rate). If TB is not detected in sputum and coughing up blood is persistent, CT scan of the chest may be needed. Bronchitis, bronchiectasis, tuberculosis. CBC, ESR, sputum AFB (acid-fast bacillus) smear, chest HRCT scan.-" "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 supernatural symptoms, and I see some signs, which seems like an unnatural entity is trying to say something to me. For example, I see something written on roads and also see lights like fireflies of blue, golden, and red color, which coincides with my life. I have an OCD problem, can this be due to OCD? ### Response: Hello. I can understand your concern. I need more details before commenting on the diagnosis. You have mentioned that some unnatural thing is trying to say something to you. Do you have the awareness that these thoughts are in your head only or do these thoughts appear in real? If these thoughts are persistent, repetitive, unwanted, and are resulting in distress, then most likely this is OCD (obsessive compulsive disorder). It could also cause seeing things written on road or colors too. Please provide me more details in the follow-up. Revert with more information to a psychiatrist 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 so much depressed because nothing happens as my choice. No one near to me, listen to my words. I cannot do what I want. I am damn jealous about everything. Please help me. ### Response: I would like to assure you that there is a way out and you do not have to keep feeling depressed this way. To understand this better, please consider the following: It is not in the scope of this message to discuss everything, but I would like you to think about the following questions. Irrational beliefs. Psychotherapy." "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 my son was about three weeks old, I woke up to see that his swaddle had come undone and was resting over his face. When I picked him up he was beat red in the face and sleeping. It took him a little to wake up but was fine when he did. I did not check for breathing at that exact moment because I was so anxious to wake him. I am very worried I may have caused him brain damage. Can a baby get brain damage from this kind of incident? I feel misinformed and uneducated on this topic. Like how it occurs and when it occurs. Also, how do you know if it had occurred? Please help me. ### Response: Hi. If the child has reduced oxygen supply due to such an incident, it may lead to brain damage which will be manifested in a day or two post this incident as a convulsion. That is how you will come to know that this kind of event has taken place. When a baby rests over his face, the nose and mouth may become blocked which will lead to air hunger which causes hypoxia which may cause damage to the brain." "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 suffering from rapidly progressive kidney disease, for which she is on Prednisone for last 4 months. As a side effect of the drug she is developing cataract in her eyes. She usually wears prescription glasses but recently her eye sight improved and upon examination her doctor said she is developing cataract although it is minor at present. They prescribed some eye drops and watch for any changes to see if she would require any surgery. ### Response: Hello. I understand your concerns. 1. Age related.2. Wear glasses at present. Revert back with the photographs to 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: About a week ago, I got off the lounge chair and felt a sharp pain in the back of my left ankle. The pain has not changed during the week. The whole ankle is still swollen. The pain has not changed, and it radiates from inside the heels up to my Achilles and into the lower back part of my leg. I can hardly walk. Three days ago I went to the hospital, wherein a portable ultrasound scan of the Achilles\ tendon was performed, which revealed that it was still intact, but the doctors said it could be torn. About eight months back, I had an accident at the workplace and had torn my L5/S1 disc. And this had created a leaking disc and a bulge affecting the nerves in my legs. I had a nerve conduction test done, and the results were positive with nerve issues in my left leg, but I never had this pain before in this part of my foot. I have attached a photo of the back of my ankle, and you can see the Achilles\ tendon is badly swollen. When it is strapped, it is a little better, but still painful. When it is unstrapped it is worse, and I can hardly walk on it. What do you think my injury is? Could it be related to my back and nerve injury? What treatment is available and what should I do now? ### Response: Firstly, there is no attachment and hence I could not see the clinical picture. Injury around a week ago. 1. MRI scan.2. Blood investigations as advised.3. Ultrasound report and images (if possible). 1. Hyperuricemia.2. Infection. As advised. Revert back with clinical pictures and investigations reports to an orthopaedician and traumatologist 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 having prolonged backache, especially after driving. I face pain when I stretch and I get a relief when I do it. And when I push my hands on the back towards the front I can hear bone cracking, like when we stretch. ### Response: In my opinion, with the limited narration that you have provided to me in your query, I feel you have less stability in your core muscles." "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 20 years old. Two to three months ago, I started to have pain on my left testicle whenever I go out as I am usually at home. I speculate that I have varicocele as upon doing a self-examination, I found that the veins were bigger than the other testicle. There were no lumps found, but the left testicle feels bigger than the right one.I would say it is around 5 mm bigger in diameter. I do not have urinary problems like burning sensation. Although when it pains, my left lower abdomen and the pelvic area also hurt sometimes which could be due to lack of exercise as I am on my computer most of the time.The pain or ache on my left testicle usually appears when I am wearing tight pants. But I did not have this problem three months ago. I consulted a general practitioner, and he did a physical check and said it was likely due to congestion of the blood at the testicle. Do you think it could be an infection like epididymitis? I only had sex once in my life with my partner, but I do not have any other symptoms of STD. And do you think that there is something serious? Or is it probably due to congestion or tight pants? ### Response: Hello. Testicular pain with no obvious pathology on physical examination is common in young boys. As the testes descend through the lower abdominal wall, they carry spiral muscle which keeps them suspended in a dynamic position. Contraction of these muscles gives rise to pain. Tight pants press on the inguinal canal and may hinder venous return causing congestion. Wearing Langot (cotton strip worn by wrestlers to support testicles in India) will prevent their hanging, so there will be no muscle contraction. Get a USG scrotum (ultrasound). Wear scrotal support (langot). Kindly consult your doctor to discuss the suggestion and take the treatment with concern. Tablet Pregabalin 75 mg with Mecobalamin (Methylcobalamin) at bedtime for 10 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: After I ate some food, I had a piece of chewy candy and felt a hole on one of my bottom right molars. I immediately spit the candy out, to find a piece of my tooth, and when I shone a flashlight into my mouth, I saw that a chunk of my molar was missing, on the area right next to my back molar. I am not sure if the chunk is a filling or an actual piece of my teeth, but the gaping hole looks pretty deep and there was a lot of sensitivity when I rinsed out my mouth with cool water. Should I be worried, and what can I do to minimize the sensitivity before I see my dentist? ### Response: Hello. I have read your query and it seems that the filling portion of the tooth is broken (attachment removed to protect patient identity). No need to worry as the tooth seems to be vital. Sensitivity is normal here because dentin of your tooth has been exposed due to broken piece. I would suggest to get this cavity filled soon as the delay would cause problems like food lodging and over time caries. Atleast have a temporary filling done for time being. Sensitivity can be minimised by brushing with fluoride toothpastes. Take a fluoridated paste on your finger tip and massage it gently over the whole involved tooth, brush after 2 minutes with a regular toothpaste after that." "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 a discomfort sensation in the urine bladder (I feel like passing urine every time) since the last one and a half months.USG and urine route are all normal but culture seems positive. Please let me know whether blood culture report is also normal. No fever and no issue in passing urine.Currently, taking Alfoo and Bladmir 25 mg but discomfort is not gone. I am not on any antibiotics. Reports are attached.Can you tell me wether urine culture report is normal? The count is over 1,00,000 for Klebsiella pneumoniae. The urologist told it is normal. ### Response: I have checked the attached files thoroughly (attachment removed to protect patient identity). In my opinion, we should clear the Klebsiella infection first and then watch for improvement. First, I would like to know if you have increased frequency. In order to clear the infection, I suggest Bactrim (Co-trimoxazole) 200 mg tablet every 12 hours for five days. Culture will be repeated after one week" "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 lot of acne over my cheeks and chin. My skin is sensitive and oily. Whatever I use causes acne. Can you suggest any home remedy for my skin? ### Response: Hello. Acne depends on hormonal effects, sebaceous secretion, etc. It reduces with age in both severity and appearance, and good control can be achieved by regular face wash with a cleanser like Cetaphil, topical keratolytic like Retinoic acid creams and antibiotics like Clindamycin, if necessary oral antibiotics." "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 lower GI and pelvic CT scan with contrast done at the age of 36 years. I fly a lot. I want kids. Did this scan harm my eggs or increase my chances of developing cancer? Nothing was found in the scan, and the MSV was 8. ### Response: I have read through your query in detail. Please find my observations below. The contrast CT scan pelvis has exposed you to radiation of 8 mSv as recorded on the machine. For a 36 year old female patient, this means you are exposed to an additional cancer risk of 0.09 percent. In other words, there is a 99.91 percent chance of having no effects due to the CT scan pelvis. Flying exposes a pilot to radiation of approximately 2.2 mSv/year. Natural radiation we are exposed to is approximately 3.1 mSv/year. In conclusion, the 8 mSv radiation exposure has not caused any significant adverse effects and will not affect your plans to have kids. Hope this answers your question." "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 sister is 12.6 years old. She got her first period about six months ago. Just about four weeks ago, she got her second period. I know when you go through your first menstrual cycle it can be on and off, so that did not really bother me. But then, her second period just keeps coming back every day. Some days, it would only be blotchy and very dark. The other day, she bled heavy in bright red with severe cramps. It usually starts and ends at the same time every day. It starts around 10 AM and ends around 3.30 PM. She has PE in school three days a week and she would get plenty of exercise. My mom thinks that she has been taking Guanfacine and it has something to do with my hormones. Do you think that she should go to my local Endocrinologist? What do you think could be wrong? My mom heard of people taking low dosages of birth control medication. Is it advisable for my sister? ### Response: Hello. Hypothyroidism, hyperprolactinemia, bleeding disorders and PCOD (polycystic ovarian disease). Puberty menorrhagia. Hemostats and Progesterone if required. Revert back with the reports to 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: Kindly view my attachments and advice whether I need a tonsillectomy. ### Response: From the pictures you have provided as an attachment, it seems you have rhinitis with a sore throat and a bad cough. To answer your question, I will request you to please provide me with the following details for better accuracy. 1) Age, 2) Symptoms in detail, 3) Duration of illness, 4) Frequency of the illness per year. Since the acute episode needs to subside first, I will advise you to follow the underwritten treatment. 1) Start on antibiotics if having a fever, a tablet with a combination of Amoxycillin and Clavulanic acid (625 mg) will work well. It is to be taken twice daily after meals. 2) Take antiallergics like tablet Levocetirizine (10 mg) once in the evening." "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: Both of my wrists and my right ankle have recently started to hurt when I run or lift weights, but they are not sore. It is in my joints. ### Response: Hello. As per history, I think you should start strengthening the forearm and leg muscles gradually. Please do let me know if you have had any ankle sprain in the past. This will provide more insights. Try doing reverse walking as well. A balance board training for the ankle and wrist should be worth to try with. As this provides more stability to the joint and correction of muscle imbalance." "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 got my tonsils removed four days ago. I wanted to know if it is okay to smoke one cigarette and some weed. ### Response: Hi, Welcome to iciniq.com. No, you should not. It is just four days and healing takes at least 15 days. The area where the tonsils were there has to regrow the mucus lining and the lining should start functioning normally after a few days of growing. If you smoke cigarettes or weed the smoke will directly get adsorbed on the raw area making it vulnerable to bleeding, infection, pain, edema, swelling, and impaired healing. Smoke and weed will deposit soot and carbon particles which will delay healing and act as a nidus for infection. Take abundant fluids. Take all the medicines prescribed by the doctor and follow up with him as per his instructions. Do ping me if you need any support." "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 18 and I rarely brush. Just a handful of months ago, I got plaque at the insides of my bottom teeth and now it has become worse with tartar and plaque. How can I get rid of it? ### Response: Irregular maintenance of good oral hygiene (like tooth brushing) can lead to tartar or plaque deposits around the teeth and on the gums. This weakens the jaw bones and mobilizes teeth in the long run. Bad breath can also be seldom avoided. However, prevention is better than cure and let me show you how to prevent it: 1. Get scaling and root planing done by your dentist. 2. Maintain good oral hygiene by brushing at least twice a day, along with using a good mouthwash. 3. Follow-up with your doctor at every 3 to 4 months to see how the treatment is working for you. All these procedures are painless and you will have no difficulty or problem during or after the treatment." "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 23 years old. I have been hearing sound and voices for a couple of weeks. I think I am having auditory hallucinations. Experienced this before when I committed suicide eight years back. Then it stopped until now I am hearing them again. No medication. ### Response: Hello. Hearing voices when others are not hearing, hearing running commentaries or as if someone is talking about you could be due to auditory hallucinations. Auditory hallucinations are seen commonly in psychotic disorders. This should be treated on an emergent basis. Please consider consulting psychiatrist as soon as you can for the best treatment." "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: There is no withdrawal bleeding after Unwanted 72. Period date: 4th of this month, sex date: 16th and tablet intake: 17th of this month. When will I get my period or withdrawal bleeding and when to have home pregnancy test? ### Response: Some women do not experience that. You should wait for your regular cycle date which might also get a little bit delayed due to intake of pill and if you missed your periods only then you have to do a pregnancy test. Otherwise, if periods start there is no need to go for it. You just relax and calm down. These pills are quite effective in preventing against pregnancy and your periods might start around 3rd or 4th of next month hopefully." "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 20 year old male.Whenever I think of sex, my penis starts secreting a transparent fluid which keeps on coming out from my penis until I masturbate.Also if I do not masturbate after the excitation, my penis starts paining.Is this a normal condition or some disease?After 1-2 hours of masturbating, there is a mild pain in my penis which persists for few minutes.Also tell me how to increase the sperm count.Please help me with this. ### Response: What you are experiencing is a normal process. Whenever men are excited, the secretions start discharging from penis. The fluid which discharges initially is the pre-ejaculatory fluid (pre-cum). When you masturbate, the seminal fluid is discharged. Slight pain after excitation and masturbation is also normal. It subsides in a day or two. This is mostly due to muscle fatigue. Revert back to a sexologist online for further follow up" "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 about to have sex for the first time, are there any suggestions on what to do? And how to do it? I want to know more before it happens. Kindly advice. ### Response: Hello. I can understand your concern, 1. Make sure your partner is STD (sexually transmitted disease) free. 2. Use a condom if you do not want to get pregnant. 3. 1st-time sex will be painful. Make sure your partner understands it and go slow on you. 4. Do not try rough sex. 5. Having sex can change your hormonal level, so expect changes in your body too. 6. Virgin is not an important thing in life, no need to make a big deal about your hymen. 7. Real sex will not be like a porn movie, in reality, it smells, tired, sweat, no background music, do not expect light effects, do not expect two hours duration usually it will be few minutes, no continuous erotic sounds from partners. 8. Post sex people feel guilty and weird. I Hope I have answered your query. If you have further doubts, I would be happy to help 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 male, 31 years old, had a CBC test, and results showed elevated RBCs as below. But I have no other symptoms, actually taken test to investigate alopecia problem.ESR 15, WBC 5.54*10 ^3 cells/microlitre, neutrophils 2.34, lymphocytes 2.24, monocytes 0.697, eosinophils 0.184, basophils 0.8, RBC 7.17* 10 ^6 cells/microlitre, HGB 13.3, HCT 42.6, MCV 59.4, MCH 18.5, MCHC 31.1, RDW 13.6, PLT 269*10 ^3 cells/microlitre, MPV 8.96 fl.After four months of alopecia problem resolved and had further tests to investigate the elevated RBCs. Took CBC, liver, and kidney function tests. WBC 5.12, neutrophils 2.58, lymphocytes 1.73, monocytes 0.39, eosinophils 4.3, basophils 1, RBC 6.61, HGB 12.4, HCT 39.2, MCV 59.4, MCH 18.7, MCHC 31.5, RDW 16.2, PLT 197, MPV 9.1, glucose 93.2 mg/dl, BUN 10.7 mg/dl, cretainine 1.03 mg/dl, NA 1.41 mmol/L, K 3.90 mmol/L, CL 104.4 mmol/L, AST 29.8 U/L, ALT 43 U/L, T-BILL 0.855 mg/dl, D-BILL 0.359 mg/dl, TP 7.78 g/dl, cholesterol 121.1 mg/dl, TGL 190.4 mg/dl, LDL 80.6 mg/dl, HDL 24.8 mg/dl, iron 123.48 ug/dl, CA 9.09 mg/dl, UA 6.1 mg/dl.Could you please advise and provide consultation? Please provide any diet recommendations. Is there any harm to have elevated RBCs with no symptoms? My WBC is on the lower side and RBC is on the higher side. Is it normal? ### Response: Hello. The borderline hemoglobin level, low MCV, and high red blood cells count are suggestive of some hemoglobinopathy. You need to investigate further with HB electrophoresis by HPLC method to rule out any hemoglobinopathy if present." "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 age is 22. I have a white patch on the inner side of my foreskin. It does not itch or pain but look weird. I have not had any physical contact. So, it is not an STD. How can I get it removed? ### Response: I welcome you and want to assure you need not 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. It occurs due to deficient hygienic conditions of the genitalia.Please do not worry as it can easily be managed. The best part of it is that there is no pain or itching in it.It is caused by either fungi or due to the fungal growth. Treatment with proper topical creams will help you get better in a short time." "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 some health concerns. I am 47 years old. I take hypertensive medications. Lately, I experienced abdominal pain accompanied by lower back pain and every morning I have experienced difficulty in urinating that started four days from now. I have no edema. ### Response: It seems you are a hypertensive patient as you are taking Losartan but the side effect of Losartan is abdominal pain and diarrhea but in your case situation is different. You have difficulty in urination and if you have lower abdominal pain then my straight diagnosis is renal and ureteric calculi. It means there may be some stones in your excretory pathway. To prevent infection, take tablet Oflox OZ (Ofloxacin and Ornidazole) 650 mg one tablet three times per day plus tablet Pan 40 (Pantoprazole) one tablet three times per day for seven days but be sure to get an ultrasound of your abdomen 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: My daughter is 3 years and 11 months old. She is suffering from a fever since last night. The temperature was between 101 and 102 F. She has been given three doses of Crocin suspension DS today and right now she has a 99.8 F fever after giving sponge. There are no other symptoms. Please suggest a remedy. ### Response: Hello. As per your clinical history, your child is suffering from fever since one day. If the fever is persistent and does not respond to this, you must visit a pediatrician for the clinical evaluation of your child, and some workup may be required." "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 66 years old male. My weight is 70 kg and height is 5\4"". I had lost around 5 kg over a year. I am allergic to dust and will get sneeze and nose blockage following exposure. I am suffering from diabetes, BP, cholesterol, chronic fissure, constipation, occasional gastric problem. My diet is as follow. Morning: Green tea, oats. Breakfast: Idli/dosa/roti and a cup of tea with milk and without sugar. Lunch: Fruits like musambi, watermelon, apple and orange. Rice, curry and vegetables. Evening: Snacks like biscuit, vada, ragi, etc., and tea with milk and without sugar. Dinner: Rice, curry and vegetables. I am under following medicines. Gluconorm SR 1-0-0 daily and taking this more a year. Corvadil 2.5 mg 0-0-1 daily. I am on this tablet for around 6 years. Fenotorva 10 0-0-1, occasionally. ### Response: Hi. I have thoroughly gone through your case and can well understand your genuine health concerns. 1. Do not stop or think of stopping diabetes medicine as this will lead to dangerous effects on your blood sugar levels. No other medication needed.2. Ayurveda medicines will not work for you and discontinuing medicine will affect your blood sugar control.3. Diabetes and blood pressure may cause weight loss.4. Yes, the tablets are to be taken lifelong. No issues with long-term usage.5. Please send your investigation reports and fasting lipid profile at the earliest. Revert back with the investigation report to a general 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 have a query on ectopic pregnancy. My wife is having one and her beta hCG levels were 125.25 ml after taking her first shot of Methotrexate. Yesterday, she got her second shot and her beta hCG levels today were 141. I wanted to know how much time Methotrexate takes to low down those levels and I was wondering if we were a little hurried in taking the second dose so quickly. ### Response: I hope you had taken the Methotrexate dose under supervision only. The usual protocol is to check for a repeat beta hCG on the fourth day of taking Methotrexate. Early testing may cause undue anxiety and panic as it takes some time for the levels to come down. Moreover, a few times the levels get slightly elevated after a Methotrexate. So stay calm and follow the instructions of the gynecologist you are following. Just report to the emergency in case of any acute pain, giddiness or bleeding." "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 very dark skin. One of my friends used skinlite cream and she has turned very fair. Can I also use that cream to get a fair and glowing skin? I really want a fair skin. I am just tired of my skin. Please help me doctor. ### Response: Natural complexion is the best. Melanin, the pigment responsible for the skin color has protective effects. Use cleanser like cetaphil to wash your face. You can use sunscreen lotions like shade lotion regularly 2-3 times a day. Skinlite is a combination cream with steroid too. It may do more harm than good. Once you stop using, it may worsen the situation or rashes may erupt. You can use peeling agents like glyaha lotion to begin with and later with glyaha-hq lotion in the night after consulting you doctor. Consult a dermatologist online for further follow up" "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 25 years old. The date of the first day of my last period was two months back. Am I pregnant? I want to abort. Can I do medical abortion myself at home at this time? Is it safe? Please help me and consult me. ### Response: Hello. You need to take a urine pregnancy test and confirm the pregnancy. Please visit a gynecologist for the further examination. You will also have to undergo an ultrasound done to rule out ectopic pregnancy which is dangerous. If your pregnancy if seven weeks or less, then you can be given medical management of abortion by pills by a registered gynecologist under supervision. If pregnancy is more than seven weeks which is more likely as your LMP (last menstrual period) was two months back, then you need to get a dilatation and curettage by a gynecologist which is the safest method. Any attempt of doing MTP by an unregistered person or unqualified person can be very dangerous and potentially life-threatening as bleeding or other complications can occur." "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 know vegetarian diet plan for a type 2 diabetes patient. She is a 58 year old female and her blood sugar level is 150. Please suggest. ### Response: You can start by following some basic rules of eating healthy. Also, please answer the following questions: Please follow up with these details to get a detailed diet plan to 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 got my normal KFT and LFT reports. My BUN is 18. Creatinine is 0.9. Both are in normal range but my BUN and creatinine ratio is 20 which is high. What does this mean? I started taking Metformin for the last 20 days for prediabetic control. ### Response: Normal BUN (blood urea and nitrogen) to creatinine ratio is anywhere between the range of 10:1 to 20:1. So your values are within the upper normal limits. In this situation, I would recommend taking more and more fluids and go for another test to see the ratio after two weeks. We would see how it responds and if there is a need to do something else. You should also consult your local physician for the same" "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 typically work out in the mornings as soon as I wake up and then shower immediately after. Knowing this, should I wash my face before I work out, rinse water on it, or just workout and then wash after? I have sensitive, acne-prone skin. So, I am trying to avoid washing more than twice a day. Also, most times on weekends, I will have to work around the house, etc. and then later in the day go out with friends. My initial thought is to wash three times on these days (when I wake up, when I shower, and before I go to bed). Do you have a different thought on this? ### Response: Hello. It is a good idea to wash your face with water before a workout to remove oil produced during sleep. Then your skin is free to breathe and secrete oil which will not be accumulated. I highly recommend it. Regards." "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 eyebrow hair root is very weak. After washing my face with water, and after wiping it with cotton cloth, I find 5 to 10 eyebrows are falling daily. Please suggest me treatment (medicine or capsules or oil) for firm eyebrow root. ### Response: I understand that your problem could be disconcerting and it can be resolved. Also, please attach a photo of the same taken in bright light and sharp focus. We can decide on the appropriate treatment based on the above." "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 endoscopy shows microscopy A and B - Mucosa of the gastric body and antrum exhibiting mature typical glandular epithelium, areas of mild interstitial edema, focal hyperemia alongside rare inactivated lymphocytes in the lamina. An absence of intestinal metaplasia. An absence of bacilli from the Helicobacter pylori pattern by May-Grunwald Giemsa staining. Conclusion: A - Body light gastritis. Negative search for Helicobacter pylori. B - Antral mild gastritis. Negative search for Helicobacter pylori.I need to understand my endoscopy results of ""focal hyperemia"" along with rare inactivated lymphocytes in the lamina.Is this an infection with an inactive v\xc3\xadrus?Is there a cure?How do I treat it? ### Response: This term simply indicates there is a little inflammation in your lamina that is part of your stomach. Hyperemia means there is an increase in the blood flow around the area in lieu of inflammation. As such, there is no infection based on your reports. Lymphocytes are normal cells of your body. This report does not signify any sort of infection. The most common infection found in the stomach is H. pylori (Helicobacter pylori) that is absent in your case" "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 taking the following medicines for my diabetes,Amaryl 2 mg 1-0-1, Onglyza 5 mg 0-1-0, Losar A 1-0-0 and Hosit-L 0-0-1I would like to know if these medicines can control and regulate my diabetes? If not, please advise me some tablet to bring my sugar level down and get better control of my diabetes. ### Response: Hi. I saw your blood reports (attachment removed to protect patient identity) and medications as well. Revert back with the blood sugar report to 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: There is a hairless patch forming in my beard. The hairless patch feels smoother. Please help. ### Response: Hi, Consult your specialist doctor, discuss with him or her and start taking the medicines after 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 had blood drawn five weeks ago and since then felt numbness and tingling in my right arm and right leg. Although numbness and tingling have gotten better, I still feel slight numbness in right pinky and third finger. I also feel burning/pinching in the crease of my arm where she drew blood/next to elbow. Also, when I am sitting at the computer, the tingling starts again in my entire right arm but mainly forearm. Is this permanent nerve damage? I am doing Bikram yoga but still feel these symptoms. Do I need to get an EKG done? ### Response: Regarding your concern, I would explain that your symptoms could be related to a pinched nerve, possibly related to the venous puncture. I do not think that the numbness in the leg is related to the procedure. It could be just a little anxiety. Anyway, if the numbness in your arm and fingers persists, I recommend performing nerve conduction study to examine your nerves. Some blood lab tests are necessary too (complete blood count, vitamin B12 plasma levels for possible deficiency, and blood electrolytes for possible imbalances)" "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 has a problem while urinating. She gets blood coming along with it and also, has pain while doing it. She has this problem after having sex. I think that her private parts got injured and so, she has bleeding while urinating. Please suggest something to get relief. ### Response: If there is bleeding in urine, then consult a doctor soon and test her urine. If there is blood, do not take it lightly and it may require sonography and other tests to find out the cause. If it is bleeding from a private part and if it is not related to urination, then give time for healing and do not have sex for at least four to six weeks. If the bleeding is not stopped, then consult a nearby gynecologist to see the source of infection clinically. If she has bled every time after having sex, then consult a nearby gynecologist and check for a cervical lesion clinically." "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: The patient is suffering from acute heartache. According to the reports, he is reported with complete LBBB and coronary artery disease. Right now patient age is 80 years and most of the doctors recommend for bypass surgery. Is there any other alternative to provide immediate relief to the patient? There is suffocation, gasteric choking, and acute heart pain experienced by the patient and under SAAOL therapy. ### Response: Angiogram pictures of the patient show disease in all three vessels and also left main vessel 30 % (attachment removed to protect patient identity). If the left main would not be having the disease, we could have thought of angioplasty of vessel of recent attack (infarct-related artery). With his age, bypass surgery is risky but if his echo is showing good heart function then you can take a risk. Also, medications (proper intake) can also make the patient survive without symptoms if the echocardiogram is good" "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 66 year old male. My only medical history is hypertension (controlled) with Norvasc. I went for my routine prostate test a couple of months ago and the result stated:PSA - 9.8 ng/mL.Free PSA - 1.9 ng/mL.Percentage free PSA - 19.4 %.I went back to another doctor a few weeks ago and he repeated the PSA and did a digital exam and the results were as follows: PSA - above 10 ng/mL. Prostate sightly enlarged, preserved median groove, not nodular, feels rubbery. He prescribed Proscar 4 mg daily for a month. I have absolutely no urinary symptoms. What do you suggest that I do? ### Response: Hello. After analysis of the history provided, I would like to give you a brief idea of the same. Stay healthy and be positive" "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 taking my regular birth control pill every night at 8 PM. I am going to be traveling abroad where it is 7 hours ahead so that would be 3 AM there. Can I move up my regular time to 6.30 PM to take my pills at 1 AM there? ### Response: There are two types of birth control pills. Common combined pills and progesterone only pills. In that case, I suggest you double the dosing of pills on the change over days, and this will help to keep the schedule with respect to its contraceptive efficacy. But one point is clear for both types. You need to be regular for rest of the days without any miss." "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 diarrhea for the past 10 months and having treatment at the hospital. I want to know about the diets I should have. The doctor says no for milk, but fine to have curd or lassi. I want to confirm if I can have curd and lassi? ### Response: Hello. Probably your diarrhea comes when consuming milk containing food, which means your intestines are intolerant to lactose, which is the sugar that is present in milk. We call such situation as lactose intolerant enteritis. Curd and lassi you can take because their lactose content has been degraded by fermentation and so you can have both." "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 100/60 blood pressure, and I feel less active. My TSH level is 0.022, and I am feeling alone and depressed, but I am getting sleep. Please help. ### Response: Hello, Welcome to ilciniq.com. A blood pressure of 100/60 is normal for a woman in your age group. Your blood counts and urinalysis are normal. Your thyroid hormones Total T4 and Total T3 are within normal ranges. A single low TSH (thyroid stimulating hormone) reading may need confirmation with a repeat test. Are you on thyroid hormone supplements? What are your height and weight? You have been prescribed an antibiotic (Mahacef plus). There is no reason for you to take medicines. I suggest stopping it. Also, no indication to take Citro Soda (you do not have a urine infection). Your health is fine, and so you can stop all the medicines. Your symptoms may have other causes like lack of sleep, stress, etc. You will need further evaluation. You can start by getting a repeat TSH test done at a standard laboratory. Stop the medicines you have been prescribed currently. Once you have the repeat TSH level, you can get 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 husband is suffering from anal burning and bleeding while going for motion. Whenever he goes motion, he starts having anal burning from morning to evening. If he does not goes motion in the morning, there is no anal burning. The doctor has suggested Smuth cream for anal area. Can you please suggest treatment and home remedies? ### Response: You did not mention about the diagnosis that your doctor made whether it is piles or fissure or something else. But avoid constipation. Give him high fiber diet like whole grains, salads and plenty of water daily. Also, tell him for sitz bath. Take sitz bath two times daily. In sitz bath take some lukewarm water in a tub and sit in it for 10-15 minutes. Add a pinch of turmeric powder in water. This will help him" "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: Hi,I am a 30 year old male, married for the last one year. We got married in February 2014 and because of job, we used to stay in different locations for the first 6 months. From last September we have been staying together.Unfortunately I do not feel any sexual attraction towards my wife. Frequency of sexual intercourse is as low as once in a month and in any of those sessions I had, I was never able ejaculate.Below are few facts which may help you understand my problem:I used to masturbate once/twice every day before we started staying together. Now also, I continue doing the same, but not that frequently.I am able to ejaculate whenever I masturbate.My style of masturbation is quite different than the too and fro action that happens in normal sexual intercourse.I used to watch a lot of porn earlier which I have almost stopped in recent past. I have paid for sex in the past before marriage.I feel sexually attracted towards other girls.And sometimes I feel like having sex outside, though I have not done that.I do not have any extramarital affair.My testosterone level is normal.I used to be underweight 2 years back.I have gained almost 25 Kg in the past 1.5 years.Currently I weigh 75Kg and my height in 167cm.Almost every day I wake up sleepy and unfresh.I work in branding job and my wife is a banker.Everything is great in our relationship apart from this. This issue is putting a lot of stress on us (mainly on her). She is going into depression which is hurting me a lot. I want this married life to continue really well. Please Help. ### Response: I understand your concern, both of you need to do a few things, especially you. Try these methods and I am sure you will be able to improve." "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: What causes a ligament to push against upper artery causing pain? ### Response: Hello. Which site are you talking about and where do you get pain? What are your symptoms? Please explain in detail. In general, these are degenerative changes. This means due to aging there is wear and tear of the ligaments leading to inflammation and enlargement. Also, there is enlargement of joint due to arthritis and subsequently ligaments. This leads to compression of nearby structures. Sometimes, this also occurs due to trauma, excessive use of the ligaments like lifting heavy weight or too much of activity" "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 35-year-old male. No episodes of herps except chickenpox in childhood. No Infection of HIV, clinically tested every six months for the last seven years. My partner and I both are not having HIV (clinically tested).I had a bacterial or fungal infection with pus and redness in the genital area. So I have done the blood test.HIV is negative.HSV-1 IgG 4.5 positive.HSV-1 IgM 0.29 negative.HSV-2 IgG 0.45 negative.HSV-2 IgM 0.69 negative.As HSV-1 is mostly non-genital infection. I did not have any episodes of HSV-1 type herps in my life. I never had HSV-1 type herpes anywhere in the body. I am straight and have a relationship only with my spouse.How can blood show HSV-1 IgG positive without any symptoms? Dermatologist says it is due to past infection and not about present infection. Doctor told I should take antiviral dose Acyclovir for 20 days for HSV-1 IgG past infection. Is it useful to take antiviral dose for the past HSV-1 type infection? Will it reduces IgG level in the blood? Is HSV-1 IgG is false positive? ### Response: First understand the situation, IgM indicates recent infection and IgG indicate chronic infection. Since you have both the IgM negative, it means that there is no recent infection. Secondly, about 70- 80% of US population is HSV-1 (herpes simplex virus) positive, it means they are infected once in a life time and antibodies will remain for throughout life. But it does not mean that 80% of US population should start taking Acyclovir. There are no guidelines for taking Acyclovir until you are symptomatic. So do not think too much about this figure. If you had any other problems, you can 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: Yesterday, I woke up with bumps on my face and neck. It started off small and it was really itchy, so I itched the bumps and they started to get bigger. I washed my hands after and got some cream to stop it from itching. Later on, more bumps started to appear after itching my self and it's on my fingers and the back of my neck, and I have no idea what I have and it's hard to find treatments without knowing what it is. I do have a feeling it is an allergic reaction, since I ate a whole packet of sweets and it had a weird texture to it. ### Response: It is urticaria and you are right it is an allergic reaction. You have to keenly observe and note the things that can flare it up or cause it. Do not worry. You will get better with proper treatment and medication. Urticaria. Urticaria. Apply Betamethasone propionate lotion, mix with Calamine lotion BD over the lesions. Take antihistamine BD like Loratidine 20 mg. Avoid things that flare it up. Do not eat food from outside the home. Maintain hygiene of area, wash with soap and water, avoid using Dettol and other irritants." "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 HPV 16 positivethree years back. Follow up Pap a year later showed positive for HPV 16 again. Last year Pap was normal but my Gyno doctor notes stated \x80\x9cpap normal but HPV still present\x80\x9d. I was told today that I had cleared the virus last year but why would he write HPV still present if I cleared it. Hysterectomy with removal of my cervix and uterus was done last year. Pathology of cervix and uterus were fine and normal. Last pap was 2 weeks ago. It showed abnormal cells in my vaginal cuff and HPV positive but it is not 16 or 18. The nurse told me it is a low risk type. ### Response: Hi. I understand your anxiety. The fortune thing is that even if last year HPV was present the treatment has been done in the form of hysterectomy. In fact it is over treated. I do not think it is a matter of concern. For your vaginal HPV, low risk types are rarely responsible for any cancer. Also If one is sexually active, HPV infection keeps coming and body deals with it by its own immunity. What should concern us is a persistent HPV infection in your vaginal smears. So right now just use barrier contraception like condoms and repeat vaginal smear at 6 months. That is all. Follow up is what is needed as you are a very low risk case." "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 is 4 months pregnant. Her toxoplasmosis report showed IgG reactive and IgM non-reactive. Our doctor prescribed her Rovamycine forte 30 tablets for 10 days. What shall we do? ### Response: Hi. I sincerely advise her to not take anything. Any infection produces two types of antibodies. They are IgG and IgM. IgG is from infections which occurred many years or decades ago. It is not harmful as it will not cross the placenta and will not affect the baby. IgM is an acute infection. It means she has an infection now. It will be dangerous to the baby. Usually, these infections occur once. Now if she has IgG, then it only means that she had infections sometime in the past. So, no need to take medicines unnecessarily now. Please share this with your treating doctor." "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 having severe pain in my eyes for two days. Swelling below eyes and headache also. She is not having eye problem but use specs for eyes sight. Please suggest effective medicine. ### Response: Pain, along with headache, suggest, increases eye pressure. I will tell medicines for relief for now, but tomorrow you have to see an ophthalmologist in person. Start with, 1. 2. Tablet Acetazolamide 250 mg stat and one at bedtime (kindly rule out an allergy to the sulfa group if" "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 taken tablet Unwanted 72 for the first time within 20 minutes of sex. I have the feeling of vomiting, chest pain and I am feeling sleepy too. Is this normal? Can I get pregnant? ### Response: Hello. I have reviewed your query. Unwanted 72 is an emergency postcoital contraceptive pill containing Levonorgestrel. Though it is effective within 72 hours after intercourse, it is very active when it is taken immediately after sex. As you have taken within 20 minutes, you will be having higher efficiency and a very little chance of getting pregnant but, not a zero percent chance. Because even this tablet also has a minimal failure rate of 0.3 to 2 percent taken within 72 hours. Do not worry much but you need to keep track of your expected date of periods and get a pregnancy test done if the periods are delayed. Regarding the symptoms you are experiencing, chest pain is unlikely to occur after taking Unwanted 72. But vomiting and sleepiness are quite common side effects" "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 27 years, had multiple fistulas last year, and we took Siddha medicine and applied Mathan oil. Now he has a fistula on one side, and now the doctor advised to take Rasagandhi Mezhugu two tablets twice daily for five days. My friends told me not to take this medicine as it contains metals which affect the kidney and liver. Is it true? Is it advisable to take two tablets? He is currently on Triphala, Sangu Rasagandhi, and Mathan oil. MRI scan was taken last month. Please reply. ### Response: Hello. It should be taken twice daily after food, along with a cup of buttermilk. For the first few days, we need to check the compatibility of the patient. If suitable, it should be continued for many weeks." "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 done my sperm analysis. The gynecologist suggested low motility grade A, and I am taking Fertisure M for past one month but, was a bit irregular in medicine but now following the strict timeline. She suggested consulting a urologist for agglutination/pus cells, etc. Kindly suggest some line of treatment.I do not smoke and drink once in a month (even that is not regular). I used to drink cold drinks but have given up now. I have reduced junk food and consume fruits, vegetables, and non-vegetarian food. I sleep for seven hours and do exercise and walking regularly.Kindly suggest a remedy for agglutination based on your analysis of the report. ### Response: I want to know what problem you have. Are you suffering from infertility? If yes, since when? Did you try any other treatment before? I have seen your report (attachment removed to protect patient identity). It appears fine regarding quantity and motility. Regarding clumping, it can be either because of infection in semen or autoantibodies. Most common is the infection of semen. So, I will ask you to get semen culture and sensitivity test done. If it comes positive, then we will start antibiotics according to culture. If not positive, then we will start empirical antibiotics" "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 slipped on a wet concrete floor from the rain. I fell flat on my back and then hit the parietal bone part of my head. I now have a bump there. I went to the ER and they did a CT scan. It showed no fractures. She checked my knee reflexes. They were good. But I still have pain in the low part of my neck and now my head feels a little numb. My upper and mid-back hurt. Nothing below my mid-back hurts. I feel very stiff. But I am very worried. What is this? What should I do? ### Response: Hello. I do not think there is anything to worry about if the CT brain is normal. This might just be a simple musculoskeletal pain due to local trauma. I suggest you try tablet Emanzen D (Serratiopeptidase) SOS for pain over the head. Take it with an antacid. This will go off in a few 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 20 year old male, who weighs 175 lbs and I am 5.11 feet tall. I had flu-like symptoms last month, which lasted for about three days. And I just had flu-like symptoms again this month. It started three days back, and it is not as severe as the first time. First time I had a fever, chills, headaches, pain and sore throat. The symptoms this month started with a sore throat, then I got a fever of 101 F, followed by a headache and back pain. ### Response: I have gone through your query, and I can understand your concerns. The symptoms you have mentioned are suggestive of pharyngitis (a sore throat) along with a common cold. You do not need to worry regarding this as it is highly curable and complications are rare. I suggest you consult a general practitioner and get the following things 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: Fourteen months ago, my wife went through a C-section delivering a baby girl. After 15 days of surgery, she started feeling lower backache with very local pain in bending, sneezing and coughing. Initially, we thought it is a post-cesarean effect. As she was breastfeeding the baby, she took homeopathic medicines.Afterwards, we consulted an orthopedic as there was no relief of pain. Three months later, we consulted Neuromedicine. With certain blood investigations and an MRI report, they diagnosed it as a Pott's spine in the L4-L5 region.The MRI report said there was an altered T2WI hyperintense and T1WI hypointense signal intensities noted involving the L4 and L5 vertebral bodies with the paradiscal destruction of the L4 vertebral body. A post-contrast study reveals heterogeneous involvement. An irregular peripheral enhancing T2WI hyperintense and T1WI hypointense collection is noted in intraosseous space, prevertebral and paravertebral space extending behind L4 and L5 vertebral level. Small similar collections were noted in the adjacent psoas muscles. Anterior epidural space collection was noted behind L4-L5 level causing spinal canal stenosis. Rest of the vertebrae were normal.Of late, she has started feeling severe pain in her back as well in the right leg. Right now she is feeling difficulty in moving and walking.Can you please prescribe her what to do next? They have started the treatment course and suggested to wear an LS belt. The medications are as follows:R-Cin 500 mg OD,Econex 850/300 OD,Pzide 500 BD,Dolo 650 mg BD,Syrup Dicalciiplex N 1 TS BD. ### Response: Hello. She has Pott\s spine that is tuberculosis of the spine and the treatment duration for this is 18 months. Now, the symptom you have mentioned suggests that she has got severe compression of the nerves of the back aggravated by a jerk. In such scenario, she needs to apply Taylor\s brace on her back to support her back and she may even need rest for a few weeks. In such cases, I also prefer to add up a medicine which helps in reducing the disc edema and that is a tablet Disperzyme (Bromelain, Trypsin, Rutoside). Consult your specialist doctor, discuss with him or her and with their consent take the medicines. Regards." "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 daughter is four months old now. She breastfeeds only. She used to defecate once or twice daily. Sometimes she defecated once in two to three days. Recently she has started defecating four to eight times a day (generally very small amount though) and her feces have become more liquidy. We went to a doctor who suggested some probiotics and told not to worry. She is otherwise healthy and shows no symptoms of any illness. However, we thought to have a second opinion. We did a stool test and I am attaching the recent one. Please suggest if there is anything to be worried about? She is on usual vitamin and Iron supplements. ### Response: Hi. It is normal for babies to have variable stool frequency. Sometimes they pass once or two times in a day, sometimes more. Some babies have exaggerated gastrocolic reflex, it means they pass stool after almost every feed. No need to worry if the stool is not watery and small amount, baby is passing urine, activities are normal, no fever, and gaining weight. No need to give probiotics or other medication. Continue breastfeeding. Maintain hygiene. ? gastrocolic reflex, ? normal variations of stool frequency. none Continue breastfeeding. Maintain hygiene. As per your requirement." "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 trying to find out a specific function of the diaphragm when it comes to taking a deep breath. There seems to be a deep breath one takes similar to when one is at the doctor and they say take a deep breath and then there is a much more satisfying deep breath one can take which seems to fill the upper lungs with much more air. It looks like the diaphragm (upper belly) moves out a little bit when this deep breath happens. Can anyone explain the mechanics of this? Why can this deep breath happen sometimes and not other times? It is as if I could hold a musical note for 3 minutes because their is so much O2 in my lungs. ### Response: Hi. It is an interesting question. Your observation that sometimes you can take a deep breath that is a bit more satisfying than other times makes me a bit more curious as to whether you are in the same posture every time you try it. The diaphragm is a muscle that divides everything in chest from everything in the belly with a few orifices that help get certain things like your food pipe through. It helps to expand the lungs by moving towards the belly while to take a breath in thereby creating more space for the lungs. Since there is a finite potential space, I wonder if you feel the difference based on how much food you have had or what time of day is it. I suggest a more detailed discussion if you can provide some more information." "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 football player and I play wide receiver. Since last week I have been having muscle pain in the inside of my left foot. I cannot fully move my foot up and down. I tried ice and resting but it comes back when I start running. What should I do? ### Response: Hello. From your description, you may have Tibialis posterior tendonitis or plantar fascia strain. Assuming you have not gone over on your foot and sustained no direct trauma. What sort of level do you play football and do you have a team physio or access to a doctor? Ideally, have yourself examined if not I will recommend you to cut down on your sports till the pain goes away completely. Gradually return to your sports and if pain returns consult a doctor and get an MRI scan done. Take antiinflammatory tablets and ice it in the meantime." "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 felt dizzy yesterday so I sat down. After that, I fainted. I do not know what happened. I thought that I am sleeping and someone is trying to wake me up. I know from my friends that while fainting I hit my head. My body was rigid with tilted head back, my eyes rolled back, I was pale and had blue lips. Is that normal? I have fainted twice during my life but never like that. I am taking no medications. I am a female, 26 years old. ### Response: Hello. I read carefully your question and would explain that your symptoms could be related to epilepsy seizures. For this reason, it is important consulting with a neurologist and performing an EEG (electroencephalography) and a brain MRI study. Some blood laboratory tests are necessary too as follows: In the meantime, I would recommend measuring your blood pressure frequently (in order to exclude low blood pressure or orthostatic hypotension)" "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 three years old. He weights 11.6 kilograms. He is given Nemocid for every six months for disinfection. What is the dose of Nemocid for him now? The previous dose was 2.5 ml. If Nemoacid is not suitable, what is the other medicine advised for him? Please help. ### Response: You can continue to give Nemocid (Pyrantel Pamoate) and follow the dose of 2.5 ml for every six months. If he has any other symptoms like anal itching, decreased appetite, and abdominal pain, you can give Nemoacid 2.5 ml twice a week. You can also give Bandy plus. It is Albendazole, and it is a deworming medicine. You should provide 10 ml once in six months at night." "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 are both 18 years old and we were wondering if you could answer some of our questions for school. We are required to consult with a psychiatrist, but we do not have money to consult with any. Our topic is psychopathy and how psychopaths are developed. The questions are as follows.How do you diagnose someone as a psychopath? What kind of therapy is needed to aid the brain condition of a psychopath? Is psychopathy a genetic condition? Are sociopaths and psychopaths developed the same way? What kind of environment is the most likely to form psychopaths? Are psychopaths more self-sufficient compared to an average person? If psychopaths are unable to feel strong emotions, what are their goals or aspirations in life? What are the signs of a psychopath targeting you? Do psychopaths lack the concept of sexuality since they are unable to form deep emotional connections? If a psychopath is able to form a family, what would be the effect on his or her children? ### Response: Hi. I would be happy to help you. What you are referring to as a psychopath is known as antisocial personality disorder in psychiatry. It is diagnosed using certain standard guidelines and criteria. These people show a persistent disregard for laws and the rights of others. Such people do not generally seek professional help unless it is for comorbid problems like substance use or mood disorder or they are in prison and brought by the police. These people have impulsive traits and extreme irritability which can be reduced with the help of psychiatric medication. Therapy may be helpful but more often than not. There is no permanent treatment because many of them do not follow up and majority do not feel there is anything wrong with them. People who have first degree relatives with psychopathy have higher chances of the same but social, economic and cultural factors also play a role. Sociopaths can be best described as a milder form of antisocial personality disorder. Psychopaths are highly intelligent but they lack empathy. So they do not generally have long lasting relationships or gain satisfaction from interpersonal relations." "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 try cabbage juice for my gastritis. Should I be worried about the effects of cabbage on thyroid? ### Response: Hi. Cabbage juice is very effective in gastritis and peptic ulcer. It contains several micronutrients, phytochemical and antioxidants. Sulforaphane is an antioxidant found in cabbage juice which helps to reduce Helicobacter pylori. So you can take it. It does not affect thyroid profile." "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 want to change my yellowish teeth to white. So which paste should I use? ### Response: First, see if the yellow shade is because of the calculus or your teeth shade is yellow. If it is plaque or calculus then you need to go to a dentist and get oral prophylaxis done. If the shade of your enamel is as such then do not bother much because there will be so many shades in enamel and do not try to change that to white. Glizer toothpaste might help you before occasions. But do not use it regularly as this whitening toothpaste contains abrasive agents also which might cause wear of enamel." "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 comparison analysis of two fundus photos to check if they are/are not showing signs of progression. Patient is on Xalatan, Timolol, and Dortas. ### Response: Hello. From the photographs, there seems to be a very slight progression (attachment removed to protect patient identity). But to come to a conclusion based on fundus photographs alone would be incorrect. One of the most accurate ways to judge progression is field analysis done on Humphrey field analyzer. All the known patients with glaucoma need to get their intraocular pressure (IOP) checked every two weeks and their target IOP is maintained then. The fields should be done yearly at least. In conclusion, from the above pictures, there is a very slight increase in the cup-disc ratio but more information is needed to come to a conclusion. Please do get the latest fields done and send it 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 stomach gets upset when I drink milk, orange juice, or even yogurt which is normally good for an upset stomach. I cannot digest banana, corn flakes, and many other foods, and it has been going on for a long time. I have been to many doctors and they had endoscopy and colonoscopy tests but nothing came out bad. Please help. ### Response: I can understand you must be very upset about your condition. So you see the diets you are kind of allergic to are containing milk protein. Yes, there are some diets that contain no milk, but the diet that predispose you to have stomch upset will disturb your stomach as often as one has allergies to almost every diets the person takes. So, I suggest you to cut down your dairy intake. It occurs due to the deficiency of an enzyme called lactase which usually digests the milk. Tablet Lactaid 9000 FU just every time before having a milk-based diet. If you want to discuss more I am here to help. Follow up in one week." "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 depression for over a year (at least symptoms of it), and suicidal thoughts almost as long. It was caused by a high school crush and has caused me to hate myself for everything I do because I am socially awkward and tend to mess everything up. I feel like I am a mess and that I made my crush life difficult at least at first, though memories are haunting me.I cry every day, the only reason I am not dead is that I do not have access to a gun. My question is about what happened today. After school I saw my crush near who have missed the school, and she was with friends, when she saw me she came towards me and as is tradition in my country she kissed me on the cheek which was unexpected and caught me off guard, especially since we have been ignoring each other this whole school year.Whenever I have to interact with people I hate myself after it because I do not know what to say usually, and this case was not different either, but it was worse than that (because it happened in front of her). Anyway, I left kind of awkwardly, and immediately I felt this unbearable stress, I wanted to shout but contained myself in public. Still, I made screaming faces, did that thing where I manually can create pressure inside my head and turn my face red like a tomato.I also sweat a lot, and I clenched my fists (not only), with which I would hit my other hand sometimes. It was like waves, I would feel super stressed at times, and then it would let off just a little. I could not hold back my tears. When I came home, I cried hating myself, looked in the mirror, and flipped off myself, told my reflection that I hated him, and I wished him to die so badly. I have never experienced something like this, at least not as strong as this. What happened to me, and how do I prevent it from happening ever again? Because it was awful. ### Response: I can feel your emotional pain by the way you have described your symptoms. Do not worry, and you can gradually get better with appropriate support. How old are you? Have you discussed with your parents or family about your emotional difficulties? Do you have any close friends? Are they understanding and supportive? Some of your experiences are related to your crush is normal and part of growing up. However, your emotions are sometimes extreme, and you appear to get distressed by these experiences. You report low mood which can decrease your self-confidence, make you feel inappropriately guilty and questions your self-worth. It will get better with support and treatment. It is worrying that you are having suicidal thoughts and struggling on your own. I will strongly recommend discussing with your family so that they can know as well that you are struggling. Do regular physical exercises. It will help to lift your mood and lower your anxiety. Eat regularly, sleep well. Try progressive muscle relaxation exercises and deep breathing exercises to calm yourself. You can consult your family doctor to assess for depression and anxiety. You will benefit from counseling support. Sometimes medication to lift your mood may be 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 snore and wake up tired daily. Sometimes, my nose is runny all day. I have attached my CT report for your reference. I just wanted to know if surgery necessary. Will it benefit me? Please explain. ### Response: Hello. We are happy to help you. Your CT scan (attachment removed to protect patient identity) concludes that you have retention cyst inside both maxillary sinuses and the right frontal sinus. Retention cysts form when fluid collections in the sinuses get covered with a mucus lining. These cysts produce nasal symptoms of obstruction or running nose, which can cause a blocked nose in the night and thus mouth breathing. Mouth has lot of soft tissues (unlike the nose) which vibrate while breathing and produce snoring sound. Yes, you will get benefit from surgery. An endoscopic clearance of the pathological sinuses will remove your nasal symptoms and help you breathe through the nose at all times including at night by avoiding mouth breathing and snoring." "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 young woman and I recently discovered that I am HIV positive after I turned 21. When I told my mother about it, she confessed that she had known since I was 16 and that my father died of AIDS whilst she has been on ART for almost a decade now. They realized my status after I got tested since I was having frequent abscess wounds or boils, almost on a monthly basis but they never told me about it.I am a health student and interact with a lot of health professionals hence my hesitation to seek help to start treatment just in case I meet up with someone I know. However, my major concern is that I have recently been having drowsiness spells and frequent, almost consistent headaches though they are very light. An FBC test done a month ago showed that my Hb and HCT, as well as my neutrophil count, were slightly below normal, and I was advised to go on a month of Saferon tablets which I followed religiously. Recent full blood tests showed that my RBC, Hb, HCT, MCV, and MCH values were all now slightly below normal whilst all my WBC were within the normal range. The Hb and HCT went lower than the initial test.Therefore, my questions are, might this be related to my HIV positive status and how so? Also if it is, why is it that my white blood cells are not affected? I am mostly curious about whether such an instance as mine is quite common where a patient is born with HIV and lives an otherwise normal livelihood though with more frequent infections that go away after some time?I really do hope to hear from you. I am now 22 and have accepted my condition and forgiven my parents. I am trying to, however, get as much information and understanding about my condition hence contacting you. ### Response: Hi. This could be related to HIV. WBC (white blood cells) count is not generally affected, it is lymphocyte count which gradually depletes" "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 periods on 30th of last month. I do not really know when my ovulation is because I have irregular menses and I am trying to conceive. ### Response: It is a really short description of your query. In an irregular cycle, it seems around 30 to 35 days better to have sex on alternate days on expected days of ovulation. It is better to have combined oral contraceptive pills for three months to regulate your cycle and then try. Have a balanced diet and BMI with exercise daily. Lots of fruits and vegetables and try to have complete check and treatment of any health issue you and husband have. If the cycle is of regular 28 days, then the fertile period is from day 9 to day 13 to have a continuous sex but in an irregular prolonged cycle, have sex on alternate days on suspected ovulatory days like from day 9 to day 20 of your cycle roughly on alternate nights. Have Folic acid. Cocp for three months if can wait otherwise have sex on alternate nights as advised. Normal weight and BMI, Folic acid, exercise daily, diet." "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 did a shave last week and hurt myself pretty badly. Now, I have this bump and it has been a week. I have been using Neosporin, Advil, Claritin, and hot baths. What is this? ### Response: Hello. I have seen the pictures that you attached (attachment removed to protect patient identity). Based on the description you mentioned, it looks like a folliculitis (hair follicle inflammation) or a razor bump. But you mentioned in the picture that a similar lesion was present since a week even before you shaved the area. So I would like to know if you have been having it before, and does it have any intense itching with tingling or pain? Or did you have any fever a few days prior to developing these bumps? If you are a sexually active individual, I would like to know if you had genital herpes anytime before, or if your partner has had genital herpes infection ever? I am enquiring all these because another possibility could be genital herpes. Tablet Paracetamol or Diclofenac for pain relief." "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 bad sinus problem. So, I use a neti pot. Yesterday, my boyfriend was drinking out of a water bottle and I used it for my neti pot because I ran out of the water, unopened bottles. Am I in any type of danger? ### Response: Hello. Not to worry much, although there is a risk of upper respiratory tract infection with such water usage. But, the body usually takes care of it, and even if you develop an infection, then it is manageable. So do not worry about 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: I have noticed that sometimes I can see two or one spinning wheel or fan type thing in my side vision. Suddenly it comes and goes on its own. What can it be? I am scared about retinal detachment. Last I got my retina tested 1.5 years ago and it was fine. ### Response: These things are floaters. They happen due to changes in the vitreous which is jelly like thing in front of retina. If you are seeing now and then, just ignore it. If there is an increase in number of floaters and if you start seeing flashes then consult an Ophthalmologist immediately. For now once yearly regular checkup is enough." "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 final year medical student. I am suffering from mild to moderate acne for three months. Acne is on my cheeks and chin, and it is papule, pustules, and scars. I am using tea tree oil and BioFade for three weeks but no effect. One doctor prescribed Isotretinoin, but I have not used it because of the side effects. Kindly tell me the effective treatment for this. ### Response: Hello. You mentioned that your acne started only three months ago. Hence there could be triggering factors like stress (you said). In your case, you should try and avoid stress. Stress sometimes leads to harmonal disturbances, which in turn cause acne. If you do not want to use Isotretinoin, you may use Adapalene or Salicylic Acid ointments, which also give effective results. Even before going into the sun, you can use a good sunscreen with Spf 50. Before going to sleep, wash your face and apply a gentle moisturizer with vitamin E. This should help. If you have more questions, please get back to me with a picture." "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 bacterial infection in my gums because of my wisdom teeth coming in. I have taken Clindamycin and Motrin but it does not work. ### Response: Gum infection can be due to a number of reasons like tooth infection or cavity, abscess, etc. If Clindamycin is not working, I suggest taking Amoxicillin 500 mg twice daily for five days. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Along with this, start with some warm saline gargles at least five to six times a day for a week. 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 widower for the last 16 years. At this age, my sex drive is high and being a widower I have no option but to masturbate whenever aroused. However, of late my foreskin turns sore more so after masturbation. Normally, on erection foreskin retracts automatically but in my case, I have to retract the foreskin manually without pain. Presently, due to soreness of the foreskin, retracting manually is slightly painful. Though a diabetic person, sugar is under control with medication. Please suggest some medicines or ointment for an application. ### Response: I went through your post. You seem to have balanitis which means an inflammation of the glans especially the foreskin part. You need to wash the area in the morning and evening with lukewarm water. Apply Candid cream morning and evening for two weeks. I suggest you start capsule Doxycycline 100 mg in morning and evening for 19 days and tablet Fluconazole 150 mg once daily for three days. Consult your specialist doctor, discuss with him or her and with their consent take the medicines" "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 always having stomach pain. Every Sunday my stool is extremely messy. But, it happens only on Sunday? What is the reason? I admit that I do not eat right. But, why is it always on the same day? Currently, I am on anti-anxiety medication. Please help. ### Response: Hi. I understood that you have constant mild stomach pain and your stool is messy on Sundays. Revert back after 15 days 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: I had pulpectomy on a lower left tooth two days ago. I am still in pain and the outside of my chin and lower lip is still numb. The dentist told me I would not be in any pain after the procedure, but it is still hurting. I had Ibuprofen 200 mg four times a day. Is this normal to have numbness and to have pain in the tooth? ### Response: As I see this, there are two issues here. Firstly, the pain in your lower left tooth could be due to a couple of reasons. Whenever there is infection of the pulp, the infection spreads beyond the tip of the tooth; it extrudes the tooth out of its socket within the jaw. When this happens the tooth is painful especially when it touches the opposing upper tooth. The other reason for tooth pain could be that the entire infected pulp was not removed. Either way, you need to go back to your dentist. The second issue here is the numbness of your chin and lower lip. This usually happens when the nerve in the lower jaw gets nicked by the needle while giving the local anesthetic. If the damage is minor, the nerve repairs itself and the normal sensation will return. If numbness persists after two to three months, then you need to consult your doctor." "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 had unprotected sex with me last night and it was her seventh day of the period. So should I give her Unwanted 72 or is there any chance of getting pregnant and can you tell me the side effects which she will face after taking Unwanted 72? ### Response: Hi. If she has short irregular cycles of 28 days or less, then it is better to have Ipill as in regular cycles of 28 days there is a fertile period from day 8 to day 13. So, better to have I-pill within 48 to 72 hours post-sex without vomitings. She can have 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 had unprotected sex with a sex worker five months back. After that every month I have taken CMIA fourth generation test. After almost 100 days, I took WB test. Then today I took again CMIA test. It is all negative but every month the index values are getting increased from 0.10 to now 0.24. since today it is 110 days over after post exposure. Now I did not do any sexual activity to date. So please confirm me whether I need to wait for six months or it is conclusive of HIV negative? Nowadays I am getting headaches and dry lips. I have also had sinusitis issue. ### Response: Hi. The HIV tests are repeatedly negative and after three months exposure. It is conclusive. You are free from HIV. There is no need for further HIV tests.The symptoms are non-specific and are not related to HIV" "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 identify the buckle fracture location in my son\s X-ray? Please see the attached files. I am interested in understanding the location and severity of the buckle fracture. ### Response: Your attending doctors may have already informed you that buckle fractures are not of any severity. This is because the bones of the child are pliable enough so that the bone saves itself by buckling rather than breaking altogether. Treatment is quite simple and straightforward. Most cases recover satisfactorily with only immobilization and on-demand painkillers. Regarding the location of the buckle, I should quite honestly say that I do not see it. Indeed, pediatric fractures in general, and buckle fractures, in particular, are often quite subtle and may be detected only by a super specialized and experienced pediatric radiologist. However, this is, in a sense, good news for you, given the fact that a subtle buckle fracture would heal more completely and rapidly than an obvious one." "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 take on a daily basic- 100 mg Ixel, 60 mg Paxet, 0.5 mg Clonazapem. My psychiatrist told me to take 5 mg of Zyprexa in cases of SOS. I do not have any psychotic symptoms. He told me it was meant to knock me down, so I could have relief from stress and I could sleep. I took this pill (first time ever) and I slept for 20 hours (I was awake for one hour in between). Then I was awake for three hours feeling really bad, dizzy, spaced out, tired. Then I slept for another nine hours. I still felt bad and restless for a day, but slowly I got less tired and more alert. I guess it is not normal. It was even quite scary. In the meanwhile, should I avoid this pill or maybe reduce it? ### Response: I can understand your problem. Olanzapine in low dose has great efficacy in depressive symptoms, anxiety disorders and in resistant depression symptoms. The" "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 baby is 2 years old and weighs about 11.7 kg. Baby is frequently passing green stools with blood spots and mucus. We gave Metronidazole and Norfloxacin, Reflora-R, Biz-Pro, Zinconia for the last four days. But there is no relief. Please help. ### Response: Hello. This is dysentery by history. 1) It will take some more time to bring the symptoms down. 2) You can go for a stool culture to find out the organism responsible for it. That would give useful information as to which medicines would be effective. 3) Look for an alternative diagnosis, but get an ultrasound abdomen to look for any obstruction or problem to the intestines. It is important to rule out this important condition which will change the management completely. The medicines which have been prescribed are good and apt, but sometimes it is a matter of time. Give him adequate fluids." "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 tray five of my Invisalign. Everything has been good so far. But, yesterday, the teeth in the bottom of my mouth started to turn brown. I am worried that something is wrong. I clean my teeth three times a day after every meal. I also clean the aligners. I will attach good pictures. ### Response: Hi. I have seen the pictures you have attached along with the complaint (attachment removed to protect patient identity). 1. Coffee or tea stains.2. Smoking.3. Improper oral hygiene. Generalized marginal gingivitis with external stains. Scaling and oral hygiene instructions. Inculcate the habit of brushing certain parts of the teeth surfaces in particular. Revert after six months to 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 forced stool and fart at the same time and that caused some pain in my anus. Thereafter, there were some drops of blood when I passed stool. My stool was slightly covered in blood too. I cleansed my anus with water and wiped it. Then, there was no sign of blood. ### Response: From what you mentioned, you have an anal fissure which is a cut injury in the anal canal. Most commonly due to constipation and hard stools. They cause severe pain during and after bowel motion (may last for hours). If not treated appropriately, it could become chronic with recurrent pain and bleeding in the future. My advice would be to treat constipation with laxatives and stool softners and local GTN (Nitroglycerin) will be helpful. The other possible cause is bleeding piles." "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 29 year old fiancee has very less sex drive. Please suggest a remedy. ### Response: Hello. I went through your query. Let me mention few important causes: A proper approach and foreplay may resolve the issue. Regards." "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: Hope you are doing fine. May I come back to you with the following query? It relates to my son who consulted with a medical doctor in our place over here with a diarrheal syndrome. He suffers from diarrhea after having certain types of meals, as also when he drinks a glass of wine or beer. Attached to this message, you will find his recent lab test results. His liver values seem to be disturbed. Best wishes to you. ### Response: Hello. I read your query and can understand you are worried about your son\s health. Hope it helps. If you need further assistance, please feel free to ask me. I will be happy to assist." "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 is losing protein in the urine. The result is ++. She usually remains tired and also has pain in some part of the body like back pain or head pain. She also has a lot of black pigmentation marks on her body. Is pigmentation marks cause any serious problem? Can you please tell me its side effects? And what are the issues we can face in future due to this problem? And does it have any treatment? Because already one doctor has told us that there is no treatment for this problem and my wife will get ill sooner due to protein loss, and there is also 20 % chances of kidney failure in the future. Is it true? ### Response: Blood pressure, blood albumin level, and random blood sugar should be measured. Her urine test shows some pus cells (attachment removed to protect patient identity). I suggest using antibiotics like Bactrim (Sulfamethoxazole and Trimethoprim) for five days. Is there any history of respiratory infection in the last three weeks? Sometimes we may need to take a sample from the kidney to find out the exact 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 am 27 years old and it has been four years since I have had hemorrhoid and a year later I could not even sit for five seconds. ### Response: Hello. I am sorry for the problems you are having with hemorrhoids. They are really fastidious. But, in your case, they ended to cause you problems with sitting now. So, this makes me think they are huge. As this has been going on for four years now, I think it is time you should see a proctologist (surgeon specialized in hemorrhoids). I think you need surgical treatment. Keep good local hygiene. Can sit on warm water for 15 minutes (also called sitz baths) several times a day especially after having a bowel movement. Apply hemorrhoid cream (Prep H: Phenylephrine) locally several times a day, especially after having a bowel movement. Take plenty of fiber, water, and laxatives to prevent constipation (ease bowel movement). Can apply aloe vera directly to hemorrhoids. However, I still think you should get further checked by a proctologist." "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 penis tip is swollen and skin is also looking different. It happened three months back. I consulted a urologist, skin specialist also, it has not reduced. I did not have any bad habits and not have any illegal relation, unmarried. Please help me. Sometimes near the tip, there is burning, irritatation and it is reducing. ### Response: You seem to be suffering from balanitis. There are various causes for balanitis which include yeast infection (the most common cause), bacterial infections, viral infection, sexually transmitted infections, skin irritation, and allergy. I would suggest you consult a physician. You may need a short course of antibiotics." "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 pain in my right wrist for a week now. But these past three days, my fingers and hand have been numb and it is getting worse and worse. Please help. ### Response: The pain is in the palmar aspect of your wrist or on the dorsal aspect? Was there any history of fall ,fracture before this and was there a huge swelling? There is a possibility that swelling lead to compression of the nerves that passes through the wrist to supply your fingers leading to severe pain and subsequently numbness. Can you still move the fingers? You need to do an X-ray of the hand and then see an orthopedic surgeon let them check you thoroughly." "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 skin on my legs feels dry after washing. I need to apply lotion immediately after I wash. However, after about an hour the skin feels tight and dry again. Is this dry or dehydrated skin? I am using Aveeno, could this be causing it? In the forearm, back of neck and underarms I have the same problem. They hurt at times. I am afraid that my skin or skin barrier is damaged. Please help. ### Response: Hello. I have read about your query. Since you are on moisturizer Aveeno, you can continue it with the following tips." "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 few doubts regarding fertilization and implantation. Is it possible to have implantation bleeding after your period? Is it possible to get an egg fertilized a week before your period? Also, how long does sperm last outside of the body? Is it true that once the ejaculate has dried, so has the sperm? ### Response: Hi. Implantation bleeding occurs only after 15 to 20 days of the period. From day 1 to day 10, it is safe period. There is no chance of pregnancy as there is no ovulation happening during this period." "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 27-year-old obese woman with venous pulsatile tinnitus in my left ear. I have no history of high blood pressure or diabetes. I have been overweight for about five years and was a normal weight before. I am being treated for OCD, ADD, and depression. I take 150 mg Sertraline, 20 mg Amphetamine salts, and 50 mg Trazodone. I am also on Loestrin 24 Fe birth control.I have been having some headaches (two times per week, mild pain) that occasionally improve with caffeine but no other symptoms. Would losing weight be the best first step to take before visiting a neurologist? ### Response: Regarding your concern, I would explain that this feeling could be related to an inner ear disorder. Your blood lab tests show increased white blood cell count suggestive of an infection. Anemia is also present. That is why I recommend taking iron supplements. A brain MRI is also necessary to exclude possible vascular malformation of the brain. It is also essential for checking thyroid hormone levels. I hope you will find this answer helpful." "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 and my partner went through an HIV 1 and 2 test five months back. Both of us tested negative. This month we had unprotected sex. I did not have sex in between and upon asking my partner, he too said that he had no sex with anyone else. He does not do any drugs and stays with parents. However, I panicked and went to the doctor and insisted upon PEP. Four days back, my partner went through a CMIA test and was negative (0.27). I think he is clean. However, I am still scared. In this situation, do you think I might be in HIV risk? Please guide. ### Response: I have reviewed your query and here is my advise. Your partner is HIV negative with CMIA (chemiluminescent microparticle immunoassay) test. But this test can effectively exclude HIV after six weeks of exposure. Mostly your partner might be right and if you believe him then do not worry about HIV. But if you have a doubt regarding any form of exposure, then again after six weeks, a repeat test is needed. As per my opinion, although a chance of HIV is less, you should get investigated with HIV after six weeks of exposure to effectively rule out HIV. (By CMIA or fourth generation ELISA test)." "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 a 600 cc breast implant the same as a 500 cc implant filled to 600 cc? Is a 500 cc implant filled to 600 cc considered extremely large with more chance of rupture? Is going from A cup to C cup (350 cc) then going from C cup to possible D cup (500 cc filled to 600 cc) that big of a difference? ### Response: Hello. I can understand your confusions. Let me tell you one thing. The implants are usually measured by three things, the volume, the base diameter and the height (profile). So the implants chosen will be on the basis of all the three criteria. An implant of 500 cc will have the capacity to be filled almost up to twice its volume (1000 cc) without being ruptured. It depends upon the surgeon that what volume will be good in your case. Again the material and shape of the implant determine the distribution of the additional fill. That all will be pre-decided by your surgeon. Going from A to C and then to D is not that much of a difference provided you do have that much skin to accommodate. If not, then the doctor might suggest a few months interval in between for the skin to stretch" "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 8-year-old son. Recently, I came home from work and found him wanking in the living room. He saw me standing there, and he was not embarrassed that I caught him. He continued to do it, so I walked away and left him wanking. I have not spoken to him about that on that day. Since from that day he has been wanking in front of me. I do not care if he does it in front of me and he does not bother me. Should I let him continue with this behavior or is it wrong and should I need to speak to him about it? ### Response: If he is wanking most of the days, in front of you, I do not think this is a healthy child behavior. Your son may or may not understand that it is unusual behavior for his age. A lot of stressors can be a cause for the abnormal action of a child. Try to find out the cause. Yes, you should talk to him more positively. So you will be aware of what is going on in his mind. You can seek an expert opinion as well, clinical psychologist or pediatric psychiatrist for counseling as well as a therapeutic intervention if needed. Behavioral remodeling will help" "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 facing ear pain since yesterday. My right ear alone is paining. When I tried cleaning with a earbud, the bud came out with a black colored deposit. What do I do? ### Response: Hi. After considering the facts of your query, it appears like you are suffering from either of these. Treatment is different in both the above situations. I suggest taking Paracetamol 500 mg for pain relief. The above conditions have to be confirmed to start with the treatment." "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 33-year-old male, Hispanic, non-smoker, exercise regularly. No significant health issues. I am 1.76 m and 68 kg. For three days, I had really bad pain on a wisdom tooth (lower right) that has erupted years ago but never really gave any problems. But this was bad, really bad. I was waking up with fever and heartbeat rate of 90 to 95 whereas I am usually 55 to 60.I went to the dentist, he cleaned the area, took an X-ray and gave me Amoxicillin and Clavulanate Potassium tablets (875 mg and 125 mg, respectively) twice a day for five days plus Paracetamol or Ibuprofen for the pain. I think he referred to this as pericoronitis. This is my fourth day of treatment and the area is a lot less swollen and tooth pain has pretty much gone. However, the part that has me worried is that I am still waking up with fever and a very fast heartbeat plus throbbing headaches. Is this normal? ### Response: Hi. I have gone through your question. I can understand your concern. Yes, as per your signs and symptoms it looks like pericoronitis. I think the treatment he or she has started is not the ideal one. After five days of treatment, I think it should have been gone. If you can upload a picture of your X-ray and teeth involved in the mouth, I can provide you with a better treatment plan. Because periodontitis is infected by anaerobic bacteria and will not respond to Amoxiclav (Amoxicillin and Clavulanic acid) that effectively. For that, I need to know if you have any" "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 I get a filling fixed while running a low-grade fever from a UTI? ### Response: Theoretically, yes. If it is an emergency or you do not have accompanying stuffed nose or difficulty in breathing through the nose, then you can go for filling. Depends on your comfort level and severity of your condition. I hope this has helped." "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 done all thyroid tests and worried about the results.TSH is high at 4.56 milli international units per liter and thyroglobulin antibodies were high 2.8 IU/mL. TOP, T3, and T4 were normal; TPO 14 IU/mL and T4 free 0.95ng/dl. I am having throat pain and I feel like my glands are swollen, along with extreme tiredness. Could this be Hashimoto\s disease or cancer? I am really worried. ### Response: Hello. Antithyroglobulin antibody can be positive in autoimmune thyroid problem. So, it can be a positive result to have hashimoto\s thyroiditis and grave\s disease. But, your thyroid hormone level is within range and TSH (thyroid stimulating hormone) not much elevated. So, clinical correlation is necessary with thyroid palpation and USG (ultrasound) scan. Your throat pain can be due to thyroid inflammation or from posterior pharynx infection that is pharyngitis. In such inflammation, glands can be enlarged as generalized infection. Your physical examination and posterior pharynx examination should be done. An analgesic or an antibiotic if needed can be prescribed. If glands get enlarged persistently, then FNAC (fine needle aspiration cytology) can be done for further diagnosis. Do not think of malignancy. Consult otorhinolaryngologist for 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: I have got a headache, body pain, unwell feeling in the stomach, fatigue, mild fever which is coming and going for five days. I had got typhoid fever two years ago. Currently, I have taken three pills of Ciprofloxacin 500 mg. What should I do? ### Response: It seems you are having a viral fever. I suggest you take tablet Dolo (Paracetamol) 650 mg thrice daily for three days. You can also take a combination of Pantoprazole and Domperidone once daily for three days. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. There is no relationship with typhoid you had previously" "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 on a low dose of Seroquel, which suppressed my thyroid FT4 and, subsequently, my FT3 during these three years of recovery from Hashimoto's disease. I have stopped Seroquel, and my exogenous administration of testosterone is reduced to half from 700 to 387. Do Seroquel increases the prolactin levels? My sugar levels drop quickly after meals, and I have low genetic TBG. If I increase my exogenous testosterone back to the previous level, will my TT3 level get lowered?I am on Propranolol and my last Seroquel dose of 25 mg. It was affecting my eye sight, so I stopped it, and my FT4 was always low after Hashimoto's recovery. ### Response: Hello. I understood your question, and the answer is: An increase in testosterone dosage will not suppress T3 (triiodothyronine) levels. It will take some time to recover from the consequences due to the long term administration of Seroquel (Quetiapine). Propranolol can cause low testosterone levels, so no point in artificially increasing the testosterone." "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: Dear Doctor,I am a chronic High BP patient since 1998. Taking medications Amlodipine 5mg and Atenolol 50mg (AMLO Press-AT). Now the BP reading shows as 160/120.How to lower the blood pressure? ### Response: Since you are a case of chronic hypertension, you must regularly get your blood pressure checked from a local doctor and the dose needs to be adjusted accordingly either to increase or decrease. Investigations:- Routine investigations must be done including blood sugar, blood urea, serum creatinine, lipid profile, urine complete and ECG. I understand from your query that, you have been taking the same medicine and the same dose, and still the BP has not come down as 160/120 is a very high range and can be risky for your health. The dose and may be the medicine also needs to be adjusted after reviewing your overall health, monitoring your BP for a few days. If you can make a chart of your BP from time to time, day wise to know when and at what time does it increase to manage it properly. Also, take below mentioned precautions: Diet control is very important. Cut down on fats. Reduce the salt intake in your diet. Do not sprinkle additional salt from the top on food. Take plenty of fresh fruits and juices. (I assume that otherwise your health is completely normal and you are not suffering from any other medical or surgical conditions) Take salads. You must go for walk in the morning and evening as your health permits, brisk walking which can be done gradually as per the age and health. Avoid excessive tea, coffee. Avoid fried foods. Take a basic healthy balanced, nutritional diet. Add sprouts and other variants to make your diet healthy. Please get back with the reports to a cardiologist online so that the medicine and dose can be adjusted accordingly" "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 experiencing mild to moderate pressure from the bottom of my right bum cheek to the middle of my leg and I cannot seem to put pressure on my right leg at all. Could you tell me what this is or could be? I am taking 50 mg of Sertraline for anxiety, Thiamine twice a day and various other Vitamins. I cannot run, stretch, move in bed, straighten the leg fully, bend downwards, touch my toes or do practically anything without there being a distressing pain from the hamstring (the top of it). ### Response: I read your concern. I would like to know if you ever had back pain or had a fall on your back. In my opinion, you should work a bit on back stability and core stability. I would like to recommend you to get a thorough investigation like an MRI lower back and hip, which will help you to exactly locate the source of symptoms as sometimes disc irritation and facet issues can produce similar symptoms. I recommend you to keep icing frequently. Stretch gently. Do stability exercises. Revert back to me with full details of your problem" "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 53-year-old male with no previous medical history. For the past two years, I observed my semen to be slightly pinkish in color (now I realized it was due to traces of blood) but I did not pay much attention. Since the last two to three months, I have been seeing blood in my ejaculate specifically if I have sex or masturbate on consecutive days (the second day the amount of blood and redness is much more). If I give a gap of 15-20 days then on the first day I do not see any blood but on the second day, it is quite distinct.I do not feel any sort of pain during or after sex or while masturbation. I do not pass blood in the urine. I do not feel any burning or itching sensation while ejaculating or urinating. I have had no injury in my pelvic area or to my testicles. I do not suffer from diabetes or hypertension. I have been having sex and masturbation two to three times a month. Recently I took Levofloxin 500 OD for six days thinking if it was due to a urinary infection the antibiotic might help but it has not helped. So far I have not consulted any clinician on the subject. ### Response: Hello. The condition you described is known as hematospermia which means blood in semen. Although, it is considered a benign symptom in men but if for any person above 40 years of age the possibility of carcinoma should be ruled out. In two-third of the cases, no cause is found and treatment is not indicated. In many of the cases there is no intervention required but with increasing age chance of prostate tumor are high. I request you to visit a urologist as soon as possible. The purpose of visiting urologist is to rule out the possibility of prostate malignancy. The other common cause of this condition is a sexually transmitted disease. You did not describe anything else in association with blood in semen, so the possibility is very low. In case, if you have any sexual exposure to some unknown or commercial sex worker in the recent past or you are having other symptoms of sexually transmitted disease it is wise to get physician consultation. 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: My son is 2.8 years old, sometimes he is blinking eyes often, the first incident occurred two weeks back, and today he is doing that, what might be the reason? ### Response: I understand the situation you are facing with your child. If your child also has any other associated symptoms like not attentive while playing or in playschool, losing awareness of the surroundings, then it could be one of the types of fits. In such a situation, consult a nearby pediatrician neurologist for further evaluation and management." "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 is suffering from a low platelet count due to leukemia. Can I donate platelets to my father? Someone at blood bank told me that son\s platelet will not increase the count to a parent. I am in search of a donor for my father. ### Response: Platelet count is reduced in leukemia because the cells in the bone marrow produce platelets known as megakaryocytes that are replaced by the leukemic cells. If your father is receiving chemotherapy then also all the blood counts including platelets will be reduced. Your oncologist will give platelet and packed cell transfusions when required. Platelets, unlike other blood cells, need not be crossmatched or typed. So platelets from any individual can be given to any individual. It is not necessary for the donor and the recipient to be related" "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: One month ago, I had a pimple on my cheek. I scratched it due to itching. And after it almost started to harden I again scratched it. Now it has become an outgrowth like structure and looking bad after shaving. Kindly give a suitable medication for this. ### Response: Although the photograph (attachment removed to protect patient identity) is not clear enough to distinguish from a wart or keloid, from your history it seems to be a keloid from a pimple you scratched. The prognosis of the keloid is often unpredictable, but quite often they will subside itself over a few months. There are certain treatment options for keloid although none are perfectively effective. This includes injection of steroids in the keloid or laser therapy. Avoid scratching and picking of pimples to prevent further keloid formation. If it does not cause many problems you can wait for a few months, most probably it will subside itself. Otherwise, you can consult a nearby dermatologist for the treatment options mentioned above. No topical cream is effective for this case" "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 noticed this on the side of my husband. It is only on the left side. He does have a geographic tongue but has never had a flare on that side at all. He has been chewing sunflower seeds like crazy due to softball season going on. He does not have aids or any immune system issues. He tried to brush it off but it did not come off. It came on suddenly. It was not there a month ago. ### Response: Hello. It is just slight inflammatory reaction of tongue epithelium. Nothing to be worried about. It changes according to diet and will become normal in few days or week" "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 30 years old. I am facing delayed menstruation cycles. It has been 15 years. At the beginning I consulted gynecologists. They did ultrasound and there was no cyst. Doctors said it was because of hormones. They prescribed Progesterone tablets for 5 days. My periods are not regular. It varies from 30-45 days. Sometimes 55 days. In last 15 years, around 4-5 times, it occurs after 60 days. This time it skipped two cycles. Sometimes I feel pain in legs or back, vaginal secretion without any odor. It has been 20 days or so that my face is full of pimples (even my face is not oily). There is no extra hair growth on my face. I am sexually inactive. ### Response: The irregular bleeding is also associated with acne and hair growth. Have you performed a hormonal 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: My daughter is 13 years old. She is having moderate to severe stomach pain for a year. We thought that it was related to constipation. After a few weeks, my daughter started to have a headache, feeling of dizziness, and shortness of breath. She had a habit of eating ice all the time. Her stomach pain got increased day by day. I took her to an urgent care. They did an iron deficiency panel. Can it be an iron deficiency anemia? Can I give her an iron supplement? Does her body is unable to convert iron to ferritin? Please help. ### Response: I have gone through the attached blood test results (attachment removed to protect patient identity). Your daughter\s serum ferritin is low which reflects the low iron stores. Her hemoglobin is low. Her low ferritin levels support it. Her TIBC (total iron binding capacity) is high, and it is commonly seen in iron deficiency anemia. But her serum iron levels are not consistent with iron deficiency anemia. Her transferrin saturation of 66 % suggests an iron overload. A transferrin saturation of less than 20 % indicates iron deficiency, while transferrin saturation of more than 50 % suggests iron overload. Higher transferrin saturation values are found in high iron status, such as megaloblastic anemia, sideroblastic anemia, and iron overload status. She needs a detailed hematological workup, and she should avoid taking iron pills. You are correct in your thinking. Her iron is being absorbed, but it is not adequately processed and utilized by the body. The underlying cause is needed to be determined soon and treated accordingly." "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 my upper left and bottom right wisdom teeth extracted 15 days back and ever since have been experiencing the worst jaw pain. I am barely able to open it most of the time with the exception of a few hours when the pain dulls down. Once it becomes intense again, it starts from my jaw and shoots up my entire face passing behind my ear and ending right behind my left eye. I know some pain is to be expected post op but is it normal to feel this way almost two weeks later? ### Response: No, it is not common to have pain till now. Go back to your dentist as soon as possible. Use warm salt water gargle twice a day for a week or two. Exercise your jaw to open as much as possible so that dentist can get a look in. You need to start antibiotics like Augmentin (Amoxicillin and Clavulanic acid) along with a painkiller for week or two. So get a prescription from your dentist." "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-in-law has hiccups since the last three years. He recently got an endoscopy done, the reports of which I am attaching here. Also, he has tried a few medications, but still he is not getting better. When I researched online about his condition, it says as chronic hiccups. So, I need to know what would be the correct treatment. Can you please help me cure him? He currently takes Ativan 1 mg for his heart. ### Response: I have gone through your query as well as the reports (attachment removed to protect patient identity). Regards" "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 grandmother is having dizziness, vomiting and headache. These problems occur constantly with a gap of five to six months. ### Response: Hello. From the symptoms that you mentioned it seems your grand mother has migraine which reccurs when she is either exposed to the allergen, which triggers her migraine, or it can also manifest as a seasonal change. How long has she has been having this problem? During her migraine episodes, how long does it last? I will recommend the following medicines :- 1) Tablet Crocin pain relief one tablet twice daily after food. 2) Tablet Ondem (Ondansetron) 4 mg, if there is severe nausea two tablets can be taken at once. Make sure her BP (blood pressure) is under control. If possible get it monitored. Ask her to avoid caffeine. 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: Can I start bodybuilding at the age of 18? Will this stop me from growing tall? ### Response: I advise you to start sports first and after a year or so, you can start going to the gym. This is because men grow in height till 20 years and after that, the growth stops. Until then, be inclined towards sports like basketball, jogging, running, bar pull-ups till 20 years of age. All the above-mentioned sports will help you increase your height. They also give you a muscular body." "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 the window period for HIV more extended when the symptoms of acute infection take a long time to show? I was tested for HIV by rapid test at 10 and 15 weeks after exposure (both negative), but have symptoms by week 9, and worse symptoms by the 13th week. Can I be calm with these results? ### Response: Hello. The symptoms of acute HIV infection appear relatively for a short duration and resolve within a few days. These can appear anywhere around two to six weeks. Your signs at nine weeks could be a coincidental finding, and there could be numerous causes for the symptoms. The tests performed these days for HIV are highly sensitive and specific and gives accurate results. Majority of the people who are infected with HIV develop antibodies by two to eight weeks. The literature says approximately\x80\x8b 5 % develop by three months. With your negative HIV rapid test at 10 and 15 weeks after exposure, you can surely relax and calm. However, there are recommendations, and I also suggest to my patients to repeat the HIV test at six months of high-risk exposure. I hope your query is answered, but if you still have any other question, please revert." "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: Yesterday, I got my ECG done. It shows sinus rhythm, abnormal left axis deviation, left anterior fascicular block. I am worried. I have long-term anxiety about heart. I am a smoker but not alcoholic. I always have a fear of heart disease. Kindly advice. My BP is 110/70 mmHg, triglycerides is 144 mg/dl and fasting blood sugar is 84 mg/dl. ### Response: Left anterior fascicular block is always associated with left axis deviation and caused by either hypertension, myocardial infarction or idiopathic fibrosis. This block means that the pathway of electricity of the heart in the left ventricle is blocked which may or may not affect the pumping function of the heart. I suggest that you perform echocardiography to identify the cause and the general function of the heart. Do not smoke as it may cause myocardial infarctions in the future" "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: The tooth has become black and feeling sensitivity while chewing and when having some cold and sweet feeling like it is due to the cavity. Can I reduce it naturally? ### Response: Hi. I had gone through your question and I can understand your concern. As per your history, it looks that you are having reversible pulpitis, that means there is a cavity in progression. If you will get it filled, sensitivity will go and there will be no further decay. If you left it as it may lead to your infection, then you have to get it root canaled or extracted. You can use desensitizing toothpaste but this is temporary. You can also avoid it by not taking hot or cold or sweet food but all these are temporary provision. My opinion is to visit a dentist and get it filled as soon as possible." "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 10 years 5 months old and is gaining weight. I feel it is more than normal. Thyroid test has been done. He is fully healthy and has food normally. ### Response: Hi. I understand all your concerns. I have checked the attached report (attachment removed to protect patient identity). The values point to the state of hypothyroidism. Please revise with me if he has any symptoms like cold intolerance, constipation, low heartbeats or over sleepiness. In case of confirmed diagnosis of hypothyroidism, hormone replacement is required in order to control the symptoms. Wish him all well-being." "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 29-years-old, male, married, suffering from slight penile itching and burning in the pipe (through which we urinate) at almost the end of the penis and some times little penile discharge with no color and smell, please suggest me the prescription. ### Response: The cause of your problem can mostly be due to three common reasons, 1. Infection of urine, for confirmation of which you have to do urine routine microscopic test. 2. Urethritis, which is sexually transmitted diseases, as you are married, there is a possibility, if it is due to this, it will cure by Azithromycin you are taking. 3. Any small stone passing through urethra? I suggest you can take Azithromycin for three days. If then also not cured then do a urine routine and also get a physical examination done by a urologist nearby to see for any other causes." "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's age is 80+ and she had heart attack four times. Two attacks in quick succession a year back and two attacks quick in last one month. Her heart pumping capacity is about 35 % with kidney creatinine 3.4 mg/dl. But it is decreasing now. She never had diabetes. But always when admitted to hospital for heart attack treatment, her sugar level increased a bit and hospital always started giving her Insulin. Last one and half year her cardiologist never advised her to go under any aggressive treatment like doing angiogram and then further treatment like angioplasty and ect.If we go for angiogram followed by further treatment like angioplasty and ring fixing. Will it be safe for her? Will she be able to survive? Traditional angiogram or CT angiogram and then angioplasty or ring. ### Response: Hi. Although bypass or angioplasty can be done in old age, if the health of patient is promising, but if other health issues are present then it becomes a high risk case. As your mother\s kidney function is poor, it becomes very risky to have an angiogram done because even non-ionic contrast medium is detrimental for the kidneys. One possibility is that have her 1 or 2 sessions of dialysis done first, then go for angiography and angioplasty and again have one or more sessions of dialysis in close liaison with good nephrologist. If this is done safely, then next risk is of bleeding. After angioplasty, blood thinning medicines are given for long time, this may cause bleeding problem in old age. Regarding bypass, it is a major surgery and needs general anesthesia, although not impossible in old age but, it depends upon overall health and organ functions of body. Cardiac anesthetist will fully evaluate her before bypass. Third option is to keep her on medicines only without going for any intervention. In my opinion, consult a nephrologist that is there any chance of recovery of kidney function, if no then periprocedural dialysis can be considered." "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 3.5 years old mild autistic son is nonverbal. The doctor has given Risperidone (Sizodon) and some vitamin supplements for the last six months. My son is under speech therapy also. As all the allopathy medicine has side effects, is there any safe and assured ayurveda treatment for this condition? To what extent can my son get improved? What is the probable time frame? My son is hyperactive. He cannot focus as there is some sensory issue. He avoids the unknown person, especially same aged children. He is very selective in food and does not chew a few foods. He does not like almost any fruit. His MRI, USG, ECG, allergy panel and blood count were normal. He was vitamin D deficient. ### Response: I just read your query. As you have mentioned about autism, autism is a neurodevelopmental disorder. It might be due to some genetic problem, environmental issue, some infection during pregnancy like Rubella and sometimes no known reason can be ruled out with this problem. The other symptoms you have mentioned like hyperactivity, lack of focus and difficulty in interaction with other people are all associated with the same problem. The reason behind all this is that your son\s neurological and behavioral development is not normal. Sometimes this problem improves up to a large extent with the help of medicine and other therapies. Sometimes, it can be there as such during a lifetime. No doctor or medicine can assure you about the exact time and the exact progress. But that does not mean you stop trying. Now coming to ayurveda medicine, there are prescribed many medicines in ayurveda which will help your baby up to a great extent. Genetic or environmental. Revert after a month to an ayurveda 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 father is 72 years old and he is suffering from jaundice. Initially, he was admitted to hospital five months back due to dengue and his platelet count had dropped down to 15,000. Now, he has recovered from dengue but his bilirubin is not decreasing. While getting discharged from the hospital, the bilirubin count was 17.64 mg/dl. It had dropped down to 8.33 but later, it got increased to 10.33 and the current count is 9.74.The doctor has prescribed him Silymarin 140 mg, Ursocol 300 mg, Pantocid 40 mg, A-Z vitamin and Duphalac. How can I help my father to recover quickly from jaundice? ### Response: Hello. I saw the report (attachment removed to protect patient identity), and in your history, you did not mention about alcoholic history of your father. It may decrease immunity status and thus, will take more time to recover." "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 40-day-old son\s left testis is undescended. Sonography shows his testis on the upper end of the inguinal canal. Please suggest whether it will come down naturally. ### Response: According to the report you have sent (attachment removed to protect patient identity), the child has left-sided undescended testis. It is a common practice to wait until the baby is six months old before operating. There is a small chance that the testis might descend on its own by six months. They usually do not descend after six months and also the risk of that testis becoming nonfunctional if waited beyond six months is high. Another thing is, there is a small risk of that testis becoming cancerous if it is not operated within one year. So, your child will need a surgery orchidopexy by about six months of age if it does not descend spontaneously. Follow up at 6 months of age." "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 an ACL meniscus repair surgery four months ago. I still have some swelling in my knee and still feel weakness in my leg. Is that normal? Can I run now? What to do? ### Response: The knee swelling can even persist till six months after surgery, the more physiotherapy you do and the earlier you achieve full range of movements of the knee, the better it is and faster the swelling will reduce. Running will depend on your physical follow up with your doctor and also will depend on your physio. Ideally, by now you should have started running but your physio and doctor will decide that as every case is different. ACL post-surgery rehabilitation." "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 has this rash for about two weeks. I have meant to ask someone to reassure her it is nothing serious. What kind of rash is this? It does not hurt her, but the skin is irritated, sensitive, and itchy. It is located around the groin but does not go further inside the vagina or near the anus. She believes it is a fungal infection, but how true is that? ### Response: Hello. I have seen the attachment (attachment removed to protect patient identity) and would like to confirm that this is a particular fungal infection with normal whitish flaky skin over a localized region and scaling present along with the classical sign of itching present. This can be controlled by the application of an antifungal cream or ointment like ointment Luliconazole 1 % twice a day for seven days and also oral intake of tablet Itraconazole 200 mg once a day for five days. Avoid any frictional injury due to tight clothes, and it would worsen the itch and sensitivity. You may in the meantime use an antifungal Clotrimazole 1 % dusting powder locally to restrict the spread till medications are procured." "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 GERD issue. Please suggest an ayurvedic cure. ### Response: Hello. I read your query and understand your concern. GERD (gastroesophageal reflux disease) is a common problem. It is mainly caused due to an unhealthy lifestyle and poor eating habits. Follow the below-mentioned guidelines to avoid the problem: Regarding medications: if you are already taking allopathic medicines, then do take these medicines along with that. Try these regularly, and you will soon feel positive results. Do consult me after four weeks regarding improvement." "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 30 year old female. I fractured my pelvis in a car accident on the 7th. I was on crutches for six weeks and am now walking the past few weeks without. The fracture was a tiny hairline fracture of the sacrum and another two hairline fractures on the side towards the hip. No fractures were in the joints and I was able to heal with no surgery. The problem is that I am still getting a lot of pain which alternates from the front round to the lower back, with the back pain being the worst as it is so stiff I am finding it very hard to walk. I also get numbness and tingling in my right lower leg and foot specifically at night which sometimes stops me sleeping. I am very worried this pain and stiffness are going to stay with me now specifically the back pain and stiffness. I was told I would make a full recovery although I do remember one of the many doctors briefly saying I could get lasting back pain in the sacrum even though it was so fine it could not be seen on the X-ray. I have been taking up swimming twice a week. I am not back at work yet. ### Response: Hello. The pain what you have could be due to SI (sacroiliac) joint which in turn may inhibit butt muscles and develop spasm. I suggest you do a lot of icing on the sacrum and on the butt muscles frequently, for 15 minutes every two hours once possibly. Since there is a fracture, I am not recommending any massage or stretches for now. Do not worry. Everything will be alright as the tingling sensation and pain is due to spasm compressing the neural structures running below the muscle and will get settled down. Hope this is helpful for 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: Yesterday my wife on her annual checkup got an abnormal ECG. The report says: Normal Sinus Rhythm, Incomplete right bundle branch block, inferior infarct, age undetermined. She is 55, a little overweight, otherwise healthy. We are very worried. ### Response: I understand how worried you are about your wife\s health, do not worry she will be fine soon. The ECG shows evidence that points to the fact that your wife has a injury to the right part of her heart. This can cause a disruption of electrical impulse traveling to that area which show cased as (right bundle branch block). I advise you see a cardiologist. She needs to do further investigations like Echo to ascertain how well her heart is working and to know the extent of damage. I wish her a speedy recovery. Best regards." "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 went to the ER a week ago for abdominal pain. A pregnancy test was performed and it was negative. An ultrasound scan was performed and they found two heterogeneous ovarian cysts, one on the right is 1.5 cm and the other on the left is 1.4 cm. There were multiple simple cysts. My endometrial lining was 6 mm. They said everything else looked good. I have a history of ovarian cysts. Do heterogeneous cysts happen before or after ovulation? Do they impact menstruation? Also, what is the difference between heterogeneous and homogeneous ovarian cysts? ### Response: First of all, 1.5 cm and 1.4 cm are a very small size for a cyst. Because, in every cycle around ovulation one of your ovary makes around 3 cm follicle (cyst). In a sonography, if it looks clear without any shadow in the cyst, then it is homogeneous and when something is found floating in the cyst as echoes (shadow), then it is called heterogeneous. Homogeneous have clear fluid. In heterogeneous cyst, the shadow may be due to blood, pus cells, epithelial cells, other debris, hormones, enzymes or turbid fluid. In 1.5 cm and 1.4 cm sized small cysts, it is not so much important that whether it is heterogeneous or homogeneous because it is mostly going to disappear around your period. Before ovulation, mostly follicles are with clear fluid. After ovulation, it may be homogeneous or heterogeneous with decreased size. Actually, it looks like disappearing follicle and not a cyst. A cyst can disturb your cycle only if it is of a bigger size and remains even after menstruation. Mostly it begins from unruptured follicle during ovulation and the size can be from 4 cm to 11 cm or even bigger in some case. This type of cyst requires treatment." "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: Dear Doctor,I have a problem of sleeping at a scheduled time. I always sleep in a different time and it is getting delayed every day, like a cycle. For example: If today I sleep at 9:00 pm, in few days I will be sleeping at 10:00 pm. And in a few weeks, I would sleep at 4:00 AM. I also have depression and different forms of anxieties.I did a blood test for sertonin in blood. The result was 65.0 ng/mL. Normal range is 151-186. Does this test have anything to do with my anxiety and sleeping problem?What should I do about it? Age:29 years, Gender: male, Height:178cm, Weight:60kg, Medications: I take only 1 multivitamin every day. ### Response: Yes. There is relation between low serotonin level and depression and anxiety. What is more important is how significant symptoms of these problem you have, how much are you distressed from these and whether they cause interference in your daily life (socio occupational decline). If you have these symptoms from last few months then I would like you to suggest that you should start medications for these. which include anti depressants and anti anxiety medications. Your sleep disturbance might be due to depression and anxiety as well. This would also improve with medications. Also there is psychotherapy (talking therapy) for these problems, in which we need to discuss your stress factors and your coping skills for these. For further discussion, you can either book for an online therapy or you can further ask any questions." "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 27 years old. I have PCOS and have been trying to conceive for four months. My gynecologist put me on 500 mg of Metformin thrice a day and 10 day cycle of Medroxyprogesterone at the beginning of each month to force ovulation. The medication is working exactly as it should. I get my period every month and I have lost weight with the Metformin. I went in for a follow up today and my doctor recommended that I sign up for an infertility study that she is doing. It requires hormone shots, extensive testing and in vitro fertilization every month for a period of four months. I have been going to the same gynecologist for many years and I know her pretty well. Let me just say that she has never seemed like she puts much thought into diagnosing and treating me. I had to practically beg her to test me for PCOS even though I have had very irregular periods and other symptoms for years. Now, she jumped straight to IVF treatment. I have heard of women staying on this course of treatment much longer and being able to conceive. In vitro is incredibly expensive. I am just worried that the only reason she recommended this is because she wants another participant in her study. Your advice on this subject would be appreciated. ### Response: Hi. I can understand your situation. Please, do not be so hard on her. I am sure it is not that she is not interested in diagnosing or treating you. However, you can wait for some more time before straight away jumping for IVF (in vitro fertilization). I have given you the information, but participating or not in the trial is totally your decision. All the best." "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 came back from a day walking around the mall. I am having cramping pain in my left calf. It feels like a rubber band is wrapped around my leg. It is better when sitting but hurts when outstretched. I am on Enbrel and previous medical history includes low blood pressure and low cholesterol. My recent blood work is normal and only a little thing off was anion gap. ### Response: I am glad to answer your query. I would have appreciated a reason for having ENBREL (Etanercept), whether RA or ankylosing spondylitis or psoriatic arthritis. Your condition might be just tiredness from exertion while walking around the mall. If you are a patient of rheumatoid arthritis or ankylosing spondylitis, then you should give some rest to your legs. soak them in lukewarm water, clean the feet and rest your legs with pillow beneath the calf muscles muscles. If you have psoriatic arthritis do not soak feet in warm water. just give some rest. Your pain should subside in a day or two. If there is no relief or decrease in intensity of pain after rest for a day or continuous increase in pain should warrant a physical examination. I have good hope that this treatment shall be enough to help you get rid of the pain." "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: What to do now? I was in love with a girl for five years when I was doing my college and then I told my parents and they did not agree. She also loved me back. In her home also they will not accept. Now both of us are not talking for the past one and half years. I am working now and she is studying now. I used to meet and send her texts when I got leave and miss her. Now she does not want to talk to me. This time I asked her if she is free to meet me. She told she is busy. Now, is she really over me or just protecting me? What should I do to get over her? Sometimes, I feel like everything is over between me and her but then suddenly I miss her a lot. Is this how it is going to be always? ### Response: The best answer is to ask yourself whether you wish to and looking forward to marrying her or not? If not, you need to move on. A girl, unlike man, cannot call and text you just for the sake of pleasing you. Girls are always under the radar of their family and society. They need 110 percent assurance from you. They just cannot be your time pass. In your case, it is difficult for you to persuade your and her family but not impossible. If you really love each other you may have a fighting chance. During the last one and a half year of non-communication, she has probably decided to move on with her life as she got no real assurance from you. So call her, and try to meet her if you really are interested in marrying her. Or else, let her be a part of your good memories and move on." "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 60 female, having pain in both knee and ankle, swollen up, does not bend knee, the pain starts from upper thigh to knee. ### Response: I think you should get your blood test done for cholesterol, uric acid, and blood urea. Apart from this, you should always wear a knee cap. Put your feet in a bucket of warm water with salt and sit for half an hour daily. It will sooth down the pain and swelling. Please do the same exercises of the knees and legs so that the circulation does not stop. Take Shelcal 500 daily and Vitamin B12 also for boosting up the immunity." "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 3 years old. He is not speaking like other children of the same age. He is speaking very few words. What do I do? ### Response: Presuming his hearing capacity is normal, the above mentioned might be the reason. Please interact with him more often in the form of talking to him and storytelling where verbal communication is significant. Involve him in playful activities and talk to him at every opportunity. He should be encouraged to play with other chil" "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 stiff neck, and some movements cause my neck to spasm and feel like something is being pinched. Which position should I sleep in tonight? ### Response: Hello. This appears like a muscle spasm. Doing hot water fermentation and gentle kneading massage should release the neck spasm and make it comfortable to lye down flat without the pillow. With the help of gravity, the stiffness will reduce in the overnight, and you should be fine. Incase if the stiffness is same, please do let us know so we can suggest the other methods." "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 told recently by an energy channeler that I have an allergy to dairy because he sensed that my general anxiety goes up when being exposed to dairy after performing some tests. I told him that I do not experience any physical symptoms, and he said that I do not have to experience them to have an allergy. I have never been told that I have an allergy to dairy, and I would like to get a second opinion possibly. ### Response: Please let me know which objective tests did he perform? Now since you do not have any symptoms on exposure to dairy products, the possibility of such thing is unlikely. If he had shown some objective tests like skin test for allergy or blood tests, then we may have some evidence that the body is allergic to dairy products. Even in such a scenario where you are not getting any symptoms, there is no need to withhold dairy products as tests can be falsely positive as well. So overall, I do not think this is significant and does not warrant stoppage of milk products. I hope this helps you and get back if you have any doubts." "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: From your desk of concern, I want to ask some questions regarding my pregnancy. I have sex with my partner about five days ago. We did not use any precautions. Even though the penis is not properly ejected in my vagina but from how penetration was done and he discharge I feel some of the liquid go inside but as the penetration was not too much we have a doubt. We go by PT test on the fifth day in the evening and that was positive. But still we are confused. Kindly guide us on how to do further confirmation regarding pregnancy? But we do not want this fetus to develop in my uterus. Also, guide me about abortion. ### Response: Hi. With unprotected sex pregnancy can happen. Pregnancy test does not come positive after five days of intercourse. You need to do one ultrasound for confirmation about pregnancy and how much growth is there and where is it growing. According to that, we will decide how to abort. But if the baby is live then every country has its own laws about abortion. So you have to consult nearby gynecologist or abortion center. And follow the proper guidelines according to the doctor and local laws for effective and safe abortion. Do not go here and there and put you in trouble legally also. And if you bleed more than there may be problem to your health and or life also." "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 18 year old male, and I have been taking Prozac for probably 6 months, which has made my libido very low. Will it go back to the way it was if I stop the medicine? ### Response: Hi. I understand that Prozac (Fluoxetine) is a known cause of low libido and this might be a single or contributory cause in your decreased libido." "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 husband and I have been in a monogamous relationship (I believe) for 14 years. We had sexual partners before this. A few weeks into my first pregnancy, he and I have just broken out into HPV genital warts. Is it possible for warts to appear 14 years later? Is it more probable that my partner has been unfaithful? ### Response: Hello. I have noted your concern. Most HPV infection is self-limited. Most of the infected individuals are able to eradicate the virus within 20 to 24 months of infection. However, HPV infection can persist and it is possible to develop genital warts years after infection. Therefore it is hard to know when did one acquire the infection if he or she has had more than one sexual partner" "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 condition is GERD and LPR and I am so stressed out with this I cannot even sleep. I take Esomeprazole 40mg per day, but still no improvement. I sleep, but sometimes acid reaches my throat when I wake up. I am on this for one month and I feel every time. I take pills that they remain stuck in my throat like down the esophagus and I must drink a lot to push it down.I am on diet with no spicy, no coffee, no alcohol and I have a list with acidic foods. I am scared about my esophagus to not be very damaged. This will destroy me for real. I am only 24. Should I double the dose? Should I change medicines? Now with the Coronavirus, I cannot find any doctor.I do not feel heartburn, but I always hear my stomach making a weird sound when lying in bed. Please help. ### Response: I understand your concern and at this point, I would recommend further evaluation in order to better assess your condition. I would recommend a barium swallow x-ray, endoscopy, esophageal manometry, and 24-hour esophageal acid test. I would recommend you shift your Esomeprazole to Ranitidine 150 mg, twice a day for two weeks and Metoclopramide 10 mg, one tablet four times a day for five days. If symptoms persist, worsen or new onset of symptoms such as diarrhea, further consult is advised. 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 lost my upper incisor after a childhood injury which later on was replaced by a dental bridge by a dentist who damaged my three healthy teeth to fix the bridge. It has been 15 years now and I want to go for implants. So, I have questions about what would be the whole approach? My bridge will be removed along with the teeth it is fixed on? And after how much time implants will be done? ### Response: Hello. Basically, getting implants is a surgical procedure where the dentist would be putting an implant in your bone through a small surgery under local anesthesia. After that you will have to wait for a few months for the implant to osseointegrate inside the bone means it will adapt itself inside the bone like the natural root. After that, there will be a second stage surgery, a very small procedure. After a few months, you will be getting the crown or the artificial tooth permanently. But before all of this, you need to get your bridge out, the teeth will not be removed with the bridge" "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 suffering from a cough for the last two days. Irritation is there inside my neck. The cough is getting worsened day by day. I am drinking lots of water daily. Till now no medication yet. I am thinking to take one tablespoon of honey. So, I bought it today. Is it good to take honey and chyawanprash? ### Response: I have reviewed your query and here is my advise. Honey has a soothing effect and it can be taken. You can also mix half teaspoon honey and half teaspoon ginger juice and take it early in the morning. Your cough could be because of posterior pharynx irritation or inflammation. For that decongestant can be taken additionally. If you have acid reflux history then mention it. Salt water gargle can be done with warm water three times a day. You can also take one teaspoon of turmeric powder with milk 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 father is suffering from gas issue from the last 7 to 8 days. He does not feel like eating from 2 to 3 days. Have checked with local doctors, after a few tests they found nothing but his bloating has not gone down. He also feels pain in stomach. Please suggest. ### Response: There are different conditions that can cause abdominal bloating that goes from non-urgent to serious conditions. If he is not passing bowel movements or gas and has remarkable abdominal pain, it can be a serious condition like bowel obstruction and needs to be taken to hospital emergency department. On the other hand, if he is passing gas and bowel movements, he needs to be checked for H. Pylori which is a stomach bacteria and has a specific treatment. If H.Pylori is negative then next step is to see a gastroenterologist for potential gastrointestinal endoscopy." "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: There is a purplish red abrasion on my vagina, which is the size of a small coin and it is really swollen. It stings when I urinate and is generally uncomfortable. I have not been sexually active for over a month, but I have had an infection for the past few days. Is this serious? ### Response: Vaginal abrasions are quite common and can cause a lot of discomfort. Hope this information 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 18 years old. Today I finally got the courage to talk to my doctor about the stress obsessive thoughts, and the physical harm it does to me. I got an appointment with a psychologist. She diagnosed me with anxiety, panic disorder, and being severe hyperemotional. The doctor did not want me to go to a psychiatrist because he might give me medication that would be addictive, and affect my learning skills. I have exams very soon, so they try to help me in some other ways, but I tried these before without any good. What should I do? I cannot deal with the obsessive feelings, crying, trembling all the time, digestive problems, and everything that comes with these disorders every day. ### Response: First of all, I am so sorry to hear about your problem. I can imagine how hard it is for you, especially when you have so much to deal with. Although therapy is essential in treating anxiety, medications are a must to control the physical symptoms. You have not mentioned when your exams are, what you can do is mention this to your doctor so they will give you non-sedative medicines. So you will not feel very sleepy, but these medications will definitely help you perform better, and help you to cope up. About therapy, I would recommend you should continue, and if you do not find the local therapist effective, we can start it online via video consultation. Lastly, please always remember, nothing is more important than your health. Do not ever judge your worth based on your exam scores, you already have so much going on, just do as much you can and do not burnout yourself. On your own, try box breathing, progressive muscle relaxation and start maintaining a journal. It will help you out." "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 five weeks pregnant. I have mild cramping in lower abdomen and no other symptom. Sometimes. I feel vaginal pressure like menstruation. Do I have any problem or is it normal? Please advise me what to do. ### Response: Hello. I have gone through your history and understand your concern. Such symptoms within five weeks of pregnancy are not normal and not a very good sign too" "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 always had trouble with my tonsils. I get tonsil stones frequently and snore. For the past month I have had a mild sore/scratchy throat. I can tell my left tonsil is swollen, and it is causing some pain. Sometimes the pain reaches my ear, but not often. My doctor did a swab to check for infections but it came back clean. Could this be allergies? I have never had allergies before, except for asthma as a child. I have no other symptoms. ### Response: Hi, I understand that you are worried about your long term tonsil problem.. Tonsil enlargement could be due to infection or as a part of some other disease If your swab is negative, we need to investigate for other possibilities also I would suggest you some investigations for the same Meanwhile also take the tablets as prescribed CBC, ESR, PERIPHERAL SMEARCT NECK CHEST XRAY Tonsillar enlargement inder evaluation T. Cefuroxime 500mg 1tab twice daily for 1week after foodT. Aceclofenac + Serratiopeptidase 1tab twice daily agter foof for 5dayBetadine throat gargle thrice daily Review with investigations" "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 34-year-old, and I have two kids one is three years and second is one year I recently tested positive for pregnancy, and I want to abort it. Currently I am six days above from the periods I missed and fifth week what is medication to abort this pregnancy. I want to use it at home or any method at home to abort it. I want to abort it safely with medicine. No previous issues regarding pregnancy or periods. ### Response: It is not recommended to take tablets without confirming the intrauterine pregnancy and ruling out an ectopic pregnancy. So, please consult your nearby gynecologist and undergo an ultrasound. After confirming the intrauterine pregnancy and gestational age, with your doctor\s advice, you can plan for the termination of pregnancy. Up to eight weeks of pregnancy, medical termination with tablets is possible. I hope I have answered your query, and I will be happy to answer any further follow-up queries." "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 wondering if I can take Levothyroxine along with MAO inhibitor? Also, I have taken Etizolam for a sleep disorder, how long do I need to wait before I can take MAO inhibitor? ### Response: Hello. You can take Levothyroxine with MAO (monoamine oxidase) inhibitor. MAO inhibitor after being stopped, show an increase of neural monoamine levels for 2 to 3 weeks. Concomitant use of MAO inhibitor with Etizolam show side effects like sedation, dizziness, etc., but not fatal side effects are reported." "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 53-year-old female. I had gestational diabetes and 11 years later my sugar levels were high so started taking Glycomet. However, the fasting sugar level in the morning is always high and PP is less than fasting. Recent HbA1c is 6.9. Do I have to continue medicine? I walk daily for one hour and eat raw vegetables for breakfast. I have constipation problem. By any chance is it related to high sugar levels? Please advice me as to how to control or keep HbA1c below 7. Suggest me natural way of reducing sugar levels without medication. ### Response: Diabetes is not curable but controllable. The first line in the management of type 2 diabetes is lifestyle modifications. Fasting should not be higher than 110, postprandial should not be higher than 140, and HbA1c should not be higher than 7.5" "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: Yesterday, unfortunately, I slept with my mobile phone under my testicles. I slept like that for five hours. I have heard of mobile radiations causing harm to the sperm and testicular cells by affecting the DNA. My problem is that my wife and I are both 34 years old and are planning for conception. Now, because of this incident, how long should I wait to plan for conception? How long will it take for spermatogonial stem cells to recover if they are affected? I am asking this as I have an autistic child and I cannot afford to take any risk and also our reproductive age is passing by. ### Response: Hello. I read your query and understand your concerns. First of all, I would like to inform you that spermatogenesis is a long process and the sperm cells produced already may be available for the next two and a half months (72 days). So, considering this fact that you had a radiation exposure, it will be ideal to avoid conception for the next two to three months. However, radiation exposure by phone is very much limited and there is little data to support mutation by phone radiation. I hope this helps you. /ask-a-doctor-online/an" "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 using my driver\s mobile phone and his screen was totally broken and after a few minutes, I noticed that I had a cut on my finger. If there was blood already on the screen and if I got a cut and there was a little bleeding on my finger then can I get HIV in this situation? Should I get tested? ### Response: I have noted your concern. There is no risk of HIV (human immunodeficiency virus). Moreover, a minor cut does not provide direct access for the virus into the blood. It has to be a fresh deep actively bleeding wound for the virus to gain access to the bloodstream" "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 skin problem on my scrotum. I am having this issue since six months. It itches every time and there are cracks on my scrotum. I am using Betnovate. When I use the ointment, it goes away and when I stop it, it recurs. Previously, I had a skin disease, which I think as keratosis pilaris. Please help. ### Response: Hi. I have read your query in detail and do understand your concern. From your description it seems that your symptoms could be due to:1. Scrotal dermatitis.2. Second possibility is fungal infection.You may put up two to three pictures of the affected area for better evaluation, guidance and to differentiate the conditions. 1. For scrotal dermatitis you can take antihistamines like tablet Levocetirizine 5 mg twice daily.2. 3. Apply Elovera cream (Aloe vera and Vitamin E acetate) twice a day.4. Use a medicated gentle cleansing lotion on your skin for bath like Cetaphil cleansing lotion once a day.5. Avoid soaps or perfumed cosmetics or creams on the affected area.6. Wear cotton clothes. Revert back with the pictures 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: My 2 year old child has knock knees. Is there any treatment for this condition without surgery? ### Response: So, I would advise the following: Once you get these tests done, I can correlate them and let you know what will be the correct management for your child.Revert back with the reports to an orthopaedician and traumatologist 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 worried about my blood work lab results. My RNP antibodies are at 2.3, speckled pattern 1:80, antinuclear antibodies, IFA is positive. I know I should not be diagnosing myself, but my findings is worrisome. Most of my symptoms match up with what I am seeing. I guess my question is, should I worry all weekend or go ahead and make an appointment with a rheumatologist given the results that I have seen in my labs? ### Response: Based on the details available, it looks that you have lupus. Possibility of mixed connective tissue disorder (MCTD) is also there. You need furthest tests that include Anti-ds DNA, rheumatoid factor. At this point, you should not get worried unnecessarily. Wait for your doctors call.He would call you and post you for further tests. I hope it helps you. If you have any further query, please ask 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: I am 33 and since having my baby a year ago I am suffering from joint pain, especially in my wrists and fingers. I have pins and needles sensation at times and writing is becoming difficult. I just got my reports and have elevated CRP and low folate. Any idea what could be wrong? ### Response: I went through your post. You have pain in the small joints of your body with an elevated CRP (C-reactive protein) level. Regards" "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 aged 54, on USG of whole abdomen shows prostate weight 31 gm. A year back, the prostate weight was 26 gm. He is taking Contiflo Icon 0.4 tablet. The doctor says it is very likely BPH. Can it turn into cancer? ### Response: Hello. This prostatic enlargement if suggested to be BPH after examination by an Urologist to be benign then very unlikely to be cancer. Prostate size growth over one year may be falsely positive due to different radiologist performing ultrasound, some variation. And progressive slow growth is expected. For cancer, have a screening (if family history of father or brother). S. The duration of treatment for BPH depends on symptoms." "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: Free TSH 5.96, freeT3 2.49, freeT4 0.76. Age 33 years.Symptoms - weight gain, depression, late periods since second delivery and 2 years back. Do I need thyroid medicine? ### Response: I would like to know when was this thyroid test done? This seems to be a very mild thyroid dysfunction. Does anyone in your family have thyroid problem? I would recommend you to consult an endocrinologist online to go for some more testing (like thyroid antibodies and repeat thyroid function test) and initiate thyroid medication if necessary" "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: For three years, my RBC has been slightly elevated (~4.9). My DNA results show a homozygous GG genotype for SNP rs12340895 of the JAK2 gene indicating greatly increased odds of developing JAK2 V617F-positive MPN. I have no symptoms and I am in good health. Should I see a hematologist to establish a baseline and periodically monitor for MPNs? ### Response: Hi. Based on your query, my opinion is as follows: Numerous DNA mutations are always present and it is difficult to monitor for any specific malignancy. However, speaking specifically, the mutation you have described can be seen in 50% of the normal population, which is very high considering the percentage of MPN prevalence. A higher RBC count can be seen due to high altitude, lung problems, smokers, athletes, etc. RBC count above 6 would suggest a possible risk. 4.9 is too low to comment and the only thing, I can comment is it is very good hemoglobin levels. Based on your BMI, I would consider you to be physically fit and this RBC count should be appropriate. Not to worry, no monitoring is necessary for now. Annual checkup of complete hemogram should be adequate. 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 queries regarding my mom\s health. She is suffering from some abdominal issues. When she had a CT scan, they found an impression with the liver. I attached her report and please tell me if there is a serious issue. Yesterday she got admitted with intolerable abdominal pain. Her doctor asked us whether she had any injuries on that area. But she never had any injuries. They prescribed some medicine and asked her to take an injection for two days. She was discharged home in the evening and last night she got severe abdomen pain. She is worrying a lot and crying all the time. She is getting pain while she coughs. She is unable to sleep and has constipation. I totally rely on you to get suggestion. ### Response: Hi. According to the CT scan report (attachment removed to protect patient identity), there are two problems. In the liver, there is hemangioma which is a benign tumor meaning it does not cause any harm. If it increases in size, then it is resected. The other problem is with the muscles of the abdominal wall in which a small amount of blood is accumulated which is causing pain. It can occur after some trauma or injury to the site. It will also resolve in a few days. So I think hopefully she will get fine in a few 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: The ECG report of my father shows some abnormality. Please tell me what is the actual problem. BP 160/100. Age 65. ### Response: Hello. You have not attached the ECG here. So, please attach it so that I can interpret it. Otherwise, for hypertension, he should be on medicine so as to keep his BP less than 140/90 mmHg. So, also let me know if he is receiving the antihypertensive medicine. Revert with more information to 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: I am 23 years old female. I have PCOS. I was a heavy coffee drinker before knowing this condition. But I have controlled it. I am taking black coffee once a week. Is it fine to have a coffee when having PCOS? ### Response: Hi. Coffee is a substance that increases the insulin resistance immediately after consumption. In PCOD, the insulin resistance is high. But having one cup per day will not be very harmful. You seem to have a lean type of PCOD. Try to have a controlled diet, high protein diet, low cholesterol, fat, and sugar. Avoid eating junk food. Do regular exercise. You may not be gaining weight, but your blood cholesterol may be the culprit. For medical management, take tablet Metformin SR 1000 mg once at night daily. It is used for treating diabetes, but it will reduce insulin resistance. Have a birth control pill like" "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 at six or seven weeks from conception. I did not have a visit yet. Today, I experienced a slight bright red bleeding. Can you tell me what I should do? I am really worried. ### Response: How are you doing? Just hope and pray for the best. Everything will be fine. All the best" "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 40 year old female. I have a BMI of 17. I am a recovering eating disorder patient and also suffer from GERD, GAD, and low BP (105/60). I saw a cardio two years ago and cleared. I developed a burning, sharp chest pain (more intense than normal GERD pain), in the upper-left sternum just below the manubrium which sent me to the ER. X-ray, bloods, and ECG are normal. I was given an Omeprazole and an antiinflamatory. But, I am still having constant pain, which varies in intensity and improves when I stand. I did lift a heavy rock a few days prior and can feel a slight crunching when I move, but I am really anxious about ischemic heart disease or something more dubious, even though I have no accompanying symptoms besides this pain. Does this sound like costochondritis, or should I be more concerned? ### Response: Hello. I passed carefully through your question and would explain that your symptoms are not typical of any cardiac disorders. Is the pain triggered by deep breathing or pressure in this chest area? This would be another argument in favor of costochon" "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, 33 years old, RTA- linear fracture of left frontal sinus, hemorrhagic collection. After 10 days, there is pain while eating in the left eyebrow. Please prescribe medication and conservation. ### Response: I have read your concern. Let me go over your CT report (attachment removed to protect patient identity) to make sure I do not miss a thing and will get back to you in a moment." "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 jock itch six years ago over the groin area and lower abdomen. It was completely cured then but has left dark patches. I have been suggested by a dermatologist to use Glycolic acid 6 % cream, which does not seem to be working. Suggest an effective ointment to clear the dark patches completely. ### Response: Infections of the skin usually heal with hyperpigmentation. This post-inflammatory hyperpigmentation is tough to resolve and would take years to go completely. However, creams containing Kojic acid do help to quicken the recovery twice daily for three months" "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 choroid plexus AVM (sm grade 2) in the right temporal horn of the lateral ventricle. Doctor said embolization and gamma knife are not possible. So they opted for microsurgery and said surgery would lead to weakness on the left side. I want to know what are the other effects? How long will it exist? Will the effect become normal after some days? Please explain.I am currently on Eptoin 100 mg. ### Response: Hello. I need to see the angiogram images to comment in detail. Anyways, I have listed the essential points : Your weakness will depend on the extent of the damage during surgery. If some blood vessels are damaged, which supply the bundle of nerves supplying the limbs, you can have a weakness. If it is damaged completely, you will have a severe weakness. Usually, that does not happen. If your weakness is partial, it will recover in six weeks. Provided you should do physiotherapy regularly. But this will not trouble you in your daily life. Apart from these two, there are no other major complications. Minor ones would be nonhealing wounds, CSF (cerebrospinal fluid) leak, development of 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 had unprotected sex 10 years back. I am just curious if I need to be worried about any STDs, which I might have contacted 10 years back? I am fairly healthy, and I am only a little overweight. The person I had the encounter with has since had two kids. So, I am pretty sure I have nothing to worry about. But, I just wanted to be sure. ### Response: Hi. Testing can only prove your surety of having nothing in the context to Sexually transmitted disease (STD). If you had unprotected exposure 10 years back and no further exposure during subsequent years and you are asymptomatic also, it is unlikely that you will have STD. However, since asymptomatic STDs are also known, I usually recommend my sexually active patients get tested for HIV (human immunodeficiency virus), HCV (Hepatitis C virus), HBV (Hepatitis B virus), chlamydia, syphilis, and gonorrhea. There is no harm to know the baseline status of these. Hope your query is answered, but if you have any other query, please do not hesitate to ask or call anytime." "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 considering an endoscopic bariatric stomach surgery procedure for weight loss. It is called the accordion procedure, which has only been around for about five years. I appreciate it. ### Response: I have gone through your query. The Accordion procedure is an endoscopic sleeve gastroplasty. It has been around for some time; a few case series and related data are available. It is useful in helping in weight reduction up to 17-23 % weight loss in six months with not many serious long term adverse effects. A few people might end up gaining weight after 4-5 years (which is comparable to laparoscopic sleeve gastrectomy). The safety data shows it is safer than laparoscopic sleeve gastrectomy in the short term. If you have further concerns, please do get in touch." "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 cousin was diagnosed with genital herpes a few days back. She also has a sore throat currently that the doctor thought was strep throat but the strep test was negative. I shared a water bottle with her recently. Could I have contracted herpes from sharing the water bottle? ### Response: Hello. The sharing of water bottle is not known to spread herpes. Genital herpes spread through sexual route. The viral infection also can cause sore throat like influenza infection. It will give streptococcus negative test." "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\s age is 56. He is diabetic for the last two years and the only medicine he takes is Metformin 500 tablets daily before meals twice a day. He is been complaining about a continuous mild pain in his pelvic area since last month and he says it hurts more usually after he pees. When he rubs that area he says the pain goes away. Currently, he is taking Glyciphage 500 tablets. ### Response: I have gone through your query. I would like to know if your father has any difficulty in passing urine like straining, thin stream or whether he has had any fever with burning sensation while urination. It is likely that being a diabetic he has a urinary tract infection which needs to be tested. Also, considering his age he will need a clinical examination by a urologist for his prostate gland to look for any enlargement or infection. If it is a UTI, it can be treated with a short course of antibiotics and he should be fine. I suggest you get an appointment with your local urologist for an evaluation at the earliest." "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 20 year old male. I have a weird rash on the back. It looks like hives but does not itch or burn at all. It only appears when I sweat or take a shower. ### Response: This is due to urticaria or hives. The mainstay treatment for this is to avoid the triggering factors, like in your case sweating or shower. I will suggest some medications. Please take them and let me know about the outcome. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Follow up after five days. Revert after five days 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: I am a female, who weighs 155 lbs, and I am 5.7 feet tall. I cut off the muscle weight because I have a lot of muscle, including the muscle, my weight is 160 lbs. I have been trying to lose weight for the past two months, but nothing has seemed to work. I go to the gym almost every day, and I do elliptical and treadmill. I also only eat about 1,350 calories a day. I do not know what to do because all my fat goes to my belly and it will not go away. Why am I not been losing weight when I go to the gym and only eat 1,300 calories a day? Please, I need advice as soon as possible. I just want to feel comfortable in my body, but it hard to do that when all your fat is in your stomach. ### Response: Hello. Losing weight sometimes is tricky, especially, if you are trying to body sculpt. Be patient, as you are on the right track" "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 four months periods were on 24, 21, 21, and 22. When should my next date be? I had sex during my period. But there was no discharge inside me (we do not remember actually). So, will there be any delay in periods? ### Response: According to the tracking, your cycle is nearly 30 days. Your periods always need not be on time. You can expect in a couple of days. Also, you have not mentioned that you have had unprotected sex. Your periods might be delayed due to other reasons. I would recommend you to wait till the month end in case you have not had unprotected sex last month" "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 white scab on the inside of my right nostril. It has been there for over a week now. It is very irritating and it hurts when I touch it. I am coughing up alot of green mucus. I was given Amoxicillin for pharyngitis a week ago and thought that would have killed any bacteria that I had. ### Response: Hello. As per what you say, you have a white scab in your nose. It can be due to viral or allergic rhinitis. You have taken Amoxicillin for pharyngitis. So no need to take any antibiotics now. Do not try to remove it with force. Otherwise, it will bleed. Even after using a saline wash, it is not getting removed, take help of ENT doctor. He will also prescribe you medicines for rhinitis also. Though it not a serious problem you should consult ENT doctor. Allergy, viral infection. Rhinitis. Saline nose wash." "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 16-month-old child. When she was 10 months old, she banged her head between her eyes, inner left brow rather firmly on a blunt object. She was attempting to stand up holding onto a chair, and when she quickly sat, her head firmly bumped the bottom of the portion of the chair which is made of metal. She cried immediately and vomited once but otherwise seemed fine and in a short time was back to play. From all, I read online, and the other family around there was no need to go to emergency.A few weeks later, I started to notice subtle changes. She developed a deep scowl that seemed to favor her left side where she hit. Also, the mark where she hit still came out when she was upset (it still does) and rubbing ensued. I took her into her Pediatrician and told him all three weeks after it happened. I Showed him pictures of the chair where she hit as well as images of her the day after and tried to explain the scowl, the rubbing, and just how I felt something was amiss.He assured me she had none of the symptoms associated with severe head trauma. Six months later and a few visits then all for the same thing I am still unsure and wish we could have look to make sure no tissue or other damage has been done. My question is, if internal damage was done to a vessel or two or a small fracture occurred, is it possible for the symptoms to be slight at this time and if there is a minor ever so slight bleed inside, could it take months if not years for visible signs to occur and irreversible damage to follow suit? Would it not then be too late? Should I push for cranial sonography or MRI? ### Response: The mark on eyebrow may be some superficial injury. Your kid is not having any symptom of deep brain injury. Your kid was back to play shortly after an injury. Did she have any headache or vomiting or weakness of one side of body or seizure? If not, she is unlikely to have any internal brain injury.Slight bleed inside brain/ small undisplaced fracture heal spontaneously and in the long term may or may not cause a seizure. Might be you are a very anxious mom. If you are much worried, you can go for MRI brain, if it comes out to be normal, your anxiety level will decrease. But if no such symptom in kid, there is no need for doing tests." "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 34-year-old female is having thick red rashes on the face. Please suggest. ### Response: Hello. The thick red rashes on the face can be because of many reasons like allergic contact dermatitis, papular urticaria, irritant contact dermatitis, and many more. I need to know more details like for how long are they present? Are they itchy? Are they transient or persistent? Kindly answer my questions and if possible kindly attach a picture of the lesion so that I can see the lesions and help you to my best." "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 44-year-old woman. I am taking treatment for a cyst in the ovary and irregular cycle for the last four months. I am given Cabergoline tablets to be taken once in a week. My weight, in the beginning, was 71 kg. Today I checked weight to be 66 kg. I did nothing for weight loss except used two staircases of 10 steps each at the workplace. Being a teacher I am bound to use staircase more. Having done nothing I am confused about the reason for weight loss. ### Response: Hi. Everything is fine. Just because your cyst has disappeared as your hormonal level becomes normal and you keep exercising, so not to worry. Your weight was high just because of hormonal imbalance. Since you have taken treatment for that, your weight reduces. It is a good sign. Not to worry. Just have protein rich and fibre rich diet. Avoid fats." "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: Lump on tonsil for the past three years. Full left ear feeling. Been to ENT twice. ### Response: It looks like a mucocele or cyst (attachment removed to protect patient identity). Do you have any throat complaints? Throat pain? Do you smoke?" "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 66-year-old male with a weight of 90 kg and a height of 175 cms. For the last four months, I am continuously facing the following problems.Moderate sore throat, feeling like a lump in my deep throat, gastric reflux, poor digestion, a feeling of air blocked in both the ears and popping sound on swallowing.After treatment, these symptoms subside for some time. But now I have deviated septum. Presently I have sticky mucus discharge from the nose in postnasal mode. Sometimes I also feel stress in the jaws.Due to continuous popping in ears (mostly left ear) and lump feeling in the throat, I am unable to sleep properly. This is having an adverse effect on my health.I am on medication for almost three months on and off, including Levocetirizine one tablet twice daily and Fluticasone spray. I also take Rabeprazole DSR for the reflux issue, steam inhalation, and saline gargles. But symptoms sometimes abate and again come up. I regularly take Bisoprolol and Metformin and glimperamide for few years.Due to soreness in the throat, popping in the ears, and continuous cough, I am unable to sleep. The sticky mucus is viscous and salty in taste and discharges in the throat. RTF test showed partial dysfunction of the left eustachian tube. What could be the likely causes and line of treatment to get rid of this? Could it be due to air pollution or some other allergy source? Due to continuous coughing, my abdominal muscles are paining, and there is a split voice in my throat. It appears like there is an overproduction of mucus all over the respiratory tract. I have started taking antibiotic Augmentin eight hours once for the last four days, but no relief. Please advise. ### Response: Hello." "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 cold hands and feet. I also have little bit of fatigue. Two years ago, I lost 90 pounds with diet and exercise. I had high blood pressure and anemia when I was pregnant with twins three years ago. Now, I have taken a complete blood count. I am attaching the reports for your reference. Please guide. ### Response: Hi. Based on your query and attached report (attachment removed to protect patient identity), my opinion is as follows: Nutritional. Thyroid hormone profile." "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 weeks ago, I met a girl in a strip club and I was fingering her vagina for at least 30 minutes but without any intercourse or kissing or anything else. A week after this, I started having gas in my stomach and feeling strange and this continues till today. Ten days after this exposure and after I drank a liter of milk, I had diarrhea. The next day I ate, 20 minutes later I went to the toilet. Since then, I did not have such problem but whenever I am eating something I have this feeling that I need to go to the toilet and my stomach is ""playing all over."" But, I did not have any symptoms of diarrhea. Also, I never had a fever during this period.Five days ago, I started having a headache and my nose was full and I was coughing like I had a kind of virus and I did not know if it was correlated with my symptoms in my stomach. I still have the feeling that I need to go to the toilet but when I go, it is either the gas or the normal stool. On day 15 after the possible exposure, I went to a clinic and I had done an HIV third generation test and the result was negative.When I asked the doctor what kind of test was that he mentioned to me the third generation but enforced which is equal or better than the fourth generation and this is what the doctor told me. My worries are if I have been infected with HIV by performing fingering and only that, and if my symptoms are related to that and if not what else might be. I am going today to give a sample of my stool for culture to see if I have any virus or anything else. In two weeks from today, my wife and I have decided to do an in vitro fertilization and therefore I am worried if the above are interlinked and I need to take any other action.Finally, my other question is linked to the latter. If I will take any antibiotics now for my stomach if they find also something in my stool and in two weeks, I need to give semen for the in vitro fertilization is this fine or the antibiotics will affect the quality of the semen? Should I do anything else with reference to my possible exposure to fingering? ### Response: There is really no chance of HIV (human immunodeficiency virus) infection through just fingering the vagina as the virus is unable to pass through intact skin. There is not even a need to screen for HIV if fingering is the only physical activity that you have performed. Your stomach issues are perhaps due to indigestion and lactose intolerance. Milk and dairy products are a common cause of lactose intolerance. You can avoid dairy products for a while. I do not see any issues with your scheduled IVF (in vitro fertilization) procedure. You can go ahead with 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: I am female of 25 years old. My weight is 58 kg and height is 5\3"". I am suffering from acne problem for the past 5 years. I tried many antibiotics. Now, I am on Isotretinoin for more than a month and it has really cleared my acne. But, my facial hair has increased. Will it become worse if I continue Isotretinoin? After the completion of Isotretinoin course, will I get acne again? If it comes back, what will be the intensity? Please explain in detail. ### Response: Hi. Isotretinoin has no effect on facial hair. An increase in the facial hair can be attributed to either hormonal abnormality or topical steroid abuse. Isotretinoin must be continued in tapering doses for at least six months. You need to go for a hormonal evaluation by ultrasound abdomen in order to rule out PCOD (polycystic ovarian disease), which is a common source of ectopic hormone." "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: For the past two months, I am suffering from sore throat. After that, I took many antibiotics and eggs and warm water with honey and lemon daily three times. Now, there is a white furry coating on my tongue from the past 15 days and having loose stool. Do not know what to do. So please help me out of this situation. ### Response: Hi. The loose stools may be due to the antibiotics you took for the sore throat. So you may stop that antibiotic and milk too as it causes loose stools. Instead of that you may take tablet Vizilac twice daily for five days and tablet Metrogyl 400 mg twice daily for five days. Please apply Candid oral thrush ointment on the white part of the tongue. It may have happened due to the medicines. Do not worry you will be fine within a day or two after starting the dose." "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: Foot pain started 18 months ago after running. It has persisted, but the severity of pain depends on how active I am. Most recently, the pain has become more severe. Please review my X-ray. ### Response: Please send me the full X-ray which you have sent (attachment removed to protect patient identity). I would like to see the whole joint, like of talocalcaneal joint." "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 is 70 years old, and he had severe headaches and nausea a few weeks ago, so the doctor ordered an MRI brain. Based on the results, he is taking some medications and is doing well. I want a second opinion, just to be sure that there are no other issues. I am attaching his brain scan results. He had an open heart surgery 11 years ago, to remove some blocks. ### Response: Hi. I have gone through your query and the reports (attachment removed to protect patient identity) with diligence and would like you to know, that I am here to help you. Let me know if I can assist you further. Revert with more information to a neuro 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 am a 53 year old female, and I weigh 60 kg and 5.3 feet tall. From the last 2.5 years, I have suffered from headaches and balance problems. I had an MRI, which was seen by an ENT two years back, and it was all clear. At that time, I was off work for six months as I kept stumbling. These symptoms never completely go but get manageable. Also since this started, I have tinnitus, and I have been off work for a month now. My GP put me on Amitriptyline, starting at 10 mg and increasing the dose every two weeks by 10 mg currently up to 80 mg. The headaches are not as bad, but my balance is awful. I now get tingling or numbness in my head, fingers, and toes. The GP said that I do not need another MRI. This is now controlling my life, and I work as an occupational or physiotherapy technician, so I am unable to do my job. Sometimes I get blurry vision. ### Response: Hello. I would like to know some details or your problem: As your primary complaint is tinnitus and balance problem, you should get an ENT check up. It might be Meniere\s disease. Until you meet an ENT specialist, I suggest you try taking the following: Revert with more information to 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 was recently in a sexual encounter with a sex worker. It was a condom-protected sex. The condom did not slip or break. But, I inserted my finger into the girl\s vagina for two minutes. Is there any chance of catching an STD from the whole thing (the intercourse and the insertion of the finger), especially HIV? ### Response: Hope your query is answered, but if you have any other questions, please revert. Best wishes" "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 44 year old male. I have itching on the head of the penis and the foreskin. It started about 3-4 days back. But now it seems that I have symptoms of balanitis. I found white substance under the foreskin. There is also some minor tear which make it difficult for me to move my foreskin. I have applied Candid cream for that. Please guide me. ### Response: Hi. There is a difference between Candid cream and Candid B cream. This seems like you are having candidial balanitis. Please apply Onabet cream (Sertaconazole) twice daily for a week. Wear loose cotton underpants. Do not wash your foreskin everytime you use the bathroom. Also get a fasting blood sugar level done. After a week you can take a follow up consult with 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 gums surrounding my third molar/ wisdom tooth (lower left jaw) seem to be swollen. I started to feel pain on it yesterday morning and gargled with Bactidol. This morning the pain seemed to intensify. I feel pain when I swallow, open my mouth, and when I gargle. Somehow I feel the pain in my throat already. I took my first Amoxicillin as advice by a dentist friend. Any advice? ### Response: It is a case of pericoronitis. Do not worry take tablet Oflox oz twice daily for five days, Hexidine mouthwash do gargles with it thrice daily for one week, tablet Zerodol SP twice daily for five days. It will relieve it. I tell you Amoxicillin will not help with this problem. Get these medicines you will be relieved." "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 29 years old. I had a small issue. I have used Primoult-N for 20 days due to vacation. After stopping the medicine, the mensus was as usual but this month mensus started but only once there was a little spot of blood and later it was only black spots. Please provide me a solution for this. I have my marriage on the 10th of this month. If it is abnormal, it will be a problem. ### Response: This could be because of hormonal changes. There is nothing to worry about. However, if you have a doubt, then get yourself checked by a gynecologist and get a pelvic scan done to rule out the exact cause. Do get back to me with reports so that I can 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: Hi sir,I\m an 18 year old boy.I have an inborn inguinal hernia.But till now it hasn\t given me that much pain as it is giving right now.If I lay down for more than 2 hours then it starts hurting and I can\t sleep anymore.The pain extends from lower abdomen, pelvic region to some upper portion of fimer.I can\t take surgery now as I have an entrance exam within a month and also there\s corona outbreak outside so I have a fear to go to hospital.So Sir, can you please tell me how can I reduce my pain at least for this month??And also, should I take surgery immediately or can I wait for this month?? ### Response: Hello Your complaints of pain related to the hernia needs to be examined . If there is no complications within the herni In normal circumstances I would suggest all hernia should be operated but since you are having exams you can delay the surgery given that on physical examination and ultrasound you do not have any complications. For the time being as a temporary measure you can use what is called as a TRUS available in the market even online . But it is temporary and once you are free fork your exams I suggest you to get operated there after as TRUS or any other treatment is just temporary and has its own pro and cons. But if on ultrasound it shows you have any complication the you need immediate surgery. Avoid lifting heavy weights add fiber rich food to your diet and avoid constipation to prevent exacerbation of your hernia." "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 extremely distressed, as I have just discovered through my physician, that in the past I have been given two diagnoses and not been told about one of them. One is bipolar disorder, which I am aware of, but the other is personality disorder NOS, and I have no idea what this is or what it means. I am currently taking Dosulepin and Mirtazapine. ### Response: In my opinion, do not get distressed by a diagnosis which you were unaware of till now, as an improvement in your symptoms is the most important. What matters is that, with treatment, were your symptoms under control. The categorical diagnosis should not affect you otherwise. Speaking about personality disorder NOS, personality disorder means chronic deviation from the normal way of reacting to a situation or expressing yourself, and NOS means not otherwise specified, that is, when you cannot exactly classify the type of personality disorder, it is put under this category. I suggest the following: Hope this solves your query. Remember every problem has a solution. You need to try to solve it. Help is only a step away. Feel free to ask if you have any further queries" "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 storage pool defect. Now, his doctor suspects Crohn\s disease on him. All cut tests will result in horrible bleeding time. Should hematology be involved? Should the doctors use coagulant as a precaution? Your further advice would be helpful. ### Response: Hi. Based on your query, my opinion is as follows: If planning for biopsy then platelet for transfusions to be kept ready along with antifibrinolytics. Revert back for further doubts to 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 was lying on my stomach for about 20 minutes. When I moved to a seated position, I get the most intense painful headache of my life. It was in both my temples and lasted about a minute. Should I worry it is a brain aneurysm? ### Response: This pain seems to be due to vasospasm, unlikely to be aneurysmal bleed pain, if it was aneurysm it should have continued for a long duration. I have another set of questions, please answer them. Is this first ever headache of this kind? Was there nausea, vomiting, and dizziness? Was there any blurring of vision? Are the temples painful on touching? Is there any weakness in limbs or double vision?" "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 58-year-old male. I got blood from my nose for two to three hours last month. Packing was done in my nose, which was removed after four days. I got all the test done at that time. I have enclosed my report. The ENT specialist told me that due to cold infection and high BP, your sinus was busted. After removal of packing, I am normal. Today, I got my blood tested as a routine check. I found that my eosinophils are quite high whereas, in last month report, it was ok. Today report is also attached. Please compare both reports and analyze the reasons. Is high eosinophils a start of cancer? Please advice, I am quite worried. ### Response: Hello. Increase in eosinophil is mostly allergic, try oral steroids (attachment removed to protect patient identity). In cases of cancer, they usually increase from 100 to 1000 times, so nothing to worry about cancer. Consult a good physician for complete physical 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: I get tanned really easily. My skin is super sensitive. None of the sunscreens really helped me with this problem. If I am under the sun even for five minutes, I get super super tanned. ### Response: Which sunscreen are you using and its SPF? Actually, sunscreens are of two types. Physical and chemical. Physical sunscreen is better in protecting from suns radiation but the problem is that they are not cosmetically acceptable. Because they are visibly seen on the face. I will suggest you use topical Vitamin C preparation along with your sunblock. Properly use sunblock of SPF 60 frequently. Apply it every two hourly and evenly. Apply sunblock of SPF 60, Use Vitamin C preparation BD." "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 39 years old male. I weigh 185 pounds, height is 5.7 feet, and BMI 29. Recently my primary care doctor had a calcium score and stress test done on me and the calcium score (Agatston method) came out 34 and he said I am in the 96th percentile. My stress test was normal. He suggested I should take a statin and Aspirin daily. I am worried about the situation. Please, can you suggest? ### Response: Since your stress test is normal, and the calcium score is only 34, one thing is certain that at present there is no significant blockage in your coronary arteries. I was wondering what is the need for a statin, you have not shared your lipid profile report with me. Is your cholesterol high? If it is normal, then I would not advise statin. As far as Aspirin is concerned, so there is no harm in taking it as a primary prevention" "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 husband\s semen analysis result shows azoospermia. We done it twice and the result remains the same. What shall we do? ### Response: Azoospermia was confirmed by two reports. He has to be examined for secondary sexual features, testes size and presence of gas. His FSH levels (follicle-stimulating hormone) must be checked too. By doing these we would be able to differentiate whether he has an obstructive or non obstructive azoospermia. If testes size is normal and FSH levels are normal, then obstructive azoospermia is likely. In such a case, needle aspiration from epididymis or testes may have sperms and shall be used for ICSI (intracytoplasmic sperm injection)." "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 HIV RNA, QL TMA accurate after 20 to 21 days of exposure? And also this came with my results. RNA is not detected. No laboratory evidence of HIV infection. The HIV-1 RNA qualitative TMA assay is recommended for use as part of a multi-test HIV-1/HIV-2 screening and diagnostic algorithm. This assay can also be used to resolve indeterminate HIV-1 antibody assay results, and to test for HIV-1 infection in patients less than 2 years old. When a fourth generation HIV multi-test screening and diagnostic algorithm is used, if the test results include a repeatedly reactive HIV-1/2 antigen/antibody (fourth generation) screen, followed by negative confirmatory tests for HIV-1 and 2 antibodies and HIV-1 RNA by TMA, the most likely interpretation is a non-specific (biological false positive) reaction in the fourth generation screening assay. There is no current laboratory evidence of HIV infection. Repeat testing on a second specimen is not generally indicated but may be appropriate if there are known risk factors for recent HIV exposure. If the recent HIV-2 infection is suspected, additional testing by HIV-2 DNA or RNA, qualitative, real-time PCR should also be considered. Can someone explain this to me? ### Response: Hi. HIV RNA PCR test is accurate after 9 to 13 days after the risk exposure. It can be used to detect early infection with HIV when most other screening tests are not yet reliable. However, it is not a confirmatory test and an early screening with RNA PCR should be followed by a more sensitive and specific screening test, this is the fourth generation antigen-antibody HIV screening test at four weeks and at 12 weeks. Therefore, RNA PCR is quite useful in the detection of early infection. Other times this test can be useful as a second test after an indeterminate fourth generation HIV screening test or when a positive HIV screening test is followed by a negative confirmatory test (usually a western blot). In the second scenario, if RNA PCR turns up as negative then it suggests that an earlier positive screening test was most likely a false positive." "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: About a month ago, all of a sudden, I noticed pain in nearly all my fingers. It started primarily with the middle finger on the left hand. There was an immediate major stabbing pain for no reason at various times during the day. Sometimes wakes me at night. All fingers bother me now, not sure if it is the joints or the tendons in-between.I cannot say I notice the pain or discomfort all day, but other times, I notice it all the time. Sometimes pressing around a joint bothers me but not all the time. Flexing the finger does not make it worse. Fingers are not particularly swollen, and my wedding rings come off the same as before. I have had a few bouts of gout in the past in big toes, not fingers. Otherwise, healthy male, no major health issues, take medications for high bp. I am going to see my family doctor today, but I am skeptical he is a finger specialist. I expect X-rays and blood tests, of course, but would like an early opinion what this could be, rather acutely and affecting many fingers. ### Response: Hello. I analyzed the symptoms which you had provided to me. From your lucid description, it looks like a tendinopathy or nerve pain. I am not favoring an arthritis problem as there is no swelling over the joints or anxiety. Do you have fever, neck pain, sausage-shaped finger, or local joint swelling? In any case, please use a gel ball for hand physiotherapy if it is tolerable to 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 have started to notice something about my eating habits. I noticed that I have gained a lot of weight this year. And I have even been eating food that I do not like. I get hungry so many times during the day, even though I already ate. Last year, I would not say I was on a diet. But, I hardly ate much. I was wondering if that is the reason why I am gaining this new eating habit. If you starve yourself for a long period of time, will it trigger you to want to eat more? This is a serious concern of mine, because I have never been such a big eater. ### Response: If the starvation continues for a long time, the body starts accumulating energy for the period of starvation, hence you feel to eat more. The best way is to provide lots of fluids and fibres so that you feel full and avoid carbohy" "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 mom is suffering from NAFLD. Is she supposed to avoid both saturated fats and unsaturated fats? Can she eat nuts like cashew and groundnut? ### Response: Hello. Dear, she may take unsaturated fats like omega-3 fatty acids or fish oils or cod liver oil, etc. Avoid spicy food and saturated fats. Vitamin E and Vitamin C are useful to reduce fat in the liver. Use tablet Pantoprazole before breakfast for one week in case of acidity or indigestion which is more common in fatty liver disease. Regular exercise, weight reduction may be useful. Please consult your physician for a follow-up scan and blood tests." "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 baby was diagnosed with 4 mm VSD during the 20th week of pregnancy. After delivery, an echocardiogram was done and our pediatric cardiologist told that my baby has large perimembranous VSD shunting bidirectionally. But did not tell us the size. My baby is 3 months old now. I wish to know whether size matters in VSD or not. My baby has poor weight gain. So cardiologist told us to prepare for surgery. Currently, he is on Furosemide 0.2 ml twice a day. ### Response: Yes, size matters like small VSD (ventricular septal defect) do not require treatment, while large one (usually more than 6 mm of the size of the aorta) needs surgical correction only. So here it is being large and no significant gradient across it so needs surgical correction. So here whether it is 8 mm, 10 mm or 12 mm or some other size, management remains the same. So relatively size is not important here" "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: Dear sir, I have right side throat pain from last 1 months. When I take the antibiotics then pain is gone. When I stopped antibiotics it will start again. Doctor said it is pharyngeal wall congestion. How I can cure from this disease. Kindly help me. ### Response: Good to hear from you. I understand your situation. The typical recurrent pain you complain might be because of the following most common causes.. 1. Chronic tonsillitis/pharyngitis 2. Chronic gastritis. 3. Persistent post nasal discharge. As you say it's subsiding with antibiotics it might be because of a recurrent infection. Whatever be the reason firstly, start yourself on the medication I suggest. Later make certain lifestyle changes. Medication: 1. Tab amoxyclav 625 mg twice daily after lunch for 5 days . 2. Tab aceclo plus twice daily for 5 days 3. Tab pantop dsr once daily before breakfast for 15 days 4. Betadine gargle, 10 ml in 150ml of Luke warm water thrice daily after food for 5 days. Life style changes: 1. Avoid cold food 2. Make sure the food and water you take are hygienic. 3. Avoid Spicy food 4. Eat on time. Don't let your stomach be empty for more than 2 hrs. 5. Do not sleep soon as you eat. Infection |" "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 may have an abscess and I am worried about going into the dentist because of the coronavirus. Currently, I am experiencing an achy jaw and ear congestion on one side, a slightly stiff neck, and a mild sore throat. This comes before one month after a filling repair, and two weeks after I had to go back to get the bite adjustment. It is not debilitating pain, but it is irritating and I am wondering if I can put it off until it is safer to go to the dentist. ### Response: Hello. I can understand the fear you have not to go to the dentist but please do not risk your health because of the fear of coronavirus. There are precautions to that and the dentist will also be taking precautions as the state has already issued guidelines for the doctors. Regarding your concern, I would advise visiting a dentist as soon as possible to look into and in case you need medication and intervention. If still, you want to avoid, just take over the counter pain killer like Advil and also use Listerine to subside the infection if possible. Impacted third molar, pericoronitis. Clinical, x-rays. Pericoronitis, Impaction. Pericoronitis. Oral hygiene and wash away debris and later on surgery may be required. Eat soft food on the side and strict oral hygiene. Follow up is important to see infection subsided and no complications." "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 itching and burning problem on my penis. I cannot lift my foreskin upward. It is painful to upward the foreskin. I think I have acquired a fungal infection. My wife was under treatment of heavy menstruation periods for her menopause phase. She had passed through heavy blood flow during her periods. Used 5 to 6 pads during the day. Now, she is perfectly alright for the last 20 days. We had intercourse before seven days and then I developed this symptom of fungal and itching. She is also having the same complaint but she is having itching experience only which is too less compared to me. I have taken one Fluconazole 150 and using skin cream named Castor-NF suggested by the family doctor. Please suggest treatment and medicines to us. ### Response: Can you forward a few pictures of the affected area, if possible? Your concern may be balanoposthitis most probably. Continue Fluconazole 150 mg. Have them weekly once after dinner for four consecutive weeks and for your spouse advise her Fluconazole 150 mg two tablets with a gap of 15 days. That is two weeks. Use Cetaphil cleanser for genital wash and Seriva cream twice daily after wash for 30 days. Check your fasting and post prandial blood sugar levels and thyroid profile and report me once you get your reports." "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 recurring ailment that I usually get once or twice per winter. It starts with extreme shivering and overheating, but no fever. Day two usually involves a very dry nose, very low energy, and heightened sensitivity to touch or light. Days 3 to 5 usually involve more traditional sinusitis symptoms of a headache and sore throat, in addition to the dry nose. Days 3 to 5 also cause an orange or white cobblestoning pattern in my throat due to my lymph nodes. I would like to know whether you think this is bacterial or viral, whether or not it is contagious, and whether or not it can be prevented. ### Response: Hi. Most of these attacks start as a viral infection and then become complicated by bacterial infection. These attacks are hard to be prevented completely but the use of seasonal influenza vaccines are helpful and can decrease the number of the attacks. Flu vaccines are taken before the winter season by 2 to 3 months." "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 20 year old. I think that I ejaculate very early during sex and this dissatisfies me often. It takes me hardly three to four minutes. Please suggest some treatment that would help me last longer without ejaculating very soon during sex. Please help. ### Response: Premature ejaculation is not a disease, and it is seen in almost all men at some point in their lives. It occurs because of stress and anxiety about performing during sex or a previous bad sexual experience. Medicines can be taken initially to reduce your anxiety if you are married or have sex regularly. Practicing exercises to strengthen the muscles which help in ejaculation and retraining the penis to ejaculate late, would be a more permanent solution rather than taking medicines. There is no permanent cure by any system of medicine. You can read in detail about these exercises online: All medicines are for temporary relief. A combination of the above-mentioned exercises and Duralast will be a permanent solution. After mastering these exercises, gradually you can stop Duralast. This tablet should not be taken every day, only during sex. Take the tablet one to two hours before intercourse. A mild" "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 aged 60 had a stroke 15 years back. Her doctor recommended Piracetam and Ecosprin 75. She took it for just six months after she stopped. Now, can she take both the tablets? Also, she has a nervousness in the left hand. What we do? ### Response: Hello. Ecosprin (Aspirin) should be taken lifelong. Piracetam may be taken for a shorter period of time. Regarding the nervousness in her left hand, I would recommend consulting with the neurologist and performing an EEG to investigate for seizures. Hope to have been helpful." "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 29 year old male. I am suffering from food allergy. I consulted a dermatologist doctor two months back and he prescribed Fexofenadine and Levocetirizine plus Montelukast Sodium tablets. He advised me not to take tomatoes, onions, potatoes, and lemon. The medications are over. Still, I find some hives in my body. How long should I take the medicines? Is it curable? Can I recover fully even if I take tomatoes, onions, and potatoes? Can you suggest me? ### Response: Hi. If you have an allergy to certain foods, you must be getting hives when you consume them. You might get hives within an hour of consuming those above-mentioned foods. Are you getting hives when you take these foods? If yes, then you have to completely avoid them in the future. Once your body develops an allergy to something, it remembers it forever. Whenever you take those foods, you will have hives. This is like, if you have an allergy to a wristwatch, you should stop using it. That is the only remedy for that. Similarly, if you have found out that you are getting hives after having these foods, then you should stop eating them. I am afraid that allergy is not curable, but it can be controlled with medications. Your dermatologist has given you the right anti-allergic pills. Are you on any other oral medications? Have you done any blood test? How often do you get hives? Do you get swelling of lips, eyes, breathing difficulty or any joint pain? 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 got my period after taking an I-pill the very next day that was heavy and the period lasted for five days. Is it safe? Is pregnancy ruled out? ### Response: Hello. It is better that you get a serum beta hCG (human chorionic gonadotropin) test done to conclusively rule out pregnancy as bleeding usually do not start the next day post the intake of the I-pill" "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 asking question on behalf of my niece. My niece is 2.8 years old. Considering the present situation regarding corona virus, can we give a flu shot to her irrespective from her normal vaccination schedule. Also, I want to ask you for a suggestion regarding a travel to do and also meeting a person who came from US. One of her aunt came from US recently, so my sister and my niece were actually planned to meet her but we came to know that she got fever and vomting after she came to India but she told that she is doing fine now but we were in dilemma to send my sister and niece to her in this little confusion kind of period where we do not know what decision to make. So please suggest which you feel good option. ### Response: Hello I understand your concern. Yes, definitely you should give a shot of flu vaccine which will protect from getting infected. It gives protection for a year. Regarding meeting someone having a fever with international travel history, my opinion is you should avoid the meeting and wait at least 2 weeks till no fever and other symptoms." "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 recently felt lightheadedness for about a week. I went to the ER and they could not find anything wrong. They did all neuro testing and I passed. Blood work and urine are perfect. Blood sugar and blood pressure were perfect. Ekg came back perfect, no stomach issues. I do not feel like I have to vomit and drinking or eating does not help or make it worse. I have not fainted at all. I do have high cholesterol but I take fish oil every day and red yeast rice as recommended by the doctor. The only thing that makes it go away is if I lay down and sleep for a bit then I feel better. I have had a headache every now and then but it does not last very long. Is this a neuro or heart issue or something to do with my sinus? My ears do pop a lot lately. I do not feel dizzy. The room does not spin. Just a few times I feel like I have to lay down or I will faint. ### Response: Hello, Welcome to iclliniq.com. Probably you have an issue with your ear that may cause a block in the eustachian tube due to allergy or infection leading to vertigo. Other possibilities like acute labyrinthitis or vestibular neuronitis may cause your symptoms." "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 hair is breaking recently a lot on the top. It is quite embarrassing. I use sulfate free shampoo and mine is chemically treated hair. Hair is so frizzy. What is the solution? ### Response: Chemical treatment is a common cause of hair brittleness as it breaks disulfide bonds that gives strength to hair. This would take some weeks time to resolve. I suggest you take an oral Biotin supplement like tablet Revilus once a day for six months. In addition, I suggest you use a serum Q-sera serum. Use it on scalp skin, twice 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 16 months old was on a 10 day antibiotic for a bad throat infection. It looks like one of her teeth has gone a bit yellow after it. Is that normal to happen with an antibiotic? ### Response: Hello. I have been through your query and I can understand your concern. You do not need to panic. Generally, the discoloration of the teeth is a reversible process and when the medication is stopped, the discoloration also gets corrected. The tooth discoloration has many reasons and yes one of them is medicine. There are several medications that may cause discoloration of the teeth like Tetracycline antibiotics cause blackish to brownish discoloration. However, sometimes it is not the medication as such that causes the discoloration." "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 19 years old. After scaling there is temporary removal of yellowness but after 15 days it becomes yellow again. I want a clean teeth like pearls. I am using Patanjali toothpowder. ### Response: Hello. I believe you are referring to scaling only, and not teeth whitening procedure. The scaling procedure only removes debris and calculus from the surface of the tooth and gums. For getting pearl type white teeth, you need to do teeth whitening procedure or bleaching. But still, after some time, the teeth will become more yellowish. You need to do brushing at least two times a day. A little bit of yellow teeth is normal. For permanent white teeth you can do teeth lamineering procedure which is a costly procedure where the front side of the tooth is slightly cut and a pure white ceramic layer is put over it. 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 bumps on my buttocks which are painless and itchy. No pus is present. They are hard, dry and usually itchy while sleeping. I am trying to avoid scratching it but the sensation of itching increases even more unless I strike my nails over it. There is no increase in the number of bumps so far and it has been 4 days till now. I have been applying Betnovate skin cream but there has been no change. Please help. ### Response: I have noted your case details (attachments removed to protect patient identity) and would help you deal with the problem on the basis of my experience with similar cases in my clinic." "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 been the best at my oral hygiene but lately, I feel I have been way better. I am aware of the tartar and that I need a good cleaning. I brush my teeth twice a day, use mouthwash twice a day, from there I use periogen twice a day and top it off with flossing once a day. When I read about gum disease, I see a lot of stories about gum recession and discolored gums. It terrifies me. When I brush my teeth and floss, they do not bleed. I see that is a good thing but I cannot help to just think that something may be wrong. I know I can do better with my teeth and I have been trying but the anxiety haunts me on a daily basis. Can anybody help me by looking at the pictures? ### Response: When you get a full scaling procedure done, all the calculus seen will go away. Then, the gums will look more healthy and good. You have some recession in lower front gums due to heavy calculus buildup (attachment removed to protect patient identity). Make it a habit to get your teeth cleaned by a dentist every six months. Other than that, you have healthy gums. You can maintain them by occasionally gargling with warm salt water gargle twice a day. It gives excellent results" "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: Recently I have been prescribed Tretinoin 0.25 cream and Benzaclin gel for my mild acne but ever since I started I have been getting dry and flaky skin around my eyes and mouth and burns on my cheek. Which cream is causing this? And how do I continue using them, if so? ### Response: I have gone through your case. Actually, it is a very common side effect of Tretinoin cream and sometimes Bezclin (Clindamycin and Benzoyl peroxide) also cause it. My opinion is to stop both medicines for a week. Also, use Vaseline lotion. First, apply on your hand and then tap your face with very little lotion in order to make your skin soft. If you apply more lotion then it will make your skin oily. After one week when your redness settles down then start with Bezclin gel only and apply only on lesions" "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 having severe pain in my left knee for roughly three days now. It is on the inside of the knee and slightly behind the knee cap while standing and with my leg straight. When it is bent, it is on the outside of the knee too. I cannot put any weight on it, cannot walk properly without limping. It hurts to bend it and to straighten it fully. What it could be? ### Response: Hello. Sudden onset of pain at this generally indicates traumatic nature of suffering. It is possible that you suffered with some minor injury in last couple of days. The second possibility is an infection in which there may be redness and slight fever over the affected joint. In case both do not apply to you, there is ample possibility of arthritis. My advice is to continue analgesics along with the application of cold or ice on the affected joint. If you do not feel improved in next two-three days, seek the proper consultation from your doctor so he can examine and make a proper diagnosis." "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: Dear Doctor,Is GERD curable through medicines permanently? If yes, kindly prescribe the medicines. I have consulted many doctors and taken tablets, but after a few days it is troubling again. Please prescribe some permanent solution to this. ### Response: In addition to" "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 two pins in my foot after having a hammertoe surgery. The doctor said that I would need to be sedated to remove them. Although it is an office procedure, is sedation common? ### Response: Hi. Yes, sedation is common, as it will ease the doctor to do the procedure, and also it calms you during the procedure. The sedation is a very short one will last for only about 3 to 4 hours." "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 26 years, I had a hip resurfacing surgery eight years back. I am an HLA B27 positive, even my father is also positive. I have joint pain since last fourteen years. Now, I wish to know that, if I marry and have children will this pass on to them? What measures should I take to ensure that it does not pass on to the next generation? I am at crossroads, I need to take a decision based on the reply. Please give me the solution. ### Response: About 80 % of people with ankylosing spondylitis have HLA B27 positive and only 1 to 4 % people with positive HLA B27 develop ankylosing spondylitis. That means out of 100 people with positive HLA B27 only one to four can develop ankylosing spondylitis and 96 to 99 are normal. Now I do not think you should worry about your kids having ankylosing spondylitis or HLA B27" "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 unprotected sex approximately 18 hours ago. I am worried if I should take I-pill. I am already taking medication for PCOD since one year. There has been some improvement and my period is due in a day or two. The medication that I am taking is Calcarea phosphorica 200 and Jonosia Ashoka. I am a 22 year old female and my weight is 63 kg and height is 4\11"". Should I take I-pill? Does it have any serious long-term effects? Also tell me if taking I-pill would worsen my PCOD problem? Please suggest few other safe contraceptive methods other than the general contraceptives. I had done lower abdomen ultrasound about four months back and the doctor observed small cysts. ### Response: So, you must take an emergency contraceptive pill within 72 hours of last intercourse. Again you are on homeopathic medication which would have its effect for long-term and will not offer you any immediate protection.After the I-pill you should expect your menses in the next 7 days. If it does not occur, then you should rule out pregnancy with a serum beta-hCG test. Besides oral contraceptive pills (OCP) the best contraception for you would be a depot injection or a Norplant (Levonorgestrel) hormonal contraceptive. But, as you are a case of PCOS, hormones should be avoided and condoms should be used as barrier contraceptives." "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 41-year-old male having a problem related to sex. When I have sex with my partner, I have an erection coming too quickly, or I lose the erection within seconds of leaving my partner pretty disappointed. I know that it is due to severe performance anxiety, that I am unable to control it. When I am relaxed, I can hold it for at least five to ten minutes.After a lot of hesitation, I started taking Viagra 50 mg. I do not think that I have an ED problem. I have taken it thrice till date having beautiful results each time. My partner is very happy. Is it safe to take Viagra for persons not suffering from ED? When the sex was irregular, the need for Viagra is also limited. It is used three to four times a month. Does regular usage mean that I cannot get an erection? Should I have to reduce the dosage or should I need to stop taking it completely? I do not have any side effects. I have moderately high BP, and I am taking medication for it in a low dosage. ### Response: Hi. You should check with your doctor about the medicines taken for blood pressure. It should not be a Nitrate. There is no harm in taking Viagra (Sildenafil) when you are not regular on sex. Sometimes, it can be due to other medical conditions. As you have not given your family details, it is difficult to comment more. It is the premature ejaculation causing the loss of erection. It has to be differentiated from the ED. If it is a problem, then a different medicine has to be taken, and a sexologist will help you more." "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, who is 60 years old, was having back pain for approximately 5 to 6 years. Now, she is having severe back pain while standing and the pain is not receding. We went for an MRI scan and I have attached the report with this query. I want to know the exact problem and the possible treatment for this condition. ### Response: Hello. You have mentioned pain in your mother\s back region since 5 to 6 years for which she has been managed conservatively till now. I have also gone through the MRI reports (attachment removed to protect patient identity), which have been attached by you. Spinal degeneration. MRI LS spine images, x-ray LS spine - AP and lateral views. Revert back with the investigation reports to an orthopaedician and traumatologist 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 31 year old female diagnosed with osteoporosis. Is Teriparatide treatment recommended? Or vitamin D supplements and Calcium tablets sufficient? ### Response: Teriparatide is an extreme treatment for osteoporosis and is always based on your DEXA scan (dual energy x-ray absorptiometry) report. Have you got your DEXA scan done? How have you been diagnosed with osteoporosis? Please specify. If DEXA scan has not been done, then just take Calcium and vitamin D supplement, it will suffice. If done then revert back to me with the blood reports and scan report so that I can advise accurately." "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: For the last two days, I have a ringing sound in my right ear. I have not been exposed to loud music but for the last week are so I had itching and the day before the ringing started and my right ear was blocked. So I cleared it with hydrogen peroxide but the ringing is not going away now.I visited an ENT doctor and he has given me a prescription and asked to wait for six days and then get a PTA and impedance done. I have a slight headache in my forehead and some tightness like feeling under the right ear. I also have an impacted wisdom tooth. I have attached the prescription. ### Response: Hi. What doctor has prescribed you is correct. Audiometry will see if you have any associated hearing loss and tympanometry will see if there is any middle ear infection that is causing hearing loss. (though the prescription is not attached). Wisdom tooth will cause radiating pain or fullness in the ears but not tinnitus." "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: Without remembering to take off my contacts, I slept with them on. It was only for three and a half hours. These are yearly lenses, so they are pretty thick. They are FDA approved but doctors normally do not recommend them. I woke up with my vision having a white haze. As the time goes by, it is going away. But I just wanna know if I should schedule an appointment with my doctor. ### Response: I have gone through what you have mentioned and feel that you do need an ophthalmologist appointment. The causes for such a foggy or hazy vision could be corneal edema. As you might already know the contact lenses do not permit good aeration of the cornea, this can cause accumulation of fluid inside the normally transparent cornea causing foggy vision. You may also experience seeing rainbow colored halos around light and glare. Corneal ulcers. These are also caused by contact lens wear and present with foreign body sensation and pain along with foggy vision. With the above in mind, I feel it is best to visit an ophthalmologist for further evaluation and treatment. Measures to be taken in the meantime are to stop using contact lenses, use glasses. Resume contact lens wear only after your ophthalmologist\s advise. Use sunglasses while outdoors and avoid exposure to dust or wind." "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 arthroscopy surgery of my right shoulder approximately five weeks ago. The surgeon repaired a rotator cuff tear, labrum tear, released one bicep tendon and did not reattach it, and subacromial decompression. The pain is still intense, and I am taking Oxycodone. I just started passive range of motion physiotherapy. How long can I expect the shoulder pain to last? It is far more than I thought, and for much longer than I anticipated. ### Response: Hi. This professional advice provided by me stands subject to the actual examination of report or image and is based entirely on inputs provided to me. It should be correlated with clinical findings" "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 tiny rashes all over my body. It started with my hands, then my laps, now it seems to be all over. Sometimes, it looks very dry, as though it is peeling and whitish. I went to the hospital and I was told it could be an allergic reaction and to relax but it has been almost a month and the rashes has spread to other places. Please help. What can this be? ### Response: I have gone through your complaint and reviewed the attached photograph (attachment removed to protect patient identity). It seems to be dermatitis. I would recommend you to apply topical steroid like Clobetasol propionate cream diluted in a moisturizing lotion in the ratio of 1:3 on the affected areas twice daily and take antihistaminic like tablet Cetirizine 10 mg once or twice daily depending on the intensity of itching for 10 to 14 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: In my left ear a thin hole in the membrane because of the putting ear bud in the ear it has been teared now, i am getting a ringing sound in my ear. what shall i do stop the sound in my ear ### Response: This is a very common thing to happen and you don\t have worry too much. The defect in the 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: I had a recent eye checkup. There is no change to the prescription of varifocal lenses. Why do I need to remove glasses for reading? Would single lens solve the problem? ### Response: If you were wearing glasses for near and now you do not need glasses for near, then that means you are getting index myopia due to changes in your natural lenses. That is an early sign of cataract changes that you can see without near glasses and it is called second vision. As you are 70 years old, there must be some early cataract changes. If you are fine with glasses for distant vision, then it is fine until your vision is further deteriorated." "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 suffering from dengue fever. The platelet has reduced to 35000. Is it critical? Her reports show sudden reduction in platelets from 1,00,000 to 60,000 then to 35,000. Please comment on this. ### Response: Hello. You have been diagnosed with dengue fever. Dengue fever\s first phase is a febrile phase in which fever last for five to seven days and then a critical phase occurs in which plasma is expelled from circulation which lasts for one to two days. So, platelet decline in one stage and afterward it recovers. So, a close clinical watch up is necessary in that case. If any unusual bleeding occurs, immediately consult your physician. That is necessary to maintain plasma volume and you can take papaya extract syrup also." "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: Would you please take a look at the attached pictures and diagnose as the felt symptoms are rare itchiness. Is this HPV or vestibular papillomatosis? ### Response: I have seen the pictures. (attachment removed to protect patient identity). It is vestibular papillomatosis. But tell me the answers to some questions. Since when it is present? Painful or not? Is it also present in areas other than mentioned in the photo? If it is since childhood, not painful, and not present anywhere else then, it is vestibular papillomatosis. There are many thoughts on the condition and some also believe that it can be caused by HPV (human papillomavirus). It is a debatable issue. So if you are confused with two or three opinions then you can go for biopsy for confirmatory diagnosis. But as I said it is vestibular papillomatosis on the first look, with symmetrical spread only on labia." "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 about one of my closely known relative who is of the age of 19 now and has tested her thyroid and USG was done. Her weight is 80 kg and height almost 165 cm. I just want to know two things on the basis of the two reports that I will be attaching here within.Polycystic ovarian pattern was shown in the USG. So will it be harmful to her post-marital life in case of delivery and it was also written less release of eggs? So is it due to her age that is going to get alright after her marriage? Or is it anything serious? If anything such serious, please do prescribe some medication or way to mend it.Her thyroid TSH testing was 3.79. Though it is normal, doctor has prescribed her to have 0.25 power tablets for the sake of not letting it grow further. So is it advisable for her to start with the medicine given? I want your valuable piece of advice in both cases. Her periods are regular. ### Response: Hi. Polycystic ovaries can give problems in conceiving. 50 to 60 females have polycystic ovaries. So right now there is no need to worry and especially if her period is regular. There is no such treatment to take right now. She may require treatment to get pregnant. Otherwise, there is no such problem. If thyroid is normal then there is no need to start medications right away. If you have some doubt then she can repeat the test with fasting blood sample." "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 2-year-old boy does not eat food and does not drink milk. I am very worried. Can you kindly suggest me right treatment to solve this problem? ### Response: Kids disliking food or milk is a very strange state. This usually it happens due to faulty weaning practices" "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 28-year-old male. I had sex with my partner two months ago, about a week later my genitals were itching and achy. I went and got tested and was negative on chlamydia, syphilis and gonorrhea. I had no bumps, pus or anything like that. My family doctor said it could be a yeast infection. I have been applying antifungal Lotrimin for 10 days now and the symptoms have not gone away. I am lost at what to do. My penis itches and occasionally aches and my testicles are itchy. It is a little red and is fairly irritated at the urethra. Please help. ### Response: It is more likely a fungal infection by the description given. It is prone to recurrence. Please keep the area clean and treat the partner also. Avoid intercourse. Use condoms if needed. Both take treatment simultaneously. Get back with details and photos." "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: Dear doctor,My mother has some problem. Nothing specific, but a general weakness with increased heart rate sometimes. After a course of gastroenterology specialist checkup, no abnormality was found in the gastrointestinal tract. But, now an echocardiography reveals some type of dysfunction in the heart. I attached the echo report. Please explain the report with the remedy and how serious it may be. Explain in detail. ### Response: Hello. I have gone through your mother\s reports (attachment removed to protect patient identity). The LV (left ventricular) diastolic dysfunction in the echo is normally seen in females of her age and is not a cause for worry. The heart rate in both the ECGs (echocardiogram) you uploaded is in the high normal range. The potassium at 3.1 is low, and that could be the cause of weakness, along with anemia for which she is receiving iron therapy. The heart appears fine to me. Regards and all the best" "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 blood group is O +ve and my wife\s is O -ve. Our child was born four years back and he is O +ve. After his birth, my wife was given an injection to avoid future complications arising due to opposite blood groups of my wife and son. Two years later, she had an abortion. The pregnancy was 45 days old. After this, above injection was not given. Please advice, if it is safe to go for a pregnancy. Also, please advice, if there are any tests to ascertain the risk and medications to avoid the same. ### Response: Since she has received injection after first delivery, there is nothing to worry about. So relax and do not worry. However, if you have a doubt then get an indirect Coombs test to make sure that there is no risk. The miscarriage could be because of some other cause and not because of negative blood group, as she has already been given anti-D. In case you are planning for pregnancy, get started with folic acid supplements" "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 gets throat infection for every 15 days. As soon as he gets the infection, he also gets running nose. As it progresses, there is ear pain, chest congestion, and chest pain. He is not taking antibiotics or any other medicines for this problem. Please suggest. ### Response: Hi. Collect the running fluids and do sugar estimation. Remember that the test has to be done soon after collecting the liquid. Otherwise, it will not be accurate. Next, get a sinus CT scan done to rule out the causative reason for having recurrent throat infections. Please send a picture of the throat to see whether there is any tonsillar hypertrophy. Meanwhile, start taking Septillin tablets to improve immunity. When there is no throat infection, give him amla (gooseberry) to eat. He can also have an allergy to pollens. So, he can develop an allergy. It can manifest as throat irritation, runny nose, and itching. You can do some tests to check allergy and follow some precautions to stay away from allergy. Revert me with more details so that I can 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: I fell on a cement sidewalk about two months ago, and my knee is still bruised. Although it does not hurt while doing normal activities, it hurts tremendously when I kneel or when I accidentally brush my knee against anything. Please help. ### Response: You described that the pain gets worse on kneeling (direct pressure), which means two or three things: I suggest you try the following: Finally, seek the help of a physiotherapist to get local ultrasound therapy to desensitize the area" "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 week, one night, I had unprotected sex twice with my fiance. The next night, I took Escapelle on a full stomach. After two days, I was experiencing cramps and I had noticed a white discharge with a mild scent. This carried on until today. After each meal, I felt extremely nauseous, emotional and tired. Now, I have started spotting and I am feeling extremely nauseous followed by cramps. Is it possible that I could be pregnant even though I took the pill? This is the fifth time I am using Escapelle within seven months. ### Response: Hi. The morning after pills are large dose Progesterone and they can cause irregularity or delay of periods. You have been taking it too frequently and it is not advisable. You should better use condoms as they protect not only against pregnancy but also prevent sexually transmitted diseases. The chances of getting pregnant are less in your case but still, you should go for a pregnancy test after two weeks." "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 sinus infection for over eight weeks now. After trying to get rid of it using Neti pot and Flonase, I started taking antibiotics. I had my sinuses scraped about four years ago due to a recurrent sinus infection. I went to a dentist because of a broken tooth, that was causing me pain. The dentist put me on two more antibiotics to treat the pain. So, currently I am under Alprazolam 0.5 mg (four times a day), Truvada (once daily), Quetiapine and Buspirone at bedtime. I have horrible diarrhea and nausea every morning and wake up with a terrible sinus headache still. I am at my wit\s end, and cannot see my regular doctor for a month. I am getting the tooth extracted in two days, hope it will help. Any guidance would be so much appreciated. ### Response: So you have two issues, one is your sinusitis, and the other is diarrhea. Gastritis is probably antibiotic associated, so you need to discuss with your doctor and change the antibiotics that are causing your diarrhea. I would suggest the following for your gastric problems. For sinusitis along with antibiotics I would suggest you try the following. For a headache, you can have Paracetamol or Ibuprofen whenever needed. If it is not helping, then you need to discuss with your local doctor for a short course of oral steroids. Consult your specialist doctor, discuss with him or her and start the medication after their consent. Get back if you have any doubts." "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 18 years old. I was playing with my friend\s dog yesterday. By mistake, the dog\s teeth touched my hand, and a little drop of blood came out. Do I did need an injection? ### Response: Hi. If your friend has done a vaccination to the dog, then there is no problem. Keep the bitten site clean, wash with warm water and soap. Apply Oxygenated water and Betadine (Povidone Iodine) locally. You can take them over the counter, and there is no need for a prescription. As you are 18 years old, and if still, you are getting your scheduled vaccines, then there is no need for getting another Tetani injection." "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 currently am suffering nighttime upper back pain. It is only painful when laying down, I have been prescribed Co-codamol but have yet to get any tests or scans done. This pain wakes me every night to a point I cannot roll over or change sleeping postion. Last night bothered arms from the elbow down, went numb with pins and needles. Kindly advise. ### Response: Hello. As this sounds like the cervical radiculopathy, an MRI is suggested of the cervical spine. Also, I will advise you to use neck collar and continue the medicine. Also, shoulder stability exercises, inter-scapular muscle strengthening exercises are advised." "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 19 year old boy with extreme hair loss. Even at this age, my scalp is clearly visible. I tend to lose around 100 strands of hair daily. Please help. ### Response: A person normally will lose 100 strands of hair daily. The main culprit is the DHT-dihy" "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 irregular periods for months. I am experiencing abnormal periods where I am bleeding every other week. Sometimes the bleeding lasts a few days whereas sometimes it lasts at least eight days. More recently, I have had my worst period. I have had it 10 days then off for three days and then back on again for another one. I am currently on a period and it does not look like it will go soon. They are not particularly heavy periods for me and are both a mixture of different shades of red. I currently take the Norethisterone, the only tablet for contraceptive. Please help. ### Response: The contraceptive efficacy of the Norethisterone is quite less and if you are taking it irregularly then also it may cause a breakthrough bleeding. So the important thing is to get a pregnancy test as this is the most common cause to rule out. If this is ruled out then irregular intake of hormones is the second cause. I suggest you get a gynecological ultrasound and a serum beta hCG (human chorionic gonadotropin) done. AUB (abnormal uterine bleeding), pregnancy, and hormonal imbalance are the differential diagnoses. The treatment plan is to stop taking the pills at present. Let us know the reports of the investigation. Preventive measures include the use of a combination of oral pills. Follow up with the reports" "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 18-year-old boy suffering from the problem of premature ejaculation. Please suggest me any medicine for the permanent elimination of the problem. ### Response: Premature ejaculation in most of the individuals occurs because of anxiety and stress. The permanent solution for premature ejaculation is to get relieved of anxiety and stress. Stop anticipating things and avoid thinking that you will ejaculate earlier. You can visit a psychiatrist for help" "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 thoughts are always racing, and I cannot focus. I am always worried, and I think for the worse. I get emotional over things which happened in the past, every day. I have gained 20 lbs over the past year. I stress about going for trips or gatherings in advance, but in the end, I always enjoy myself. I have had my thyroid checked, and it is normal. I have previously been on Buspirone, but I hate taking medicine, so I stopped after three months of taking it. Although, it helped to an extent. Currently, I take multivitamins, and I am overall healthy. ### Response: Hello. I can understand your concern. So, please do not remain distressed. These symptoms can be controlled even without medicines. But in rare cases, medicines will be 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 have got high blood pressure, low potassium and vitamin D levels. Also, my aldosterone level is very low that is almost non-existent. I think low aldosterone is supposed to cause low blood pressure. I am wondering once I start the low aldosterone treatment will my blood pressure, potassium and vitamin D level go back to normal? Please reply. ### Response: You are right. Hyperaldosteronism causes hypertension with low potassium. But, in your case the things are opposite. That means the high BP is not related to aldosterone levels. You might be having an entity called essential hypertension. Low vitamin D levels are present in 60% of the population, so do not relate it with BP. Just have a good sunbath for at least twice a week and have vitamin D3 supplements 60000 IU once a week orally. For treatment of hypertension, I suggest ACE inhibitor therapy such as Telmisartan or Olmesartan. This will correct your BP and potassium levels. Consult your doctor, discuss with him or her and take the medicine with 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 am going to have sex for the first time with my fiance. We have decided that he will be using a condom for protection. But to be 100% sure about not getting pregnant, I want to take pills. We will be together for a week so there are chances of having sex every day in that week. Which pill would work best and also not affect my regular period and hormonal health? My period cycle is almost accurate all these years and I do not want to disturb it. We will be meeting after seven days from now. Please guide me. I had my last periods seven days ago. ### Response: Hello. I have gone through your history and understand your concerns. As such if you are using a condom properly, there is no chance of pregnancy. But for extra precaution, you can use combined oral contraceptive pills. Usually, it should be started on the first day of your menses but you can start on the fifth day of your cycle on a daily basis. So you should start it from today itself. Regards." "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 extreme swelling from under the breast to the belly. My legs and feet are also very swollen and painful. I have gained 40 pounds in two years with no change in diet or activity. My lower legs and ankles were swollen about a year ago. I went through all the horrible heart testing and finally, my heart is fine. My current medications are Bupropion, Carvedilol, Cetirizine, Furosemide, Losartan, Potassium, Hydrochlorothiazide, Gabapentin and Norco. ### Response: Hello. Swelling of feet and ankle is known as pedal edema. Edema occurs due to the accumulation of fluid in the tissues. There are many causes of edema. One is congestive cardiac failure or right heart disease. As this progress, it appears in abdominal wall too. Edema revolves around cardiac, liver and renal that is kidney. It would have been great if you upload 2D echo report, ECG (electrocardiogram) and chest x-ray. Serum albumin, CUE (complete urine examination) to look for urine protein, 24 hour urine volume and protein and thyroid profile are a few tests required. Your blood pressure is perfect; hence the dose of the diuretics cannot be further increased. Curtail salt in food. Consult your specialist doctor and discuss with him or her regarding the above medicine." "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 12 year old son is suffering from nephrotic syndrome since the last seven years. Two years ago, when his biopsy was done, the result said FSGS. His creatinine levels at that time was 4. Now it is raised to 10.1. He is currently taking Calcium, Folic acid, Pantoprazole, Sodium bicarbonate and Cilnidipine. Please suggest the course of action. ### Response: Please furnish the following medical information, so that I will be able to give you further advice. Revert with more information 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: My little daughter has a supravalvular pulmonary membrane that causes minimal stenosis. So I do not know what to do. The doctor said that the stenosis is very small and will wait and see. So I need to know what should I do and what is the next step. Can this be treated without surgery? Now she is 10 months old. ### Response: This condition is more of pediatric cardiology rather than adult cardiology. However, I think that if the stenosis is minimal then it should only be observed at this stage with regular yearly echos. If the stenosis progresses and become of severe degree, then this can be managed with means of balloon dilatation in the first instance in young age group and only if this fails, then she can have surgery. I wish your daughter good recovery and happy life." "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 18 years old. I am suffering from a squint eye. Can I have any solution for this problem without surgery? ### Response: Hi. I have gone through the query. I can tell you the options available to you. It mainly depends on the type of squint and your eye function. Is the squint involved in one eye or both? How do you see with the squinting eye? When you have double vision, how do you see? In case, if you see well, you are eligible for prisms. These are particular types of lenses which are embedded into glasses. They can be used, but this needs training to the people for straightening their eyes. In some instances, they produce useful singular vision. In case, if you are ineligible for prisms, you have to go for surgery. As soon as the surgery is done, the results will be better." "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 an ulcer a couple of years ago. I watch what I eat so not to aggravate it, but I woke up early this morning having horrible stomach pains all over the midsection. What could be going on? ### Response: Your stomach pain is mainly due to the stomach ulcer. Based on the location of the ulcer in the gastrointestinal tract, it can be classified into two types: I request you to attach a copy of the endoscopy report to have a proper idea about it. I suggest taking syrup Sucralfate 10 ml early in the morning before food and tablet Pantop (Pantoprazole) 40 mg once daily early in the morning after getting up from the bed, as these will reduce the acid secretion. Consult your specialist doctor, discuss with him or her and take the medicines 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: My girlfriend had her periods 16 days back but two days back she had a white spotting and today she had blood coming out of her vagina for a second but stopped. Please tell me what does this mean. ### Response: Hi. The reason for this kind of bleeding can be some abnormal uterine bleeding or simply ovulation bleeding. Today is her 16th day of period probably ovulation day and her detailed obstetric history is not known. So watch for any pain or repeat episode of bleeding and if so get one ultrasound pelvis 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: Dear doctor,I am 34 years old and am married with two kids, the youngest of the two is 5 months. I have three queries.I procrastinate a lot. Is it psychological? Can it be rectified?I have low self-esteem. Things which happened in my past keep coming to my mind and it hurts me. My mum has told me that I am a good for nothing and I cannot do anything. Is there a way out from feeling so worthless?My husband is an awesome guy. He is very caring and kind. He is the perfect match for me except the fact that he is not interested in sex. Right from when we got married, he never was interested in sex. He has sex when I force him too much and for having kids. Is it due to a low amount of testosterone in him? Can it be rectified via a testosterone injection? If that is the case, will he be interested in sex only or will his whole personality change? He is very emotional and helps out with everything. I do not want that to be changed. ### Response: I can understand your concern. 1 & 2. A lot of individuals have the habit of procrastinating. If there are no other associated symptoms, we cannot label this as psychological. You have mentioned that you have low self-esteem and you think a lot about past. Sometimes, you feel worthless and these symptoms might be associated symptoms. Delaying anything without any reason could be due to lack of motivation, initiative or judgment. This should be properly evaluated. This might be due to underlying mood disturbance. Mild depression can cause similar presentation. If there are no such symptoms and you just have the issue of procrastination, then this is not an alarming thing. Try to remain relaxed, make a proper routine of your day to day activities and follow that routine. This will help improve the functioning. Once you are engaged in your routine, the problem of feeling worthless will also go. Try to get pleasure by finishing the work on time and this will motivate you to do more and ultimately the worthlessness symptoms will go. 3. You have mentioned that your husband is an awesome guy and is emotionally very supportive. But, one issue is that he is not very interested in sex. If he has low interest in sex but during sex, if he is getting good erections, then I do not think there is a problem of low testosterone. I hope he is not overweight and has mesomorphic build. In obese individuals, low testosterone could cause problems. Still, to get a clear picture, you can talk with him and get his serum testosterone and prolactin levels done. This will rule out any hormonal cause. Testosterone injections are given for hypogonadism and this will improve the libido and erection of individual. You can give him herbal medicines containing supplements like L-arginine and yohimbine. Both these supplements will increase his libido and erection. You can find these in supplements stores" "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 eye floaters, halos around the lights, photo after image, ghost image. First floaters started two years ago, then after 6 to 7 months later. I started seeing halos around the light then ghost image and three months ago, I started seeing photo afterimage. I am really scared of this. Please help me to cure this. ### Response: Floaters, photo after-images, ghost images are usually seen in disorders of the retina. Halos are indicative of corneal edema due to various reasons. There are a lot of diseases which can cause such a picture. At the same time, if you only experience these problems once in a while and have no problems with vision, you could actually have no treatable problems. The best and only way to confirm it for sure would be to visit an ophthalmologist. In case you do not have any of the above, I would say a non-urgent visit would suffice." "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 tachycardia (resting heart rate 125 bpm) while just walking around the house and not doing much. My heart rate was about 160 bpm. I do get chest pains and tightness. I also have a 70% LAD lesion. My question is would the lesion be causing my tachycardia? Should I consult my cardiologist? I am currently on Amitriptyline. My CSK level is slightly raised and normal FBC. ### Response: Hi. Blockage of 70% is referred to as noncritical blockage. I suggest tablet Ecosprin 75 mg (Aspirin) every night, so that the blockage will not progress in the future. Tachycardia can be because of a large number of causes varying from anxiety, stress, anemia, decreased coronary blood supply and defective electrical currents in the heart. Tachycardia can be of two types. Sinus tachycardia and arrhythmias. In sinus tachycardia, heart rate increases, but the rhythm of the heart remains normal. This can be corrected easily with the help of beta blocker. Arrhythmias can cause disturbed rhythm of the heart and are to be taken very seriously. They can even be fatal. I would suggest you to go for an ECG, 2D echo and Holter test for getting evaluated. If you have an ECG, then attach a copy so that I can see the basic rhythms of your heart. Smoking and alcohol can also cause palpitations. But, you have not mentioned them." "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 two year old daughter is generally healthy. But, today I noticed some horizontal lines on her toenails. I am sending a picture of the same. Could it be a serious problem? ### Response: I have seen the picture (attachment removed to protect patient identity), and understand your concern" "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 16 years old. I just recently discovered that I have scoliosis. I do not know much about it but I will tell you what I know. My scoliosis currently has only a 3-degree curve and I am pretty confident it is a C shaped curve, although I am not sure. What do you think are the chances that my scoliosis will develop into adulthood? Do you think it will stop progressing once I am fully grown? ### Response: Before going into the progress of scoliosis, I would like to make you some clarity about the facts on it. 1) The Cobb angle is a measure of the curvature of the spine in degrees. This helps to determine what type of treatment is necessary. A Cobb angle of 10 degrees is regarded as a minimum angulation to define scoliosis. 2) A scoliosis curve of 10 to 15 degrees normally does not require any treatment except for regular check-ups. 3) If the scoliosis curve is 20 to 40 degrees, the orthopedic doctor will prescribe a back brace help to keep the spine from developing more of a curve. 4) More than 45 degrees need correction surgery keeping many pedicle screw and osteotomy to correct the curve. I hope you go for x ray done of your spine and it will be easy to measure properly about the curvature." "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 red or pink hive from the last fifteen years on my right hand. ### Response: Hello. I have gone through your query and have viewed the image (attachment removed to protect patient identity). Regards." "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 23 year old son was diagnosed with ASPD. I have read that there in no cure. How do we deal with him? My local psychologist says he should be kept separate from the family to prevent him being parasitic. What should we do? ### Response: Hello. Antisocial personality disorder is a personality disorder. Those affected may lie, break laws, act impulsively and lack regard for their own safety or the safety of others. The ray of hope is that the symptoms may lessen with age. Therefore you should be always hopeful. Psychotherapy, awareness, psychoeducation to the family members, etc. can effectively be applied to the patient as well as the family members. There is no need to keep the patient away from home if the others are educated" "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 ago after having a couple of falls, my mother was diagnosed with progressive supranuclear palsy by a neurologist. Last week, she suddenly started to experience urinary incontinence. Over the past few days she has complained of the urge to pass urine quite often and sometimes as much as several times within an hour. When she does visit the toilet, she sometimes passes little or no urine. Last night we got her tested for UTI and the test came back negative. We are concerned and exhausted. We look forward to getting your input. ### Response: The increased frequency of urination and urinary incontinence are due to bladder overactivity. Your mother should undergo an urodynamic study to know what exactly is happening in the bladder during filling." "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 shallow and fast breathing, usually bubbling and wheezing at bedtime along with nasal congestion and post nasal drip. My mucus is low and clear with a little cough. I have these symptoms for the past three months. I used Mucinex nasal spray, salt water spray, and Benadryl. I am a smoker for 30 years. I did not get any health problems so far. I have nofever but a little pain in chest with heart palpitations. ### Response: I can understand your concern. By your history and description, the possibility of bronchitis is more likely. It is commonly seen with smokers. It is the inflammation of airways. This inflammation causes bronchospasm which inturn causes wheezing, breathlessness, mucus production, etc. So please let me know, how many cigarettes you smoke in a day? Have you ever undergone a chest x-ray and PFT (pulmonary function test)?" "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 always have bad breath and a smelling mouth. Recently, I found stinky tonsil stones. Is there any antibiotic or treatment available to cure it? ### Response: Hi. Bad breath or halitosis is a problem where the breath is smelly. It has some causes from food to some disorders. As you have tonsil stones, you can have infections in it. It can be treated by using antibiotics. If you have a recurrent infection in the tonsil, then I suggest you visit an ENT specialist. If you are not allergic to antibiotics, you can take Azithromycin tablet once a day for three days. If the infection persists, continue taking it for six days. Take Montral (Montelukast with Levocetirizine) tablet daily after dinner for seven days. Do mouth gargles using Chlorhexidine mouthwash (1:1) two times daily. Maintain oral hygiene. Brush your teeth two times daily and floss it every 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 was accidentally hit in the face by a teammate in volleyball. It was not that bad, and no immediate bruising but the left side of my face felt mildly swollen. The next day as I kept touching it, it flared up and broke out in a rash on the whole left side of my face. Is it possible that it was a reaction to the hit? Anti-histamines do not seem to be working. What can I use? Is Cortisone safe on my face for this type of rash? ### Response: I have gone through your case. In my opinion, you should not take it lightly. Either see the doctor in person or send a picture as the face is very sensitive part of the body and you may need a course of oral antibiotic. And in this case, antihistamine has no role. There might be a collection of blood or it colud be just soft tissue 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 am hoping you can answer this question for me. I am submitting a photo of what I am hoping is a skin tag. I have had this for years but never asked about it. It is on my testicles. ### Response: Hello. Yes, it seems like a tag (acrochordon). Another possibility is that of a wart. Is it soft and swishy when you squeeze it? Or is it firm? A skin tag either has to be removed with a cautery machine or it can be fulgurated." "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 21-year-old female and 160 pounds and at a height of 5'6"". I have been having a problem with my left ear. I woke up one morning and felt that it was clogged and made the mistake of using a Q-tip which resulted in my being unable to pop my ear. That was over a week ago. I have tried wax softener drops and a saline spray to try and clean my ears out but it has not worked. Now there is a pressure inside my ear. I am not sure what to do. Is there anything I can do to fix this? ### Response: Possibilities are impacted wax, ear canal infection, middle ear infection, eustachian tube catarrh. Unless one sees inside the ear using an otoscope or endoscope it is difficult to diagnose. If you need more information on that revert back to me. One can buy ear cameras and they do help in cases like yours where you are not able to go to an ENT. You can take pictures of the inside of the ear and share with us online and we can guide you on what is to be 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 have a braces-related question. I wore the traditional metal braces on my upper jaw as a teen, 10 years ago. I wore the retainer for five years every night, and then I reduced it to one night per month after that, as instructed. My front four teeth shifted a lot (they are crowded, so it was a quite visible shift, some were pushed out, and some pushed back).The retainer could make a big difference in one night when I wore it, but I was advised to get a completely new brace. So a few days ago, I got a lingual brace on the front teeth (the social six). My concern now is the speed of shifting. A couple of hours after getting the braces, my teeth were significantly straighter (1 to 2 mm difference).A day after they look almost perfect, I was told I would be wearing the braces for six months to a year. How is such a drastic change possible so quickly, and is it healthy or normal? It hurts always, but it is not unbearable. And could I have used a new retainer instead of getting new braces then? I hope you can help with my worries. ### Response: Hello. All the movement and everything depends on the bone density in your oral cavity so no issues if it is going faster, it is a good sign that it is showing you benefits so soon. And braces and retainers each have their course of works so you should not be regretting on putting braces, there might be some issues your dentist would have observed through X-ray that is why she or he felt the need for braces. If you have been told six months, does not mean six months always, if there will be good results, it might be reduced to four to five months even. So go ahead confidently, your dentist is doing right." "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 18-year-old male and I am trying to find out if there is any way to lower my hairline. I had a big forehead since birth and I am wondering if there is any way to change that. ### Response: There are two ways we can use to achieve a lower hairline or a smaller forehead. The first is a surgical approach to remove a portion of the forehead skin and effectively lower the hairline. The second is to make the forehead appear smaller by grafting hair to the front of the hairline. Occasionally, these two procedures can be combined but as it is a very expensive method the only way which you can do is undergo a hair transplant by FUE (follicular unit extraction) method to create a new hairline to hide your big forehead." "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: From one month, I started to observe some rashes on the skin under my lips. I have been diagnosed before with dermatitis, but this is a different kind of rash. I have attached a picture of the rash. I have already tried applying moisturizing cream, Fisiogel, and Aciclovir. I thought it to be due to herpes, but these creams did not work. Please help. ### Response: I have seen your query and examined your picture (attachment removed to protect patient identity)" "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: Before eight hours, I got my wisdom tooth out. My mouth was filled with blood. Just 30 minutes ago, a small piece like a blood clot came out of my bottom right socket. When I look at my holes in the mirror, they are all filled with dark blood. Can I get a dry socket? Should I need to go back to my dentist now? What should I do? I am terrified of the pain. ### Response: Hi. Since your socket is filled with blood, there is nothing to worry much. Regarding this socket, I cannot assure you without seeing the image. Maintain your oral hygiene and follow the instructions given by your dentist. Do warm salt water gargling after a day and for the next 24 hours do not gargle forcefully or spit forcefully. Do not try to manipulate the area with tongue or finger. All the other instructions would have been given by your dentist." "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 pain in my right elbow and shoulder for a couple of weeks. I lift heavy weights and workout every day. I am doing this for many years, so this is nothing new. But, it is agony now to hold the bar in squats. If I am lying on the floor with the elbow at 90 degrees, I cannot put the rest of my arm on the floor. Also, wearing a sports bra, etc., hurts me and I cannot rotate my arm to try and reach my back. When I am sleeping, I tend to wake up with my arms straight out and above my head, since this is the least painful position. The last day, it is also painful to just stand with my arm straight down, feels like something is ripping across from above my sternum to my deltoid. Is there anything you can do to help this? Either exercises or stretches, which one will be helpful? I cannot recall anything happening during a workout as that has caused this. ### Response: Hi. I am glad to respond to your query. 1. Overstraining in the gym.2. Lifting weights that are too heavy for your shoulders and arms.3. In the absence of the above, it may be because of insufficient healing time (rest) after a minor injury. Ultrasound shoulder would be sufficient and can get an MRI if warranted. Pectoralis major muscle strain. Ice application and rest. 1. Prevent any position of the limb that hurts your shoulder. Keep the arm supported.2. Stop visiting the gym for at least three weeks or till the pain subsides and be regular with your medicines." "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: At my 17 week ultrasound, the baby had an echogenic bowel. I was offered for level two ultrasound on the same day. Other than echogenic bowel, I had a normal scan. After that, I was suggested for the quadruple test, which came back low risk (1:2226). At my 19 week ultrasound, echogenic bowel was still present but not that much bright seen than the 17th-week scan.So, we were referred for genetic counseling. Genetic counseller also performed a detailed scan and told that everything was normal but there was mild echogenic bowel present. She told that due to an infection that it may happen. So I had a TORCH test. In that result, everything was within normal range except CMV IgG. My CMV IgG was 83.7. Will this CMV cause echogenic bowel in the baby? WIll it affect the baby\s health? I am very much worried about this result. So I did amniocentesis this week. The result has not yet come. Will amniocentesis identify the infection in the baby? Please explain. ### Response: You have undergone level two ultrasound twice by radiologist and geneticists. So, you need not worry. Your triple marker report shows low risk which means there is 99.99 percent no problem. The TORCH (toxoplasmosis, other infections, rubella, cytomegalovirus, and herpes simplex) test shows CMV (cytomegalovirus) IgG (immunoglobulin G) positive. It is of no significance as it indicates a past infection before pregnancy and you have already gained immunity against that so it is not the cause for any infection. Amniocentesis you have already done it. You can request the generic counselor for karyotype of the sample taken. It will rule out any chromosomal anomaly. It takes nearly three weeks for karyotype report to come" "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 had an intercourse and after which she took an I-pill. After 10 days, she had her period. It started yesterday and stopped. Now, again it started and she is vomiting whatever she eats. She is feeling dizzy and weak. Please suggest some way to overcome this. ### Response: Hello. You have not mentioned after how many hours of intercourse your friend has taken I-pill. And secondly, she had bleeding after 10 days of I-pill. To come to a conclusion we should know on what date of her cycle she had sex and when I-pill was taken. Revert back with the asked details to 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 want to know what procedure is better for a nervous person? Twilight with nerve block or general anesthesia? ### Response: Fibula is lower leg bone for that usually they will give anesthesia called spinal anesthesia in which injection is given to your spine at your lower back, that is simple, and pain free surgery can be done and only your two legs will have anesthesia another full body will have senses you can see, feel, talk and everything will be normal after four to five hours your legs will lose anesthesia, and you can start feeling them. If you are terrified and having the anxiety of operation, you can ask for spinal anesthesia and sedation so that you can happily sleep. General anesthesia for this surgery is not a good option because they will anesthetize full body and you will be connected to an artificial ventilator, and it will support your breathing. My choice is to go for spinal or block." "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 26 year old female, who has an inflamed looking foliate papillae on right side of the tongue towards the back, it has been like this for more than three weeks now. It has not gotten better or worse, pretty much looks the same.It creates this feeling of something stuck in the back of my throat, and this feeling gets worse after I eat food or talk a lot. When I wake up in the morning the feeling of something stuck in the throat is less obvious. But as the day progresses, the feeling is more obvious. I think it is because of the enlarged foliate papillae rubbing the back of the throat when I talk and chew.There is an ulcer like a hole in the middle of the swollen foliate papillae as well, and I am not sure if it is because the papillae is swollen. I do not have pain at all, but sometimes there is this burning sensation. The area looks the same for the past three weeks, and it did not change in appearance or size.Everywhere I read online says sores that do not heal within 2 to 3 weeks can indicate oral or tongue cancer, so I am terrified. I do not smoke or drink. But I had bad oral hygiene before which resulted in a tooth infection and abscess (on the right upper tooth) about six weeks ago, which has since gotten better but never completely healed. The dentist suggested root canal, but due to the expenses I am not able to get it done anytime soon, so I am just managing the tooth with antibiotics, salt water, and colloidal silver until I can get a root canal. ### Response: The lesion on the tongue (attachment removed to protect patient identity) appears to be an ulcerative lesion. You should get yourself examined by an ENT specialist because I think a biopsy might be required. As you might have taken antibiotics for tooth infection, the tongue lesion must have improved. I suggest you try doing the following. Consult your specialist doctor, discuss with him or her and start using the medicines after their consent. Any further questions are always welcome." "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 cold for three years until now. I think it is due to a dust allergy. Please help me. ### Response: The long-term cold is suggestive of allergic respiratory tract infection. You need to investigate with allergic testing for further work up. The causative allergen needs to be avoided like dust, mite, pollen exposure, cold atmosphere, etc. The Levocetirizine or Fexofenadine like anti-allergic medication can be prescribed for your case. Immunotherapy is also beneficial in such 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 have pilonidal sinus. I had two surgeries one with the endoscopic method and the second one six months before by incision and drainage method. After recovering from this, I had a small pimple on the wound. Doctor said it is normal and it is because of surgery. But now I am having redness around that. I am using alcohol swap to clean the opening areas of pilonidal sinus and they are closed. Kindly tell me is this recurrence of pilonidal sinus or boil or what it is? It is causing pain while sitting as well. ### Response: Hello. Do not worry. I will help you with your problem. As you said, you underwent surgery for pilonidal sinus two times and now you have one boil at the same site. As I can see in the image (attachment removed toprotect patient identity) it can be boil or recurrence of pilonidal sinus that may be due to infection of that local area. I will prescribe you some medicine. Please maintain local hygiene shave your hair in that area. Get back to me after five days. I will add some more medicine and local remedies. Sitz bath in luke water with Betadine twice a day, tablet Augmentin (Amoxicillin and Clavulanic acid)625 mg TDS for five days, tablet Chymoral forte TDS for five days, tablet Serradic P BD for three days, Capsule A To Z OD for 10 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: My left testicle has a dull ache when I stand for a period of time. I can also see an enlarged vein on my testicle. It goes away when I sit or lay down for a little bit. I will attach a picture of the vein. ### Response: I think it is a hernia. Kindly give some other details. Do it have cough impulse (it means the swelling expands upon coughing, it is said to have a cough impulse). Can you get over the swelling? (this means when swelling is there are you able to pinch your spermatic cord?) ignore if you are not able to understand. Do you do weight lifting? Diabetes or hypertension? Any medication?" "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, 32 years old, seven years back during delivery time epidural anesthesia was given. After that, have got a headache now. It is a chronic headache like a migraine, no other complication, no hematoma, and all rigor and shivering present. What is the diagnosis? ### Response: Hello. First of all, I would like to say that the epidural analgesia taken seven years back is definitely not the reason for her chronic headache. As she is having chills and rigors, check her temperature, and headache along with that suggests some acute viral fever. Although keeping in mind her chronic complaints of a headache I would suggest her to visit a neurologist for the evaluation of cause and treatment of same. A migraine. Acute viral infection. Acetaminophen." "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 recurring UTI. Last time,a few months back, after taking medicines for the recurring UTI, results were normal. I took Cital syrup and antibiotics. After experiencing pain recently I again went for urine test, and it shows RBC, epithelial cells and bacteria. I have attached the reports. I was consulting a gynecologist prior to this, but she told me to consult a urologist. I have attached my last ultrasound and kidney function test along with today\s urine test. ### Response: After reviewing your complains and your blood and urine test with ultrasound reports (attachment removed to protect patient identity), kidney functions are normal, your ultrasound is normal, your urine analysis showed pus cells and few red cells and white blood cells. My question is do you have symptoms like difficulty in passing urine? Or pain while passing urine? If not then did you have urine culture result before your antibiotics treatment? If you have documented UTI before and you got treated then you have pus cells and white cells in urine, your test might have been performed soon after antibiotics. The possibilities are incomplete treatment or chronic inflammation of the urinary bladder as sending infections are also common in postmenopausal period. You will need to follow up with urine culture test, if it is negative and you have no symptoms then no need to treat. If it is negative and you are still having symptoms (pain while passing urine), we need to do more tests. I hope to follow up you after urine culture results. Cystitis, incomplete treatment. Urine culture. Cystitis bacterial, TB. Cystitis. Observation and 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: My mother has asthma as she used to smoke and live near roads. Her X-ray showed that trachea is in the midline, the cardiac shadow is not enlarged, pulmonary vasculatures are not prominent, hemidiaphragm is flattened, costophrenic sulci are blunted, right lower lung infiltrates present and pneumonia entertain. Please correlate clinically. Emphysematous changes are also considered.The last X-ray was negative for tuberculosis. She was using Ventolin as nebulizer three to four months back. ### Response: I have checked the attached report, along with the data you provided (attachment removed to protect patient identity). Your mother has COPD which is a chronic obstructive lung disease due to changes in the lung with age and due to smoking. In COPD the air is entrapped inside the lung with difficulty to get it out, so the oxygenation is impaired. Thus the patient becomes hypoxic with frequent exacerbations in winter with any infection of the lung. The infiltrates found in the right lung are due to pneumonia. The treatment includes inhalers regularly with antibiotics and long-term home oxygen therapy may be required if certain criteria are found. To identify the stage, I need to see her oxygen saturation in room air and arterial blood gas test" "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 love myself and think I am a great guy, but feel no one else sees that. I have feelings of pending failure, feelings of inadequacy, fear of rejection, fear of police, fear of persecution, lots of mental ambition but no energy to actually do anything because I am convinced I would fail, near constant nightmares about being in jail often without knowing why or being hunted down by people determined to kill or imprison me again without knowing why. Occasional ED which I attribute to the antidepressants, obesity, cholesterol and sleep apnea, and fear of emotional intimacy and talking about my private self. I have been diagnosed by the VA with dysthymia depression and at a non VA psychiatric hospital after a suicide attempt with PTSD, which the VA says I am not. My research tend to point more towards C-PTSD and I have an inability to trust people especially authority, I often feel as though there is an orchestrated conspiracy against me, but grounded enough in reality to know that makes little sense, but often cannot shake the feelings and have a number of instances in my life that simply reinforce that thinking. I fear criticism and rejection from those I should be closest to like my wife and mother. Desire intimacy but have none, being more emotionally intimate, but not cybersex just erotic conversation, with strangers on the internet because of anonymity. I never use my real name online. That is background information.Anyway my question is about the medicines but it just seems like so much and I tend to distrust the VA doctors but have no other healthcare options. Just looking for someone else\s opinion. ### Response: Yes, you are on right medication. Bupropion is a good antidepressant and very safe although it can cause insomnia, anxiety and dizziness as side effects in few patients but it would decrease on its own. As an antidepressant, Sertraline is so potent at stimulating the brain that it can cause anxiety with initial use. But it goes off after some time. Using a Benzodiazepine like Alprazolam for the initial 10 days of treatment with Sertraline. Once you get used to it you may taper the Alprazolam and stop it. Sertraline would continue. You can talk to your psychiatrist regarding this. But you have to comply with medication and you have to reduce your weight." "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 received a root canal treatment on my tooth (#37 tooth), and after 10 months, I have not been experiencing pain. Just this few weeks my tooth hurts every time it comes to contact with another tooth. But it does not hurt when I do not bite on anything. Is my wisdom tooth is growing and gradually affecting the treated tooth? Or is there any possibility that a root canal treated tooth will still give me pain after it was handled? My tooth is sealed with resin composite filling, and my endodontist never suggested if I should have it crowned. ### Response: The best possible way to find out is to get an X-ray done of the area to find out if there is an abscess related to the wisdom tooth or the RCT treated the molar adjacent tooth. Bite on a pen or pencil on that treated tooth, if it pains then it may be related ot it else the wisdom tooth may be causing a problem. You may need Antibiotics and painkillers, so get a consultation with your dentist and ask for an X-ray." "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 want to confirm that whether I-pill is safe. Actually, my wife had taken I-pill a month back and two days back we had again unprotected sex. Is it fine to take I-pill now also? Please suggest. ### Response: If she did, then at what date did she had her bleeding as that would be important to calculate whether she was in her safe period or unsafe period. If unsafe period then it would still be best to take the I-pill again in this cycle to be protective against pregnancy, but yes, her menses shall become irregular and her dates would stand changed completely. Also, there may be delayed menses for next two to three cycles. Moreover, she may have heavier than normal menses in next cycle, so she should be prepared. Nevertheless, please share her 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 have had very low creatinine levels for more than four months (low 11 highest 68) normal is 110 to 135. Do you think there is an issue? ### Response: I can understand your worries. Low creatinine levels are caused by low muscle mass either due to age or a disease like muscular dystrophy (MD) that may be causing muscles to deteriorate. The liver makes creatinine and if liver functions are compromised, it can also lead to low creatinine levels. Please get yourself examined by your local physician in order to rule out the causes." "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 know the best treatment for advanced keratoconus after using scleral lenses as well. Will there be a condition, where I do not have to use lenses like ever? ### Response: Hello. I understand your concern. There are a number of different treatments for keratoconus based on the corneal topographical measures and your visual needs. The best to halt progression is corneal collagen cross-linking (C3R). This procedure causes the development of a lot of chemical bonds inside your cornea stabilizing it, thus preventing it from bulging out further. This procedure can only bring stabilization and will not improve your vision. For vision, we have a number of surgeries and implants, which can improve vision after corneal collagen cross-linking. In case you need more information regarding the specific treatment suitable for your eyes, please send me a scanned copy for your topography reports along with your present glass power and doctors reports. I will do my best to explain the pros and cons and guide you regarding the best course of action." "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 really need your help. I had unprotected sex and then, within 12 hours, I had I-pill. After seven days, I started bleeding and the next month I did not get my periods and in the month end, I took Deviry 10 mg for five days and now it has been three days, my periods have not started. What should I do? ### Response: Hi. Since you have taken the emergency pill within 72 hours of intercourse there is no chance of pregnancy. So relax and do not worry. The delay could be because of hormonal changes due to the pill you have taken. There is nothing to worry about. However, if you have a doubt then get a urine pregnancy test done with early morning urine sample to ensure that you are not pregnant. Do get back to me with reports so that I can 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: My lipase and amylase are above normal with a level of 100 U/L and 192 U/L. Can you suggest some supplements to restore them? ### Response: Hi. Increased lipase and amylase level indicates a sign of other complication, and it needs to be diagnosed. Your BMI (body mass index) is 27.8 (attachment removed to protect patient identity). You need to reduce your weight through exercise and by following a healthy diet. However, your symptoms can also be caused due to pancreatitis, kidney dysfunction, gallbladder infection, or gallbladder stone. You have to do some test to rule out these complications. You have to do CMP (comprehensive metabolic panel), CBC, and CT scan of the abdomen or ultrasound of pancreas and gallbladder. You have not mentioned about other symptoms. But if you have nausea, that stops you from eating, diarrhea, pain, fever or abnormal sweating, then you need to see a doctor soon." "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 21 year old male, who weighs 70 kg and I am 5.6 feet tall. I am having a lot of problems while waking up in the morning. I cannot move my body when I get up in the morning. It happens when I have a disturbed sleep. One of my friend, who is not a physician and a patient of sleep paralysis himself, diagnosed my condition to be a case of paralysis. ### Response: I have gone through your query with diligence and would like you to know that I am here to help you. Try these simple steps for four weeks, and you will find the difference yourself. Revert after four weeks to 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 son is 14 years old. He is a bright and loving person, but he argues a lot even for petty things like brushing his teeth, if he is asked not to read an 1100 page book in one stretch, or prepare for a test. He will argue to limits. He would lie, distort facts, cheat, would do anything to win an argument. He will think about how to get to his target. He cannot withstand anything against his will. How to deal with him? ### Response: Hello. You are describing your son\s oppositional behavior in specific contexts when he is asked to do things against his will. Has your son always been like this arguing a lot or did he develop this behavior recently in the teenage years? Does he argue at school with his teachers and friends? If this behavior started early and pervasive across all situations it may be more entrenched and will take more effort to shift. It is important to help them find the right balance without causing much hostility. Some general strategies can help in these situations. 1) Spend more quality time with your son. Playing together and having fun helps. 2) Talk regularly about his feelings, aspirations and how he is managing things. Teach him gradually that he need not win all the time. Try to reinforce positive values. 3) Discuss about unacceptable behavior like lying and cheating. Try to avoid a blaming stance but make it clear that manipulating behaviour is not welcome. 4) Have realistic expectations that chil" "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 40-year-old male. For past five to six years my hairline has reduced drastically, a kind of pattern balding or thinning of hair. So, please suggest whether I should opt for ayurveda, homeopathy, or any other alternative medicine? ### Response: Hello. I understand that hair loss can be quite disconcerting. Please provide me with a few details so that I can prescribe you an appropriate medication. Also, if you could please provide with a picture of the problem, taken in good light and in sharp focus so that I can prescribe you an appropriate medication." "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 pain in the lower part of my stomach. I also have an urge to urinate but, feel that the urine is not coming through. It happened to me quite a few times now. Can you explain what is causing this and also suggest a medicine. I am on regular medications for thyroid, migraine, and high blood pressure. ### Response: This professional advice provided by me stands subject to the actual examination of the report or image and is based entirely on the inputs provided to me. It should be correlated with clinical findings. Revert with more information to a family 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: My 1 year five month old baby poured Dettol antiseptic over his body. We washed it only after four hours. Later, we found a brown and burnt skin area around the genital organ. Please help. ### Response: Hi. Dettol antiseptic does not cause any burn injury to the skin. It may be that your baby had this skin problem prior to this incident. Babies frequently have these kinds of rashes. Follow these steps: It will be cured in a week\s time." "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 17 years old and I am having a minor pain in my heart. I also have heart palpitations regularly. I exercise regularly and eat healthy. I do not know if something is wrong with me. ### Response: I can understand your concern and will try to help you sort out your problems. What does heart pain mean? Where is it present? Usually, heart pain does not come where the heart is located. Heart pain causes pain in the inner border of the arm and also radiating to shoulders and jaws. So I do not think your description of heart pain matches it. If you are having left side pain may be due to lungs also. Is the pain varies with breath? If no then it will be musculoskeletal pain only. Kindly take any analgesic if necessary. Palpitations are common due to anxiety and especially if you feel these pains thinking could be due to heart. Also in your age group palpitations are more common. So I hope you should not worry about 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: I have scrotal pain for the past one year and my ultrasound is normal. Please help. ### Response: Hello." "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 33 years old. I have been trying to conceive for eight months from now. I have monthly periods and positive OPKs and BBT shifts, but periods are also very light, basically spotting. I had an Ultrasound which showed a few cysts, had mildly elevated testosterone, normal LH and FSH, normal estrogen, low progesterone. My PCP is not convinced. I have PCOS but I am wondering if that is still a possibility and what I should anticipate for treatment in the future (clomid vs. progesterone therapy, etc.)? ### Response: Hello. The fact that you are getting positive OPKs each cycle indicates that you have an anovulatory cycle or in simple terms that you are ovulating regularly." "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 gets hyper for no reason. She keeps repeating things over and over again. She gets too upset easily. She has a high blood pressure, thyroid problems, as well as migraine. But, she takes medicines only for her thyroid issues. Can you tell me what she should do? ### Response: Symptoms you described could be part of a depressive disorder. It is difficult to confirm with out knowing more details. Kindly read the questions I have asked and reply" "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 may be infected, the side of my face is numb and swollen. Are antibiotics necessary for its cure? ### Response: Hi. I have gone through your question. I can understand your concern. As per your history, it seems to me that you are having acute pericoronitis. You need to take antibiotics like tablet Nigox OZ (Ofloxacin and Ornidazole) twice a day for five days. Tablet Lyser D (Diclofenac 50 mg plus Serratiopeptidase 10 mg) twice daily. So that it can be safe." "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 recently delivered twins, both weighing 2.2 kg. One of them was preterm and the other had IUGR. Now, I am concerned. Which of them have a better chance to survive? ### Response: How are you doing? Hope I have clarified your query. Do write back if you have any more queries. All the best" "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 Asperger syndrome when I was 13 years of age. I am 22 now. How does the DSM-5 change that disorder? ### Response: Asperger was previously regarded as a separate disorder, but now it is categorized as a form of autism spectrum disorder (ASD) in DSM-5 Diagnostic and Statistical Manual of Mental Disorder). This is because; previously when Asperger was introduced in 1994, it was distinguished from autistic disorders as there was no delay in language and general cognition. But now it is put under autism spectrum disorders because there is no evidence of different response to treatment or of a distinct cause in Asperger syn" "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 late on my period. My last period was two months back. Generally, my period is late, irregular and maximum it goes for 45 days. I have never been late so much. It is almost 50 days.I have a kid of 2 yrs and do not want to have another one. I did the pregnancy test at home twice and it came negative. I am not sure whether I am pregnant or not. If yes, then is it a safe time for abortion?For my first kid, the pregnancy test at home used to be always positive. So, I am not sure what to do. I have booked an appointment next week with a gynecologist. I have heard that medical abortion is only possible within 7 weeks. So, what will happen in my case? ### Response: Hi. If the pregnancy test is negative, then the chance of pregnancy is almost nil. The period may be late due to many reasons including anxiety and stress. Pregnancy test becomes positive by the fifth week. So, you will be able to get abortion two weeks after the test becomes positive, if by chance. So, you have time to check with the 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 am suffering from chilblains from the last 10 years. My current age is 21 years. So suggest a medicine for the deficiency which causes it in winters. The fingers of foot and hands are swollen in winters and cause itchy experience. So please help me. ### Response: I have noted your concern. Chillblains is due to vasoconstriction of vessels due to cold weather. It is not due to any deficiency. So, keep yourself warm during the winters. I suggest you apply a topical Nitroglycerin gel if you develop chilblains. Regards" "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 21 years old. I had been diagnosed with a mild mitral valve prolapse four years ago. I have been prescribed beta-blockers for the same. Last year when an echo was performed, it showed that the prolapse had reduced. But, in the last few months, due to an increased amount of activity and my varicocele medication, I feel a chest pain. I also feel depression, anxiety, and panic even though there is nothing to worry about. Do I need a surgery or can I continue with the same medications? ### Response: If you have only MVP (mitral valve prolapse), and no other complication such as valve leakage, there is nothing much to worry about. Follow up with echocardiography and ECG is advised. Regards." "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 38 year old male, and I have been feeling twitches in my arm. I started feeling this constant twitch about six weeks ago. I did not experience any weakness in that arm or anywhere else in the body. The twitches lasted for about a week and then went away.The twitches have now appeared four weeks later in the same area (upper arm). Again, there is no apparent weakness, which I have tested by lifting weights at the gym and both my upper and lower body strength seems to be fine.What is worrying me to death is, could these twitches be an early sign of ALS? Is it possible that weakness will follow even though I do not have it now? Do ALS twitches go away for four weeks at a time and reappear?If I started to experience constant twitches six weeks ago, if this was ALS should not I have experienced some weakness by now? Is the fact that the twitches are localized to the same place a bad thing? ### Response: I have read your query and understand your concerns. First of all, I will suggest you consider other possibilities before jumping to conclusions. There are a number of conditions which can present with twitches without any disease, and ALS (amyotrophic lateral sclerosis) is one of the remotest possibility for a 38 year old young male. The commonest cause for twitches is simple worry or anxiety. I know at least 100 individuals with anxiety, who presented with simple twitches and no other symptoms. In my opinion, you need to see whether these twitches have any relationship with your anxiety level. The another common conditions which present with twitches is endocrine abnormalities, such as thyroid and parathyroid disorders. In case the stress level is not able to explain the twitches, an evaluation for endocrine abnormality is indicated. The list may go on in a similar fashion. Find the answers to your questions below: I hope this helps you. If you have more questions, feel free to write back." "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 18 year old female.A few days ago I noticed that my left breast was very tender.Yesterday morning I started feeling sharp stabbing pain inside my breast near the nipple every hour or so.Yesterday night I started to feel the pain 10 times worse and more frequently.I also noticed that my nipple started to turn red.The pain goes away and then comes back.I would like to add in that my mother was diagnosed with invasive ductal carcinoma about 5 months ago in her left breast and she has had it removed and has now started chemotherapy.This obviously makes me more worried about my symptoms.Please advice. ### Response: Invasive ductal carcinoma at 18 years of age is unlikely even though you have a history in family recently. The pain in the left nipple area which had a sudden onset in last few days and have been decreasing with a localised redness around nipple goes more in favour of an abscess rather a carcinoma. As there has been no blood discharge from the nipple which is classical in cancer, it would be too early to comment. But it is suggested that an ultrasound breast may be undertaken to look for an organised lump if present and if required an FNAC may be done to sample the local tissue and send for histopathological examination. Consult your physician for a local examination. Consult an obstetrician and gynaecologist online for further follow up" "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 not able to pull my foreskin back which I believe might affect my sexual life. My age is 28 years. I was told by someone that circumcision is an option. ### Response: Difficulty to pull the foreskin back over glans (head of penis) is a problematic situation, it does hamper the sexual performance as well. This condition is called phimosis. It can be physiological, which is present since birth and resolves spontaneously by early adolescence. It can also be pathological, resulting from scarring, balanitis, underlying medical risk factors. Phimosis presents with the following features: Treatment involves: If you want to go ahead with circumcision, I would recommend you to seek help from a local surgeon in your vicinity." "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 it a must to remove wisdom tooth? I have attached an image of my tooth. Kindly advise if it is possible not to remove it. ### Response: Hi. Abnormal position of wisdom tooth. IOPA (intraoral periapical radiograph) x-ray with respect to wisdom tooth or an OPG x-ray (orthopantomogram). Can lead to pericoronitis. Depends on x-ray findings. Do warm saline rinses and keep that area clean with floss recommended. Revert with x-ray to 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 and my partner had safe sex before three months, after that we never had sex. She had regular periods till now, but this month she did not get her periods on the expected date and till now no periods. She is saying that there is some white discharge. Is this any symptom of pregnancy? If periods are regular why she delays this month? Please explain. ### Response: Hello. If your partner has regular periods and you have not been sexually involved, then she is unlikely to be pregnant. It is not necessary that she should get her mensus on that very date itself. If pregnancy is ruled out with a urine pregnancy test, then the most common cause of delayed menses is stress per se, which can be either psychological, emotional or physical which can cause a hormonal imbalance and can cause a possible delay in the periods. Though it mimics early pregnancy symptoms it also occurs in the absence of pregnancy indicating that menses shall ensue in the next few days. As it has already been more than seven days now, it is advised that she may wait till 15 days post missed periods to allow her menses to return naturally, and if it does not then she may get an ultrasound pelvis to check for the endometrial thickness (ET). If the ET is more than 10 mm, then she can opt for a 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 taking Nexito Forte and Skizoril 12.5 mg daily for the past three to four years. I am under psychiatric medication for the past 10 years. I was diagnosed with schizophrenia and ADHD. I have also been diagnosed to be suffering from hypertension and have been given Nebimac 5 mg and Telma 40 for the past six months. Now, my life is back on track and I have a good job in hand. But, I feel that my life is going on just because of the medicines and fear for the worst when I stop taking medicines. I have had a talk with my doctor who said the dosage would be reduced gradually. What would you advise regarding this? ### Response: Hi. If you are doing well with Skizoril (Clozapine) and Nexito forte (Escitalopram), I think you must continue with the same. Schizophrenia is a terrible psychiatric illness. If it reoccurs, then it will be difficult to manage. Skizoril 12. You can talk to your doctor about gradually reducing Nexito forte." "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 period is late by 21 days late. I got all the pregnancy tests done, but everything came back negative. I have lower left side pain, feel bloated on that side, back pain, and abdomen pain. I am 18 years old and weigh 170 lbs. ### Response: I suggest you get beta hCG (human chorionic gonadotropin) test to rule out pregnancy and ectopic pregnancy with 100 % confidence. If beta hCG is positive, you need to go to the emergency room as there is a chance of ectopic pregnancy." "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 36 year old male. I am suffering with OCD and I stammer for past 15 years along with laziness and tiredness all the time. My appetite is not good and so my weight is approximately 53 to 55 kg only. I have changed many psychiatrists in last 15 years. I had Nexito 20 mg, Ciplar 40 mg and Lonazep 25 mg twice a day and a capsule Performax for libido under doctor supervision. Few days back I went to a physician and I told him about my issues. He prescribed me Fluoxetine 20 mg to take in the morning and Nexito 10 mg at night that is 2 SSRIs together. After which my libido was totally reduced. I am single now.So, what should I tell to my partner about my issues? First of all, should I tell or not? Because medications can be life-long and I do not like either my partner or in-laws questioning me for that after marriage. My parents and friends advised me not to tell anything now. Second thing, as I told you, in the past I was having good libido but now it become less. Earlier I used to masturbate regularly but now once in two weeks. Should I get this issue solved before marriage? I had an affair in the past. After break up, sometimes I feel like does not want to mingle with anyone. I faced a lot of negativity in my life and still not able to prepare myself completely for marriage. Please give a genuine marriage. ### Response: I have read the query, and I can understand your concern. You have OCD (obsessive-compulsive disorder) and co-morbid anxiety. The combination of Fluoxetine 20 mg and 10 mg Escitalopram (Nexito) was totally irrational. It is not advisable to take two SSRIs (Selective serotonin reuptake inhibitor) at the same time." "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 4 weeks old baby boy. He was healthy without any pain or colics. But yesterday I noticed a swelling in his inguinal area, I went to the hospital, and the doctor said he had left inguinal hernia. But it is not bad. The problem is he is not taking feed regularly, and when I try to feed him, he wants to eat only when he is hungry. But he cries. He vomits four to five times or even more after feeding and also has a lot of hiccups. I feed him in the upright position. His stomach looks like a balloon, and he is having a problem to excrete. Can it be a reflux or lactose intolerance? I told the doctor, but he said it is normal. It does not seem to be normal because the baby is uncomfortable and always arch his back, and he is always grunting as he wants to excrete. ### Response: Hello. From the way that you are describing, it looks like this is your first baby. Please note that the weight of your baby is perfect, and all the phenomena that you described are completely normal at this age group. But the hernia is definitely a concern. It is probably because of this hernia the child may wriggle about and have occasional pain and colic. I hope that the doctors have explained and showed you how to reduce the hernia. Please be advised that this hernia would require a regular follow for six months to see if a surgery is required to close the hernia. Do not worry, it is a minor surgery. The abnormal phenomenon in chil" "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 wondering if anyone could tell me about my condition. I used to go to an eye doctor when I was little but I cannot remember when I last went. I was never pushed to go by my parents when I was younger, only when I needed a new pair of glasses.I was born with one eye small, the other normal. My vision is fine, I am very nearsighted but with glasses, I see quite well. My depth perception is normal too, I can see most things and when I tried to drive once, it went well. In my affected eye pupil is floating around. I cannot see much out of it, and it is not big enough.Other than that, no other health conditions. Could anyone tell me what this is? Is it something that progresses and will I go blind someday? ### Response: You have unilateral microphthalmos i.e. your one eye which in your case is right eye is not fully developed and has developed a squint. Other eyes appear normal but I will advise you to get a fundus in the left eye also to rule out any retinal anomaly. The condition in the right will always remain like this and this condition will not affect the left eye. If it is normal just do not engage in activities that can lead do an injury in the left eye also. So please consult a vitreoretinal specialist to rule out any retinal lesions in the left eye and get yourself rechecked for glasses every six months. Though your left eye appears very normal from outside but since you are nearsighted I will advise you to get retinal examination in your normal eye too, so that if there is any treatable lesion we can fix it at an early stage." "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 nephew is having left kidney size of 90x36 mm (moderate-gross dilatation PCs is seen (AP diameter of pelvis 23 mm) cortical thickness 5 mm and his right kidney is 70x28 mm.Impression: Moderate-gross LT hydronephrosis (left side hydronephrosis with possible PUJ obstruction). Age of the patient is 2 years and 3 months, trying to understand if this case needs to be operated to remove urine. I am concerned that as patient is only 2 years old, does this really be operated immediately or can we wait for a few more months under monitoring. ### Response: There is narrowing of left kidney tube called PUJ obstruction (attachment removed to protect patient identity). He needs to undergo DTPA renogram to know extent of kidney function and degree of obstruction. If kidney is functioning fairly and if an obstruction is confirmed, it needs to be repaired. Age is not an issue as it can be operated safely after 6 months of age. Left kidney thickness is 5 mm, so it may be getting damaged, better to do DTPA scan and then go for surgery without delay." "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 27 year old female. I had my last period 60 days before. I am pregnant and I opted to abort at home. Four days back I have taken one tablet of Mifepristone at 10 AM and then two tablets of Misoprostol 10 AM the next day. I have been bleeding lightly after taking Misoprostol tablets. There are still two tablets of Misoprostol left. Could you please advice when and how to take these two tablets of Misoprostol. I have attached my transvaginal scan reports taken yesterday for your reference. This is my second abortion. I did home abortion eight years ago using a set of two pills, but I did not remember the names. Now, I feel slightly dizzy with headache. Please guide me. ### Response: Hi. The methodology you have adopted for abortion is incorrect. You should have asked this question before taking the medicines. You have already crossed the time for the other two tablets. Ideally, two Misoprostol should have been taken orally and two inserted in vagina. So, I would suggest you to insert the two tablets as soon as possible. You will bleed a little more. As far as the reports are concerned, your pregnancy of 9 weeks is absolutely intact in the ultrasound. So, it does not seem that the pregnancy has been terminated." "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 husband and I have been having sex using a condom and it has been fine. Now we want to conceive and we are having sex without a condom and he experiences pain in his penis which causes him to lose his erection. He also experienced a cut in his penis area which caused bleeding that stopped quickly. Please suggest what to do. ### Response: Hello. Relax and do not worry. Your husband may have phimosis or short frenulum. Is the skin over the penis head going behind the head smoothly or is it tight? If possible, pull the skin and send me images so that I can see and suggest" "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 12 years old. He bit a cookie yesterday, and it has hit his tooth. Now, he has a pain in the tooth. What to do now? ### Response: If it is a permanent tooth then, wait for a day or two. If there is no sign of any visible fracture line, allow them to heal after sudden blunt trauma. On considering his age, if it is a milk tooth, then it has to be removed. If there is a pain, then consult a dentist soon and get an X-ray done to know whether there is a fracture in the root." "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: Should I think about going to a hematologist? The last few years of my CBC shows WBC 8.4, 9.6, 13.9, 11.3, 11.3, 10.5, 8.3, 12.3, lymph (abs) 3.2, 4.4, 3.9, 4.0, 3.8, 3.6, 3.9, platelets 331, 400, 380, 453, 428, 407, 459, 389, neutrophils (abs) 5.8, 8.5, 6.3, 6.4, 5.8, 3.9, 7.6, eosinophils (abs) have all been .1 or .2. I am an active 50-year-old female, 156 lbs, with hypothyroidism 175 (since past nine years, Levothyroxine MCG), Genetic high cholesterol (since I was 18 years old), cholesterol total 257, tri 273, HDL 80, LDL 135. Just started on Atorvastatin 20 mg. I am starting to get concerned that I am in the early stages of CLL. Should I request to be sent to a hematologist? ### Response: Hello. I do not find any significant abnormality in the report. At one stage your lymphocytes were high that is 4.4. But it fluctuates as per reports and not raised to more than 4.5 at any time (attachment removed to protect patient identity). If absolute lymphocytes remain persistent high greater than 4.5, then CLL can be ruled out by flow cytometry investigation. You can consult a hematologist for your detailed physical 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: I have gallbladder surgery tomorrow morning and I told the nurse that pre-op I took a multivitamin with my girl. I did not realize we had bought a different type that contains vitamin E and fish oils and flax seed oil. I am now freaking out as I have had two of the gummy vitamins once a day and have been for weeks. The vitamin E content per gummy is 6 mg and the oil content is 220 mg. I have also been eating lots of fruit and vegetables so have probably been eating almost 200 % of my daily vitamin C. Are they likely to cancel the surgery? Currently, I am taking Keppra 500 mg twice a day and brown preventive inhaler. ### Response: Relax and do not worry. They will not postpone your surgery depending on your above vitamin intake. Though you are orally taking more body absorbs only what is required so nothing to worry. They should go ahead with surgery" "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 82-year-old senior. I went to my dentist to have my teeth cleaned and he did an exam first and the X-ray showed an infected tooth (#30). He has recommended that I go to an oral surgeon and have the tooth pulled. I do not want or cannot afford a root canal. Considering my age, what do you think about my starting to rinse my mouth with 3 % Hydrogen peroxide and delay the tooth pulling and see if the infection clears up? ### Response: Well, as per your age, the root canal is the best option. But, as you cannot afford treatment then removing tooth is the only treatment left. Infection in the tooth cannot vanish permanently but you can keep using mouthwash for few weeks and gather money or take dental insurance to get root canal treatment done, if possible. Else, I suggest you go for treatment as soon as possible because the more you delay, more the infection will spread from one tooth to another. Also, inform your dentist about your medical health like blood pressure, diabetes, breathing problems if you have any, before removing the tooth" "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 37 year old male. I am suffering from polycythemia for the last two years. My Hb is 19.17 and HCT is 51.9. The doctors informed me that it is all due to smoking. ### Response: Chronic smoking can lead to heart failure, chronic lung disease, etc., and hence, polycythemia occurs. It is called secondary polycythemia. With the treatment, the prognosis is good in secondary polycythemia. But, polycythemia can occur as primary polycythemia as well, and in that case, the prognosis will not be good as it is considered under myeloproliferative neoplasm. Primary polycythemia called polycythemia vera and for that JAK2 mutation study done by a molecular method to confirm it. For polycythemia, the treatment is therapeutic phlebotomy in which 250 to 400 mL of blood is removed as per needed frequency. Our aim is to maintain HCT - hematocrit of less than 45% in polycythemia male patient. Initially, phlebotomy can be somewhat aggressive with more frequency and then maintained as less frequency." "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 28 years old. Experiencing intermittent palpitations from last three months. ECG, echo, TMT is normal. The lipid profile shows increased triglycerides in serum 189 mg/dl. Recently, I was diagnosed with subclinical hypothyroidism for which I am taking Levothyroxine from last one month. I feel my heart is beating fast and loud intermittently. ### Response: Hi. Please be advised that a normal ECG while you do not have the palpitation feeling, is not diagnostic of the palpitation. You need to have a cardiac monitor. If the palpitation happens every day, then a 24 hours cardiac monitor should pick them up. If they happen every 2 to 3 days, then you need a 72 hours monitor, then the cardiologist can look at the ECG at the time when the palpitation happened. It might be that you are just feeling the normal heart beats stronger. However, it still needs checking." "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 going to undergo a laparoscopic fundoplication surgery after a week for severe GERD. For the past two months, I am taking Valium 5 mg for severe anxiety (mainly related to my health) three times daily. I am also taking Omeprazole 80 mg daily for several months.I recently came across a study that stated the AUC and half-life of Valium are increased by 130 % with a dose of 40 mg Omeprazole. As I am taking double the dose of Omeprazole, I am afraid that it has raised my plasma level. I am concerned about the concurrent use of other drugs (opioids) that can help me.I need to talk to an anesthesiologist before my surgery. Is this dangerous, or are there any other alternative sedatives to opiates that would interact less with my Valium dose? Is there any increased concentration in my body? This is my first major surgery, and I am terrified. I am taking Aspirin 81 mg and Crestor 10 mg. My past medications are Lorazepam, Citalopram, Escitalopram, Zoloft, Propranolol, Esomeprazole, and Ranitidine. ### Response: Please convey your medical history to the anesthetist when you have a pre-anesthetic consultation. I am sure that they will be using Remifentanil infusion for the surgery. I suggest you consult an anesthetist before surgery and stop taking Valium. There are better medications for controlling anxiety. I recommend a psychiatrist referral after the surgery. This will cure your stress and anxiety related gastritis." "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 root canal done two years ago. They had to drill into a new crown. The crown was filled afterward. Today I noticed a hole where the filling was. I am scared now that the root canal is going to get reinfected. Is there a good chance that the crown can just be refilled? Or is there an equally good chance that bacteria has already gotten in? I do not think it has been longer than two weeks based on my last dental visit. ### Response: I have gone through your question and I can understand your concern. In case there is no pain and swelling, the tooth is not infected. The root canal is always filled with gutta percha material and sealed. The filling is done after the root canal procedure is properly done. Even if there is an infection that would be treated with antibiotics and refilled after that. My advice is that visit your dentist as soon as possible and get it refilled. There will be only restoration and not new root canal treatment. Fallen restoration. IOPAR X-ray. Prosthetic crown fracture. Rerestoration." "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 smoked marijuana three days ago. I am feeling very strange from the past three days. ### Response: I went through your post. It is normal to have an abnormal feeling after marijuana for up to a week, especially if you have used it for the first time. You need not worry. Just try to forget the incident and do not use it in the future. Take enough water and fresh fruits, and start doing routine work. You will be normal in the next few days. Regards" "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 mom has swollen ankles in her lower feet. The skin is stretchy and tight. When you touch it, it is warm. Does she have edema? ### Response: Hello. Yes, she has a sort of edema. It is fluid retention in the ankles. Take less of salts and a low sodium diet. Please get all the investigations done like heart echo and blood tests, kidney tests. You may take a course of antibiotics and anti-inflammatory as well as it may be infectious too but it certainly is due to some circulation disturbance in the body. Also, you may get her feet elevated when she lies on the bed and do not allow her feet in the upright postion for a longer period of time. Get her thyroid, BP and fasting blood sugar also checked." "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 keratosis pilaris. My upper arms are full of bumps. Please help. It is like rashes in my upper arm and thighs. ### Response: The keratosis pilaris is diagnosed by physical examination only. So you should confirm your diagnosis by dermatological consultation. For that you can be prescribed topical exfoliant, topical retinoids like treatment to improve your symptoms. There is no definitive treatment for keratosis pilaris. Usually, this condition precipitates in winter and resolve in summer. You can use warm water while taking bath. Use soap that contains glycerine and oil. Use moisturizing cream over the skin." "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 21 years old, male, 5\9"", 105 kg. When I woke up, I felt a tiny lumped mass on the back just above left hip. Only hurts when pressed hard. I am anxious. Could it be constipation? ### Response: Hi. There are lots of differential diagnosis for the lump. Lipoma: It is an overgrowth of fat in an area. It is soft to touch. It is a benign condition. It is a slow-growingtumor and usually recurs if removed. No treatment is needed if small. Sebaceaous cyst: It is cystic swelling with a collection of sebum. It is a benign condition. It can be removed by excising the cyst. Malignant tumour: They are slow growing in the beginning but when it undergoes malignant change it grows rapidly. It is hard to touch. It needs to be biopsied to find the nature of a tumor. Abscess: They are an infection which is quite painful to touch. If the swelling is small, does not cause any discomfort, it can be left like that with regular follow up. If there is a sudden change in colour, consistency or size it needs to be looked upon by a doctor who can evaluate it 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 foreskin is attached to the head of the penis. Is there any solution to release it without pain? ### Response: Phimosis means tight foreskin. In this condition, the foreskin may not be moving freely. There are two ways to treat it. One is medical and other is surgical. I will suggest medical treatment. First pull down the foreskin as down as possible and apply Betamethasone cream on the inner side of foreskin where it is tightly attached. Do it three times daily for next two to three months. Betamethasone will help to loosen the skin. Also, do daily stretching exercises of the foreskin. Strech forward foreskin for 30 seconds and then stretch downward for 30 seconds. Do it daily for five minutes" "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 the condition of enlargement of the prostate for the last over five years. I am 53 years old. I am taking capsule Urimax 40 mg once in a day and I am able to manage the condition. However, it seems that of late, my libido is negative and the sex life is absolutely zero. Though sex at this age is not important but sometimes for the sake of feeling that you are not 70 years male one desires to feel with a certain enthusiasm. So could you please let me know that whether the prostate enlargement and the Urimax is having a fallout on my libido and poor sex life? Is there any mild medicine for the treatment of this condition which is not having any side effect and is not habit forming and has no withdrawal symptoms if the medicine is discontinued after use? ### Response: Hi. I have gone through your query. The medication that you are currently taking, does not have any effect on libido but itself. That said the most likely reason in your case must be reduced testosterone levels, which can be checked. If reduced, you can be given supplemental testosterone. Also, if your symptoms of BPH are not very severe, there are medications that improve erectile function which are effective for early BPH as well. You can consult with your treating urologist for changing your medication and see if there is an improvement." "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 suffer from an L5-S1 disc hernia, with pressure on the S1 root. I also have a partial tear in the right hip labrum. My surgeon is not sure which one is the cause of leg pain which starts at the low back and ends at the back of my feet. I suffer from a great deal of pain and would really like to get it over with. ### Response: Hello. I understand your concerns. Disc herniation causes considerable pain that needs step-wise management" "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 diabetes from the past 18 years. I have been advised to take Accentrix injection by my doctor. Kindly, suggest me in this regard. I have attached my OCT reports for your reference. ### Response: The optical coherence tomography report that you have attached is showing increased macular thickness in both eyes. This condition is known as diabetic macular edema." "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 24 year old female. I am in a relationship since three years. I am not treated with the same love and dignity by the person. In this duration of our relationship, he left me twice for two months without communication, and he used to text when he needed anything. It is always me, who has to give and make efforts. Whereas on the other end, he seems happy, and he does not bother nor miss me till he wants to have fun or money. He often treats me as an option. If I call, he gets irritated, and if I message, he just ignores them. I think it is time to put a stop to this. He does not give any commitment. He often says that some day our paths will be different. He wants materialistic things from me, rather than wanting me.Whenever I talk about marriage, he says that his family will not support us. Still, he wants to keep a relationship with me. I have left my close ones, and I have changed my personality for him. He was good before, but now I do not recognize him. I feel like a beggar, who begs for his time. I know that I am holding on to someone whose does not even care about me, but I am unable to get over it. I tried to divert myself with my hobbies and interests. I left my job, and now I do not have money. And he is earning well now. All this frustration is ruining me. I have insomnia, and I cannot sleep at nights. I have got hypothyroidism. This lonely feeling is eating me. I have many things to do, but I am not able to work on anything. Though I train myself to be strong, ultimately I land up getting fooled by his messages or the thought of seeing him with somebody else. But, I cannot take this kind of behavior from him. Please help. ### Response: Hi. I read your query and understand your concerns. I hope this answers you. If you have more questions or need to discuss in details about anything related to it, feel free to write back to me. I will be glad to assist 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 62 year old female. I get palpitations quite often. My blood pressure remains 130/90 with Telma 20 mg and Nebicard 2.5 mg. Also, some friends told me to take Disprin 2.8 mg for prophylaxis. Please advise if I need to take Dispirin or anything else. ### Response: Your blood pressure is fairly controlled. Continue both the medicines. Please do an ECG when you are getting palpitations. Take Calcium and Vitamin D3 tablets and Meconeuron OD (Methylcobalamin) once a day for three months. Get serum vitamin D3 and serum vitamin B12 tests if it is not 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 am a 24 year old, and I have Graves\ disease. I had a total thyroidectomy last year. I have since been screened for other autoimmune conditions, but so far none have been found. Over the last 2 to 3 weeks, I have been noticing a gradual onset of some strange neurological symptoms. It began with a blurred vision like the static you see on old televisions. I think it is called visual snow. I have also noticed some dizziness when I blink or close my eyes, and I feel like the world is spinning. In the past few days, I have started noticing a tingling sensation in both legs and feet, and it gets worse when I walk and better when I sit down. I work as a medical scribe in an ER, and I am pre-med. I want to believe that I am just imagining things, which is common for someone just learning medicine. But with my family history of autoimmune diseases, as well as Alzheimer\s, I am just too afraid that I could be ignoring something real. I am trying to schedule an appointment with a neurologist, but it is really difficult to get in to see a doctor in-person with my work schedule. I will of course still work on getting an appointment, but I guess I am just looking for reassurance in the meantime. I am currently taking Vitamin D tablets. ### Response: I read your query and understand your concerns. I hope this helps you. Feel free to write back to me if you have more questions" "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 26-year-old female. The signs and symptoms of my health are headache, nausea, sore throat, with pain and rashes on my tongue, and gums. Also, I see something white in my tongue. ### Response: Hello. From your history, you likely have oral candidiasis. You can take these measures for the relief of sore throat and rashes on tongue and gums. 1) Avoid spicy food intake." "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 had an MRI on my neck. I have a 75 % weakness and pain on the left arm (tricep). Should I anticipate surgery? ### Response: I am sorry to hear this. I have gone through your reports (attachment removed to protect patient identity). Wishing you a speedy recovery. Best wishes" "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 problem of premature ejaculation. I want to make it perfect. My sex time was just 10 to 20 seconds. Please help. ### Response: Hi. I have read and understood your problem. Premature ejaculation is very common. It is usually not associated with any disease, but may be PE due to anxiety. However, there may be problem with prostate gland and thyroid hormone. You can learn to control PE by doing this exercise - Pull your muscles at the end of urination for few seconds then release, repeat this several times daily. Another method is stop-start technique: When you feel that you are going to ejaculate, stop the sexual stimulation and divert your mind, the penis will relax. After sometime start the stimulation again and repeat the procedure. Over few months you will gradually increase your ejaculation time. Most often it is a chronic problem; you have to take medicines in between and period off medicine. You can apply Lignocaine gel to head of penis 10 minutes before sex and wipe it off before starting sex." "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 60 years old. Admitted to a nursing home for the past six days having severe pain just below the breast and surrounding the backside. Have done all tests like echo, TMT, USG, CT scan, and mammogram. Everything is fine. But still the pain persists. Without pushing injection no other option is left now. The doctor has discharged recommending no bad symptoms. But pain is beyond control. Please suggest what sort of tests further we should do. She has a neurological disorder. ### Response: Regarding your concern, I would explain that her symptoms could be related to pancreatitis or a nerve pain. For this reason, I would recommend performing a cervicothoracic spine MRI and some blood lab tests as follows: A fibrogastroscopy is necessary if she has not performed it yet. Does she have any skin lesions? Shingles could mimic this clinical situation" "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 it comes to physical intimacy, my partner enjoys having sex with me. I am a male. For me, it seems blunt. In spite of the erection, my penis seems less sensitive and there is very little excitement. Is there something like sexual compatibility? That is, is one only compatible with certain women? I also do not enjoy much when it comes to touching her. She is the first person with whom I had sex with. Or, does it take some time for my body to get adjusted to her? Other than this, she is a great person and we have wonderful chemistry. ### Response: Hello. Yes, it sometimes happens this way. You get an erection and can do intercourse because you are (probably) excited at the prospect of having sexual interaction with this woman, who you seem to have good chemistry with. But, you also probably did not realize at that time that she is not the right sexual mate for you, though a great intellectual companion. Although your body responded through erection and other bodily reactions, your mind remained cold and unresponsive because the sex appeal is missing or you just see her as an intellectual companion but not as a soulmate. This happens, and maybe a reason why there was very little sexual excitement during intercourse or upon touching her. That way, your guess that one is compatible with only certain type(s) of women is valid. What does this lead to? At least two possibilities are there. It depends on how you see the situation and how you mend yourself" "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 44 years old. From the last one month, I have problems with my legs, especially my left leg, when I get out of my bed or chair and start walking, the portion below the knee is sleeping (numb), sometimes it happens in the right leg as well, but most of the time in my left leg. I want to know the reason behind it and how to solve this issue. ### Response: It can happen due to nerve compression in the spine or below that. Also can be due to vitamin B12 and calcium deficiency. So you need to get investigated properly, with vitamin testing and MRI scan. This is only a second opinion platform. This professional advice provided by me stands subject to the actual examination of report/ image and is based entirely on inputs provided to me. It should be correlated with clinical findings" "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 developed white patches in my mouth from a few days. The images are attached herewith. There is a pain some days and other days there is no pain at all. There is no bleeding either. Recently, I visited an ENT specialist. He referred me to a dentist. The dentist advised me to remove the upper third molar as there was no place for it to grow which impacted and had caused this. When I enquired about the healing time of these patches, the dentist told that they would not heal unless the wisdom teeth are removed. Is it some kind of oral cancer? I am a non-smoker and a non-drinker. I have never chewed tobacco. This lesion has been there for about 45 days. This lesion is on both the sides of my gums near the wisdom teeth. There is no history of a toothbrush trauma too. But, there might be a chance of cheek biting at the same position. Are there any medications available for this condition? ### Response: Hello. I have gone through the images (attachment removed to protect patient identity). Wish you good health and happiness. Keep me updated with the improvements." "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 diabetic patient. I am having weakness, shoulder pain, and tingling sensation on hand.I am taking the following medicines:1. Lantus injection 26 units in the morning.2. K GEM (Gliclazide 50 mg and Metformin 500 mg).3. K pio (Pioglitazone hydrochloride 15 mg).4. Tendia (Teneligliptin 20 mg).5. Forxiga (Dapagliflozin 10 mg).Blood sugar level: FBS 200 mg/dl and PPBS 250 to 270 mg/dl.What to do for this? Please help. ### Response: I read your query, and from what you have mentioned, I would suggest increasing the dose of Lantas to 30 units once daily. Try to rotate the insulin injection sites as well. It will help the natural lowering of your blood sugar. I suggest taking Neurobion forte one tablet twice daily for your tingling. Try shoulder rotational exercise to help with your shoulder pain, but it should not be a weight-bearing exercise. just do flexibility exercise like yoga for the shoulder. Keep a regular follow up for better diabetes control. 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 had urinal infection two weeks back. At that time the pus cells were 55. Then, I got treated and the pus cells became three. After four days, the urine culture result shows the growth of Enterococcus. The doctor advised Utinift SR 100 mg 1-0-1 for five days. I have only two more tablets balance, but from that day of infection, I cannot have sex with my husband. I have severe burning sensation while having intercourse. ### Response: Hello. Burning is common after urinary infection and this is the reason they advise to abstain from sex while on treatment. If you are having burning during sex then please avoid sex for a couple of weeks. Your partner should also receive full antibiotic course. After that, you can use lubricants like KY jelly during sex and this will reduce the pain." "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 27-year-old female. My weight is 124 kilograms, and my height is 159 cm. I am trying to have a child. I have an absence of periods for the past three years. I get my periods only after taking a birth control pill (Yasmin). I have done my ultrasound scan. I have all the symptoms of PCOS. Please see my pelvic ultrasound images and say about the abnormalities seen. Please help me. ### Response: I have gone through the images (attachment removed to protect patient identity). Your ultrasound scan shows a bilateral polycystic ovarian morphology. However, the antral follicle count is not so good (less than four). Having a good antral follicle count of 11 to 30 in ovaries with less number of follicles allows you to try naturally. Try to have assisted techniques that support to have a natural conception. It results in a better outcome. Your uterus and endometrium look fine with no abnormalities. There are no signs of infection in the pelvis." "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 should I take probiotics? ### Response: I just read your query. You can take probiotics in the following conditions: The most common indication is when you have been suffering from diarrhea because it may cause a disturbance in the normal intestinal environment and also loss of normal gut flora. When you take antibiotics because antibiotics along with disease-causing bacteria also harm normal bacteria up to some extent. If you are suffering from a condition like gingivitis because it can also disturb your oral flora." "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 hypothyroidism. With that, I am facing hair fall, skin infections, overweight, high cholesterol, and memory loss. Are all these happening because of thyroid or there are other factors involved? I am a firm believer in Ayurveda but can this be treated with Ayurveda permanently? I do not want to pop hormone pills for the rest of my life. More details about the presenting complaint. I used to be a heavy smoker and drinker. I have started following a good diet from the last 2 to 3 months but the effects are negligible so far. Previous history of the same issue. Never got myself tested but I have been facing these symptoms from the last 4 to 5 years. The current medications: None at present. Past medications of the same issue include Medohar Vati, Brahmi, and Panch nimbadi vati. ### Response: Hi. Hypothyroidism may cause these symptoms as you have described. But it is other possibilities too. Hair fall may be due to infection, excessive use of different kinds of shampoo and conditioner, changes in food habits and water, stress, etc. Stress and anxiety may lead to loss of memory. A sedentary lifestyle may cause obesity. But according to your complaints, it seems like hypothyroidism is one of the major cause. It can be managed naturally through ayurvedic medicines and Yoga techniques. Thyroid profile, lipid profile, blood sugar, blood pressure. Obesity, diabetes. You are taking good medicines, and there is a need to add some other medicines too. Avoid spicy and fried junk foods. Quit smoking and" "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 33 year old male. Two years back I had severe running nose and could not breathe through nose, especially during the night. Then, I was diagnosed with antrochoanal polyp in my right nose. After taking medications I no longer felt cold and running nose. However, my right nostril always remains blocked. So, I decided not to go for FESS and manage with blocked right nose. However, for the past three months, I started feeling right ear blockage and sometimes feel liquid movement in my right ear when I move my head. Over last 15 days I feel ringing in my right ear, so I got shocked and got my right nose FESS surgery done. However, even after seven days of surgery I am not relieved of tinnitus although I can breathe now normally from both nostrils. I can feel reduction in volume and my pure tone audiometry is normal. Please help. ### Response: The nasal blockage did not cause tinnitus and hence, it is not relieved. The FESS surgery (functional endoscopic sinus surgery) you had was for nasal blockage and its consequences of auditory tube blockage and middle ear fluid retention. Now after surgery, your nose is opened, auditory tube and middle ear fluid must have settled down (or will settle down) and just a week after surgery you should not start calculating improvement. Coming to tinnitus, there are various causes. You need to be evaluated for it. Discuss with ENT (ear, nose and throat) surgeon on your next visit." "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 know how does our skin change through the decades? How our skin changes in our 20s, 30s, 40s, and beyond? Also, looking for tips on how to care for our skin. What products we should be used for certain problems? When should we start acid-toning? How about retinol products? ### Response: Hi. Our skin undergoes aging process continuously. There are two types of aging going on in an individual. Intrinsic aging that is inherited (in our genes) and the other is extrinsic aging (that is due to environmental factors most importantly the sunlight). With aging, the following things happen across the decades: 1. Collagen in our skin becomes less resulting in wrinkles. The process of degeneration of collagen gets aggravated by the exposure to sunlight due to the formation of reactive oxygen species. 2." "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 25-year-old female, weigh 67 kg, and height is 5\4"". I am not sexually active but on the fourth day of my period, I and my partner were feeling each other and he accidentally ejaculated on me. The semen landed on the side of my stomach and front of my thighs. I do not remember if it went near my vagina. I was wearing a sanitary napkin at the time though and was fully clothed with jeans. Because I had my doubts I had an emergency contraceptive pill within 48 to 72 hours and am on birth control (having since five to six months because of PCOD). I started the pill on the same day of the incident. Is there a possibility of me getting pregnant? As I am taking birth control pills and had the emergency pill, will my period be delayed? How soon can I get tested for pregnancy? ### Response: I went through your post. Firstly, he had not ejaculated inside you which means you cannot become pregnant because of that. On top of that, you have used emergency contraceptive which has a success rate of 99 %. There is no possibility of you getting pregnant with that episode" "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: God blessed me with a baby boy before three months. This is my second child. I faced many problems such as diabetes, before two years back. I had low platelet counts before six months when I took a test for CBC. Three days before delivery, my platelet count was 44000 per microliter of blood. My doctor suggests me to go for a blood transfusion for delivery. Before delivery, I took three units. After delivery, I took one unit of blood, my platelet count was 172000 per microliter of blood. After a month when I took a test for CBC, my platelet count was 72000 per microliter of blood. I experienced a headache and fever for a few days. I take one Paracetamol tablet in the night. What can I do? Please suggest. ### Response: Hello. Fever with a headache can occur in viral infection. Viral infection can affect the platelet count and can lead to low platelet count. Your peripheral smear examination, a liver profile is also needed to be done for the primary work up. Peripheral smear examination will detect any parasite and abnormal cells if present. Repeat CBC (complete blood count) after few days and if still, it is elevated then, think of other investigations" "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: Recently, I had a very high PSA spike. Antibiotics were given for a UTI, although in the end, the culture was negative. Nonetheless, all returned to normal. Antibiotics ceased a couple of weeks ago. Everything normal except now a reading of leukocyte esterase at 25 wbc/Ul (rechecked next day, same result). Psa 3.4, nitrates negative, protein negative. ### Response: I have gone through your query and the urinalysis report (attachment removed to protect patient identity). You have had an attack of prostatitis, which has led to the very high level of PSA (prostate-specific antigen), and had been subsequently treated with antibiotics. I would like to know the duration of antibiotic therapy prescribed for you. Minimal leucocytes in the urine are due to residual prostatic inflammation that will resolve with time. As you are not symptomatic at present, a urine culture after a prostate massage to ensure there is no lingering infection is sufficient at this time if it has not been done post-antibiotic therapy. Hope this was helpful" "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 question is about my high lymphocytes. My CBC shows that I have 6.6\xc3\x9710 WBC count and 60 % lymphocytes count. the rest is normal. Lab remarks are normochromic but my IgE level is 422. Please help me and tell me can high IgE levels increase lymphocytes count? Or is there something serious? I have had asthma. Currently, taking Myteka. ### Response: Hello. You are a known case of asthma. Your IgE level is high because of asthma as it is allergic inflammation of respiratory tract. Complete the course of prescribed Montelukast course. Turmeric powder with milk can also be taken. Your lymphocytes can be high because of temporary viral infection. Your total count and rest of report normal so do not worry. After 10 days repeat CBC, your lymphocytes will mostly be normal. If not then investigate with peripheral smear examination for further workup" "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 and my fiancee had unprotected sex on the third day of her period. I did not ejaculate inside her. And she also has the history of an irregular period but from the past three months, she is getting her regular period. I just want to know what are the chances of pregnancy. ### Response: I have gone through your history and understand your concerns. As you had unprotected sex, the chances of pregnancy are there in your case but as it is done on the third day of menses that is why there is no chance of pregnancy in your case. These symptoms could be due to hormonal imbalance. Get urine pregnancy test if you missed your menses by seven days. Hope you found this useful" "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 lateral incisor #7 fractured at the gumline and will likely require a surgical extraction. Also, while a temporary filling was provided after removal of pulp pending a root canal, the root canal was not done for many months due to an insurance lapse, and the tooth became infected as well as surrounding bone. I have read that some dental surgeons advocate for the removal of the periodontal ligament during extraction to facilitate healing and the proliferation of new bone cells, and that this must be done explicitly with a bone burr. I have read that this is common practice for ""biologic"" dentists and biologic dental surgeons, and uncommon otherwise. My Med-Cal / Denti-Cal providers are not ""biologic"" dentists.I have four questions. 1) How important do you think the complete removal of the periodontal ligament really is? 2) If the extraction is surgical vs. simple, is it likely that the ligament would be removed anyway? Perhaps because some extra surrounding bone may need to be removed? 3) If removal of the tendon is not standard practice by the dental surgeon, can I request it and would they know what to do and not be offended?, and finally 4) If an implant is contemplated, would the region of the removed tooth and perhaps some surrounding bone immediately be packed with a bone substitute for socket preservation? Or would the infection need to clear first? ### Response: There is nothing like ""Biological"" dentists as such, but you might be referring to Oral and Maxillofacial Surgeons. Anyway the removal of root stump of a lateral incisor is a simple procedure and any dentists should do it. There is no separate removal of periodontal ligament, which usually is resorbed by the wound healing itself. In any case, if you are planning implant you should not be removing any surrounding bone at all to get maximum implant attachment and minimal bone graft." "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 cold for more than one month. And have a swollen nose. What are the remedies to get relief? ### Response: Hello. It may be due to viral infection or bacterial infection or allergy. Use water vapor inhalation and salt water gargling thrice a day for five 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: After eating greasy food, the following day, I pass stool and floating on the top is a transparent white substance globbed together, my stool is not formed usually and is mostly short segments. I often go about four to five times a day, and sometimes less. I am not on any medication. ### Response: It does not look like an infection to me. Could be due to some undigested food material. However, you have mentioned that a few tests have been performed. I would like to see the report before I comment 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: I have horror mornings. After I open my eyes and I get out the bed (only after I stand up) I start sneezing maybe 20 times. I have itchy eyes and years and runny. I feel like I have sand in my eyes. I have done prick tests for allergies and all come back negative. I also have done nasal cornettes turbino reduction and all in vain. My mornings are the same. What is the cause of this? ### Response: Hello. Allergic rhinitis is a perrinial manifestation of allergic reactions to unknown triggers. Also you may have coexisting allergic conjunctivitis. Though, Prick test is negative for most of the allergens, we can not neglect the role of unknown allergies in your case. Definitely we will be able to find out the single cause for your allergy. About medications, all" "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: Could cocaine use two days before blood draw cause the LFTs (ALT=90 and AST=86) to be elevated? If so, how long of an abstinence period (not using cocaine) would be needed to get LFTs back down to normal levels? ### Response: I have read through your query in detail. Please find my observations below. Revert back to a general medicine physician online for further follow up" "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: Kindly clear me these doubts. 1. How does exercise help mental health?2. Which is the best time of the month to get pregnant? 3. Give some tips for trying to conceive a boy (or girl), any truth to old wives tales?4. And tips for how soon a woman can take a pregnancy test. ### Response: Hello. From day 1 to 10 days of the period it is safe period, there is no chance of pregnancy as there is no ovulation happening during this period. From day 12 to 24, it is a fertile period, and there are high chances of pregnancy. Conceiving a boy or girl depends on the chromosomes, and it is difficult to predict. Still, according to old tales, it depends on your date of birth, last period date, and time of ovulation. Once you have missed your period, you can get a urine pregnancy test done with early morning urine sample after three to four days, in case of a regular cycle." "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 26 years old male, for the last month and a half, I feel a pressure on the back of my head. It sometimes causes mild pain in different parts of my head, like the sides of my head. It makes me feel hot sometimes as well. I also have some neck pain, but it is not much. This headache is not very painful, but it is just an annoying pressure that has not gone away in six weeks. When I wake up in the morning, I do not feel anything, and then around 11 AM, the pressure is, there, and it will get worse until I lay down in the evening. And it pains a lot at night. I think about it all the time, so I am sure that does not help with the feeling. I think that I have a brain tumor. Should I see a doctor? I do not want to waste my time and have them say do this or try this without doing an MRI. I have only taken Ibuprofen a few times to help with the pain, and that seems to work. ### Response: I would like to know some details about your problem. Revert with investigations mentioned above and response to this medication. Revert with more information to 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 had a DVT with massive pulmonary embolism with infarction before four years. I had a few \xc3\xa4nxiety or panic attacks since then. Had a heart sonar and ECG done two months ago, which according to the physician was perfectly normal. I stopped taking Bisoprolol on his advice, and started with Alprazolam and Ativan when needed.Two weeks ago, I had an incident where I had my blood pressure shot up to 210/107 and a heart rate of 110 bpm. I went to the ER and had an ECG done as well as a cardio markers blood test is done. The doctor who did the ECG said that it looked like the right side of my heart did not get enough oxygen. I made another appointment with a physician, who now wants to send me for an angiogram. I want a second opinion on the latest ECG. The ER doctor said that a panic attack could also influence the ECG. ### Response: Hello. Your ECG is fine (attachment removed to protect patient identity). There is left axis deviation, which is expected in hypertension or with age. Probably this left axis deviation is mistakenly read as Q waves by a physician and thought of right side not getting enough oxygen. So, by viewing your attached ECG, I do not see any immediate need for an angiogram. However, considering your age and hypertension and a history of pulmonary embolism. It is better to obtain echo is not done recently. Also, better to get one stress test like treadmill test or stress echo. BP spike may be age-related combined with panic or anxiety, so you should have BP apparatus at home and monitor it frequently, at least thrice a day for a week. And if most of the BP readings are above 140/90 mmHg then you should have regular medicines for it. You should take low salt diet and do regular exercises as well. I hope this helps you and get back if you have any doubts." "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 daughter is in the ICU with pericardial effusion and multiple tumors. The fluid has been drained and there was blood mixed with the fluid. The regular blood test came back normal with no sign of cancerous cells. My question is, what are the chances that the tumors are benign? Through my research, there is a good chance that the tumors could be a rhabdomyoma. My daughter is only 9 years old and I want to take her to the best facility. They said her heart is weak and are unable to perform any test on the tumors. They have her on Coretec and albumin and said that it was not working and put her on something stronger. Could this be a result of the pericardial effusion? I am attaching the blood test reports. They said everything was normal with no sign of cancerous cells, but are still unable to say for certain if it is benign or malignant. I am just a very worried father. ### Response: Firstly, there is a diagnostic dilemma. The reports you have uploaded (attachment removed to protect patient identity) are fine. But, you should upload the echo reports and the fluid investigations as well. Now, considering the pericardial effusion with multiple cardiac tumors, the possibilities of a rhabdomyoma or a teratoma are high. However, an effusion is not common with rhabdomyoma. It is possible to have some other cause for the effusion and it can also be as a result of a heart failure. Both of these are benign tumors. However, at this stage, we cannot rule out a malignancy. The next thing to be done is that she should undergo a cardiac MRI for further characterization of the lesions, which will give us a diagnosis and also resolve the issue of malignancy. Also, if the fluid is available, it should be tested for ADA (adenosine deaminase) and GeneXpert. She should also undergo a thyroid test. Rhabdomyomas usually occurs in patients with tuberous sclerosis, so she should be adequately examined by the doctor for the same. A definitive treatment is the excision of these tumors surgically. So, you can discuss this with the doctor as well. Hope this helps you. Do write back in case of doubts. Revert with more information to 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: I just got my blood results, which I have uploaded. There are two files. One is about three months old and the other one is from today. I am afraid that I have a liver damage. Should I get tested for hepatitis A, B and C? I had donated blood four months ago and that time there was no problem. I got an ultrasound scan done five months ago along with other every other checkups. I drink two to three beers every day and sometimes, I drink wine. My weight is 83 kg with a waist size of 94 cm and my height is 183 cm. I would appreciate any advice you can give me. ### Response: Hi. I have gone through all the data posted (attachment removed to protect patient identity)." "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 back molar was sore when I chewed on it and my dentist found an infection under it, so he did a root canal but afterward, it was still sore. He sent me to a root canal specialist who found that the tooth is cracked and needs to be removed. Given that the infection was under the tooth in the bone, was it appropriate to do a root canal before checking whether it would solve the problem? ### Response: Your chief complaint in itself suggests tooth was infected so there were two treatment modalities: RCT (root canal treatment) or extraction. As the doctor has done RCT and problem has not solved, it can be due to accessory root canals difficult to negotiate or perforation due to faulty RCT procedure. The endodontist after examination arrived at the conclusion of a cracked tooth. So, he advised extraction. As for your question is concerned the doctor has tried best at first instance to save the tooth and it is a routine which dentists do. But based on the complexity he was not able to solve it. Under such cases we dentists extract tooth particularly in case of third molars which has much complicated anatomy." "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 69 year old male and retired internist. Other than vitamins and prostate-related herbs, I take no medication. I have no allergies and have never smoked. My past medical or surgical history is rather unremarkable. I have had several bouts of acute sinusitis in years past. Four weeks ago, my wife and I developed URTI. My illness had a sinus component featuring marked nasal and sinus congestion, postnasal drip, upper airway congestion and cough productive of clear sputum. I assumed the etiology was viral and treated it as such. After two weeks of little improvement, I assumed a bacterial etiology and initiated Augmentin 875 mg bid. After five days with little improvement, I switched to Cipro 500 mg bid. After four days, I saw my primary care doctor who prescribed Azithromycin 500 mg per day. Following the second day of treatment, I developed severe fatigue, generalized weakness and headache, which forced me to discontinue the Azithromycin. I then decided to wait until the Zithromax cleared my system before re-evaluating. After some eight days, I developed a purulent nasal discharge for which I again saw my primary care MD who prescribed Doxycycline 100 mg bid. Note that I requested a culture and sensitivity of the purulent discharge but was rebuffed. After 24 hours on Doxycycline, I felt greatly improved with little sinus pressure or congestion and minimal, clear nasal discharge. Now, on day four of Doxycycline, I have noted some return of the sinus pressure, post-nasal drip and nasal congestion. However, the mucus is clear. I was given a steroid nasal spray which only served to increase the mucosal irritation of my sinuses, nasal passages, throat and upper airways. I was never febrile at any point. I am exceedingly frustrated. Note that in the past I used Levaquin and developed marked insomnia and very lucid dreams when I was able to sleep. Please help. ### Response: Hi. We are here to help you. You are suffering from chronic sinusitis. And I feel this is all allergic and you do not need antibiotics. Usually an acute attack takes five days to settle down. But, if you have persisting sinusitis, you would require CT paranasal sinuses. If the CT shows slight sinus infection, then it can be treated with conservative treatment. But, if the infection is severe, you would require surgery for the same. The conservative management of sinusitis includes the following: Please share my opinion with your doctor before acting upon it. 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: Can tubes placed in ears cause pulsating tinnitus? I never had this prior to the tubes. I was getting dizzy all the time. So, they placed tubes in my ears. ### Response: Grommets or ventilation tubes should not cause pulsatile tinnitus usually. Is your MRI normal? Can you share the report with me? Any other symptoms? Why were the tubes put in the first place?" "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 got married and have a few doubts about intercourse. I am not clear about the vaginal spot. Where should I insert my penis exactly? I had a chat with my partner and she said that it is the spot where the gynecologist tested her uterus when we had a general check-up. Please suggest. Also, in the missionary position, I am able to insert easily but not in doggy or other positions. Does the position matter? During full erection, my penis is slightly bent downwards. In that case, which position exactly works out? When I try to deeply penetrate it is hitting or blocking at a spot and she seems to be quite uneasy. Also, do I need to release my sperms on that spot where it hits? Sometimes, post ejaculation and two hours after being in bed when she urinates some sperms come out of her vagina she says. Is that expected or do we need to deeplypenetrate? She is an O- blood group and I am B+. Being a third-degree relative to her, does negative blood group matter or block conception? We have been trying for the past six months and post marriage she got her periods early twice and only once she got her periods delayed. On all other occasions, she had periods regularly. Also, we have big differences in height as well. I am 5 feet 10 inches and she is 4 feet and 9 inches and weight is 79 kg for me and 50 kg for her. ### Response: Hello. I read your query and understand your concerns. I hope this helps you. Feel free to write back to me if you have more questions" "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 know, can cortisone help if taken before transferring an embryo? And if it can help so, in which way? ### Response: Yes, cortisone can increase the chance of getting pregnant. If you have a doubt then get 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: Six weeks ago, I had tooth #2 pulled. The healing process has been normal as described by my dentist. I am now experiencing temperature sensitivity on tooth #4, which was previously asymptomatic. Even room-temperature liquid hurts. About eight weeks ago, I had the crown on tooth #4 replaced for cosmetic purposes. There was no pain with this and it did not hurt until this past week. Is there a chance my roots or nerves might be shifting due to the healing process of the extraction and causing the sensitivity? As a side note, tooth #3 in between the extraction and the one that hurts has had a root canal therapy years ago, which (I assume) is why I am not feeling pain in that one. ### Response: Hi. Yes, your tooth might be sensitive due to the extraction process that happened in the surrounding area. Keep doing saline water mouth rinses. Take a 1/4th teaspoon of salt in a cup of lukewarm water and do its rinses 3 to 4 times a day for a week. If sensitivity goes away, well and good. If symptoms remain same, and sensitivity to air and liquid increases, it means your root is now sensitive and you might need removal of the crown, get a root canal done of this tooth and get back the same crown on it. Give me followup after a week. Stay happy and blessed." "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 unprotected intercourse two days after my period. The first time we used the condom, the second time without and did the withdrawal method. I took the action about one and a half an hour later. I do not know when I was ovulating and did not think it could be my fertile week. I started bleeding five days later and it was light and pink then has gotten heavier and turned red and moderate enough to soak a panty liner. I have taken HPT twice and both showed negative. Is this implantation bleeding or withdrawal bleeding? ### Response: Hello. Your period can be irregular this time and may take two to three cycles to get regularize and maybe the next cycle will be normal depends on your body\s own hormonal cycle. If HPT (home pregnancy test) is negative then no need to worry, you are not pregnant and the second day of menses is counted as safe days of any cycle. So you cannot be pregnant during that period because of no ovulation during menses." "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 vocal paralysis over four months now from a fist fight from strikes to my throat. One doctor says it will take a year and another told me some people never recover. Will I eventually recover because I cannot speak well and it is making everything harder? Voice is raspy and breathy and takes a great effort for me. Will it eventually heal? I am a type 1 diabetic and taking medications for the same. ### Response: I understand your concern. You are having unilateral vocal cord palsy. As sufficient time had passed but need not worry. You should consult a good speech therapist and try a full course of speech therapy. You may get relief but if no satisfactory result comes then finally, a phonosurgeon may do thyroplasty. Thyroplasty usually gives a good result" "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 leg cramps, especially after taking lunch. I am on a gluten-free diet because of irritable bowel syndrome. This gluten-free diet helped cure my loose motion. ### Response: Hope it helps. Please feel free to ask more queries if there are any doubts. I would be happy to assist" "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 40 and Male, do not smoke. Four years back, hemoglobin was 18.1, RBC normal, hematocrit 50 % normal. Now, hemoglobin was 18.4 (value was up to 17.7) RBC normal 5.78 value up to 6, and hematocrit at 50 %. Platelets were 226. The doctor thinks I just run high but nervous. Would the counts be much higher? All other values are normal. Should I worry about anything like polycythemia? ### Response: Hello. Your hemoglobin level and red blood cells count are slight high (attachment removed to protect patient identity). The hematocrit level is within limit. So you can have secondary polycythemia case. I suggest you investigate with serum EPO estimation, EKG and chest X-ray investigation for further work up. Your physical examination also should be done. If all reports and physical evaluation is within limit then you may need not worry about that." "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 23 year old male. I am working as a software professional. I recently had some discomfort with digestion. I had severe bloating, gas formation and a frequent sensation of motions. I went to a gastroenterologist and he made an endoscopy and endoscopic biopsy. The biopsy result is yet to come, but I am scared after seeing the endoscopy report. He said it is not serious and some bacterial infection. The report looks scary to me. I had antral gastritis a year back and took medication for some time. I am always eating outside food, but nothing spicy. I have attached my endoscopy reports here and I just want to take a second opinion from you. Kindly explain me the problem and give a solution. ### Response: As your doctor said, there is nothing serious. H.pylori infection and spicy food. 1. Specific antibiotic course for H.pylori for 14 days.2. Continue your current medications for acidity. Avoid spicy food and take bland diet till the completion of your course of therapy. Also, try to reduce any form of caffeine and nicotine." "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 pain and numbness over both hands for long, and fingers recently. Since pain also was there, he took Ayurvedic applications for arthritis. I had consulted neurologist last week, undergone NCS test, and I have attached the files. Advised medication for three weeks to be followed by surgery. Please help. ### Response: I understand your symptoms. I have seen the files attached (attachment removed to protect patient identity)." "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 addicted to heroin and have been using a lot of drugs. I have been trying to quit these drugs, but I cannot. Whenever I do not use it, my body is painful and dull, and I cannot do any work neither do anything. My mind is all about the drugs whenever I do not use it. I really want to stop this addiction because it is killing me. I cannot stop it because I am a spinster and presently working, so I have to take my drugs in order to work. I went to the rehabilitation center before and was normal, but I got a relapse again. I want to be a normal human with a healthy life. Can you please help me to get out of this addiction and what medicine I have to take?I took Valium 10 mg, Tramazac and Zolam to help me sleep and forget the pain for five days. ### Response: Heroin addiction is known to be a chronic relapsing condition. It is positive that you are contemplating to stop using heroin again. You mentioned about being in detox before but relapsed again. More important is you also need to have post-detox follow-up and support to minimize the chances of relapse again. You will need support to develop better coping strategies to deal with life\s stressors." "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 slight red rash on the tip of my penis, and there is redness on my foreskin. The retraction of the foreskin is painful. Erections are also affected. There is no discharge. There is no swelling noticed. There is a slight irritation at times. I had a similar problem once long back and had used Canesten cream. I tried it this time also, and it has reduced the problem. But it has not finished it. Please advise. ### Response: Hi. You have a yeast infection (fungal infection). I suggest you take an oral antifungal tablet Fluconazole 150 mg once daily for three days. Continue with the cream for a week" "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 21-year-old female. I have a lump in my neck for about nine weeks now. It is between my hyoid bone and sternocleidomastoid muscle on the right anterior triangle of my neck. It is palpable when I tilt my head back. It is probably as big as a penny but not as round as a penny. It is oval shaped and non-tender. when I first noticed it, it was the size of a kidney bean but then two weeks later it shrunk down to the size of a baked bean and has stayed this size for seven weeks now. It never went back to kidney bean size and it is been two months I noticed the lump. It will move left and right, but not up and down. It feels firm when I tilt my head back but soft when I have my head upright normally. When my head is tilted back and I put my fingers on it, I can feel a pulse. But when I put my fingers on the other side of the neck I can feel a pulse in the same spot, where there is no lump. Just curious as to what this could be? I do not feel any other lumps or bumps that are larger than a pea size, and I am not sick and I was not sick when I first spotted the lump either.Does this sound like lymphoma to you, considering the location, and shape and what it is doing? From what I read, hodgkins lymphoma is common in my age group but rare overall. I do not have any other symptoms (fever, night sweats, weight loss, loss of appetite) other than just a random lump in the middle of my neck. ### Response: Hello. I understand your concern regarding this lump. I also understand that you have gone through the internet trying to get an approximate diagnosis for the same. As per your history and description, it appears that this lump is arising from superficial structures of the neck, as it is mobile. It could be muscle. The pulsation which you are feeling are probably due to carotid artery beneath it and is quite normal to feel its pulsation. At this time to relieve your anxiety, it will be best to get a radiological evaluation. In my opinion, MRI (magnetic resonance imaging) or CT (computed tomography) neck will be a good option. Also, I will suggest getting a thyroid function test. In case, getting an appointment for CT or MRI is difficult for some reason, then even an ultrasound neck can give you a clue regarding the origin. Meeting a surgeon will be helpful at this moment." "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 weak erections and they are not hard enough and also I do not experience morning erections. For many years I could not experience due to excessive masturbation. I also see foamy urine (probably semen) and urine dribbling. I suffer from loss of appetite, too many gases. My sugar and BP are normal. Testosterone 0.972 ng/ml, LH 2.09, FSH 1.38. ### Response: I have gone through the reports and the reports are fine but the testosterone levels are low. This should be evaluated properly. If you are obese then high weight could be the cause of low levels. This might be contributing to poor erection. Testosterone injections are one option for improving the levels. You can talk with your doctor about that. Exercise daily and have healthy balanced food. Get your levels done again after a couple of months and this should come normally." "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 blood group is B positive. I am going to marry a person with B negative blood group. Is there any problem? ### Response: Hi. I can understand your concern. From history, I hope you are telling that you (male) is B positive and your fiance (female) is B negative. It will not cause a problem in first pregnancy but in second pregnancy severe hemolytic disease of the newborn can occur. So, we have to prevent this sensitization when she will be pregnant. So, just keep this in mind and in first pregnancy of your wife (she is having a negative group as per history), she should be given Rh(D) immunoglobulin injections in the antenatal period at 28 week of gestation. In addition, before marriage, you both should be investigated for thalassemia minor status." "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 26 years old. I have never had any problems with my eyes. I had a perfect vision. But, from yesterday morning I feel blurred vision in my right eye. I am an informatician, so I am in front of a screen every day for almost 10-15 years and I do not have pain in my eyes when I use it. For past one month I am taking Rhinocort for my nose. Please help me. ### Response: I reviewed your history. Computer screen. Vision testing. Refractive error. Artificial tears. Avoid continuous use of computers or laptops. Revert back after a month with the reports to 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 heart is normal, but I have ventricular ectopic beats. Could these cause cardiac arrest and kill me at the age of 23? I worry about it every day. Kindly advice. ### Response: Hello. It is unusual for ventricular ectopics alone to cause cardiac arrest. Still, it depends on various factors like cause of ectopics, the morphology of ectopics, frequency of ectopics LV function on Echo. What symptoms do you have? Please provide your ECG and Echocardiography report. You have uploaded your photo as an attachment (attachment removed to protect patient identity)." "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 summer, I sat in the sun for a few hours tanning. Nothing to drink and I used two oils on me. My face and chest have been red ever since. After then, I donated my blood and they sent a letter saying about some blood cells. I had my appointment with a rheumatologist and got blood work done and I guess it had come back stating I had lupus. Everything has cleared up on me with the redness except my so called bufferfly rash. What do I do? I am starting to get annoying also. This week I have also started to notice my hair has been thinning and I have a weird bald spot on top of my head which in fact I have not had my hair cut trimmed in over a year or two. So what would you think about that also? Last year, I had pain in my knuckles in the winter every morning I would wake up but not come back that is the confusing part. I am starting Prednisone tonight to see if that helps and I am on Topamax and Adipex right now those are it. ### Response: I have gone through your history and images. (attachment removed to protect patient identity). Your rash seems still very florid and the alopecia is setting in. I am not sure about the medications you are taking as it does not show up on the phone app, but you need to increase your medicines. Oral steroids are needed in your case. It will stop the hair fall and improve the rash. Although they do come with side effects of weight gain and increased hair over the face, it will help to stop the disease process. Topical steroids are not recommended for the face as they can cause scarring. Topical Tacrolimus creams are helpful. Lastly, I would like to know if there are any major organs involved in your case. From the history, it looks like minor organ lupus only, but remaining workup is essential to be sure." "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 history of recurrent early miscarriage (before seven weeks). Investigations pointed to high autoimmune antibodies and high NK cells. With medication, I conceived naturally and had a successful pregnancy. I am now pregnant again (unplanned) and am 7 weeks + 3. I had some spotting and cramping three days ago. The spotting was light and stopped within a few hours. The cramping continued for another day. Blood hCG levels are rising very well and are currently over 83,000. A transvaginal scan yesterday showed the heartbeat and we were told all is well. Today, I had some light spotting (dark brown) and discomfort and passed a brown clot. My query is whether this may have been the cause of the spotting the other day, or maybe this was caused by irritation from the TV scan yesterday. I am concerned anyway and any advice would be greatly appreciated. Current medications: Eltoxin, Prednisolone 5 mcg, Clexane. Sarting Intralipids next week to target NK cells. ### Response: How are you doing? I understand your concern. From your history, I do not see any reason for you to worry. This spotting could be from mild erosion on surface of the cervix, which may bleed spontaneously or during sex or due to scan probe. In your history as you have not mentioned pain, I can say for sure that there is no intrauterine blood. Scan also did not pick any hemorrhages (attachment removed to protect patient identity). The medications you are having is absolutely the perfect ones. Most of the miscarriages before 12 weeks are due to genetic problems. But in the present scan as baby\s growth has been adequate, you do not need to worry. This clot could be an implantation bleed. This is normal and nothing needs to be 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: Hello,What are the symtoms of vaginitis and how can it be cured? ### Response: Hello.The most common symptoms of vaginitis will be itching and white discharge. In case of bacterial infection, the discharge will be yellowish or greenish and in case of fungal infection it will be curd like discharge. It is quite simple to cure. You need to get the respective medicines depending on the origin of vaginitis like: 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 a 59-year-old female who was diagnosed five years back with the rare I have not had an MRI scan or seen by a neurologist for a follow-up. Since I was diagnosed, I have not been given a prognosis of myelopathy associated with Hashimoto's. I was paralyzed from the chest down before diagnosis. I was put on a course of three months Steriods and then 125 mg Azathioprine which was in last year and increased to 150 mg currently. I get three hours of physio a week and three monthly blood tests, full blood count, TPO, and TSH.In your opinion what would be the expected neurological care for this condition, and the absolute minimum acceptable standard of care? Is an annual MRI necessary? Should a specialist be able to provide a prognosis on my condition? Any other advice you consider helpful to me. ### Response: Hi. I am sorry to hear about your illness. You are likely suffering from Hashimoto\s myelopathy based on your description. It is rare condition and only a handful of cases have been described worldwide. It is known to be very steroid responsive and there should be a remarkable improvement with steroids injections. If you had no response to the injections, I wonder about other diagnoses as well, given you have a history of cervical disc bulge causing weakness. The best way I can come to a better answer is by looking at the MRI images of the spine and brain, report of CSF studies with CSF level of anti-thyroglobulin and anti-microsomal antibodies. If we are seeing damage in the cord and the muscle power testing is weak with atrophy of muscles, for the past three years, then the recovery will be guarded. I will strongly advise, rehabilitation with PT, OT and botulinum toxin injections or spinal cord pump installation if significant spasticity is there in both legs." "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 period was before a month, and it has been nine days I missed my period. I got positive in my blood and urine test. My beta hCG on last month was 675, and yesterday it was 3300. I almost completed 10 days after the missed period. Yesterday I went for scan my doctor told no sac is visible. I have some breast pain heavily and feel like period pain but no other symptoms. My TSH value is 2.9, and my doctor suspected may be ectopic. I do not have any pain or bleeding so far, but it is only like period pain. Please help. ### Response: By the dates, you are five weeks pregnant. If no gestational sac is visible in your uterus even on transvaginal ultrasound, then it may be an ectopic pregnancy. Ectopic pregnancy presents with symptoms only if it grows or gets ruptured. That is an emergency and can even be life-threatening or at the least cause liters and liters on blood loss inside the abdomen. I advise you to go for a transvaginal scan. Rarely MRI to confirm the ectopic pregnancy. It may be dealt with medicines or go for laparoscopic removal of tube or milking whichever is feasible. Do it before it becomes an emergency." "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 33-year-old female and I am pregnant. I have a cough and runny nose for four years. I am taking Loratadine only. Kindly suggest me an antibiotic. I am currently on tablet Loratadine, tablet Aldomet and multivitamins with folic acid, and tablet Aspirin. Please help. ### Response: It seems you are allergic taking Loratadine. You need to consult with your doctor. If bacterial lung infection is confirmed then you can start antibiotics. Apply Menthol Balm on the chest and shoulders to ease stiffness. Aerosol therapy can help together with multivitamins supplements" "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 been suffering with pain while urinating. He is a 6 month old baby boy. Here a local doctor did a urine test and said as Escherichia coli urinary tract infections. What is the proper treatment for this? ### Response: As per the report, your child is having urinary tract infection, which is resistant to many oral antibiotics. The only oral antibiotic it is sensitive to is Co-trimoxazole that is Septran. You can start a course of Septran for at least seven days and repeat a urine test after seven days. The other option is start IV therapy with injection Ceftriaxone and Amikacin and repeat the test after five days. IV therapy is more effective than oral. It is not a serious condition and it is curable. So, relax and start the treatment." "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 problem with my throat. Can you check the bumps present above my tonsils in the throat? I have attached my complete blood count report. I also have lymph node raised in the neck on the right and left side shoulder, so my body is fighting with something. Current symptoms are sore, redness, inflamed throat, and tight feeling when I swallow. Is left tonsil lower than right? Also, I feel dry throat all the time. These strange bumps circled in the picture along with red throat are my concern. ### Response: From the picture, I can see a slightly congested posterior pharyngeal wall along with tonsillar region (attachment removed to protect patient identity). The bumps you are referring to are small tonsillar cysts which do not carry any significance. They are benign and are not a cause to worry. The tonsils are only slightly enlarged and hence do not need any removal." "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 about my menstrural cycle. Two to three weeks ago I took a few Plan B pills throughout two weeks. I was supposed to get my period around 15th and it came only two days ago, but it is a dark brown discharge. I took several home tests and they are all negative. I was wondering why is my discharge is in this color? There is no blood just brown discharge. Am I pregnant? ### Response: Plan B Pills are to be taken only once after unprotected intercourse and not continuously for two weeks. The brown discharge which you are getting now is probably the 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 20 year old girl. Last month on 22nd, I had protected sex. And on 28th, I got two or three drops of bleeding, and it was my date of periods. After that, I did not get any periods. Am I pregnant? ### Response: Hi. From what you have said, it looks like you are not ready for a pregnancy. As the bleeding on 28th was not like a normal period, pregnancy chance is very much possible. It may just be a delayed period, due to the stress and tension you are having. But we need to check. Please have a home pregnancy test or a urine pregnancy test. If the test is positive, we need to deal with the unplanned pregnancy. If the test is negative, then we can give you medicines to induce periods. You may also need tests to check why there is a delay in periods, in spite of not being pregnant" "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 inflammatory myopathy confirmed by EMG, NCS and biopsy with CPK 2300 range and SGOT, SGPT also were little higher. I have already taken five days 1 g Prednisone steroid injections and later was on oral steroid tablets Omnicortil for 1 to 1.5 months reducing doses gradually starting with 80 mg daily to bi-weekly reducing doses. Along with this, doctor had given Cellcept, 750 mg daily and Vitamin B12 and Vitamin D. Right after steroid that month only I feel little better improvement. After steroids effect or a month later like dilution, it goes away and I am back to my previous difficulty in walking and leg hitting floor condition since 2 to 3 years same.I was thinking inflammatory myopathy was cureable or atleast walking condition would be better and treatment would stay on. I do not see any options and want help in best advice for recovery. Completely confused now. I want other option and for mobility not hitting ground while walking or to have steady balance. Physiotherapy made me very fatigue that I had to stop. Any tablets for balance control or leg devices to help lift little upwards or muscle tightnening substances like enzyme powder Coq10 if any please suggest, any. ### Response: To be very honest myopathy inflammatory in origin needs lifetime treatment. We just have steriods and other immunosuppressive therapy to control the disease progression. Definitely, Prednisolone works magically but since it has lots of side effects, we taper and reduce it to bare minimum. I would recommend to discuss with your doctor to put you on lowest possible dose of Methylprednisolone based on your symptoms and total CPK levels. Co enzyme Q10 has controversial role. If you can afford you may go ahead with 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: I am 31 years old female, 5\8"", 175 lbs. Three days ago I started getting a really sharp pain in the lower left abdomen. It came on sudden and was gone within seconds but still bad enough to have me doubled over in pain. Thought it was related to period that was due following day. Happened on and off all day.Next day period did start as expected. Normal flow, normal cramps, etc. Then the sharp stabbing pain came back. It is stabbing in a very precise location, down and to the left from the belly button, kind of in-line with the hip. It was radiating hellfire to my low back, groin, thigh, hip, and left flank. I was on the floor in pain for four hours before it faded away enough for me to even stand.That night it happened again waking me from sleep. Lasted for hours, stabbing in the same spot, burning pain spread to the other areas. Later that day my toddler laid across me and his elbow got that same spot and started the pain up all over again but it only lasted about an hour. The area is very tender. I still get the brief stabbing pain when walking or coughing or bending over. I am thinking it is a ruptured cyst. I have never been diagnosed with one before but I think it fits the bill. But can they rupture multiple times within days? Is it likely to happen again? Could it be something related to period or just coincidence it started at the same time? What can I do at home for it, since I am unable to go in to see a doctor? ### Response: Hi. I went through your complain which I must say you have very nicely written down. As per the location of the pain that you mentioned, there are some conditions that need to be ruled out. First is appendicitis. It is followed by vomiting and constipation. Second is renal calculi or stones. This pain comes from behind while passing urine. Third, as you mentioned ovarian cyst but the ruptured cyst is a medical emergency and is unlikely. Get an abdomen and renal ultrasound is done to get a proper diagnosis. If you can, then do it after your periods." "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 married with two kids and a loving husband. I quit my job a year ago and started selling clothing online. I love watching movies. And recently I have a crush on an actor in a movie that is about cross country sport. Since I was young I used to get easily attracted to people who are good at sports. Hence, suddenly I am totally starstrucked by the lead character. And I follow the Instagram of the actor and I am trying to get to know about this actor. He is totally a good, charismatic person and have that odd looking feature. That is the thing I love about him. Now, every single second I cannot stop thinking about this actor. I cannot do my job well because I would go viewing his instagram and watch his videos most of the times. When I was young it was normal to have a crush, but now? I really feel my life is so complicated. I cannot stop thinking about the actor. I cry every time I had to watch him on television or view his Instagram and not doing my work properly. At this time I just hate myself. Please help me. ### Response: 1. Celebrity obsession.2. Anxiety.3. Depression." "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: As of now, I experience abdominal pain with cramps in the lower right of my abdomen. What could be the problem? ### Response: Hello. This could be as simple as digestive problems with gaseous distention. It requires medications for indigestion or gaseous distention like Charcoal tablets, passing by symptoms of gastroenteritis. If diarrhea and vomiting develop, food poisoning is one of the reasons as well. Also, it can be a kidney or ureter problem (stone or salts). This site can suggest acute appendicitis as well, which should be dealt with as an emergency. In all circumstances, I recommend a visit to your general physician or internal medicine specialist for further history taking, clinical examination, and evaluation. Visit your doctor for further 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 have been getting acne for a few months. Two years back, I skipped a period. Then, my periods are regular, but the cycle is usually delayed by four to five days and sometimes more than that. My period lasts for 3 days rather than 5 to 7 days. I consulted a gynecologist and underwent some hormone tests and ultrasound. I am sharing the reports with you. Please let me know whether I am a patient of PCOS. Will PCOS cause acne? What could be done to prevent cycle delay? How to resolve this PCOS problem? My gynecologist prescribed Gynex syrup and Ovalife tablets for three months. However, I have not started yet. Please provide a second opinion. ### Response: I have seen your reports (attachment removed to protect patient identity). All other tests ordered are normal. To confirm this by hormonal correlation, you need to get your FSH (follicle stimulating hormone) and LH (Luteinizing hormone) levels done on day 2 of cycle. It is the reversal of this ratio in PCOS. You may take Ovalife tablet. It is just a supplement. PCOS is not a disease, but just hormonal imbalance. You are a lean PCOS as you are very thin with a BMI of 23. Try to maintain your weight by a good and balanced diet and regular exercise. For reduction of acne and maintaining regularity of your cycles, I suggest tablet Diane 35 (Ethinyl estradiol) once a day for 21 days starting from day 2 of the cycle. Consult your specialist doctor, discuss with him or her and take the medicine with consent. However, regarding acne, your male hormone testosterone levels and also free insulin levels are within normal range and probably not the cause of acne. Consult a dermatologist for acne." "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 29-year-old female. I have a 9 years old daughter. After two months of my delivery, my one breast produced more milk than other. But now I am planning for second child. My query is whether there will be normal or same production of milk after second delivery? ### Response: Hello. This cannot be told. Breast milk production depends on many things like how much baby suck from it, how much development of breast tissue occurs under the hormonal influence during pregnancy, the nature of cell, how much these cells are sensitive to milk production signals after delivery and what are the glandular tissue. So, try to breastfeed equally on both sides, and it should end your problem. There is some chance of less milk production on the same side." "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 CTE (chronic telogen effluvium), but my doctor did not provide me with any information basically what to do about this condition. Can you help me out? What should I do to get it under control? ### Response: Hello. 1. And rest of the times no cause can be appreciated. 2. So then you need to look for these and control. Take plenty of fresh fruits, and protein sources including eggs, meat, and dairy products. 3. Use a Ketoconazole 2 % shampoo once or twice a week to help scalp keeping free of dan" "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: Dear Doctor,I am a 24 year old female, was prescribed with Celexa 20mg once daily and Buspar 5mg twice daily for severe anxiety/panic attacks.Both of these medicines are SSRIs though, and I read about it online that everyone/every source says never to take them at the same time due to risk of serotonin syndrome.Today, after taking the Buspar, I felt cold and shivered constantly. I could not get warm and I was very sleepy. Now I am scared to take the night time dose of Buspar and Celexa.I would like to have a second opinion on the safety of taking these medications together. ### Response: Hi. You are not on too high a dose of celexa or buspar. I feel just the chills and sedation are too general to be indicative of serotonin syn" "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 pain in the penis, yesterday I went with a urologist, and he did a physical examination in the external genitalia after which he found inflamed EUM, the frenulum is short and tight, balanoposthitis, and mild discharge. Please suggest what I should do now? ### Response: From your description, it is clear that you have inflammation of foreskin and glans penis, which is called balanoposthitis in medical parlance. Usually, this does not occur in normal persons, if one can keep the undersurface of foreskin clean once a day. However, cleaning the same during inflammation is difficult. So you need to take antibiotics as well as anti-inflammatory agents for a week and then, can undergo circumcision as you have a tight foreskin. It is not a life-threatening condition. Please get back to me if you need any more clarification." "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 taking only daily Vitamin with a fish oil omega 3 supplement. I am 5\6, 120 lbs, and 42 years old female. About a year ago I started having problems with my neck. After MRI, it was determined I had a degenerative disc at my C4 to C7. I opted for no surgery and decided to go the pain management route. Being on Hydrocodone and getting steroid injections for about a year, I decided to stop cold turkey. I went through withdrawal symptoms and a month back I went to the emergency room because of heart palpitations and chest pains and shortness of breath. (Earlier that day, I went for a 4-mile walk). The EKG and X-ray which came back normal. But the laboratory work showed an elevation of TSH at 6.455. All other lab work was fine but I was a little low in potassium (3.4). Blood pressure was normal as well. The doctor on call suggested that I might have hypothyroidism. My question is could the high levels of TSH be a result of withdrawal from Hydrocodone and if so how long will it take to clear up on its own or do I have a thyroid issue that needs to be taken care of? ### Response: I just read your query and from what you have mentioned it appears that you have subclinical hypothyroidism. You do not need any treatment for that currently but you need to repeat your thyroid function tests after six weeks again just to be on the safe side. Yes, you are right. So, ultimately you just have to give your body time to heal itself. It could take anything from six months to a year to get back to normal, which is usually what has been observed" "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 want to ask that I drank some liquor (two bottles of beer) 11 hours before taking HIV test. My result was negative. It was ELISA test. Can I be conclusive of my result? Should I test again? Will consuming liquor affect HIV test result? Please help me. ### Response: Hi. Consumption of alcohol will not affect the test result for HIV. However, HIV has a window period of one to three months during which the test result can be a false negative. The result can be considered conclusive if done after 12 weeks of the last suspected exposure" "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 severe constipation for the past 10 days. There is also discharge and itch from the anus. I am also feeling excessive weakness after passing stools. ### Response: From your history, it looks like severe constipation. But I would like to know a few more details so that I can confirm the diagnosis." "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 I have damaged my penile suspensory ligament. The penis even in flaccid state is dipping down. I feel some tight sensations around the body of my penis. Also, the sexual excitement has very much reduced. ### Response: The best way to know for your erection problems is to do an erection test by a urologist. It is done by giving small injection at the base of penis and create an erection, then the urologist does a physical examination to see if deformity is within normal limit or it requires any correction. Penile suspensory ligament injury usually happens after external trauma, and not related to skin problems. MRI of pelvis is done if clinical suspicion of the injury exists." "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 wearing contacts for a few years, but recently after I take my contact lenses out. I feel like there is something in my left eye when I blink. Do you know what this could be? ### Response: Since you have been wearing contact lenses for a few years now, you could have developed giant papillary conjunctivitis. Here patients develop a few bumps on their conjunctiva (the lining of their eye) due to prolonged use of contact lenses. Prevention: Change your contact lenses frequently, especially if they are monthly disposable, do not wear them for over a month. Clean them each time before you insert them into your eye. Avoid using colored lenses. You should meet an ophthalmologist if in case you continue having the feeling that there is something in your eyes or your eyes become red and start watering or if you have blurry vision in your eyes. Contact lens use. Slit-lamp examination. Allergic conjunctivitis. Contact lens holiday, Cromolyn sodium or Olopatadine eye" "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 got married before 10 months and since then my lifestyle has changed. As a result of this, I am suffering from increased bowel movement. Over last three months it has become very frequent for almost two to three times a day. Sometimes they are fine but at times stools are like soft porridge and even undigested particles in it. Stomach has become a bit sensitive towards infection. Kindly help. ### Response: Hello. I want to assure you need not have to worry as everything is going to be fine, if proper care and treatment is opted in for. I have gone through your case thoroughly and can understand your genuine health concerns. 1. It can be a gastrointestinal infection and needs care and treatment. 2. Change of diet and emotional changes also play a role in post-marriage stomach upset in some cases. 1. You need to get a complete stool culture and stool culture and sensitivity test done from a laboratory.2. Once you get the stool laboratory reports, do upload the reports in the follow up question directly.3. If there is a need to deworm, then you can start taking medicine Albendazole.4. If you feel good with the above mentioned treatment, then no need for any further investigations.5. In case you feel nothing is working, then you can consult a gastroenterologist for physical evaluation and get a diagnostic colonoscopy done, if the need arises. 1. I would advise you to have Rifaximin.2. In case of loose stools take Imodium immediately.3. Citrucel (Methylcellulose) dietary fiber supplement is good for your health. 1. 2. Do not take refined meat and red meat.3. Take Pedialyte that helps to replenish water and to keep electrolyte in balance. Revert back with the laboratory investigation reports to an 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 am a 26-year-old female. I recently found out via online test results that I have an enlarged heart, but no reason was given for why it is enlarged or how enlarged it is? The impression is Cardiomegaly with no evidence of focal infiltrate.I am currently obese but in good health with the exception of this enlarged heart and insulin resistance (not diabetic or insulin-dependent). Is it too late to reverse this heart enlargement with diet, weight loss, and lifestyle changes?I am currently on Metformin, Xanax and Provera. ### Response: Enlarged heart only on chest x-ray is not reliable. X-ray is just like a shadow, the farther you stand from the wall, the larger will be your shadow. In the same way, if you stand away from x-ray film even a few centimeters, it will give an enlarged shadow of heart on the film. Best way to assess the size of the heart is via echocardiography. Echocardiography is indicated if you have symptoms of shortness of breath not explained from other causes. If you have such symptoms, have echocardiography and ECG done. I hope these will be normal." "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 62 years old. She has purple-like patches on her arms and legs as shown in the attached picture. She said that she has it for over three to four years and these patches fade in a few days once they appear. My mother also has diabetes and hypertension. She is using some antibiotics for diabetes and hypertension. She also has substernal goiter and her biopsy was negative. I am attaching her blood and hormone results, which are in the normal range. Liver function tests were also normal. What are these fading purple-like patches? ### Response: I have gone through the pictures and reports (attachment removed to protect patient identity). 1. Blood thinner agent.2. Minor trauma. Bleeding time and clotting time. 1. Ecchymosis.2. Senile purpura. Revert back after a week 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: My 2 months old got her shots a week back, and that night she got a cough. It has almost been a week and she still has it and it has gotten worse. Should I wait it out? Or take her to urgent care? ### Response: Hi. I believe this is your first child that is why the query. Coughing has got nothing to do with vaccination. Frankly speaking, it does not require treatment as long as the child is able to feed without any difficulty." "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: Please explain about the things that are toxic to humans in their day to day life. How do they affect the health? Please advise. ### Response: Detergents contain hazardous chemicals that irritate the skin and cause eczema. Some individuals who are prone to allergy, also get contact dermatitis. They also cause damage to the mucosal lining of the gastrointestinal tract when they are ingested. Detergents contain phenol. The skin absorbs them quickly, and they result in a renal and hepatic dysfunction for a long term. Perfumes or body sprays contain hazardous compounds. When they are inhaled, they irritate the delicate mucosal surfaces of the respiratory tract, and they result in asthma and allergic rhinitis in some individuals. Certain compounds in perfumes can also cause a headache. Processed foods like sausages are harmful to the digestive system, and when they are ingested for an extended period, they result in colon cancer. Processed meats are said to be carcinogenic. Canned food also contain chemicals that are carcinogenic. Canned foods which are rich in fructose also cause hepatotoxicity. Foods rich in trans fat predispose to atherosclerosis. Air fresheners that contain artificial fragrance can irritate the eyes and cause inflammation. It can also cause asthma due to chronic inhalation of phthalates present in these compounds. These hazardous fumes when readily inhaled cause lung parenchymal diseases in the long term. Some may affect the reproductive functions also." "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 want to know if it is possible to correct the eyes of a child that does not focus properly. The condition is when the child is looking straight, the eyes appear as if it is looking elsewhere. ### Response: Your child has squint eyes. This can be due to multiple causes. 1. Refractive error or glass number. 2. Congenital squint due to neurological issues. 3. Retinal or optic nerve pathology. Kindly get your child evaluated from a pediatric ophthalmologist. Initially, they will prescribe glasses and then observe. Occasionally patching therapy may be recommended. If the eyes fail to align after a few months of therapy and after ruling out all treatable causes of squint, surgical correction of squint may be undertaken if needed and desired by parents. It will help if you post a picture of the squint so better guidance can be provided." "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 thickened tip of mitral valve leaflet with prolapse of the mitral valve leaflet to the left atrium during systole producing moderate mitral regurgitation with an EF of 34% and left atrial enlargement. There are normal coronary artery sizes. There is normal pulmonary artery pressure. Good left ventricular systolic function with an ejection fraction of 66% and a left-sided aortic arch. No pericardial effusion nor coarctation.The conclusion of 2D echo procedure is rheumatic heart disease and mitral regurgitation. I have attached the copies of the report. ### Response: I have gone through the attachments (attachment removed to protect patient identity). Your echo report is showing that you have rheumatic heart disease with involvement of mitral valve. There is a leak in mitral valve termed as mitral regurgitation. Mitral regurgitation is quantified as mild, moderate, severe. It is moderate in your case" "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 recent non-contrast CT scan of thorax, taken 10 weeks after undergoing a right hemicolectomy, showed:1. Expansible sclerotic lesion in right rib may be benign. Bone scan might be useful.Given that I have only one kidney left, how would the injection of radioactive substances affect my single kidney?2. Moderate right pleural effusion. What are the risks of draining this effusion? What natural alternatives are there (home remedies)? How urgent is it to drain this moderate effusion?I have right pleural effusion, no chest pain, but some shortness of breath especially when climbing stairs. ### Response: To answer your first question, it all depends upon your creatinine clearance (how good is the remaining kidney functioning), also the reason why one would want to investigate this lesion further. Say for example if I am concerned about a metastatic lesion I would consider a PET-CT (positron emission tomography-computed tomography) if I am worried about a primary bone cancer an MRI and so forth. Moderate pleural effusion in a diagnosed condition is treated by watching closely and making sure that it is improving by serial chest x-rays. Salt restriction in a patient with heart failure, liver and kidney issues helps to improve the pleural effusion. 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 had two Paracetamol 500 mg and I started feeling a sharp pain in the throat. Is that normal? ### Response: Hi. The sharp pain in the throat is suggestive of acute pharyngitis case. You can take Paracetamol that is available to you. Now for congestion relief, decongestant also needs to be prescribed. Salt water gargle can be done with warm water three times a day. Avoid excess spicy foods." "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: Hey doctor,I have always wanted white teeth. My parents had told me when I was a baby my teeth rotted as a result of the milk bottle getting left in my mouth. Fast forward to all the way now. Nothing has worked. I went to a dentist for an evaluation. And he gave me teeth whitening tray to take home. And it seems that has not worked. Is there any way possible for me to get white teeth? Without having to resort to veneers? ### Response: Firstly, I would like you to know that baby teeth are always pearl white in color and that is the reason they are called milk teeth. The permanent teeth which you have now are always slight yellowish to greyish in color by nature. I saw the picture you have attached (attachment removed to protect patient identity). And your teeth seem to be perfectly alright. There are no evidences of any problem of milk bottle decay with your current teeth. With the home bleaching tray given to you, it can only bring one or two shades lighter than the original. You cannot expect miracles to happen. And veneers are not for you as well because we do not want to ruin your shiny enamel. I reckon you maintain good oral hygiene and stay happy with this beautiful set of teeth. May be home whitening once in a while will do" "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 22 years old. I have been observing that since last 3-4 period cycles, I have been having blood in urine. Just an hour before periods then it is normal once I get my period and the urine is again clear. Recently, I got my period and an hour back I urinated with little blood but the last few drops after I was done wer really red. I have lower back pain that comes and goes and sometimes when I walk I get pain in left buttock. 10 days back I had UTI which is treated now. 10 days back I also had a really bad pain in lower abdomen and I placed a hot water bag on it and the pain was gone. I will be going for a scan and urine test after my periods are over.I had posted this query on a health app and was told by the doctor that I may have bladder endometrosis. It has terrified me now. It is so scary q nd needs surgery. I am healthy, do yoga and never smoked nor am I sexually active. I wanted to get a second opinion whether I could have this. I Can understand that a doctor cannot give an opinion till the reports are out. And I still have to wait for 3-4 days till my periods are over to go fr the test. But for my peace of mind an experienced doctor\s insight could help me relax a bit. Do I really have a major problem? My doctor who told me to go for scan told me that it could be an infection or kidney stone. ### Response: Hello. Endometriosis is not so common. Although you have a pattern of bleeding which goes in favor of bladder endometriosis. First thing which needs to be ruled out is a stone disease. Get an NCCT KUB done which will confirm or rule out stone disease. If it is not there then next step is a cystoscopy that means having a look inside the bladder by passing a small telescope through urinary passage. In any case these things are treatable and you should not worry much. Revert after the scan ." "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 on fasting for the auspicious month (dry fast), but I also have to take Lithium for my bipolar disorder. I have seen that higher Lithium concentration can cause serious damage to the kidney due to dehydration and also to the metabolism. During fasting and with keto diet the body needs a lot of potassium, but the cells get lithium instead. What is your opinion about that? Is dry fasting, keto diet, and lithium intake at the same time harmful?I take normal Lithium carbonate 650-1250 mg a day. ### Response: In such cases, we recommend to increase the amount of fluid. That is to consume a good quantity of fluid in the morning before your fast starts and to" "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 31 year old male. For about two weeks or more, I have been experiencing a mild nonspecific pain in my upper body. It is mostly at the upper back, at the center and slightly towards the right. At times, it occurs in the middle and lower back, at the sides, behind the right upper arm, and occasionally around the chest and right collarbone. Mostly it is in the upper back at the center and slightly towards the right. The pain is mild and not at all severe or crippling. The feeling is sometimes of little stiffness, and sometimes a throbbing or pounding. I do not feel any trouble in doing my usual chores.I have a habit of examining my body, pressing here and there to feel anything unusual and on one such occasion, I had found a couple of places on my chest which was painful when pressed deeply, but I do not feel anything unusual under the skin. In fact, several months ago, I had found a couple of other places on the sides which were painful when pressed deeply. I have a desk job, though I get up and move around quite regularly. I do not remember having any injury. I have never had any major accident. My queries are, what may be the possible causes and could they be serious? And, is there any chance this has any connection with lungs? I do not have any breathing difficulty and do not feel any pain or anything unusual while deep breathing. In fact, I have a habit of walking, and only a couple of days ago, I had walked 4 km at a stretch without any extra effort or discomfort. Please advice. ### Response: Hello, I went through your detailed post. The predominant complaint is a mild pain in the upper back and around the arm. If these possibilities are excluded by investigations and a clinical examination, then a chest X-ray is warranted. Regards" "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 absence of ductus venosus during pregnancy during the first and second trimester. Please suggest. ### Response: Absence of ductus venous during the first and second trimester scan is a vascular condition that might be of concern for fetal abnormalities. It can put the fetus at risk of other congenital anomalies including facial clefts, hemivertebrae, cardiac, genitourinary, and gastrointestinal anomalies." "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 22-year-old female. I have had irregular periods since the beginning. I was sexually active, and I had protected intercourse before six months and had my period on second of very next month after having sex. I had sonography done, and the reports said only slightly enlarged ovary. I have not had my periods till date. Its been three months now.Please advise what could have gone wrong. I recently had unprotected intercourse on last month and had an I-pill within 12 hours. Its been 10 days I have not got any withdrawal bleeding. I took a pregnancy test yesterday and it is negative. I started having Primolut N to induce my periods. What are the chances of pregnancy? And what should I do to regularize my periods? ### Response: The chances of pregnancy are close to zero. You may be suffering from PCOD. Please get your blood tested for LH, FSH, TSH, free testosterone, prolactin, DHEAS. Also, do your insulin fasting and transvaginal ultrasound. If the diagnosis of PCOD is confirmed you will have to take oral combined hormone pills with a prescription. That will regularize your periods and give contraceptive protection too. Also, your weight is towards the higher side. Try to lose weight that will help too." "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 very severe cystic acne mixed with white heads on my shoulders, chest, and back. I have been prescribed Doxycycline, 100 mg twice daily, this is my third week on. My acne got worse for the first week and then better. Much less swollen. But it is still very painful, bleeding and oozing through all my clothes. My doctor advised against non-comedogenic lotion, but I find it is making my skin dry, and that is making the acne split open as well as the scabs. Does it take very long to heal? I believe the acne started because I have been using anabolic steroids, but I believe it got infected (as does my doctor) and that is why she prescribed Doxycycline. My question is, what would you do for someone who developed severe cystic acne due to anabolic steroid use? Stopping steroid usage also is not an option at this point as body and hormones could not recover on their own. Please tell me how this would affect your treatment and how health insurance would be affected? ### Response: Hi. I have gone through your case. If your anabolic steroid is the causative agent then you should really stop it in order to keep it in control." "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 oil went into my retina around 20 days back. I consulted some doctor\s, but different doctors gave different advice. While doing some work my retina swells up in the left eye and the vision is not proper. When will it be all right? ### Response: I have seen your medical notes and can assure you that you should be doing fine. I also read that you have had lasik surgery done in the past. First of all the oil did not effect your retina, which is the innermost portion of the eye, not exposed to the out side. The oil effected your cornea which is the outer layer in front of your eye. Because of the oil splashing on your cornea, there was a swelling on your cornea, which is called as corneal edema in medical language. Fortunately, your vision is 6/6 in both eyes, which is 100% normal vision. My advice is that please continue the current treatment and follow with your treating doctor. I can assure you that as the corneal edema subsides your vision will also improve." "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 on birth control continuously for three years. About a month ago, I took a pill late instead of in the morning. My boyfriend has not ejaculated in me. But, I noticed that I have gained weight. What are the chances of me being pregnant after taking a pill late? I do not have periods since I take the pills continuously. ### Response: This is a common mistake that you have faced. However, a single late pill intake is in no way could turn you fertile as well as pregnant. Even if you miss a single pill, the chance of pregnancy is very remote. Now, continuous pill intake could be the reason for absence of cycle. We advice this sort of continuous pill intake only if you have endometriosis, a disease produces painful menses. However, you need to take pills with a gap of 7 days pill free period or have to be on inert pills for 7 days. Then only, you will have cycles." "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 acne since a week. I used Clindamycin gel but it is not effective. I have attached my photos. My acne goes and comes. Also tell me which face wash, moisturizer and sunscreen to use? Kindly suggest treatment for my acne. ### Response: I have reviewed the attached photographs (attachments removed to protect patient identity). I would recommend you to use Salicylic acid face wash twice daily and apply Benzoyl peroxide 2.5 percent gel twice daily on the affected areas. Along with this take a course of antibiotic tablet Azithromycin 500 mg daily before lunch or dinner for three consecutive days in a week for six weeks. Use Face Guard sunscreen gel and silk moisturizing cream as sunscreen and moisturizer respectively. Use cosmetics labeled as noncomedogenic and reduce the intake of sugary foods. Continue the above mentioned guidelines for six weeks. Seborrhea or hormonal disturbance. Acne vulgaris. Revert back after six weeks 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: My daughter, 11 years old, has her eardrum damaged. I want to know the advantages and disadvantages of ear drum surgery. ### Response: Hi. On the other hand, if it is a chronic perforation then surgery is the only treatment. Usually surgical results are good and the patient gets cured but unfortunately, sometimes complications develop like the failure of surgery by a rejection of the graft, hearing loss, recurrence of discharge, facial palsy." "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 high fever of 100 degrees. I am overweight. Please suggest. ### Response: Hi. In my opinion, high fever can be due to infection either bacterial, malaria or viral. You can take Paracetamol to reduce the high temperature. Do laboratory tests to rule out the infection for proper treatment." "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 has diabetes, and the doctor said he loses the fat of the body through urine. Like no muscle inside the body. He takes electro homeopathy NaCl drip two to three times a week. Please suggest some thing how to be better? ### Response: Hello. Patients with diabetes mellitus can develop contracture of digits and limbs as a result of soft tissue thickening in these areas. This can lead to wasting of the muscle from disuse. This is referred to as atrophy. You did not mention your father age, and if he is old enough, then he supposes to go for DEXA scan and blood levels of Calcium and Vitamin D and Vitamin B12. Ask him to go to the physician, and if I were his physician, I would keep monitoring of his blood sugar, prescribe his calcium and vitamin D supplement and injection of Vitamin B12 or mecobalamin tablet and further follow-up accordingly. We have to be always on the safe side, and patient safety is our top priority. Also, your father needs an annual screening for his eyes, foot, and kidneys." "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: Dear doctor,I am suffering from piles. Taking aloes and Aesculus daily. It completely disappeared after taking this for 14 days. But it came back again when I was travelling long distance by car. How to cure it permanently? Suggest some homeopathy medicines. ### Response: Have lots of water and fiber-rich fruits to help regular bowel movements and avoid constipation. For the piles problem, I would advise you to take three doses of Nux Vomica 200 every three days. Hope this helps. If the problem persists, consult a homeopathic 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: My eye doctor told me, after doing an eye scan, that I have no pigment in my sclera. She said she could see right through my eye in the scans. I cannot find anything online regarding this. I would like to know what this condition is called so I can research as I also have glaucoma that is unresponsive to any drops and trying to find out if there may be a connection. As in a genetic link of some sort. So my question is, what is the medical term for having no pigment in the white part of the eye? ### Response: Hello. I think what she meant was iris, not sclera. There is brown or black pigment in our iris. Normally, some people have blue or green. Patients with these conditions suffer from glaucoma too. To correct glaucoma these patients need a surgical intervention like laser trabeculoplasty or trabeculoplasty. Kindly share your docs case file with me so that I can guide you better." "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: Kindly provide some health tips that every woman should know. ### Response: Hello. 1. Eat a healthy diet. Women are always conscious about their food." "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: Recently, I have been diagnosed with uterine fibroid with submucosal extension. Following are the results: The Uterus is retroverted and measured 10.9 x 8.8 x 8.7 cm. It is bulky. An intramural fibroid of 6.8 x 5.6 x 6.0 cm is also seen in the posterior wall. The fibroid is pushing the endometrial cavity anteriorly in the mid segment. What about my pregnancy? ### Response: Since the fibroid is comparatively big in size and bulging into endometrial cavity, it should be removed. Laparoscopic myomectomy is a better option. Chances of conception will be more after removal since it is posterior meaning behind uterus. If it enlarge then your uterus will also retrovert more. So, I suggest you to consult a gynecologist and preferably laparoscopic surgery may be 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: My face is not as fair as my body. There is a huge difference between my face and body. My forehead is much darker than my face. What should I do to get fair skin? Please suggest. ### Response: Hello. I read your concern and by the sound of it, it appears that you have developed a lot of tanning on your face. There are few steps that you can take to get a fair skin If it does not help, consult your dermatologist to get a combination of advanced treatment with Q-switched lasers and peels." "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 how many days a normal person (22 years) suffering from all symptoms and just have tested HIV 1 and 2, and tridot test with negative result at 120 days develop antibodies? I have symptoms from day 10. Is my test at 120 days conclusive? I tested that six months back and I am very worried about HIV. Will I die with it? Or is it a normal virus that can be controlled? Is the result of 120 days test accurate? Please provide information as I am suffering from lots of tensions. I gained weight in the last two months. I have stretch marks on my body with pimples and headaches. There is a blood vessel break in my eyes and it is like a red dot. Should I get a test for HIV again? Or else should I relax? ### Response: Antibodies are the proteins produced by the body in response to fight the foreign substance (antigen, virus, infectious agent) it enters the body. When antigen enters the body, it stimulates the immune system to produce antibodies. It is very difficult to tell that how much time a particular person takes to develop antibodies. Your negative HIV antibody test at 120 days means that 99.9% of your body has not been exposed to HIV. The test kits used these days are highly sensitive and specific and give accurate results.120 days HIV negative test is highly conclusive of your negative HIV status. But, I think that you are not letting it go. The symptoms are more likely due to stress. There are very rare cases reported in the literature where the person has been exposed to antigen but the time taken by the body to produce detectable antibodies was longer, up to six months. There are recommendations and I also suggest to my patients to repeat the test at six months and if that will be negative you need not repeat it further. 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: My doctor told me that I have balanitis. He prescribed Clotrimazole and Beclomethasone cream, Itraconazole capsules (one capsule every day) and Levocetirizine dihydrochloride (one tablet for every night) for 10 days.I have finished all medicines in 10 days. First three days I felt that I have benefited, but still I am not cured. Why? ### Response: The treatment which you are taking is entirely correct. Continue it for another two to three weeks. Undergo a test for diabetes as balanitis is a recurrent problem in a diabetes patient. Also, please attach some photo of the area so that it will be easy to diagnose the condition and provide effective treatment." "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 27 years old. My weight is 65 kg. Height is 1\6"". At 9 AM I took three tablets of Cytotec drugs orally and inserted one. But have been having cramp and diarrhea but no bleeding just sign of small blood when I urinate. Please can I insert another one this night? ### Response: The abortion procedure depends on the age of gestation. Cytotec contains Misoprostol and it is used for the abortion procedure. For the first trimester, abortion Mifepristone should be given orally as 600 mg dose and than Misoprostol orally or vaginally inserted after 72 hours. If no induced bleeding, then repeat the dose if needed. You have no induced bleeding, so the abortion process might be incomplete. According to my opinion, you have to consult your gynecologist for examination and transvaginal ultrasonography (TVS) will confirm whether the pregnancy is intrauterine or extrauterine. In only intrauterine pregnancy, abortion procedure is carried out in this way through medication. So do not try any self-medication for abortion. Consult the gynecologist for examination and discuss your further management plan for carrying out abortion" "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 39 years old. My ocular pressure has been measured three times within the last month and values vary from 20 to 24 mmHg. The field vision test is fine. OCT shows some damage to the RNFL. Do I have glaucoma? What treatment do you suggest? ### Response: Hello. In my opinion, we can still keep you in the category of \glaucoma suspect\ rather than labeling you with the diagnosis of glaucoma. To summarize, in my opinion, you are glaucoma suspect. If you have any family history of glaucoma, then I will start treatment for glaucoma. But if there is no family history of glaucoma, then I would like to wait and keep you under observation. I would like to get all tests repeated after six months for initial 3 to 4 times, and if findings are consistent and non-progressive, then we can reduce the follow-up to yearly once. I hope this will help you. Regards" "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 five months pregnant and I am having severe pain in my teeth since morning. I have taken Dolo 650 but the pain is the same. ### Response: Hi. Even though you are pregnant, it is completely safe to do any dental treatment in this trimester (four to six months). It is also safe to take X-rays in this trimester. Dolo 650 is basically a Paracetamol tablet which is a very mild painkiller. It can only relieve pain for less than four hours and cannot completely cure a toothache. And, other high dose painkillers and antibiotics are not advisable for you now. So, I advise you to visit a dentist immediately and get it sorted. Active dental treatment will only help in this situation" "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 24-year-old female. My weight is 57 kg, height is 163 cm. My complaint is face chubbiness, and I gained about 5 kg for the past 6 months, and the main problem is that I am missing my menses this month. My LMP was on 15th April.As per gynecologist advise I did CBC, fasting sugar, TSH, prolactin, HCG, total testosterone, DHEAS, FSH, LH, USG pelvis for PCOD. Doctor advised to take Primolut N but I have not yet started the tablet. Do I need to start that and what is the line of treatment? All reports were normal except the two TSH -13.740, DHEAS-53.19. Please help. ### Response: Hello. Yes, you can take the Primolut N tablet as advised by your gynecologist. As your periods have gotten delayed by almost more than 45 days, it is unlikely that they would come naturally, even if it does, it may not be similar to your natural menstrual pattern, this is because this is an anovulatory cycle (meaning no ovulation must have occurred in this cycle). Usually, when periods come after such a delay, it could range from spotting to scanty flow to excess flow, or sometimes prolonged bleeding which may need hormonal medications to stop the bleeding. I would like to know if you face any acne or unwanted facial hair growth problems, if so, then you must be having PCOS (even if the USG is normal). And yes, you definitely need to start treatment for your hypothyroidism as your TSH (thyroid-stimulating hormone) level is high. So, definitely you need to start your thyroxine replacement 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 was on Lithium 300 mg thrice a day and 50 mg Zoloft once a day for a year and a half but they were of no help so I stopped taking them. My anxiety symptoms are coming back. I have racing thoughts and panic attacks. I cannot wait for 30 days to see a psychiatrist. Would I be able to go to the ER to get something for anxiety? I work on roofs and building garages. I cannot keep having panic attacks. ### Response: I will strongly recommend to consult your psychiatrist at the earliest so that your mental state can be reviewed and started back on appropriate medication. You may know that stopping medication without medical supervision puts you at risk of relapse. Also I note that you were on Lithium which has mood-stabilizing properties. You report racing thoughts. So it is advisable to get reviewed sooner. Try asking your psychiatrist for an urgent appointment. If not possible, go to ER and seek psychiatric 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 poor blood circulation, and my hands are affected. My finger is swollen, and it hurts me a lot. I have tried using hot water over it, and it has not helped me. What can I do now? I am taking Daflon. But it has not helped me. I have attached my picture. Please see the images of the same finger present in different hands. Please help me. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). Please say about the duration of the swelling present in the finger. If the finger swelling is present for a few days, it can occur due to an infectious cause. If the finger swelling and pain occur due to cold exposure, then it can be a Raynaud\s phenomenon. It is an autoimmune disease. As there is involvement of finger in one side, it can occur due to an autoimmune cause. Your blood circulation is poor. So, you can do an ultrasound color Doppler of the arterial system of your hand. You must exclude an infectious etiology. If there is a pus formation under your nailbed, an antibiotic can be taken. In case of severe pain, you can take Nonsteroidal anti-inflammatory medications like Aceclofenac plus after having food." "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 cavities since childhood. And have got four teeth removed by the dentist. My age is 25 years old. What suitable treatment should I take for cavities? ### Response: To avoid dental caries, the most effective thing is proper oral hygiene. It means brush two times a day using floss, clean your tongue in a proper way. After that, we come to the treatment part. The best thing when you see a single black dot in your tooth, see your dentist without delay, in the initial stage of cavity your dentist can remove it and fill it with tooth color material. This is the best cheap and painless way. But if you have an old and deep cavity in your teeth then your dentist will take a dental X-ray and could advise you for a root canal treatment followed by dental crown. These are ways to save your natural teeth against cavity. So always care your teeth and routine dental checkup." "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 horizontally impacted wisdom tooth. I have an appointment to get them removed. But I started getting pain in the lower left base of my head. I think my tooth has got infected. I could see right into my lower left wisdom tooth, and I am keeping it as clean as possible with brushing and salt water gargle. ### Response: Hi. I can understand your concern regarding dental health.The occurrence of pain is very common in an impacted wisdom tooth. That is very good that you are keeping it clean as much as possible in multiple ways. But, if your pain is too much, then go for the dosage of antibiotics and analgesics under the prescription of your dentist only to relieve the pain and inflammation.Hope this information will be helpful to resolve your query, and further queries are always welcome. I will like to answer them." "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: The problem started in 2010. Social withdrawal, isolation, inability to continue at a job, negative talk, jealousy, lack of initiative, low self-esteem and fickle minded behavior. What could these point to? The prescriptions are lost in transit. No medicines are being taken. ### Response: Hello. I can understand your concern. Since the symptoms are persistent and are resulting in impairment they should be evaluated properly. It could be either depressive disorder or bipolar depression. Depressive disorders or bipolar depression can be treated properly with medicines. Most of the newer medicines are safe to use and have no serious side effects. These medicines have great efficacy. So, taking proper treatment would solve your issue." "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: Since last year, I am having a lot of health problems such as back pain, fingers joint dull pain, chest inflammation, irritation at penile area, inflammation inside the penile hole, body irritation, body weakness, fever. I often do sense inside my head, i.e., pricking with pins and needles and flu-like symptoms all the time.The reasons for the above-mentioned problems are due to unprotected sex with a creature (dog). Under the heavy influence of an alcohol, such a blunder was committed. I have an apprehension of contracting rabies from that encounter. Can rabies be sexually transmitted? Please suggest me what test should I need to do to rule out the above-mentioned symptoms. I have great hope in you as you are one of experienced and best doctor cum pathologist. Please advice me the test so that I can perform the test and revert it to you for treatment. ### Response: Rabies can spread sexually but your symptoms do not classically point towards rabies infection. The neurological symptoms like confusion, nausea, excess salivation, etc., are missing. So the chance of rabies is less as per my opinion. However, for rabies, testing multiple samples like saliva, spinal CSF fluid, etc., like examination are needed. You can rule out leptospirosis by serological ELISA testing as you have a history of sex with the dog. There are many zoonotic diseases which mean those infections which spread from animal to human. HIV also can be ruled out by ELISA testing. So your detailed evaluation is needed to do further work up. For primary work-up, you can investigate as follows. Blood pressure measurement, serum all vitamin B estimation, SGPT, SGOT, urea, creatinine estimation, ESR, full CBC, serum ionized calcium estimation, serum vitamin (OH) D estimation. You can revert back with reports. For your detailed physical examination, you need to consult nearby internal medicine specialist." "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 sister has been diagnosed with pancreatitis, portal vein thrombosis, and a blood clot in small intestines. Doctors cannot seem to pinpoint what is going on in her intestines/ abdomen. They have her on blood thinners. However, no clot will cause this much pain. Her pain is literally unbearable as she is screaming in pain right after she vomits. Not even morphine helps. Please help. Hours after she eats, these same symptoms come back. Vomiting is very bad and nonstop and the pain is not bearable. They keep sending her home with narcotics but she cannot even keep those down. ### Response: Hello. She needs a CT scan along with a colonoscopy and upper GIT (gastrointestinal tract) endoscopy to detect the cause of her symptoms" "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 gets frequent nose bleeds and leg pain. The doctor tested him for Von Willebrand, all was normal except for the thromboplastin time. It was elevated to 36 normal is 22 to 34. His complements levels were elevated to ch 50 to 60, c3 178 normal is 80 to 170, CRP was 9 normal is >8, absolute eosinophils was 524, normal is 15 to 500. Is there any concern with these levels? ### Response: Hello. Your mentioned reports are borderline and not much elevated. I do not think you have to worry much about that. The following causes have to be ruled out for nosebleed like: Your rhinoscopy nose examination is also advisable. You can attach your reports 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: I am a 44-year-old female. From the last one year, my B12 level is constantly high between 1400 to 1500 pg/ml. I do not take any B12 supplement at all. My health seems to be perfectly fine and I feel fit and active. Sometimes, at the left side of my chest, I feel uneasiness. My stool is most of the time frothy. ### Response: Hello. First of all, you should get investigated with full CBC (complete blood count) with peripheral smear examination report to exclude any myeloproliferative neoplasm if present. If liver or kidney disease is present, then B12 excretion is affected. So, liver or kidney disease has to be ruled out. You can investigate with SGPT, SGOT, total protein estimation, serum urea, creatinine estimation, and EGFR estimation to rule out liver and kidney diseases" "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 got a red rash near the tip of the penis. The doctor told me to use Mupirocin T-bact, I started applying once a day and it has been 10 days. I want to know how much time it can take for a complete cure? ### Response: Mupirocin is a topical antibiotic. It has to be used twice a day for two weeks for infectious conditions like impetigo. Also, it depends on the extent of involvement and severity. Since I have not seen the rash, I cannot really tell you how much time it can take to heal the rash. Please attach your clinical picture so that I can see and make a diagnosis that helps me to comment 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: I had chemo treatment for stage 4 breast cancer with bone metastasis. I have attached the PET scan reports. My last bone scan does not show any abnormality. Does that mean cancer has gone away or has stopped growing? Would you say the amount of location is significant or normal for BC with spread to bone metastasis? What should I be worried about most? I have been on Femara (Letrozole), but had severe reactions such as stumbling, aches, pains and I am going to switch to Tamoxifen from next week. Should I be concerned about this? ### Response: I saw your Positron Emission Tomography PET scan report (attachment removed to protect patient identity). If I was your oncologist, I would be very satisfied with the report. Bone metastasis cannot completely disappear after treatment. They become less prominent. As I have mentioned, it is a very satisfying result for the treating doctor. Tamoxifen (Nolvadex) is also a very effective" "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 15 years old. I am having abdominal pain for a month now. Sometimes localized on the right side or left side. Mostly, the pain is all over the abdomen and going to the back and pelvis as well slightly. It is recurring, sometimes serious, sometimes dull ache and sometimes mild. Also, I have not had my menstruation for two months. Doctor recommended ultrasound and ultrasound came with a report of mild appendicitis. I went to the ER, but the pain subsided by then and was recommended to go back home and come when it is severe. When pain gets severe, by the time we reach the hospital it subsides. I went to the doctor again, they gave me pills for irregular menstruation. I have a loss of appetite. I do not want a temporary solution for my pain as I have already visited three different doctors (one in the ER, one who gave Ultrasound, and one who gave hormonal pills). I am having a doubt if it could be pancreatic cancer or ovarian cancer? I am very scared. Also, I have not started the pills yet and it is three months now I did not get my menstruation. My menstruation started three years ago. I do not have diarrhea or constipation. No headaches and nausea. ### Response: The first thing to be ruled out in amenorrhea or not having menstruation is pregnancy, get a urine pregnancy test done. If there is no possibility of such a thing, then start your hormonal pills and get your menstruation. Amenorrhea could also be due to stress, yet times stay cool. Prolong amenorrhea causes lower abdominal discomfort. If once you get menstruation your symptoms may subside. It could not be ovarian or pancreatic cancer chances are very less. Regarding appendicitis, it is often associated with fever and vomitings and the pain does not subside until the appendix is removed. Sometimes in mild cases, it can be treated with antibiotics. If you are still suspicious get a repeat scan 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 have PCOS, and my recent report says that prolactin level is 42, what does it mean? Otherwise, my period is normal. ### Response: Hello. The serum prolactin levels are high, which indicate hyperprolactinemia. This can cause hypomenorrhoea or shortened menses even though the cycles may be regular. The aim of the treatment should be the PCOD regimen and Dopamine agonists like Cabergoline tablet to control and treat both PCOD and hyperprolactinemia, respectively. The classical sign of hyperprolactinemia is the discharge of watery substance from breast nipples, also known as galactorrhea. This often leads to breast heaviness and tenderness." "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 18-year-old girl. I have had thyroid problems since I was around 11. It used to be just considered hypothyroidism but now we have figured out that it is Hashimoto's disease. I rotate daily between 88 mcg and 100 mcg of my Levothyroxine to keep my TSH in check because that is the only thing that works. I get my blood drawn every six months but my doctor has not checked these antibodies lately even though last time, the number was around 5,000 when it was supposed to be 0 to 59. Some days I can barely move, and I am really limited to the activities that I am physically able to participate in. I am just scared. I do not know what is going to happen to me. If someone who is older could help or tell me what happens, I would really appreciate it. ### Response: Hi. Hashimoto disease also causes hypothyroidism and you are already taking medication for hypothyroidism. So do not worry. It is a type of autoimmune disease." "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 23 year old male suffering from back pain. Mostly pain occurs during sleep at night and soon after I wake up in the morning. And the pain vanishes after sometime (approximately 10-15 minutes). What could be the reason for the pain? ### Response: Hi. There are many reasons for back pain like We may have to do some investigations to pinpoint the source of pain before starting the treatment. As of now do hot water fomentation and take tablet Paracetamol 650 mg thrice a day. Consult an orthopaedician online regarding the investigations to be 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: My dad is having a persistent BP of 150/95 even after taking Telma 40 in the morning and Cilacar 20 in the evening. What should be done and how much risky is this BP? ### Response: Hi. Telama is Telmisartan and your dad is talking 40 mg once a day. If he has been on it for over two weeks and the kidney function is stable, then it can be increased to 80 mg in one dose or divided dosage, that is either 80 mg in the morning or 40 mg morning and 40 mg evening and he is to continue in Cilacar 20. Ideal BP should be less than 130 for the systolic (top number) and less than 85 for the diastolic (low number). If the BP is not controlled to the above recommendations then other medicines are to be added." "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 child is 4 months old. Since birth, he is on formula feed because my breast pores have been blocked. I really want to breastfeed him. Please suggest a way to feed my child. ### Response: Hello. It is a common problem which women face. An underwired bra or any kind of pressure on the breast could have caused a plugged milk duct. It is recommended to position the baby\s chin pointing to the lump and to change the baby\s feeding position. Unplug the duct by taking steam or manually preparing the breast for feeding the child, try to unplug it with some moist heat pack, massage, pumping, and nursing. Once you start feeding, it will start unplugging without any additional effort. Before nursing, gently massage your breast with hot water steam. Do try this and it will help you a lot. 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 found I am vitamin D deficient for the past five months. My vitamin D3 level was 7.04 (too low). So the doctor prescribed DV 60K once a week for two months and then once in a month. I am having this medicine for three months. I was fine and had no pain. Now already I took 15 pills in a period of three months. Now I am having pain all over the body. Hand pain, joint pain, and lower leg pain, even I took rest but it is still there. I did blood work. Everything looks fine and within normal range except high cholesterol. My calcium level is good 10.1 mg/dl. I feel tired and fatigued all the time. I got watery stools for the past three months, I know this is not diarrhea. My stool is clear and no WBC in it. My urine is clear. I got a gland on the floor of teeth and a small lymph node in the neck. I completed an antibiotic course for it, but they are not going to its original size.My question is why am I having pain all the over the body even when I am having a high dose of vitamin D (DV 60K)? My calcium level is good but why I feel bone pain? Why I am having watery stools? I am vitamin D deficient so do I have cancer? ### Response: Hi. See muscle pain or joint pains, watery motions are some of the side effects of vitamin D. These symptoms can also be seen in thyroid problems or diabetes. You have mentioned that your blood reports are fine, but have you been tested for thyroid and diabetes? No, definitely it is not cancer so relax. My advice to you is to take vitamin D once in two months instead of monthly once. Get exposed to bright sunlight. Repeat vitamin D test after two months." "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 daughter is 15 months old, and it has been three weeks that she did not sleep at night. 1 to 2 hours at most and then she will cry waiting for me to bring her to the living room because she wants to play. She would not stop crying if I ignore her (I am trying to let her try to soothe herself), even if I try rocking her or put the pacifier. She will only stop crying once I brought her to the living room. I am working, so I sent her to a babysitter during the daytime. I thought she will sleep more during the daytime, but apparently, her sleep routine is just the same as before. Her babysitter said that she slept for 1 to 2 hours in the morning and the afternoon.She is healthy, so active, happy as usual and looks completely fine to me even though she does not sleep enough. Is this normal? Will this new habits affect my daughter\s health or growth? What cause her sleep routine to suddenly change? (Previously she will sleep throughout the night, with 2 to 3 times milk feeding in between). What can I do to put her back to her previous sleeping habit? I really need advice. ### Response: Hi. Sleep habits of babies vary from one another. Your child is normal and there is no cause of concern. Most of the babies do this but become difficult to handle cause of working parents. She requires more patience. I really appreciate your concern. This will not affect her growth. Sleeping habits change because they become more active and locomotion takes priority over feeding. They like moving around. There is nothing anybody can do except handle with patience as you have been doing." "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 having severe left middle rib pain for about a month and now it is always hurting. I had an upper endoscopy, colonoscopy, left kidney CT scan, gallbladder ultrasound, blood work, and HIDA scan and found nothing, but I have a torturous colon. The pain gets pretty bad and I am worried it is something more serious, but I try reassuring myself that it is not since I have had so many tests. What could this be?! Should I be worrying so much? ### Response: From your history, it seems to be an inflammation of one or more of the cartilages that connect the ribs to the breastbone." "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 work on the computer for over 10 hours daily. I have dry eyes and minus power of 1.75 in both eyes. However, of late I see light flashes in left eye followed by heat like sensation coming out from the eye. Please advise. ### Response: Hello. Heat sensations are due to continuous computer work. 1. Always use a well light room. The light position should be behind your head not in front. 2. Screen height should be below eye level. 3. Every 20 minutes take your eyes off the screen and try to relax for 20 seconds try to see an object as far as possible for 20 seconds. 4. Every 45 minutes take a five minutes break. Use HD screen for your computer and mobile screen. 5. For light flashes, you need to get your fundus checked by a vitreoretinal specialist ophthalmologist to rule out any retinal lesion." "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 47 years old. I have a gastric problem, stomach pain, and headache. Please help. ### Response: As per your clinical history, please do an endoscopy and ultrasound abdomen to know the exact status of your GI (gastrointestinal) tract. Regarding medications, you can take Clarithromycin, Metronidazole, and Pantoprazole. You can have lifestyle modifications. Wash your hand before eating anything. Try to reduce your stress. Take vitamin B complex tablets regularly. Try to eat small meals and avoid taking spicy, and fried fatty foods." "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 PCOS patient. I did not take any ovulation induction agent for this cycle. I went for a scan yesterday and the doctor said I had one follicle, but the follicle was very weird looking for me as most follicles I have seen on scans are well rounded and defined. Please I will like to know is this a follicle or he just measured one of the cysts in my ovaries. And is it too late to take any medication for ovulation induction? ### Response: It does not look like a follicle. The hypoechoic shadow does not really even look like an ovary. The shadows are non-specific as I believe this is an abdominal scan because for follicular monitoring transvaginal scan is a must. The picture is not clear though (attachment removed to protect patient identity). On day 12, there is no point starting ovulation induction now. You may start from the next cycle." "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 hemorrhoids for a few years. My doctor has suggested me a colonoscopy to rule out cancer. Is there any simple test available to rule out colon or rectal cancer? Please mention an opinion regarding stool occult blood test. ### Response: Hi. First of all, you get an MRI (magnetic resonance imaging) abdomen done. You can have a presence of mass when you have a colon or rectal cancer. If there is a mass seen, then you can do a colonoscopy. You can also do a CEA (carcinoembryonic antigen) as CEA show an increase in range when you have colon cancer. You can also do a stool DNA test. If the stool DNA test is positive, then you can also do a colonoscopy to confirm the diagnosis." "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 16 year old male with gynecomastia. I weigh 70 kg and I am about 5\ 4"". How can I reduce gynecomastia without surgery? ### Response: Gynecomastia during puberty of your age is normal. It will subside in one year\s time on its own. Do not worry about it. If you are overweight or obese, then you must lose weight. No medicine is required right now and please do not develop any complex because of it. It needs attention and treatment only if you do not have other male secondary sexual characteristics like beard, facial hair, or change in your voice" "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 7 year old son who vomits or gags at the sight or thought of food that he does not like. He has been doing it for as long as I can remember. Every time I talk to his pediatrician about it, she says that it is no big deal, but I feel it is. He has to sit alone at lunch while at school. He also vomits every day at school. I need to know what is going on. Please help. ### Response: Hi. Vomiting at the sight of food is psychological, but I would like to know to which kind of foods does he do that like is it for milk products, etc.? This also means he might be allergic to some foods. Those foods can be avoided. Is his weight normal for his age? If he vomits daily, I would suggest some medications like Domperidone or Ranitidine. Sitting alone during lunch might not be good in the long run. Try to talk to him at home. The other way is to expose him to foods which he does not like in a graded manner, that is with a little amount initially and then increase the quantity gradually. Your child needs counseling for boosting confidence so that he does not face social isolation in the future." "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 18 years old and due to many personal reasons, I have not brushed my teeth regularly as you should, I might have brushed 10 times in the last two years. I cannot see a dentist due to my situation but I want to change my life now that I am older. My top left molar hurts a little when I apply pressure, and same with a few others, I am going to start brushing three times a day but is there any way I can stop my tooth pain? There are no visible holes or anything, and no food stuck in or near them, my gums bleed a bit when I brush. So, I know something is wrong with them, but I need help. Please do not judge me. ### Response: Hello. We will not judge. It is alright. You can still have your teeth in good condition but you have to keep brushing twice every day. Just follow this. Wish you good health and happiness. Keep me updated with the improvements" "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 younger brother\s blood electrophoresis report is HbA 61.5, HbS 34.5, and HbF 3.6. So kindly tell me the condition of the patient and precautions to be taken. ### Response: Your attached report (attachment removed to protect patient identity) is suggestive of sickle cell plus beta thalassemia combination case. It can be sickle cell trait as well." "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 tooth pain, and I am not sure what the cause is. I do have a cavity on the top row beside my front tooth, but would that affect my bottom teeth too? The pain feels like a dull pressure, so maybe it is the wisdom teeth? I am 18, so I suppose it is possible, but I do not have insurance or the money to figure out any solutions.My teeth have started hurting more since I started brushing them more often. I only brush in the morning and at night, but I brush for about five minutes each time. Could that be bothering my teeth, and the cavities I already have? Also, I have a tooth in the back left where one-fourth of it just broke off while eating, so now it is just a sensitive hole, so maybe that has something to do with it? ### Response: Your teeth look fine in the picture (attachment removed to protect patient identity), but I suggest you get an appointment with a dentist and get to know what is causing you the pain. Is it the wisdom tooth or the broken tooth or any other tooth having a cavity or is it just a sensitivity. It can be confirmed by a dentist, that too after checking out an X-ray. Rather than worrying, better have a dentist appointment soon" "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 hair loss problem. Please advice. ### Response: Hello. Hair fall is a very common issue nowadays. There are several causes for hair fall. It may be genetical or acquired. Acquired hair fall may be due to changes in food habits and lifestyles, using excessive shampoos and conditioners, using hot water to wash hair, direct exposure to sunrays, consumption of salty and sour foods, etc. Some diseases like diabetes, hypothyroidism, chemotherapy treatment also lead to hair fall. Raised DHT hormone level is also responsible for hair fall. So there is a need to know the exact cause of hair fall and try to resolve them physically or medication. Blood sugar fasting and PP, thyroid profile, DHT, lipid profile. Apply Baidyanath Mahabhringraja oil in hair roots and do gentle massage with finger tip for 10 minutes daily at night and in morning wash it with Himalaya gentle protein shampoo. You should shampooing alternate day. Orally you can take Follihair tablet one tablet once a day after meals. Do these things regularly for two months and provide your valuable feedback." "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 diabetic taking Glimepiride and Metformin. I have developed a kidney stone measuring 1.6 mm and the doctor has advised for a surgery. Is there any non-surgical management? ### Response: Hello. I have seen your report (attachment removed to protect patient identity). It is unlikely that 1.6 mm Kidney stone will come out on its own. You require surgery. There are many options like URSL and PCNL" "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: This is my CBC report and everything is normal except RBC. In it, RBC shows anisopoikilocytosis predominantly microcytic hypochromic cells along with normocytic hypochromic cells and few targets cells. WBC is within normal limits. Platelets: adequate. (MCV) mean corpuscular volume72.0 fL, normal range 80 to100 fL. (MCH) mean corpuscular Hb. 18.6 pg, normal range 30 to 36 pg. (MCHC) mean Corpuscular Hb. Concentration 30.0 g/dl, normal range 32 to 36 g/dl. I will attach the report.Please suggests cause and solution for this. ### Response: Your report is suggestive of microcytic hypochromic anemia. Do not worry about that. It is a treatable condition. With the recovery of hemoglobin level by tablet, your PS (peripheral smear) will be reverted to normal. It is not an alarming condition. But I suggest the following work up for you. 1. Serum ferritin estimation. 2. Serum transferrin saturation. 3 Serum FEP. 4. Serum TIBC. These four investigations, help in rule out iron deficiency anemia. 5. HB electrophoresis. This fifth investigation will rule out any hemoglobinopathy if present. Kindly revert back with these reports so that I can guide you further. Hope I have answered your question." "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 nasal passage was cauterized four months back. Two days later I began having lots of yellow pus like discharge from my nose. It mostly was being expelled via my throat with sputum. The cauterized site was yellow and there was yellow pus like all over.I have been prescribed Amoxyclav 625 for seven days, Cefuroxime 500 for seven days. The cauterized site was still not healed and was still having yellow discharge. I then consulted an ENT doctor who took a look at it and gave me Linezolid 600 for 10 days. The infection of the cauterized site is still not healed and still oozing with yellow pus-like discharge although there is slight improvement. I have low grade fever on and off. I feel I may be having an infection in my nose that is resistant to antibiotics.Can you please help me and advice me on how to treat my nasal passage? And also what other investigations should I do? I am worried about the infection whether it could harm me as it continues. ### Response: Hello. The cauterized site you have mentioned might be infected as you said. 1. The best treatement now in this situation is take a sterile swab and touch the swab with the pus and send it for culture and sensitivity, it will definitely give the medication sensitive for your bacteria. 2. Meanwhile start injectables preferably Ceftazidime 1 g and injection Amikacin 500 mg after test doses for five days. 3. Start application of Neosporin ointment on the site." "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 50 year old female. I have aches in my limbs and thighs especially at night. It is often characterized by heaviness in limbs. I am getting headache chiefly in left side of the head. I am taking painkiller at least once in a week for the same. I am taking Newtel 40 mg for blood pressure since a year. Kindly help with my condition. ### Response: Hi. First tell me in detail about your headache to help you in better way." "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 29-year-old female. I have had ear pressure and fullness since may of last year in my left ear only. I had a hearing test that showed mild hearing loss. About a week ago I noticed a small lump (Maybe 2?) in my neck. It feels hard but hurts when I push on it sometimes. I do not have an ENT appointment for a few weeks and I am worried I might have nasopharyngeal cancer. ### Response: The chances for it being NPC is minimal. To rule it out we need to do a nasal endoscopy. What hearing loss came out in the test? Conductive or sensorineural? Did you take any antibiotic to remove the neck lump in case it is due to any infection? I suggest you try a course of Amoxicillin clavulanic acid appropriate for your weight so that the lump goes off if it is due to some infection. If you have the report of audiometry please upload the same." "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 sore throat, white patches, excess mucus (postnasal drip), and small red bumps on my tongue. What kind of infection is this? ### Response: I have seen the image (attachment removed to protect patient identity). It looks like you have a bacterial throat infection and the red spots on the tongue are due to inflamed tongue papillae. For confirmation, consult an otolaryngologist and get a thorough clinical evaluation and investigations like throat swab culture can help in diagnosis. They will suggest a course of antibiotics like Augmentin, anti-inflammatory painkillers like Ibuprofen, doing warm saline gargles, steam inhalation and using a humidifier in your room. You can also suck throat lozenges, chew Vitamin C pellet and avoid spicy and chilled foods. 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: First of all, I have an anxiety disorder so I got shaken up by bad news a lot and I just want to ask you about this. I am afraid of this and please can you give me an answer that does not scare me more. I have had sensitive nasal passages and mild ETD for about 12 years. I get very dry sinuses when the temperature is low and it can sometimes clog up my ears and nose. I keep it in check by using nasal rinse with Neilmed purified salt and alkalol all natural products. These work great. We live in a small island country where we get water from mountains straight into a commercial cleaning station with filters and laser. I have always used this clean tap water in a netipot and then pour a little bit of boiled water into the netipot to get the temperature perfect. But now, this morning, when my sinus feel dry and just by accident I googled what is the best water is to use in netipot, and all kinds of warnings pop put that you should never use tap water for netipot. A google report says that: Tap water is not safe for use as a nasal rinse because it is not adequately filtered or treated. Some tap water contains low levels of organisms such as bacteria and protozoa, including amoebas that may be safe to swallow because stomach acid kills them. But in your nose, these organisms can stay alive in nasal passages and cause potentially serious infections. They can even be fatal in some rare cases. Very well I can very fast shift to distilled water and sterile water in the future, but I just want to ask you if I make these changes now? Can I be safe that these dangerous bacterias are not living inside my nose already and get problems in the future? Or would I feel sick right away if I get this after using clean tap water for years without problems? Can I be safe that I did not get any of these dangerous bacteria? Will distilled water even improve my nasal rinse? ### Response: First of all, netipot nasal washes are a great way to keep your nose and sinuses clean, this method is used in India from ancient times it is a part of yoga practice. Now you can understand that neti pot washes what was used centuries back were always from tap water and there are no complications written anywhere in the older textbooks and even in yoga literature. It is the duty of health department of the country to warn the citizens regarding the use of regular tap water because in some places it may be impure. It should not be generalized. Since you have not developed any significant signs and symptoms of infection there is no need to worry, tap water has not caused any problems." "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 weight is 80 kilograms. As per my height, my weight should be around 60 to 65 kilograms. Please suggest some tips to lose my weight. ### Response: Hi. Start your day with a half liter of warm water followed by eight to ten soaked almonds and raisins. Never start your day with tea or coffee. Then try to do simple exercises like walking or light aerobics. You have to do simple exercise for at least 45 minutes for five days a week. Eat all your meals at a set time. Eat a healthy snack in between your major meals." "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 20-year-old female. My height is 5\1"" and weighs around 160 pounds. I am having sharp burning pain in my chest and back in the mid to left side between the shoulder blades and under the breast bone. It lasts between 30 minutes and a few hours of this sharp pain. Usually, it becomes difficult to breathe or move my upper body until it goes away. As a kid, we visited a doctor for some chest pains, but the doctor said they could not say anything wrong other than a possible heart murmur. There is a history of heart disease in my family. ### Response: I have gone through your query. I would like to know some more details about your present complaint. What type of murmur has your doctor described? History of which heart disease your family has and who has it? Is your chest pain associated with any other symptoms like breathing difficulty, palpitations, giddiness? Does this pain gets aggravated on movement or on exertion? Is it localized or diffuse? Is there any tenderness i.e. pain increases on pressing with the hand? Any reddish discoloration on localized area of pain? Since when you are having this pain? If possible attach all the available reports like ECG, echo and any other reports. Kindly get back with the above details for further discussion and management." "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 uncle is suffering from bleeding through stool and has undergone colonoscopy and endoscopy. But the bleeding location has not been detected. We have been asked for doing capsule endoscopy. Should we go for CT abdomen with CT angio first for diagnosis? The patient has polycythemia vera. Also if at all the capsule endoscopy is required, where we can get it at a cheaper rate? ### Response: I have read through your query in detail. Please find my observations below. Bleeding through stool is a serious concern and must be evaluated in detail and treated early. Endoscopy reports (upper and lower GI) show no significant active bleeding in the areas visualized (attachment removed to protect patient identity). Keeping the above in mind, I would recommend an abdomen and pelvis plain and contrast CT scan with CT angiography study. The endoscopy done shows us that there is no bleeding point in the visualized portion of the esophagus, stomach, duodenum, and colon. We are unable to evaluate the extra luminal portion of the bowel and if there is any abnormality. The capsule endoscopy can be done later depending on the findings of CT angiography and CT scan contrast of the abdomen." "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: About a year ago, I had nevus excision. Neither shaving nor laser, it was total excision. But two days ago I have realized that the nevus has come back there along the edges of the scar, the same shape of the scar. The biopsy report of the first one is compound nevus and there is nothing abnormal. There is no note as dysplastic or something like that. I visited my dermatologist today and he said we will follow it for the next 3 months. I have been becoming paranoiac. I need some advice. You please see the pictures of old and new ones. ### Response: Hi. I understand your complaint and gone through the photos (attachment removed to protect patient identity). Any nevus is a collection of melanocytes that are able to multiply violently. Hence, even if a small section is left it can potentially regrow. You can go for elliptical excision with at least 5 mm margin and then laser sessions to blow out the reminder." "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 gave birth to my son three months back. Shortly after the bleeding stopped I had a discharge coming out it had a tinge of yellow to it. A few weeks after that it stopped. It has recently started again. What could it be and should I be worried? It causes some cramping. ### Response: Hi. As now you are experiencing cramps it is better to send this swab for an investigation to a laboratory in form of a high vaginal swab. Collect the reports and discuss here or local 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 am suffering from heartburn, chest pain, nausea, and breathlessness. I got done 2D echo, ECG, vitamins D levels, endoscopy, and blood tests. All the reports are normal. ### Response: There are several things you can do to prevent an episode of heartburn like: 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: My mother was just diagnosed with ovarian cancer. She underwent a hysterectomy and the pathology report, to my understanding, reads T3b NO MO. She is 72. What can you tell me about this and what are the survival odds? They said she will be treated with chemo for five to six months once a week. ### Response: Hello. It looks like FIGO stage III ovarian cancer. I need to know the histopathological type of this tumor. Does she have any co-morbidity like diabetes, hypertension, etc? Any family history of cancer? This tumor needs chemotherapy intravenous and maybe peritoneal chemotherapy depending upon the response and extension of peritoneal involvement. Overall, this tumor initially responds to chemotherapy. But, the recurrence rate is very high and also chemotherapy-induced toxicity mainly neuropathy is significant in this age group" "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 fever, headache, and cold from yesterday night. I took Paracetamol. Please help. ### Response: Hi. You are most probably suffering from common cold and flu. The headache is due to sinusitis." "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 26-year-old female. I am suffering from halitosis for the past 15 years. Consulted many doctors and they could not find out the reason. Please help me. ### Response: If it is such a long history, it will surely need good investigation, medication and regular check-ups. And as you are saying it is not possible in your area I can only give you oral home remedies which may or may not work without timely scaling. This condition can either be related to your mouth or to your stomach even. Many a times this may be due to stomach conditions, upsets or poor oral hygiene. Avoid things like raw garlic, onion. Take more fresh fruits and vegetables. Chew parsley, it helps. Clean your tongue after you are done with tooth brushing. Floss at least once daily. Rinse off properly after every meal and clean your teeth with fingers. Do warm water and salt rinse three to four times daily. Do not take in more of sugary things as they stay for longer time in your oral cavity and cause bad breath. Keep clove in your mouth. 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: My son is 16 years old and gets an allergic cold bout at least once a month. His symptoms during that time are an excessive running nose, frequent sneezing bouts, and nasal irritation. Please suggest the appropriate remedy for curing his allergy from the root and also for immediate relief as he is studying. How do I detect the reason behind this allergy so to keep away from the cause? ### Response: Hi. Give him Allegra M (Montelukast and Fexofenadine) tablet for a week in the evenings. This medicine is better than others as it produces the least sleep. This will help him read well. Keep away from dust, smoke, fumes, perfumes, mud, pollution, direct air-conditioning, etc. After his exams are over, note down whenever he gets allergy and that way you may be able to find the offending agent. Allergy cannot be cured. It can only be prevented and kept under wraps. To detect the allergen one must do a skin prick allergy testing." "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 husband was diagnosed with APL before six years. He underwent treatment by following the pethema protocol for APL. After consolidation phase, BMA revealed there is still 7% of PML Rara using fish rara test while negative on cytogenetics. His doctor proceeded to his maintenance phase two years on ATRA, Mercaptopurine, and Methotrexate. For two years monitoring blood counts are within the normal range. BMA was done this year and revealed there is still 3% on FISH Rara. Is this considered a minimal residual disease? Or incomplete remission? Does he need to undergo chemo again or start a new ATRA? ### Response: Sorry to hear about your husband\s diagnosis. He is having acute promyelocytic leukemia cancer and it is considered among favorable outcome leukemia. After starting chemotherapy complete remission includes less than 5% blast in bone marrow aspirate, ANC more then 1500, platelets more than 1 lakh, extramedullary hematopoiesis absent and molecular testing negativity. After consolidation chemotherapy, if cytogenetic study remains positive then prognosis cannot be considered good as compared to a negative cytogenetic leukemic patient after chemotherapy and it can be considered here as a minimal residual disease. Treatment was given in the right way along with proper chemotherapy and retinoic acid as well. But you have to discuss your case with your treating oncologist and he will guide you further about what is the future treatment protocol. 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: 1. What are the dangerous effects of restrictive dieting?2. What vitamins help the people in losing weight?3. How the basal metabolism rate (BMR) connects with weight gain or loss?Kindly help. ### Response: Side effects of restrictive dieting may include more cravings for food and overeating, lower metabolism rate, bone density can also decrease, intestinal health may also get affected adversely. Vitamin B complex helps in reducing the weight because it maintains our normal metabolism. Basal metabolic rate (BMR) is the amount of energy our body requires for normal functioning at rest. If a person has low BMR due to underlying health issue like hypothyroidism, then it may lead to weight gain because the body is not producing proper energy and the calorie-burning is lower. However, our diet, lifestyle, and exercise also affect BMR." "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 big issues with getting cavities. I take good care of my teeth, never had any soda in almost four years. I keep getting cavities in the bottom of my front and back teeth. Almost all my teeth have cavities. I really want to get them fixed but I have always been embarrassed to go to a dentist. I think it is time I get them fixed before they get worse. I really need help on what I could do to fix them. Some information on my teeth: I recently got two crowns on my two front teeth, my teeth are very small and got gaps. Surprisingly, I do not get any pain. I have been ashamed of my teeth my whole life and it has got to the point where I try my best not to smile or talk and cover my teeth. It has brought my self-esteem and confidence very low. I really need help. Please provide me information on what I should do. I will appreciate any help. ### Response: I have seen the images (attachment removed to protect patient identity). You have enamel hypoplasia which is a sort of defect when the teeth were forming or genetic. You can ask your dentist to give crowns to all teeth which have such large broken cavities. Else, you can go for composite fillings if the defects are too small. Your teeth will keep on breaking down in the future if not restored properly" "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 71-year-old female. I have white coat hypertension. I have had this all my life. I have been to numerous psychologists and therapists. I am in good health and take 1 mg of Synthroid daily. When I go to the doctor\s office my BP goes sky high. At home, it is around 120/70. I went to the doctor last Monday. Just before leaving for the appointment at home it was 140/80. At the appointment, it was 180/90, and the pulse was 123. I got home an hour later. It was 120/75 again. I have a great fear of high BP since I was a child. At my last appoinment, I took Xanax 37.5. It is the first time ever I have taken any meds like that hoping that would calm me down. I guess it did not work. I am so worried that that high number will kill me. I am so tired of worrying about it. ### Response: They are caused by the anxiety when consulting with your doctor. These spikes do not need to be treated. There is no need for any treatment, as they do not impose you to any increased cardiovascular risk. I would also recommend checking your thyroid hormone levels, in order to make the proper dose adjustments to Synthroid (Levothyroxine), if necessary" "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 hemoglobin is 6.2 and I feel very weak from inside my left chest. My reports are normal ECG, sugar, vitamin B12, X-ray, everything is normal. Why my blood is getting low and what should I do? I am a male aged 63 years. ### Response: Hello. You are having anemia and because of that weakness can be felt. You should get further investigated with peripheral smear examination, reticulocyte count, serum ferritin estimation, serum TIBC (total iron binding capacity) investigation, serum transferrin saturation to do further workup for anemia. You can be given an iron injection or PCV (packed cell volume) transfusion to raise hemoglobin level. Take iron-rich foods for increasing hemoglobin level like green leafy vegetables, jaggery, red meat, beans, etc." "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 pain in left testicle. So, my doctor sent me for an ultrasound and varicocele was observed. He said everything is fine and it will go with medications. The medications he gave me are Zenflox Oz, NAC-SR 100 and Pantogen 40. When I reached home, I started researching online about varicocele. I was scared to find out it links to male infertility. Since my left testicle pains I am more scared. ### Response: Hello. I went through your post. Well, there is about 4 % possibility of infertility in people with varicocele, but usually, it is seen in people with bilateral varicocele. So, I do not think you should worry. Just take meds. If you are still concerned, do a semen analysis. That will relieve your anxiety. Regards" "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 is in the 14th week of her pregnancy. During a routine checkup, we came to know that she was infected from HEV. What will happen? Do we have to abort the child? ### Response: Hello. There is no need for the abortion as HEV (hepatitis E virus) does not cross the placenta, but you need to have a close follow up for the pregnancy. Also, you have to get in touch with fetomaternal doctors (baby-mother doctors) and get a regular check-up of your liver function test. You would need to be delivered in a hospital setting as HEV may infect the baby at the time of birth. I hope it has helped you. If you require any further queries, please do not hesitate to contact 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: I am a 22-year-old girl. I have had eye problems for around nine months and have seen several eye doctors and ophthalmologists who all have told me different things and tried a lot of different treatments that have not worked. I am a contact lens wearer with extremely bad eyesight and first had eye problems eight months back. It started after a plane ride and assumed it was an eye infection from being on a dirty plane and touching my eyes.My eyes were stinging and crying and red and I could not bear to put contacts in. Nine months later I am still having this problem. I was first treated with antibacterial drops by a normal doctor then referred to an eye doctor when this did not fix it. The eye doctors diagnosed me with ocular rosacea, blepharitis, and MGD.I have rosacea on my face too. I have done eye compresses, gotten a liposcan (meibomian glands were not clogged enough to need lipoflow), I have punctal plugs in both eyes and I took Doxycycline for over three months which did nothing but destroy my digestion. I have been prescribed Restasis and Lotemax which I use multiple times a day. I use lid scrubs and a tea tree oil eye and face cleanser. But my symptoms are still severe, I have extremely dry eyes, my eyes are bloodshot 24/7. I have red lower lid margins and cannot bear to wear contacts which is extremely upsetting because I am an athlete and this is really impacting my athletic ability and quality of life. I just really hope someone has an answer and treatment that will work. ### Response: Hi. I can imagine the situation you are going through. Your doctor is treating it very well but in spite of all, you are still having problems. You have done warm compresses, taken oral and topical antibiotics and steroid" "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 husband takes too much alcohol daily. I want him to stop alcohol forever. About one week before, we have done a health checkup. His SGPT level has increased by 108. What should I do now? ### Response: Regarding quitting the alcohol, firstly you need to take him to nearby deaddiction center. You need to talk to him regarding the harmful consequences like liver damage which has now begun. You need to take him into confidence and take him to deaddiction center. There he will get counseling and assistance to quit alcohol. The patients are given medicine to reduce alcohol craving like Naltrexone and also medicines which will produce adverse effects on alcohol consumption, which you must have heard about. This medicine is Disulfiram 250 which you will be provided there which is given once daily. Regarding his SGPT, the best treatment is abstinence from alcohol. Also, other contributory factors like obesity, healthy lifestyle and weight loss will help to prevent further liver damage. At this stage, damage can be recovered but later this may become irreversible. Also, get him vaccinated for hepatitis B if not yet done. Also, he should be given plenty of water, adequate nutrition, fruits, and vegetables. Hope this helps you and get back if you have any doubts" "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 daughter is one and a half months old. One of her eyeballs appears to be more inside than the other. What should we do? Should we consult a specialist or will it get alright as the baby grows? ### Response: Hello. I read your query and understand your concern. But, there is nothing to worry about as such" "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 stomach pain for the last two days with loose motions. I took medicine to control loose motions. But, I am using bathroom for every four to five hours.I feel some heavy pain in stomach and feels like going bathroom. The motion is not loose and not regular too. It is dark and greasy. When I press the stomach I feel the pain. Please advice some medicine. I am fasting all day due to the festive season and having heavy food late night. I had a heavy diet with chicken before two days and since then it has started. I can feel the pain over the stomach and sometimes in the back too. Please help. ### Response: It is really a troublesome situation you are facing nowadays. I feel sorry for this health issue. But do not worry. With care and lifestyle changes you will get better soon. Ask your local physician for a prescription of Metronidazole (or) Rifaximin to be taken orally and Imodium (Loperamide) for the loose motion. Mainstay of management is taking a lot of fluids, including Pedialyte to replenish fluid loss. Avoid fried and fast foods, spices and stuffy meals. Remain as light as you can." "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 97 year old mother, who is in a nursing home, is more tired and feeling unwell. A blood test has shown she has likely got multiple myeloma. She had left-sided paralysis from a stroke six years ago. She cannot speak, and she is slow in understanding and writing, but she has no dementia. She also has atrial fibrillation from 12 years. Usually, she is alert and enjoys life with what she has. A bone marrow biopsy would be too nasty and cruel for her, so our physician and I have ruled it out. The physician can only offer palliative care, and maybe a blood transfusion if she gets anemic. I have been researching other alternative supplementation to help her.The physician is reluctant to refer her to a hematologist, but I think she should be referred just to get an expert assessment and possibly other tests, even though she cannot have a bone marrow biopsy. Could more be done to help with diagnosis and determining what stage of cancer she is at, or if she has MGUS or smoldering multiple myeloma through a hematologist referral? What do you think? Do you have a particular view about the blood results? Are there any more interpretations to be had? Weirdly, the physician also says you have to do bone marrow biopsy to refer her to the hematologist. But my understanding is the physician refers to the hematologist, who then orders bone marrow biopsy, right? I think they are just fobbing me off because she is old.Her blood report shows, total serum protein is 83, serum albumin is 27, serum globulin is 56,\tIgA is 1.12,\tIgM is 0.56, serum protein electrophoresis discrete band in gamma region, serum immunofixation monoclonal band of IgG lambda paraprotein band is 26.1, serum TSH level is 1.46, serum free T4 level 12.9, serum ferritin is\t30, basophil count is 0.02, eosinophil count is 0, monocyte count is 0.4, lymphocyte count is 4.46, and neutrophil count is 2.71. Her platelet count is 166, MCH is 31.5, mean corpuscular volume (MCV)\tis 95.1, hematocrit is 0.37, and red blood cell count is 3.93. ### Response: Hi. Sorry to hear about your mother\s condition. Hope your concern is solved. I wish your mother good health." "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 itching in my under legs and skin around the area is getting darker and itches so much. ### Response: Hello. You seem to be having a fungal infection of the area. I have seen both the photos you sent me (attachment removed to protect patient identity). If you were to come to me for a consult, I would give you the following advice. Do revert back for more details. Do send me a picture with the next query so that I can assess how much of an improvement you have had" "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 MRSA and severe spinal stenosis. I was in hospital 8 months ago. Since leaving the hospital I have had rashes, burning, itchy and twitching in my face and neck areas. About 5 months after hospital visit I had severe burning feeling in muscles and major muscle atrophy and increasing muscle spasms. A MRI was done on my spine and 3 areas with severe spinal stenosis was found. I first thought it was autoimmune but bloodwork was negative. I then insisted to see an infectious disease doctor who just found MRSA in my nose.Is it possible the MRSA is in my spine causing this stenosis. I am 46 years old and very active and I have never had muscle or back pain and now all of a sudden neurologist is saying I have radiculopathy and MRI showing severe spinal stenosis in multiple places with significant symptoms. So after being active for 46 years I now have these back problems during an 8-month period where I have no activity? ### Response: MRSA occurs asymptomatically as a carrier in many people. MRSA is not related to your spinal stenosis problem. Kindly tell the exact MRI report as if there are no hyper intensities in spinal cord we will not suspect autoimmune etiology also. Spinal stenosis is commonly caused by intervertebral disc prolapse which causes narrowing of spinal canal and produce symptoms like radiculopathy pain, neurogenic claudication and if severe can cause muscle atrophy. The occurrence of symptoms are not related to your hospitalization and minor symptoms might have been ignored previously. If spinal stenosis is severe, it requires surgery. Kindly consult neurosurgeon or spine surgeon for further management. Iif you are on in my no suppression therapy like steroids or if you are going for surgery then medication for MRSA carrier state may be required, discuss with your doctor regarding this and take antibiotics appropriately." "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 with my partner two months back using a condom. After ejaculation, she was getting off from me, and as she got up, the condom slipped off. I, however, pulled it out of her. When I did this, the semen leaked on my leg. As she was on top of me (due to gravity), all the semen fell on my leg. At that time I was 80 % confident that no semen had gone near her. To be careful, I recommended her to take the morning after pill, and she took it 12 hours later. Approximately eight days after sex, we did a pregnancy test which was negative. She usually has her period around the 17th of the month. Her period is now four days late. Can you advise why this could be? This is the first time she has taken any pill. ### Response: Hello. It is normal to see delayed periods after taking morning after pill. There is no need to get worried" "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 dog scratched me with its claws. So, what should I do? ### Response: Hello. If your pet dog is vaccinated and if the attack was provoked and if there was no bleeding then you just need to observe the dog for ten days, and chances of contracting rabies are very little or nil. However, if there was any bleeding, the attack was unprovoked and if you do not know the vaccination status of the dog, you must get a full course of rabies vaccine along with tetanus immunoglobulin shot." "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 these hard clusters of bumps show up in the pubic region. The bumps are not razor burn. They are not filled with fluid. They can be cut off, but I want to get to the source to remove them. They do not itch, nor do they hurt. Any help would be appreciated. ### Response: It could be molluscum contagiosum or folliculitis. A skin biopsy would help to diagnose. Do you have a history of unprotected sexual exposure? Do not touch or prick it. It can lead to a secondary infection. 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: Before five years I consulted an ayurvedic doctor. I was suffering from hyperthyroid back pain. Then had a concentration problem in all the aspects of life. So I asked the doctor to suggest me some ayurvedic medicine for that. The doctor asked me to take manasmitra vatakam from kotakkal arya vaidyasala, the dosage of one tablet twice a day.Till date, I am taking it. The doctor told me that it does not have any side effects. Till now, I have had no side effect because of this. I feel focused and less anxious. Just wanted to ask will it be done or I have to continue with these two tablets? Will it have any side effect on the long run? I am still taking the medicines from the same brand. ### Response: Hello. Manasmitra vatkam is a good product and has no side effects in general. But it is always advised to take it under supervision only, so if tapering off the medication is required or dose adjustment is required only your physician can do that. Also only for anxiety bouts, it is not advisable for long periods. I advise you to visit your ayurvedic physician who prescribed you to take it and ask for the complete clinical psychological examination and then take it accordingly. I hope you understand my point." "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 days ago I had thick mucous in my nose and from the carving of my nose I had a wound without special nosebleeds ... I put Vaseline and it stopped the next day but the mucus continues. they are yellowish sticky and odorous and every time I try to blow my nose I bleed again. I put only rinopanteina when I see bleeding. what can I do? ### Response: " "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 36 year old male. For mild chest pain, I have got my chest x-ray PA view done as suggested by my rheumatologist. My doctor said that x-ray report shows changes of chronic bronchitis in both lungs more in lower zones and old fibrotic scarring is seen in left apex. I am suffering from arthritis for which I am on medication. I have glaucoma. My medication at present for arthritis is Cobix 200 twice daily, HCQS 200 once daily, Pan D before breakfast, Rosuvas once at night, Tryptomer 10 in night, Espidase DP, Folvite 5 mg and Imutrex 15 mg once in a week. Kindly suggest me medication according to the reports attached. Please do not suggest me any other doctor or any hospital as I want to get treated through your medication. ### Response: We are here to help you. The treatment would be based on the symptoms that you might be getting. I would advice in such case to first get a HRCT chest (high resolution CT scan) along with sputum for AFB (acid-fast bacilli) done, which would rule out the evidence of tuberculosis. Rest for rheumatoid arthritis, your treatment is going in right direction. Further treatment decision would be based on CT chest. Rheumatoid arthritis. CT chest. Avoid smoking." "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 cavity in my lower front tooth. I filled it and placed a crown over it. After a month, I started to have pain and sensitivity. The X-ray was normal. Yesterday, I had pain again. The X-ray was quite fine and healthy. I also have soreness in my gums and pain in the chin. Please advice. ### Response: I have gone through your query (attachment removed to protect patient identity). Yes, it looks like stress related periapical periodontitis. You may need to readjust the crown if you feel muscle heaviness on the same side or opposite side. Please upload a picture of your X-ray so that I can guide you further. To prevent the further spread of infection, you need a course of antibiotics." "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 rash on my back, neck and chest for over a month.I visited my physician and she thought it could be a fungal infection.She prescribed an anti-fungal medication which I took for 2 weeks.However, the medication did not do anything, and the rash is still present.It gets itchy when I sweat and the biggest portion of the rash is on my back.The rash is slightly scaly, but it does not flake or ooze.It is slightly raised.The rash appears to be a cluster of defined circular patches.Please advice. ### Response: Hi. I have gone through your query and attachments. (attachment removed to protect patient identity) It is not looking like fungal infection. It is more in favour of urticaria. Revert back with the details 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 have erectile dysfunction problem. My doctor prescribed me to take Nano Leo sachet twice daily and Tazzle tablet 2 hours before intercourse. Is it fine to take those? ### Response: Please provide me details about your medical history, age, weight, marital status and reasons for this. Medicines should be taken after proper evaluation. Please give me more details to help 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: What are the causes of pain in the first metatarsal that radiate to the entire forefoot? ### Response: Hi. It will be better if your age, other conditions, profession, recreation, alcohol intake and dietary pattern are known. The causes can be divided into two major groups." "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 missed my period and my actual due date was 20 days ago. But, the pregnancy test shows negative and this is happening for the first time. My period is always regular. What could cause this? What will the reason behind this? ### Response: At the age of 35 years and with the concern of your weight 39.92 and BMI 14.2, you may have early menopause. Do a thyroid test. Sometimes, due to thyroid also your periods can get elongated. Or it is more likely perimenopausal period from which you are passing and your period starts being irregular as 6 months to 2 years before menopause. Try to put on some weight and see. Do one sonography to rule out any ovarian pathology and thyroid test. If tests are normal, then no need to worry. It is just a normal phenomenon. If any other symptom comes along with, then we shall investigate it 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: If a tooth with a little bit of a composite filling that is chipped off at the edge should it be replaced? It is on a molar tooth and does not hurt. The dental explorer does stick in there but no signs of decay on the X-ray. What should I do? ### Response: As there is no sign of decay, so you need not worry for now. But be extra careful with that tooth, you should maintain good oral hygiene, clean full mouth with fingers after every meal, there should be no food lodgement in your tooth. Rinse mouth properly after every meal. Do revert back for more queries." "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: Dear Doctor,I had unprotected sex. She took unwanted 72 within 12 hours. Will she be pregnant?In case she becomes pregnant, suggest any options other than abortion. ### Response: You have taken emergency contraception as advised. That is very good. 99% of the times this will work well, but her menstrual period may be delayed. At this point you do not have to do anything. If the periods are delayed more than a week then you have to check for pregnancy. If positive we have to deal with it then. Either way, it is better to follow some form of reliable birth control to avoid this situation in the future. Also emergency contraception is for once a cycle use only. In case her periods are delayed, 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 had unprotected sex 90 days back and my symptoms now are penis pain. The body pains, muscles pain, and my upper lips have white spots. Two months ago, I got a sinus surgery. I am afraid of HIV. After 65 days of the exposure, I had an RNA-PCR test done, p24 and a duo combo test. In 90 days, I had a Western Blot and ELISA test and everything came negative. I have a tonsils problem too. ### Response: I have gone through your problem and understand your concern. As all the test for HIV (human immunodeficiency virus) are negative at the initial level and after 90 days, it means you are not infected with this virus. So do not panic. Pain at multiple sites can be due to other medical conditions that are psychological in origin because of excessive worry and anxiety. For white spots on the upper lips, get a consultation with a dermatologist to find the cause of it. Probably you are having too much anxiety as to suffering from a serious infection. In such situations, SSRI (selective serotonin reuptake inhibitors) and psychotherapy are helpful" "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 severe ankylosing spondylitis since 19 years. I am a 28 year old male, married and would like to have a baby now. I am taking Indomethacin 75 mg and Omeprazole twice a day. My left hip is completely fused, but I have no pain. There is pain in right hip and lower back. Please let me know, can I have a healthy baby. What should we do to get healthy, fit and fine baby? I do not want baby to be defective. Kindly give me suggestions to improve my health. My wife is completely fine and healthy. I have attached my Hb, CRP and ESR reports. Please guide me. ### Response: Do not worry about your condition and your future baby. You are fine and your baby will also be fine, as genetic transmission is rare in this case. Again you should change the painkiller if you are not responding to it. You can start tablet Rofecoxib 50 mg daily for five days and let me know the condition of your pain. Apply Dolopar gel (Diclofenac) topically. Go for active physiotherapy exercises. Take a capsule Nutrolin B plus (multivitamin) daily for 15 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 have a right side hip labral tear and a probable sports hernia on the same side. Can both these issues be addressed in the same surgery, or do they have to be addressed in separate surgeries? ### Response: Hi. It can be tackled in the same anesthesia and surgery. Hip labral repairs or excision is done arthroscopically and after that, the surgery for sports hernia can be done either open or endoscopically. So, it can be done in the same sitting of anesthesia. Before the surgery, the clinician should confirm the diagnosis of sports hernia. Has the MRI scan been done? This professional advice provided by me stands subject to the actual examination of report/image and is based entirely on inputs provided to me. It should be correlated with clinical findings" "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: For the past six days, I feel softening continuously around the anal area when I walk. Now, I am suffering from slight constipation. I have no hemorrhoids and no staining in the undergarment. I have no blood in the stool and no pain in the anal area and also on bowel movement. Then why do I feel so? Please help. ### Response: Functional constipation. Sigmoidoscopy. 1. Avoid constipation.2. Avoid non-vegetarian foods and take lots of green vegetables. Revert back after sigmoidoscopy to 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 had protected sex on the fourth day of my periods. And I did not take any emergency contraceptive pill after that. Now I am eight days late. Am I pregnant? Please suggest some medicine to bring my periods. I am a hypothyroidism patient and was suffering from irregular periods for almost 13 years but from last one year under medication and am working out. I was having my periods regularly. ### Response: Hello. As you were on the day four of your cycle, which was your safe day and also that the sex was protected, the chances of pregnancy are minimal. However, the best way to rule out pregnancy anyways would be to get a urine pregnancy test done at home with a home pregnancy kit. If the test is negative then you can be sure that you are pregnancy safe and the delay is likely to be stress induced during this cycle" "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 8-year-old daughter had labs done twice now and I have one doctor saying its concerning and another saying they are fine. I need another opinion. Labs done two months ago TSH was 5210 and free T4 was 1.43 and labs done this month are TSH is 5960 and free T4 is 1.14. I have attached lab reports for your reference. ### Response: I just read your query and from what you have attached (attachment removed to protect patient identity), it appears that your daughter has a slightly high TSH (thyroid-stimulating hormone). As of now, there is no need to take any treatment. However, her tests have to be repeated in every three months. You have to observe her closely for growth parameters like weight and height according to her age and later keep a watch regarding achieving puberty. If any of these aspects fall behind then she needs to take treatment for it. Regards" "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 pregnant with my first child. I was diagnosed with preeclampsia in the first trimester. My obstetrician told me that I have a placenta percreta, and I will require a C-section. Additionally, my dentist has told me to make sure that the anesthesiologist should know about your difficulty in airway breathing because of trismus. I am worried about my delivery and want to know how to proceed? ### Response: If you have preeclampsia alone, then the delivery can be done under spinal anesthesia. As you also have placenta percreta, the surgery may be very extensive with more blood loss and hemodynamic instability so that general anesthesia will be the best one. Since you have trismus and difficulty in airway breathing, the anesthesiologist should always be ready with all the aids for difficult intubation and ventilation" "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 32 years old, and my weight is 53 kilograms. I am affected by C type of dengue. Last week, my platelet count was 204,000 platelets per microliter of blood. Now, I have a mild fever at night and mild abdominal pain in the right side. I am feeling weak, and I am taking good food and drink. Please help me. ### Response: Hi. In dengue, platelet count usually falls after having a fever. So keep on monitoring the platelet count, and if it goes below 1 lakh, then it requires an admission. Never take any painkillers other than Paracetamol. Take antacid like Pantoprazole to avoid having a gastrointestinal bleed. Avoid doing heavy activities, and do not strain during passing stools and micturition. If the platelet count becomes low, then avoid doing brushing as well as using mouthwash. Go to the hospital immediately if there is shortness of breath, and bleeding because even normal platelet count causes a bleed due to platelet dysfunction." "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 participate in resistance training activities and one exercise, in particular, has been giving me problems. The exercise in question is the dumbbell bench press. It causes a sharp pain in the triceps and sometimes across the brachioradialis. There is no pain in any other exercises that extend the elbow with resistance. I am also not experiencing golfers elbow or tennis elbow symptoms. I know that one of the best things I can do is rest the muscle. My question is, can I just avoid the specific exercise that is causing me pain and choose ones that do not? Or does rest mean completely forgoing every elbow extension exercise? I am just taking psychoactive medication. ### Response: It might look like your tricep muscle imbalance or the tricep muscle fibers are not adapting to the resistance in this position. I recommend you to do not stop exercise but doing the same exercise with little to no resistance and then gradually start increasing the resistance. That will help these muscles to gain strength" "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 got eucalyptus oil in my eye by accident while trying to open a bottle of the same. I tried flushing my eye with water which then I read on the internet not to use water. I then tapped olive oil around my eye as suggested on the Internet. My eye stung so much with the water but then it did not sting anymore. It was late at night. So, then I went to bed. Is there anything I should do? ### Response: The main thing to watch for now is an infection of your eyes. This is usually seen as sticking of eyelids with discharge especially after you wake up after sleeping" "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 76-year-old male. I have difficulty to fall asleep for more than two years. I started to take 0.25 mg of Restoril and 1 mg of Melatonin. As the days progressed, I increased my Restoril dosage gradually to 1.25 mg and Melatonin to 3 mg. Last night, I found it was not enough. In desperation, I took one tablet of Valium and slept until 10 a.m. I feel that Restoril may have lost its effect on me.Unfortunately, I do not have the courage to commit euthanasia. I do not know what to take tonight. Please advice. I had many serious ailments in my life describing them in detail is tedious. Shortly those ailments were Potts, acid-fast bacilli, and heart valve replacement. Please advice. ### Response: It seems that you have tolerance for Restoril (Temazepam). We can increase the dose up to 30 mg before sleep. Kindly do not stop the medication abruptly. It should be stopped gradually over at least a period of two weeks. Also Valium (Diazepam) 10 mg before sleep can be used instead of Restoril not adding to it and the same precautions must be taken. I suggest you take Valium 10 mg or Restoril 30 mg before sleep. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. You need to follow all good sleep hygiene. Provide me with all your medications and medical reports in order to exclude any secondary cause of insomnia such as hyperthyroidism or side effects of other medications Follow up after one week. I strongly recommend against euthanasia" "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 I get pregnant without having sperm released inside my vagina during the intercourse? How can I confirm if I maybe pregnant? If I am pregnant what should I do for abortion without surgical means? ### Response: Hi. Until there is ejaculation in the vagina or precum, there is no chance of pregnancy. So relax and do not worry. However, if you have a doubt then take an emergency contraceptive pill within 72 hours of intercourse. There is no chance of pregnancy. However, if you have crossed 72 hours of intercourse then please do not take any medication without expert advice. If you happen to miss your period then get a urine pregnancy test done with an early morning urine sample to ensure that you are not pregnant. However, if you have a doubt then get 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: I am 33 years old. One year back, my HbA1c result was 8.2. Then, I started to take medicine Dailyglim M1 for three months and started some workout and took light food. Then, my sugar level came down. Fasting and PP result were in 105 and 160 range respectively. But, after some time it went bad again and I started to take Dailyglim M2 twice a day since the last two months. One week back, my HbA1c result was 6.7 and my fasting 105 and PP (without tablet) was 180. I consulted a doctor. She told me to take Insulin 10 units two times a day. She said this is better than taking tablets. Please suggest what to do. ### Response: I can understand you are hesitant to use Insulin. But what she has said is right. Finally, Insulin is what controls your blood sugars. Since people are hesitant to use it, we usually do not prescribe it as a first-line treatment. Oral medications help the pancreas to produce insulin. So in case, your cells are not producing any insulin at all, they would not be useful. Also, in the future, you would require using Insulin once your cells are exhausted of insulin. Your body is still responding to medicines. So, if you want, you can tell her that you would like to use oral medications and see how your sugar levels turn up. Or else, you can give Insulin a try and see. Regards" "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 38 years old, weight 47 kg. Since childhood, I lack confidence, remain depressed all time, poor concentration and memory, fearful nature. I lack strength, too much exhausted, fatigue all the time, general debility, impotence, premature ejaculation, erectile dysfunction, low sperm count due to excessive masturbation, lack of vitality, alopecia, poor appetite, underweight, negative and unwanted thoughts all time, constipation, poor appetite, and digestion. Please advise. ### Response: How do you react in anger and insulting situations?" "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 18 years old, boy and I have a very tight foreskin and I have not even pulled it back. I tried to do it once using oil but it was of no use. ### Response: Hello. The mentioned history is suggestive of phimosis in which foreskin cannot be retracted back over glans. Topical steroid cream can be beneficial in mild case. But, in severe case like in your case, if foreskin cannot be retracted, then circumcision like day care minor surgery can be done. So, I suggest you consult Urologist for your examination and operation." "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: Since three months, I have a head tingling which is irritating and sometimes dizziness. Also, I have left arm numbness sometimes. I am not sure what to do. I am currently taking Maxgalin M 50 and Neurogin. ### Response: Your symptoms could be related to epilepsy seizures. I recommend performing a brain MRI (magnetic resonance imaging) and an EEG (electroencephalogram). An anti-epilepsy agent (Lamotrigine, Topiramate, etc.) may be necessary. Kind regards" "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: Please provide information about my query. I am a cable operator. Once I visited a foreign lady\s house. While doing the work, the lady provided me a water bottle. I drank the water and after 10 minutes I had small sores. I think the lady has poured her blood in the water. I think she had HIV, and can I get infected in this way? What is the period of the virus in the water? ### Response: Hello. HIV cannot be transmitted through water, and it is not infectious because HIV cannot live in water. If it is possible, then no one can stop HIV infection and all the population will be infected. So, there is nothing to worry about." "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 unprotected sex with my fiance, but we also took care of it by I-pill, but we are still not sure because she is seeing some changes in her body and we do not know if it is due to medicine or she is pregnant? ### Response: I-pill is quite effective in preventing against pregnancy, so probably there are no chances of pregnancy, but if she is concerned, she can get a pregnancy test. I hope it has helped you. If you require any further queries, please do not hesitate to contact 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: I have a yellow thick foul smelling discharge. It has been a while but it seems to be a problem. My partner also mentioned that I have extra smell compared to his previous partners. Why is this? ### Response: Hello. You are suffering from bacterial vaginosis which is a bacterial infection. This can be confirmed with a high vaginal swab culture and shall require a course of antibiotics for a week with avoidance of intercourse during treatment. Try using alkaline vaginal washes to clean yourself and avoid chemical soaps. Meet your gynecologist for a local examination and prescription." "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 in my 9th week of pregnancy. My husband was out for a month and has returned now. Both of us feel like getting intimate. Since this is my first pregnancy and I have not completed the first trimester, I wanted to know whether making love could hurt my baby. Should we avoid intercourse throughout the pregnancy? ### Response: Your doubt is justified. It is recommended that intercourse should not be practised till the 16th week of gestation to avoid any chances of threatened miscarriage. I feel there are other ways to express emotions and intercourse should be avoided during the early first trimester." "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 26 year old male. I am having hypertension, palpitation, depression and anxiety. ECG, 2D echo, renal Doppler, VMA culture, cortisol and lipid profile are normal. I need advice. ### Response: Hi. The tests you have mentioned are used to find a cause for significant hypertension. You have not mentioned anything about your BP levels and whether they are really significantly high. We have no details of your weight, your lifestyle and your family history. There can be a possibility of hyperthyroidism which would cause all these features in a normal looking adult. Also, you should get a psychological evaluation done. Alternating depression and anxiety shows that you are under severe stress and tension due to some cause. The BP being high might just be a sign of that stress. Please get a thyroid function test done and look for a more common cause. Medications will help a lot." "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 this mole on my leg since I was a teenager, and I am 31 years old now. I remember it being lighter in color and more oval, whereas now it is more of a triangle with darker pigmentation and two shades of brown. I measured it, and it is about 4 mm in width. I have an olive skin tone and never used a tanning bed. Though at times, I have not used sunscreen, and have had sunburn, but never blistering from what I can recall. I have attached a picture. ### Response: Hi. I have seen the picture (attachment removed to protect patient identity). Melanocytic nevus is basically tan, brown macules with increased melanocytic activity. One should always look for following changes for melanocytic nevus: There are types of melanocytic nevus. These are basically benign growth, but there can be a chance of malignant transformation. The exact incidence is not known. Since there is a change in the size, shape, and color of nevus, I would suggest you consider skin biopsy test. Or complete excision for aesthetic purpose" "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: Dear doctor,I am a 19 year old male. Some type of viscous liquid comes out of my ears and when it dries up, it hardens. Please help me. ### Response: Hi. Viscous fluid coming out of ears indicates a middle ear infection. It has to be attended to immediately to avoid damage to the ear. I request you to meet an ENT specialist at the earliest to prevent further damage. In the meantime, you can take tablet Levocetirizine 10 mg twice a day to reduce the secretions and the inflammation." "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 severe problem with my lips. I am having severe chapping of my lips. I do not have dryness or itching. I am only having severe cracking of my lips. I used an ointment and B complex tablets, but those did not work. ### Response: I understand your concern, but there are no attached photographs in your message. Kindly send a picture of the affected area to help you better. I need to see the affected area to assess the condition and to suggest the appropriate diagnosis and treatment. Please send the picture of the affected area." "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 21-year-old male. I have OCD for past five years. I went to several doctors and used too many drugs such as Sertraline and Fluoxetine and Anafranil. The only drug that helped was Anafranil. I asked from my doctor to prescribe Anafranil but he denied and in every visit he prescribes SSRI, but it does not help me like Anafranil.What is the highest dose of Anafranil for OCD? Can I use only Anafranil 75 mg once a day? Please help me. ### Response: Hello. Because of the side effect for file usually, doctors refrain from going for higher doses." "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 24 year old and I had an ultrasound for the first time today. My periods have been slightly irregular for last few months and hence I went for a checkup. I am attaching my scan reports for your reference. Kindly guide me. ### Response: The ultrasound scan report (attachment removed to protect patient identity), which you have posted shows a single follicle dominant, may be in the right ovary. Also, please mention your details of menstrual cycles and dates for last three months to understand the pattern of bleeding. Revert back with the reports and detailed information to 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 a 41-year-old male. For a long time and I am afraid of death, aviation and diseases, and despite my only and I fear flying. I always found myself assailed by the fear of death while I pray because of that I am trying to finish my prayer soon to escape from there and heading towards the house. This case has happened for more than 20 times.Eight months ago I experienced a state of severe fear when I am in a barber shop. While I was getting shaved I started sweating and my heart accelerates. I left the shop before my shaving was over. I went to the hospital the next day and they told me that my BP was high and I need medication to lower it. Three days after I visited the hospital after a dizziness in my head and my BP was 160/110 mmHg and they prescribed me a medicine, and after the stability of the pressure to 130/84 mmHg anxiety started again and my previous drug was then substituted by Eisenberg 10 mg but I still have a permanent feeling of fear and anxiety, and currently troubled, because I started to forget some of the names and mention them after some minutes at most times. But rarely I have this a kind of confusion, on seeing somebody and due to fear of getting their names wrong I moved away from them.After this, I have done all blood tests to detect the problem and I decided to go to a psychiatrist and he told me that I have an anxiety disorder. He prescribed me Escitalopram 20 mg. But I did not take it. Please help me I am confused. ### Response: Hello. I read your query word by word and affirm that this is an anxiety disorder. As you are aware that anxiety disorder is characterized by excessive concern about one or another thing. As your psychiatrist told you the antidepressant class of medicines are the" "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: This is more of science question, I read somewhere we can hear our blood flow when in extremely silent room zero DB room, Is that true? ### Response: Hello. Yes, you can hear not only the silent room. Average person\s carotid artery pulse and blood flow sounds can be heard in ears. During palpitations, we can hear the condition aortic stenosis blood flow sound. So many valvular diseases can be understood." "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 57 year old female. I am 4.3 feet tall. I underwent a leg surgery 11 months back. The surgical wound has been infected three times already with pus discharge. After cleaning the discharge, a small area remains unhealed, and the implants fixed during surgery can be still seen through this area. The skin in this area has become black and looks dead. I already have thyroid and arthritis. Is there any way to treat the infection without removing the implants? ### Response: Hello. Kindly post the images of the affected leg and the infected wound after the surgery. I will be able to comment only after seeing the photos. Revert with more information to an orthopaedician and traumatologist 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: Yesterday during lunch, I ate drumstick leaves curry. Whenever I eat that, in an hour or two, I go to the toilet (little loose stools) two times. Is this normal? Yesterday I had the same, further after about 5 hours, I ate grapes. After an hour, I had to go to the toilet often (loose motion). Why does this happen? Did I eat anything in the wrong combination? I also get loose motion and stomach upset whenever I eat watermelon after food, especially it becomes severe and affects for two days. Am I sensitive to any such components? I understand that eating fruits after food can cause indigestion, but my friends seem to be not affected, even if they eat a lot of melon after lunch. ### Response: You seem to have allergy to some food products. You should do an allergy sensitivity test for food products and fruits. This test will tell you which food and fruits you are allergic to and you should avoid having those foods. What is your age? Did you have any fever or rash on your body? For now, try tablet Levocet (Levocetirizine) twice a day for 5 days. Also, take tablet Loperamide 2 mg twice a day for 5 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 have attached the PFA and the blood test report of my wife who is 29 years of age. Can you please advice on the reasons and corrective measures to get the exceeded test values in control? Do I need to perform any follow-up tests? She has got the blood test profile checked just as a general checkup and not specific to any illness. We get it checked once every two years. ### Response: Hello. I have thoroughly gone through the reports (attachment removed to protect patient identity), and I understand that she did not have any symptoms, but you got the tests done just for the regular checkup. Out of these, there are some red flags which need to be further evaluated like the low iron and low values indicating an iron deficiency anemia. Also, the stimulating thyroid hormone is raised, but T3 and T4 are normal which could be subclinical hypothyroidism. For this, we need to see if there are any thyroid antibodies present. Please get the tests that I mention below done. Also, the raised ALP (Alkaline Phosphatase) needs to be looked at. Given that CRP (C-Reactive Protein Test) is raised it means there is an underlying disease process. It could be the subclinical hypothyroidism, or it could be something else. Sometimes autoimmune hypothyroidism can be associated with other conditions that can cause both anemia and a raised ALP. Please get the tests done so that we can promptly get to the bottom of this. Also, tell me if she has other symptoms like itching or fatigue, etc. 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 been waking up from a racing heart accompanied by belching at night sometimes two or 3 times a night. At times the HR has been in the 140s after I get up and belch a few times my heart rate returns to normal. I have had my heart completely checked out along with a 30 day monitor and no problems have been found there. I am wondering If GERD could be causing this to happen . It only happens at night while reclined or lying down for bed. ### Response: GERD in itself cannot cause increase in heart rate. However, anxiety associated with GERD can cause increase in heart rate. So in my opinion, you should see, if you have anxiety, there are no issues related to heart. But if you have any anxiety, you would need treatment for that. I would recommend you to get Holter monitoring, thyroid profile done. If done, please share report with me. If all normal my recommendations would be to discuss with your doctor to put you on Propanolol which would keep your anxiety and pulse rate under control." "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 64 years old. She has a fibroid above the uterus. The doctor has advised removing the uterus. She has a low level of hemoglobin, and she is given injections to increase the range. But it got increased from 10 g/dL to 10.4 g/dL. But the doctor advises my mother to have hemoglobin to be at 11 g/dL. The doctor recommends for a blood transfusion, and he ordered 350 ml blood from the blood bank. He plans for a uterus removal operation a couple of days later. Is this advisable and a routine procedure? ### Response: Hi. As your mother is 64 years old, it is better to have uterus removal and removal of fibroid along with it. Please mention about the symptoms faced by her. Please send the ultrasound report to guide you further. For increasing the range of Hb (hemoglobin), iron injections alone will not give quick results. So the doctor has decided for transfusion of blood before or after surgery. Depending on the location of the fibroid, there will be excessive bleeding, and it is better to have a blood transfusion soon." "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 baby is 3 months old. She is suffering from swelling on thigh due to vaccination. Can I use plaster to reduce it? ### Response: Hi. I understand your concern. Local swelling after vaccination is the known side effect. Just apply ice over it for 3 to 4 times a day. No need to rub or massage, just apply ice. No need for plaster. It is local swelling, not a fracture where plaster is needed. It shall go over time and may take 7 to 10 days. If the swelling is persistent and painful, then you need to show the doctor." "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 26 years old, and I weigh 96 Kg. My kneecap hurts a lot while jogging or doing any cardio exercises. For one year, I have been having this problem. My knee joint trembles and often I have a problem walking. Please advice. ### Response: You are very young and only 26 years old. Sometimes you can have such kind of pain in the knee at young age. If there is no history of any injury, swelling, etc., then there is no need to worry. My advice to you will be: If the condition does not improve in 2 to 3 weeks time, you may have to get certain tests done for your 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: What is the best tan removal treatment for me? I am suffering from tan since 16. I am now 23. My tan is all over my face, but when I put on a beard for a month and then shave it off, it all goes away back to original. Is my tan deep or stubborn or easily removable? Sunscreen application is recommended every two hours. I am thinking of day Vitamin C serum application. I need to wash my face with water before re-applying sunscreen? Can I wash my face? Will washing off for sunscreen reapplication deter the efficacy of Vitamin C serum? ### Response: Hi. Tanning is due to sun. When you grow beard your hair protects the underneath skin hence it looks fair when you shave. Tan is not deep or stubborn. (attachment removed to protect patient identity). Keep Vitamin C application in evening and night and sunscreen should be used only when you go out in sun. It is useless to use sunscreen when at home. Any medication applied leave it for 2 to 3 hours before washing." "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 just noticed a white spot embedded in my gum behind my lower back molar teeth. The area is a bit swollen and is a little sore. My throat is also a bit swollen and a little sore. ### Response: Hello. I have been through your query and I can understand your concern. I need to know if you have any cavity or carious tooth near that sore. If yes, it might be due to the infection of the tooth which is exudating via the gum. However, if no carious tooth is there, then it is an aphthous ulcer and it will subside on its own within a week or two. If the sore does not go after two weeks, make an appointment with your nearest dentist to get the sore tested for any anomaly. I would have prescribed you with Mouth Paint Ora-Gel or Dolo Gel in order to get relief from the pain (if any). I would also suggest you do warm saline gargles in order to relieve your throat. I would advise you to have good oral hygiene and brush your teeth twice daily and floss regularly. Consider follow up after a week here." "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: This query is for my dad who is 75 years old. He has been seeing the same doctor who has recommended the same tests to be done for each follow-up since the past five years. Initially, he saw him once a year, recently it has become quarterly. I have uploaded a copy of the blood test reports and ECG was done for the follow-up on eighth of this month. Yesterday too he had to do a confirmatory blood test (Troponin) as well as ECG which confirmed he had a silent heart attack 10 days back. The admitting doctor after being informed of the test results recommended to stop Eliquis 2.5 mg 1-0-1 and take Ecosprin 150 mg 0-1-0 and tablet Plavix 75 mg 0-1-0. Also injection Clexane 80 mg SC twice a day for five days. He strongly advised getting admitted for a couple of days at least. My query is:Is hospitalization necessary now or can we wait for five days since injection Clexane 80 mg has been recommended? What is the function of the injection Clexane 80 mg recommended for five days? How does it work?What would be the purpose of hospitalization now?If we do go for hospitalization, what would be the likely tests to be done? Why has the doctor advised to get admitted along with recommending taking the injection Clexane 80 mg for five days? ### Response: So he did not have any symptoms, and this was detected on routine blood testing, right? His troponin is elevated here (attachment removed to protect patient identity), so it suggests he had a heart attack. So such patients are admitted for observation and administration of medications. We usually recommend admission immediately after a heart attack for 5 to 7 days, but since this time has already passed, admission is not absolutely necessary, but better to get admitted for observation, injectionClexane, and angiography. He should undergo echo and angiography, and for angiography, he has to be admitted. After angiography, he may need angioplasty or bypass. Also, if any warning signs like low bp or shortness of breath are there then he should be admitted. Also, Clexane is blood thinner which helps in the dissolution of an already formed clot which is the reason for heart attack. So it should be given after heart attack" "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 a severe headache on the right side and on the back side of the right ear. Also same time, I am having teeth clattering with cramps all over the body. Why is this happening? ### Response: Please get the following investigations done: There can be various causes which need to be ruled out. It can be a deficiency of vitamin B12 or calcium which is a very common cause for such a problem. Get CT head to rule out any brain-related problems. Follow these instructions as of now: Revert back with the reports to a general medicine physician online for further follow up" "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 days back, my son put a plastic stick into his ears and the membrane got damaged and blood came out. We went to the doctor immediately. He gave us Azithromycin to give the child and told us to keep his ear safe from air, water and, all other materials. He also told us to watch out for fever. But after five days, a pulp is seen in the ear. Will it affect his hearing capacity? What should I do next? Please give me an answer immediately. ### Response: Hello. Since there was damage to the membrane you need to be careful. It can cause a decrease in the hearing if the damage does not heal properly or get infected. If pus is coming from the ear, kindly consult a nearby ENT doctor and take treatment for the infection. It can take a bit long for the membrane to get healed properly. Until then, you need to be careful and make sure water does not go inside the ear at all" "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 just had sex about seven hours ago, and we did it without any protection. So my penis was inside her vagina and we did a handful of up and down movement (she was on top of me, basically sitting on me- cowgirl position), and we decided to stop because of the consequences unsafe sex may lead up to. My concern is that although we stopped way before I could have reached orgasm, precum could have secreted out of me. I am considering buying her Trust pills as it is said to work as an ECP would. In my country, Plan B is not available. ### Response: The Levonorgestrel content from trust pills is too low. You will need five pills taken at the same time, then another five pills after 12 hours. However, your partner may feel nauseous and uneasy because this pill also contains Estrogen and a high dose of it also have side effects of nausea and vomiting. But yes, theoretically you can substitute it but be ready for the estrogen effects." "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 cough since last six months. What should I do for curing my disease? ### Response: Hello. A chronic cough can have different causes. It is important to know if it is mostly in the mornings and you have symptoms of gastric reflux (this is the most common cause). We also need to asses if you have other symptoms like eye or nose itchiness or a runny nose (this could be allergic). If you smoke you could be starting symptoms of COPD (chronic obstructive pulmonary disease) or chronic bronchitis. Last, we need to know if there are other important symptoms like weight loss or night sweats. The treatment will depend on the 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 am 36 years old. I have a problem on the right side of the large intestine. I have four babies with cesarean surgeries. My youngest baby is 13 years old. My uterus was removed five years ago due to rasoli. After this operation, I felt pain in my anus and a year later I was alright but later on my mother suddenly passed away. Due to sorrowness, I felt pain in my stomach and a pull in my belly. Followed by I had constipation and piles (no bleeding). Now whatever I eat or with empty belly I feel heavier on the right side of the large intestine. After eating something I feel that it has blocked due to any hindrance. I thought it may due to eating beef or meat but now doctors say that my large intestine is infected and even using medicines show no improvement. My hunger is normal but I have constipation and little pain in the right intestine with a large amount of urine with crystals in it. Please suggest medication. ### Response: I have reviewed your situation. For confirmation, what is going on, you need to visit to a gastroenterologist and get booked for upper and lower GI (gastrointestinal) endoscopy. But reading at your situation, it looks you have both acidity problem and constipation. Till you meet some gastroenterologist, you can take capsule Nexium 40 mg (Esomeprazole) once a day before meal, and Isphagol husk two teaspoons in a glass of water, keep it for four hours and then take it. If you still feel symptoms, you can follow us. So we can upgrade the 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 feel as if there is something stuck or moving in my throat around the back of the mouth to the Adam\s apple. It has been bothering me for a few days. There is no pain associated with it, just the feeling as if something is moving up and down my throat. It goes down if I swallow, and comes up if I let it. ### Response: A foreign body sensation or a feeling of something stuck in the throat is a very common complaint. There are so many causes like acid reflux, pharyngitis and allergic rhinitis that could cause the feeling. I suggest: Consult your specialist doctor, discuss with him or her and start taking the 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: My gynecologist said that I should opt for a C-section because of the following reasons: Low HB level (9.6 now), low amniotic fluid, fibroids which is at the cervix, age factor. ### Response: Hello. I could not see the fibroid in the cervix in this report (attachment removed to protect patient identity). It says fibroid in anterior uterine wall and size is very small. I do not see any of the above-mentioned reasons to go for a C-section as none of them is an indication to opt straight for operation without giving a trial of labor. Age is not at all a factor to consider for a C-section straightaway neither low HB. As the operation will result in even higher bleeding as compared to normal delivery. I feel vaginal delivery would be a safer option too if everything remains fine." "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 5 year old (turns 6 next month) has gone for a root canal a few hours ago. I was not with him but they told me that they used a gel anesthetic, if it matters. Now, he is back and his cheek on the treated side is swollen and numb, and he seems to have difficulty smiling or speaking with it (no pain). Is this normal or do we need to revisit the dentist again? Is it a dental emergency? ### Response: Yes, it is normal. The numbness will go away in a couple of hours. The swelling may remain for two days. Give all prescribed antibiotics and painkillers as suggested" "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 has completed 39 weeks of pregnancy. We got an ultrasound yesterday, and the report is completely normal. But her labor pain is not getting induced, so the doctor is suggesting cesarean, as the baby\s weight is 3.65 kg. My wife would like to have a normal delivery by inducing pain artificially. Our first baby was normally delivered six years ago, by inducing pain artificially when he was 3.33 kg.My wife is 35 years old, and I am attaching the latest ultrasound reports. ### Response: Hi. I have seen the reports (attachment removed to protect patient identity), and it is normal. No, delivery is risk-free, normal or caesarean. If her BP (blood pressure) and blood sugar are normal, then there is no contraindication to normal delivery. Regarding the chances of the head getting stuck, it can be assessed only at the onset of labor by internal physical examination of her pelvis and relative size to head of the baby. A baby of this size may be delivered vaginally, but many parameters should be optimum. She had normal delivery six years back, she is 35 now, her pelvic bones and muscles may have become less stretchable, and she may not get good enough contractions, and the labor may become prolonged in that case the baby in the womb may get less oxygen. These are possibilities that may or may not happen, if she goes into labor, she and the baby has to be carefully monitored, and if the things do not go wrong, then she may deliver normally. Until the outcome, no prediction can be made with surety" "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 M2-PK is 150. Does it mean that I have cancer? There was no pain, just a regular checkup. Kindly help. ### Response: No, it does not imply cancer alone. Many healthy people, as well as patients with other non-cancerous diseases like rheumatic diseases, diabetic nephropathy, chronic heart diseases, inflammatory bowel disease, pancreatitis, sepsis, may have elevated levels. So there is high false positivity rate as well. But, since it is elevated and also you being asymptomatic for other diseases I mentioned that it is better to undergo an evaluation to rule out cancer. Also, the blood test is not a very good test for screening of colorectal cancer (attachment removed to protect patient identity), and it is not recommended due to high false positivity rate, and fecal test M2-PK is a better option. So, I think you should have a fecal test as well. If positive then we will get a colonoscopy done otherwise you should undergo screening CECT (contrast-enhanced computed tomography) chest and abdomen to look for any cancerous change" "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 little bumps on my foreskin. Are they Fordyce spots? ### Response: Hello. Yes, they are Fordyce spots (attachment removed to protect patient identity). Do you have any symptoms in them? For how long you have noted? They are normal. Nothing to be worried about." "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: Hi, I have acne like boils on my face. When it comes in contact with sweat and water it looks white. What could it be? ### Response: This could be an entity called milia. Milia are small white bumps that appear superficially on the skin. There are several treatments for the same. Do not try to squeeze the lesions. It will lead to pigmentation. To confirm if the lesion is milia, attach pictures of the same and 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 am 18 years old, and I was given a painkiller injection before seven days due to an extreme headache. Recently, I have noticed a swelling and a severe pain near the injected area (an area just below my hips). What can I do to get rid of it? ### Response: You had a painkiller injection in the gluteal region. The pain and swelling can be due to inflammation. You can apply an ice wrapped cloth frequently over it for one to two days. There is no need for taking any further medication as per my opinion. Kindly upload your post photo of the swelling to check it and 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: I am a 46 year old male. My height is 165 cm and weight is 65 kg. I am a known HTN since 3 years. My medications were Olmezest 10 mg once daily in the morning and Prolomet XL 50 mg once daily in the evening. Now I am diagnosed with type 2 diabetes. My readings are FBS 141, PPBS 236 and BP 130/80. My physician has prescribed me Gemer 1 twice daily and Tazloc-H 40 mg once daily. I heard that Metformin ER has to be taken daily once but he asked me to take twice daily. I would like to know whether my medicines are fine or not. Do I need any more medicine? Also my heart rate was higher earlier but is under control with the use of Prolomet XL. Now the Prolomet is replaced by Tazloc-H 40 mg. Will it be a problem? Please help. ### Response: Previously, you were on tablet Olmezest (Olmesartan) and tablet Prolomet XL 50 (Metoprolol tartrate). Now you are on diabetic medication and tablet Tazloc-H 40 (Telmisartan). So, taking one" "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 tried magic mushrooms, and the last time I took it, sounds from the TV in the next room felt like they were entering me. Afterward, I started ringing bells of unknown homes and simply run around everywhere. I also had delusions. I was given a diagnosis of paranoid schizophrenia and was treated with ECT and Risperidone 4 mg. I returned to being normal without any delusions.Then after a while, I stopped taking my medicines and in a week I was having delusions again. My intellectual capacity was lessened and I was in the hospital again, and I was treated with ECT and Risperidone. Again I went back to normal. Before I took magic mushrooms, I was socially not that talkative but I still I had friends in my class but beyond that, I did not have many connections apart from my three school friends and one other friend. I had failing marks. No one ever said I talked weirdly or has delusions or is abnormal. I still avoid socially but I have friends in my current class. My academics are better and I do not get failing marks. But that is because I got better in managing my computer addiction and to study in my spare time. I am currently taking Risperidone 3 mg.My question is do I have schizophrenia? And I want to discontinue my medications because its side effects are unbearable, can you please help me to do so? ### Response: Hello. I can understand your concern. You consumed magic mushrooms and the symptoms started after that. This was four years back. You responded well to treatment and are doing good in academics, and social domain. Well, if we consider whether the medicines should be continued or not then that depends upon the treating doctor. You developed two episodes of psychosis within a year gap and on stopping the medicines it is positive that you are doing good. So in my opinion, a gradual dose reduction of medicines can be done. You are currently on Risperidone and its doses can be reduced gradually over the next three months and there should be no problem. You have one episode of acute psychosis precipitated after magic mushroom use. But the second episode is pointing towards schizophrenia. The worsening of symptoms post stopping the medicines cannot be explained by acute psychosis. So yes, you might have schizophrenia or psychosis NOS in my opinion. You are yourself seeking treatment and are clear about history which is not very common in schizophrenia. So you can try to reduce the doses gradually and this should help 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 have tingling in my hands for a few years, and now I am feeling tingling off and on in my feet and legs with occasional inner tremors. I had all my blood work done to test for diabetes, thyroid, vitamin deficiency, CMP and CBC all came back normal. I had an MRI of the brain that came back normal and an EMG/NCV that showed severe carpal tunnel in both hands. I am currently on Metoprolol and Metformin. I also suffer from anxiety. My question is could these be a sign of ALS? I am terrified of that. Could this EMG report show carpal tunnel to be mistaken for ALS? Would ALS show on this test? I also have my report to include the EMG test. ### Response: Hi. These symptoms do not look like ALS (amyotrophic lateral sclerosis). Anxiety and CTS are more than enough to cause these symptoms. So, my recommendation is that you should start on Pregabalin 75 mg along with Nortriptyline 10 mg once at night time for two weeks.The response to medicine would confirm the diagnosis. I hope it helps you. If you have any further query, please ask 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: I have a fever of 101 C. It has been almost 12 hours. I cannot breathe properly. My eyes are burning. I ate a Paracetamol 650 mg about one hour ago. Head feels heavy. Dizziness and confusion are the symptoms. ### Response: After careful analysis of the history provided, I would like to assure you that having symptoms of eye burns, dizziness and confusion while having a viral fever is normal. You do not have to worry about that. Having said that, since you have mentioned that you have been having similar episodes in the past, I would like to suggest you to: As of now, Stay healthy and positive" "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 locked-in syndrome patient. MRI report indicates marked hydrocephalus, diffuse cerebral and cerebellar atrophy, attenuated blood flow in the cerebral vasculature, and hypoxic encephalopathy. I cannot move or do anything but I react to pain. Please help. ### Response: These MRI (magnetic resonance imaging) findings are indicative of chronic severe changes in the brain. In most of the cases, patients with this syn" "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 clear wart looking things pop up on my genitals for a few years now, never many I just burn them off and all is fine. However, a few months ago, I had three darker color things popped up and I burned one off but it did not heal fully. It actually got bigger and redder and more painful. I have attached a picture. Can you tell me what I am dealing with here, please? ### Response: I have seen the picture. (attachment removed to protect patient identity). This does not seem to be herpes genitalis. In case of herpes, you would have got vesicles that would burst to leave erythematous erosions. These can be verruca plana variety of wart. The second one looks inflamed. Use antibacterial cream for it. Between I hope to burn them of means, getting them treated medically." "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: For the last almost three weeks, I am having a pain in the lower right-hand side of the soft palate while swallowing saliva (or while swallowing on empty, without food. It does not happen all the time, but it is frequent. When I swallow food or liquid, there is no pain. I feel that the pain originates somewhere behind the skin of the soft palate, or within the soft palate itself.When touching that region with my finger, there is no pain. I do not see any redness in the back of my mouth, and generally, I do not see any irregularities. However, this is not a doctor, but me viewing. Also, I noticed that the arc of the right-hand side soft palate is a bit dropped compared to the one on the left-hand side. I do not know if this condition was present before (I never paid attention to that) or is something that I have for a while, or since birth. I am 51 and have regular yearly medical exams (complete blood work, biomarkers, abdomen, prostate, etc.). I do not take any medications. So far, I have been a healthy man. Any advice is welcome. Any suggestions on what to check, look, or do, too. I am asking for advice because I do not have at the moment medical insurance. I will be back at home in three months. ### Response: Hello. I have seen the pictures, and your oral cavity seems to be normal. Can you highlight the area where you have pain? Do you have acidity? Generally in any infection of the oral cavity or larynx pain is more while swallowing saliva than swallowing solid bland food or liquid. So if you have a mild infection, you will not have much pain or any pain while having food. Also, let me know if the pain is associated with the diurnal variation. Do you consume alcohol, tobacco?" "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 19 year old female. I have watery heavy white foul vaginal discharge every day since four months. Is it due to hormonal imbalance? ### Response: From what you have described, it looks like you have a bad vaginal infection. You need to see a gynecologist doctor fairly quickly and get treated. This is important as untreated vaginal infections can spread upwards into the uterus. Hormonal imbalance has nothing to do with this. Your doctor will also check your sugar level if you are overweight, if you have PCOS, or have a family history of diabetes. You will also need a testing for urine infection as it is common for both to co-exist. Do not hesitate to post further queries to 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 a history of genital herpes, and the infected area is at the base of my penis where condoms do not cover. Should I worry about HIV if I use condoms regularly in the future? Or will I get HIV despite using condoms because of my herpes infection? ### Response: An open wound or raw area is a potential focus for acquiring viral infections like HIV when contacted with an infected partner. However, once the wound heals, the risk falls back to that of normal skin as elsewhere. The risk for HIV in your case would be high only if you participate in intercourse when your genital herpes has not yet healed completely. It is advisable to abstain from all sexual activities for up to two weeks after an episode of herpes so that the infection resolves completely. You could continue to participate in sexual activities as normal people after two weeks. With the use of a condom, after the healing of the wound, your risk would be the same as any other person." "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 32-year-old woman, autistic and I live with delusions. I am aware of my delusion disorder. I have taken evaluations for schizophrenia before, and the result came back with early schizophrenia. Is it possible to live a healthy life with delusions? I am aware of my delusion disorder which is only visible and audible to me. I am also grounded and level-headed even though I have this. ### Response: Hi. You may have early schizophrenia. If it is not affecting your healthy life, then it is fine. But it will progress with time. You need treatment to have control over your disease. I have seen many persons with delusional disorder doing functional and social life. If you do not have any hallucinations or any other psychotic symptoms, then it is more likely to be a delusional disorder. If you are taking any substance like alcohol or cannabis, it also causes the same symptoms." "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 21 year old female, and I have seen a lot while growing up. Since I was 6 years old, I started crying every day. Fear grew within me. I started having bad grades since I was 11. I was bullied twice by my friends when I was 7 and second time when I was 13. My parents had no time to love me and indulged in verbal abuse all the time. It made me feel even more depressed till today. I find pleasure in other ways that keep me alive. It is just a living and not a life. I am so very tired deep down. I have no one to talk to wholeheartedly. I feel lost and all by myself. I just want some affection and a person who understands me and lives through me. I feel incomplete. I have not consulted any therapist or not under any medication. Please provide me with some peace. ### Response: You have mentioned everything about your history in details. I can understand your concern regarding your low mood. Hope my answer helped you. Regards." "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 baby is 1 year 2 months old. The doctor prescribed Albendazole 5 ml-5 ml two doses in half an hour interval but by mistake, I had given 10 ml-10 ml dose of Albendazole. So, is there any problem? ### Response: Hello. The recommended dose below 2 years of age is only 200 mg. Albendazole is an anthelmintic or anti-worm medication. It prevents newly hatched insect larvae. You have over dosed your child. As such child may be fine, keep a watch for adverse symptoms. If any, visit a Pediatrician for a clinical 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 hear my pulse and heartbeat-like sound in my right ear if I bend over, especially after exercise or eating food. Is it normal? Can it be due to blood pressure or is it due to any blockage in my blood vessel near my ear? ### Response: Hi. The symptoms you feel are called as heart palpitations. It may be due to thyroid disease, anxiety, heart disease, blood pressure or many other reasons. You need to consult your cardiologist for proper evaluation of the cause and to treat that accordingly. Diagnosis is the first step and that need proper and thorough diagnostics. Usually taking Atenolol 50 mg once daily may suffice the need to relieve the symptoms. As this is a prescription medicine, your cardiologist can recommend it and prescribe you after an in-person visit." "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 about 4 inches of patches of ringworms on both of my buttocks and a 3-inch patch on my vaginal area. I am using Covate GM cream for the treatment but it is not showing any results. Please help. ### Response: If you have ringworm infection, kindly use oral and topical antifungal agents. If it is very red, mild steroid combined with an antifungal agent is to be used. You will get better after treatment. Scraping for fungus. Tinea cruris. Tinea cruris. Tablet Terbinafine 250 mg OD. Apply topical Terbinafine ointment BD." "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: Dear doctor,I am having pain above my right hip. It feels a little swollen and a little pain in my lower back above the right hip. I can feel the pain more when taking a breath. My lower back feels like it is burning. Give me any advice. ### Response: I have studied your case. As per your history, there can be hip arthritis which can be degenerative or due to avascular necrosis of femoral head (AVN). I will advise you to take an x-ray of hip again and you can consult me with the reports or with your doctor. After clinical examination, if AVN (avascular necrosis) is suspected, then you will need MRI. Till that time, you can take analgesic and cartilage protecting medication like Glucosamine sulfate. For hip arthritis, joint flexion, extension and rotation exercises will help. If required intra-articular injection can be given. Diet rich in calcium and protein will help. If the pain is in pelvis then, ultrasonography or MRI spine may be required. Hope this answers your query. If you have additional questions or follow up queries, please do not hesitate in writing to us. I will be happy to answer your queries. An expert physiotherapist online will help you better to learn more exercises in proper protocol" "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 42 year old male. I had a seizure episode about 15 years ago and skin tuberculosis, for which I was hospitalized and treated. I was not on any kind of medications until a year later. But during that period, I was unable to concentrate on my sales job. I could not speak fluently at times. I would be so tired when I got home from work that, all I could do was sleep. I then visited a psychiatrist, who gave me a Phenergan injection. But that did not solve my problem permanently. I then met my friend\s cousin, who was a psychiatrist from abroad. He prescribed Oxetol 150 mg and Rivotril 5 mg, both twice a day. Then I got better at work. I used to walk for 4 km every day, but eventually, I had to discontinue my walking because of my job schedule. I also started taking Quetiapine 25 mg, half tablet, every night for the last two years to help quit my smoking habit.I have a throat irritation for the past three years. I went to the best hospitals in my city and consulted ENT physicians there, who told me that my throat was alright. But I was diagnosed with GERD, and I was put on Rabicer. I got breathing problems often, and nothing gave me relief. I was referred to an allergy specialist who gave me Doxcid, Fexofenadine, Ambroxol, and Montelukast. He also prescribed me an Airtec inhaler 250 mcg, which I use five times a week. About 15 years ago, I tried to discontinue Quetiapine for five days, which improved my breathing trouble, but my anxiety increased and I restarted the Quetiapine 25 mg at night. Can you please help me? I have to fly next month for an official trip. Can I travel with these medicines? My IgE in the blood tests is 740, and eosinophil count is 13 %. I am also pills, which contain vitamins, minerals, and Inositol. I am attaching my latest lab reports for your reference. I recently started using Nicotex, and I am not smoking for the past two weeks. My problem now is, I still have the throat irritation. I am unable to wear a neck tie since it is not comfortable. Sometimes, I still get breathing difficulty, and I feel tired in the morning. Can I stop taking Quetiapine? ### Response: Hello. Well, I can understand your concern. Here are the facts and the solution for your queries: Do not self-medicate. It could be harmful to your health" "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 major problem with my penis regarding the foreskin. I am 18 years old and the foreskin still does not go back. Please suggest some solutions for the above problem. ### Response: The most common cause of the condition is poor genital hygiene. You see a lot of dead cells and bacteria get collected in the space between the head of the penis and foreskin, making foul smelling grayish white substances, known as smegma, to come out. If you do not clean it daily by retracting your foreskin, it may lead to chronic infection and inflammation. Such chronic inflammation causes the foreskin to get adhered to the head of the penis. This condition is called phimosis. Try to retract the foreskin while under the shower using mild soap as a lubricant. If it does not get retracted and cause severe pain, then you will have to visit a surgeon to cut of the extra foreskin and expose the glans of the penis. It is a minor procedure and will have an extra benefit of having clean genital" "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 turned 19. I suffer from irregular periods. I did not have my periods for two to three months and then when I have them it would continue for a whole month straight without a pause. I have had the period gap problem for a few years now and recently started with these elongated periods. I have also consulted all kinds of doctor but never actually could find a permanent solution to it. Is this some kind of dangerous issue in my body? (Never had any physical relationships). ### Response: Hi. There is nothing to be worried about and it could be easily tackled and controlled. I would advise you to kindly get the blood tests and ultrasound and get back to me. Meanwhile, keep a track of your menstrual cycles of they get delayed by more than two months please consult your gynecologist for 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 get white spots on my teeth periodically in cold weather climates. I am getting married in this climate and I do not want spots on my teeth on my wedding day. What should I do? ### Response: Congratulations on your wedding. Good to hear. Sounds like a fluorosis. It happens due to fluoride deposit on tooth. And it do not appear periodic. It will be there all your life time. Need a picture of your tooth for better diagnosis. If it is cosmetic issue you can consult a cosmetologist for bleaching of your tooth. Visit your dentist for better results." "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: Sometimes I see flashes of light as kind of line in the side vision. That too where more light focus is there on the walls, etc. That too if I observe clearly. ### Response: Hello. Such flashes of light can be seen in a number of different conditions. A retinal examination will be able to rule out the more dangerous ocular cause-retinal detachment. Usually, such flashes can be seen in posterior vitreous detachment, which is a benign age-related condition and does not require any treatment. The last possibility is of fortification spectra seen in migraine. These are usually immediately followed by a migrainous headache. In case you have flashes accompanied by headaches, meet with a neurologist. In case you just have flashes and no other problems, given that you have a normal retina, I suggest that you just observe your condition for a while and get back to your ophthalmologist in case of any changes in symptoms." "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 baby is 9 days old. Heart murmur was identified during check with the pediatrician. He said that the cardiovascular system is abnormal with soft systolic grade 2/6 murmur at LSB. We have done the echocardiogram and the results are as follows: Ventricular septal defect (Q21.0) with stable condition and atrial septal defect (Q21.1) with stable condition. Moderate size secundum ASD, moderate size perimembranous VSD with PG of 55 mmHg. I would like to know the risk factor on the identification of the murmur and the steps to cure this as early as possible. We need your support and guidance on this. ### Response: I appreciate your trust in our services. I have carefully reviewed your query and can well establish the sensitivity of the health issues you described." "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 done first IVF last year, but it failed due to a bad quality egg. Embryos were not developed after two days. AMH level is 1.52, and the egg count was low. On consulting another doctor, she suggested to go with PRP injection to rejuvenate the ovary, so that egg count and quality will increase. I am afraid if PRP will cause any harm to the ovary? Are there any issues to try PRP? ### Response: Hello. You have been wrongly guided by your doctor because there is no apparent need for PRP (platelet rich plasma) therapy and injection into ovaries to rejuvenate the ovaries to produce better quality eggs. The therapy modality is relatively new and not sufficient studies have been done yet on them. It is being done for women with really low antral follicular count and AMH (anti-mullerian hormone) less than one and failed two natural timed intercourse and six IUI (intrauterine insemination) and one IVF (in vitro fertilization) cycles. You were directly subjected to IVF cycle, which was wrong without treating the pathology." "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 saw red spots, and skin crack on my penis head. Sometimes, it become painful. Urine open area is also painful and open like a lip. ### Response: You may be suffering from balanitis or pearly penile papules or sexually transmitted disease. If you have any sexual contact with an unknown person, then we can think of HPV warts (human papilloma virus) which comes under sexually transmitted diseases where you need investigation and start you on antiviral and surgical removal of the wart. If you had sex with a known person, maybe you would have caught simple infection and that can be treated. If it is due to condom allergy, balanitis inflammation due to painful sex, simple antibiotics and anti-inflammatory will help you. Another condition is pearly penile papules where there is no need to worry about infection. Sometimes it will heal on its own, or you need to meet a dermatologist to confirm the diagnosis for its removal. I hope I have answered your query. If you have further doubts, I would be happy to help 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 had a miscarriage two months back and got my first periods last month. Ten days back I had sex with my husband with a condom but I wonder it leaked perhaps. I took emergency contraceptive next morning. Now I am worried when will I have my periods? I do not want to get pregnant so soon. ### Response: Hi. You have already had emergency contraceptive pills. So you might have this hormonal pills effects for few weeks as these interfere normal menstrual cycle and prevent fertilization and pregnancy. In this case, for your satisfaction, you can have serum beta hCG (blood pregnancy test) to know your status of pregnancy. But here as you said you took an emergency contraceptive pill (if taken within 72 hours of unprotected sex), then less chance of pregnancy." "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 unprotected sexual intercourse on the day 1 of my period, and the penis was rubbed against my vagina. But we have not done penetration. I was worried due to precum. So I took an I-pill on the day 2 of my period within 13 hours. Should I be worried? When should I expect my next period since I took the pill on day 2 of my period? I have my cycle for 24 to 26 days. Should I expect withdrawal bleeding in this case? And what can I do to get my regular periods? Are there any chances of getting pregnant? ### Response: The chances of pregnancy are minimal as you are in your safer period with regular cycles. If you do not have a 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 concerned that my son may have Lyme disease or Skeeter\s syndrome. I have several pictures of the area. Site description: Red, slightly swollen with blotches around. There is no bull\s eye rash present at this time but from what I understand, this is not always present in Lyme disease cases. The areas surrounding the bites are much warmer than the rest of his skin. There are no blisters, pus, or discharge at this time. He has had a fever 102.2 F and has had a noticeable decrease in activity. ### Response: I suggest you continue antiallergic (antihistaminic s) and use Lactocalamine lotion over the area and see if it subsides. It should in a day or two. Give him Tylenol as per body weight for fever and any pain. Give him plenty of fluids. If he does not improve in 48 hours, it is prudent to take him to the hospital to be checked by a pediatrician or an infectious disease specialist. You would also wanna examine his body to see if there is any insect attached to him, any tick biting him, or to see if there are any other rashes and if any rashes appear in bull\s eye form. Warning symptoms and signs to get alerted are" "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: This is for my husband. On Saturday, he had a master health check-up and a few values are not good. I would like to hear your opinion on those. He is 35 years old. His weight is 71.9 kg and height is 168 cm.The abnormal values are as follows:1) Serum globulin 4.2 gm/dl - High (normal range 2-3.5).2) T4 - 11.46 ug/ml - High (normal 4.6 - 10.5) whereas T3 and TSH are normal.3) Vitamin D - 9.65 (low).4) Serum HDL 34.9 (low) other triglycerides and LDL values are normal.5) Vitamin B12 - 144 (low) (normal 180-914).Also, I attached his ECG where it was mentioned unconfirmed report. Please check and let me know the outcome of the report.He is an athlete who is active in a cycling race, running and swimming. But, he was out of the sport for one year and hence gained weight around 75 kg from 68 kg. Now, again he reduced 4 kg in the last three months. But he is following bad diet plans such as paleo one week, intermittent for the next week, proper balanced normal food for one week. Hence, I am really worried about his health. ### Response: I feel his low vitamin B12 levels may be linked to his paleo diet, which can be deficient in legumes, nuts (which are beneficial for the heart). He need not be so fastidious about the diet, I feel and vitamin B12 can be got from dairy products, eggs, fish, and chicken. His low Vitmain D levels are almost very prevalent in Indians, and basically this can be rectified by more outdoor activity, and if need 60,000 units of D-rise once per week for six weeks. His HDL levels are low and although his LDL (bad cholesterol levels) are also low, I would recommend daily exercise (half an hour daily) to boost HDL levels. His isolated High T4 levels, mean you need to check for a thyroid goiter and possibly do a thyroid scan, but it could also be linked to high globulin levels. Isolated high globulins need work up too, possibly disorders of immunity or rare disease like multiple myeloma (possibly consult a hematologist). 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: Fraternal twins are when two eggs have been released and both get fertilized by two different sperms. Does this mean the woman had sex twice to fertilize the second egg or one sperm fertilized both of them? ### Response: Actually, twins are babies produced by single same pregnancy can be monozygotic (identical) or dizygotic (fraternal). Monozygotic develop from one zygote which splits in an early stage of development and form two embryos. Dizygotic (fraternal) twins mean each twin develop at the same time from a separate egg and each egg is fertilized by its own sperm at the same time. It means woman had sex once only and at time fertilization two eggs fertilized by two sperms. In a few milliliters of semen, millions of sperms are there. So two sperms used to fertilized two eggs." "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: This is regarding a male, 27 years. He is suffering from type 1 diabetes from the age of 5 years. He is having an erection but is unable to sustain it during the intercourse. Firstly, he is not sure if he is suffering from ED or is it just anxiety. Are there any tests to be sure of ED? Secondly, if it is diagnosed to be ED (which most probably can be), can this be cured? How will his sexual life be? If it is curable, can it be cured with natural methods or medicine or surgery? If it cannot be cured, is there an alternative for him to have a happy sexual life? ### Response: Hi. I have gone through your symptoms and I would like to know a few more details to answer your query better. Is he able to achieve an erection sufficient for vaginal penetration during intercourse? Is the loss of erection due to early ejaculation or happens without ejaculation? The mechanism of erection can be tested by a penile doppler study during which the response to medication can also be tested. If he is able to achieve an erection sufficient for vaginal penetration, then the cause is more likely to be either psychological or just early ejaculation. A detailed clinical examination is also required to make sure that there are no other abnormalities that can affect full erection. At this age, the cause is most likely anxiety, but given his history of diabetes, a full evaluation is necessary to rule or other causes. The treatment is based on his most predominant concerns, though it cannot be completely cured, it can definitely be managed to get a normal sexual life." "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 strange episode the other day where I was driving, and it was like I lost and had been in a trance or asleep. When I snapped out of it, I was not sure where I was. I thought I was lost at first and did not recognize anything, although I take this trip daily. I had not been sleepy, deep in thought or stressed or anything. I got to work finally. I do not remember anything which has to be done in office on that day. I was told I had said something to someone and had no recollection of it happening and causing a bad argument. I had an appointment with a neurologist today, because of other symptoms. I told him about it, and he said let us see if it happens again. I work in a maximum security male prison with inmates around me for 8 hours. The driving thing scared the crap out. With my job, I cannot risk that happening again without being on a path to figuring out what caused it. What would or should I do? I am not terrified there is something wrong with me, but I am scared of that happening again. ### Response: The episode you describe fits into either a syncope or a dissociation. I think your neurologist is right. One episode of syncope is not a big problem. However, my further recommendation is to make an appointment with a cardiologist also. Some cardiac problems such as arrhythmias and cardiac valve problems could be associated with this kind of episodes." "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: Please evaluate my report that shows elevated RBC and platelets and eosinophils. ### Response: Hello. I have reviewed your reports (attachment removed to protect patient identity) and here is my advise. In your reports, the main concern is raised eosinophils. The common causes for that include allergic rhinitis, common allergic cold, asthma, skin eczema, and parasitic infestation. So kindly mention your clinical complaint like fever, cold, diarrhea, etc., if present to guide you further. Your hemoglobin, RBC, and platelet values are borderline. For that, you have to repeat complete blood count report after a few days. If still, they are abnormal, then will think further. So, acknowledge me with clinical complaints 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: I am a 28-year-old female. My T3 is 5.8. I am obese at 76 kg with 153 cm. I take 25 mg Thyronorm tablet every day. Weight loss becomes very difficult as thyroid levels have not decreased in the past five years post-pregnancy. Can I increase my Thyronorm dosage to 100 mg? ### Response: I find you are having hypothyroidism and consulting for Thyronorm dose adjustment. Dose adjustment will be made on free T4 and TSH (thyroid-stimulating hormone) levels and not based on T3 levels. So, I request you to upload the full thyroid profile results then we can decide upon the dosing. Hypothyroidism." "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 TORCH test after 12 weeks of pregnancy. It showed Rubella IgG and CMV IgG to be high, but the Rubella IgM and the CMV IgM were normal. Please advice. ### Response: Hello. Feel comfortable to contact me anytime for more queries. I would be happy to assist 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 have PCOS. AMH 7.99, LH 15.6, FSH 5.7. The doctor prescribed me Met and Normoz. After three months, he gave me Genotropin injection 75 ui from day 2 to 6 and Letroz from day 3 to 7. He said they are small-sized follicles, he abandoned the cycle, told me to go for ovarian drilling. I want a second opinion on that, please. Why do I not respond at all? I follow diet and exercise. ### Response: Hello. Your hormone profile suggests PCOD. What is the size of ovaries on ultrasound? If not done, you should do blood tests, sugar PP, TSH, prolactin, and testosterone. Often, oral contraceptive pills like Diane 35 (Cyproterone and Ethinylestradiol) taken for three months help in increasing the size of follicles in the subsequent cycles. If your blood prolactin or testosterone level is high, then you will need medicine to normalize 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: I had unprotected sex five month back and took I-pill within 12 to 14 hours. I have done home tests on the sixth and ninth day which were negative. I had brown spotting on the 13th day and some spotting today as well. My last period was ten days before having sex. Is the spotting due to the I-pill or it could be early pregnancy symptoms? Also, how late can someone get spotting due to the I-pill as in my case it is over ten days? ### Response: Well, the best way to find out whether this is spotting due to pregnancy or I-pill is by doing a simple blood test namely the serum beta hCG (human chorionic gonadotropin) to rule out pregnancy. Please share the report when ready. Home pregnancy tests are not very accurate. With regards to the duration till when one can get I-pill related. Spotting or bleeding following I-pill intake is highly unpredictable. If the blood test is negative for pregnancy, I suggest you not to worry and also avoid using I-pill as a regular contraceptive" "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 37-years-old female. My weight is 68 kg with the height 5\6"". There was a sudden numbness in the right arm starting at the shoulder, traveling to the palm. The numbness began while sleeping and triggered again while trying to sleep again. I experience a strange heaviness while awake. Tried applying a pain relief ointment but no effect. Please help. ### Response: Numbness may be due to compression of the nerve while keeping the hand under head in flexion. Hypothyroidism, anemia or electrolyte imbalance or peripheral neuropthy or diabetes patients are more prone for numbness. So do not keep tha hand under your head. Use tablet Methylcobalamin regularly. If there is no improvement please consult your physician he will examine and treat you accordingly." "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 back acne. It is all over my back. It is like red pimple marks and black spots. Kindly suggest me ointment and soap or any medication which will help me get rid of acne completely. ### Response: Hello. I have read your query. I understand your concern. Acne on the back have mainly two differentials: Treatment depends upon the diagnosis. Kindly upload images so that the lesions can be visualized. And do reply whether the rash is itchy or not. Upload the images and revert back 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: The one side of my face became red and swollen after Restylane. The vial must have had bacteria in it. I was put on several rounds of antibiotics and the doctor had to finally squeeze the filler out. It is a year later and the entire side of my face is swollen where the infection was. The doctor, of course, claims it was not from that because it is a year later but my face never looked like that. He did Sculptra, putting more on the un-swollen side, but it still does not match. What can I do? ### Response: Restylane fillers rarely produce infection but may cause a viral infection. One possibility is you would have had a hypersensitivity reaction to some proteins in the filler. But it is very unlikely for it to stay for a year. If there are some localized swelling and induration may indicate a foreign body granuloma or reaction. There are very few options available you could try like dilute steroid injection. But as your doctor has done filling the opposite side seems logical" "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 21 years old. I pass blood whenever I use the toilet. There is a burning sensation and also, a swelling. ### Response: Hello. You can have proctitis like inflammation condition of the rectum. Infected piles, polyp, fissure also can present with such symptoms. So to find underlying cause I suggest you proctoscopy examination of the rectum and anal canal. According to the cause, specific treatment is given. Meanwhile, for pain relief, you can be prescribed Ibuprofen 200 mg BD for five days. I suggest you consult a surgeon or physician for examination and further work up." "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: From the last 15 days I have a problem that I feel pain in my belly and then after that, I have to go to the toilet to pass stool. This happened 4 to 5 times a day. Because of this I also have a problem of rashes on my anus. Kindly suggest. ### Response: Hello. You can have acute gastroenteritis like infective pathology. It is advisable to take an antacid like Rabeprazole for a week. Empirically broad spectrum antibiotic like Ofloxacin plus Ornidazole combination can be started. Take bland diet more. Avoid excess spicy foods. I suggest you investigate with ultrasonography of abdomen, stool routine micro examination and occult blood test for further work up" "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 mom is always complaining of a severe burning sensation in her head. She is 67 years old. She has some problems detected by MRI with a white matter like minute clogs. She started forgetting short term events. She is on medicine but the burning never goes away. ### Response: What medications she is on currently? Do you have the MRI report so I could have a look at it? Based on the MRI, we can treat her. Does she have any cardiac issues? Has she tried Clonotril?" "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 24 years old female. I had unprotected sexual intercourse before two months. After that, I got my periods regularly for two months. But this month, I have not got my periods. My usual period cycle is 28 to 30 days. But now it is 40 days. I have not got my periods. I am having menstrual pain and headache. I am more tired with back pain. Can I be pregnant? ### Response: Hi. As you already had two menstrual bleeding episodes after your last intercourse, so pregnancy due to that episode is unlikely to occur. If you have not been sexually active in this cycle, then pregnancy is unlikely to happen. The delay can be stress induced." "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 34 years old, male and I am suffering from high BP and my creatinine level is 1.57. I am daily walking, my ankles are swelling once I get up from bed. So, now I have stopped. If I have to walk, up to how many kilometers can I walk, what kind of food I should take, whether this disease is curable? Please give me suggestion. ### Response: I can understand your concern. I have gone through the reports you have attached (attachment removed to protect patient identity). Your weight is also slightly high. So you also need weight reduction. So avoid oily and spicy food. Avoid junk food. Avoid large meals, instead take frequent small meals. Take more fruits and salads. Strict salt restriction in diet. Daily walk for 2 km. With proper blood pressure monitoring, weight management, your creatinine can be reduced." "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 21 years old. My date of period is 16th and it got over on 20th. I need to travel. If I start taking pills 15 days prior to my date, will it delay my periods? ### Response: Hi. In case you want to postpone your periods, then start taking the medication a week before your scheduled periods and then you can postpone the periods" "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: Patient\s left leg is swollen at ankle with severe pain at the joint for the past 10 days. He is unable to walk regularly as before. He has taken antibiotic and still the pain remains the same. Patient has done x-ray and blood test and everything seems to be fine. There is no accident or any hit there. He used to go for evening walk daily for around 3 to 5 km. These symptoms started 10 days ago. Patient is 61 years old, having gastric issue and has undergone stomach surgery twice. Please advise me how to deal with his health issue. ### Response: Hi. I guess you are talking about your father here in this query. To arrive at a provisional diagnosis kindly answer these questions." "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 40-year-old female recovering from eating disorder. My BMI is 16. I am suffering from clinical depression and GAD. I was diagnosed by a neurologist with migraines approximately two years ago, and have been on Lyrica 75 mg twice daily. Recently, I started having trouble swallowing (endoscope was normal), so I returned to the neurologist who prescribed Topamax 15 mg SC. I suddenly switched to Lyrica 75 mg in the morning, and Topamax 15 mg at night and developed the most insane premenstrual migraine I have ever experienced. I have never experienced that intensity of migraine symptoms, ever. I had shimmering or flickering vision, sometimes a white haze, parasthesia across forehead (with or without a slight headache), parasthesia down right side of body, upper back or neck muscle pain, irregular heartbeats, sudden whooshing sensation and feeling like I was going to faint accompanied by feeling of doom, confusion and mild hallucinations (almost like I was having a seizure), dizziness and nausea (especially with light and smells), dehydration (could not eat or drink because of nausea and swallowing issues), occasional twinging in chest. It got so bad that I got the family to drive me to the ER. By the time we arrived, I was unable to answer simple questions, and the attendor was concerned about TIA, so they admitted me, and I was seen by my neurologist, who ordered a CT scan. My results were blood count, platelet count, ESR, urea, creatinine, a lipogram, glucose fasting, TSH were normal except slightly low kidney function. ECG was normal (normal on the previous admission too, so were cardiac blood tests), chest X-ray, CT scan were normal, BP was consistently low (between 95-105 over 65-75 mmHg) lowest 88/45 mmHg while in hospital. The temperature was consistently normal.Since being discharged, I have had nausea, dizziness, sweating, urea kind of smell through my back, extreme muscle pain, low blood pressure. I returned to my GP twice because I was concerned about these symptoms. It suddenly dawned on me that these opiate-like withdrawals could be due to me suddenly stopping all of my medications before admission, the Lyrica in particular. The more I read, the more concerned I get. I saw a study where a woman had gone cold-turkey on Lyrica and ended up with cerebral edema. I guess my question is, can I safely continue weathering these withdrawal symptoms? Would the CT have picked up edema and would there be a danger of it randomly happening now that I am a few days cold-turkey off Lyrica? I do trust professionals and do not like to self-diagnose, but my anxiety levels are through the roof, and I am now certain even the hospital visit was a result of the sudden drop in dosage and combination of Lyrica and Topamax. I would appreciate your input. ### Response: It is fine to stop Lyrica (Pregabalin). In my opinion, your symptoms could be related to a panic attack, probably caused by Topiramate adverse effects. Besides, as Topiramate can also cause kidney dysfunction. So, I strongly agree with your doctor on stopping it. Brain edema is a serious medical condition, where the patient is usually" "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 4 months old and started chewing on his tongue. Is this due to teething? ### Response: Hello. Teething usually starts about six months of age, but at this time kids try to pet objects more often in the mouth because that is the way they try to learn about objects. It is very natural. But if your child is continually biting on the tongue and not occasionally, it could be something else. You can take a short video that would be more helpful. You can discuss with your doctor when you visit." "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 can get violent in my sleep and attack my wife. I also talk, sing and shout. I also suffer from headaches, migraine, and tremors in my hands. ### Response: With your limited history, it seems you have REM sleep behavior disorder. This would need further evaluation by a neurologist. Do you have tremor at rest or both during rest and motion? You can try Melatonin 10 mg at bedtime (OTC medicine). This should help you with your sleep behavior. Also, an alternative is Clonazepam (this would need physician prescription). You would need polysomnography for definitive diagnosis of REM sleep disorder. Also, neurological evaluation to make sure you do not have early Parkinson symptoms. REM sleep behavioral disorder." "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 is 30-years-old has ESR 85, and other blood reports CBC, lipid, thyroid, SGPT, SGOP, urine routine are normal. Does any other test is required? Any medicine? ### Response: Your wife ESR (erythrocyte sedimentation rate) is high, and other blood reports are within normal limits. ESR is a non-specific test, and it only indicates that a person has some infection or inflammation in the body. If you provide some clinical symptoms, then I can help you better, if she has no complaint, then this will typically resolve once the inflammation and infection in the body have subsided. Advice to check for uric acid, vitamin D, calcium, and RA factor if the history of join pain. There is no specific medication to bring the ESR down unless we find what is causing raised ESR." "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 32-year-old male. I am going to motion normally about three times a day immediately after having the food. I took Loperamide tablet but, it worked for only one day, and the next day the same problem recur again. Can you please suggest some medications to overcome the problem? Also, can you please advise some medications to clean my digestive system. ### Response: I can understand your concern. First of all, let me clarify the details. Motion once in three days or thrice daily is normal. So, if you do not have any problems like abdominal pain, loose stool, foul-smelling stool, etc., then no need to worry about this. Please let me know if you have any other symptoms." "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: Recently I have noticed that at certain times when I am with my fiancee, I experience excessive semen leakage that leads to my testicles hurting very bad, and I also cannot urinate during this time. I would like to know what can be done to stop this, so anything will be appreciated. ### Response: It is natural to have secretions when you are with your fiancee. It is nature\s way to make good lubrication to avoid painful intercourse. Testicular heaviness is due to cremaster pulling them up if not excessive is natural. Unable to urinate is due to bladder neck closure with sexual stimulation to help antegrade ejaculation. If really bothered by urinary issue I can suggest medicines for the same" "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 unprotected sex with an unknown person before 35 days. After 30 days, I did a tridot test, and it showed me a negative result. But I have a sore throat and white tongue for the past three weeks. Can it be the symptoms of HIV? ### Response: First, it is a bad practice to have unprotected sexual activity with unknown persons. Second, 30 days is too early for the tridot to be positive. You need to wait for at least 45 to 90 days. Tridot test is an antibody test, and HIV antibodies will not form within 45 to 90 days. A sore throat is not a symptom of HIV as it is a common upper respiratory tract infection. A white tongue is not a common symptom, and it should be ruled out for candidiasis. The symptoms of HIV needs time to form around one and a half to three years. Finally, get fourth generation HIV test done after 45 days for the final confirmation" "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 sister has been having seizures. So, we consulted a doctor, who said she has abnormal brain activity. Her EEG showed abnormal spikes. Currently, she is taking Levipil 1000, twice a day. What is going on with my sister? No one is explaining anything, and the medication is affecting her behavior too much. Please help. ### Response: I have read your query and understand your concerns. I hope this answers you. If you have more questions, feel free to write back to me. Please do not forget to mention the symptoms of the patient along with the description of the behavioral change, which will help us in pinpointing the probable cause. Revert with more information to 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 am 29 years old and suffering from acne from the last 17 years. Can you please help me? ### Response: Hello. You would need oral retinoid treatment from your dermatologist for four to five months for treatment of acne" "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 an unprotected anal sex for a small duration with a guy before two days. Now, I am worried about HIV and other STD infections. So I would like to know about the chances that how could I have gotten HIV infection from him if he was positive? When can I have my tests of HIV and STDs done? ### Response: Unprotected anal sex carries a high risk of acquisition of HIV. You are still in the window period, where the post-exposure prophylaxis can be given as it can be initiated within 72 hours of last exposure. HIV test can be done now. This will help you to know about your pre-existing status. Get the first test done at four to six weeks of the last exposure" "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 want to clarify something regarding a recent incident I had. I was smoking shisha at a shisha lounge. The waiter delivered the shisha to my table, but before that, he tried it himself, and I smoked it after that. I am worried that any diseases such as HSV1 or HSV2 may be transmitted to me if the waiter has it, I am sure that I did not come into contact with his saliva, but he did put his mouth on the shisha pipe a couple of times to test it. So please clarify this for me. ### Response: Hello. There is a chance that you could acquire HSV1 (herpes simplex virus) from the waiter if he has it. HSV2 is familiar with genital herpes, not the mouth. Unfortunately, blood tests are not sensitive enough to know whether you got the virus or not. In all cases, if you start to show the symptoms which can take few days up to two weeks which are blisters around the mouth, you need to follow-up with it, and appropriate treatment will be prescribed. HSV1." "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 Vitamin D is very low. Should be between 30 to 100 but it is 5+. What is your recommendation to get it to normal? ### Response: I just read your query. Your Vitamin D level is very low and you should definitely start supplements under supervision. Along with oral supplements, you require supplements through injection too. Also take diet which improves Vitamin D level like fortified dairy products, fortified orange juice, fortified cereals, fatty fish as tuna and salmon, egg yolks, etc. Spend some time early in the morning in sunlight. All these things will help you in improving Vitamin D level. Poor eating habits and improper lifestyle. Blood test for vitamin D." "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 I take Coenzyme Q10 and Ashwagandha on the same day? ### Response: Coenzyme Q10 had a specific benefit. Ashwagandha is a herbal supplement with multiple actions on various biochemical and metabolic pathways. From pharmacology, Naturopathy, and Integrative Medicine perspective, I can suggest taking both the medicine together. But I suggest you have a gap of one hour between these two supplements." "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 38 year old male having pain in the hip and severe leg pain from calves to ankle, tingling, pins and needles in both feet, and stiffness in thighs. Please find all the reports attached. Also, suggest a medicine for RA. ### Response: Hello. I have gone through your history and the files attached here (attachment removed to protect patient identity). X-ray images are of poor quality and cannot be visualized. However, the hip joint can be observed which is the site of pathology in your case. As per the X-ray report, you have avascular necrosis of the hip, the treatment for which is a total hip replacement. The hip replacement can be delayed until the point where pain is bearable. You need to mention your occupation, weight you usually lift, any exercises you do, any walking aid, duration of medication mentioned in the query, the distance you can travel. Your blood reports do not have any tests related to rheumatoid arthritis, then why do you seek treatment of rheumatoid arthritis? Kindly follow up with answers to these questions for further discussion. Regards" "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 TSH level is 0.056. I am at present taking Thyronorm 75 mcg as I have been suffering from hypothyroidism before. At present, I have low blood pressure and I feel dizzy and weak. ### Response: I read your query and from what you have mentioned it appears that you have overcorrected hypothyroidism. I suggest that you decrease the dose of Thyronorm to 50 mcg once daily. Repeat your thyroid function test after six weeks and then we will review again. Also, you have urinary tract infection and therefore maybe you can be dizzy and weak. You can also take tablet Paracetamol 500 mg thrice a day for three days. Consult your specialist doctor, discuss with him or her and with their consent take all the medicines." "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 scheduled to have the two wisdom teeth on my right side extracted tomorrow. While waiting for the appointment, I developed pain in my right upper jaw which became increasingly worse over a few days. I went to see the dentist who found out I have an infection in my first molar (upper right) which is a tooth that has been root canal filled for about 20 years.I started Penicillin for the infection but after three days with no improvement, I switched to Clindamycin 24 hours ago and I am still not sure if that is working either. My first question is, should I still have the wisdom teeth extracted as scheduled even in the presence of infection in that other tooth?The dentist made it sound like it would not be a problem but I am very nervous especially since I am already in quite a bit of pain. ### Response: Hi. I have read through your complaint and the relevant details. Penicillin and Clindamycin are the antibiotics and are usually prescribed for a course of five to seven days. So, you might not notice a big change in how you feel. It is the painkiller which makes you feel that the" "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 heart suddenly starts beating very fast from the last three years. My echo and ECG are always normal. Nowadays, I can feel the chest pain and some kind of picking in my right arm. My thyroid test is also normal. I do not know what to do. Doctors here do not know what my actual problem is. Can you please help me? ### Response: Hello. This can be cardiac arrhythmia like PSVT (paroxysmal supraventricular tachycardia) or atrial fibrillation, in which heart rate suddenly goes up and also suddenly decreases. Usually, ECG is normal as it is usually done between the episodes. ECG done during episodes will show abnormality. It is better if you can upload your ECG and echo reports for an opinion. Is there any stress or anxiety associated with or prior to the increase in heart rate. Until the time your evaluation is complete, you can continue Concor (Bisoprolol). If none of the above is successful then last option is an electrophysiological study which is an invasive test which can diagnose and treat the arrhythmia permanently in most of the cases. Hope this helps you and get back with some more information" "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 facing with erectile dysfunction from the past couple of weeks and low libido, decrease in sexual desire. Before that, everything worked fine. I have performance pressure. ### Response: Please elaborate on what kind of issues you are facing? Do you have any ongoing stress? Any history of hypertension or diabetes? Any medicines you started recently? How the problem developed?" "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 planning to go for liposuction to lose weight. My weight is 78 kg and height is 5\3"". Kindly suggest. ### Response: Hi. Your calculated body mass index (BMI) is 30.4 kg/m2. Generally we perform bariatric surgery to achieve permanent weight loss for any patient whose BMI is 30 kg/m2 or above. Liposuction is not a treatment option for weight loss. It is a cosmetic procedure for body shaping. There is a set point for fat storage for everyone. This is not altered by liposuction. Weight loss by liposuction, diet control, exercise, naturopathy, amway, herbalife, etc., is temporary, as all these methods do not have any effect on set point for fat storage. So, any fat that is removed in liposuction will reaccumulate over a period of 6 months to two years. Those who can reduce weight by diet control and exercise does not need liposuction and those who cannot reduce weight by above methods will not reduce even after liposuction. Bariatric surgery provides permanent weight loss as it lowers set point for fat storage. If you are looking for permanent weight loss then bariatric surgery is the only scientifically proven method for that." "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: Few days before, my skin got irritated. I thought it was natural. Last night, just after washing my face with facewash, my skin got red patches in the morning and I have itching type sensation. It looks very awkward. Please help me. ### Response: Irritation and itching on the face can be due to seborrheic dermatitis, polymorphous light eruption, irritant contact dermatitis, and many more. It would be easier for me to make a diagnosis if I see the picture. Can you please attach your clinical pictures of the face? Any changes in the skin products such as using new soaps, new face creams, any history of exposure to sunlight for longer duration and history of travel to a new place can cause changes in the skin" "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 girlfriend is 20 years old. She recently started losing her hair. Now, within two and a half months you can see her scalp near the front of her head and the very back of her head. It happened suddenly. And now she is pulling her hair out in clumps throughout the day. I have also noticed that her eyes are very dark and she complaints of being tired. She does not sleep well at night either. Her job has been stressing her out lately. She is working as a teacher for the past two years and managing kindergarten kids. What I really want to know is, can there be such a rapid hair loss due to stress of her job? Or is it something worse? I have almost ruled out thyroid. She is perfectly healthy. I have a thyroid problem and her symptoms are not similar to mine. And it does not run in the family too. Please help with her problem. ### Response: Hi. Let me explain everything about hair fall. Straightening and other procedure also cause weakness of root. Other condition like fever, typhoid, malaria, thyroid, etc., can also cause hair fall, but these are less common. Regarding treatment, have good sleep. Eat proper food with green vegetables and fruits. Take Iron and multivitamin like Follihair for at least three months. Check your blood hemoglobin. If it is less, then she should start iron and folic acid supplement. Also, check thyroid and diabetes to rule out other 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 am a 24-year-old male. My main issue is people say that I behave like a 10-year-old boy. I think I have dyspraxia. I lack gross motor skills. I cannot play any sports. I cannot drive a car properly. People get averted due to my behavior. I have bad handwriting and I attempt things in a clumsy way. I have an unusual gait. So basically I have learning disabilities in everything. I have a migraine and bipolar depression too. People often tell me that there must be definitely some maturity problem with my brain as I behave very oddly. Please look for any developmental anomalies in my brain MRI or any abnormalities. I have attached the file.Currently, I am using 5-HTP anti-depressant for my mood enhancement. ### Response: As discussed earlier, there is no doubt about the diagnosis of motor coordination disorder or dyspraxia. Many of your problems can be explained on the basis of dyspraxia itself and I feel you are right in saying that you have dyspraxia. However, your current post does not contain any file or attachment for view. I request you to attach the file in proper format or possible way so I can see whether there is any structural abnormality. 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 a 27 year old female. I have skipped my periods which was due on 4th. I have PCOD issue. Now I have morning sickness, cannot eat something sweet, fatigue and mild crampings on right and sometimes throughout with upper backache and lower backache. Did my urine test at home yesterday, it was negative. So, kindly help me out with this. ### Response: The period may be late due to many reasons including anxiety and stress. In your case, it may be due to PCOD or thyroid problem. The chance of pregnancy depends on when you had unprotected sex. If it was in the middle of the cycle, then repeat urine pregnancy test after five 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 just found out I was pregnant a couple of weeks ago. I smoke weed. I am slowly trying to stop. I have about seven months left of my pregnancy. If I was to cut way back and stop completely at five months of my pregnancy would I and the baby be clean when I deliver? ### Response: Hi. We need to worry about what the baby is facing now and not about what will happen after you stop. All the components of smoke, the bad air (carbon dioxide), tar, the chemicals in the smoke, which may vary with what you are smoking are all powerful vasoconstrictors. I mean they narrow the blood vessels, so they reduce the blood flow to the baby. If we could go back I would have advised you to stop it the moment you got pregnant. Late better than never. Every\x80\x8bday baby is growing, so the requirement of blood flow is increasing as the baby\s vital organs are growing and getting blood for that. So if the flow is compromised even a day, we do not know if any damage has occurred. This may not be visible on any scan, but it would be safe to immediately stop smoking and start having lots of highly nutritious food with lots of sugars, juices. Do yoga or breathing exercises, in short, improve the supply of nutrition and oxygen to the baby as these two are the secrets of a healthy and active baby. Hope I have made it clear. Baby will not have any of it in its body, but the damage caused by the smoke will be seen in the baby\s body. For your baby\s sake do try to stop it today or as soon as possible." "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 age is 27 years, my height is 5'4"" and my weight is 65. I have trigeminal neuralgia for which I take Lyrica 75 mg during flareups. I recently had a blood test which indicated low vitamin D (6 ng/ml) for which doctor advised me to take D-rise 60,000 IU/week for eight weeks and then 60,000 IU/month for a year. In my CBC done last week, my ALC and my WBC were high that I had a test again eight days later in which the lymphocyte was increased again by 1000. Apart from this, I have pain in lower abdomen and my body keeps having hot and cold flashes. I also have pain in legs and arms and I do not feel hungry like I used to for the past one month. ### Response: Your increased WBC and lymphocytes, I could certainly relate it to your trigeminal neuralgia as this is an inflammation of a nerve which would rise WBC levels even if you are in recovery period with no symptoms. But, what I am concerned about is your appetite and abdominal pain and hot and cold flashes as these symptoms correlate with endocrinal dysfunction. So, we can be certain by doing thyroid function tests to see how it is going" "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: From the last two weeks, my eyes are reddish. So after three days, I consulted an ophthalmologist, and he said that I have got an eye infection, and he suggested to use Vigamox, Floace, and tear eye drops, four times daily. But after two days, my vision started to blur, so I rushed to the doctor again. He again said it is a bacterial infection, and he said it will take 2 to 3 weeks to recover. I am using the prescribed eye drops from a week, but my vision has not recovered even a bit. I am afraid because, before the infection, my vision was 100 %, but now my left eye is totally blurred. Will it take three weeks to recover? Do I have a corneal infection? Please help. ### Response: Hello. Having said that, it is a provisional diagnosis. Kindly share your case report, so that I may guide you better." "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: Since the age of 6 to 18 (current) I have had sharp pains in my mouth whenever I use my chewing teeth. No cavities whatsoever. I do not know what is the problem. And the pain is on and off. What is the problem? ### Response: Possibilities are many: 1. There might be fractured teeth. 2. There might be sinus problems. 3. There might be condylar or TMJ problems. 4. Might this be related to the nerves. I suggest you go to a good oral and maxillofacial surgeon or an endodontist. Different test reports can tell what the actual problem is because your problem is not on the surface, it is in-depth, so radiological reports are a must. Do revert back for more queries. Follow up with X-ray and other related reports." "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 got a swelling in the left lower eyelid as can be seen in the picture before four days. It is painful and the eye turned red. Since yesterday, I have been using Ciprofloxacin eye drops, but there is no relief. I got similar problem in my right lower eyelid a year back. Since, two months I am staying in hot climate. Also, I have mild dandruff. What is the diagnosis and treatment? ### Response: I have gone through the pictures of your eyes (attachment removed to protect patient identity). Revert back after a week to 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: I have been to six different rheumatologists. One of those rheumatologists said I have fibromyalgia and I still do not agree with this diagnosis. My labs come back normal. My radiographic test concludes osteoarthritis in both knees and thumbs. I have pain in these joints and have a bone island in my right knee. I am under pain management, but I just feel like we are missing something. My body feels way off and I am almost positive with seronegative RA. I just feel like the physicians are in someway scared to conclude this diagnosis. I have bad flares that are bilateral on my hands, knees, hips, and between my shoulder blades. I have swelling and fever in these joints. I have no idea what to do but I am progressively getting worse. Please help.I am currently taking Nucynta ER 150 mg, Xanax 1 mg, Lyrica 100 mg, HS Tizanidine 2 mg, and Synthroid 25 mcg before meals. ### Response: You seem to have multiple joint arthritis. Since CRP (C-reactive protein), R factor, Anti CCP (cyclic-citrullinated antibody) antibody, and ESR are normal no one is going to conclude this as rheumatoid arthritis or seronegative arthritis. I need the following details: Since how long are you suffering from it? Do you have an increase in pain and stiffness in the morning when you get up or is it the same throughout the day? Within how many minutes to hours of getting up in the morning you start feeling lesser stiffness? Do you have pain and swelling in distal interphalangeal joints of hands?" "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 18 weeks pregnant with my third child, and I have not felt any movement or had any symptoms of pregnancy. I am wondering why I am not able to feel any movements. ### Response: Hi. Ideally, in multiple pregnancies, the baby movements are being perceived by 16 to 18 weeks. You may wait another week and then go for your antenatal visit and get an ultrasound scan done. You are already due for your anomaly scan between 18 to 20 weeks. That should answer all your concerns." "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: Recently, I have been playing quite a lot of sport. However, my left bicep seems to be going into spasm or is twitching. There is no pain, but I cannot stop it. Please help. It is only on my left arm. ### Response: " "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 mother of a 26-month-old boy. He usually developed until around 18 months then began falling behind. He had maybe two words by 18 months, and now he has none at all. We strongly suspect he has autism (many red flags present, MCHAT score of 13) and is working towards getting him a diagnosis and treatment but we live in a developing nation where professionals in this field are scarce, and waiting lists are long.My question pertains to receptive language. Up to around 18 months, I felt sure he understood most of what was said to him. At present, I do not think he understands language at all. I have heard of autistic regression where children lose words, but do they lose receptive language too? Is this something you have seen? ### Response: Many times in autism, the language is not lost the sensory issues, and the attention deficits are so higher that the child fails to pay attention to speech. Language is based mainly on attention and imitation. In many autism cases, the need to express is hampered, and the chance to speak or we can see the need to show is decreased as parent or caretaker tend to provide everything to the child without a demand on his part to express his wants. For therapy purpose, I would suggest you to search if there are not many professionals in your city and start speech therapy. You can contact back if you have any questions." "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 got a slap on my ear and then I also got a bump in my head. After that, when I try to unclog my ear, it gives me an air passing sound and there is a hearing loss also. Please suggest a medicine. ### Response: Hello. That needs to be ruled out at the earliest by an ENT specialist. Pure tone audiometry. 1." "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 I have cell carcinoma. It started a year ago. Tried antibiotic cream, antiseptic cream, fungi cream, etc. In the last two weeks, it has spread. It crusts over, then falls off, and then weeps or bleeds. Very sore and itchy. ### Response: Hi. I have gone through your case (attachment removed to protect patient identity). Right now, your lesion has taken the shape of a scar. The diagnosis of carcinoma can only be made on biopsy and you are already on a dermatologist\s list. So, do not panic and be patient. In my opinion, it is just a local spread which has occurred during the last two weeks. So, it seems to you that it is spreading. However, from the above explanation, the diagnosis of carcinoma cannot be excluded as it is based only on biopsy. Be patient. Suggest you keep on applying Sudocrem (Antiseptic cream). Do not apply anything else until you see a doctor. Moreover, it does not look to be an aggressive lesion, so relax" "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 3-year-old daughter. I am planning to buy a non-ozone based air purifier for her. I want to know if an air purifier harms or impacts the natural immune system of a child? ### Response: Air purifiers are used for the purpose of filtration of particulate matters which are not filtered by the lungs. They actually purify the air and avoid the harmful dust. So, I suggest you can use. However, consult your specialist doctor, discuss with him or her and with their consent use it. So, it is good. Regards" "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 my nose cauterized for the second time a week back and have a flight booked in two days. I am worried that it is too soon to fly as flying triggered my nose bleeds. I can change my flight to stay longer so it can heal further. Not sure. Just do not want it to start bleeding again and start the whole process over again. I am guessing that you can only be cauterized so many times. ### Response: Hi. Nose bleed is a very common problem. It is treated with cautery which may need repeating a few times. Since you had it only a few days ago, it might be better to avoid flying for 3 to 4 weeks, if possible. Carry on using the ointment for one month and then have yourself reviewed by your doctor. This is the standard practice everywhere. Nose bleed. Ointment in the nose for one month. Avoid nose blowing and picking. Keep blood pressure under control. Avoid blood thinners." "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 know more about my kids CBP blood report. Her age is 6 years. Last month she got a viral fever and we got her tested for CBP along with other tests. As part of that, we found that she has less absolute neutrophil count. Though pediatrician said it is fine, we were worried. So, repeated test after one month and looks this time some other values are in not expected range. We see she is having frequent colds but she is very active. ### Response: I have checked your attached reports (attachment removed to protect patient identity). Your latest reports show absolute neutrophil count slightly low. But your count improved as compared to the last month report. The frequent cold might be the reason for low absolute neutrophils and high lymphocytes. The peripheral smear examination report is normal and any specific abnormality is not mentioned in the peripheral smear report of WBC. So, you may need not to worry about your CBC report as per my opinion. If your kid has clinically improved, then no need to worry." "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 dental abscess. Will Flucloxacillin help? ### Response: Hello. Firstly, I would like to know if you are sure it is a dental abscess or could it be another tooth infection. I do not know if you have visited a dentist for this problem. Also, if available, forward me your X-ray or any other investigation reports. Coming to your question, Flucloxacillin does help in case of a dental abscess, but it is always advisable to visit your dentist for a thorough check up and get treated accordingly. Flucloxacillin 500 mg twice daily for at least three days should help. Lastly, have you been allergic to any medicines in the past? Regards" "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 mom is diabetic for last 11 years. She is on insulin for the last six years. Now, she is not feeling well, as she has a nerve pain in her foot and ankles. The skin of her foot is getting rough from the last year. She is losing her appetite and is very weak. She is currently on Novomix, Azulix, Tazloc CT, and Astin. ### Response: Hello. I read your query about your mother and saw her reports (attachment removed to protect patient identity). Hope you find my advice of some benefit. Good luck" "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 very sore throat for the last three days and have been taking pain killers and antibiotic (Azithromycin 500), but they only gave temporary relief. I noticed small ulcers at the visible part of my throat, not sure if these were there when the symptoms started. These are the only symptoms I have. I checked symptoms of tonsillitis but did not have them except sore throat. ### Response: If it is an ulcer, the antibiotic can worsen it, so please stop antibiotics. Please capture a photo for your throat and send it to me. I need to see the ulcer. Is the ulcer tender for food and water? Do you have reflux?" "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 year I had depression with anxiety episodes (diagnosed by the psychiatrist). I did not get any pills. I get well with some kind of psychological therapy. But this year I had several panic attack episodes and neurologist prescribed me Valium to get sublingual during the attack. Now I have some kind of fears, I am afraid when my heartbreaking arises, I am afraid of eating different foods (fear of intoxication), I am afraid of staying alone, etc. Too many fears in my life. I cannot live like this. Can you give me any advice, please? ### Response: We are happy to help. From what you have described of your problem, it seems anxiety is a greater problem for you. It is good that you have improved only on psychological therapy but then whatever has been taught in psychological therapy, you need to continuously practice it at home. Please look up Jacobson\s progressive muscular relaxation and practice it 3 to 4 times a day. This exercise will significantly help you gain some control over the somatic symptoms of your anxiety. As far as medicines are concerned, Valium is a medicine which will relieve anxiety to some extent but will make you feel sleepy. If you have been experiencing anxiety episodes every single day or at least 3 to 4 times a week, I would advise you to take Paxil 12.5 mg in the morning and gradually consult a psychiatrist to alter the dosages. But if you have been experiencing anxiety only in specific social situations and require medication only to suppress the anxiety for the time being without feeling sleepy, I would advise you to take tablet Etizola SOS." "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 felt doing snowboarding 2 days ago. My shoulder hurts more and more. My chiropractor gave me a prescription for an X-ray. I have my X-ray but nobody to read it before next week. Can someone read it for me and tell me if I need to go to emergency hospital or it can wait? ### Response: Hi, Welcome to ilciniq.com. I am so sorry for what happened. I can certainly help you to read your X-ray. If you are able to move you arm most probably it is not a complete fracture. Of course there may be incomplete fracture. Need to see the X-ray. Meanwhile try to stabilize your left shoulder and arm." "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: In the morning, I have a strong and frequent urge to pass urine. It continues for an hour or two. After urinating normally, only droppings take place. Today, a few drops of blood also came. My intake of water is about 2 liters a day. There is no discharge or itching. Throughout the day it is normal. This symptom is persisting for the last three to four days. I am a thyroid patient as well as diabetic and also on medication for high BP. ### Response: It seems you have developed urinary tract infection (UTI). It is common in diabetic patients to develop infection despite good water intake. I suggest you get urine routine and microscopy along with urine culture sensitivity done. Take antibiotics accordingly. Let me know the result, so that I can help you with the prescription. All the best. Hope you get well soon. Revert back after the test to 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: Two weeks ago I had 10 positive home urine pregnancy tests. I consulted with my obstetrician and they sent me for two blood tests 48 hours apart. The blood test showed my hCG level more than doubled within 48 hours which the obstetrician said was great.Well because I have irregular periods I did not know the date of my last period, so my obstetrician scheduled me for a vaginal ultrasound today and the ultrasound showed a gestational sac but no fetus in it. My obstetrician asked me to get another blood drawn in which results came out good and normal. she has asked me to come and do another ultrasound in two weeks to see if they can see the baby.Is it normal to not see the fetus and just the gestational sac in early pregnancy? I have been so nervous and going nuts since my obstetrician did an ultrasound this morning. It is driving me insane. Please send me any information if you can. ### Response: Hello. In early pregnancy, by six weeks of gestation, the gestational sac is often not seen and only decidual reaction can be appreciated in the uterus, but as the hCG levels are doubling, there is definitely a viable ongoing pregnancy either inside or outside uterus, so a repeat ultrasound after two weeks shall establish the location and presence of a sac, considering that it would grow to a recognizable size in next two weeks." "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 has been three years of my marriage and my marriage is still unconsummated as sex is extremely painful for me. I am able to reach orgasm, but not penetration. I have not tried lubricants. Shall I give it a try? ### Response: Hi. I am sorry to learn of your troubles in the sexual area. As you have not tried any lubricant I would suggest you do the following things: If, despite this you have a lot of pain, then please visit a gynecologist to see what the problem is." "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 fell on a wooden set of stairs last night and landed mostly on my right lower back. From the morning, I feel like someone is squeezing my kidney every time I move. The pain is even more severe when I move my right leg. I do not see any blood in my urine and I do not want to go all the way to the ER for them to tell me nothing is wrong. What shall I do? My leg does not hurt, but I can still feel the pain when I am not moving my leg. But, it increases dramatically when I do. My pain is only on my lower right back. Please help. ### Response: I feel sorry to hear this. 1. Muscle injury.2. Bone injury - ileal tuberosity or coccyx injury. X-ray pelvis anteroposterior view. Take painkillers and muscle relaxants like a combination of Diclofenac, Paracetamol and Chlorzoxazone along with Pantoprazole. Do not take these medications if you are in early pregnancy. Consult your doctor, discuss with him/her and take the medicine with consent. Revert back after three days 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: I had been suffering from low back pain for many years, I had X-rays which showed disk space narrowing in my lower spine. I fell two weeks ago and suffered enough pain to see a chiropractor in hopes of relieving the pain without narcotics or analgesics on a regular basis. I have been to chiropractor six times in two weeks. Lower back pain seems relieved but the pain in right buttock radiates down, outer right leg to the foot and is searing white-hot shooting stabbing breathtaking. I am uninsured so I have to be frugal but should I see someone for something other than X-rays? ### Response: Hello, Welcome to ciliniq.com. From your description of the symptoms and the fact that the back pain has improved while the leg pain (nature and radiation to the foot) remains indicates the cause to be from a disc in your spine pressing on one of the nerve roots (possibly L5 nerve root). You have two options: One wait and watch as long as there is no numbness or weakness of the leg or any bowel and bladder disturbance and take Diclofenac 75 mg twice a day with an antacid assuming you have no allergies or asthma. Lyrica 75 mg twice a day (makes you feel sleepy for a few weeks and then wears off ) to help with the nerve pain. You may need to take it for a length of time before actual improvement in pain is noted. Secondly see a spine doc and have an MRI to confirm the diagnosis and take the above mentioned or opt for surgery on the doctor\s advice. Discogenic." "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 26 years old, and I have never used any product for my hair or skin. I am working in IT night shift, and I have dark circles. I came across a video from a bright side that Aloe vera can reduce dark circles. So I wanted your suggestions on this. Can I start using Aloe vera gel for my skin and hair? And for hair can I use it as a styling gel which means can I leave it after applying on my hair or I will have to wash it after a few minutes or hours? Please advise. ### Response: See the dark circles you are having are due to awakening at night. So during the night shift, try to relax your eyes in between. You can use ice packs to soothe your eyes once or twice. Take fresh fruits and vegetables, also for dark circles and do not let them increase because they are hard to cure at later stages. As far as Aloe vera gel is concerned, you can use it on your hairs and skin. But make sure that it is 100 % natural. If you are using it as a styling gel, then you can wash it after a few hours. I will not recommend you to leave it on your hairs. I hope you understand my point." "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 reflux and a bit of a tummy ache off and on between my naval and hip, for the last week (no diarrhea). (I also know this can be indicative of an appendix problem but it is where I always have pain with tummy troubles and it is not my appendix). This is not uncommon as I have digestive issues kind of often. However, this time is different. I have had pale, clay-colored stools and some pain in my right flank for going on five days. It feels a bit more sore on my right side after a bowel movement. I went to the ER, my blood work indicates no problem and is normal across the board, no infection, normal pancreatic enzymes and liver enzymes, normal bilirubin and I had a had a scan of the biliary ducts and they appear normal. I have two gallstones that are not blocking anything and there is no indication of inflammation of my gallbladder. Please help me find an answer or an alternative reason to pale stools (also no change in diet). ### Response: Hello. I need following details to help you better. Revert with the asked details for a better help. Revert with more information to 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 am a 30-year-old male. My lab results suggest,1. Normal CBC, ESR, kidney function, and liver functions.2. Normal CT scan on the brain.3. I am not diabetic and do not have blood pressure or heart disease.4. I am negative for all the virus A, B, C and HIV gen 1,2 and 3.5. Elevated CRP level is 8.6. My health condition is IBS, anxiety, tension headaches, allergic rhinitis, and poor dental care.I have an elevated CRP level, and I do not know why? And also how can my ESR be normal while my CRP is not? ### Response: The CRP (C-reactive protein) raised in case of any inflammation in the body. ESR (erythrocyte sedimentation rate) doesn\t need to be always increased when CRP raised because ESR is a non-specific marker of inflammation. It is not as much sense as like that of CRP. Your CRP value mildly increased which will fall within range once inflammation resolution occurs. Allergic rhinitis probably might be the cause. So you need to treat anxiety with anxiolytic medicine and with SSRI (selective serotonin reuptake inhibitor) 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: A dog licked my leg on the street. I have no wounds on the leg. When I came home, I washed my leg with soap and then I found out that I had a little scratch near my hand nail (I did it when I was doing manicure). Is there any chance to get rabies in that way? ### Response: Hi. I will recommend you to follow the dog\s trails. If it is normal, then there is no problem. If you have any feeling of doubt, then you get a rabies vaccine. Licking an open wound can transmit the virus if the dog has a rabies infection. But, if the dog is good and if you do not have any open wound or scratch on your leg where the dog licked, get relaxed. You will be fine. But if you are anxious, then consult your general physician for further approach" "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 multidrug-resistant tuberculosis. I have attached the reports. Please suggest a way to treat this. ### Response: I have seen both the reports (attachment removed to protect patient identity). Sputum report is positive and has also grown Mycobacterium tuberculosis. Patient weight is also not mentioned. If it is M" "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 19-year-old female. Whenever I breathe, I have pain in my upper back. I have pain in the upper back of the left side region. It even hurts when I am not breathing. I do not have the pain when I cough or sneeze. ### Response: You are suffering from back pain when you breathe. You do not have the pain when you cough or sneeze. The pain appears to be localized to the upper back region towards one side. According to the age and symptoms, it can be myalgia (muscle pain). I would suggest you take a muscle relaxant like Thiocolchicoside for a couple of days twice daily. If the pain is severe, take Paracetamol or Aceclofenac tablet along with the muscle relaxant. Take Aceclofenac after having food and take the antacid tablet (Ranitidine or Pantoprazole) before taking food. Take good rest. Avoid doing any strenuous activities. Do a hot fomentation, and a pain relief balm or gel (Diclofenac ointment) can be applied. Take a bath in hot water, especially pour hot water over the area that has pain. Avoid taking cold foods and" "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 38 years old. I am diabetic for the past three years and sugars are not always in control. I am taking medicine Euclide 80 mg and Galvus met 50/500 and Novomix 30 injection 10 units (injection only for few days). My issue is, post diabetes I am experiencing severe recurring yeast infection in vagina and itching in groin area and near anal area. Due to scratch the area has become sensitive and scars and cuts are there. There is burning sensation when the area comes in contact with water. I have tried all Clotrimazole creams (Dres V, Surfaz B, Candid, etc.), but no relief. Itching is severe at night and very uncomfortable. Please help which medicine or cream to apply to stop this infection everytime. I am unsure if that is eczema. Are there any tests which show what kind of infection is that? ### Response: Diabetes is comorbidity that makes patients prone to fungal infections and some times there is a secondary bacterial infection too. I advise you to follow certain steps. 1. First step, proper sugar control. 2. Anti-diabetic diet and exercise. 3. Proper genital hygiene. 4. Use of clean cotton underwear. 5. 6. No tight clothing. 7. No talcum powder application. 8. Do not use regular soap and hot water to clean genital areas. Take Itraconazole 100 mg two times a day for two weeks, Luliconazole cream to be applied three to four times daily on area of infection after proper cleaning and" "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 got my back right wisdom tooth removed today. How often do people get dry socket? How long until I will know I have it? Is there any way to check if the blood clot is missing? ### Response: Hello. As a specialist in third molar extraction, I will guide you through. It is nothing serious just unhealed extraction site. Upon extraction healing takes places by the blood clott that stays in the socket post extraction.That clott dislodges if rinsed vigorously by the patient , so as a precautionary measure I make sure to advice each of my patients not to rinse forcefully for atlest 24 hours and after that warm salinge gargle gently, just to remove if any food lodgement to the socket." "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 starting a pack of pill two weeks after my periods. After completing the pack will contraception start? Do I need to take the 7 pill free days after the first pack? Will remain protected during those seven days? ### Response: Hello. I guess you are taking combination pill that is hormonal contraceptives containing both estrogen and progestin (synthetic progesterone). These act by preventing your ovulation and making your cervical mucus thicker. You need to take combination pills within five days after the start of the period. Then, you need not follow other means of contraception. You may start combination pills at any time and only concern is that you will be protected from pregnancy 7 days from then. Some measures you need to follow. You need to ensure that you take these pills regularly at the same time each day. If you vomit immediately following pill consumption, then take one more pill. You should not miss the pill. If you miss a period, then do not panic as irregular periods are common. You need to confirm by urine pregnancy test ." "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 get pain in my joints like ankle and wrist occasionally. It goes off when I take Mobizox but comes after a few days again. Also, it goes off when I do massage or when I use compression glove. My uric acid is 10 mg/dL, and it is in a higher range. Does this pain occur due to increased uric acid or it is some kind of arthritis like rheumatoid? ### Response: Hi. You have arthralgia, and it is not arthritis. This condition will have pain along with swelling. It is unlikely to occur due to uric acid. You need to do a few tests which include RF (rheumatoid factor), ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), anti-CCP (anti-cyclic citrullinated peptide), vitamin D levels and TSH (thyroid stimulating hormone). There is a possibility of early inflammatory arthritis which can be confirmed by the tests mentioned above." "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 30 years old. My weight is 140 lbs and height is 6\3"". I am doing a computer-based job. My diet is poor for the past 2-1/2 years. As I often work at night my sleep too gets disturbed. I am single and never had sexual contact with anyone. There is no history of skin disease, smoking and alcohol. My current issue is, I have a wart-like growth on the penis. It is located on the shaft, middle of penis, slightly towards the right side. I have this for over 20 years. It has never been carried over or has affected any other area of my body. There are no such growths anywhere in my body. I first observed it when I was 8 or 9 years old. It was neither painful nor caused discomfort. It is a flat, long hard mass appears as if inserted into pinched skin. Three years back, I had a very slight negligible discomfort after a long period of erection. When I was pinching, it came out of the sleeve of skin. It was growing in and detached from the body. It actually did not grow down into the penis, rather perpendicular. Six days ago, I had a long period of erection. Afterwards, the sensation of very slight pinching, localized pain focused on a few millimeters deep where the growth is. It is still there, but not bothering me much. But, this time it is slightly higher on the sensation scale and it is not going away.I have noticed some increase in the width. I am trying to keep it clean by frequent washing. There has never been any bleeding, redness on or around the affected area. It does not cause any problems in full erection. In fact, I feel less discomfort in full erection. Is this a wart? Is this dangerous? Would it be contagious to my sex partner? I am scared of surgery and I really prefer something non-invasive. Please suggest any topical cream or oral medication? What would be the expected time frame of recovery? Is prevention possible? It is quite close to the dorsal vein. Would it have any effect on the neurovascular bundles? Please see all the attached images. I am paranoid and scared because I think this will make my life very hard. ### Response: I have gone through your history and relevant pictures (attachment removed to protect patient identity) and I appreciate the same. As I can see that you do not have any signs of wart or contagious disease, please relax. The lesion you are having is just a dilated hair follicle or pore which is not dangerous. It is similar to a black head seen on the face, but a bigger one. It is commonly seen as a single lesion and forms a canal in the skin which contains skin debris that is frequently shed. Occasional pain or irritation is because of the debris hardening and poking to the stretched skin. There is no topical treatment for this as the creams cannot reach till root of the canal. The only effective way is to get it excised and sutured. It is a very simple and affording procedure with hardly any recurrences. Please go ahead with the surgery as it does cause irritation during erection and intercourse." "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 21 year old female. I am seven weeks and two days pregnant today. I woke up this morning bleeding. It has been constant as if I were on my period. I called my doctor, but got no response. I do not know if I should go to the ER or not. ### Response: Hello. How are you doing? Hope I have clarified your query. Do write back if you have any more queries. All the best" "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 detected with a dentigerous cyst and compound odontoma inside my lower gums. I have been advised for removal of the cyst and to have a biopsy of the cyst for odontoma. I do not have pain and swelling. I visited a dentist before few months where I took an X-ray. We found a small dark area in the X-ray. It was an odontoma with an unerupted canine. It was confirmed again in a CBCT scan. The results came with a dentigerous cyst and odontoma. I am scared of the surgery done under GA. Is it necessary to remove the cyst?Surgeons suggest me different opinions. One oral surgeon is implying for removal of the cyst, odontoma and placing a plate on the canine. Another surgeon is recommending for the removal of the cyst and odontoma. Another dentist says me to wait and watch as it is asymptomatic. I am attaching my reports. Please suggest. ### Response: Hi. If the cysts are small, they can be left untreated. But the problem is that the cysts can create an infection later. They can also cause more issues like tooth mobility, bone loss or any other transformation. So it is better to remove it. Odontomas are developmental. They also create problems when they are left untreated. But again, there are chances of cyst formation and expansion later. So, if the oral surgeon suggests for removal of the cyst, try to go for it. I have gone through the reports (attachment removed to protect patient identity). It is better to remove the cyst. Currently, you do not have problems. If it is left untreated, it can form ameloblastoma in the future. You do not worry. These cysts are found in any person due to the impacted tooth." "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 husband has been voluntarily admitted into a mental health hospital for loss of reality, confusion and self-doubt. He has been diagnosed with schizophrenia and bipolar. However, his triggers and signs started eight days ago and they are working with the medication. However, he did not sleep for the last eight days and is deathly concerning me. Am I over reacting? Do I trust that he will be monitored? Even the sleeping pill they are giving him is not working. ### Response: Hi. If he has been diagnosed with schizophrenia and bipolar disorder, then his sleep disturbance is expected. There is reduced need for sleep in bipolar mania. As he is in the admission, I do not think there is a need to worry. They will treat him with proper guidelines and if needed, they can use injectable antipsychotics, which will help him in sleep. He is on Invega or Paliperidone and if the medicine is not resulting in proper improvement, then the best is to change the medicine. Risperidone, Olanzapine, etc., can be used, which are more potent and help in controlling the symptoms with improvement of sleep. You can talk with his doctor for these medicines." "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 31 year old male. Recently, I have been diagnosed with tubercular lymphadenitis and started the treatment three days back for TB. My USG whole abdomen reveals hemangioma of the liver. I have pain in left side below ribs which radiates to back and a couple of months back on CT scan done for other reasons showed stomach rugae thickening. Now my question is what is causing the pain? Can stomach rugae thickening cause pain in that area? What is the treatment of stomach rugae thickening? Please suggest medicine for it. One of my brothers who is a pharmacist suggested Pantoprazole and Acogut 100 mg tablets. Is it worth taking the medicine for stomach rugae thickening? I need your suggestion. Can bacterial infection like tubercular lymphadenitis cause mild splenomegaly? ### Response: Hello. Rugae thickening by itself is not going to cause you stomach pain. Such thickening is usually normal or a result of hyperacidity, or rarely Menetrier disease. Now, first of all, you need an upper gastrointestinal endoscopy as well as a biopsy to rule our H.pylori infection and other causes. Tuberculosis can also cause such thickening. It is unlikely that tuberculosis would cause mild splenomegaly. However, it is important to see if tuberculosis has involved spleen also. You can take the medicines suggested by your pharmacist but cross check with your doctor in case they have given the same with your tuberculosis medications. I hope it 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 had a blood test today and the results show hemoglobin is 18.05 and the RBC are 5.8 and hematocrit is 42 %. Should I be worried? ### Response: Your hemoglobin and RBC are certainly high. So your diagnosis can be polycythemia. It can be secondary erythrocytosis for which you can investigate with EKG and chest X-ray to rule out the cardiac or respiratory cause. Kindly provide your full CBC report and any clinical history if present to guide you further. After your reports and total WBC count review, I can 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: I am almost 22 and I am pretty sure I have rosacea. My face gets flushed frequently around my nose, a small part of my forehead and chin, particularly during summers. I also get small pimple-like bumps on the red areas, especially my nose. Sometimes the tip of my nose also swells up a little. And a small part of my chin is bumpy almost all the time. I have also noticed that my skin has become a little leathery. Like it has aged. This has been happening since two years now. Although it was more noticeable last summer. It seems to go away during winters. I went to two different doctors, two times to each. One of them said it is age-related. And the other one just gave me an allergy medication. Which did cure my condition. But the symptoms started to appear again once I stopped taking the medication. What should I do? ### Response: Hello. I would suggest you attach your clinical picture along with your query so that it is convenient for me to comment on your condition." "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 having an issue for two months on and off and I need help with identifying it. I have been constantly feeling the need to go to the toilet when nothing comes out and it is a burning sensation when I do. Also, a lot of white thick discharge comes out too. ### Response: I understand all your concerns. From what you mentioned, you have urinary tract infection. UTI causes a burning sensation while urinating, frequent urination and change in the color of the urine. Sometimes, there is a pain in the lower part of the tummy. A short course of antibiotics will improve the condition" "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 herpes 2 and have taken Valtrex for three years faithfully and last outbreak was two years ago. My labs show that my numbers were very low. Trying to explain to a new partner:Never have sex if I have an outbreak.Condoms are recommended by doctors for all sex because there is the possibility of transmitting HSV even if there is not an outbreak. He thinks this is excessive and unnecessary because it is a legal issue of liability. He also thinks he is smarter than doctors.My question is that if we have unprotected sex during a non-outbreak, is it 100 % certain that he will get HSV? We read that his hands touch my herpes outbreak area, he could wash his hands after and he would not get HSV. Does this apply to his tongue to the same genital area, just cleanse the mouth and teeth and what if there is no outbreak, is oral sex safe for him? Yes, we know about dental dams. ### Response: Hello. Regarding your first question, it is better to avoid sex during an outbreak because there is a high risk of transmission during this period. Also, it would be painful to have sex if lesion involving near the vagina. Next thing, it is possible to acquire an infection during non-outbreak duration as there is asymptomatic viral shedding although the risk of infection is less. So it is better to take precautions in order to avoid transmission. In hand, we have a protective epidermal layer, which prevents direct transmission of viruses unless there is a break or wound. But, same is not true for tongue and mucosa as there is no protective layer. So, it can directly transmit infection. So oral transmission may occur irrespective of washing teeth or tongue" "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 fluctuating elevated blood pressure for three to four years between 135-180/85-112 mmHg. I did not take any medication. I have had episodes of sudden fainting, pain and burning in the chest. When tested, ECG was fine. But four days ago, it was different. I had felt extremely fatigued for two days, then I felt pain in my center and left side of my chest. My hands seemed numb. I had periodic episodes of cold sweats on the back of my head and neck, as well as a dull ache in my left upper shoulder. The heaviness was there also. This stayed off and on all evening, during which I took two baby Aspirin, which provided a little relief. The next day, I was still very tired and my chest was sore. The pain was sporadic in my chest, like a quick stinging pain. When I tried to do anything, it would try to start again. During this time, my blood pressure reached its highest at 167/112 mmHg. The third day I felt better. I am currently on Zoloft 100 mg once daily.Does this sound like a heart attack? I was terrified. ### Response: Your symptoms are not typical of a heart attack. They seem to indicate musculoskeletal pain or inflammation. Is the pain triggered by deep breathing or body movements? This would be another argument in favor of a musculo-skeletal pain. The increase in blood pressure values during these episodes is a normal physiological reaction to the pain. So, there is nothing to worry about. Anyways, an exercise cardiac stress test would help reassure you that nothing bad is going on. Regarding your blood pressure values, I would recommend you to measure your blood pressure frequently during a week and write those values down. If blood pressure values are frequently above the normal ranges (140/90 mmHg), antihypertensive therapy may be 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 am a 25-year-old male, around 199 cm tall and 85 kg weight. I have been playing sports when I was young (volleyball, tennis, and basketball) and I was fit for a long time. However, since I started with higher education (around six years ago), I tended to study in a semi-bent position in my bed. Recently, I started feeling a dull pain on the right side of the bottom of my spine, which persists until I either bend my spine upwards with a pillow or sleep.I also have to note that I sleep on my side, with a pillow between my knees. When I walk, this pain in the side of my spine increases (I do not feel any unbearable pain, it is just uncomfortable), but I feel a sensation from that spot in my spine to the bottom of my right leg (on the back side of it, mostly). Does this seem like a common issue? If so, please tell me what exercises I can do to prevent my spine from going bad? I am in a period of intense exams, and I need some advice on how to stop this pain? ### Response: Hello. I read your concern. I feel the pain what you describe is due to bad posture adapted all these days. It could be a neural pain due to any disc issue and may not be a worse prolapse. This may warrant a thorough examination of your spine and hip. As of now, I recommend you to do spine extension with pillows frequently, avoid the semi-bent posture which gives you the pain. Do certain glute and core stability exercises. Keep a lot of icing often like once in two hours. Please do revert back to me after two days and let me know the status of the pain." "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 painful lump on my perianal area. I shaved on Friday and at first I thought it was only an ingrown hair but I am not sure anymore. For the last two days, I have been working sitting for many hours and it became very painful and swollen. I do not know if it is an abscess. Please help. ### Response: Well, I do not know the particulars of your case, it sounds as if you may have what is called a Bartholin's cyst. This represents inflammation of the glandular structure in the perianal area in women. It is generally benign but can be very painful and uncomfortable. Try sitting in a warm tub with warm water several times a day or applying warm compresses to the area such as a warm cloth for about 15 minutes and as it may bring down the inflammation. If that does not work then you should probably see a local doctor who has other methods of bringing down the inflammation including the use of antibiotics." "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 my last molar extracted about a year ago, and never had my top wisdom teeth pulled. Is it possible for my wisdom tooth to try to come down in the empty space that the molar was extracted? I have a swollen jaw and slight pain when touched. ### Response: Hello. I understand your concern. When a tooth is extracted, the opposing tooth tends to compensate by over erupting, since there is no stop for the tooth to rest on. This is called as supra eruption. From your query and the details provided, it looks like your upper wisdom tooth is supra erupting and is infected. The only option is to get that tooth removed. If the pain is quite disturbing, you can take mild painkillers like Acetaminophen (Paracetamol) or try warm saline mouth rinses thrice daily. During this pandemic (Covid-19), dental offices are instructed to provide emergency care only. So minimal and non-emergency procedures are generally postponed three weeks later for now. You can call your dentist or the nearest dental office and get an appointment if the pain becomes unbearable. 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 urination problem from six months. There is no urine build up during the day. But while taking bed rest in the day, I have started to urinate more frequently. There was no problem in the morning. I got a checkup done. The ultrasound, urine test, and blood test were normal. Now, I have no urine in the morning. A very small quantity of deep yellow colored (very concentrated) urine with no pressure in the morning. After two hours of taking tea and water, I urinate frequently. There is normal urination during the day. I am under deep stress and anxiety. Sometimes, I feel puffiness on my face and sometimes mild swelling on my legs after sitting for a long time in one place. There is no swelling in the legs while moving. I am sending my latest report. Please suggest me is there anything to worry. I am on Alfuzosin, Clonazepam, Alprax, and Sertraline. ### Response: Relax and do not worry. Your problem is not big. I have seen all the reports sent by you (attachment removed to protect patient identity). It is perfectly fine. Regarding urinary complaints, it looks like the side effect of Clonazepam and Sertraline tablets. These tablets cause decreased urine production and hence your symptoms. I suggest you maintain a bladder diary for three days. I suggest taking tablet Dytor (Torasemide) 10 mg at bedtime. This will improve your symptoms" "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 20 years old, type 2 diabetes patient. Please give me information about diabetes. Every morning, I do running around 2 to 3 km. ### Response: Hello. However, if levels" "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 78 years old. She has high BP and diabetes. She takes regular tablets. She gets UTI at least once a year. She is currently complaining of a burning sensation all over the body. During the daytime, she passes very less urine. But during night time, she is going very frequently. I have uploaded her urine culture report. Please suggest. ### Response: Do you have sonography of abdomen? If not, please do an ultrasound of abdomen with post-void residual urine to rule out any physical cause of UTI (urinary tract infection). As per the history, you can give tablet Levofloxacin 500 mg once daily for seven days and tablet Cranpac (Cranberry extract) twice daily for 30 days to prevent UTI" "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: What does it mean when you have hurt your foot? It is not swollen but it hurts. ### Response: Normally, when the foot is twisted, it is likely to have a soft tissue injury like sprain of the ligaments. If you have flat foot then minor twisting can also lead to hairline fracture and sprain. Although both the conditions will cause swelling, in your case no swelling is present but throbbing is a sign of inflammation. So, start anti-inflammatory treatment like Diclofenac 50 mg or Ibuprofe twice a day. Get an X-ray done to look for a repeat fracture. Use ice packs. Tie bandage under guidance of an expert as correct positioning is essential and pain relief sprays for local application. Give the foot adequate 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 suffering from vomiting, and when the vomit came out, with vomit some tissue also came out from my mouth. And now, I am feeling something held into my throat. Please help. ### Response: Hello. If you are suffering from vomiting for a long time, you should do some examinations and consult a gastroenterologist. A fibrogastroscopy (endoscopy of your upper gastrointestinal tract), is needed to determine the pathology. If you have had a history of intermittent stomach pain or ulcers or if you have bleeding in your vomits or stools, you also have to go to the ER and consult your gastroenterologist. If none of the things mentioned above have happened, do not worry." "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 weeks ago, I fell down while mountain-biking. I went over the handlebars and hit my head and chest. I was wearing a helmet and a chest protector and both of them had cracked as a result of the impact. The helmet strap had strangulated my neck pretty hard. Ever since I have been continuously having sensation pressure at the place where the strap had impacted. Activities like turning my neck, yawning, laughing cause some pain. Over the past five weeks, the symptoms have not improved. I am very worried because I am afraid I might have to deal with this forever. They did a CT scan and said that it was normal. Should I ask for an MRI? Could this be some kind of hernia? ### Response: Hi. Sorry to hear about your injury. Since your CT (computed tomography) scan is normal, it is very unlikely that there is any bony or skeletal injury hence reducing the possibility of something permanent. It appears that there is some soft tissue injury in the laryngopharyngeal region or a cartilaginous injury that is resolving very slowly. This indicates an injury closer to the voice box region because of constant movements during speech, laughter and swallowing delay recovery. This may also explain why it is taking so long to heal completely. In my opinion, an MRI (magnetic resonance imaging) is certainly indicated since there has been no improvement in symptoms for five weeks and to look for cartilaginous injury or soft tissue lesions such as a granuloma or hematoma following trauma. In addition, a video laryngoscopy performed by an ENT will help to evaluate the voice box and supporting apparatus internally for any injury (specifically the inter arytenoid region). A hernia in the neck or a laryngocele may be a possibility following neck injury but seems very unlikely in your case since there is no visible bulge in the neck which worsens on coughing, etc. There may be an internal laryngocele that may be picked up on video laryngoscopy. 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 feel headaches for the last five days after reaching home from the office at about 7 PM. What do I do? ### Response: You have to rule out hypertension by measuring blood pressure. It is advisable to check your blood sugar levels and hemoglobin level as well. Sometimes, a headache can be from a tension headache because of constant work in the office. I suggest taking Paracetamol SOS for that. But, I suggest you consult a physician for examination first. Kindly mention any other specific history if available to comment further. Also, mention whether your headache is unilateral or bilateral and if it is throbbing in nature" "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 herpes zoster. Should I consult a dermatologist or a general physician? My age is 24. What kind of diet has to be taken? ### Response: Hi. Herpes zoster is a dermatology condition. It is a viral reactivation. It has to be treated as soon as possible to prevent the postherpetic neuralgia (residual pain). It is the varicella virus, not related to diet. You can continue taking your regular diet with 2 to 3 liters of water per day. Need to avoid excessive physical work or exercise. Rest is very important." "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 one be color blind if one has 20/20 vision? ### Response: Well, for your knowledge color blindness and color deficiency are two different things. You gain color vision due to cone cells in your retina. True color blinds see only black and white. They have no cones or have only blue cones. This is rare and they do not have 20/20 vision they nearly have 20/200. Most others are color deficient people; however, it is erroneously used as a color blind. They have either two types of cones including the blue and all three types of cones. They see the world colored but they have issues with color discrimination. They can have 20/20 vision" "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 is a 33 year old female. She has spots of brownish skin discoloration over her right forearm, about 10x5 cm, not raised, not itchy. She does not have a history of medicine use, no recent investigations, not pregnant or lactating. She has no similar lesion elsewhere, nor does she have any other skin manifestations. ### Response: I have seen your query and concern. With your descriptions, it is not clear the discoloration is in which form. Is this hypo? or hyperpigmented? or depigmented? One thing is clear that it is asymptomatic macule. There are N number of macular diseases. I need a detailed history and possibly pictures if you can share. Please get a review with pictures for better evaluation and best possible treatment of your concern. 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 am in the process of getting ready for a dental bridge, a total of seven teeth order of porcelain fused and then a crown, etc. Now, tomorrow I am supposed to get a temporary bridge. I got a call today that they are going to prepare my teeth tomorrow and go ahead and do permanent bridge but the price is still the same. Does this sound correct? I was charged including a temporary bridge but now I am not getting one, just permanent. ### Response: Hi. Your temporary bridge was just for the time being that your dentist might have thought permanent will take time for fabrication, so temporary was only for your comfort and esthetic issues. Temporary is generally given if there is a delay in permanent and to check if the patient will be comfortable with the size, color and all or not. It is good that your permanent bridge has been fabricated before time, you just need to take this much care that when tomorrow before fixing permanent finally you will be asked by fitting it in your mouth if it is proper in size and comfortable or not, so be very fair to yourself and your dentist and do tell him or her whatever you feel so after that it will be their duty to fix it up whatever problem may arise." "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: For the past three days, I am having pain in backside of my neck. The pain actually is not in the complete neck it is in a part from neck to mid of the back. When I turn my head to the left it is a kind of electric shock feeling. This may be because of some sleeping angle, I do not know but I am feeling it very badly. The pain I feel is from goes from neck nerve at the back to the left arm and down to neck till the middle of back. From today morning I have a little headache. Also, I am diabetic. Please help. ### Response: Hello Are you using a thick pillow? Neck muscles seem to be in spasm. Muscular spasm. Give elaborate history on any medications you are allergic to or taking at present." "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 5 years old son has a problem in one tooth (second last on down left side ) and doctors are suggesting for RCT (root canal treatment). I have attached the pictures to this query. Here are my questions:Can RCT (root canal treatment) be done for a 5-year-old child?Will it affect his next teeth (at around 7 years of age)?Is there any alternate for RCT as he is least cooperating? ### Response: This tooth is a milk tooth which will fall off in around 10 to 11 years of age (attachment removed to protect patient identity). So, till then to save it, you have to do a root canal treatment. Root canal treatment can be done on a child if he is cooperative or at least parent approves. It will not affect the permanent tooth which will come out below this around 10 years of age. So do not worry. It is advised not to extract this tooth at this age as it will affect the normal growth of jaw" "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 thermal shock and I felt like I am dying. They took me to the hospital and she was there and saw me and the whole situation. I was not able to move my body. She was shocked, she was not able to say a single word just watching them taking care of me. She spent all the night crying. She could not stop herself. I called her all the night and tried to calm her down and tell her that I am okay and everything is fine but she could not stop herself from crying and she told me that she feels guilty because she was not able to do a thing while we were in the hospital.Since that day till now every night before going to sleep she starts feeling scared and sometimes she starts crying and when I ask her why are you crying she says I feel scared and I cannot forget the day I saw you in hospital. I thought it is just a matter of days till she forgets the whole thing but yesterday they called me and told me that she has lost consciousness while working. I went to her and she told me she felt like choking and her heart beats rate were so high and she felt cold. The doctor told her that she is fine and she may be so stressed and would have had a panic attack and this could have lead to such behavior. I told her that we need to go to a psychologist but as expected she refused and she told me that she can handle but I need to be around all the time whenever she calls or looks for me. I thought of taking her out to change her mood, going to walk or the gym to release the stress but she keeps refusing and telling me that she wants to stay in her room and she does not want to be around people. She just wants me next to her. That is all. What scares me the most is that she might have physical issues, feeling tired, and panic attacks add to the random high heart beating rate. Please help me. ### Response: Hello. The condition of your electric shock is stress for her and guilt is also present that she did not do anything to save you. These are creating severe stress to her. Maybe she is having flashback episodes of those events in the night time. Internally she has accepted that she is responsible for all those events. The best way of treating her is psychotherapy and medications. Stress. Depression. Psychotherapy with pharmacotherapy." "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 experiencing foamy urine since last six months. The froathing in the urine has considerably increased in last one week. I often also notice dry mouth symptom. I had undergone a kidney function test a couple of times and reports were normal. I am not diabetic nor any other history of medication. My age is 38 years and weight 88 kg, height 171 cm. ### Response: I have gone through your query and the attached reports (attachment removed to protect patient identity). Your reports are mostly within normal limits, there is nothing to explain about the foamy urine in it. Ideally, I would like to examine you to see whether you have any signs of dehy" "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: One of my front bottom teeth feels ever so loose. I give it a gentle push with my tongue and feel a movement sensation. However, when I look at it in a mirror and try to wiggle it to check if it is definitely loose, you cannot see it moving at all, nor can I feel the sensation mentioned above. Is what I have just a loose sensation or is the tooth actually loose? I brush twice daily and use mouthwash once a day. If I continue my current cleaning regime, will the tooth tighten back into place? ### Response: Hello. I understand your concern. Unless the tooth is visibly moving there is less to worry. The sensation you are feeling could be due to a number of reasons like less space for the tooth to be in position (crowding), excessive force from the opposing teeth (trauma from occlusion) which leads to swelling of the structures supporting the tooth, an infection to the minute fibers which holds the tooth in position or certain habits (grinding). A consultation with your local dentist is recommended. The treatment depends on the underlying cause and needs an in-person consultation. You may practice the oral hygiene you have been following." "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 viral fever six years back. I had a very high temperature of 105, bad cough, also hallucinations. I was seen in the hospital by a CDC doctor and was told I needed to see him a month after I got out of the hospital. I saw him and asked him what I had, and got no answer what so ever, I was still feeling pretty bad. Later that year I had my left knee replaced, and other than some side effects from the anesthetic everything went well. I had some slight balance problems, and a slight tremor in my right hand for about three years before the virus. I went to a neurologist and was told it was nothing. Last month I had my right knee replaced, and within a few days I had a severe tremor in right hand, weakness on the right side of my body, and was dragging my right foot, and severe speech problems. My wife took me to ER as she thought I was having a stroke. I was in the hospital three days, and was told it was stress and was given a script for CARB or LEVO ER 25/100, told to make an appointment with a psychologist, and motion specialists. I was able to see a motion specialist, and was diagnosed with Parkinsonian features affecting balance, gait, aphasia, apraxia, and was told this was brought about by the virus I had six years back more than likely. I get a fairly good response from the medication once it kicks in. I have some pain in my joints, and suffer a low-temperature fever about three nights a week, and have been getting speech therapy two times a week. I can no longer work and wonder if you have any experience with this. I have had MRIs and DAT scans which are normal. ### Response: I want to assure you that do not 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. Started back even before six years you had the onset of what we call Parkinson disease. This is a disease, nobody may ever be able to stop or make it to a pause even with medications. But we may delay the onset of symptoms of the disease for sure.The dopamine-producing neurons are lost in the brain and the patient loses the inhibitory effect of the neurotransmitter dopamine on our activities. The patient presents with unintentional movements of body parts which were normally kept in check by the inhibitory action of the brain chemical dopamine. In treatment, you are taking the best available therapy LevoDopa-CarbiDopa. You need to carry on the treatment. This will help you keep the symptoms suppressed for as long as you keep taking the medicine.Temazepam is also good for you. It is a second line" "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 was operated on 18th July for cervical cancer (Wertheim\s Hysterectomy).The operation was successful and she is fine and recovering.After the surgical biopsy, they declared it as stage 2B.Further we sent her slides to the laboratory for review and there they found the left parametrium free and right parametrium with few tumour cells that are non-reactive.The report states, ""right parametrium show few tumour cells, however no reaction is seen against these tumour cells, thereby interpreted as floater"".Can you please throw some light as to what do the above statement means in the lab report?What impact does this statement make in relation to the staging of tumour? ### Response: Hello. I went through the reports and my opinion is as follows: Diagnosis is that of squamous cell carcinoma of cervix, moderately differentiated, non-keratinizing type. Your mother has undergone Wertheim\s hysterectomy, also called radical hysterectomy. This is the surgical procedure of removal of the womb along with some of the surrounding structures. Tumour cells, at any location induce inflammation. They are foreign cells, so some amount of inflammation will be found around the tumour tissue. During the time of taking bits of tissue for histopathology reporting, some tumour sections stay back in the sectioning area. These can attach to other areas and can present as tumour tissue. These are called as floaters. Parametrium is the fibrous tissue that separates the cervix from the bladder. The above mentioned tissue is found in the right parametrium and hence interpreted as floaters. Also during sectioning times, tissue overlapping can occur. Here the tumour tissue is attached to the parametrium, thereby being interpreted as parametrium invasion and hence changing the stage of the tumour. Unless tumor cells with surrounding inflammation are present, they would be floaters. Here it is only an overlap. Lymph nodes are not involved. So further treatment will not be necessary. Consult a surgical oncologist online for further follow up" "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 stiffness and numbness in my hands and legs for past six months and so I cannot pick up any object properly because they slip. Before seven months, my B12 was 211, then I started to take supplements, and now it is 2000. Kindly help. ### Response: You are suffering from weakness in both the hands and legs. It appears like you are suffering from peripheral neuropathy. I have seen your reports, sugar is normal, B12 was low, but now it is normal. And many other routine reports are normal. My advice to you is to go and consult a neurologist or neurophysician. It is not a straightforward disease or vitamin B12 related. Please do NCV (nerve conduction velocity) or EMG (electromyography) and if necessary, go for nerve biopsy." "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 daughter is 18 years old. She is diagnosed with microcytic hyperchromic moderate anisopoikilocytosis. Please tell me, what it means and what is the condition. ### Response: Hello. What you have described above is a description of red blood cells seen on a peripheral smear. This means red blood cells are smaller than normal with less hemoglobin in them and there are variations in their size rather than them being uniform. A complete blood count and good peripheral smear can help in this. This picture is usually due to iron deficiency anemia which is common in the young adult group. And it is often gets reversed with iron supplements." "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 a lot of pain and burning in my chest. I had an ECG done about 20 days back which was normal. I have pain on the left side, (it is like on my breast) sometimes I feel it moves. I have been suffering from this since more than a year. Last year, I went through a complete evaluation and my ECG, 2D echo and TMT were normal. I was diagnosed with acidity but not on any medication now. ### Response: Such a long duration of the pain and pain which increases on movements or pressing over the same site is usually costochon" "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: Do Zoloft cause muscle pain and cramps or tingling? ### Response: Hello. Yes, Zoloft (Sertraline) may cause muscle cramps, tingling by disturbing blood sodium chloride levels. Zoloft is an SSRI (selective serotonin reuptake inhibitor), which may cause a disturbance in these ions (sodium and chloride) hence may cause it. Get the blood test done serum sodium and serum chloride, or you may try increasing salt intake in your diet. Which if improves your problem then it is undoubtedly due to low sodium and chloride." "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 severe acne in my face. I am using Erytop cream daily at night time for the past three years. Please suggest me a better solution. ### Response: Hi. Treatment of acne varies according to the severity of the problem. Topical medicines alone are helpful for mild acne. For moderate to severe grade acne, both oral medication and topical treatment are effective. Topical treatment of acne comprises topical antibacterials like Clindamycin, topical Benzoyl peroxide and topical Retinoids. Oral therapy includes oral antibiotics like Doxycycline, Minocycline, Azithromycin, and Oral Retinoids such as Isotretinoin. Acne scars improve a lot with chemical peeling. Other methods used to improve acne scarring are dermabrasion, micro needling, and fractional CO2 laser. I would be able to guide you better if you upload a picture of the acne affected area. So that, I would be able to judge the severity of your acne and acne scars, and I can guide you appropriately." "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 32-year-old female. Last night out of nowhere I started having a pain suddenly under my ribs on the left side. About an hour later pain developed in my upper back on the left side. I did not fall or lift or hit anything that would cause this pain. Currently, there is no nausea or vomiting. I know this pain is much different from any other pain I have felt. The pain seems to be connected as it is wrapping or radiating around from the abdomen to back. While the pain is not yet excruciating it is still very bothersome and uncomfortable. I could compare the feeling to beg deeply bruised. It almost feels like I was kicked hard in the abdomen and back. I am dealing with something autoimmune but right now it is labeled as UCTD (undifferentiated connective tissue disease). I think it could be related. My concern is that it could be pancreatitis. Do I need to go to the ER? Does pancreatitis progress slowly? This is day two and I do not want to get to the point of excruciating pain. ### Response: Hello. I read through your concern. The pain what you experience may not be due to pancreas as you feel as usually it will get referred to the right side. There is something like spasm between your intercoastal muscles that will lead to same symptoms and pain that you described, and limited movement of ribs to give rise to associated stiffness and pain in thorax and abdomen. So, I recommend you to keep icing over the painful area." "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 and my friend involved in physical intimacy a few days back and there was no ejeculation and penetration was only for 2 minutes. After that considering precum she took Unwanted 72 within 3 hours. She had bleeding after six days. She has regular cycle of 28 to 30 days and her last period was 30 days back. She did not have period till now.We performed urine pregnancy test at home. All are negative. Is it confirmed that she is not pregnant? If yes, how long ideally she should wait for period after bleeding? Is there any medicine required? ### Response: However, the conclusive test for ruling out pregnancy remains serum beta hCG test which is a blood test. if hCG levels are less than 5 mlU, then she is surely not pregnant. Also, now she should be expecting her menses only after 10 more days as she had her bleed marking the start of her fresh cycle. Just get the serum beta hCG test done to get conclusive results. She can wait for her menses." "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, who is 10 years old, is suffering from skin problem like a tiny bumps in hand, finger and lower part of feet. There is mild itching. The old eruption dries and disappear. There is no fluid sac in the new bumps. Earlier we applied Ascabiol lotion for 5 days and then started Permite lotion. Also, given half tablet Levocet and applied Lactocalamine after a bath. ### Response: Hello. I have read your query and seen the attached images also (attachment removed to protect patient identity). I understand your concern for your son. As per details, there are the following possibilities for your son\s condition: 1) Scabies - It is characterized by fluid-filled lesions or red bumps or excoriated marks over the body. You have given Permethrin lotion for the same. However, itch and symptoms may persist for a month or so. 2 ) Atopic dermatitis - It is an allergic condition of the skin characterized by a variable rash. In this, the child has sensitive skin leading to the appearance of rash with an itch on exposure to allergens. I would advise you to apply a cream containing antibiotics and steroid-like Futop B cream (Fusidic acid) over the affected area. Avoid the use of harsh soap or chemicals to avoid precipitation of allergic reactions. You should visit a dermatologist in person for proper examination and evaluation. You may discuss my opinion with him." "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 part of my skin has become extremely sensitive for no apparent reason. The skin does not look different at all, and it seems to literally be the skin and nothing deeper or muscular. It is an area roughly 10 cm by 10 cm (~5\x80\x9d) on the front of my upper right thigh, the bottom of the area is around where my boxers end. I can clearly outline it by tracing my fingers up my thigh. If I just stand still, I cannot really feel it. Lightly tracing my fingers over it, even through my pants it hurts a fair bit. Rubbing and such hurts more. But applying a lot of pressure straight down does not make it hurt particularly more than the initial touch. Light-fast rubbing hurts the most. Walking or just moving also hurts because my clothes interact with the area. The pain feels sort of like burning, or like touching a burned part of your skin. It started two weeks ago, got worse over the first few days and now I am not sure if it is still getting slowly worse (more painful) or if it is just bothering me more and more. Any ideas? ### Response: Please provide a clear photograph for better understanding. With the description given it can be frictional dermatitis or tinea if it is itching. If there is no itching and only burning sensation, avoid friction of both legs by wearing suitable clothes and apply some moisturizers or aloe vera cream. If there is itching, try Miconazole cream 2 % for 10 days and see if there is any improvement. If there is a visual photograph then we can give better 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: My creatinine level is 2.0. What is the best medication? ### Response: This indicates diabetic nephropathy (attachment removed to protect patient identity). Metformin should be avoided in near future and consider replacing it with Insulin shots. Consult your Nephrologist to streamline your" "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: The patient is my wife.Patient age is 30 years, we have one child 2.3 years old and healthy. She was feeding baby till 2 years of her age. During pregnancy TSH was 5.7 and taken medication, after pregnancy, TSH became normal, stopped the medication as advised by the doctor. During pregnancy, heel pain was there continuously with coccyx pain. Did MRI whole spine, it was normal. Since last one month, there is no heel pain but while getting up from bed in the morning, there is a pain in both feet. She takes a few seconds to get up from bed in the morning only. She is taking Tayo 60k for seven weeks and one on monthly basis. She feels very low energy throughout the day with mild body pains. We consulted the doctor (general physician), advised CBC, TSH, vitamin D, vitamin B12. I am attaching reports. TLC was 3.97, after one week it was 3.56. Platelet was 125, after a week 158. As of now, I do not have any problem except weakness, mild body pains. Patient weight is 42 kg to 45 kg for many years. During pregnancy, it is 53 kg, now it is 43 kg. Height is 5 feet. My query is regarding TLC count and platelet. If we need some more investigations? If there is any abnormality then how fast TLC can go down. What is the reason for low TLC? Does she need to consult someone else? If after three months TLC count will be the same, is it worrisome? If it is not going down or up, is it serious? Assume it is the same for the next six months than what should I do? ### Response: Hi. Kindly find answers of your questions as below. Your total leukocyte count and platelet were low initially. But gradually it has been improved so suggest recovery of any unnoticed infection. Moreover, the peripheral smear examination report was normal (attachment removed to protect patient identity) and not showing any abnormal cells that warrant further investigation. You have to still repeat CBC after few days. The TSH is high, so hypothyroidism should be ruled out. For that repeat TSH estimation after few days and investigate with T3, T4 estimation as well. If there is any abnormality, then gradually all counts go down or high and peripheral smear shows abnormal cells if blood cancer is present. It is difficult to say one reason for low WBC. But the infection can be possible. If no cause is evident then ANA estimation can be done to do work up for autoimmune disease. If your CBC values do not fall within the range in the next few days then hematologist can be consulted for a detailed evaluation. If hypothyroidism is confirmed then Levothyroxine should be started." "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: The attached PDF are the results from CBC tests and Hb electrophoresis of a girl baby. The first CBC was done in one month, and the following CBC and Hb electrophoresis tests were done in two years of age. The tests seem to indicate that the girl is (at least) a carrier of the alpha thalassemia Hb constant spring (CS) mutation. I have two questions related to this.Is it possible to say from the test results which of the following Hb genotypes are possible?a)\t3 normal, 1 CS.b)\t2 normal, 1 CS, 1 deletion.c)\t2 normal, 2 CS.d)\tSomething else?What is the difference between a, b and c above in terms of expected symptoms later in life?Additional information: weight, height, and head circumference are normal. (14 kg, 88 cm, and 51 cm). She is taking Budesonide 200 ug and Montek 5 mg once per day. ### Response: Hemoglobin constant spring is non-deletional alpha thalassemia. This abnormal hemoglobin results from point mutation at the stop codon of the \xce\xb12-globin gene (TAA > CAA) which leads to the addition of 31 amino acids to a normal \xce\xb1-globin sequence. The heterozygous of Hb CS (hemoglobin constant spring) is clinically and hematologically normal with mild anemia in some cases as it appears to be in this case. Heterozygous cases have a good prognosis and a fairly normal life expectancy. The genetic abnormality can only be confirmed by genetic testing." "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 husband has mood swings. He feels either depressed or very much excited. He is very irritable and gets angry for small things. This has started before four to five years. He sleeps for very less hours. He also drinks alcohol daily and goes for late night party in the weekend. Currently, he is out of a job and trying to start a new business. Does he need psychiatric help? His father is also under psychiatric treatment. Is this genetic? ### Response: I read your query and understand your concerns. The information provided is not adequate to make a diagnosis. If he had frequent mood swings and lost his job due to mood swings or irrational decision, then there is a possibility of bipolar disorder where you have extremes of mood including depression and mania. The possibility of bipolar disorder is high as there is a family history and a history of substance abuse (alcohol), which compounds the problem. Out of 100 % with mood disorders, there is at least 50% have a family history of mood disorder. So, it can be said that this problem is half genetics and half environment." "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 two psychotic episodes last year and was diagnosed with schizoaffective disorder. I have recently prescribed Risperidone (1 mg) in combination with Wellbutrin (150 mg). One is a dopamine blocker while the other is a dopamine reuptake inhibitor. Would not these cancel each other out? ### Response: The short answer to your question is no. They do not cancel each other out. You may be aware that Risperidone (a dopamine antagonist) is prescribed as an antipsychotic and also helps to stabilize mood whereas Wellbutrin (Bupropion- norepinephrine-dopamine reuptake inhibitor) is used as an antidepressant. You need to be monitored for any potential side effects when you are taking a combination of these two medications. So kindly follow up with your prescribing doctor who will be able to review and titrate the dose accordingly. Also, inform your health care professionals if you are prescribed any other medication for other reasons." "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 about my soon to be 12-year-old son. Since he was 1 year old he has had febrile seizures about once a year. They only happen at night. When he is sick during the day I would give him Motrin or Tylenol. Through out the night and he would not have any symptoms. When he did not show signs of being sick that night his fever would spike. Two years ago we had his first video EEG and there were no abnormalities or no concerns. We did MRI, blood tests, and EKG all are normal. He had two seizures this year both while being sick. So the neurologist wanted another EEG. So we did a video EEG. The first night nothing looked wrong so she wanted to keep him another night. During the day he was getting sick he was running a little fever. So that night they choose not to give him Motrin to see if he would have a seizure and he did. It lasted a minute and was a full-body one. They looked over the tape and said there was no evidence of one coming on it came so quickly. They believe (but are not sure) that it came from the frontal lobe. They put him on Keppra for two weeks and then the doctor looked it over with her partners and they decide that Trileptal and Keppra would be what he needs. I happen to total disagree. He has never had a seizure during the day or one without a fever. I feel they so quickly diagnosed him with epilepsy without considering that all his tests are normal. That seizure they saw came on because we didn\t give him medicine for his fever. Which to me seems like he has the rare case of febrile seizures lasting till the age of 12 years. He did not have any seizures last year but just two seizures this year. I personally want to try and build his immune system to stop him from getting sick to see if that will prevent his seizures. His father disagrees with me and agrees with the doctor. I believe the side effects of both these medicine out way the actual problem. I am just overwhelmed and stressed. Because I do not know what is the right thing to do? Can febrile seizures last to the age of 12? Is it rare for someone to have a seizure maybe once a year then not have any, then have one the next year? Does the medicine he is on sound too extreme? Please advise. ### Response: I understand your concern. I would say that both you and your doctor are correct. Your doctor diagnosed epilepsy because: 1. Primary epilepsy is more common in those adolescents who had febrile seizures. 2. Along with the fact, the EEG (electroencephalogram) was supportive of epilepsy, because, the febrile seizure would not start in a single region and spread over. Your concern is also justified because: 1. The child is a very classic case of febrile seizures. 2. The night when the child had a seizure, the child had a fever and the anti-pyretic was not given. Have patience, as of now continue the medicines. But three months down the line repeat an EEG when he does not have any fever (after taking off the medicines in a controlled environment, if we can do sleep-deprived EEG, would be better) if he has an epilepsy syn" "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: This afternoon I noticed some pretty severe gum recession on my left lower cuspid (approximately 5 mm). As far as I can tell, it is the only tooth with any signs of gum recession, and I think it might be due to crowding (my lateral incisor and first bicuspid are slightly behind and might well be pushing forward) because of that. Is this an urgent issue for a dentist or can it wait, and if so, is there anything I can do to help the issue? ### Response: It is okay. You do not need to rush to the dentist. The clinical scenario of teeth that you told indicates that most probably this gum recession is caused by yourself. You brush like giving a slight high power stroke on right and left bicuspids and then with normal force on rest of the teeth. Because of high-pressure stroke, gums in that particular area goes down, causing sensitivity of tooth. Another cause could be plaque or tartar around that particular tooth causing gums infection that results in receding gums. But still, I think it is your brushing technique that is the main cause of receding gum. Tell me about it. You just have to change your brushing technique, do not do harsh brushing in that area. Take a soft bristle tooth brush. Avoid severe hot or cold food stuff till you visit your dentist. Rest treatment will be done later by the dentist and that could be scaling or filling of abrasion. Stay happy and blessed." "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: Before three days, I had a feeling in my eye that there was something in it, probably my eyelash. I tried to get it out with water, but the sensation did not go. After two days, I met a pharmacist who prescribed me an anti-allergy eye drop (containing Antazoline). I have been using it every three hours. However, the first time I used it, and then I woke up with a swollen red eye. Today is the sixth day of use, the redness has reduced, but the swelling is still there. The vision in the affected eye is now blurry along the side with a burning sensation on exposure to sunlight. ### Response: Hello. I would advise you to consult an ophthalmologist because the blurriness that you are now experiencing is more worrying than the swelling of the eyelids and redness of the eye. Please take some high-quality photos of your eye and send them. I will try and help you in the best way possible. Also, provide me with your body temperature." "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 extreme fatigue last month, so I got a Widal test, which was positive. I have had typhoid many times earlier, and two years back I got hepatitis. Last month I got LFT and CBC tests, and I am attaching the reports. LFT was normal, while CBC shows lymphopenia and macrocytosis, I showed these reports to another doctor, and he told me to get tested for HIV polymerase chain reaction test. I had sexual intercourse five months back, and I did the tri-dot test three times, but they came back negative. But, the doctor told me that tri-dot test is not reliable, so I should get a PCR test. Please help me, I am so tensed. I have a bacterial infection and itching on my back, which is not fading away. ### Response: I had seen the reports that you have attached (attachment removed to protect patient identity). With keeping my answer in mind, consult a nearby infectious disease specialist or physician for examination and treatment accordingly" "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 21 years old. Since childhood, some of my teeth are sort of crisscross. So the accumulation of food has led to yellow spots in some places. I brush once a day but properly. I consulted a dentist and she suggested me to get my teeth cleaned. But that is not a permanent solution. What can I do for permanent white and well-aligned teeth? ### Response: Your teeth are actually crowded. So, deposition of food and stains have lead to these brown marks on your teeth. What you have to do to make your teeth white is go for proper scaling and polishing, and brush your teeth twice daily regularly. Second Option, if still, it is the same, even after scaling and polishing, marks are not going, you can go for a veneer. Now let me ask you some questions. Are you a frequent user of some tea, coffee or black tea, beverages? Are you taking any medicines regularly? These all can cause these marks to appear again. Then for proper alignment for your teeth, you can go for a fixed orthodontic treatment. You can also use aligners if there is only a small difference in alignment." "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 brother has thalassemia intermedia. His Hb is between 7.8 to 9. Please suggest how soon he can recover from this. ### Response: Thalassemia intermedia is severe as compare to thalassemia minor. In this condition, episodic blood transfusion is needed, especially during childhood. Your brother can be prescribed iron tablets if there is no improvement then blood transfusion might be required. I hope I have answered your question. Let me know if I can assist 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: I have a few doubts regarding annual flu vaccine. Is it a must to get an annual vaccine shot every year? Is it mandatory for kids? What will be the effect if we miss the dose a year? As all the doctors are not suggesting the vaccine, I am confused whether should I get it for my 5-year-old son or not. He used to get cold and cough often till 4 years. But he is quite fine for the last six months without severe cold or a cough. Please clear my doubts. ### Response: Hi. I understand your concern. Flue vaccines are annual because every season there is change is strains of Virus. WHO notify six monthly which strain to be used for next shot. It is not a mandatory vaccine, but it is optional. I usually recommend to my patients if they have poor immunity. If the baby is healthy, no above risk factor, then you can exercise not to give. As flu is air born disease and kids are in general high-risk population, I would recommend. It will be safer to give." "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 itchy and reddish private part since last two months. I have pain at the tip of penis and during intercourse. I consulted a doctor, he suggested me AF-Kit. After taking this for one month it was just perfect. The symptoms returned again. I tried AF-Kit, but this time, the symptoms did not go off completely. Hence, after 3 weeks again I took AF-Kit, but symptoms still persist. Please suggest how to overcome this issue. ### Response: You are suffering from fungal infection candidiasis which is notorious for recurrence. The common causes of recurrence are: I will suggest you to apply Clotrimazole cream available as candid cream twice a day on the lesion. Take your AF-Kit (combination of Fluconazole 150 mg, Azithromycin 1 g and Ornidazole 750 mg) also. In case of severe itching, take some antihistamine once a 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 have a skin rash near my left ankle area. It is 5 cm long and 3 cm wide. The skin is very rough and dry. The area is very painful, and I am even unable to touch it. I also have a few white spots, which are filled with pus in the area. I am a 43 years old female, and I have no medical history. ### Response: Hello. Do you have any history of trauma or diabetes? You should try antibiotics for this. I suggest you try taking the following: Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. Hope this helps you and get back if you have any doubts." "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 has done a medical abortion at five weeks of pregnancy. At that time, her hCG level was 614. She had done abortion with the help of Mifepristone 200 mcg and Misoprostol 800 mcg. She took Mifepristone in the morning and after 24 hours, she took Misoprostol orally. After taking Misoprostol, within 40 minutes she started bleeding with clots. For four days, she got bleeding and then it stopped. Then again after seven days from the day Mifepristone was taken, she again did a blood test. At that time, her hCG level came down to 9. So, can you tell me if her abortion is successful? ### Response: If her hCG levels have gone down from 600 to 9, it means she has successfully aborted. No need to worry" "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 got married six months ago. My husband behaves weirdly in the bedroom. And he is using psychiatric medicine. Those are Limbitrol, Flutop 60, Prolol TR 40, Ventab plus from three months and Sildenafil too, but it is not effective.He keeps locking himself, avoids me, washing things repeatedly, repeats things and is scared when I am beside him. He is saying he does not feel like having sex with me. He says he is not getting erections. I asked him to take a semen test as well. The sperm count is 18 million and actively motile 5 % and asthenospermia. Could you please suggest whether he is marriage material or not. My in-laws blame me for not conceiving. ### Response: Your husband is suffering from some psychiatric illness most probably an affective disorder. Semen analysis report (attachment removed to protect patient identity) is suggestive of asthenospermia, that is, low sperm motility. But all these problems including erectile dysfunction if present can be treated and several treatment options are available. First of all make sure he is taking treatment from a psychiatrist and not from a non-specialist, that is, a general practitioner. Support him and say you are with him and motivate him to share his problems with you. Open communication is the key for a healthy relationship. Not having a baby is not necessarily your fault, asthenospermia is one reason, and also to have a baby proper sexual relationship should be there. To conclude, I would say that every problem has a solution. You just need to try solving it. Help is just a step away. Feel free to ask if you have any further queries" "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 back pain for the past three days. I do not know the reason behind it. I usually sit in front of a laptop for 10 hours daily. I have the pain while sitting or standing or when I bend. I do not have it when I sleep at night on the floor. Please help. ### Response: Back pain comes from fatigued muscles. Your back muscle gets relaxed at night. So you do not have the pain at night. Sitting for long hours can aggravate back pain. Poor posture while sitting can also lead to back pain. Do back extension exercise, and sit only for 25 to 30 minutes on the chair. Sit in a chair which is having lumbar support." "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 writing regarding the newborn screening of my baby. He was prematurely born at 29 weeks and spent 40 days in NICU. During his stay, we tested his hearing via OAE method. At first, both the ears did not respond and in the second screening, the left ear was perfect. But, there was no response from the right ear. After three consecutive failure of OAE in the right side, we went for BERA. However, BERA test showed no response in the right ear even at 90 dB. Hence, the audiologist recommended a review after one month. Now, I am a bit worried. What could be the cause for BERA failure? Kindly assist us to rule out the issue. And, what should be done to overcome this? ### Response: I have gone through the files (attachment removed to protect patient identity). Do revert back with all the details. Hoping to see your son healthy and good soon" "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 boy baby is 9 years old and is still passing urine on the bed while sleeping. While I discussed with him, he said he is not feeling. As per doctor suggestion I used to wake up him by night for passing the urine but it did not work. Day time he gets it urgent and runs towards the bathroom. Study time in one-hour minimum three to four times he goes to urinate. He is maximum time watching TV, and want to play game in cell or laptop. Her mom was also under psychiatric care for the last eight years after his birth. During that period while taking medicine she fed him also. I am not getting a solution. I have explained everything. I request you to suggest proper solution and steps need to be taken. ### Response: Hi. First, you have to rule out the organic or structural cause of enuresis, like urinary tract infections, obstruction, polyuria, diabetes, and any medicine. Second, if the organic cause is ruled out then you have to review the toilet training of your child, and medicine such as Desmopressin or Reboxetine are alternative. Also, behavioral therapy has a significant role like bell and pad system is effective in 50 percent cases. Also, limit the time spent on the screen like mobile or television, and it should be noted more than two hours 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 have been feeling some pain in my lower left abdomen for past three months. The pain is not intense though, and it does not disrupt my daily activities, though it comes for a few minutes and then goes. I did an utrasound scan, no stone was found, the radiologists said it might be a muscular pain as all the organs examined through the abdominal scan were fine. I did urine analysis (sample was taken after sweating from the heat of the sun), the result says crystals of calcium oxalate (+) was found. I took Buscopan, Amoxicillin and Ciprofloxacin. I need your expert opinion on this. ### Response: Relax and do not worry. Yes, it is possible that you may have a stone in the urinary system. Sometimes, stones get missed on ultrasound examination. I suggest you get plain CT scan (without contrast) of abdomen and pelvis region. It will 100 percent rule out the stone in the urinary system. If no stone in CT scan is there, then your pain is musculoskeletal origin" "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 24 year old female. My period has been late by 13 days. I am sexually active. I took a home pregnancy test but that was negative.My period has been fairly regular in the past with them happening 4 days prior or after my date. I have taken emergency morning after pill in the past (thrice in the last 4 months). What could be the reason? Is there a possibility that I could still be pregnant after a negative test, though I have not had any other symptoms of pregnancy nor am I having any sought of discomfort? ### Response: The striking point in your history is that you have taken morning after pill thrice in the last 4 months. It has to be understood that the most common side effect of an emergency contraceptive pill is delaying the next 2-3 menstrual cycles. As your pregnancy test is negative even after 13 days post period, it clearly indicates that you are not pregnant . Hence, the delay in periods is likely to be due to ipill side effect. Or another possible reason for the delay could be stress induced hormonal imbalance during this menstrual cycle. Stress including emotional, psychological, physical or social disturbances, all have a bearing on the reproductive hormones and can easily delay your menses, once pregnancy is ruled out. As pregnancy test is negative, you can rest assured and wait for another week safely." "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 18-year-old male. I recently believe in having been suffering, and possibly still do, derealization and depersonalization from drug usage (tetrahydrocannabinol, psilocybin or psilocin), and I am currently recovering. Would future usage of these drugs under a better mindset create the same symptoms for me? ### Response: Depersonalization and derealisation symptoms can occur more in people experiencing anxiety. Using cannabis and Psychedelics like Psilocybin can trigger depersonalization or derealisation symptoms. It can persist for varying periods, sometimes lasting for weeks and months. As you have already experienced, your mental health and wellbeing can be adversely affected by using these" "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 brother has jaundice, and it is occurring every year during summer. He feels very low and lazy, and his body becomes yellow. He is experiencing weakness and swelling on face and across his ankle. He also has a fever. We do not know why he gets sick every year. In addition to that, he has low IQ. Hence, he is unable to explain his situation well. We are really confused. Can you tell me what is actually happening? Please find attached the various lab reports for your review. ### Response: Hello. I went through your post and the investigations (attachment removed to protect patient identity) that you have posted" "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 head hurts. I have got a bad runny nose, my whole body hurts, and feel very sick. Is this bad? ### Response: Your symptoms are quite consistent with influenza or the common cold. If you do not have a fever yet, you will be coming down with it soon. It is viral so it will run its course. Over the counter, Paracetamol will help with the fever and body ache. Do not take any other painkillers like Aspirin, Ibuprofen or any other NSAIDs at all." "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 are trying for IVF to conceive. We have frozen our embryos and have planned for embryo transfer this month, that is on the 14th day of my wife\s menstrual cycle. In the scan, everything looks normal, the endometrial thickness was 9.7 mm and had good blood flow. Today when we went for a follow-up, the doctor told us that the lining has dropped to 7.8 and conceiving would be difficult, so they have canceled the embryo transfer. She informed us that this could be due to the fibroid, which was discovered today. To confirm that, I got a scan done in two different centers, and they also confirmed that she has an intramural fibroid of 1.5 cm. What are the complications that could happen due to this? How to overcome this problem? What are the treatment options? We do not know how the thickness of the lining dropped all of a sudden. She was on Progynova tablet, and the doctor asked us to stop it for the time being. Please help us recover from this. I have attached the reports. ### Response: Hi. I have reviewed both the reports (attachment removed to protect patient identity)" "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 is 20 weeks pregnant, and we got an ultrasound done. The report shows a small myoma measuring 49x26 mm in the anterior wall of the uterus. Can you please see the attached report and evaluate her problem to me? What to do next? Are there any chances of complication during delivery? Will she stay in good health after the delivery? Can she deliver the child safely? Will both the mother and child be safe? Is there anything to worry about as such? Please suggest. ### Response: Hello. I have seen the ultrasound report (attachment removed to protect patient identity). Myoma or fibroid are sometimes seen along with pregnancy. It is very tricky how myoma reacts with the pregnancy. The thing is that the chances of it increasing in size during pregnancy are high, and sometimes it may cause pain. And very rarely, abortion can happen due to severe pain. But, some patients have uninterrupted pregnancy and do not have any symptoms due to myoma. So, it will depend on the size, position, and its blood supply. You need to continue all medication regularly and take adequate 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: About two and a half months ago, I was at work with one leg tucked under the other in a computer chair. When I got up to use the restroom, I noticed tingling in my lower leg and developed drop foot as a result. My first visit was to a podiatrist and he suggested me to visit a neurologist. The neurologist did not run any scientific test and determined I likely crushed my peroneal nerve and said to return in four to six weeks for physical therapy. About two weeks later, while lying in bed on my side, I noticed my arm tingle a bit and when I got up to shake it out the tingling eventually subsided. But, I have experienced weakness in that arm. Last night while sitting upright on my bed, my left leg began to experience a similar sensation. The limbs are still functional and the tingling does not persist, but it feels weak. The uncertainty due to the lack of scientific testing is weighing very heavily on me and the troubling issue is the onset of additional symptoms which are causing occasional unsettling stomach feelings due to the mental anguish I have been experiencing. Mainly the fact that all of my limbs feel weak are making me very concerned. ### Response: Hi. I have read your complaints and first of all I should compliment you for having patiently written a thorough history of events. Let us analyze your problems You have tingling in all four limbs and weakness in all four limbs. That is upper limbs and lower limbs on both sides, but onset on various days. The next important point which you have told is the mode of onset and the tingling eventually subsided. The following parameters can be found out only by a clinical examination and they are most important to fix the diagnosis. In the same way, need to get at least two investigations, nerve conduction studies and MRI spine. It can be either a peripheral vascular disease leading to low perfusion or a peripheral neuropathy. I would strongly recommend as well as request you to consult your neurologist immediately and treat these symptoms as top priority. 1. Nerve conduction studies.2. MRI spine. The symptoms suggest either it could be peripheral neuropathy or peripheral vascular disease. Revert back with the investigation report to 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 am a 30- years-old female. I have yeast infection and intolerance to gluten, lactose nuts, and other few things. I can not eat anything as everything hurts me. If I consume tea, some times I will have diarrhea, the other time I will become tired and have a high heart rate. ### Response: Hello. I need more information. Yeast infection of which site? What are the symptoms of infection? How do you know about the infection? Kindly provide answers for quality consultation. Regarding gluten intolerance. How do you know? If you have any investigation? What is the duration of your symptoms? Regarding your problems. 1. Yeast infection: may be a routine infection or due to some underlying immunodeficiency. 2. Gluten intolerance: If it is present then we need to remove wheat and related products from your diet after that only your symptoms will subside. Lactose intolerance may be a part of this gluten intolerance. 3. High heart rate and tiredness are due to anemia, it will be cured after a gluten-free diet if you have an intolerance. We need to know about your hemoglobin status. Advice: Please provide answers to the above questions and get the following tests done. 1. Complete blood count with hemoglobin level. 2. tTGA (tissue transglutaminase) test. 3. HIV test (do not afraid about this investigation). 4. Thyroid function test. If you have firm evidence of gluten intolerance, then avoid wheat, barley, and related products completely otherwise symptoms will not improve. Please report back along with a scan copy of the investigations." "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 24-year-old female. I missed my monthly periods for 10 days. Is there any medicine to get periods quickly? ### Response: From the information you have provided, your periods are delayed by 10 days. You have not mentioned whether you are sexually active and pregnancy is a possibility. If that is the case, please do a urine pregnancy test and consult a gynecologist irrespective of the result. If there is no chance of pregnancy, you can wait for another five days safely. If still no periods, we need to find out the reason apart from taking tablets to bring on periods. You will need blood tests and scan along with full physical examination by a gynecologist to treat you properly. 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: My son is 2 years 10 months old. He has a viral infection. He did not have a cough initially, only fever, so the doctor advised Sinarest plus or Meftal P if fever persists. He recovered in one day but the next day again he started coughing and had the fever. I am giving him Meftal and Sinarest plus both. What should I give for cough? ### Response: I can understand your concerns. Sinarest syrup (Acetaminophen, Chlorpheniramine) is mainly used for cold and nasal discharge. In my opinion, Sinarest syrup should be stopped and cough syrup like Chericof (Phenylephrine, Dextromethorphan) 5 ml three times a day for three days can be started. If fever persists, then investigations like malarial antigen test and widal test for typhoid with complete blood count should be 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 am 21 years old. About a month ago, I realized I had tiny smooth painless bumps on the inside of my butt cheek. They do not have pus, itch, or hurt. I have had unprotected sex, so I went to a clinic. That doctor said it was not herpes and she did not think it was warts because there were too many of them and they were too smooth. She recommended I see a dermatologist. I do not shave my bottom so I knows it is not razor bumps. I do not remember ever seeing them before and they do seem to be spreading although some have disappeared. Any ideas what it could be? ### Response: I saw your clinical pictures (attachment removed to protect patient identity). I am very sorry the pictures are bit blurry, but it looks like molluscum. You will have to meet dermatologist because you are saying that they are spreading. Molluscum is also sexually transmitted viral infection. Molluscum is a highly contagious viral infection, presents with pearly white papules (bumps) with a central pit. It can be confirmed by dermoscopic examination. Another possibility is folliculitis in that area, they are usually painful pustules" "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 months old baby suffered from loose motion and fewer doctors gave Ofloxacin 50 mg and Flagyl 200 mg syrup. They told to give 3 ml three times a day, each syrup for 5 months old. Is this dosage correct? ### Response: Hi. The dose specified above is too much and unnecessary for a child so small as 6.8 kg. It is advisable instead to just give the child Enterogermina 1 capsule twice a day for five days along with ORS with the passage of each loose stool. As for the fever, you can give syrup Crocin (125 mg/5 ml) 3.5 ml (six hourly) if temperature is above 100 F. Also, give ORS 70 ml with passage of each loose stool. If worsening, please show to a pediatrician." "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 this sore on my lip for a week now. It is drying up but before it was drying I masturbated using my saliva and touched the sore. For certain reasons I am aware, this sore could be herpes. My question is could I have passed it to my genitals by touching and rubbing my penis. ### Response: Less likely, but it is possible if the sore on your lips is herpes only. But, chances of this happening are less as infection at lip will give you immunity against current infection. So virus will not be able to multiply at other sites. So overall, I do not think you will get genital herpes" "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: All of a sudden, my skin has become very dry, but it was oily before. So, I got a thyroid profile done, and the values are T3 1.35, T4 12.4, and TSH 0.77. ### Response: Hello. I just read your query about your thyroid function test, and it appears that you have a normal thyroid function. Although it would have been better if you had mentioned the units of each as well." "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: For the past three days, I am having sniffles. But today morning, when I got up I found a small amount of blood spots in my cough. So please advise me what to do now? I never found this before.I am currently taking Corectia, Glyciphase 500 mg, Ovipauz-L, and Aspirin gastro-resistant tablets. ### Response: The image that you sent (attachment removed to protect patient identity) shows brown rusty expectoration for which you need not worry. It is due to the capillary leak at the inflamed mucosa due to the medical condition." "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 with a friend and have a swelling on my lymph node under my ear when asked he said he has genital herpes. I wanted to be sure if I have any sort of STD. Please tell me what are the tests I have to go through to be sure. ### Response: Usually, the blood test for herpes becomes positive only after 2 to 3 weeks because antibodies in the body take time to give you positive results otherwise false-negative results can occur (antibodies test for HSV1 and HSV2). Herpes infections can be diagnosed by looking on the lesions on body and blood investigations are often not required. If you have any symptoms then consult a nearby physician or dermatologist for further evala uation. Sometimes, the viral culture of a swab from skin lesions or nuclear amplification test (NAT) can be done without waiting for blood test as this test can be done earlier." "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 daughter is 22 months old. She weighs about 16 kg and she goes for potty with a gap of three days. Is there anything to worry? Moreover, her potty is very very hard to come, I can feel the pain during her potty. Please suggest. ### Response: I assume your daughter\s age is 22 months. May I suggest. The child is getting less fiber. Water intake may be less. Not to worry, but her food and dietary habits need to change. Give her more of a homemade diet, like vegetables, and soups more option. Water intake should be at least two liters a day. Laxative/ suppository is too early for her to use. That should be avoided. Increase her fruit/ juice intake. I am sure these options will surely help her" "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 31 year old unmarried male. Over the last few months my sperm looks watery whenever I ejaculate. Will it create any problem? Also my erection is not like earlier. Kindly advise me doctor. ### Response: Hi. I have read and understood your problem. The fluid that male organ secrete during ejaculation is called semen. Semen is a visible liquid. It contains millions of invisible microscopic male counterpart of female eggs called sperms. It does not matter if your semen is more watery, the sperm count in semen should be normal and that can be detected by semen analysis, which is done at a pathology laboratory. Erection problem appears to be due to stress or anxiety. So, do relaxation exercise. However, to exclude other cause you need to do some blood tests like sugar and hormones. Stop smoking if you smoke. Check your BP (blood pressure). If you are taking any medicine or nutritional supplement on regular basis then it may be due to side effect of that." "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 know my partner for ten years. I am living with my partner for a year. We have not done sex. But now, we may have sex once a month. He does not have a feel like me. It makes me feel depressed. I tried to talk to him about this, and I wanted to make him understand. But it feels like he is not ready to get fixed. I do not know what to do at this point. Please suggest. ### Response: Planning to have sex on a regular basis with your partner is perfectly a regular thing, and there is nothing to feel ashamed. But sexual appetite between two peoples may vary. You may feel which is less can be a sufficient one for your partner. So the key is communication. Hammering him about sex every day will not help you. Make an effort to spend time with him by doing activities, and gradually you can approach about this. You can take a short trip and explore. Be sensitive if he is facing issues at work or with his family and if he is preoccupied with it. If nothing works, please see a counselor." "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 8.11 years old. He had an eye injury one week before, which caused left eye corneal epithelial defect (3 mm, no infiltrate). He was adviced for constant use of single vision white glass. His reports are,Right eye (SPH=+0.00), (CYL=+0.75), (AXIS=95), (VISION=6/6).Left eye (SPH=+0.00), (CYL=+0.25), (AXIS=90), (VISION=6/6).Does he need to wear glasses? Or eating a carrot, beetroot will help him to be normal? ### Response: Hello. I understand your concerns and have gone through your son\s eye records. I can confirm that the power given cannot be reversed by eating carrots and vitamins. A" "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 started growing hair on my neck when I was about 12, and since then I have pulled the hairs out with my finger, dug the skin with my nails to get the hairs out of the bumps, used razors and also tweezers. Now my skin looks horrible is scarred up pretty mad. I am embarrassed at how my neck seems to be a woman. The hairs grow so much, and I get hair bumps as well. I want to clear my skin up, so it does not look all bump and scard. ### Response: You have a case of pseudofolliculitis barbae, although a term reserved for male beard condition, you got it because of tampering and ill hair removing practices. Treatment includes manual correction of ingrown hair (visit your dermatologist) under magnification. Your hairs have changed their direction due to pulling. Once pulled out, they will grow normally and will not cause redness and bumps within the skin. Make sure it is a laser and not an IPL (intense pulse light) device. Things can be normal if you start following the right path. I hope this answers your 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: My left foot big toe has been swollen and painful for a couple of months. I first thought it was an ingrown toenail. I consulted a doctor who thought it was a fungus or grout. I have checked for both, and they are negative. I cannot get an appointment with the specialist for more than two weeks, and my toe is getting redder, more swollen and painful. I am concerned about possible infection as there is now some throbbing. Please help. ### Response: Hello. It appears from the description that you have an infection in the great toe. the question is which type If fungal culture has been done and found to be negative then remaining options are bacterial (staphylococcus) or gram-negative infection. The treatment is local therapy and antibiotics. Local therapy will include warm soaks with a salt solution. However, if there is throbbing then the likelihood of pus formation increases and you need to get examined by a doctor. In the meantime keep your foot elevated and take anti-inflammatory tablets." "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 experiencing a patch of hair loss and it is getting bigger. I had two but the one is gone now. I am very proud of my hair and this makes me emotional. ### Response: This is alopecia areata, and the patch on your backside of the scalp is ophiasis, a subtype of alopecia areata. It is thought to be an autoimmune disease in which hair loss is in the form of patches but comes back itself as you have told. Meanwhile, you can apply topical steroids over it like Fluticasone propionate ointment or lotion. Another option is a mixture of topical Canthradine plus topical Capsicum and Methylated spirit in equal proportion and apply for five minutes twice per week as they have an irritant effect. Topical steroids will be beneficial for you. Follow up at one month. Alopecia areata. Apply Fluticasone propionate ointment or lotion over the area, take Multivitamins." "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 wanted to ask a question. My platelets count is consistently low when examined. What is the cause for the decrease in platelet count? I am not sure what are the tests checked? I am taking tablet Zoloft. ### Response: According to the history, you are having low platelet count. The various causes are dengue, malaria, hemolytic anemia, ITP (idiopathic thrombocytopenic purpura), hypersplenism, a viral infection like hepatitis, EBV (Epstein Barr virus), HIV (human immunodeficiency virus). So, according to your history and physical examination, the required test can be done. For example, for dengue, you can test IgM ELISA (enzyme-linked immunosorbent assay). Peripheral smear examination report is advisable to detect any abnormal cells present" "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 unprotected sex. Within 72 hours, I took an I-pill. Now, my period is late for about 11 days of my actual period date. But till today, I have no symptoms of pregnancy. Can I be pregnant? I had PCOS before six years. I took Ayurvedic medicine to cure PCOS. ### Response: Hi. Since you have taken the emergency pill within 72 hours of intercourse, there is no chance of pregnancy. The delay could be because of hormonal changes due to the medicine you have taken. So relax and do not worry. However, if you have a doubt, then get a urine pregnancy test done with an early morning urine sample to ensure that you are not pregnant" "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\s age is 60 years and is a patient of type 2 DM. He is also a patient of hypertension with an abnormal lipid profile. His RBS is now 360 mg/dl. He is suffering from extreme fatigue although BP is controlled by anti-hypertensive drugs. In this condition, how can we manage fatigue although he is taking Metformin regularly? ### Response: Hello. Looking at RBG given (360 mg/100 ml), he has totally uncontrolled diabetes. When this happens there is a lot of glucose lost through urine, leading to excess urination, excess thirst and excess hunger. Plus there is unexplained weight loss and severe tiredness. The remedy for that is to achieve strict glucose control. Ideally, in a well-controlled patient, fasting glucose should be less than 100 mg, PP 150 to 170 mg and HbA1c % less than 6.8. For his age, it can be around 7 %. It is clear that his current treatment is totally inadequate. There is a need to upgrade the same." "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 discontinued Risperidone two months ago. I have not had any psychotic symptoms. I believe my schizoaffective disorder is in remission. However, can Risperidone continue to have an effect two months after taking it? If so what is the maximum amount of time Risperidone continue to have an effect? I took it for four years and took 5 mg twice daily. I am a 44-year old male. I also take Buproprion 75 mg once daily. ### Response: Since you have taken Risperidone for four years, the brain circuits and its neurotransmitters had been under control. The medicine though it might have been washed out from your body, the effect of it remains for a few weeks to months and your brain circuits may start functioning abnormally after few months and once your symptoms come up again, the dose at which you were taking may not be sufficient to control the symptoms later. So, I advise you to immediately restart medications and do regular follow up with the doctor." "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: Four years ago, my uncle had a paralysis attack on the right side of the body. He has recovered now, except his right eye vision. He can clearly see straight and left, but not the right. He cannot see full 180 degrees. His age is 48 now. Is this a permanent disability or it can be cured? ### Response: Hi. Visual field test or HVF for both eyes. NAION (non-arteritic anterior ischemic optic neuropathy - loss of vision due to insufficient blood supply). Consultation with a neurologist or cardiologist to prevent stroke recurrence. Revert with the reports to 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: I had unprotected sex with a man who forced himself on me. Five days later, a node on the right side of my neck appeared with a sore throat. I went to the doctor, explained everything, took an HIV test and it came back negative. The node is hard and gets soft sometimes but has been there for months. Sometimes, I feel like there is pressure on my neck and ear, found another node recently on my neck, lower part of the left-hand side, soft and movable and another one on the front side of my ear on the left and I have a tooth that has been giving me problems for a while on the same side. Could this be HIV because I read that nodes on the neck are normally associated with it? ### Response: Lymphadenopathy is not related to HIV (human immunodeficiency virus) and probably caused by infected teeth as HIV infection takes approximately six months to one year to get lymphadenopathy. Get HIV test after 45 to 90 days with generation four dual tests or western blot to confirm infection. Soft movable node is probably due to infection and abscess may be formed. So, rule out TB tuberculosis). Finally, it is not HIV infection, for confirmation get tested after 45 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 65 years old with weight 88 kg and height 5\10"". I suffer from moderate hypertension and diabetes since last eight years but always in control of medicines. Last year I had undergone angiography as an age-based test and symptom of pain on starting walking short distance a few meters. Many times it does not, in a mid-thoracic area of the upper back and epi-gastro area. But things were seen normal except for a small branch which was 100 % clogged but the cardiologists said it does not matter. This problem of feeling pain when walk some meters started four years back. It is surprising that if I jog stationary position for even two minutes no pain. Now since a few days when I lie down on the bed also the pain starts but not in sitting position. So an MRI was recommended and I underwent MRI of the spine with contrast. The report is in brief here:Under report one MRI dorsal spine, spine curvature straightened. Generalized spondylotic changes were seen in form of osteophytes and disc desiccation at multiple levels seen in the form of loss of hyperintense signal on T2W images. Rest normal.Report 2 MRI cervical spine with contrast: spine curvature straightened. Generalized spondylotic changes were seen in form of osteophytes and disc desiccation at multiple levels see I in the form of loss of hyperintense signal on T2W images. Diffuse broad-based posterior and bilateral foraminal disco-osteophyte protrusion seen at C4/5, 5/6, and 6/7 levels having left propensity and causing compression of bilateral exiting C5,6,7 nerves root in their respective foramina. Rest normal.Report 3 MRI thorax with contrast: fibrotic band seen in left basal lung parenchyma. Rest all normal.Report 4 MRI lumbosacral with contrast: spinal curvature is straightened. Generalized spondylotic changes were seen in form of osteophytes and disc desiccation at multiple levels seen in the form of loss of hyperintense signal on T2W images. Diffuse broad-based posterior and bilateral foraminal disc bulge with posterocentral disc protrusion seen at L5/S1 level indenting the thecal sac and compressing bilateral traversing S1 nerve roots.12 years back, I had L4/L5 disc bulge problem stenosis and sciatic nerve type pain in leg left and burning sensation and pinpricks in feet of both legs. I was about to go for surgery but an osteopath corrected this with manipulations for 5 to 6 days and signs abated. Till then this part is fine. But now there is some pain or mild sensation sometimes in legs. I sit long hours on the computer and am academician so have a sedentarylife. I also have GERD type problem. It is also noted by me that if I continue walking for a few days by stopping frequently then after a few days pain does not occur or come after long walks. Now my worry is in light of all the history and records. Questions:Is it possible to treat this pain by physiotherapy or medicine or both or any other method?What is prognosis for the type of MRI pictures reported? And how spine health can be restored or brought near normal? The line of action suggested so I do not have pain in back and epigastric region when start walking.Currently, I am taking medications for diabetes, acidity, and hypertension. ### Response: I appreciate your detailed history. The symptoms you have described are suggestive of neurogenic claudication due to the neuro-foraminal stenosis and disc bulges in the spine. If the pain is the prominent symptom, then conservative therapy should be done first. But if you have any weakness or sensory loss or urinary symptoms, then I would recommend consulting a spine surgeon" "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 facing hair loss problem for the past three years. I am a male, 25 years old, 5.4 inches height and 71 kg weight. My hair volume becomes very less. Please help. ### Response: Hi. How are you? Hope your physical condition is good. I have read your problem carefully. Your history is incomplete, and so I have a few queries. The most common reasons are, 1. Familial.2." "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: Dear doctor,I was two months pregnant when I got vaccines to complete my citizenship status (immigration). My son was born with aortic stenosis. Is this because of the vaccine? ### Response: Hi. Could you provide more information: The above are the important factors causing heart defects in newborn. The incidence of the heart defect in the general population: First look at the incidence of congenital heart defects. The crude incidence of congenital heart defects is approximately eight per 1000 live births. Among them, aortic valve stenosis accounts for 3 to 5 % of all the congenital heart defects." "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 on Finasteride for three months now. Recently, I have been having a huge shed of around 100 hairs a day, up from 5 to 10 before the treatment. The hairs I shed are thick but half the length of the rest of my hair. They are also thin at the base of the hair. This hair loss is in a diffuse pattern on my whole head rather than just at the temples like before. Is this sort of hair loss normal for this point in the medicine? ### Response: When Minoxidil is started, it can lead to hair loss at first because it regulates hair cycle and all hairs go into one phase leading to diffuse shedding of the hair. But eventually it stops. Ensure proper diet with Vitamins and Minerals. Take Biotin supplements along with it because Biotin is very important in hair growth." "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 knee problems for a while. It feels like my knee needs to be popped but it will not. I cannot bend my knee without having pain. Could someone please tell me, why is it? And what should I do to make it feel better? ### Response: You are actually quite young to be having persistent knee pains. Your knee pain could be due to certain reasons. If there is no history of any injury, and no signs and symptoms of inflammation or infection like swelling, skin redness or local warmth on touching, then I would like to advise you for conservative management initially in the form 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: I have a sore throat. My right sinus and ear are always full. The sore is behind my right tonsil. ### Response: Hi. I understand your concern. Your right sinus is full which indicates that you are suffering from right-sided sinusitis. Therefore, a sore throat and a clogged ear are likely to develop. It will be better to consult your ENT doctor for a thorough examination. Do a necessary investigation to finalize the diagnosis. Then only the treatment can be planned" "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: Sometimes when I concentrate in a silent room, I can hear a low sound from my ears. I went for a checkup, and there was nothing wrong in my ear. The doctor told me that the sound occurred because of hair cells and said to me that it is normal. What is hair cells? Is it normal to notice it? Could it be a sound of normal blood flow near the ears? ### Response: Hair cells are hearing cells inside the inner ears provided with cilia, and when vibrated, it stimulates auditory impulses. Yes, these cells have a unique sound, and it will not be audible to us. It needs a high technology device to pick it. Tinnitus has a lot of causes. First, you need to perform tympanometry and pure tone audiometry. Show me the results, and then we can diagnose the 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 marriage offer but the girl has hypothyroidism. She is currently taking 75 micrograms Thyroxine from one year and now TSH is 15. I am worried will it create complications in pregnancy in the future. I do not want any risk. Should I accept the offer or reject it? Please help me. ### Response: Hypothyroidism if well controlled has fewer chances of pregnancy complications. If uncontrolled it is associated with pre-eclampsia, preterm labor. But as she is on 75 dose, it can be further increased to 100 or 125 mcg under an endocrinologist observation. I do believe if well controlled it will not affect her fertility or pregnancy outcomes" "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 18 weeks old baby appears to have less interest in her bottles. She is only drinking approximately 20 to 24 ounces of milk instead of the recommended 30 to 35. She has become more irritable, crying, biting her hands and tethers. When I give her a bottle, she drinks a few ounces then chews on it and tries to spit it out of her mouth. She does not seem to have much of an appetite. I took her to my GP, who said she appeared to be teething and that her temperature, ear, nose, and throats were fine. She is also making strange noises and crying when anyone other than me picks her up. She normally has one dirty nappy per day and about six wet ones. She is smiling and follows things with her eyes and picks up things with her hands. She also appears to be sleeping more than before. At 15 weeks, her weight was normal, and her growth was fine. Could this be teething? ### Response: I understand your feelings and preoccupations. I might have to ask you a few more questions but here are some attempts to give you a beginning of an answer. Well, I would be dishonest if I would send you the miracle answer. But let us try together. Revert with more information to a paediatrician 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 green and brown poop with blood dripping in the toilet and on the toilet paper after the first wipe. But not on the second. Should I be very concerned? It has been like this for three days. ### Response: I have gone through your case and can well understand your genuine health concern. As you are having bleeding per rectum, you should get evaluated properly. Bleeding in the proximal part of the gastrointestinal tract can cause brown colored stools. There are many causes of rectal bleeding like piles, a fissure in the anus, bleeding in the intestine, rectal ulcer, rectal polyp, etc. I suggest you consult a surgeon. You need proper examination and colonscopy or simoidoscopy. You can follow the mentioned instructions. Take a diet rich in fibers like vegetables, salads, etc. Avoid oily, fatty and spicy food. You may need a stool routine and occult blood examination. Hemorrhoids, rectal polyp or rectal ulcer." "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: Yesterday I have given my blood sample for a random test. When reports came I got shocked. Is there any big health issue? Do I need to consult the doctor for this? See below lab report: RDW-CV 14.4 high 11.6-14.0 %, Eosinophils 9.1 high 1.0-6.0 %, Absolute eosinophil count 0.70 high 0.02-0.50 10^3/Ul, Thyroid profile ultra triiodothyronine (T3) 97.63 60.0 - 181.0 ng/Dl, thyroxin (T4) 6.60 3.20 - 12.6 \xb5g/Dl and thyroid stimulating hormone (ultrasensitive) 7.244 high 0.55 - 44. ### Response: Hello. Regarding the eosinophils increase, it could be due to allergic condition or parasitic infection. So do you have any remarkable symptoms like for example coughing,sneezing, etc.? As for the elevated TSH (thyroid-stimulating hormone), it is subclinical hypothyroidism which you do not have to do anything about." "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: Do I need post-exposure prophylaxis for HIV after the following exposures:1) Open mouth or french kissing.2) Handjob and hand masturbation.Have there been known cases of HIV transmission after such exposures? ### Response: I have noted your concern. There is no risk of HIV transmission from the open mouth or deep kissing or skin to skin contact as in a handjob. They do not qualify as a risk for HIV transmission. Hence there is no need for post-exposure prophylaxis." "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: For the past 8 days I am having mild palpitations both morning and evening. Since, eight years, I am taking tablet Metolar 50 mg for BP. I consulted my doctor, he asked me to get ECG, ECHO and also thyroid tests. I even got lipid profile, kidney and liver function tests done and all the tests came normal. Though, all my tests are normal, I still feel some discomfort. I am very much concerned. When I got a regular check up of my BP it was 130/70, pulse was 65, LDL was 103, HDL was 57 and triglycerides was 65. Now my doctor has asked me to take BP tablet regularly. Kindly advice. ### Response: Hi. I have worked through your query and understand your health issues. I assure you not to worry. With all the normal laboratory reports (attachment removed to protect patient identity) palpitations in the morning and evenings may be due to anxiety. Anxiety is considered to be the biggest cause of palpitations. I suggest you to consult a cardiologist and get a complete physical examination done. He will insist you to take an EKG (electrocardiogram) and run few tests accordingly. Some of the causes of tachycardia and palpitations are: There are chances that after all the cardiac investigations, your cardiologist might change the tablet from Metolar 50 mg (Metoprolol) to tablet Atenolol." "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: Our family member is having severe itching, redness, and weals. Previously it was only on arms and groin area. Now it has spread to the chest and abdominal area. He is currently on tablet Zempred, Ebast and Oriel M. ### Response: I have reviewed the attached photograph (attachment removed to protect patient identity) and need to ask you few questions: Kindly revert with the answers. 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 have a 5.5-inch penis but it has a narrow opening because the front lower attachment is not broken down. I am 21 years old. Please advice about it. Also, tell me if with any treatment my penis length can be increased. ### Response: The size of the penis has no role in sexual intercourse. If your erection is normal, then stop worrying about the size. If you are not able to move the foreskin freely over the tip, then this should be evaluated by a surgeon. This could be due to phimosis" "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 looking to get a prescription for Clotrimazole-Betamethasone. I currently have one, but I am almost out. I have been dealing with anal yeast for around 10 years. Now it goes away with the cream but comes back when I run out. I do not wish to see any more doctors. ### Response: Hello. I presume that this recurrent anal yeast infection is candidiasis, and you have been using a topical mixture of antifungal and corticosteroid cream over it. Have you checked for immune statuses like HIV, and blood sugar level to rule out diabetes? Then if you have been using a steroid medicine for a very long time, that can also depress your immunity. If all these tests have been done and are negative, and you are not on prolonged use of the steroid, then I will prescribe an enteral antifungal together with the topical cream. Get Fluconazole tablet 200 mg daily for two weeks that will kill the candida from inside. You may also continue your Clotrimazole-Betamethasone cream till the yeast disappears. I want you to run a test for HIV and blood sugar." "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 sensitivity in the upper right tooth. There is no ditch or cavity but I feel the sensitivity while eating sweets. What could be the treatment option for it? ### Response: Sometimes any cavity or decay is not seen clinically but there can be some infection or carious activity going on inside the tooth that can be detected in X-ray or on examination. Considering the symptoms following could be the treatment options. Filling of the tooth if there is some carious activity diagnosed internally. Varnish on the tooth if there is no carious activity seen and there is just wear off of enamel seen. Root canal treatment if carious activity inside the tooth has involved the root." "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 walk and jog for 40 minutes and my pulse crosses 165. My age is 39 and obese. Taking Olmesartan 20 mg for blood pressure and taking Rosuvastatin 5 mg for cholesterol. I read that one should not exercise more than 140 counts keeping into view my age. Please let me know whether I should reduce my speed and maintain pulse lower than 140. ### Response: Hello. No, there is no such cut off that exists. Now, for your age, you can exercise till your heart rate reach around 180. It also depends upon your exercise capacity whether you are able to do it or not without excessive shortness of breath or other symptoms like chest pain. So, if you can tolerate the exercise then you can perform it, no issue about pulse rate. In general, the intensity of all the exercises should be gradually increased so that they are tolerated better. Hope this helps you and get back if you have any doubts" "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 27-year-old female. I have dry and sensitive skin. I noticed some changes in my skin. I got dark spots with dull skin. I feel like I have a hard surface. Please suggest some best skin care products for daily use to get a glowing and healthy skin. ### Response: Hi. You follow these steps. Wash your face twice daily. Remove your makeup before going to bed. Apply moisturizer after cleansing. Take warm showers. Get eight hours of sleep every day. In the morning, use cleansing gel, antioxidant serum, and toner. In the evening, use cleansing gel, toner, and oil-free moisturizer. Eat a diet rich in vitamin A like carrots and tomatoes. You can use vitamin products for the skin once a day. Do not forget to" "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 done a pre-marital test with a prospective groom and he has beta thalassemia trait and I am not a carrier. Is it safe for pregnancy and child? His hemoglobin count is 13.1 and HbA2 is 5. How safe is this for child\s health? ### Response: Hello. Following is my opinion for your asked question. If you are not having beta thalassemia minor then no need to worry. Your future child can have thalassemia minor. But no need to worry for trait of thalassemia minor. Thalassemia major is the dangerous one in which life span is reduced. But as your report is normal as per history there is no chance of thalassemia major in your future child." "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 little swelling in front of ear on parotid gland for about 10 days. I feel pain while chewing. Nothing else apart that. I can open my mouth wide. Local doctor gave me some antibiotics and now my pain is gone 90 %. Since I am a smoker. So my question is what is the reason for this swelling and I have quit smoking past two days. Does smoking does this? And what should I do next? Swelling is not visible but can be felt. There is no swelling inside the mouth. ### Response: Your symptoms of swelling in front of cheek while chewing and increase in pain indicates it is originating in the parotid salivary gland. This obstruction can be due to calculi within the duct or simple inflammation and obstruction of duct. You have to undergo ultrasound examination and X-ray of the parotid gland to look for presence of any calculi or cysts. Only antibiotics may not relieve your problem. You need to identify the cause of obstruction of salivary gland duct and need appropriate treatment. For more informtion 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 am 33 years old. I delivered a baby girl through cesarean around four months back, but unfortunately, she survived just for a day. Now we want to have a baby as soon as possible. How soon can we start trying for a baby? Please advise. ### Response: As you delivered the baby by caesarean, the wound takes some more time to heal. If you become pregnant before two years, then there is a chance of weak scar due to early stretching over the scar. Ideally, you should wait for three years. But you can start trying for pregnancy after a year. It is not advisable to conceive before one a year as it has its risk to pregnancy as well as baby due to weak scar. So it is better to plan after a year. Till then wait and build your health. I wanted a few information so as to give you the most relevant opinion and suggestions. I suggest you start taking Folic acid 5 mg once daily, two to three months before planning for next the pregnancy. This is recommended by WHO. The Folic acid will help in decreasing some problems in the baby." "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 urinating too frequently, around 10 to 15 times a day. If I drink a coffee or glass of water I will have to urinate around three times in the following hour. I often feel a sense of urgency before urination, and I often only produce a very small amount of urine when I go. Sometimes during or after sexual intercourse, I experience some pain like a sense of pressure in my lower region. Sometimes during exercise (or if I am jumping), I experience a small amount of urine leakage. I have had these symptoms for around two years. I have recently been visiting a urologist to discuss these symptoms. I have seen the urologist four times. Each time I visit I give a urine specimen. During my first three visits, bacteria and a high count of white blood cells were found in my urine, which was subsequently treated with a number of different antibiotics. The antibiotic that cleared the bacteria is called Levofloxacin. I was told to try daily Kegel exercising to help with urine incontinence, which I am currently doing.When I visited the urologist again yesterday I had an even higher count of white blood cells and bacteria than my previous visits. He has again prescribed Levofloxacin and told me to come back in two weeks. He suggested me taking one of two possible medications to control frequent urination called: an anti-choline or B3 stimula. He explained these medications can be taken long-term for a year or two. I expressed concern that if the persistent infections are causing frequent urination I do not want to try a different medication to control this. I am very confused about what is causing my symptoms, is it a reoccurring UTI or something that needs long-term treatment from the other medications he suggested? ### Response: Hi. Recurrent UTI is very common among young and sexually active females. The above symptoms can definitely be caused be it UTI or overactive bladder (the one which you are referring for long-term medicines). If your urine report is showing pus cells as in your case then we need to treat UTI only first. Simultaneously, you should take B3 stimulant or anticholinergic to relieve your symptoms till UTI gets cleared. Once UTI gets cleared, you should reassess to stop anticholinergic." "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 low grade burning sensation in the upper thigh on the right side, near the groin. I have the same burning sensation in the left arm, below the shoulder to forearm. I have heaviness in my legs with a sharp pain in the feet. It got started after taking Ativan. This burning is pretty new to me, and I have this problem for a week now. I also have loss of circulation in my left arm at night during sleep. What can I do now? ### Response: Your symptoms are related to anxiety or peripheral neuropathy. I have reviewed all your tests, (attachment removed to protect patient identity) and they are perfectly normal. You have vitamin B12 level in a higher range, and it is not a problem. Coming to this point, I would recommend performing nerve conduction studies to investigate for neuropathy. I would also recommend checking magnesium plasma levels. If all these test results are normal, you can consider anxiety as a possible cause of your symptoms. In such a case, I would recommend adding Pregabalin or Gabapentin to your current therapy. You should discuss with your doctor on the above issues." "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 want to explain my wife\s situation and I need your help and assistance. When my wife was in the kitchen, suddenly she felt some pain and heat in the upper part of her stomach and felt all her body become hot. I took her to the hospital, in the emergency department her pressure was 110/70 mmHg and the doctor requested ECG.The doctor showed some kind of worry in respect to the ECG, made some mark in the ECG and requested for a blood test. After four hours he repeated the blood test and the ECG and then he discharged her from the hospital and gave her some medicine for the stomach and advised me to follow up with heart doctor.Then we went to a heart doctor and he did another ECG and echo for her heart and advised us to get a CT image of her heart, so that he can decide and give opinion. We did not go for CT image until now and went to another doctor. He made another ECG and once he saw the ECG he was surprised and said that the ECG belongs to women of age 60 years old and not 32 years old. He requested blood test, gastroscopy, exercise ECG and prescribed Concor tablets 2.5 mg.Please advise me what is the problem with my wife\s ECG? And what shall I do next? Shall I go with CT image or exercise ECG? Is it fine to take Concor tablets? By the way my wife age is 32 years old and we have four children of age 12, 9, 6 and 4 years. This is the first time my wife complaints of pain and now she is feeling better and doing her household works normally. Also, she does not have diabetes or blood pressure. Her weight is 63 kg, which is correct for her height. Please assist and advise me. ### Response: First relax. There is nothing to worry about. I have gone through the detailed history and investigations (attachment removed to protect patient identity) you have attached. I found cardiac markers are quite normal. Her 2D echo is normal. Her other blood investigations are normal. Endoscopy showing that there is gastritis and duodenitis. It can be cured easily. Coming to ECG (electrocardiogram) there are some T wave inversions in lead V2 and V3. They are of little concern. Coronary artery disease is very rare in a woman of 32 years age. You can go for CT coronary angiogram, which is a very simple procedure. With reports of cardiac markers and 2D echo we can say she does not have any cardiac muscle injury and she does not have any functional problem in her heart. Just go for Coronary CT angiogram to feel tension free. Her stomach pain is most likely due to gastritis. Revert back with the CT angiogram report 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: My 2 months old baby girl is getting a thick milky white vaginal discharge from last week. We see it once or twice a day in her diaper and some stuck in the vagina. What may cause this? What treatment we should do? The baby was born prematurely. ### Response: Hi. Please maintain a good hygiene for the child. Avoid diapers for a while till the discharge is gone. You can place the baby in a tub of clean water with some vinegar or baking soda for 10 to 15 minutes every day for 2 to 3 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: Dear Doctor,I have taken Harmoni F for the past three months. Now I stopped taking it and planning for a baby.When will I get pregnant? ### Response: It will take 3-6 months for you to get pregnant. Start taking folic acid tablet. Hope it helps. Consult an obstetrician and gynaecologist online for further help" "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 want to fly with my three-month-old infant. What are the precautions to be taken while flying? Should I carry any medications with me? ### Response: I have reviewed your query and can understand the sensitivity of the situation here. If your infant is on no medications right now, has no allergies, or disease, there is no need to worry about. No special precautions are needed in that case. I would recommend Acetaminophen (Tylenol) to be kept with you in case the baby needs it for any reason. Otherwise, nothing much is needed. The flight safety precautions can be obtained from the airline website and it would be better to get a bassinet for the baby. Hope it helps. Feel free to ask me more questions if you need further assistance" "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 tooth removed from the back left of my mouth two weeks ago and I have been doing everything the dentist told me to do but I looked in it before and the hole is white but there is a little green thing in the shape of a square sitting on top which I think has been there since the tooth was removed. I was just wondering if you had an idea what it might be because I have looked online and I cannot find anything and now my brain is making me think it is something bad. ### Response: Hi. When a tooth gets removed from the socket, it is kept open for healing. By the time you start eating food, it is possible that a particle of food might get stuck in the wound which is very common. So, please consult your dentist to check out clinically" "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 20 year old. I have 20 to 25 strands of white hair. Can I stop this? Which oil is best to prevent white hair? Which shampoo do you suggest? What is the right way to use the oil and shampoo? ### Response: Hello. I just read your query. Try these things to control further graying of hair. Try all these regularly, and you will soon see positive results. Sometimes white hairs are due to genetic or environmental reasons. So control them initially. Follow-up after one month. I hope you are satisfied with my answer. Revert after a month to an ayurveda 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 recently went through a medical abortion yesterday. I was two weeks into gestation, the cramping and bleeding started four hours later. I did pass out a few blood clots shortly after the cramps started. My concern is that the bleeding was not heavy at all that today the bleeding stopped. Is this normal? And does this mean that the abortion was successful? Are blood clots an indication that the pregnancy has ended? ### Response: Abortion will definitely cause bleeding more than normal periods. Passage of blood clots may just indicate the start of process of abortion and bleeding may continue for 5 to 7 days. It all depends on the quantity of blood clots you passed. If it was indeed excessive abortion might have been complete (which is rare, as bleeding generally lasts for a week or so). Just wait for a week and then you can decide further course of action depending on further bleeding." "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 thyroid and PCOD for the past four years. Currently using Thyronorm 37.5 mcg. I gained weight after getting a thyroid disorder. Please suggest any ayurvedic medicine. ### Response: Hello. I just read your query. Ayurvedic treatment is very helpful in these problems. There is a procedure named virechana in ayurveda which is medicated purgation therapy. It can be very useful for you. So, I advise you to visit a nearby ayurveda physician or a panchakarma center and ask about the procedure. Along with the procedure, your physician will prescribe you ayurvedic treatment. You should go for 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: Dear Doctor,I am a 26 year old male. From the age of 13, my chest is developing into breast and it looks very weird on me. I feel like, I have gynecomastia.I feel very upset. Please help me with a cure for this. ### Response: Please do not worry. There are a lot of options for treating your problem. Check all these before you consult a doctor: After you follow the above check-list, you can consult a general practitioner 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 33 years old female, and I have had three c-sections and normal regular periods. My menstrual cycle three months back was short and lighter, and I ovulated about a week early. I noticed some pain, which almost reminded me of implantation pain. This continued on and off with pain and twinges. I thought maybe I was in early stages of pregnancy. Then I started having pelvic pain and lower left ovary area pain, which continued throughout the week. When I would push to have a bowel movement it hurts. I really thought I was pregnant. The fullness and achiness reminded me of early pregnancy. My most recent period was three days late. I went in and saw my OB yesterday. He did an exam and a transvaginal ultrasound, and he said everything looked fine. He tried to recreate the pain by touching some spots. Ever since then, my ovary pain on the left has been through the roof. What is going on? I am terrified I have ovarian cancer. Would he have been able to tell yesterday? What else could be going on? It hurts right around the ovary area and in the groin crease area. ### Response: Hi. After undergoing three cesarean sections, it is quite possible to have intra-abdominal adhesions. Which may give rise to intermittent pain associated with the bowel movements. Hope your bowel habits are regular and you do not have a problem of sticky stools. As there are multiple organs inside an abdomen, other causes of such pain should be ruled out. Hope this advice 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 do not know what happened to my scalp. A transparent fluid releases from my scalp and because of this, my scalp becomes hard. I am unable to comb my hair. After scratching it feels like burning. Can this problem arise due to lice in the head? Kindly help. ### Response: Hello. Yes, this is happening due to excessive scratching of the scalp that is rupturing the membrane of the scalp, and thus a white discharge is coming out. Please do not scratch so much. Please wash your hair daily with some anti-lice shampoo or neem water." "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 19 year old male and I weigh 46 kg. Over the last seven months, I am suffering from fever along with chest and back pain. I also have body ache and little blocked nose but not runny nose. The mucus keeps coming out from my mouth. I have headache and I feel very tired. My stool is also not regular. It happens in every 3 days and I have no appetite. I visited a doctor, who examined me and suggested Levofloxacin and Azithromycin tablets for 5 days, Nam Cold for 10 days, pre and probiotic capsules for 10 days, Pantoprazole and Domperidone tablets for 2 months along with a cough syrup, if necessary. My question is this that I have searched about Levofloxacin and Azithromycin tablets online and found these tablets have very bad side effects. It is mentioned that it increases the risk of death and serious cardiovascular disease.So, I am very afraid to take these antibiotics. Will it increase the risk of death? I do not know what to do. Please tell me what I need to do. Is there any alternative medicine. And if I take this, will it affect my health badly? Is there any alternative home remedies or antibiotic medicines that prevents bacteria? I have not took any medicines yet. Please suggest. ### Response: I have read through your query in detail. Please find my observations below. It is right that tablet Azithromycin might cause heart disorder like increased abnormal rhythm and this is seen usually in the elderly age group. At 19 years of age and if you have no known cardiac disease then you might take tablet Azithromycin. Tablet Levofloxacin is a safe antibiotic in adults. In your case the doctor has given a combination of tablet Levofloxacin and tablet Azithromycin. Since mucus is coming out of mouth, you probably have a bacterial infection in the throat. There are alternative antibiotics like tablet Augmentin (combination of Amoxicillin and Clavulanate) or tablet Cefixime which have been used to treat upper respiratory infections. However, these medicines require prescriptions and to be taken in recommended dose. If you have started taking tablet Levofloxacin and tablet Azithromycin, then you can continue it for five days without any significant risk. If you have not started the medicine then you can talk to your doctor and ask him to give tablet Augmentin for five 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 got married last year and I noticed that my wife feels down for a day or two every few weeks, most of the times she has a reason but she overreacts, and recently we had some financial problems and she faced some troubles at work that she considered might effect her career and it has been a week now, she feels depressed, but she refused to seek a professional opinion about her case and she is not taking medication for her depression. She suffered certain hard circumstances at her childhood and teenage years and I need your help to know how best I can deal with her and what can be done for her to feel better. ### Response: Hello. When a person is depressed, their thinking can be distorted and can view even slight setbacks in a catastrophic manner. You continue to be considerate and supportive in dealing with your wife\s emotional problems. Try to have an open talk with her whenever she is ready. Do not force her to talk against her will but if you continue to offer support she will gradually be more receptive. Encourage her to eat well, sleep regularly and go for regular walking." "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: Please read my query and give me your best opinion. I am currently under a cardiologist due to fears that I have had a heart attack in the past and chronic chest discomfort. My cardiologist asked me to take a Holter monitor for 24-hours and the reports he gave me last week were normal. He said that everything was normal. He stated that my maximum pulse was 134 (while working hard), minimum 55 (while sleeping) and average 87. He did capture palpitations but said these were normal increases in pulse associated with activity. He stated that my ECG shows Q wave. Though he said, that is not a pathological and I do not have right BBB, (last week) he did, however, referred me for an echocardiogram to reassure me. He also said that it would be very unlikely for it to be abnormal considering everything else normal.I have had lots of ECGs for the last few months and all normal aside from the Q waves. I have also had my troponin levels monitored, and these too were normal. All doctors say that it is due to anxiety. Before four days, I was taken to A and E due to a sudden increase in pulse from 81 to 135. It then settled within 2 minutes, however as it had panicked me I attended A and E. In A and E, they checked my oxygen (99%), BP (153/92 mmHg) and my pulse (118). The ECG showed normal, sinus tachycardia; however, I was concerned over what looked like ST elevation in AVR. When I asked for the second opinion, I was told that it is fine as it was only in one lead in AVR and not an acute heart attack. I then requested a second ECG as my pulse had gone down to 90s. It again showed normal sinus rhythm and no issues and was sent home from A and E. I have since been in a state of worry over my ECG, which I have attached here. I would like to ask you if the ECG show any issues aside from my usual Q waves. Also, my QRS is long on the new ECG and on this day I started a new course of medication called Omeprazole, which can allegedly cause changes to heart rhythm. Could this have caused my long QRS and heart rate spike? I am a non-smoker, do not drink and have no family history of heart disease. ### Response: Anxiety and panic are the first possibilities. Sudden onset of palpitations is a very unusual sign of heart attack. None of the investigation and symptoms are compatible with the heart attack. Although there are some ECG changes like Q waves, which can be present, are indicative of heart damage in case of heart attack. But, your echo is normal and so no need to worry at all. There is also T-wave insertion in lead 3 and non-significant elevation in AVR. So, given these changes, I would advise for some stress test like treadmill test or stress thallium, which you did not mention anything about. If you have not undergone it, then you can have it to rule out the possibility of inducible ischemia. The QRS prolonging of such mild degree is not significant, and this much variation may normally occur with different ECG. It is not very common with Omeprazole." "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 crowded upper and lower teeth. So, I have been to two orthodontists yesterday, and I got different opinions from both of them. One said we do not need to remove any teeth, however, his upper teeth will come little forward and will not cause much deformation in his face. The other one said, I would not take the case unless you agree to remove four teeth, which I have marked in red, in the attached x-ray. As per him, there is no way to make these teeth straight without removing the teeth. I am really confused on who is correct. Can you please provide your opinion? ### Response: I can understand your state of confusion. I have seen the x-ray (attachment removed to protect patient identity). It can be quite difficult to decide. So, I will give you information about both line of orthodontic treatments and the reason behind them" "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 know what does my lab tells you about my current liver function.I began to struggle with daily gout pain a few months ago and finally gave in to taking the traditional drugs about one and a half months ago. Both allopurinol and probenecid caused worrisome impacts on my body. I began to experience flank pain, confused thinking, and fatigue. Around this time, I was also compelled to have my A1C checked because I was struggling with headaches, insomnia, and various degrees of itching after eating. My A1C turned out to be 5.7.I stopped taking the drugs, and did a lot of research, and was fortunate to find some supplements that seem to be effective at the intersection of both metabolic syndrome and gout. Presently, I have found that Berberine (approximately 1000mg/day) works. Gout pain is essentially gone, and blood sugar seems to be coming under control with each day, though my caloric intake in unsustainably low. Admittedly, I have taken some hesperidin, ALA, chromium, NAC, ECGC, nigella sativa oil, or triple strength turmeric occasioanally if I was having a momentary concern (not all at once), or even all in a day, but occasionally.My concern is for my ongoing liver function. Though things seem to be getting better, as the day goes on and I have taken some supplements, I will start to feel pressure in the middle of my back, kidney area, and left flank discomfort. It tends to have gone away by the time I wake up in the morning. On looking at my labs, the markers for liver function have fluctuated, but my primary care doctor never made mention of them. Is there anything you can tell me about what the changes in these ratios say? ### Response: Hi. I have seen your blood works. (attachment removed to protect patient identity). It is all normal. Usually, during the acute attack of gout, we do not start Allopurinol or uric acid decreasing medications as it can exaggerate the situation." "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 60 year old female, who is 5.4 feet, and I weighs 157 lbs. I am looking for a name for my condition. The only medication I take is Imipramine hydrochloride 40 mg tablets each day. I have been told that I have a neurological condition, but the symptoms do not follow any diagnosis.When I was 26 years old, I had an operation, a day later it was hard for me to move my right leg and arm. Within a few days, my speech was slurred, and it was more difficult to use my right arm and leg. I had to use crutches to walk. My doctor gave me high doses of Prednisone, and I did tests for MS, which were negative. My symptoms went into remission, and I had periodic symptoms during times of high stress.When I was 56 years old, I had a case of shingles on my face, left lip, and nose area. When the blistering and ooze was finally gone, the MS like symptoms returned. I had slurred speech, and my legs were weak and unable to stand or walk without assistance. My hands shook when I tried using them to eat, turning a page in a book, and handing something as small as an envelope to someone. When I hold out my arm to hand someone something, my arm slowly starts to drop.I recently had an MRI that showed no myelin scaring for MS. My neurologist said I have an unknown neurological condition. I would like more information than an unknown neurological condition that the doctors are giving me, but I do not know where or what kind of doctor that can give me more information. What can I do to have a better quality of life for myself and my family? ### Response: Hi. Sorry to hear about your prolonged symptoms, I can understand your frustration. A neurologist would be able to help you discuss or exclude some of the above. Kind regards" "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 miscarriage last year. Planning to conceive now. My periods are all regular. Please advise. I hope that it is all well this time when it happens. ### Response: If regular periods, just have to take precautions. Then those will be helpful for you. As already had a conception, it means can have more as well. Have Folic acid daily 5 mg if high BMI and/or have been treated for any chronic health issues. Have complete treatment of any health issues you have. Have a balanced diet with less salt, sugar, oil, and spice. Have sex in the fertile period of the cycle with proper penetration, orgasm and rest after sex. Have normal BMI and weight by daily exercise, walk or yoga. I hope things would be better." "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 stye, and it is reoccurring from 15 days. As my CBC report, hemoglobin is 11.8, and RBC is 4.02, and WBC is 10200. So is it because of the increase in WBC? ### Response: I reviewed your history. A stye is because of bacterial infection of glands if eyelids. Since this is infection WBC count is expected yo increase. WBC count in your cade is within normal limits, up to 11,000 is normal, no need to worry. The recurrence is because if recurrence of infection and recurrences occur in people with risk factors like blepharitis, exposure to dust. Hence consult your eye doctor to find out the underlying cause and treatment accordingly. As of now, you need to use antibiotic eye ointment and hot compression." "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 is suffering from dengue and typhoid. The test for dengue showed a positive result, and typhoid titer is 1:360. Initially, he was treated with Ceftriaxone injection BD and Paracetomal for five days. But the symptoms got worse. His platelets suddenly got reduced to 21000 platelets per microliter of blood with petechiae and bluish lips. His SGOT, SGPT, and GGT are elevated. He has vomiting and diarrhea. Now, he is treated with fluid replacement, Doxycycline, Paracetomal, and tablet Ursocol. ### Response: Hi. Your friend appears to have severe dengue. Kindly do blood cultures for typhoid fever. Blood culture helps us to identify the presence of salmonella, and it guides the choice of antibiotic therapy. The petechiae can occur due to low platelet count. The bluish lips or cyanosis should be evaluated further. You have to do chest X-ray and arterial blood gas test soon. I suggest you do an holo-abdominal ultrasound and a plain abdominal X-ray. Elevation in liver function tests are seen in dengue or typhoid, and the liver can be enlarged in dengue. But intestinal perforation is the catastrophic complication of typhoid fever. I would recommend aggressive fluid resuscitation. If there is any sign of severe bleeding or unstable vital signs, a blood transfusion can be given with fresh whole blood or fresh packed red blood cells. Ceftriaxone always works well for typhoid fever. Identifying the complication is essential." "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 questions are regarding my painful period. I used to have extremely painful period every month, similar to contractions. I am unable to drive, work, or do normal activities while on period. Birth control pills were prescribed (to control acne) and lower the pain last year. Medicines I am taking are called TriNessa. After taking them for about 1.5 years, the skin looks better (not perfect), and the pain went down but not entirely disappeared.I am wondering if I can skip the last week on the pills to eliminate the periods and pain. If yes, what harm will it cause to my health? My age is almost 30. A gynecologist regularly checks me and no abnormalities were ever found. I am looking for a second opinion. ### Response: Painful periods are widespread, and they usually get resolved with pills. But if you still think that your pain is not getting fixed with those, then you might try pain killers like Mefenamic acid during your periods. And yes, that is possible to go without periods for two to three months, and it will not cause any harmful effects on your body. But you can also try to switch to another formulation of birth control pills before proceeding to this getting period absent option. I hope it has helped you. If you require any further queries, please do not hesitate to contact 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 triglycerides are 296. Should I take some medicine to normalize it.? My total cholesterol is 183. ### Response: Hello. I suggest you take tablet Atorva (Atorvastatin) 20 mg once daily at night time before sleep for two months. Consult your specialist doctor, discuss with him or her and with their consent take the medicine. Some patients do complain of myalgia after using this dose. If you find any kind of body pains after starting this, you need to take 10 mg tablet once daily. Diet management and regular physical exercise should be continued along with medication" "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 right eye is stinging with blurry vision. It is red and a bit swollen. I am experiencing the above every day. Do I have pink eye? ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). It appears as conjunctivitis, and it is of two types. They are bacterial and viral. A slit lamp examination is required to differentiate them. As these symptoms are present for a few hours, then it can be bacterial conjunctivitis." "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 left shin is numb to the touch and it has been like this for about a week and I do not really know what is going on. ### Response: In my opinion, the numbness in your shin could be due to mild swelling over there. These kinds of swelling can be caused due to excessive loading or due to prolonged stress imposed over the bone like playing some sport without warming up and cooling down or sudden increase in activity. Kindly revert to me and let me know how you feel doing these things after two 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 have been diagnosed with osteoarthritis in both hands. One doctor suggested erosions in the left hand while another read that the right hand did not see evidence of that. I was wondering what your opinion is, do you agree with osteoarthritis diagnosis and if so is there evidence of erosions? All blood were negative for any autoimmune causes, ANA, RF, ESR, CRP, etc. ### Response: Osteoarthritis is not an autoimmune disorder, so autoimmune markers are expected to be negative. In an osteoarthritic joint, as cartilage is irreversibly destroyed and bone abnormalities develop, movement becomes painful and more difficult. In my opinion, regarding left-hand x-ray (attachment removed to protect patient identity), I agree there is interphalangeal joint (distal more pronounced) narrowing and sclerosis. I hope this helps. Osteoarthritis. Injections of Cortisone to decrease inflammation and physical occupational therapy, self-management strategies." "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 19 years old and had taken three I-pill in a month and after having the third pill, I am feeling very strange like vomiting and uncomfortable. What is the reason behind it? Can it be a serious problem? Please help me. ### Response: Hi. I-pill is hormonal contraceptive pills that affect the menstrual cycle and prevent conception. But hormones have their individual effects as well. Recurrent I-pill can give you nausea, vomitings, breast tenderness, etc. If I-pill is taken in the first ten days of periods with proper dose and without vomiting, then it will inhibit ovulation and as a result, conception. So, no need to have recurrent I-pill in the same menstrual cycle. Now have plenty of water, fruits, vegetables and avoid any hormones as recurrently ovulation has stopped. It can take around two weeks post last pill or a few more days as you have taken three pills in a cycle." "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: One of my front teeth is lower than the other and my orthodontist told me I am getting my braces off tomorrow. What should I do? ### Response: Hi. Please ask your dentist to take this into consideration. If there is only 0.5 mm difference or very negligible then ask him to level it off by slicing the tooth a bit. But if it is prominently below the level of occlusion then he must reposition the bracket and give it some time like two weeks or a month more to intrude the tooth and then give you fix retainer after it. Discuss it properly with the dentist before removal. Stay happy and blessed." "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 baby is four months old. He has white patches on his forehead and around his eyes. They are flaky and little skin peels off. I am much worried. Please help. ### Response: Please consult a dermatologist for examination and management. Use mild soap or cleanser for face wash. You can also use a moisturizer." "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 allergic rhinitis. My eyes are itching, sneezing, I have runny nose, and hives. Kindly help. ### Response: Hello. I understand your concern. If possible kindly send photo of the wheals you are getting. Also, I would need to know how frequently you get them. Meanwhile, you can use the following medicine to help you with these symptoms. Levocetirizine 5mg, Montelukast 10 mg twice a 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 a 17 year old male. I have been having some problems, like:sore throatnasal congestionpain in musclesclicking jointsThe problem is today I could feel sick like I have a cold and tomorrow I can feel normal like nothing happened. All the symptoms go away within a day and come within a day. I also get this tired feeling and sore throat (post nasal drip). I thought it was allergies but now I am not sure what is going on. This has been going on for three weeks on and off. It started after I choked on some water pretty bad. It might be all in my head. I was diagnosed with generalized anxiety disorder about a year ago. ### Response: It is commonly associated with sore throat and sinus congestion. When it occurs along with the symptoms you mentioned, it frequently points to allergies. For instance, recurrent exposure to dust mites. Attacks of allergic rhinosinusitis may be accompanied by flu-like symptoms even body aches. And, they frequently clear up in a day or two. Your case seems quite likely to be chronic rhinosinusitis due to allergies or frequent cold. Steam inhalation with menthol can help with the post nasal" "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 41 year old male. My creatine phosphokinase is mildly elevated. The reports came as 220 twice and as normal thrice. And, there was hemoglobin in my urine test. I constantly have muscle weakness and mild pain on my left side, at the forearm and hip. The weakness started suddenly or probably it was so slow that I did not feel any change during these four years. The symptoms started one day morning when I was 37. I feel the weakness much more in the mornings rather than at nights. What disease could this be? ### Response: Hello, I read your query and understand your concerns about muscle weakness and raised muscle enzymes" "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: Till school, I was a very bright student but while pursuing graduation, I lost my interest in studies. Now I am not able to concentrate on studies and keep on thinking about other things. I am very tensed. What to do? ### Response: Hello. There are various reasons of lack of interest in studies. Not having the subject of one\s choice, parental expectations, the stress of performance, anxiety problem, lack of motivation. I would advise you to make a schedule and follow it strictly. Set some rewards for better performance. Do yoga, meditation to increase concentration." "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 noticed after masturbation that my penis had friction like burns on the gland portion of my penis. I got circumcised at the age of 21. So, I have a little extra foreskin. I had a few small red bumps show and then disappear. One doctor said it was balanitis and the other said penile friction. One prescribed an antifungal cream and one prescribed Bacitracin. The area burns a little. What do you think? ### Response: Hi. I have gone through your history and seen the attached photograph (attachment removed to protect patient identity). I think it is due to penile friction. I do not see any signs suggestive of fungal infection. You should apply a steroid-antibiotic combination like Mometasone Fusidic acid cream on the affected area twice daily for a week\s time. Use plain water for washing this area and avoid vigorous masturbation till it gets healed." "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 touched my penis to my fiancee\s vagina, and some lubricant came out of it (not sperm). Would it make her pregnant? Or any problems? ### Response: This is unlikely to cause pregnancy in your fiancee. However, she can use urine pregnancy test if she misses her period on the expected date of her menses. Pregnancy can occur only if that time she was in her fertile period and sperm is ejaculated inside vagina or nearby area. Hope this clarifies your concern" "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 18 years old. I bit my mouth while eating and my jaw hurts since yesterday evening. It is swollen, and now it is whitish yellow in color. It is painful and it has become worse. Do you have any clue of what this might be? ### Response: There might be some infection in the affected area. At times, pain and swelling can be due to inflammation. So, my suggestion is to consult a dentist and get evaluated. For now, take some anti-inflammatory painkillers like Ibuprofen and do cool compresses over the swelling. Take soft diet. Suck ice to reduce inflammation. 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 had tinnitus for five to seven years now. I had suffered a lot during the initial years as there was no solution and doctors had to control using anti-depressants. I am on a regular low dose of Escitalopram even now. My tinnitus is a very shrill sound and has no trigger or cause and is constant. I had done audiometry and there was a slight loss of hearing in one ear.Lately, I chanced to read up on some forums and have found that there are various medications that are being tried for tinnitus. Tinnicar, Ginko Biloba, Complamina Retard SR, etc.Can you suggest in your opinion what I should take to reduce or end the tinnitus? What dosage and for how long? And for Ginko Biloba which is the best brand?My other problem is, I have a sinus problem. Due to cold exposure such as sleeping under an A/C, I get stuffed sinus congestion. I can feel some liquid behind my cheeks when I jump up and down and my nose and my ears are blocked. This is not very troubling. However, this causes a loud buzzing sound in my left ear which is what gets me terrified because of my already existing sinus problem. The sinus stuffiness and buzzing stays for a few days (even if the nose blockage and stuffiness goes away). It takes a few days and I have seen that exposure to heat and hot areas makes the buzzing subside quicker.However, even after the buzzing sound is gone my tinnitus gets and stays louder than normal for an additional few more days. This used to happen regularly every few weeks. However, now it has become a constant problem. I have a constant buzzing in my ear. I went to an ENT and was prescribed Lukotas, Tinnicar and Xylometazoline drops. However, I wanted your second opinion. Should I take something like Solvin to relieve pressure (again read from similar cases in forums)?Note: In my childhood, I can recollect that I had a similar ""Sinus congestion"" a couple of times and the doctors had drained my sinus using a syringe put in through my nose. ### Response: Hello. Your tinnitus problem could be due to sinusitis, which blocks the eustachian tube and causes tinnitus. But if the tinnitus is due to sinus problem it should subside with decongestants, etc. In your case, I do not think so that your ear problem is due to sinusitis. To rule out that we need to get audiometry and tympanometry done. Also, let me know if you are on any medication or if you are exposed to loud sounds. I do not support multivitamin supplements for tinnitus. But you can take any of them for a month and see if symptom improves then you can take for a longer time. But again we will need an audiometry test. For recurrent sinusitis, you should get a nasal endoscopy done. If needed CT (computed tomography) scan of nose and paranasal sinuses also. Only then we will know the severity of the disease." "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 felt pressure in my head on Monday (thought I was getting a headache). I woke up Tuesday morning with blood in the white of my left eye. This morning I saw blood on my pillow the size of my thumbnail. What is my next step? I am currently on Pristiq, Lamictal, and Potassium chloride. ### Response: It seems to be subconjunctival hemorrhage. Are you 65 years? Is her blood pressure levels controlled with medicines? If not then monitor your BP and then get the treatment accordingly. Do you swim? Or do yoga? Any history of fever?" "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 21 years old now. I am suffering from asthma for more than 17 years. It was horrible until my 15 years of age. It was pretty bad. But the severity has reduced now. It usually occurs at night time. Sometimes it happens in the daytime too. Wheezing is present, and there is chest tightness. I am taking Foracort 400 Rotacap during breathlessness. I am taking the tablet for the past four to five years. ### Response: Having night symptoms mean that your asthma is not well controlled and upgrading the treatment is required. Foracort Inhaler 400 mg is a right combination that is used daily. I recommend you take Singulair 4 mg tablet (Montelukast) once daily in the evening. Use blue inhaler during the time of exacerbation every five minutes till 20 minutes. If there is no improvement, you should visit the nearest ER (emergency). Also, let me know if you have a PEFR (peak expiratory flow rate) chart." "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 taking steroids on and off for the past three years. I got artial fibrallation a year ago (never again since then). My blood pressure was quite high 152/90 at the doctor. LV is normal and LVEDD is 53 mm, normal systolic function, no regional wall movement abnormalities.LVH - 14 mm and beginning diastolic dysfunction (E/A=1, E/E\x80\x98 8-15), LA 21 cm^2.I already lost 24 kg and now I am weighing 110 kg at 194 cm, my goal is 93 kg. I also stopped steroids and now my blood pressure is 123/75. Will my diastolic function recover once I managed to reverse the LVH? ### Response: I have gone through your query. Can I know why were you on steroids? Was there any particular disease that was diagnosed and started you with steroids? As there are many determinants causing diastolic dysfunction, one of the common cause is hypertension. And yes, diastolic dysfunction is reversible in the majority of the cases over a period of time if you properly control your BP, obesity, and start doing regular exercise, consume a healthy diet, and lifestyle modification. You should also stop any addictions like smoking or alcohol if any. Also, get your blood sugar levels and thyroid profile checked. Get back with details about your disease and indication for steroids for further discussion and management." "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 really like to try LSD just as a matter of curiosity, I am aware of all the risks and side effects as well as having no known history of mental illness in my family and I am a happy person with no depression or anything like that. While I believe the risk for me personally to be very low I would still like to be safe hence my question. Do you think if I went to my GP and told them what I wanted to do, do you think there is a chance of even getting 1 pill of an antipsychotic to kill the effects in case things go downhill. Obviously I know the best thing is to not do it at all but if you had a patient come to you and ask you what would you say? ### Response: You have raised a very interesting query. Well done for seeking information on safety. I see that you are keen on experimenting with LSD and knowing the risks involved you want to make an informed decision. Hence it is not advisable to try it. It is highly unlikely your GP or any other doctor will prescribe an antipsychotic prophylactically just incase you have a bad trip. Antipsychotics are powerful medication and can cause side effects on their own, so needs to be used with caution when necessary after appropriate examination. Moreover, if you develop any altered mental state that persists after using LSD you will need a proper medical 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 a 60-year-old male and I am not sexually active. After masturbation, I use a moisturizing lotion. I developed a sore on the shaft of my penis. It is not painful and does not itch, but there is a slight awareness of sensation. This could be due to the bump catching friction as opposed to the smoother areas. In my lifetime, I had an occasional clogged pore or pimple when I was a virgin. I had examinations and never been diagnosed with an STD or genital warts. ### Response: Hello. I understand your concern. Please send the photographs not as collage, but as separate files. It is difficult to appreciate the morphology like this in a collage (attachment removed to protect patient identity). You can send one photo of each of these days separately." "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 started birth control a few weeks ago, so this is my first week of my period. I had brown discharge a few days before I started the sugar pill. My period started kind of light but is kind of thicker blood. I just had horrible cramps this afternoon, probably the worst ever. I took a nap and when I got up there was a large clot that looked like some sort of tissue. It was slightly smaller than an egg and was pink with dark spots. I am sexually active but my partner always wears a condom and has never finished inside me so there is no possibility of a pregnancy. Is this something I should be concerned about? ### Response: According to your description, the possibilities are: During the first months of Contraceptive pills, you can have some amount of menstrual irregularity like intermenstrual spotting. It may take a few months for regularization of the flow. And missing the time or pill can lead to spots. Regarding the tissue you mentioned could be endometrial tissue with blood spots. Anyhow better to check with a urine pregnancy test to be on the safe side. If the test gives a negative result, you can continue with your pills." "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 two-year-old daughter. She suffers from a cough for the past 17 days. It is nonproductive, and it gets worse when lying down. During night time, it comes as a dry hacking cough. The illness started with nasal congestion, and quickly, it became a cough. There is no rash, no changes in bowel movements or urination, or energy level. She has undergone tonsillectomy and adenoidectomy before ten months for sleep apnea, and it was successful.She gets this problem for the past six months. She does not have a fever. We used steroids before these events. Now, her cough got worsened for the past two days. We consulted a pediatrician, and she was given with Prednisone 15 mg two times a day and Augmentin. I gave steroids to her.She woke up in the night and had vomiting two times. She had a fever of 104 degrees. She also had congestion. I consulted the pediatrician. Currently, she takes Zofran 4 mg, Ibuprofen 10 mg, and Augmentin. Does she have a new viral infection? Why does her cough got worsened? Is it due to a progressive lower respiratory bacterial infection? Is it due to a drug reaction to the steroid? ### Response: Hi. It is less likely to be a viral infection as the temperature is quite high. It may be a viral bug, and it can be worsened after the administration of the steroid. Do not give steroid without a prescription to the child. Do a respiratory PCR, and it helps to find the exact cause of the same. A cough may have worsened following the steroid probably, because, it can be an infectious disease to be treated by antibiotics." "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: 1. I went to a spa treatment and the lady therapist after the massage gave me a blow job, and I am worried, and I asked management and tested that girl for HIV.2. Both HIV screening and western blot tests were done on the day after the blow job, and she got both negative.3. But in the worst scenario, what if she is recently infected and it does not show up in screening or western blot?4. And what are the chances of transmitting HIV through oral sex (getting a blow job)?5. My main concern is on first, second, and the third day I have a fever with chills and from fourth day loose motions and temperature continuing.6. If a person immune system is a week, do symptoms show from the first day?7. And how much percentage I am safe. I know it is a long question, but please help me out. ### Response: Do not worry about the percentage of transmission of HIV us very less through oral-genital contact. The rate of transmission in HIV positive patient through oral-genital route is 0.01 to 0.04 %. The risk of transmission is high in case of ulcers on the mucosa is active. Present symptoms may be due to some other viral fever or viral gastroenteritis. Few other viral infections like herpes or hepatitis or bacterial infections also transmitted through oral-genital route. So you may repeat the PCR for the virus after four weeks. Usually, it will be detectable between three days to four weeks. Very less chances to be an HIV. Getting a blow job partner chances to get 0 to 0.01 %. But receptive partner (giving a blow job) chances of getting 0.0 to 0.04 %." "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 had a meeting with a hair transplant clinic and they told me I needed 3000-3500 follicular units (8000 follicles). Attached is a photo of my hair loss, is this overkill? I am afraid of running out of the donor area. ### Response: It is a genetic, sex hormone imbalance disorder. There is a shortening of hair growth cycle and delay in new hair growth (increase in dihy" "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 know about small freckles on the cheeks and forehead of 1-month-old male child. Also, the left eye is watery and collection of yellowish mass after few hours near the inner end of the left eye. Please suggest. ### Response: Hi. It is very normal for a newborn baby up to 6 months of age to develop such minor skin problems. It is called milia. There is no need to worry about it. It is due to insignificant obstruction in sweat glands. I will prescribe a lotion. Please apply the lotion three to four times a day for the next two weeks. Please stop using talcum powder if you are already using it. And regarding this watery discharge in the eyes, if the discharge is very mild, no need to give any medications for the same. Please give a gentle massage on the inner side of the eye (nasal side) for four to five times a day. In some babies, such insignificant discharge can persist up to three to four months. It will settle with regular massaging daily for the next 12 months. Milia. Conjunctivitis. Dacryocystitis." "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 22 years old. And for four months I have had emergency contraceptive pill four times. One in each month after having unprotected sex. I got regular periods for four months after having the medicine. But this is the fifth month in which I have not consumed any pill and still did not get my period. Please help. ### Response: Hello. Emergency contraception is not to be taken regularly. There are two phases of the menstrual cycle first 15 days estrogenic phase and second secretory phase. These tablets are high dose hormonal and delay ovulation. So depending upon which phase you took medicine, the period will prepone or postpone. Or you can have erratic bleeding, irregular cycle eventually. Side effects of nausea acne bloating breast tenderness may occur. Get a urine pregnancy test done three weeks after taking a pill as it can even fail. Consult a gynecologist for regular contraception soon." "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 had a CT scan for head injury. I have attached the two CDs for your reference. One important thing is different in the reports. It is about a crack of parietal and temporal bones. Could you take a look and describe them to me? ### Response: I have seen the images of CT scans (attachment removed to protect patient identity). Revert back with the answer to the above question to a radiologist 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 having slight bleeding for past three days along with mild cramps in five weeks of pregnancy. Is it normal or sign of miscarriage? ### Response: Hello. I have gone through your history and understand your concern. It could be a sign of miscarriage but it could be due to threatened abortion. Get your pelvic ultrasound to rule out the for the fetal well being. Take Progesterone and do rest and consult your treating doctor for the same" "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 29 years old. I never had intercourse before. I was dating and my partner did oral sex and fingering for a few minutes. I am not too sure if he had semen on his hand or his hands were clean. I am really worried if this will lead to pregnancy. I am feeling stomach cramps on and off after that. Please advise. ### Response: Please tell me when was your last period, period pattern, and cycle length so that I can tell you about the chances of getting pregnant. If you had the act before a week it is too early to detect pregnancy. Please share the period details for further guidance." "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: Today I checked my liver function test. My SGOT is 40 (5 to 35), SGPT 55 (5 to 40), but when I searched online, the normal range is SGOT (5 to 40), SGPT (7 to 56). What to do? And the doctor asked me to take fibroscan. Actually fibroscan is three stage in fatty liver. Should I take fibroscan? ### Response: I just went through your symptoms and I also saw your laboratory investigation reports (attachment removed to protect patient identity). Your liver function test enzymes are very normal and you do not have to worry about it. The second thing is your hepatitis B surface antigen is reactive which means you are hepatitis B positive. You do not need to get fibroscan. You do not have to get it done at present. Instead, if you have an ultrasonogram or CT scan of the whole abdomen that might be able to tell you if you have any underlying lesions in the liver." "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 right eye corner is swollen and having pain when I close my eyes for the last two days. Swelling is on the edge of the lower lid. My baby threw his soft toy which kind of touched my eye two days ago. From then onwards I am having this issue. Kindly suggest a remedy. ### Response: It seems like the infection has occurred due to injury. It appears to be bacterial blepharitis. You can do hot fomentation first of all for pain relief. ocupol eye ointment at bedtime for five days. Start tablet enCifixime 200 mg twice daily for three days. 1. Tablet Diclopara plus (Diclofenac, Paracetamol), Serratiopeptidase once after meals for three days. 2. Tablet Pantop 40 mg (Pantoprazole) once before breakfast for three days. Please rule out any allergies beforehand. You will get relief within 24 hours." "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 27 years old male. I am unable to sit crossed legs, also unable to sit with straight legs. While trying to sit crossed legs, I am unable to keep my back straight and also left knee does not touch the ground completely and I tend to fall backward. Similarly while sitting with straight legs I need a support on my back else I have to bend my knee. If I try to sit without support, again I tend to fall backward. Please help. Can this issue be resolved by physiotherapy? Any specific treatment or advice? ### Response: The problem you are suffering from is because of excessive use of chairs while sitting. The reason you are not able to sit with your knees close to the floor maybe because of the tightness of the muscles on the inner side of your thigh which needs stretching. It may also be because of the structure of your hip joint. The reason you are in need of a back support when you sit with your legs straight is because of hamstring muscle tightness. If you stretch your hamstring muscles you will be able to sit with your legs straight without any back support" "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 four big fibroids. Two intramural 12 cm and 10 cm each and other two 4 and 10 cm each which are subserous. I do not have any symptoms except for frequent urination. My periods are also regular. Is there any medication to shrink the fibroids? ### Response: Hello. According to your condition, along with Ayurvedic medicines you also require panchakarma procedures like Vamana or Virechana. Vaman is emesis therapy and Virechana is purgation therapy. They are done under the supervision of a physician. They will help you in removing excess toxins from your body and also will help you in fibroids. Along with that, you can take Ayurvedic medicine for fibroids. Rather than taking medicine alone take panchkarma therapy along with it. So I advise you to visit a nearby reputed Ayurveda physician and ask him regarding this" "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 27 years old and my weight is normal. I have fat balls on my body everywhere and some are painful. How can I get rid of those? Please help. ### Response: From your description, most probably you have lipoma which is the accumulation of fat. If they are painful, get them surgically removed. Please tell me the following things to help you better: Revert with the answers 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 had eye checkup nine months back as I had light pain in right eye. The doctor advised me to get OCT and CCT. With the test reports he said that I have glaucoma. He advised me to take an eye drop named Lumigan one drop daily at night in both eyes. I am not satisfied with his opinion and so went to another doctor. He said no glaucoma and advised to take vitamin tablet daily. After a week consulted another doctor and he said that the OCT report is normal and no need to take any eye drop. After a week I went to a famous eye hospital and consulted there. Again took an OCT and reported to have glaucoma and advised to take Brimosun 0.15% drops twice daily with a gap of 12 hours. A month later went to another hospital and the doctor said he is in confused state and asked me to check my eye regularly and take OCT for every six months. Then two months later I visited a glaucoma expert and he examined my eye deeply and done another OCT. After all tests he said I am a glaucoma suspect patient and advised to take eye drop Timolast 0.5% or Timolet od every morning one drop in both eyes. My eye pressure is always between 20 and 24 in both eyes. My first and second time CCT reports are 502-503 and 533-534 respectively. My OCT reports showed 10% area in red figure and balance in green figure in the left eye and 10% area in yellow and balance in green in the right eye. Is it necessary to take glaucoma drop? If yes, which one to take from the above? Is Timolet a highly concentrated one in comparison of Brimosun 0.15%? My mother suffered with glaucoma. I am taking Thyronorm 75 daily. Please advise me in detail. ### Response: First of all please relax. There is nothing to worry. All the doctors are correct. Now let me explain you. Glaucoma is a very slowly progressive disease. You are glaucoma suspect means you are at risk of glaucoma or have many predisposing factors for glaucoma, but there is no conclusive evidence to diagnose glaucoma. Predisposing factors present in you are as follows: All these factors make you susceptible for glaucoma, but it is not conclusive. You should not worry about glaucoma or loss of eye sight." "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 husband is 32 years old. From the last few days, there is a problem with his skin. He is having a very sensitive and oily face skin. But the rest of his body is dry. That is why he is very much prone to acne. But, nowadays there is some pigment kind of marks in his knuckles and feet. I have attached the picture herewith. Kindly suggest me something. ### Response: Hello. I have seen your query but can not find any attachments. Please get a review with pictures for better evaluation and best possible treatment of your husband\s concern." "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 a severe rash on my forehead which is painful and itchy. Can you kindly take a look and advise the treatment? I fear that this may be a sign of skin allergy or maybe the onset of cancer. I have tried to use Fluticasone propionate, Flutivate and also tried Ketoderm-Hydroval Cr AA 50:50 gm cream. ### Response: Kindly upload the images so that I can have a clear picture of the condition and can guide you accordingly" "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 one lump under my jaw and one on neck. They are movable and shape of them is round in size, may be to my fingers tip and one more lump behind my ear, it is hard. All three do not cause any pain and I have not checked with any doctor. I am worried I am suffering from any serious illness. ### Response: Hi. I have read your query carefully as you told that you have movable fingertip-sized lumps and it does not cause pain, please do not worry about that. It does not look like a serious matter although if you want to be 100 % sure then you should go for a test called FNAC test otherwise according to my knowledge these are normal sebaceous cyst or lipoma." "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 has type-2 diabetes and has lost several teeth. I am trying to talk him into a dentist visit, not necessarily to walk out with implants or dentures, but to just get an exam and a cleaning done. He believes that the few teeth he does have left will not survive even something as simple as teeth cleaning. That the dentist would take one look and want to pull them. ### Response: How are you doing? First of all, do not worry. Maybe he is afraid of dental visits because of previous experiences. Uncontrolled diabetes can cause bone loss and hence tooth mobility, in conjunction with improper oral hygiene. Since I do not know the condition of his remaining teeth, I cannot comment on the treatment that will be advised for him. You can maybe send me an image of his teeth and I can advise you more precisely. Secondly, I would advise him to get his missing teeth replaced as this prolonged period of missing teeth might cause aggravated bone loss. The implant will not suit him as he is diabetic, you can go for removable dentures or fixed partial denture (if he has sound teeth left). Tell him to go get a dental visit done. Dentists are there to help you out. Nothing will be done without his consent. Moreover, he can explain his problems and fears and the doctor will accordingly plan the treatment. Feel free to ask further questions" "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 going to have the muscles shortened in both eyes and then my eyelids lifted. They say I will be asleep when these muscles are shortened and then they will wake me up so I can talk and move my eyes. Will they put a tube down my throat? I am so scared about having this done as I panic when a lot of people get around me. I was in a serious car several years ago and it took for the medical personnel an hour to get me out. ### Response: As far as anesthesia is concerned in your case, the eyelid surgery may be done under general anesthesia which does require securing your airway safely. Prior to securing the airway, you will be given injectable medications to make you fall asleep so that you do not remember and also you are not aware of the procedure when it is being done. So I would suggest you not to worry. As general anesthesia is a safe procedure when given by an experienced anesthetist. Now let me tell you about either of two tubes that may be used for the procedure are laryngeal mask airway (LMA) and endotracheal tube. LMA has advantages over endotracheal tube of less postoperative sore throat and lesser intraoperative rise in blood pressure and heart rate. This insertion and removal of airway tubes are safely done while you are unconscious so you are not aware of the procedure. So please do not worry. General anesthesia is given meticulously nowadays and patient safety is a primary concern." "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 RA and have been on prednisone for 15 years or more. I was tapered off with the last dose taken five months before. I now can barely walk, my pain is unbearable, and my right leg and foot are swollen. I have tried every OVC pain medication possible, and nothing is working. What is going on? Should I go to ER? ### Response: Hello. And Prednisolone will be required until the Dmards combo works. It does not help in reducing the steroids dose in three to the fourth month, and then biological therapy should be planned. 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: My daughter is 11 months old. By mistake, I gave expired Vitazyme drops to her. After giving the dose she vomited immediately. Will this act of mine harm her? ### Response: Hi. As she vomited immediately, nothing would have gone inside. So, it is unlikely that it will cause any effect on her health." "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 50 year old male. My weight is 84 kg and 5 feet 10 inches tall. I am experiencing pain while urinating in the outlet of the organ. This is the first time I am getting such a pain. Please help me. ### Response: I have gone through your case and can well understand your genuine health concern. 1. Urinary tract infection.2. Calculus in bladder or urethra.3. Any local pathology in urethra. 1. Complete blood count.2. Urine routine examination.3. Ultrasound of abdomen and pelvis. Revert back for follow up along with the investigation reports 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: I have had a sore throat for about three weeks now. Two weeks ago I have had strep throat and doctor gave me 10 dose antibiotics but my sore throat came back on my left side and it hurts my ear and throat when I swallow still. What could this be? They did a swab for the throat but no strep but what else is this? I have a minor cough. ### Response: With the conversation I understand that you had suffered sore throat for which swab was done and appropriate antibiotic was initiated. Now again you have developed sore throat, more so on left side, with ear ache while swallowing. Most probably there is inflammation which has not fully got resolved. Since throat tests are negative, we can conclude that there is no active infection. But infectious products may be remaining causing the body to produce counter products (inflammatory response). The same is causing you the troubles. Since the back of throat is connected to ear through the eustachian tube, it pains in the ear also. I suggest you the following which if you take you will find relief. Anti-inflammatory tablets of Trypsin-Chymotrypsin and Rutopside/Bromelain combination, taken before food twice a day for 5 days. Also painkillers Paracetamol/Acetaminophen appropriate dosage will do. To relieve ear ache and eustachian tube obstruction you may use nasal decongestant" "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 had a full blood count as he experienced fever (38 degrees) for the past 10 days. The onset of fever is around 5 PM. I took him to the emergency department and they are questioning whether he may have lymphoma. His WBC was 16.65x10 e3/uL, LY% 5.6, BO% 26.8, NE 9.73. Can it not be a simple infection? Glandular fever for instance? ### Response: His total leukocyte count is increased but the main reason for your doctor\s suspicion for a hematolymphoid malignancy is the high basophil percentage. Leukemia is diagnosed by the presence of blasts more than 20 % in the blood and/or bone marrow and more than 25 % in case of lymphoblastic leukemia. It can only be confirmed by the examination of the blood and bone marrow. If the percentage of blasts is consistent with leukemia further tests like flow cytometry and genetic testing will be required for treatment. It is better to get a hematolymphoid malignancy ruled out" "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 35 year old male. Earlier this year, I had chlamydia for about four months. I have been clear of the injection since about seven months. Now, my partner and I are trying to conceive. I had a semen analysis and the results were not great. The worst part is the morphology. Only 2 % of my sperms are formed normally. The rest are abnormal. So my two questions are: is it possible that the chlamydia is the cause of this? Can chlamydia cause permanent problems for male fertility? Is there anything I can do to increase this percentage? I am taking vitamins and exercising. I am soon going to cut out sugars and watch my diet. Will this help? Are there other things we can do? Lastly, the evaluation said I have a \poor prognosis\ in terms of my morphology. And overall it said I have \moderate male factor\ circled on my sheet (I assume that means - moderate male factor infertility?). But the person who did the analysis said I am suitable for IUI\s. How successful are these in my circumstance? I will attach a photo of the evaluation so you can see all my numbers. I have only blocked out personal information. Sorry for all the background. Again three questions: Did chlamydia play a role in my current situation? Anything I can do to improve my normal morphology? How successful is IUI in my circumstance after looking at my evaluation? ### Response: Hello. Chlamydia is one of the major reasons for this situation along with other factors like smoking, and alcohol. Complete the course of antibiotics given by your doctor to improve your semen. Also quit smoking, and alcohol consumption if you are taking. Yes, there are good chances of IUI (intrauterine insemination) in your case because only viable, motile sperms are inserted in the uterine cavity" "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 erectile dysfunction. Kindly tell me what to do. ### Response: The causes of erectile dysfunction are many including medical conditions such as hypertension, thyroid dysfunction, diabetes, local genital pathology, low sex hormones, etc., and it can be psychological also. So get the investigation done to rule out medical conditions. Secondly, it can be managed first by a technique called Master and Johnson. Read it and practice it. It is difficult to explain it here, if you cannot understand it then consultation with a psychiatrist in person is required." "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 went to the dentist because I am having bad breath problem whole day from last eight years. This bad breath is also there after brushing. The doctor did scaling and polishing and gave me a mouthwash (Chlorhexidine gluconate solution) but it did not work. I am still having bad breath. One of the dentist suggested me to go for ENT. When I wake up in the morning my mouth smells very very bad, then after brushing also my mouth start smelling after few minutes, brushing two times a day did not make any effect on my bad breath. My friends say you have unusual smell in your mouth because of which I am not able to talk with anyone. This unpleasant smell is not for some time, it is the whole day. Do not know why. Please help me. X-ray paranasal sinuses were done and ENT specialist said everything is fine. ### Response: Hello. The patient is suffering from halitosis or GERD (gastro-esophageal reflux disease). Practice good oral hygiene. Brush twice a day with fluoride toothpaste to remove food debris and plaque. See your dentist regularly, at least twice a year. Stop smoking and chewing tobacco-based products." "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: This patient is complaining of prolonged chest pain for three weeks now. Took medication for gastric issue and the pain has not subsided. I have attached the angiogram report. ECG performed several times and nothing abnormal in it. The angiogram report showed mid LAD 12 mm length and segment eccentric calcification. Soft plaque in LAD causing 50% stenosis. What is the recommended course of action? ### Response: Hi. I appreciate your concerns and can well realize the sensitivity of the issues. There is considerable calcification of LAD (left anterior descending artery). If it reaches up to 75% that is quite possible in the near future, then complications and consequences can be severe. In case of single artery involvement in coronary artery disease (CAD) it is best to have an angioplasty of the vessel with stent placement." "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 wear Essix retainers at night after braces. Recently, I broke my two front teeth and had them bonded. I had to get new retainers and got them from the clinic but my new retainers do not cover my wisdom teeth. I have all 32 of my teeth. Is there a risk of my wisdom teeth hyper erupting? ### Response: Hi. The night only wear of retainers will not cause over eruption of wisdom teeth, as during daytime you will have a normal bite. However, you might feel a slight change in bite as you remove your retainers in the morning. It does settle down within a short period. Usually, third molars are not included in the retainers. And patients wear them quite comfortably without any side effects such as over eruption. However, if you feel uncomfortable, you can request the dentist to make a new set of retainers that cover your wisdom teeth as well." "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 two sexual encounters with women whom I do not know their HIV status. Both were vaginal and a condom was worn. In the fourth and fifth weeks, I had a fourth-generation antibody-antigen test performed and it came back negative. Should I be retested again? ### Response: It is a good idea to get repeat testing, here is why. The antibody testing at the fourth and fifth weeks can give you some idea of the HIV (human immuno deficiency virus) status, but the one at 12 weeks after the exposure will confirm the negative status completely. The reason being the window period. The window period is a duration where a person can have HIV but still test HIV negative. The fourth generation is antigen-antibody based testing and the best we have so far for screening. When suspected acute HIV infection or high risk exposure, PCR (polymerase chain reaction) is the best in the fourth and fifth weeks post-exposure. Of note, the window period for a fourth-generation antigen-antibody test is short as compared to other HIV tests available (about four weeks). Usually by this time, 95% of infection will be detected in the blood. In general, there is a three month window period for HIV after a given exposure, and therefore for the fouth generation testing to confirm that a person is more than 99.9% infectious. Hence the 12 weeks retesting is recommended. 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 56 years old male. I have eye floaters problem. I have blood pressure. I am taking tablets for it. ### Response: Hi. The floaters in the front of the eye indicate disease in the posterior segment of the eye that is retina or vitreous. As you have raised blood pressure, though you are taking medication, you have an increased chance of having retina and vitreous problems. You can get your dilated examination to check the posterior segment. There may be bleeding or swelling in your eye or a degenerative process called posterior vitreous detachment which is common in your age." "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: How likely is it to re-tear (or re-separate) the acromioclavicular joint after surgery was performed on it with a cadaver tendon? It has been a year and a half post surgery. He was lifting 50 lbs overhead, wind pushed equipment back, causing loud popping in left shoulder (previously had surgery). Shoulder is now presenting with swelling, no mobility and pain.I want to know the likelihood of acromioclavicular joint getting separated again. ### Response: There is a high likely chance since you are symptomatic (pain and swelling). Subjecting to vigorous exercise and history of previous surgery adds to the suspicion. It is better you get evaluated and treated earlier. Though cadaver tendons are stronger and it is been 1.5 years. It can never equate your original strength. First get your pain and swelling down with analgesics and get an X-ray. If no bony injury and pain persisting, get an MRI done. X-ray followed by MRI shoulder if needed. Acromino-clavicular joint dislocation. Analgesics and anti-inflammatory followed by 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 8 weeks pregnant. Can I take Prodeine Forte for the chronic wisdom tooth pain? I am going to see the dentist tomorrow. But, now I am crying in pain. ### Response: Hi. You can take Paracetamol 500 mg up to three tablets maximum for the pain relief. But you need to consult your Gynecologist first for the advice. High dosage of Codeine is harmful during pregnancy at early stages. The best way is to visit a dentist and get an access opening done. My opinion is to go with Paracetamol 500 mg." "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 24 years old male who is seriously suffering from stomach inflammation, back pain with inflammation and chest pain with inflammation. Please help what can be done. ### Response: Hello. The stomach inflammation and pain can be because of gastritis or ulcer like condition. It can lead to referred back pain and chest pain as well. For that, antacid can be prescribed. I suggest you investigate with chest X-ray if the pain is not burning type. You should consult a physician for the 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: Two days ago, I was eating some food, and afterward, I noticed the back of my throat was hurting. I did not think anything of it, and as I went on, it got worse. I took a picture of it which is on my palatoglossal arch right below my tonsil. There are two whites spots, and they are inflamed. I went and got a streptococcus test, and it is negative. But it still hurts, but the pain goes away with oral mouth wash and when I have put tea tree oil on it. What could this be? ### Response: It seems to be a simple inflammation. Continue the mouth wash and the analgesic plus an antibiotic as Amoxicillin 500 three times daily for a week. Do you have reflux? Or any other chronic diseases?" "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: Before two months, I had one stent put in the complete blocked artery. Scans showed heart muscle damage from an old heart attack this was caused by me not taking my BP drugs. So for the first time in my life I have stuck to taking all my prescribed drugs, these were Aspirin 75 mg, Amlodipine 10 mg, Atorvastatin 80 mg, Bisoprolol 1.25 mg, Ticagrelor 90 mg. It has been eight weeks I felt a great minus few chest niggles presumed this was stent settling and I am still smoking 20 a day. Now for the last one week I have a severe dry mouth all the time despite drinking and my urine output is 5 liters to my input of 1 liter. At night I am going after every two to three minutes. My doctor is thinking I have a UTI despite being negative for it. Now they are testing me for gonorrhea and chlamydia. My suspicions are that the drugs I am taking causing this? I feel like stopping them all together or halving the dosage I cannot see my cardiologist until next year. Is there a link between my drugs and these symptoms? And am I safe to temporarily stop a few of them to rule them out? If so which ones are crucial and which are not? I am eternally grateful for your help. ### Response: All the medicines you are taking are essential medicines and should not be stopped except in case of severe allergy. None of these medicines cause increased urination. Amlodipine is a blood pressure lowering medicine, it can be changed to some other medicine. This medicine may cause fluid retention and swelling of feet in some patients. Regarding increased urination possibilities include maybe you are taking medicines called water pills or diuretics which are sometimes given in heart patients, these increase urine output. Please review your medicines. UTI (urinary tract infection) may cause increased urination. Raised BP itself may cause increased urination. Keep BP (blood pressure) in control. Please reduce weight. Take Mediterranean diet, do regular exercise, and have a proper sleep. Never stop or switch to any medicine without consulting a cardiologist." "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 49-year-old male. I took Prevacid for 17 years. One or two pills a day. I stopped five months ago after I read about that it increases the risk of dementia. If I do not have dementia now, and I have stopped the medication do my risks of dementia remain elevated for the rest of my life? Is the effect reversible? Does stopping the medication mean I am no longer at higher risk for dementia? Is the damage already done even if it is not noticeable at present? I asked my GP, and she said nobody knows. That even if I took an extensive test from a neuropsychologist, it would only mean I do not have dementia today, but it does not mean that my past Prevacid use would not cause dementia in the future. That leaves a life of uncertainty ahead. Is that the answer we just do not know? I wanted to ask a neurologist before I accept that answer. ### Response: Hello. After careful review, I understand you are worried about the side effects of Lansoprazole (Prevacid). The reversibility of effects is based on the extent and the nature of damages done by any" "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 baby is three and a half months now. Since he completed three months, he is more on formula milk than breastfeeding due to supply issues. He poops every alternate day. I am concerned as his poop color is dark green and at the end of the process a slight yellow poop comes. I have learned that babies on formula milk poop green but it is dark green. That is the reason I am concerned. Please suggest. Also, I would like to add that the consistency is normal, not too hard or too watery. ### Response: The color of the poop does not matter much unless it is dark black, which is a possible sign of occult blood. Usually poops in babies on formula feed is dark green. A breastfed baby will have golden yellow poop. So, do not be worried at all. I also suggest you take some medicines to increase your milk supply as every mother gets milk at least until the baby is six months old. You can try supplements like Lactare or Lactonic granules in milk. If this does not work, I suggest trying Domstal (Domperidone) tablet and it will surely increase milk supply. I hope you use a breast pump too at home. The more you pump and stimulate your breast, the more milk you will get. Hope this answers your queries" "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 took an Unwanted 72 tablet on 15th last month and had bleeding from the 26th to 31st. Her expected date for the period was 6th this month but a doctor suggested she should wait till 15th. She started with an odorless vaginal discharge and has reduced since but is yet to have her periods. She has no common symptoms of pregnancy but is under tremendous stress. What would you suggest? ### Response: Hello. So, now her next bleeding or menses would only be after a month post 31st, that is by 2nd or 3rd next month onwards. In some cases, this may be delayed by a further one or two weeks as it is a known side effect of Unwanted-72 to delay natural menses for the next one or two cycles. So, pregnancy is unlikely as she had a 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: My uncle had a heart attack four days back. The balloon was put, and he had three stents. The balloon is being removed tomorrow. The reports are three days old and were taken before two stents are inserted. I just want to know what are the chances of recovery based on the report and damage. Is it very severe? ### Response: I understand you are worried about your uncle\s health. He will be fine hopefully. I had gone through the reports (attachment removed to protect patient identity)." "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: There is a tight feeling below my ribs on my right side. Sometimes, a little painful but other than that I am feeling very well. ### Response: Hi. I have gone through your query and can understand your health concern. The tightness could be due to gaseous problem or disease of the organs present in that area like liver, gallbladder or ascending colon. Sometimes, liver pathology can cause such symptoms. In my opinion, you should consult a physician and get your check up done. You may need an ultrasound of the abdomen and liver function test. Avoid oily, spicy food. Avoid tea and coffee. Include more fibers in your diet like salads, green leafy vegetables, whole grains." "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 21 years old. My main concern is, I have a lot of stretch marks on my body. I had them on my shoulder and thighs since I was 10 years old. Now, I have them even on my belly and biceps area. For the past three months, I have been working out. I do not feel it is because of working out. Please have a look at the pictures and let me know if they can be cured? What other alternatives do I have? Kindly suggest. ### Response: I have checked the photographs (attachment removed to protect patient identity) and noticed that you have a lot of old stretch marks on your shoulders and abdomen. I would suggest you start topical application of Tretinoin cream 0.1% on the stretch marks daily at night. Use it for at least for a period of six weeks and check for any improvement. In case you do not achieve the desired results, then you can go for laser treatment. In chronic cases, Nd: YAG (neodymium-doped yttrium aluminium garnet) laser and fractional photothermolysis will be used. 1. Seen in adolescence and associated with rapid increase in size of particular region.2. In weightlifters it is seen, when their muscle mass increases rapidly. Striae atrophicans." "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 has been around four years that I am always scared to sleep. It usually happens if there is an accident I am scared that it will happen to me too, and I would not sleep for about a week. I am so scared of earthquakes, and many nights, I will not sleep thinking that our building will fall. If there is any news like killing people, I will lock all the doors and windows thinking that I will be killed too. And another thing is supposed I eat at 1 pm for the next two hours I will be full and suddenly I feel so hungry, and in a minute I started feeling so weak and start to shiver. This happens whenever I am feeling hungry. ### Response: Hello. Your symptoms are suggestive of an anxiety disorder, which is making you excessively worried about things happening around you. It can be tiring and emotionally exhausting to experience high levels of anxiety all the time. Try relaxation exercises to help manage stress and related anxiety levels. Deep breathing techniques and progressive muscle relaxation exercises will be beneficial. If possible, try yoga as well, and counseling or talking therapy will be helpful. If symptoms are severe and persistent, you will benefit by consulting a psychiatrist for a full assessment and consider medication options as well." "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 narrowed disc in the center of back. There were no problems for almost a year. I usually do surfing, yoga and kung fu. But I woke up early around 3 AM last week with a super sore and stiff back. When I am lying down it hurts to cough, or I will roll from side to side. When I am getting out of bed, if I am upright, the soreness goes away. I can have a nap after lunch, and I do not have sore at that time. The pain in the back comes due to alignment and causes problems. But it resolves quickly. ### Response: The back spasm is due to excessive activity that could have aggravated due to faulty posture in the bed. Do a lot of icing. Stretch your back and your hip flexors. Do spine extension like cobra stretch. If you can, engage in glute stability exercises and do warm up and cool down. Hope this is helpful for 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 21-year-old married female. I have been suffering from anger and anxiety issues since last one year. I also did online counseling which benefitted me a lot. Now my anger and anxiety are under control. But during the time when my problem was at its peak, I developed a liking for alcohol which I am not able to overcome. I consume about 180 mL of alcohol at once and often two to three times a month. I am scared that it will cause irreparable damage to my mental and physical health. My therapist advised me to divert myself in some other activity when the craving develops. I do this for some days but after that, I fall prey to my temptations. I do not know what to do. Please advise me. ### Response: I went through your query and appreciate you for realizing the problem and being motivated to quit. Regards" "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: Recent health check (which I do it by myself routinely and I do not have any diabetes, BP or any other disorder), I found abnormal values of the following hematological parameters, Hb- just normal, RBC- low, MCHC- low, MCV- high (lab has marked all the last three items under bold). Liver , kidney and other blood parameters are normal. Cholesterol- normal, except TGL, which has slightly gone up. My age is 53, BMI- 23, active and fit. Kindly advice whether I need to worry. Even two years back also the parameters RBC/MCV/MCHC were marked as abnormal which now I have noticed. ### Response: Hello. I have checked your attached reports (attachment removed to protect patient identity). Your hemoglobin level is within normal range. So you may need not to worry about that. You need not worry regarding slight low red blood cell count. For slight high MCV, you can investigate further with serum B12 estimation. Your triglyceride level is slight high. For that you can continue with prescribed medication that is Atorvastatin. So finally you need not worry regarding your all attached reports as per my opinion." "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 31 years old female. My weight is 49 kilograms. I have raised TSH level of 7.5 mIU/L. I have severe hair fall, and my iron, vitamin D3, and vitamin B levels are normal. How to bring my TSH level to a normal range? ### Response: I have gone through the attachment (attachment removed to protect patient identity). You have raised TSH levels. But it is not significant enough to necessitate treatment. You can repeat your thyroid function test after three months again to make sure that it has not risen further. Regarding your hair fall, it depends on the thyroid function also. You can take tablet Zinc gluconate 100 mg once daily for two months for your hair fall. You can use Minoxidil 2 % hairspray for your scalp for four months. Use it with care and avoid having contact with your face. Try to avoid having pollution effects on your scalp." "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 issue is that around six months before I started getting tinnitus in both my ears. A month later, I had an MRI and a couple of neurologists said that the MRI is fine. I was referred to an ENT doctor. One ENT doctor said that all is fine after several audiography tests. Now, three weeks before, I started getting giddiness and the tinnitus continues the whole day in both ears. I went to another ENT specialist. He is of the opinion that my MRI might be read by a well known neuro radiologist. I am sending my MRI image herewith for your perusal. I am a 65 year old male. I am neither diabetic nor hypertensive. I am a vegetarian with no smoking and drinking habit. Please look into my MRI and give your opinion. ### Response: Hi. Your MRI looks grossly normal. In an unexplained tinnitus like this, you need further investigations to rule out two rare conditions, jugular bulb abnormalities and sigmoid sinus diverticulum (sinus wall abnormality). You will require high resolution CT of the temporal bone to look for any bony abnormalities. Another possibility is dural arteriovenousfistula dAVF; however, MRI does not show any evidence for this. You will need cerebral DSA (digital subtraction angiography) for excluding this condition because of tinnitus. The same test will also identify jugular vein and sigmoid sinus problems." "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: This is really nerve racking but I noticed these growth on my shaft (fold area) that are very small and round. They tend to itch quite often especially when touched. I have attached a picture. I am afraid it could be genital warts. I last had sexual encounter with a female escort earlier this month. We kissed, rimmed her anus and I used condom for vaginal sex. ### Response: The last picture shows a genital wart-like lesion (attachment removed to protect patient identity). They are treatable too, they would require a physical ablative therapy like cryotherapy or radiofrequency removal, which can be done in a skin clinic. Warts are not usually itchy. If you have itchy, scaly lesions, better to complete an antifungal treatment and then go for wart removal." "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 husband is suffering from heredomacular degeneration. And I am pregnant and have one daughter. Will this problem also affect my unborn and daughter? Kindly suggest me. Someone told me it is a genetic disease. ### Response: Hello. Heredomacular degeneration refers to a broad collection of diseases which affect vision by causing problems in the macular region of the retina. Some of these diseases are known to have a hereditary predisposition. The pattern of the precise inheritance can be known if you can provide details of the eye examination and the exact diagnosis made. Coming to the question of your daughters, I am afraid they too are at risk. The best way to deal with the situation is to have regular visits to your ophthalmologist, preferably a retina specialist with a decent setup of retinal diagnostic equipment. Home monitoring: The best time to do this would be while they are watching TV or doing some work requiring visual attention, attention is required if they may object to closing one eye/ go very close to the TV/ hold books or mobiles very close to their eyes. The earlier the problem gets detected the better is the position we will be in to prevent irreversible problems." "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 40-year-old female. I went to my doctor a year before because I had a little blood in my urine when I wiped. He did a urine analysis, and some blood work and everything came back fine. There were no problems until three days ago. I peed then a few minutes later it felt like it still had to go so I went back to the toilet but I just got only blood. There was a lot this time, and it was fresh blood and small clots.It is hurting while passing the blood but that is all that came out though I had just emptied my bladder a few minutes before that. The only other symptom I seem to be having is all of a sudden there will be an immediate need to pee out of the blue but then when I go it is not a full bladder of pee just like half but it the onset was very sudden, or I am going to pee my pants.These are my only symptoms. I do have a long history of stones, but I am confident this is not due to that, because I have had blood from stones but not this amount of blood. And every time I have ever had a stone, it hurts worse than childbearing, and I am not in that kind of pain. I feel whatever is going on is the same thing I went to the doctor last year, but he found nothing. What is likely to be wrong with me?I am currently on Coumadin, Lanoxin, Coreg, and Propylthiouracil. Laboratory tests performed are urinalysis, hemoglobin a1c, CBC (complete blood count), fasting lipid panel, and fasting glucose. ### Response: Hello. A bladder infection (cystitis), stones and overdose of Coumadin (Warfarin), all three can be the likely reason for your bleeding. In case of any such bleeding, an ultrasound is a must. I prefer to start with a short course of antibiotics (mostly Nitrofurantoin and Cipro or Levofloxacin are given) for five days depending on sensitivity patterns. Blood clotting parameters need to be checked to see if you are on the overdose of Coumadin. Ultrasound is a must to rule out any other serious causes of bleeding like a tumor. Since antibiotics are not available over-the-counter in your place, you need to get back to your general physician. Moreover, even for getting an ultrasound and clotting parameters to check the overdose of Coumadin, you need the help of your general physician. Please do at the earliest." "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 fibromatosis of muscle, ligament, and fascia after having a fibromatosis removed from my thigh. But the margins were not clear. I have been scheduled with a second surgery now. I am concerned about the diagnosis. The clinical history shows a soft tissue mass. The gross description shows a lobular yellow adipose tissue aggregating to 2.5 x 2.5 x 0.9 cm. The specimen was received in formalin, and it consists of two irregular friable portions of lobular yellow fatty tissue. Sections reveal a slight fibrous cut surface. I am attaching my laboratory reports. Please help. ### Response: I have gone through the reports (attachment removed to protect patient identity). Your report does not show a definite diagnosis. I am taking fibromatosis as the final diagnosis. Fibromatosis is also called as a desmoid tumor. It is a slow-growing disease. It has an uncontrolled proliferation of fibrous tissue in the body. It starts as a slight tightening of the skin, and it slows down the functions of the structures or organs it involves. It is treated by doing surgery. Some oral medications can keep them under control." "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: Fasting blood sugar is 194 and postprandial blood sugar is 354. Please tell me if sugar is confirmed or not. If I am diabetic, what should I do? ### Response: Hello. Looking at your blood sugar level, it is on the higher side. You will need medication to bring it under control. After a few months of treatment, your doctor will decide whether the dose can be reduced depending on your blood sugar control. As of now, it is important for you to start therapy and bring this under control. Remember, diabetes is not a disease by itself if it is under control. If the levels remain high constantly, it could lead to disease. Hence, I recommend that you visit your doctor as soon as possible for further guidance" "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: About six months ago, I developed pain in my lower back mainly in my waistline towards the right side. I visited a doctor and we tried PT but it did not work. I then scheduled an appointment with a chiropractor, however, it was canceled dude to COVID-19. A couple of days ago, I was lifting at the gym and everything was going fine. I started noticing the left side of my back waistline beginning to hurt so I went home. Since then, the pain has worsened a lot. It is a sharp shooting pain that will extend from my waistline into my buttocks. I can barely sleep at night because when I try to turn over the pain is too extreme. I feel it a lot when walking as well, or trying to stand up if I am sitting down. Also, lying on my back causes the area to ache really bad. The pain is at its worse when I need to roll over in bed or when I stand up from being in a lying position, even if I was lying or lounging for a minute or less. I am a 23-year-old male in the military. The initial back pain that started months ago was found to be caused by wearing my sidearm at work for 9-13 hours a day and additional gear such as body armor. However, this new pain is something different. Please help. ### Response: You will need some investigations to confirm the cause. However, the likely possibility is lumbar spondylosis with nerve compressions. Most importantly, you should avoid heavy activities, lifting heavy weights, etc. You will need an x-ray of spine AP (anteroposterior) and lateral view and may need an MRI (magnetic resonance imaging). Physiotherapy would be helpful. You may continue to have Aleve (Naproxen) according to need. You may use local Diclofenac gel or hot water fomentation. We usually give patients a multivitamin like Neurobion forte (B12) which is good for nerves and next in the line is Pregabalin which is a nerve stabilizer. 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: My 26-year-old wife got her first seizure one year ago and she gets the seizure once every month or two although all her checkups are fine with no sign of epilepsy. The doctor put her on Keppra 500 mg and she still gets her seizures and complains a lot of side effects. I am wondering is it catamenial epilepsy or PNES. Please advise. Of note, we are planning for a baby too. ### Response: Hello. Regarding your concern, I would explain that the catamenial epilepsy is a very specific type of epilepsy where a seizure occur every month at the same time closely related to the menstrual cycle. Anyway, the dose of Levetiracetam that your wife is taking is low." "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 30-year-old female. I have thalassemia minor. Is there any problem in the future relating to pregnancy and delivery? Or is it fine to be pregnant at this age with thalassemia minor? Please reply. I dont have any problem now. My hemoglobin level keeps between 10 to 11 g/dL. ### Response: Hello. Thalassemia minor is not a major health disease and do not worry about that even though it is present in your future child. But you need to rule out thalassemia minor in your husband. If your husband is thalassemia minor then the child can have 25 percentage chance of acquiring thalassemia major which is dangerous. So kindly rule out thalassemia status of your husband and let me know about that. Kindly upload your report 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: My son is 22 years old and doing final year college. He used to be good at studies. During his first year college, he was in love with a girl and that was a one side affair. So, he became depressed. He was diagnosed with acute psychosis and treated with Divalproex sodium and Olanzapine. He was stabilized by then. He continued medication for three months and then stopped it. Again, before four months, he became hyperactive, sleepless, angry and began to feel invincible. He was being treated for acute mania with Lithium carb 900 mg and Olanz 15 mg. Now, he has to appear for his final examinations and he is too much worried and depressed. Sometimes, he cries. I took him to the same doctor and he gave some antidepressant, but no improvement in the last six days. Only we have five more days to exam. Kindly advice what to do. ### Response: I can understand the situation that you and your son are in and you have my sympathies for the same. If worry and exam anxiety are the main issues currently, then he can be given tablet Trika SR (Alprazolam) 0.5 mg in the morning daily. This can be given till his exams are over. Alprazolam should help to certain extent by temporarily reducing worries and stress. Bipolar depression takes time to respond and I am sorry to say that there is no therapy, which will treat it instantaneously. Continue with the prescribed medication and things will hopefully improve with passing days. I would also like to recommend that you convince him not to burden himself with the pressure of exam unnecessarily. The priority must be on coming out of bipolar depression and remaining normal in the future with proper treatment. If he is not able to clear the exam this time, he can always do it at the next opportunity. You could also consider the option of not appearing for the exam if you feel that failing in the exam will hurt him emotionally more." "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 30 years old and unmarried. I am suffering from erectile dysfunction. There is no erection when I go near a female. When it comes to masturbation, erection is there, just timing is very short. Moreover, many drops and colorless viscous fluid appears after urination. Is it curable? Please help. ### Response: Hello. This is not a problem. The discharge of sticky fluid is nothing but precum discharge. This will not cause any weakness. Since you have an erection during masturbation but are losing during sex, this is probably occurring due to psychological reasons. You should seek an opinion of a psychiatrist for treatment" "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: From last two to three days I am feeling some pressure on my left side chest, and my left hand is also paining a bit, and when I eat food, I feel that I am not able to breathe and a bit pain on the left side of the chest, please help. ### Response: If you are having recurrent chest pressure and chest pain at rest and also after eating food, this may be a very well be a symptom of heart pain and, hence, I would recommend you to visit a hospital to get an ECG and Troponin I blood test is done soon. If both of these are normal, we may be dealing with either non-cardiac condition or mild heart pain or attack. To distinguish these two, there are various types of tests available, the most common being a treadmill test. Your cardiologist can decide appropriate next test based on detailed history and ECG or blood test results. So, for now, I would recommend you to go to a hospital to be checked. I hope this solves your 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: I have a severe toothache. I have tried clove on it but that only takes the pain away for 2 to 3 minutes and my tooth is rotted and another tooth is growing out of it. What is the fastest way to cure it at home now? Also, do you think they can put me to sleep and then take the decayed tooth out? ### Response: Hi. Home remedies will not give long-lasting relief from pain, therefore you should consult a dentist and get evaluated. A combination of antibiotics and anti-inflammatory painkillers like Ibuprofen can help in reducing infection and also relieve pain. The tooth can be removed after numbing it, therefore, you do not need to get general anesthesia and just numbing the tooth and adjacent structures is sufficient." "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 genital molluscum contagiosum (about a month and a half ago). I am being treated now and there are few number of bumps left (less than 5) when it first appeared there were 8-9 bumps. I wanted to ask if this had anything to do with the HIV virus. I have almost never been in a relationship without protection. But that still made me worry for a while. Please let me know if I should panic. ### Response: Genital molluscum is a viral infection but not caused by HIV virus. It is a sexually transmitted diseases and therefore usually spread from sexual route. Genital molluscum is considered to be a marker of HIV infection. Therefore, it is usually advised to rule out HIV infection in patients of genital molluscum. As you are having genital molluscum does not mean that you are having HIV infection. If you are practicing safe sexual practices then chances of HIV infection is minimal at least not because of sexual route. But to be in safe side I will advise you to rule out HIV infection by doing HIV testing as it is considered in protocol to test for it incase of genital molluscum." "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 went to a massage parlor and got a handjob. I was told by my doctor that STDs are not transmitted this way. Is this true? ### Response: I understand your concern. This is true. Only direct genital contact or contact through cuts on genitals, blood, semen or saliva can lead to STDs, not hand job." "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 Wednesday night, I got palpitations. I took Rivotril 5 mg and slept. Next day I rushed to my physician. He prescribed me Ciplar 10 mg tablet and advised me to take one tablet daily after breakfast. Palpitations did not happen from past three months. My doctor advised me to continue the tablet and said nothing to worry. But I am worried as what could be the reason for my palpitations. I am disturbed by thinking that will I get heart attack? I am sleepless now. Please help. ### Response: Hi. Palpitations in the absence of loss of consciousness/blackout/sudden fall are not considered as malignant. Occasional non-recurrent palpitations may not be significant at all. Hence you need to see if you have any of these alarming symptoms or these palpitations are recurrent or not. On the background of structurally normal heart - your normal ECG and ECHO study (attachment removed to protect patient identity) with no other cardiac symptoms, absence of alarming symptoms and absence of recurrence, speak of a non-cardiac cause. These may be related to stress, thyroid disorder and certain medications. I would suggest you to upload your recent ECG if possible. Revert back with your report and answers to 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: My child had critical pulmonary stenosis and had balloon dilation at three months. She is now 13. She has moderate pulmonary regurgitation, her LV ejaculation fraction is 69 %. She has a mildly dilated RV and pulmonary artery. She gets breathlessness. Should I be concerned? ### Response: Hi. As per cardiac MRI (attachment removed to protect patient identity), the degree of pulmonary valve regurgitation is moderate at the most with only mildly dilate RV. Please be assured at this stage. However, she still needs yearly follow-ups either with an echo or another cardiac MRI. If you have the full report of the MRI, I am happy to go through with 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 male and I am 30-years-old male. I have a mitral valve problem, and it is moderate mitral stenosis. What remedy do you advise? If I did the valvoplasty surgery will there be any other problem? If there is a problem, is there a possibility to do the valvoplasty again? I am afraid. Please relieve my tension. The left atrium is 46 mm. I am currently on Spiromide 20 mg and Tinormin 50 mg daily once. Please help me. ### Response: There are specific criteria for surgery in case of mitral valve stenosis. Surgery does not resolve the problem and you may have to stay on anticoagulation therapy for your entire life. It can help improve your physical performance and avoid pulmonary edema (shortness of breath during physical exertion). Anyway, as you have mild mitral valve stenosis, I would recommend anticoagulation therapy and follow up with your cardiologist with a cardiac ultrasound every six months. Hope this would be helpful for 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: What is raw water and how is it different from the tap, spring, and other types of water? What are the perceived benefits and dangers of drinking raw water? When did this fad start? Have you ever seen a patient getting sick by drinking raw water? ### Response: Hi. Raw water consumption has become quite a thing recently, particularly in certain parts of the united states and among people depending on or advocating alternative or herbal medicine. It is unprocessed and totally natural water so it is high in salt contents and other constituents that prevent or slow down cellular aging, however this is just theoretical with no published results. It differs from filtered water and spring water in its high salt contents and silica and lacking chlorine and fluoride which are usually found in processed water. Also, the main difference is that it contains many pathogenic organisms ranging from bacteria to parasites causing various diseases and serious infections some of which are life-threatening. Namely, typhoid and paratyphoid fever, leptospirosis, shigellosis, schistosomiasis, cholera, amoebiasis, etc. I have heard of many cases of raw water making people sick. Cases of typhoid, amoebiasis, and cholera which are water borne diseases are quite prevalent in some areas." "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 white patch on my face. It was very pale but when I apply Fluticasone, it appears as white even my cheeks are rough and slightly depigmented. ### Response: Hello." "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 recently had an RCT and crown placed on the upper front tooth. Now, there is a gap between my two front teeth. Can the crown be adjusted now? ### Response: After capping, it is very difficult to adjust the crown because it may lead to misalignment of the crown with respect to occlusion. There is another method by which you can close the gap between tooth like composite filling between tooth leaving the cervical area or another method is to repeat the capping procedure. Please share your pictures of the front tooth which will help me guide you more. Treatment failure. The composite filling between tooth leaving the cervical area or another method is to repeat the capping procedure." "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 was diagnosed with type 2 diabetes. Her first blood sugar test report was at 437. Now, after three months, the fasting level is 86. Last month fasting was 105 and post-prandial was 120. She is taking half a tablet of Glimepiride 2 mg and Metformin 1000 mg both twice a day. She follows a strict diet. Now I am worried about the possibility of hypoglycemia and unsure if she is considered a diabetic or not? ### Response: Hello. I just read your query about your mother and it seems that she has a very good diabetes control. Hope you find my advice of some benefit. Good luck." "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 15 months old baby girl does not eat anything at all and does not take a bottle or sippy cup, only breastfeed. I have tried everything but all in vain. I am very much worried now because she is very weak. ### Response: Hello. It is a slow and painful process for weaning off milk. The best way is to keep trying. Try to find out which particular food the child likes and make that food only. It has to be a constant effort, the results of which you would get in a few months\ time" "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 type II diabetes five years back. I have maintained good sugar control. Currently, I am taking Trulicity 1.5 weekly, Lantus nightly and 2000 mg of Metformin with my evening meal.Toward the end of last year, my diet was not good, as I was eating a lot of carbohydrates and I was also a little irregular in taking my medicines. About a week and a half ago, I got vigilant again about eating a low-carbohydrate diet and taking my medicines regularly.My blood sugar got as high as 380 mg/dl during this period. In the week and a half since I have gotten back on track, I have seen my sugars starting to trend downward. I have had readings as low as 164 mg/dl and the highest in the last few days was around 250 mg/dl.I am wondering if it typically takes a while for blood sugar to return to acceptable levels, once they have become as elevated as mine. And, do you think I need additional medication in order to achieve that? ### Response: Since you have started proper diet control, your blood sugar levels are getting better and better day by day. Yes, it does take some time to get back to normal once you are careful about your diet and exercise. You can check your HbA1c levels now and after three months to get an accurate account of how well your blood sugar is controlled, once you are back on track. If it does not work out then we can review again in three months for further management" "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 got cancer and the treatment was done. According to the reports, some of the doctors said he must need the surgery right now, and some of his doctors said he is fine after radiotherapy and chemo as the tumor and cancer cells are unseen in his body right now. So what do you suggest after seeing all his reports on the file there? Please help me with your valuable opinion. ### Response: Hi. I have seen all your reports (attachment removed to protect patient identity), suggesting adenocarcinoma of text, which is 3 cm from anal verge with infiltrating surrounding lymph nodes. As I will tell you they did chemotherapy to reduce the extension of cancer cells surrounding the anal canal. As it is now very important to resection of that tumorpart, to prevent further extension. As good news is that this kind of cancer response is good for the surgery, so surgery must be done to treat this condition. So, your doctor has advised correctly." "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 doing research on diagnosis and treatment of mental illnesses.I have already interviewed couple of psychiatrists and now would like to focus on asking some questions to endocrinologists. ### Response: All these things can lead to paranoid symptoms. 2) Low ferritin or iron level decreases de-iodination activity which slows down conversion of T4 to T3. Low ferritin decreases the activity of enzyme thyroid peroxidase which is dependent on iron. Hence, it causes increase in concentration of circulating TSH (Thyroid Stimulating Hormone). 3) Raise in homocysteine level is not considered to be good. It could be genetic and due to other causes. In genetic cause it can cause short life span of the person as it causes atherosclerosis and more effect is seen on cardiovascular system. High level causes damage to arterial wall and plaque formation, may also cause aggregation of platelets, clot formation and blockage of an artery. It is more dangerous in case when coronary artery supplying the heart gets affected as this can cause myocardial infarction (commonly known as heart attack). Hope this answer 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 cry a lot even on little things on little words, loud voice tears come into my eyes too much. I face worst days of my life. I was happy suddenly everyone at home turns their behavior bad. I am little one of my siblings and my age is 22 years. From my childhood, everyone says I will cry and I start crying. Then I grew up. Now one at home scold me but then I fell in love, they disrespected me and they stopped my education and whom I love was not able to marry as his education is not complete he did not have any job. He was also very aggressive I needed love, care, attention but he fought with me to leave my friends five years. All this continues then now I gave up on him because I cannot bear my family worst behavior with me. He has his job now, he is little changed. He is loving me, we were planning how to make agree both of families for our wedding but yesterday he again talked about that days I broke up with him. But since childhood and these put bad memories in my mind so even on little things tears come into my eyes and everyone got fed up because of the tears. I want treatment of this, please. ### Response: Hello. Repetitive crying spells, mood swings, etc., could be due to some mood disturbance or this could be due to depression. This can be occurring due to some hormonal issue. All these should be evaluated properly. If you have low mood, lack of interest in anything, poor energy, fatigue, tiredness, etc., symptoms then these symptoms are occurring due to depression. Please visit a psychiatrist for opinion and treatment" "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 husband is mostly sad and depressed. He cannot listen a word against him or his family(mom, dad & sister). He gets mad and behaves very rudely with everyone if they do not agree to what he says. He fought with his boss in his company for silly reasons. He abuses me emotionally and mentally. He hides from colleagues and friends about his marital status, to some he says he is not married and to some, he says he is married, and his wife stays with his family and works in a bank (but I live with him and work in MNC). He always uses to tell a lie to me in small things also, he is never ready to accept his fault. Even if it is evident that it is his fault, he will never agree. He was flirting with some girl and went to meet her, and I got to know this when I checked his phone when I confronted him, he got mad at me. He is not ready to accept that he is at fault. He never answers my questions, always diverts the discussion. He does not have any plan. He hates my family for no reason and always say abusive things against them. He says he loves me but never let me live happily. In short, he is still right. Is he mentally ill? ### Response: I can understand your concern. Considering the history of the symptoms you have mentioned, there are few possibilities. One is some underlying mood disturbance which could part of bipolar disorder. This should be appropriately evaluated to make a diagnosis. Repetitive mood swings, keeping grudges, anger outbursts, repetitive lying, etc., are seen commonly. Such symptoms can occur as part of some personality disturbance. Anger, irritation, etc., could be related to personality issues. Please talk to him and if possible, consult a psychiatrist. Mood stabilizers can be used to control his anger and mood swings." "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 30 years old. I am facing premature ejaculation and my ejaculation time is less than one minute. Please help.I am currently taking Prodep capsules daily. ### Response: Do not worry. It is completely curable. You need to send me a detailed history of your condition including the onset and progression, dietary habits, and addiction. Then we can proceed with your treatment. And please stop Prodep (Fluoxetine), because it will do more harm than good. Follow up after two days with detailed history." "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 frequent motions (today it was three times from 8 AM to 2 PM). Motion is semi-solid and lightly smelly. I have had a mild cough for two weeks back. Took antibiotics and cough syrup. A cough has reduced now. Loose motion started a week back. Frequently and it was liquid format and smelly. I had vomit once on that day.Consulted GP and the doctor gave Oflox 200 mg with gastric tablets also. Had same symptoms the next day. Two days later, had mild stomach pain and consulted the same GP. The doctor gave stomach pain tablets and pain reduced. Everything was fine since today morning but now loose motion has started and also a little bit smelly. There is no blood in motion and there is no stomach pain right now. Also, I checked my weight it is reduced by 2 kg.Questions:Why has loose motion has reoccurred? Is this related to stomach or colon cancer? Since my weight has reduced I am worried that this might be related to cancer. Please help. ### Response: You are unnecessarily worried about stomach cancer. These are not symptoms of stomach cancer. I would recommend you: Let me know the results after five days. Avoid spices in food. Avoid pain-killers. Avoid milk in the diet. Since these are prescription medicines, please seek your doctor\s advice to obtain the prescription" "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: Dear doctor,I had a medical record saying that ""the lungs are clear, there is mild obscuration of the left costophrenic angle, which may be related to pleural thickening"". What is the meaning of this report? ### Response: Hi. Pleura is a covering membrane (a plastic cover like structure) which covers the entire lung. If the pleura gets thickened, then it causes obscuration of costophrenic angle. There are many causes of pleural thickening like: If you do not have any problem presently then there is no need to evaluate at present for the cause of pleural thickening except avoid exposure to chemicals (if at all you are getting exposed). You can repeat chest x-ray after six months for a follow up. But, if you are having any problems like cough, weight loss, or breathlessness, I advise you to get HRCT of the chest (high-resolution computed tomography) and pleural biopsy test done. Revert back to a general 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 40 years old, and my weight is 97 kilograms. I am a diabetic patient, and my A1C test showed a result of 9 %. I am taking Sitaglu Met 500 mg. It has not helped me. When I take it, within five minutes, my sugar level gets increased to 250 mg/dL and comes down again to 180 mg/dL or 190 mg/dL. Sometimes, it does not get reduced. My fasting blood sugar level is 180 mg/dL. I am thinking to change my medicines. Please suggest. ### Response: Please verify the dose of Sitaglu Met. It is a combination medication. It has two medicines Sitagliptin and Metformin. Please mention whether you take 50 mg/500 mg or 50 mg/1000 mg dose. Please send a picture of it. Medication alone cannot control diabetes. Determining the type of diabetes is essential. There is a possibility that you may have type 1, so appropriate testing is required. You are overweight for your age, and the blood sugar is high. If your diabetic level is not controlled at this stage, it can lead to kidney problem and vision problem in two to three years. Both are irreversible once they get developed. Have control in your diet. If you are surely diagnosed with type 2, I can suggest you take Glucophage 1000 mg (Metformin) daily and Linagliptin injection. It is not insulin. It controls the blood sugar, and it helps to lose weight." "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 ago I had a right side upper molar issue. I went to a clinic and was given an antibiotic, but it did not help. I went to the clinic after some days, and I asked for Clindamycin and still there was no result. The dentist tapped on the tooth, and there was no pain. He surmised it as chronic sinusitis. I purchased a lavage apparatus and all kinds of nasal sprays.The pain was really bad because I thought it might be a viral infection. I used Tylenol after reading how to deal with the pain. Though I know that Tylenol is not the correct drug for my pain, it worked for some time. Now I get unbearable pain (burning sensation) above the molar on both sides. I started using Tylenol many times a day. I am not addicted to it but thought of getting relieved from pain for at least six hours. Kindly advice. ### Response: You need to get a professional evaluation because your symptoms may lead to septal perforation, nasal bleeding and permanent loss of sense of smell. I would advise going for nasal endoscopy if you were to do that then follow it up if needed with a CT scan of nose and sinuses. If there is any sign of infection go for a sample culture sensitivity and take the most appropriate antibiotic after the culture sensitivity report comes from the microbiology lab which usually takes three days. If there are no signs of infection, you can have some nasal saline douching with steroid nasal sprays and nasal anti-inflammatory steroidal sprays." "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 bad experience today. My bowl was entirely reddish. I do not know what it could be. Currently, I am taking Envas 2.5 mg. ### Response: Hi. You have blood in the stools. If you have blood in the stools again, then you have to investigate with a stool routine examination. It can be an infection of the colon, and an antibiotic course can be taken. If the bleeding is painless and fresh red, then you can try to rule out piles by doing proctoscopy 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: Post a severe attack of herpes on the left shoulder, left ear (in and out), chest, and back I am now suffering from Bell\s palsy on the left side. Symptoms are as follows:Cannot raise left eyebrow.Cannot tighten left nostril.Cannot move lips (left side).Left eye constantly watery.Which steroid and what strength do I need to take? I am already taking Acyclovir 800 mg four times a day. ### Response: Hello. I suggest we do not start on steroids now as there is an active herpes infection which can flare up with steroids. Once it is six to eight weeks of Acyclovir therapy, we can start Dexamethasone 4 mg eighth hourly. However, you will have to consult your physician, discuss with him or her and start taking the medicines 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: Continuous dizziness. Losing balance could not sit or stand for more than few minutes. Age:65, Height:6\2\\, Weight:220 lb. ### Response: Your MRI spine reports osteophytes at multiple spinal levels along with bilateral neural foraminal stenosis at C6-C7 level (attachment removed to protect patient identity). These cervical changes though can cause dizziness but persistent imbalance is not usually seen with these spondylotic changes. If you would have presented to me as an outpatient, I would have asked you the following questions to answer your query well- 1. Do you have history of double vision? 2. Do you have history of hearing loss or tinnitus? Please follow up with answers to these queries. Meanwhile,please start taking- Tablet Tryptomer 10 mg once a day at bedtime. Tablet Pregalin-m 75 mg twice a day. Tablet Calinept-d once a day. Please take medicines under a physician\s guidance 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 have hearing loss from childhood. I had an infection in both the ears four years before and got it treated with antibiotics and got well. But, within weeks, a fluid of light green and sometimes brown color started leaking from my ear often during the day and it was itching. The doctors just gave me eardrops like Candibiotic and said its nothing. Until today, I am unable to find a solution. Recently, I took Augmentin 625, Omez 40, Allergen tablet and Ciplox D ear drops for one week. At that time, it stopped and started leaking again when I completed the medication. I again took the medicines after one month and the same happened. I have vitamin B12, vitamin D3 deficiency and I am taking medications for that. I have slight thyroid. I always have giddiness. Kindly help. ### Response: You can have two of these conditions. This is what I can diagnose based on your history that you have given very well." "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 5-year-old daughter has scalp ringworm. I am using head and shoulders intense medicated shampoo and topical 2% Ketoconazole antifungal cream. Her doctor also prescribed an oral antifungal Lamisil packets granules 125 mg to be taken in food for a month. I am terrified of giving my 5-year-old daughter an oral medication with such a scary track record or side effects including liver failure and death as well as vision problems, low white blood cell count, and psychiatric problems. Is there any alternative to this terrifying drug for curing scalp ringworm? ### Response: Scalp ringworm infection stays for a longer time. Topical ketoconazole cream is good. The oral medication prescribed is also good for the infection. There are a few alternatives. Any medicine carries some side effects along with it. We need to weigh the benefit and risks. If the benefit is more, we go for the medication. Side effects are mentioned but are rarely seen. Alternative medication is called Griseofulvin which is to be used for four to six weeks or more if required. It would not be available over the counter. It needs a doctor prescription. It also has some side effects but usually tolerated well. Fungal infection of the scalp. Griseofulvin or Terbinafine." "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: There is a gap between my front two teeth. I want to close the gap. Can you please suggest any process for it? ### Response: Hello. Yes, there are two treatment options. 1. Ortho (braces) treatment. 2. Tooth-colored fillings. Gap closure by braces is a permanent solution. Your teeth will be aligned and the gap can be closed naturally. This option is suggested when the gap is very wide and this helps correct other tooth alignment issues if present. Whereas in the second option, the gap is closed with a tooth-colored filling material. This is not a permanent solution. This filling can last anywhere between three to seven years. If this filling fractures in the future, you may require a new filling in its place. However, the longevity of this filling depends on our maintenance. This will best suit if the gap between the two teeth is less than 4 mm. The option that best suits you is determined by the amount of gap present, general oral hygiene, and your gum health. A clear picture of the gap will help suggest. If you want to close your tooth gap naturally without any filling, please visit an orthodontist to start a braces treatment. But if the gap is minimal and you want a filling to close the gap, this procedure is best done by a cosmetic dentist. 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 26 years old. I was looking for a professional opinion on treatments to remove a double chin and saggy area around the jawline and if possible some type of restoration to the cheek area.I have sent some pictures. The first five pictures are recent the other two are taken before few years. I am a smoker for eight years. Could this have contributed to the cause? Of note, I weigh about the same weight as I do before a year. Over the past year, I have lost 25 pounds (current weight is 170 lbs) due to exercise and diet, yet double chin persists. Is sagging around the jaw due to loss of skin quality or would more weight loss solve the problem? ### Response: Hi. I have seen your pictures. (attachment removed to protect patient identity). On the detailed analysis of your face, it seems you have a bit of prominence of the jowls. There is no double chin. It seems to be entirely normal but if it worries you, you can go ahead with botox for muscle hypertrophy or thread lift." "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 fistula two years ago. It healed without surgery, but now it has again developed with the release of pus. I am taking ayurvedic tablets. ### Response: An anorectal fistula is an abnormal channel from the anus or rectum usually to the skin near the anus. A fistula may be painful and discharge pus. We can determine its direction by inserting the probe. Sometimes it is healed with proper medications and changed lifestyle. But if its root (fibrosed tissues) remain inside the sinuses, then it recurs due to changes in food habits and lifestyles. Ksharasutra ligation treatment is the best option to treat it. Treatment plan: Now you are taking good medicines to this concern. You can add Amrita Bhallataka one teaspoon twice a day after meals. But the ultimate treatment is Ksharasutra ligation treatment" "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 blood pressure and diabetes. Currently, I am using Triolmezest 40 mg and Starpress XL 25 mg for blood pressure and Glimestar-M1 for diabetes. All levels are normal including lipid, echo, HbA1c, etc. Two days back, all of a sudden, my neck started paining and there was a blurredness for sometime. After closing my eyes for few minutes, I was normal. Neck pain continued and after one period I was not able to recollect the names of the people for five to ten minutes and fully conscious. After 10 minutes, I was able to recollect everything. Of course, I was under little stress. Kindly suggest what could be the reason or is it normal for everybody? Kindly advise the precautions and any diagnostics. Longtime back, I was diagnosed for spondylitis but there is no pain usually. ### Response: Since you are a diabetic and hypertensive, in such a case I would like to evaluate you for the possibility of transient ischemic stroke (TIA). I would recommend an MRI (magnetic resonance imaging) brain and a color Doppler. If all results are normal, then this could be a postural fainting attack, cervical myalgia or could be simply stress-induced. So, go ahead with the tests. Start exercises, meditation for stress relief. Never skip your breakfast. Do not stand for long hours. Also, keep a watch on your blood pressure. 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 always overthink on things which are really impossible to happen and I feel it becomes reality. I start to panic and feel like I am going to be crazy at any time. I feel like there is no safe place to go and I am shaking. It feels like I forgot to breathe, I cannot even focus on my thoughts. It is like I do not understand what people are saying even if it is a simple word. I feel fears eating the whole of me but nobody will never ever notice me. I suffer from this panic attack almost thrice a day. When I was a kid, I almost lost my life when our house got burned. I have not taken any meds. I am just keeping it to myself because I am afraid of what others might think. ### Response: I understand your problems. Your panic attacks can be controlled by medication. Revert with reports of cardiac evaluation, so that I can help you better." "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 relative of mine is admitted to a local hospital and tested positive for dengue. His platelet count was checked thrice. The first time they checked it was yesterday afternoon, and the count was 83,000. The second time they tested him yesterday evening and the count was 81,000. The third test was done today morning and the result was 79,000. The clinical assistants said they are not able to ensure an increase in the platelet count. We are too tensed. Meanwhile, the WBC has steadily increased from 3600 to 5400. Please tell me what we can expect? Is it serious? The patient is active, walking, talking, and eating fine. He only has joint pains and rashes. ### Response: Hello. Fever with body ache is one of the typical symptoms of dengue fever. Do not get worried about the present situation" "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 mild irritation type around the navel area. What medicines to take? Please suggest medicine. ### Response: The irritation around the navel area is most likely due to fungal infection, especially if associated with itchiness and redness. So, please provide me with a clear photo and tell me if there is itchiness or redness. A local antifungal cream will be suitable after confirming the diagnosis. The other (less likely) diagnosis is scabies" "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: In sonography of the baby\s heart, there is an echogenic focus on the left ventricle of the heart. Please suggest. ### Response: Intracardiac echogenic foci in the left ventricles are due to papillary muscle injury/insult and most often resolve spontaneously but they hint at the underlying chromosomal abnormality. I would highly recommend an early anomaly scan this week itself instead of 20 weeks so that if other abnormality is detected, you get some time in hand to decide the next step. If the anomaly scan is done at 20 weeks, you would not get any time to decide and also no action could be taken" "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 20 years old and suffering from a rash on my face. The first breakout was around five weeks ago. I noticed a red spot above my left eyebrow after hearing a stressful news and eventually it spread to my chin and above my lip. I was at the beach and after around three days, the rash hardened and left. The skin was kind of dry. The rash has a blister look to it up close and is red. It looks like a ton of little pimples and some of the spots even have what look like whiteheads. It is not painful but does itch somewhat. One week later, the rash came back and I decided to see a dermatologist. The dermatologist said I had seborrheic dermatitis, but did not take a sample to have a lab test or anything. She basically just looked at my face and told me what I had. She prescribed me Ketoconazole for two weeks day and night. It kind of came and went. The Ketoconazole cream I guess worked because I did not break for around two weeks. Well, I just stopped the Ketoconazole five days ago and today, I woke up to the same blister-looking rash again. This literally happened overnight. It has just gotten worse throughout the day. Now I have it above my left eyebrow up onto my forehead, the bridge of my nose and around my right eye, chin, above the lip, and some on the right cheek. I need help. Was the dermatologist right when she said it is SD? Or could this be something else? I know they say the skin is scaly with SD but I am not sure my skin has a scaly look. It is more like pimply. To be honest, my skin most resembles a heat rash in the pictures. The pictures do not do it justice. ### Response: It could be seborrheic dermatitis or photodermatitis. Allergies may be playing a role. All these are visual diagnosis and the lab tests or biopsies have limited or no role. Photodermatitis would be present over the sun-exposed areas. In all of these conditions, a mild steroid cream would be useful if applied for a few days. You can apply 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 am a 41 year old male. I am a non-vegetarian and intend to take paleo diet. For the last 20 years, I have been having IBS symptoms, sinus, ringing in ears, extreme anxiety, depression, respiratory allergy to dust and smell, muscle tension around nose and rectum, bad breath, stomach getting too full on eating, smelly outer ear, etc. Before 15 years, I had seizure once. 5 years before, I was diagnosed as having NASH, GERD, Lax LES and high cholesterol. I am ex-smoker, quitted 6 years ago. The treatment so far has been unsuccessful and I am currently on no medication. I had health check up a few days before and attached the report here. Please advise on the following. What should be my paleo diet? Does the report provide any clue to the symptoms I have experienced so far? I can see positivity for anti-CCP in my report. Do I have any serious medical condition? ### Response: I have gone through your query with diligence (attachment removed to protect patient identity) and would like you to know that I am here to help you. From your report, you have the following problems: I would suggest the following treatment for you. Consult your specialist doctor, discuss with him or her and take the treatment with consent. Your paleo diet should be as follows:" "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 dark bump like spot in front of tragus. Ever since I have noticed this small bump it has got flattened and less puffy. I have some other spots too. I guess it is not a keloid. I went to a facialist and she stated it as not a pimple. I just need a clarification of what they are? What should I do now? ### Response: I have read your query in detail and viewed the attached pictures (attachment removed to protect patient identity) and I do understand your concern." "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 13 months old and 8 kg weight. He is having loose motion over a week. I have given him Oflomac-M and Sporlac tablet twice a day. As he did not suffice, stopped giving him Amul milk and started Isomil. Later he was fine for the next 2 days and when I started back Amul milk since yesterday, again the stools are thin. As of now I am giving him Darolac twice a day. Should I give Zinc supplement for him? I am feeding him with tapioca water, curd rice, and rusk. Stopped biscuits also. He is absolutely fine and active. Was the medication sufficient? If not please suggest for his speedy recovery. Is this because of lactose intolerance? Do I need to stop feeding him on packaged milk? Currently we are using Amul. ### Response: Hi. I have read your question in detail and I know that you are very concerned about your child but do not worry. By what you quote it seems that your child has probably got lactose intolerance, resistant stomach infection or worm infestation. I think you should do stool routine microscopy test and stool culture test to look for any infection and stool for reducing the sugar for lactose intolerance. Continue Similac formula milk and stop Amul milk. Continue Darolac (Lactic Acid) for three days and Zinc syrup for a total of 14 days to increase gut immunity. No need to stop other foods or giving special items like tapioca water. Also, give deworming syrup like Bandy plus (Albendazole) 10 ml once at night before sleep." "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 seen today for what seems to be carpal tunnel pain in both hands or wrist right being worse. It has been going on for over two weeks straight. Massages do not work, splints do not work. The pain is horrible at night, my hands are not just numb, my middle fingers feel like they are on fire, no sleep, now numbness has been going on for over a week during the day also. Constantly no matter what I do, I received steroid injection today in right carpal tunnel. Now my concern is that I have hip dysplasia and have had injections. Yes, they help with pain but now that it has worn off my hip is actually worse. I am scared that is going to happen with my hands also. Is it wrong to tell my doctor I want surgery still and soon? And I have no clue how severe I have it since I just saw him today for the first time for this and only test that was performed was the tapping on my wrist. ### Response: Hi. Greetings for a healthy future. Regarding your questions about severity and surgery I hope following helps you. In order to know the exact cause and the severity of problem, it will be helpful to get objective test done. EMG NCV is a good test to reach a diagnosis of carpal tunnel syn" "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 pelvic muscle weakness. I want to know is there any blood tests or any other diagnosis. ### Response: Pelvic and lower back muscle weakness will give you symptoms of back pain and leg pain. You should do blood tests. Check for vitamin D and B12 levels. These blood tests are useful to check the vitamin levels in the blood which co-relates with muscle weakness of the body. You should also learn to do some physiotherapy at home like Mckenzie back strengthening exercises and core strengthening exercises, gluteal muscle strengthening exercises. Do these blood investigations and get back to me. I will suggest you the treatment based on the reports." "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: How many IVF can one person undergo in total? We have attempted three ICSI with negative results. Each time, the embryo failed to develop more than four days, once developed only up to morula stage on day five. My wife is 30 years old with AMH 4.5 with type-2 diabetes. Next, what can we plan? Our doctor has advised ICSI with donor eggs. ### Response: Hello. How are you doing today? There is no limit to the number of times you can do ICSI (intracytoplasmic sperm injection). But if I may advise, why not try to correct the underlying cause for the failure of a healthy embryo growth? An AMH of 4 or more means she has plenty of eggs. But diabetes is mostly spoiling her chances. Hopefully, her HbA1c is normal and other complications have been ruled out. Also, semen factor should be alright. Any problem in either of these should be the reason for poor embryo quality. If you feel all these are fine, then maybe have the procedure at a different IVF clinic, with a different embryologist. I know it is a tough call, but do think about it. Hope I have clarified your query, do write back if any more queries. All the best" "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 currently taking treatment from a psychiatrist for depression. Her major symptoms are heaviness in the head, lower back pain, mood swings, feeling sad, and negative thoughts. Recently MRI and CT scan were done. CT scan was fine.MRI indicates multiple small T2/FLAIR hyperintense foci without restricted diffusion are seen in bilateral centrum semiovale, the subcortical and deep white matter of bilateral frontal and left parietal lobe. No demonstrable signal alteration was seen in the corpus callosum at present. No evidence of restricted diffusion or blooming seen.Features suggest the possibility of demyelinating etiology or pronounced microangiopathic changes. Please suggest what should be done? Either psychiatry treatment, or neurology treatment? Her main issue is the heaviness of head. She wakes up with negative thoughts, feeling like crying and suicidal behavior. She is currently on Ventab Xl, Mirnite, Clonotril, Olimelt, Lupirtin SR, and Sertee. ### Response: I understand your concern and would explain that your mother\s symptoms seem to be related to depression with psychotic signs. The lesions in MRI are suggestive of small vessel disease. I would recommend taking daily baby Aspirin 80 mg to help the progression of these changes. I would recommend stopping Mirnite (Mirtazapine) and Sertee (Sertraline) because they both interact with Ventab XL (Venlafaxine). Increasing the dose of Ventab XL may be necessary. Treatment of depression will help reduce the headache. You should discuss with her psychiatrist on the above treatment option." "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 taking Cipralex 20 mg before 15 months and was fine, and my sex drive is good even with Cipralex. I went to the doctor before five months, and she said to stop the medicine, so I was lowering the dose to 5 mg. While doing intercourse or masturbating, I am so excited, and my sex drive and erection is good. But when I ejaculate, I feel no pleasure, and I do not have a good feel. It seems like my brain not connected to pleasure nerve or something.I went to the urologist and he checked and says everything was fine. He gave me Gentaplex. I tried it for one month and had more power in sex, but there is no pleasure when I ejaculate. I went to the psychiatrist again, and she told me that she does not know what to do in this condition. So I do not know what to do. It is 4-5 months since I stopped taking Cipralex, and I still have this problem, and I am so much worried about it. Please tell me what to do. Is there any other medicine should I take? ### Response: You are probably experiencing orgasmic anhedonia, which means you are not able to experience pleasure when you reach orgasm. It can be due to either physical problem or psychological problem. It is good that you have already consulted a urologist and no physical cause has been found. Have you been on any other medication apart from Cipralex? Have you been using any street" "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 is 65 years old. He has bipolar disorder for 40 years. He also has diabetes. He is taking medicine for high blood pressure.For a very long time, he took lithium 1000 mg and oxcarbazepine 900 mg. 2-3 episodes used to happen, normally of long manic spell followed by gloomy/not so active spell. He stopped lithium due to toxicity, as even low dose was toxic. He started 200 mg quetiapine at night. In manic spell, he used to take up to 30 mg aripiprazole for 2-3 months.Considering his age and other medical conditions, what should be the right combination of medicine? Is aripiprazole safe? (it is very effective in mania for him) Now he has stopped aripiprazole, and he is fine. But he is complaining of restlessness sometimes. He feels like not wanting to sit in a place. What should be given to him in this post mania phase? Please ask for any more details if you require. ### Response: I have read through your query in detail. Please find my observations below. Medicines for mental health conditions should be taken under the strict supervision of the psychiatrist. As mentioned above, lithium toxicity is a serious concern and it is good that you have stopped lithium due to toxicity. Quetiapine is an atypical antipsychotic medication and studies have shown that it is a safe and effective medication for the elderly. The side effects are less when the patient takes Quetiapine. Transient hypotension, dizziness, and somnolence are the only side effects in patients and is seen rarely. Long term use of Quetiapine has shown no serious side effects in the elderly. Aripiprazole is good medicine but might cause agitation and activation in about 8 percent of elderly people who take it. Studies show that in most patients Aripiprazole can be continued at a dose of 10 to 15 mg/day. Aripiprazole has less metabolic side effects than other medicines." "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 7-year- old son fell out of a top bunk and as he was bleeding from his ear we took him by an ambulance to the hospital where he was diagnosed with a major concussion and possible non-displaced skull fracture. He was discharged the next day but we were told that as he had been bleeding from his ear there was a possibility of bacterial meningitis as there was a trail from the outside into his brain. So, we have been keeping him quiet but I have a couple of questions. How long before he can go swimming? He goes back to school next week, what about P.E and running around in the playground? He goes to rugby training, how long before he should return to that? What about tennis coaching? I would really appreciate knowing how long I should be a fussy mother? ### Response: Hello. I understand your concern for your son, I hope he is fine. Since then, if he has no further bleeding and no seizure episodes, and is fine with no complaints he can attend the school and participate in sports and other activities. I would suggest to avoid swimming for at least four weeks and use ear buds while swimming after that. Even rugby would be risky, so try to postpone rugby training for at least four weeks to prevent any further head injury which would complicate the previous injury. The rest activities are fine." "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: MRI scan on right ankle following a climbing fall of 3.5 m and hitting the ground, inversion rolling on impact. This was a year back ongoing pain and issues. The pain is around ATFL and joint and occasional swelling after heavy activity. I am a rock climber and train in the gym. I work part-time personal trainer so spend a lot of time on my feet, and also studying physio. The report and scan are attached, would like a second opinion as the scan is slightly subjective. I work in the sport and rehab industry. Please see scan images to see any issues, impressions are high grade 2 sprain of ATFL and CFL large tibiotalar joint effusion lateral malleolus trabecular fractures. I would like a new report, please. I need a second opinion 20 years old, 158 cm tall, 52 kg. Currently, I am taking Fluoxetine 20 mg daily for anxiety and depression. ### Response: " "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 7-month-old child has rashes on the sacrum and intercrural area for five days. It is persisting on the sacrum, reddening more in the intercrural area. There is a bubbly type appearance. I have been avoiding diapers for five days. He has been prescribed a Fusidic acid cream. I have attached pictures for your reference. ### Response: Hello. I have gone through the attachments (attachment removed to protect patient identity). It seems like acute dermatitis perhaps allergic or irritant. I suggest you apply Flutibact ointment (Fluticasone propionate and Mupirocin) twice daily. Avoid diapers for a few days. Also, give syrup Phenergan (Promethazine) 2.5 mL twice 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: Hi I have been diagnosed with plantar fascitis. Doctor said to use heel pad. Using it but no relief. Pain is increasing gradually. Please help. ### Response: Sorry to hear about you being troubled with plantar fascitis. it\s a fairly common problem. heel pad is indeed helpful but apart from it you need to stop walking bare foot as much as possible. don\t use any accupuncture type of footwear, use soft footwear. contrast bath is helpful- alternative warm and cold water fomentation one after other for period of 10 mins atleast twice a day is beneficial. if there is no relief after this conservative treatment along with some pain killers, local steroid injection (methylprednisolone) injection at the site of maximum pain can give you immense relief in those symptoms. please get the injection only from orthopedic surgeon. i hope you get cured of your ailment. feel free to ask any other querry" "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 fingertips feel like there are broken glasses in them, and it is getting worse. When I lay down, it is extremely painful, and if the weather is cold, it becomes unbearable. I work in construction, so this makes it impossible to work. ### Response: Hi. I can understand how worrisome this situation is for you. Hope it helps. Feel free to ask for more details if you need further assistance. Regards" "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 want your opinion on the symptoms I am experiencing. I am a 73-year-old female with 8.4 kilos, and height 5\3"". I have been trying to fast during the day for the last two weeks. But have been taking an optimum diet shake in 250 ml morning and afternoon, and having a main meal in the evening. My weight when I started this diet was approximately 9.4 kilos.I am taking medically prescribed tablets for cholesterol, for high blood pressure (Olmetec), and Sertraline for chemical imbalance (depression). None of these is a high dose. However, over the last six to eight hours, I have been experiencing some degree of heart palpitations and feeling unwell. I have been trying to stay cool indoors and decided to snack on some salty biscuits with salty cheese. This did help somewhat, but the heart palpitations, although not severe, are still noticeable, with a little pain when taking deep breaths. I do not want to go to the hospital but would appreciate some advice regarding these symptoms. ### Response: Hello.I read your symptoms and as far as losing weight is concerned fasting is the worst way to do that. But symptoms like these should not be overlooked, and you should visit a nearby hospital. Looking at your symptoms and the history that you provided it looks like as a hypoglycemic and hypotensive attack which happens when required amount of glucose does not reach the brain, and you might have felt unwell, and palpitations can be the presentation of that." "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 69-year-old mother constantly makes cooing sounds like a pigeon throughout the day. She says she has not passed urine and stools for the last two days. From two years, she has not been keeping good health. Two years ago, she started complaining of stomach pain. We got her admitted to the hospital twice. Current medications list is attached.We got her an endoscopy, colonoscopy, a PET scan, and a CT scan of chest and abdomen done. Doctors say there is no major problem. No malignancy. However, she has lost a lot of weight almost 15 kg. She does not want to eat. Please advise ### Response: Hello. I have gone through the attachments (attachment removed to protect patient identity) Her symptoms could be related to a psychiatric disorder called dementia with psychotic signs. For this reason, I would suggest increasing the dose of Quetiapine to 50 mg daily. Consult your specialist doctor, discuss with him or her and with their consent take the medicine. You should discuss with her psychiatrist about this" "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: Approximately one year back, my left chewing tooth got a small hole due to something which I bit. So, that became a tooth decay, over there it looks black. I recently consulted a dentist. So, he suggested a root canal but I do not have any pain nor loose of teeth and also I am afraid of root canal so please suggest any other medication for this. ### Response: Hello. If the cavity is deep, the root canal treatment is necessary to save it. Else, it will have to be pulled out later. If it is not too deep then you should ask him whether first a temporary filling can be given and if there is no pain even after one month, it can be replaced with a permanent filling. There is nothing to be afraid of the root canal treatment as it is painless after anesthesia is given" "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 32 years old. I am very worried. I have symptoms like numbness, weakness, tingling in my limbs, head, tongue, and face. I have tooth print on my tongue sides. I have soreness behind the ears and on the eye. I can see black spots with one eye. I went to the eye doctor. He said everything is fine. I have all these symptoms for nearly two months. ### Response: I read carefully your question and would explain that your symptoms could be related to a metabolic disorder (thyroid gland dysfunction, vitamin deficiency, etc.).For this reason, I would recommend consulting with your attending physician and performing some tests to investigate for the possible causes: If all these tests result normal, I would recommend as follows performing a brain MRI study. Hope you will find this answer helpful" "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 having transient visual disturbances (looks like moving or static bubbles) around the periphery of my vision in my right eye that lasts a few seconds every time. The vision also sometimes grays out then comes back seconds later. This happens dozens of times a day, every day. Often they are caused when I stand up or move my head around.I first noticed the symptoms when I had a sinus infection and was on Doxycycline three months back. I had pain in my right eyebrow that went away after antibiotic use, but the visual issue stayed. I had an eye exam with an ophthalmologist who told me he did not see anything wrong and that it was ocular migraines. I have since had recurring headaches that are persistent, but the visual disturbance does not change whether or not I have a headache. I have an appointment with a neurologist in three weeks, but I am wondering if it is safe to wait that long. Ibuprofen helps with the headache and reduces visual disturbances. Currently, I am on Lexapro 10 mg. ### Response: Hello. Regarding your concern, I would explain that your symptoms could be related to optic nerve damage or low blood pressure. As standing up triggers these symptoms, orthostatic hypotension cannot be excluded. Coming to this point, I would recommend measuring your blood pressure in sitting and standing up position. I think there is no need to go to the ER (emergency room). When consulting with a neurologist, I would recommend discussing the possibility of a brain MRI (magnetic resonance imaging) to examine your brain and optic nerve." "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 22-year-old male with ulcerative colitis since the age of 9. I woke up with a nasty fever, mucus filled coughs, and runny nose. I was curious how a Z-pack would affect me. ### Response: I can understand your concern. The possibility of respiratory tract infection is more likely. You should definitely take Z pack, no need to worry about this. Along with Z pack also, do warm water gargles and steam inhalation 4 to 5 times a day. If not improving in five days, get done chest X-ray. Please let me know if you have chest pain, breathlessness or wheezing." "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 tell me if a unilateral posterior polar cataract has a congenital onset or develops after birth? I am desperately seeking answers as my daughter who is 5 years old has been diagnosed for the first time with a congenital polar cataract. The doctor who originally diagnosed her stated with confidence that it has been there since she was born. My daughter has been diagnosed with 20/300 vision and deprivation amblyopia. I took her to another doctor to get a second opinion and he stated there is really no way to tell if it has been there since birth but stated it could have been. How was the first doctor able to make this diagnosis with such confidence when another doctor stated there is really not a way to tell? From what I have researched online, posterior polar cataract is very rare and has a congenital onset, is this true?The second doctor has started her on a patching regimen for half of her waking day. Her vision has not improved since she has started wearing her eyeglasses and I am wondering how much or if at all it will improve, with such a late diagnosis. Also, I, unfortunately, contracted HSV type 1 during my third trimester while I was pregnant with her and I have also read that this could be a cause, is this a potential cause? If it is a cause in your professional opinion, would you recommend that a newborn born to a mother with HSV 1 developed during late pregnancy with an ophthalmological issue due to the risk? Any input you can offer will be greatly appreciated. ### Response: Since you had an HSV (herpes simplex virus) infection, there are increased chances that this polar cataract is congenital (since birth). Your ophthalmologist has correctly started patching therapy but my question here is why has he not thought about surgery because then we can remove the cause of amblyopia, get a clear visual axis, and start patching again. In my opinion, that would yield a much better result. Please consult a pediatric ophthalmologist who does pediatric cataract surgeries and discuss the case there because I think removing the cataract and implanting a lens is a very good choice and it will help in amblyopia therapy very much" "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 protected intercourse with a CSW, but the protection broke at the tip during insertion and I immediately pulled out. Enough space was left at the tip for semen to collect and I do not know whether the tip of my penis has come in contact with some vaginal fluid.I am totally stressed out after the incident and do not know whether STDs can be passed in this period of one to two seconds. After a week, I am experiencing some pain below my armpits but no lymph node swelling.Is that due to stress that I feel the pain? I am totally stressed out and your support would be extremely helpful. ### Response: Even a minute touch of an infected vagina can spread STDs (sexually transmitted diseases). As partner status is unknown and has high-risk factors, it is better to use prophylactic treatment. Secondly, pain in armpit has almost no relation to STD. It is probably myalgia and it may be exaggerated by stress and fear. Are you having any ulcers on the penis or surrounding skin or had shaved before the act? These acts or ulcers can increase the chances of transmission. You can use prophylactic antibiotics to restrict STDs. Consult your specialist doctor, discuss with him or her and start taking the medicines 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 am using a penile pump under the direction of a urologist. Over a period of each of five days, I think I had overstretched the penis and now have a loss of sensitivity and soreness with no erection. Do you know if it will and how long it may take to recover sensation and remove the soreness? What are the treatment options? The numb penis is very distracting. I am not sure how much damage the penile pump could cause. I am worried waiting too long. ### Response: Hello. A penile pump is a form of physical or mechanical treatment. Have you tried oral PDE5 (phosphodiesterase type 5) inhibitors like Viagra (Sildenafil)? It is not advisable to use a penile pump for long durations as any form of physical treatment is bound to cause some form of damage. I discourage you to use a penile pump as it has started to cause physical damage. Maybe your technique is wrong. Numbness and soreness are very common and it will revert back to normal but after how much time, it cannot be predicted. It may take four to six weeks. Injection therapy also has a few side effects. At present, you just discontinue using the pump and wait for it to heal. If you want you can continue using it provided you know the correct technique" "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: Gender male, age - 51, height- 167, weight- 74.8, latest BP - 140/90, presently no medication, slight neck and back pain, attached latest report. ### Response: I just read your query and saw the attached file (attachment removed to protect patient identity). Your cholesterol level, uric acid level are increased. Along with this your TSH level is also decreased which is indicative of hyperthyroidism. I am advising you medicine for high cholesterol level and for back and neck pain here. Take it regularly for two weeks and consult me after two weeks regarding improvement and for further management or you can consult a nearby Ayurveda physician. As far as hyperthyroidism is concerned you need hormonal therapy to correct it. So for that you should visit a nearby general physician. Take capsule Arjun two capsules two times a day with water after food for two weeks. Take capsule Giloy two capsules two times a day with water after food for two weeks. Take tablet Triphala two tablets at bedtime with lukewarm water. Do not take anything after taking these tablets. Capsule Shallaki two capsules two times a day with water after food for two weeks. Take Mahanarayan oil and do gentle massage with it of your neck and back two times a day. Do not sit under fan or AC for sometime after applying the oil. two weeks" "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: Does this lesion in my lower back (pink) appear to be worrisome for amelanotic melanoma? It now appears flesh-colored. Pictures attached. ### Response: I have seen the pictures. (attachment removed to protect patient identity). Yes, they are looking like melanoma. Signs of vascularization in the previous nevus is suggestive of melanoma. Kindly consult a local dermatologist as dermoscopic and histological examinations are required to confirm the diagnosis." "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 get a swelling on the temple after chewing on hard food, for example, steak or candy. The swelling goes down after I stop eating, but the area feels numb for a long time after that. What can cause this? I have chronic urticaria and MGUS. ### Response: I have carefully reviewed your health query and will answer your concerns. The issues you mentioned are related to mastication (chewing). It is a process where you have to put a lot of energy, and the muscles of mastication are widely used. It seems there is some neuropathy causing the muscles of mastication to get fatigued. Other symptoms like swelling and numbness can be a feeling due to the same muscles spasms. Local edema (fluid accumulation) can also be a reason behind the swelling. Regarding MGUS (monoclonal gammopathy of undetermined significance), I want to add that it can lead to multiple myeloma, so keep an eye on your health. Keep a timely follow-up with your treating physician. I suggest you try using anti-inflammatory medications like Acetaminophen, which can help you. Consult your specialist doctor, discuss with him or her and start using the medicine after there consent. You have chronic urticaria, and that may also contribute to local swelling of tissues. Hope it helps. Please let me know if I can be of further help to 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 have been bitten by a stray dog on the left leg on March 10th. The next day I went to a nearby doctor and he advised me to take two doses of vaccine as I had taken three doses earlier before four years. There was no blood visible at the wound and I washed it in soapy water also for five to ten minutes but from March 23 I am feeling pulsating sensation at the bite site often, they come and go. It does not happen always. I have consulted with four nearby doctors and they all told me this not a sign of rabies. So is it for rabies or for extreme anxiousness? The dog is still alive and fine. ### Response: Firstly, yes this is not a symptom of rabies and it would have progressed by now if it was rabies. Also, since you are vaccinated and the dog is still alive, you are unlikely to get rabies. So, it is unlikely to be rabies and trust local doctors. Also, keep watch over the symptoms. So, you should not worry at present." "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: Following is the growth hormone test report of my son aged 11 years and 7 months and his height is about 129 cm and weight is 32 kg. I am very concerned about his growth. Please comment in detail about the possible treatment and their side effects, if any? ### Response: I just read your report about your son and I am sorry to say that he has a growth hormone deficiency (attachment removed to protect patient identity). He needs to take growth hormone injections for it. These are to be taken on a proper prescription from a pediatric endocrinologist in your place. These are to be taken daily. The side effects are listed here like peripheral edema, edema, arthralgia, paresthesia, skeletal pain, flu-like symptoms, rhinitis, pain, hypertension, gastrointestinal side effects." "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 had a full blood count done and would like a second opinion on the results. It was my cholesterol which surprised me. I have never suffered from high cholesterol but over the past three years, it has kept up and recent tests showed serum cholesterol 7 mmol/L/HDL, 1.25 mmol/L/LDL, 5.07 mmol/L, triglycerides 1.5 mmol/L. This surprised me as my cholesterol two years ago was 5.0 mmol/L and I gave up all meat four years ago.I am 45 years old, eat healthy, exercise 3 to 4 times a week. I find it weird that my cholesterol has gone up when I have given up meat though there does seem to be a family trait in my mother\s side for high cholesterol. I have also been reading a lot recently that views on cholesterol are changing and studies show that it is not directly linked now to saturated fats and heart disease. The other test I wanted to briefly discuss was my liver results. My doctor said they were all fine. I have looked at them and they all do seem to be fine except I noticed my Bilburin level was up a bit to 24 umol/L which sits just outside of the norm. My doctor mentioned nothing about this. Is it a concern? ### Response: I can understand your concern. I have gone through the reports you have attached (attachment removed to protect patient identity). Yes, your cholesterol is high especially LDL. This is more worrisome. Cholesterol runs in family. So, despite a healthy lifestyle, some patients fail to reduce cholesterol. For bilirubin, get done ultrasound abdomen for liver and biliary tract. Please let me know if the ultrasound is already done. I will be happy to help 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: Is it right to take a beer while breastfeeding? Is it different from other forms of alcohol? ### Response: It is not healthy to take an alcoholic beverage during pregnancy or breastfeeding. It has a lot of adverse effects on the baby. Wait for at least three to four hours before nursing the baby again. Breastfeeding mothers should stay away from alcoholic beverages always." "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 baby is 2 years and 6 months old. She is having worms in her poo and also having new white patches on her hand. I consulted with her pediatrician. He advised giving syrup Bandy 10 ml, it is 400 mg HS and a repeat dose after a week. Is it safe to repeat the dose? ### Response: Hi. I understand your concern. Your baby is suffering from worm infestation, where deworming medication like Bandy (Albendazole) is to be given. It is safe to repeat the dose after a week if the baby is having an excessive worm. Make sure you deworm baby every six months till 5 years of age minimum. The baby should not have low hemoglobin, as worm infestation causes blood loss in the stool (in small quantity)." "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 has PCOS and is undergoing a treatment for the same. She had irregular periods issue even before marriage. We got married eight months back. My wife has not yet conceived. Our previous doctor said that my wife has a primary infertility problem and she suggested Mychiro tablet for three months. Is there any severe issue for her? They mentioned in the report that E7 was 9.3 mm on the eighth day of the period. We are very confused and we need clarification. My wife is now 24 and she does not have any thyroid issue. ### Response: Hi. For pregnancy to happen, good quality ovum from the female and good quality sperm from the male is very important. Let us assume that you are normal. In a regular 30 day cycle, women normally ovulate around 14th day in the middle of the cycle. When there is an irregular cycle, then there may or may not be an ovulation. If ovulation is occurring, then there is a chance of pregnancy. But, most of the time there is either no ovulation or there is bad quality ovulation happening in an irregular cycle. So, pregnancy fails to occur. In treatment also, they may advise to ovulate in a normal manner and ask you both to have sex near, before and after ovulation to maximize the chances of getting pregnant." "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 24 years old. I have loss of erection in my penis for the past four days. Before two months, I had the same problem. But at that time I was taking medicines for my urine related problems. When I stopped taking medications, everything became normal. I have a stone in my right kidney for the past six months. I am not taking medicines this time. I am taking a syrup (stone go) for my stone problem. But, I am facing the same problem now. Please tell me the cause of this problem. Suggest me a solution. ### Response: I can understand your concern. Your syrup (stone go) can cause loss of erection. The other reason can be renal stones. It can also cause loss of erection. All the medicines have some side effects, and loss of erection can also be a side effect due to the medication." "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 24 year old male. My left eye was damaged in an accident when I was 7 years old. Can any procedure possibly be done now? I did not go for any check-up previously. ### Response: Hello. I have gone through the picture (attachment removed to protect patient identity). Do follow-up for any queries" "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 baby is 5 weeks old. He is frequently urinating but slow weight gain. Is my breastfeeding enough for him or not? ### Response: Hi. Frequent urination is because of more of foremilk feeding. Poor weight gain due to hindmilk deficiency. Hindmilk is rich in fat which helps in baby\s weight gain. Foremilk contains more of water which makes the baby pass urine frequently. Your feeding has to be assessed. You should feed for at least 15 to 20 minutes. You should put her on next breast only if the first breast completely empties. Follow this advice and recheck weight after one week." "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 white itchy spots on my penis and on its skin inside. Kindly help. ### Response: I understand your concern but there is no attached photograph in your message. I need to see the picture of the affected area to make appropriate diagnosis and to suggest you the appropriate treatment. Kindly send the same." "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 has been a patient of recurrent local squamous cell carcinoma. In the last one and half years, he has been operated for cystoprostatectomy and urethrectomy with an ileal conduit for urine bypass followed by lymphonodectomy. After all these surgeries, he had a recurrence seven months back. So, the sinus tract was operated and second line chemotherapy with Carboplatin and Gemcitabine was given. The MRI showed very good improvement. A week ago, he underwent a penectomy, scrotectomy, and a surgery of the pelvic bone. I have attached the recent biopsy report. How should we proceed? ### Response: Hi. I have reviewed the information and the biopsy report (attachment removed to protect patient identity). I know that is not a good news, but I think you people and your doctor did their best." "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 you to please analyze my lipid profile and liver test where I can see that a few numbers are at a very high end. Currently, I am taking following medicines Rosuvastatin 10 mg one tablet daily, Amlodipine Besylate 5 mg one tablet daily. I am a chain smoker and smoke average 20 to 25 cigarettes daily. ### Response: Your liver enzymes are raised a bit, and lipid profile is deranged a bit, for which you are taking Rosuvastatin. Rosuvastatin may cause the liver function to derange. Since how long are you taking Rosuvastatin or any other lipid-lowering medicine? If the liver function was normal before starting Rosuvastatin and deranged after taking it, I will advise you to continue taking it and re-monitor LFTs (liver function test) after two months. If it rises even more, then stop statin and remeasure levels after two months. If you have muscle pain, fatigue, etc., do creatine kinase levels. Do regular exercise, stop smoking immediately. Follow up after one month." "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 are planning for parenthood. My wife is 30 years old and was recently asked by the gynecologist to undergo rubella quantitative IgG antibodies test. The test report shows value as out of range having value as 14.60 IU/mL, and RDW as 15.2 %. What does these report signifies especially the rubella quantitative IgG antibodies, and does it impacts the pregnancy cycle? ### Response: How are you doing? To understand better let me give you few facts about the test. Rubella is a virus, which can affect anybody and the usual clinical presentation may be just a cold or maybe slightly higher respiratory infections with or without rashes. Everyone is exposed to this throughout life, as it might have been the last common cold you got last time. Also the MMR (measles, mumps, and rubella) vaccine everyone gets in childhood. Rubella infects only once in life. Next, if anyone gets any infection due to any bacteria or virus, etc, they immediately develop IgM (immunoglobulin M), which is body\s immediate response. Then after few days, this replaced by IgG, which only means that sometime in past you had the infection. So her result of IgG high means she had rubella sometime in the past 30 years, not recently. If you are still worried about the levels, just postpone pregnancy for next 2 to 3 months. Even if her IgM was high, she is advised to avoid pregnancy for next 2 to 3 months. By then her IgM values come down. So my advice would be to just forget about these unnecessary test, just go ahead and have a great pregnancy" "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 aged 67 years old suddenly got speechless. When he woke up in the morning we went to throat specialist but there is no problem with the throat. We got CT scan of the brain done. Then we had referred to the neurologist. He then immediately admitted to the hospital and the treatment started. Then we have done MRI of the brain, the neurologist said there is shrinkage in the veins of the brain. After the five days in the hospital, my father came home. But still he is speechless slightly a word he can say in a whole day. He can listen very well, understand everything, react to everything. BP, ECG, and 2D echo are normal. Complete blood count and blood sugar are also normal. ### Response: Your father\s symptoms are compatible with a stroke. Coming to this point I would recommend performing a Doppler ultrasound of the carotid arteries to investigate for possible narrowing. It could be due to atherosclerosis. It is also important consulting with a speech therapist in order to improve his situation. I would recommend taking aspirin 100 mg daily and Piracetam" "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 got my periods 48 days before. I had an unprotected sex 40 days ago after which I took an I-pill. I had slight bleeding after one week for three to four days. I again had sex 11 days ago during which condom got ruptured. So, I again took an I-pill the same night. I have not got my periods since the last time. I am a bit worried. I did a pregnancy test 12 days ago itself but it was negative. Kindly help. Of note, I have had a medical abortion. ### Response: Hello. This could be because of hormonal changes due to the pills you have taken. There is nothing to worry about. However, if you have a doubt then get yourself checked by a gynecologist and get a pelvic scan done to rule out the exact cause. Do get back to me with reports so that I can 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: I am not fat, but my body gets really warm sometimes especially when I sleep, which makes me uncomfortable. So, what might be the reason?Secondly, I get pain near my left ear when I open my mouth. Three weeks ago, the pain went after four days (it started and ended when I woke up after sleep). Again, the same pain came this week, but this time on the right side. Lately, I found my both hand fingers are shivering sometimes but most of the time, I have that feeling even if they do not. Why? ### Response: Are you suffering from an allergy? If the ear pain is arising during the opening of the mouth at ear area it may be arising from temporomandibular joint. Middle ear infection or eustachian tube block may also give rise to pain in the ear. But in your history, you did not mention clogged ears. Avoid cool" "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-in-law is aged 77 years. He has diabetes and blood pressure. His creatinine level is between 3.6 and 3.8. Has high levels of albumin in the urine and high levels of urea (129). He is admitted to the hospital following less to nil urine output. They have placed a catheter and are observing the urine output. However, it is still less. Around 600 ml for 24 hours. For now, the doctors are running an infusion to reduce acidosis. Does he need a dialysis? Is this a case of CKD? If yes, what could his stage of CKD be? What would be the further line of treatment? ### Response: Hi. Yes, unfortunately this is chronic kidney disease stage 4 to 5. May be the late stages of CKD is rapidly progressive especially in diabetics. If urine output has not been improved after treating the infection and achieving good water balance, I am afraid he might need dialysis." "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 retina detachment in my left eye before three months. I have silicone oil in the eye. Vision is not bad, but I have a problem with depth perception. Everything is smaller in the bad eye. I see people with small heads and big bodies. Is this normal? ### Response: I understand your concerns. The main problems you mentioned are depth perception problems, and distorted images also called metamorphopsia. Depth perception occurs when both the eyes see well, it is hampered when one eye has blurred vision or squint. Metamorphopsia happens when the central area of the retina (macula) is affected or the retina becomes edematous due to the effects of surgery. These problems can be troublesome but do not indicate any specific information regarding the progression or recurrence of retinal detachment. I suggest reviewing with your ophthalmologist to clear your doubts. 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 had unprotected anal and oral sex with a guy. This makes me very stressful. The symptoms I encounter after the incident are as follows. I am feeling very tired from day 10, and I think it as stress. From day 12, I am having some sort of difficulty in breathing and numbness all over the body. On day 14, I have experienced itch inside the penis with clear watery discharge like urine, and it lasted only for a few days. On day 17, I had fever and headache which was cured in a day with treatment. I got an itchy rash on the chest, back, face and scalp on the 19th day. It lasted for about five days and got reduced, but still remains some. Then other symptoms persist till date which occurred gradually are sore throat, lower back pain, abdominal pain, joint pain, coating on tongue, bumps on back of tongue, red spot on tongue with irritation, itchy legs and hands without rash, blurred vision, painful itchy and sore armpit, thigh, genital area and buttock areas. I have attached the photos, please have a look. Do these symptoms suggest acute HIV infection? Or can it be other STDs?I have undergone the following tests to check HIV. Rapid blood test on day 19 and the result was negative, and I repeated the same test on day 35 and that too negative. My partner tested in front of me one day before sex, and it was negative. He claimed that he is clear and safe. But, he said that he had one partner three or four months ago and also many partners before. If my partner is truly clear and safe and I am HIV negative, then what cause all these symptoms?My doctor said I have very similar symptoms of acute HIV which makes me freaked out and nervous. I made mistake to have unprotected sex with him. I am going to get married soon. I will decide my marriage according to my HIV test result only. Please answer my questions and give advice. ### Response: Hi. I would try to provide you with the best possible answers to your questions." "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: What are the symptoms of having a blood clot in the lung? ### Response: The common signs and symptoms of having a blood clot in the lung (pulmonary embolism) include: In case of any of these symptoms, 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: My wife delivered a baby boy two months prematurely and he was underweight (1.210 kg). The reason was almost nil movement of the fetus and very less fluid in the fetus (3.5 to 4).After the delivery, the doctor said that all the other parameters of the baby like the height of the baby, the size of the head and heart, etc. are normal except for the weight, low blood count, and high sugar level. So, he was given blood.Initially, the sugar level was beyond 500. So, the doctor put him on continuous insulin. Due to this, his sugar level came down but, it was never below 150. So the doctor said that he might have diabetes. Since the last two days, he is given insulin injection at intervals instead of continuously. Even though at mornings, the sugar level is in the range of 140 to 180, at evenings, it jumps to 250 to 350. However, today it jumped to 484. All the other tests like USG of stomach and head were conducted but, found to be normal. The doctor also tested a fluid from his spine but, all were normal. There is no infection and no hearing problem. He is otherwise normal. He is active, cries and moves like normal babies. But, I am worried. What is going on? ### Response: For now, taking care of sepsis is of prime importance. If it is sepsis-related or prematurity-related, it will improve with time" "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 31 years old, before 16 years underwent anterior discectomy of c3c4&c4c5 with fusion. Even had neck pain and pain got radiated to neck and back while working. Suffering with pain for 16 years but I got used to it. But for past few months neck became very very week am not able to bare my head weight and not able to keep neck in straight position. Now for past 20-25 days having severe neck pain, weakness of full both hands and legs sometimes with numbness. Eye pressure and back head pain. I am not able to keep neck at straight position. Getting breaking sound if I rotate the neck. Neck movement is restricted. I have attached my recent MRI report, can you please tell me what is the actual issue with this. ### Response: Hi. I have gone through your query and medical history along with the attached reports (attachment removed to protect patient identity). The problem does not seem to be due to the fused C3-4 or C4-5 levels. Infact a disc prolapse at C5-C6 with nerve compression is causing the present symptoms. I would suggest you to go for physiotherapy sessions including cervical traction along with neck strengthening passive and active exercises,SWD/IRT. It would always be better to avoid going through another surgery considering the post-operative complications. Hence, in my personal opinion, you should avoid a re-surgery and go for conservative line of management. Analgesics,anti-inflammatory tablets, hot fomentation and use of cervical soft collar will help. If the symptoms do not improve, you can consult an Orthopedist/Neurosurgeon for further management." "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 suffering from the derealization symptoms for the past 5 years. I believe they were caused by B12 shots I was taking to treat autism. After my brain scan I got to know that my inhibition was too high. I do not find any safety net to keep my mind from deconstructing things. A part of me have a dislike for anything involving neuroplasticity. There are too much dichromatic thinking and lack of magical thinking. Currently, I am on Adderall and Prozac. ### Response: Hi. I read your query and understand your concerns. I am sorry to know that you are suffering with multiple problems related to thinking and inhibition. Before saying anything I must assure you that vitamin B12 is not known to cause any of the mentioned symptoms and we need to find out the alternative reason for causation of these symptoms. They can be due to autism itself or may be due to other psychopathology that has been arising due to autism. It is also possible that you are excessively sensitive to minor changes in thinking process. Before we make final decision, I would request you to post follow up query with the following details. I will be glad to assist you in recovering from all kind of problems related to mental health. Revert back with the information requested above to 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 a long, complicated cardiac history and currently seeing a cardiologist. It started with chest pains, and I ended up having an episode of NSVT last year. I am now on Bisoprolol and Amlodipine. The cardiologist thinks my condition is coronary artery spasm and just an ectopic focus causing the NSVT. I have had a normal CT angiogram with no luminal narrowing and no signs of any blockages or atherosclerotic changes, and a negative stress echo. I have had a normal echo after the NSVT with everything normal and a cardiac MRI. The MRI showed a very mild dilation of left and right ventricle (the cardiologist looked up studies and said mine is not dilated and it falls within the normal range for my age).I had a normal echo just taken yesterday, which showed no dilation ventricle with normal wall thickness, size, and normal function with 66 % EF. The only finding at all on the echo was a mild tri-leaflet aortic valve, normal cusp excursion, and no regurgitation. I also noticed that every time I am stressed or anxious, my T waves in leads III and AVF on ECG flip. As my other echo did not mention this sclerosis of the aortic valve, has this always been here and because of my NSVT does this put me at risk of an SCD? Also, is it likely for me to have blockages in my arteries now even after a clear CT angiogram less than a year ago?Since the one episode of NSVT, it has not happened again although I have had on Holter, premature atrial, junctional ectopics, and ventricular trigeminy, all of which are very infrequent. One episode of trigeminy with emotional stress on three-day Holter. Total ectopic beats in 24 hour period less than 30. I am a 31 year old male, who does not smoke and. All the best. ### Response: An excellent narrative history. I think you had only one episode of tachycardia of ventricular origin, which was nonsustained" "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 having recurrent vaginal yeast infections for the last six months. I have taken medications earlier. The gynecologist prescribed Azithral 500 mg in the beginning. After that, the doctor gave me tablet Orni-O.The first time it got cured. When it came back again, she prescribed Vibact-DS for one month and Flucon 150 once in a week for three weeks. The infection came back again after two months and she gave me Candid V3 vaginal tablets.Now again, I am feeling the infection. I am also taking treatment for acne (Elvac-20 from last six months). Is Elvac 20, the reason for my recurrent infection?I am 31 years old unmarried woman, but in a relationship since last four years. This is the first time in my 31 years life that I am experiencing this repeated infection. Please help. ### Response: Hi. As you have repeated yeast infection, you require following investigations: And also your sexual partner should be simultaneously treated as these kinds of infections are transmitted through sexual intercourse. Revert back with the reports to 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: My mother is 85 years old. She is diabetic and blind. She is complaining of foul odor from under her big toe nail. The nail looks like it is normal. What should we do? ### Response: Hello. Your mother seems to have paronychia. Paronychia is the infection of the finger or toenail along the edge. It might be a bacterial or fungal infection. Accordingly, she will require a topical antibiotic or antifungal application. If the infection is severe, she might have to take oral medications. Please get a complete blood count done and also check her diabetes status and revert with reports." "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 cannot grow beards on my cheeks but moustache and beard near chin grow properly, what can be done to grow full beard? Please help. ### Response: This is very common not to have full grown beard. As you have mentioned you have hair on chin and moustache but not on cheeks, you can consider meeting an endocrinologist and get your hormones laboratory test done. This is just to ensure that you do not have any hormonal issues. If everything is normal, you can consider beared transplant surgery. It is safe and permanent solution to your problem." "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 daughter is 20 years old and studying in a hostel. For the last one month, she is suffering from a headache. After taking painkiller it subsides and again it stars on the next day. So after three days, I consulted an ENT doctor and he after examining and after taking X-ray, diagnosed it as sinus headache and gave antibiotics and painkillers for five days. She completed the course and while using the tablets she did not have a headache. Now, again she has a headache.Kindly advise whether the headache is really from sinusitis. Why am I doubting that she has only headache with mild nose block and no other symptoms like discharge or fever. So, my doubt is whether it is sinus headache or not and if it is due to sinusitis even after completing the course why again headache? ### Response: Headache can be of many reasons but while pertaining it to ENT, it is mostly due to sinusitis. For declaring the headache due to sinusitis you should have got done a nasal diagnostic endoscopy by an ENT surgeon or should get a CT scan of the paranasal sinus. X-rays are of the very very old generation and no one is using it as a tool to diagnose it. But since you have got the X-ray done, kindly share it along with the reports. Kindly understand that if at all the sinusitis persists the medical management which may completely reduce sinus infection is antibiotics up to 4 to 6 weeks (for a permanent cure) along with mucolytics, a short course of oral steroids and nasal spray if the patient is allergic to dust or pollen. If the above medical management fails then the patient has to be subjected to surgery which we can decide with our CT scan. As you have also mentioned regarding nose block a deviated nasal septum can also be a cause for headache. So kindly share the X-ray report." "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: Our 12 weeks NT scan indicates developing placenta is fundo posterior lower edge reaching internal OS. The doctor advised 30 days complete bed rest. I need your opinion on the same case and also doing an ultrasound scan after two weeks. This scan was done 10 days back and since then I am on bed rest. I have a family vacation (one hour flight) planned to travel in 15 days. Is this something possible and non-risky to do? ### Response: At 12 weeks gestation with placenta fundo-posterior with lower edge reaching internal is a fairly acceptable finding for early pregnancy. It does not really call for bed rest if there has been no episode of any bleeding per vaginum. The safest distance of placenta is more than 2.5 cm from internal os but that is in the third late trimester when the lower segment is formed. The placenta tends to climb up by 32 to 34 weeks and the present low lying status shall change. However, care should be taken to avoid intercourse completely throughout pregnancy and not to lift the weight of any kind which can cause an increase in the intra-abdominal pressure which can cause bleeding. She can walk and do her daily chores with care. Travelling is advised even in normal pregnancy after 18 to 20 weeks when the placenta matures and the fetus has become resilient to any pressure changes with an increase in amniotic fluid. Unless it is absolutely necessary, she should not be traveling as a precautionary measure." "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 was previosuly diagnosed with renal tubular acidosis and diabetes mellitus, was maintained on Potassium citrate and Gliclazide OD. Currently he had an infected insect bite on the left anterior lateral aspect of the leg. He was started on CO-Amoxiclav BID. Currently on its 4th day, I had his labs taken which revealed HbA1c: 8.5, FBS: 7.57, Crea: 2.79 mg/dl, BUN: 3.67 mg/dl, Hgb:195, Hct: .58 wbc:13.2, plt: 157 with normal lipid profile and uric acid. ### Response: Hi. High creatinine suggests a CKD picture for a long term diabetes particularly uncontrolled DM. Your fathers HbA1c is high which shows his diabetic status is not under control. High potassium levels is one of the complications of CKD, in this picture taking Potassium citrate is not advisable as it may increase its levels. It is safe to shift the treatment with Insulin. You need to visit a Nephrologist for alterations in your medications and appropriate advice for CKD. serum potassium, sodium, phosphorusurine routineUSG abdomen DM, CKD" "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 46 years old and never had any indication of herpes. No new exposure, same partner for over a year and neither have strayed. 20 days ago I got up with some redness and uncomfortable feeling on left side of vulva. I have an anxiety disorder and super high stress level right now. For some reason, I decided this was herpes and started looking at myself with a mirror and flashlight. Never really saw anything. I have been obsessed ever since. Tingling and numbness in buttocks and down backs of thighs off and on for 20 days. Uncomfortable but not red in vulva area. No signs of herpes. Went to a gynecologist, she did a pelvic scan and said no signs of herpes in or out.I still cannot stop thinking about whether they missed something. I also went to my chiropractor who did an adjustment and said lower back can cause tingling and numbness even in the genital region. Yesterday a little red pimple looking bump popped out on my inner thigh. I decided it must be the sore that never came out before. It does not hurt or itch but I am obsessed with it now. It is smaller today. Question is that does prodrome last 20 days (tingling numb butt area) and can one sore pop out after 19 days? The gynecologist I saw said I need to be treating my anxiety again and to get back on the Zoloft I took for two years for that. ### Response: Herpes has many myths asssociated with it. No, it is unusual to get a blister after 19 to 20 days like this. Blister may be due to some other skin disease or any other reason. Still worried, you may go for a PCR for herpes blood test and you may consult me back with the reports of the test. Secondly, if this blister or sore does not heal up in a couple of days, increases in size or number, you should go to a physician for taking a sample of this sore (few cells will be taken on a swab) and send it to the laboratory for herpes testing. The final suggestion is that relax and do not worry much." "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 gay, married to a woman and had sex with my wife. My question is can my sperms impregnate my wife? If it happens, my children will be straight or gay? ### Response: Hi. Yes, even if you have homosexual orientation even then you will be able to make your wife pregnant. No need to worry for that provided your sperms count is normal. Homosexuality does not have direct genetic inheritance. So, no need to get worried for that too" "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 ECG shows low voltage with QRS 86 mm. I am physically fit and active with no such issue a year ago. What could be the cause and solution? ### Response: Could you upload your ECG picture? It must be 86 msec, I guess. Low voltage ECG may be seen as a normal variant, also seen in obese individuals, smoker or patients with heart disease like fluid around the heart or in lung disease. But, if you do not have any symptoms then it is likely a normal variant. Patients with a disease will have other symptoms too." "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 dad who is 70 years old, recently had a severe chest pain which started three weeks ago. Since it was of a recurring type, we visited a hospital for a check-up. They initially conducted ECG and then, a 2D echo, after which they said there is a problem but, a minor one and that we need to do a coronary angiography to get a detailed picture. After doing that they suggested a bypass. I am apprehensive about the suggestion since minor problems do not require a bypass (CABG). I am attaching the reports. Can you please go through them and suggest the most suitable option? ### Response: I understand your concern. I have gone through all the test reports (attachment removed to protect patient identity). There is a significant evidence of blockage of multiple vessels, which are over 70 and 90 % blockages. In the case of a coronary artery disease that involves multiple vessels with over 70 % blockages, CABG (coronary artery bypass grafting) is indicated. I advise you to discuss further with your cardiologist. Wishing your dad a quick recovery" "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: For the past few weeks I have had a development of some kind of white lump just behind my two front teeth. It moves a little if you touch it, and it is painful if you press down on it. Otherwise, it does not hurt. It is noticeable when you take pictures of the inside of my mouth, at the appropriate angles. It seemed to catch more of my attention now than before, however. I cannot seem to figure out what it can be because it has been here for a while now- several weeks. What could it be? I have never had this before, and I believe I maintain adequate oral hygiene. ### Response: It could be an abscess which needs antibiotics for a week. Show to a dentist soon, else it may get painful. Send those pictures to help me confirm." "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 23 year old female. I am not yet married.In October 2013, I had a laparoscopic removal of a chocolate cyst measuring 10cm.The doctor suggested me tablet Ovral-L.But, after that I had aneurysm and could not take those tablets.Now, when I got scanning done 4 days ago, they found 2 chocolate cysts size 4cm and 3cm.What should I do now?Is it possible for me to get pregnant after marriage? ### Response: Hi. Yes, there are chances for the recurrence of chocolate cyst. Usually the cyst wall is removed while doing cystectomy (removal of the cyst) to decrease the chances of recurrence. For this, you can consult your gynaecologist and take only progesterones or GnRH agonists (Gonadotropin-Releasing Hormone Agonists). You can get your ovulation study done to see the number and size of developing follicles and their rupture, which means ovulatory cycles. If you are planning for a pregnancy then best will be to get a diagnostic laparoscopy done which will confirm the actual status of the cyst along with tubal patency, etc., and so many other things." "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 recently diagnosed with a blood clot in my left jugular vein and put on Eliquis (10 mg twice daily for a week, now 5 mg twice daily). I was also recently diagnosed with some sort of autoimmune disorder, but it is not clear yet which one. After being diagnosed with the blood clot, my rheumatologist performed a lupus anticoagulant panel to see if I am taking the correct blood thinners. Everything came back normal except the dRVVT which was prolonged with 52.2 seconds. The dRVVT mix was 45 seconds and I was told that it is negative. I have read a lot about dRVVT testing online now and I am concerned that I am still LA positive because the mix can show false negatives. I have also read that converting the results into a ratio is preferred. Also, my aPTT was slightly elevated (37seconds). I have no risk factors for blood clots (normal weight, no hormonal birth control). What is your opinion? Do I need further testing? How likely is it that I should be taking different blood thinners? ### Response: Additionally in APS, the raised RVT (renal vein thrombosis) is not corrected by adding normal plasma. So lupus or APS chance seems to be less in your case. I suggest you investigate with full coagulation profile workup including coagulation factor assay and factor V estimation as well. You have been given Apixiban which is a very good" "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 this something I should worry about? I have been hypothyroid for 25 years and have recently gained about 25 lbs.Thyroid ultrasound states, history of goiter. We have no previous examination available for comparison. Both thyroid lobes are diminished in size.The right thyroid lobe measures 2.3 cm in length, 6.4 mm in depth and 9.4 mm in width.The left thyroid lobe measures 3.2 cm in length, 6.5 mm in depth and 1 cm in width.Each thyroid lobe is diffusely heterogeneous and without visible nodularity. No parenchymal calcifications are visible.The impression is diffusely heterogeneous and small thyroid lobes. No evidence of dominant nodule on either side. ### Response: Hello. Your weight gain is due to hypothyroidism and probable physical Inactivity. I need to know what is your recent TSH (thyroid-stimulating hormone) level if it is not in a reasonable range, your medication dose needs to be adjusted. Also, do 30 minutes of aerobic exercise daily, avoid sweets, carbonated beverages, and nonveg food. As of your scan report is concerned it is suggestive of atrophic thyroiditis where the thyroid gland shrinks and later becomes inactive. So you may require thyroid hormone supplement. But your scan finding is nothing to worry about. Any doubts or queries feel free to ask." "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 regular periods every month. I missed my period 10 months back and until now I have not received my period. I took two pregnancy tests a month later and both came out to be negative. I would sometimes get light cramps and discharge (clear). I want to know is this normal or is something wrong with my body? Could I still be pregnant? Please let me know I am desperate for help. ### Response: Hello. If your prime concern is pregnancy alone, then you can get a serum beta hCG test done which is the gold standard and conclusive. If the hCG levels are less than 5 mIY then you are surely not pregnant and the delay of menses could be stress induced as in most women. The other most common causes of oligomenorrhoea are PCOS, hypothyroidism, and hyperprolactinemia. So you may get a hormonal profile to get these levels checked as well and an ultrasound pelvis to rule out polycystic ovaries which are again very common in young women." "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: What does high risk 1:50 trisomy 21 mean, at an age of 32 and 18 weeks pregnancy? ### Response: I totally understand your anxiety. But please do not panic. In other words, if we take a general population, and consider any women in general, there is a risk that one in 250 women may have a baby who is affected with Down\s syn" "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 5 months old and he is suffering from loose motions. He was on antibiotics (Moxikind) for 7 days last month and from there onwards, he was on Wallamycin to stop the loose motions and Darolac, Sporoges powder sachets but there was no result for 15 days. Again from there, he was taking Normula, Delphonorm and Lactase enzyme drops. Everything was good till seven days back but he had loose motion with blood content in it. Today also he had motions with blood content. Please help me out. ### Response: I can understand your concerns. If the child is having loose stools for 20 days and still loose stools are persisting, then stool routine microscopy test, stool for reducing sugar and stool for occult blood should be done. If the child is having decreased feeding, decrease urine output or decreased activity, then the child needs to be hospitalized. Review with the report" "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 blood pressure is 150/90 mmHg and my age is 18 years and there is a pain in the neck and at the top of the head. Please help me. Currently, I am taking Arbitel 250. ### Response: I noticed that you have grade 1 obesity (attachment removed to protect patient identity). You will need to give more history, for example, do you have a family history of hypertension. The neck swelling needs to be evaluated to rule out a thyrotoxicosis. 1.Urinalysis.2.Serum electrolyte urea and creatinine.3.Fasting lipid profile.4.Fasting blood glucose.5.Chest radiograph.6.Urine VMA (vanillylmandelic acid).7.Neck scan. Rule out substance use disorder. Endocrine cause of hypertension. See a doctor to prescribe antihypertensives. 1.Reduce salt intake.2.Lifestyle modifications like weight loss, exercise, alcohol reduction, smoking cessation.-" "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 swimmers ear and I do not know how to get rid of it and now my ears hurt extremely bad. ### Response: Hi If you have diffuse otitis externa then you must rule out malignant otitis externa. If you are immunocompromised or a diabetic you need to worry about the same. It will be prudent to get a culture sensitivity swab of the discharge from the ear whenever you have the condition. A permanent solution would require you to avoid water entry into the ears. Anti-inflammatory medicines like Trypsin-Chymotrypsin will be contributory to remove the edema and swelling inside. Acetic acid" "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 severe leg pain in both legs. It occurs during night time. I have pain in lower back. My MRI report says there is diffuse disc bulge causing thecal sac compression at L4 to L5 and L5 to S1. There is small disc bulge causing thecal compression at D11 and D12 level. There is ligamentum flavum hypertrophy and facet hypertrophy seen at multiple levels causing bilateral recess stenosis. Please help me. ### Response: These MRI findings indicate chronic degeneration of the column, with intervertebral disc displacement in two levels (thoracic and lumbar). There is no need for surgery. I recommend painkillers, a muscle relaxant for the pain and physiotherapy. It is necessary to lose some weight and avoid weight lifting" "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 31 years old and got married three years ago. This is my second pregnancy and I am currently 12 weeks pregnant. I had terminated my first pregnancy due to my bad health condition. I am a practicing architect and a teacher. My work schedule is about 9 to 10 working hours a day with a sedentary pattern.My first sonography was taken during my fourth week of pregnancy which showed that I have a septate uterus. During my eighth week, there was some bleeding observed in my vagina. On my gynecologist suggestion, I had another sonography which showed that everything was normal. Post that my doctor put me on bedrest for four weeks. I also had NT scan and dual marker blood test during my 12th week whose reports were normal. The doctor has recommended me to have a uterus stitched at 14 to 16 weeks.Please guide me as to what precautions should I take with respect to food and lifestyle? Since I have a successful architectural practice, I am under stress to complete the work on the given deadline. There has been a month backlog in work which may cause me severe financial issues. Is it advisable to return back to work with all the above complications? If yes, what precautions can I take? ### Response: Hello. With working job and pregnancy, it is a difficult task. First being pregnant you need to relax. Do not stress out. Stress even mental stress has ill effects on pregnancy. Also, your weight is on the higher side. As you crossed 12 weeks, do a minimal routine physical activity. Avoid junk, processed, fried food. Also, stitch, you can put for the betterment of pregnancy. As far as now, your pregnancy is more important than anything else." "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 a lot of irritation on my vagina opening and when I scratch it, it feels good but it gets more irritated. I went to the doctor recently and I had a UTI, however I am still feeling very itchy and I am getting concerned. I am 22 years old and right now I am only taking the antibiotics for the UTI. ### Response: Hi. It looks like boil. And mostly it is UTI related (attachment removed to protect ptient identity). Continue taking antibiotics. Can be in healing phase and that is why itching must be there. But you can take Syrup Cital like liquid 2 times a day for 15 days. And can also apply Candid - B like ointment which will help in reducing itching. Do not scratch. It will increase the infection. Keep the vaginal area as" "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 unprotected sex with my partner today. She is on the 22nd day of her cycle. Will she get pregnant? We do not want to have a baby now. What should we do now? ### Response: If she has a regular cycle of 28 to 30 days, then there are no chances of pregnancy, and these are safe days. So nothing to worry. I hope it has helped you. If you have any further queries, please do not hesitate to contact 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 10-month-old baby is cutting her top tooth and there are orange and red lumps above where the tooth has started to come. What are these lumps? I have attached few pictures for your reference. ### Response: Hello. I have seen the photos (attachment removed to protect patient identity). As your child is 10 months old, the upper teeth should have been erupted by this time. But three to six months delay is normal and it looks like your child is putting teether in his mouth and bitting it hard which is normal during teething. If the lower teeth are there, they also exert pressure if the child bites strongly on upper gums which also leads to this condition. Just check if there are no other lesions like this in the baby\s mouth. If the child is irritable, you can use an over-the-counter analgesic gel, like Dologel (Choline Salicylate and Lidocaine Topical) over the lesion only and keep the area clean. Take lukewarm water and wipe the area with wet cotton and you can give the child a chilled teether to give relief. If there is associated fever that is also normal up to 100 degrees Fahrenheit. If the lesion does not resolve in three to four, visit a pediatric dentist to get a treatment. But, from the picture, it looks like it is only a teething trouble and this will resolve on its own." "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 disk golf in an area where a decent amount of poison oak is present. I would like to know how fast urushiol binds to skin, and once it does is there any possibility to spread?I use an electronic cigarette which requires me to handle cotton that I feed into the atomizer. My doubt is if urushiol vaporizes automatically, what will be the harm? ### Response: I have read your query. Poison oak causes allergic contact dermatitis (ACD) and is the most common cause of ACD than all the other causes combined. The allergen which cause ACD is usually present within the sap named urushiol and it will be mainly present in the leaves and the inner stems of the plant. After the contact with any part of the plant it usually takes 12 - 48 hours for the symptoms to occur. But the resin will bond immediately to the skin on contact. So, you should remove it with a mild soap wash immediately. If within 10 - 15 minutes of contact washing is done, 50% can be removed. But, if it is beyond one hour, washing does not help much. You can use Bentonite barrier creams which can prevent bonding of urushiol to your exposed parts. Urushiol once bound to the skin does not vaporize and does not spread to other parts of the body. As it is a local reaction, the intensity of it depends on the amount of resin contacted." "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 46 years old, man. Following are my lifestyle. Limited food, especially at night. (anything only two), weekly 4 to 5 days morning treadmill walk up to 4 km, no fried items, 120 ml of drink daily with salads or egg, two cups of tea daily, weekly one or two times non-vegetarian (except broiler chicken). My problem is I have put on weight by 4 kg (68 to 72) one year before. I need to reduce my belly and weight. Please suggest to me. ### Response: Your diet and exercise schedule is fine. You did not mentioned whether is there any health issue or not. You can take Apple cider vinegar 5 ml (1 tablespoon) mixed with lukewarm water and take before 30 minutes of lunch." "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 when I am alone in a closed room or studying, I hear some sound. My father used to say this is because of wax in the ear, but when my ears are clean, I still hear the sound. I am sure that my hearing is fine. Could this be the sound of blood circulation? Is it normal to hear a little sound in a closed room? ### Response: Hi. This is called tinnitus, and there are many reasons for it. Some of the reasons are an infection of the middle and external ear, otosclerosis, sensorineural hearing loss, glue ear, anatomical variations of the vessels, etc. First, we need to examine your ears and do an audiogram, then only we can come to a diagnosis." "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 19 years old. The area surrounding my urethra is enlarged. It is whitish, and it has a cottage cheese-like texture. There is no discharge or odor. I do not know what to do. I am embarrassed. Please help. ### Response: Hi. It can be a pelvic or sexually transmitted infection or candidiasis. Have strict hygiene. Use soft, comfortable, and cotton undergarments. Use condoms while having sex to avoid having sexually transmitted disease. Have high, low vaginal and urethral swab. After collecting the swab, have one Canesten pessary for two alternate nights at bedtime. So the infection can flow out if you have it. You can have sitz bath if you feel irritated. Collect the swab report and discuss here or with your local gynecologist. You need to treat it soon." "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 it possible to prepone my periods by a few days? ### Response: I do understand that when we want our periods to be earlier rather than later. But unfortunately delaying cycles is usually better. If you have 28 days cycles then this month your cycles will start on the expected date. But, if you have 30 or more days cycles I will suggest starting tablet Meprate (Progestin) 10 mg twice daily from two days before the expected date till the day you do not want your periods. After stopping tablet, the cycles will start in 2 or 3 days. They might be heavier than usual but no worries." "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 is 34 years old, has thyroid deficiency for which she takes medicines and is under control. But she also has recurring allergy problems, her face cheeks, become red itchy and swollen frequently along with hay fever symptoms. She is very sensitive to facial creams. Please suggest tests, medicines to manage these conditions. Currently, I am taking Thyronorm 88 mcg, Dazit M and Tezine prescribed by skin specialist on the day two of medications. ### Response: Hi. The most effective way to treat the allergic reactions your wife experience is to avoid the allergen (the substance that causes the allergy) like pollen, dust, mites or detergent, etc. If it is difficult to identify the cause of allergy a batch skin test could be done to identify the cause. The medication prescribed is suitable for her condition. A short course of steroid can be tried if the symptoms are severe. Regarding her thyroid condition, follow up with TSH (thyroid stimulating hormone) level (target below 5) is required every eight weeks." "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 54 year old female. I was taking Raciper plus for 15 days. After stopping, I have upper abdominal discomfort and hunger feeling. The abdomen is gurgling. Is this normal? ### Response: First of all, I need to know what symptoms were you prescribed Raciper plus for. Did you have the same symptoms before starting the medication? I am providing you a free follow up to answer these questions. Revert with the asked details for a better help" "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 intrusive thoughts, blasphemous thoughts that keeps returning to my head. In the past I had porn addiction, and the day I forced myself to stop, I began having those thoughts. I already had OCD symptoms when younger but more subtle. I suspect I have some low serotonine so I am taking St John's Wort and some Magnesium which are helping in my porn withdrawal and thoughts. I had these thoughts for around 2 to 3 years and sometimes I do compulsions especially digital compulsions. My work is mainly on the computer, so even deleting or renaming files create some thoughts in my head. I hear about exposure prevention therapy and I was reading that we can record the thoughts and listen to them till they reduce the anxiety, but I cannot in record the thoughts which are blasphemous.What do you think is the best therapy in my case? As I already have anxiety issues which led me to go to the emergency room (because of panic attacks, probably because of my past addiction post acute withdrawal symptoms), do you think those thoughts would go away along with the anxiety itself? Or should I treat them separately? ### Response: I have gone through your query with interest. As you had OCD in childhood and anxiety disorder and taking St John\s wort, Omega 3 , Magnesium and Vitamins (attachment removed to protect patient identity). The therapy for OCD or blasphemous thoughts are exposure and response prevention and / or cognitive therapy. You need to visit your therapist to do these therapy as you alone might not be able to do these. You need not to take different" "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 girlfriend is a virgin and we were intimate on two consecutive days last month. During that time, her periods were delayed by two weeks. I was careful not to ejaculate anywhere near her vagina nor was it knowingly in contact with my penis. She waited for another 10 days and since she did not get her periods. She had Meprate tablet twice a day for five days. Then, she got her periods after another five days. The blood discharge was more in the first day and the bleeding diminished subsequently and it lasted only till the fourth day, though usually it lasts for five days. Her periods is due now for this month and still she does not have any menstrual symptoms. Will she be pregnant? Please advise. ### Response: So, it would be wise to get a serum beta hCG done (human chorionic gonadotropin). It is a blood test that detects minutest pregnancies. As per the timeline, if the value comes less than 5, then the test is negative. Review with the value of the beta hCG report, so that I can suggest medication safe for her. When you review make sure you mention the following. The value of beta hCG, starting date of last periods (before intercourse), date of intercourse and intake of Meprate and if she has associated thyroid or prolactin disorder. Revert back with the reports to a childbirth educator 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 regular runner and have recently been trying out a new programme running five days per week, with lots of gentle short runs. I have had a few running related injuries in the past year. I got shin splints and peroneal tendonitis on the outside of my left foot for several months, last year. I had physiotherapy for the tendonitis. The physiotherapist discovered that my left hip flexor is weak and the hamstring is too tight on that side, which was causing the foot issues.Last weekend, I seem to have pulled a muscle in my left hip. I did a steep trail run and feel like it was on the downhill that I triggered the injury. It was hurting when I tilted my pelvis forwards. I tried swimming, but the side-to-side tilt of the pelvis caused little sharp pains what felt like inside my pelvis. The sharp pain has now gone, but all of the muscles in my lower back, mainly on the left, but also on the right are now tensing up causing me discomfort. Any ideas about this? I have done a bit of self-diagnosis and it sounds like one of the muscles that do balancing on the hip. ### Response: Hello." "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, 32 years old. I do not understand what my ultrasound report means. My gynecologist and PCP both felt a large mass on the right side of thyroid and told me that they have to refer me out and I need another biopsy. The last biopsy was a year back and it was benign. It was a solid dense nodule measuring 1.3 cm. All thyroid tests are normal.Can mixed spongiform nodules be malignant if they are hypoechoic, vascular, lobular and with peripheral calcification? I cannot find anything regarding other abnormal feature with mixed spongiform nodules. ### Response: Hello. I just read your query and from what you have mentioned it appears that you have a thyroid nodule. According to the guidelines, if the nodule is more than 75 % of spongiform appearance, then they are benign and if less than 75% then there is a chance of malignancy which must be confirmed by FNAC (fine needle aspiration cytology). In your ultrasound, there is no percentage depiction of the spongiform portion. Secondly, the malignant nodule has hypoechogenicity and microcalcifications which is present in your report. Please, it is my advice to you to not come to any conclusion before an FNAC" "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 using Fluvoxin 100 mg, Oxetol 450 mg and Quetiapine 100 mg for depression and OCD for five years. My problem is I am not regular to work as I do not feel to go to work. I feel like this only in the morning. I want to be in the bed. I do not feel it is because only of sleepiness. I do not understand the reason as well. I have lost 12 jobs in the last five years all because of the irregularity. Please find the reason for my problem. I am extremely upset with my behavior as my family depends only on my salary. I am facing extreme financial problems because of frequent job loss. Please help. ### Response: Hi. It seems that your depressive symptoms are bothering you. It may be helpful to increase the dose of Fluvoxin (Fluvoxamine) and reduce the dose of quetiapine, so discuss with your psychiatrist for increasing the doses of antidepressant Fluvoxin. Do regular exercise, or go for a morning walk at least five times a week." "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 21 years old and I have always been a shy person. When I was younger I used to sweat a lot because of it and I could barely speak with anyone. As I got older, I became more and more sociable, now I have got friends, I am getting along with everyone at work and I am feeling quite good about myself. I have never been depressed and I am a really happy person. The problem that I am facing is that whenever I talk to somebody, with anyone at all, my heart starts to rush and my face becomes red in just one second. I blush like I have done some dumb thing and it is intense and very very red, anyone can notice it. I have tried to manage it by going out as much as possible and I have learned that when I get comfortable with someone, the blush and red face thing disappears (but it took two years to get comfortable with my boss for example). I am aware the problem might be associated with anxiety, but I have never taken pills for it. I just want the blushing to go away, as that will make me less awkward and better in general. I have got a mitral valve prolapse and a ventricular hypertrophy. ### Response: The problems you have mentioned like the history of shyness, palpitations and flushing of the face on talking with any new person, etc., are occurring most likely due to anxiety. This could be due to social anxiety. You are facing these problems in day to day routine too and to get rid of these symptoms you should consult a psychiatrist for help. Sertraline can be tried. The" "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 2 years and 9 months old. Five months back, he got rashes all over his hands, face and legs, from buttocks to toe. We have consulted many doctors. One of them said it would last three months and prescribed some medicines, but it did not subside. I was then told he is hypersensitive and was given medications for the same. Even though it did not help, we are just continuing those medicines. ### Response: From your description, your kid might be having acute urticaria symptoms, papular urticaria or purpura. Please send me a few pictures, taken when the rash is active. This will help me in diagnosis" "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 usually pains in joints and happened for some years now. I have shown to various doctors and was told that it is due to a low level of Vit D3 and cured by taking regular Vit D3 medicines. Recently I have noticed pains in my joints in leg, hand, elbow, and foot. The affected area becomes a little red with swelling and pain. I had tested for uric acid and the level is under range. Though after the uric acid test, my doctor suggested avoiding rich protein diet and also drink a lot of water. Currently, I drink 2 liters of water per day.Since with all this, the pain has not completely settled and therefore I have done some more tests - CRP [result-33.6 (normal: under 6)], and other reports RA-quantitative (serum), and ASO are normal. With the increase of CRP, my doctor has suggested consulting Rheumatologist for further advice. Hence, I am requesting your advice. ### Response: Hi. I have gone through your query. It is an intermittent form of arthritis that can keep throwing joint pains and swelling intermittently initially. CRP done during an episode may have been high. There is a 50 percent chance that it may become persistent and 50 percent it may remain this way. Only one test is missing which is an anti-CCP antibody. Kindly do that and let me know what it says. As for the treatment, I would suggest you maintain a diary of attacks. If joint swelling is persisting for more than seven days, then we need to start treatment or else if it goes off. If you do not get another episode for a month, then we shall wait. Hope the information was useful. ESR anti CCP antibody and ANA(IFA)" "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: What do this reports indicate? After one-year exposure, following tests were taken HIV 1 and 2, western blot, which was negative. HIV-1 RNA PCR qualitative- non-detectable. Please let me know whether I am positive or negative for HIV. ### Response: Hi. I have gone through the reports (attachment removed to protect patient identity). It is a confirmatory test. It is done after one year of exposure. You are free from HIV. You can allay fears of HIV from that exposure. Forget about the incident and lead a normal and safe life. You can get back for any clarification." "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 daughter (3 years 11 months old) has a fever for the last five days. My doctor prescribed Calpol syrup for normal fever. If the fever is more, then he told to give Meftal-P for my daughter. When can I give this Meftal-P? Before food or after food? How much mL I have to give and let me know that how many times we have to give? ### Response: Hello. I have reviewed your query and here is my advise. If fever crosses above 101 or 102, then use Meftal P. In syrup 100 mg is present per dose. So 5 ml can be given at one time. It can be given two to three times a day. If the fever does not resolve, then further work-up is needed in the form of CBC (complete blood count)." "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 eyes normally are very dry and get red too often. The doctor once gave me Mezol eye drop and it becomes white instantly. So, can I use it regularly whenever eyes are red or not? What can be the side effects of Mezol eye drops? ### Response: Mezol (Chlorpheniramine maleate, Methylcellulose, and Nafazoline) has no long-term side effects, but as it contains preservatives, I advise you to use it only when your eyes are red and not on a regular basis. Refresh Liquigel is a lubricant which is preservative free and can be used on a daily basis four times a 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: Recently, I found a bump in the area in between my scrotum and anus. The dermatologist removed it and sent to lab. Lab said it was a viral verruca. The doctor said this most likely is not an STD and more of a normal wart in a weird location. Should I consider this not as an STD and move on with my life? ### Response: Hi. I have gone through your case in detail. In my opinion, wart in this area is likely to be transmitted through sexual contact. So, it is part of STD (sexually transmitted disease). You need to undergo complete workup of STD and then move ahead. This is not a location of a common wart" "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 red lump on my gums. Not sure if it is an abscess or something and wants some advice. It is red and bleeds when I brush, and there is only pain when I brush. ### Response: Since how long do you have this lump? It could be an abscess, but need a clear picture of it for confirmation. Is there any decayed tooth associated with it nearby? If possible, send pictures or go to a nearby dentist." "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: Suddenly, I am getting whiteheads around my nose and chin and sometimes on cheeks, since two years. My nose is heavily targeted. ### Response: Hello. Please send me the photos of the area where you are having whiteheads. There is a chance of it being molluscum contagiosum or milia. So, the exact treatment can be suggested after looking at the photos. 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 have an eye problem, eye itching, irritating eye, white thread discharge, and facing these problems for the past one year. ### Response: Hi. As per your symptoms, I could understand that you are suffering from allergic conjunctivitis. It is a common problem in people with allergies of nose and lungs." "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 16 year old boy. I have a short penis. Should I take any medicines? ### Response: If you are a perfectly healthy adult male, then there is no reason for your penis size to be small. Mostly all men go through this phase where they feel their penis size is smaller. This thought will hamper their sexual life. If on an erect state, your penis size is anywhere between 10 to 15 cm, then there is nothing to be worried about. You will have a great sex life in the future. Try to get rid of this anxiety as soon as possible. Also, I advise a very healthy diet with lots of vegetables and protein. Work out regularly. There is no recommended treatment for increasing the size of the penis. I suggest the following nutritional supplements:" "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: There is a sharp pain, itching and burning sensation in my anus. I am suffering from hemorrhoids. I am taking ointment and painkiller with a sitz bath. What can I do to treat them? ### Response: According to the history, you are having piles of a greater degree. Your local anal examination and proctoscopy examination has to be done to check rectum and anal area to look for ulceration associated with piles. Take less spicy foods. Do not strain while defecation. Stool softner like Cremaffin syrup can be taken to reduce the friction while passing stool and water sitz bath are useful. If you are having prolapse associated or piles non-treatable with medication, then surgical intervention might be 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 am a 29 years old female with a proper BMI index, but I have high blood cholesterol. I do not have any other physical problem. I did not start any medicine. I do yoga. I want to decrease my cholesterol level. ### Response: Hello. If the cholesterol level is too high, like above 300 or so, then you will need to take medications. But if it is less than that, then you can control it with natural remedies, food, and exercise. You can continue doing yoga. Also, you can do vigorous exercises (only if your body permit, if you have any physical problem then do not do it) like a brisk walk, aerobics or swimming as these exercises will help to lower your fats and cholesterol. Also, eat raw garlic (1 to 2) every day, you can even mix it with food and eat. There is one homeopathic remedy called Allium Sativum made from garlic. Try these methods for one month and then let me know how you feel. I hope you start feeling better." "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 skin rash on my legs or arms all the time. There is only one rash at a time and at different places every time. What could this be? I have had this issue for at least 10 years and maybe more. ### Response: I have seen the image (attachment removed to protect patient identity). But, please let me know the following: Please send few clear images of the lesion, one in the close-up view and the other involving the body part affected. 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 am a 16-year-old male. For the past few months, I have been getting sudden electric shocks (a little bit more than calm) in my neck when I move it. These are not at all frequent. I get them once in a while. I am not that fit and I use my tab (for studies) while sleeping a bit relaxing almost 4-5 hours a day. Please help. ### Response: As you described, using the tab for 4-5 hours a day will make your neck bent forward to see the tab continuously for long hours. That might be the reason for your neck pain. As all elders advice, sit straight, keep your books or tab at an elevated location while reading so that you need not bend your neck much. And do some exercises for your neck daily while sitting free. Move your head up and down, sideways, and slow rotatory movements clockwise and anti-clockwise. Neck sprain. Neck exercises as advised." "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 an MRI of my back, and they saw cysts in my kidneys. I had a follow-up ultrasound, and one found to be complex and then a follow-up kidney MRI. In the right inferior pole, there is a complex cyst measuring 2.2 x 1.5 x 2.0 cm with multiple thick septations. Twinkle artifact is seen within a portion of the cyst, which may represent milk of calcium or wall calcification. There is no flow within septations. They said it was an IIF complex cyst and to just follow-up. Are these cysts usually benign and what do they look for on the follow-up MRI\s? Currently, I am on Zoloft and birth control. ### Response: Relax and do not worry. Bosniak 2F cyst is usually benign. You just need to follow-up regularly. In follow-up, they see any change to grade 3 or 4. If change is present, then you need to get it removed. So, follow up is must at the prescribed schedule" "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: For the past one month, I have been working out a lot such as running, body building and following a healthy diet. I have lost weight. My blood pressure is 95/59 mmHg. My resting heartbeat is around 55. My weight is 73 kg. I wanted to ask if it is fine to have this low heart rate and low blood pressure. I am feeling lightheaded, tired and shortness of breath sometimes. Should I be worried? ### Response: It is very normal for athletes to have a low heart rate. Sometimes some people are born with this condition where they have very low heart rate and blood pressure. Try to be physically active at most times of the day you are awake, this will keep your heart rate up. Try to avoid smoking if you do. In case you continue to feel shortness of breath or experience fainting, please go to the hospital. You might require a pacemaker. 1. Congenital.2." "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 little bumps on my genital area that could be genital warts. How do I know for sure, and what do I do to remove them and prevent infection? ### Response: I have read your query. I have seen the attached photograph also (attachment removed to protect patient identity). As per details, these are the following possibilities for your symptoms: The confirmation of diagnosis is done by clinical examination and if needed, a skin biopsy is done. Treatment depends on the diagnosis. Broadly, Radiofrequency ablation (RFA) works in all the above-mentioned conditions. You should visit your doctor for clinical 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: This query is about my 19 weeks pregnant sister-in-law. She had a USG today and found bilateral moderate fetal hydronephrosis. Her gynecologist told her that the kid will require surgery after delivery. Can you please check the report and explain the situation? Is surgery required? If so, what is the outlook of surgery? Can this be life threatening for the kid after birth? ### Response: No, it is not life threatning. It has to be serially monitored every 15 days. Any intervention is usually successful after birth only and exact nature of urine obstruction also becomes clear after birth 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 had protected sex 75 days ago and tested for STD, syphilis, chlamydia, herpes, and HIV. It came negative after three weeks. Again, after eight weeks, test with EIA is done. HIV came negative. Is there any chance of getting HIV and STD after protected oral and vaginal sex? Do I need to test for HIV again after 12 weeks? When I was born, I was a premature child. Recently, I got hepatitis E infection. Would these conditions cause any effect on the test results? ### Response: Hi. The chances of transmission of HIV (human immunodeficiency virus) by protected intercourse is impossible if used in a right manner. The HIV test is negative after eight weeks is good. The chances of HIV test results coming positive is impossible after eight weeks. You can go for HIV antibodies test after twelve weeks to get totally relieved of anxiety. It will be negative too. There is no further risk exposure. Preterm or hepatitis E does not affect the test results" "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 struggled with anxiety and depression my whole life and have finally gotten myself into a relationship. But at the moment, I have found it very hard to keep and obtain an erection. I have stopped masturbating, but still, I feel no desire to have sex or masturbate (and when I try to get erect the erections are rubbish). I have stopped watching porn and looking at soft porn, but it is hard. Kindly advice. ### Response: The most common cause of erectile dysfunction is psychological. The anxiety and depression can affect your erection as brain control the erection. So you have to treat your anxiety by counseling and medication. Yoga and meditation are also beneficial. With six to eight month of medication intake, and by counseling, your depression can be treated. For that, you need to consult a psychiatrist for counseling. Moreover, you have to rule out hyperlipidemia, prostate problem, hypertension, spinal problem, etc., by history and physical examination. It is advisable to check your testosterone and prolactin as well. I hope I have answered your question. Let me know if I can assist 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: I am a 29 year old male. I am suffering from right inguinal hernia for the past two months. I have consulted a doctor and he asked me to go for surgery. Is it possible to cure inguinal hernia without surgery? Currently I have consulted a homeopathy doctor and I am on medicine given by him. ### Response: If the hernia is in first or second degree then there is a treatment. For third degree hernia, surgery is the only treatment option. At the time of pain and swelling you can take the following medicine. Try to avoid things which give excess pressure on abdomen such as coughing, laughing loudly and lifting heavy things." "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 to see my GP a while ago about hemorrhoids. I cannot remember when I first got them. It was a while ago. I have done the usual. Eat fiber to soften stools. Taken herbal tablets to soften them. Have done the warm water baths. Have done pile creams. I went to the toilet yesterday and it was slightly harder than normal. Now have a massive lump. After I had gone, I found blood when wiping. It is absolutely agonizing. I am now weird about going to the toilet because of how much it will hurt. I wanted to know if there are any other treatments you could suggest. I have had a look up about it and says about surgery. I was wondering, I think I remember something about an injection to reduce it. Any advice would be greatly appreciated. ### Response: Hello. There is a procedure other than surgery, called sclerotherapy. This is a very simple procedure, done in the outpatient department. A sclerosing agent is injected into the hemorrhoid which allows it to shrivel and shrink. It is done under local anaesthesia. 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: My fiance fingered me and I am not sure whether he had masturbated before fingering. But after that I found chocolate like blood spots. I had my periods done before six days. Also, I suffered loose motions day after. And I could see the same colored spots. I am scared if I am pregnant. ### Response: Hello. The presence of clots per vaginum post-fingering can be seen in cases of cervicitis but if chocolate coloured blood spots are seen , it could be collected blood or if you are suspecting pregnancy, then you need to get a urine pregnancy test done to rule out pregnancy. If pregnancy test is positive, then this could be threatened miscarriage." "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 want to know if the pre-seminal fluid can infect HIV. I had an exposure. My anus was in contact with his fluid. One guy put his penis in my anus four or five times, no penetration but that fluid was present. I took an RNA HIV test 16 days after that exposure. It was negative. After 48 days, I took a fourth generation HIV test antibody/antigen. It was negative too. Is that conclusive? Do I need more tests? ### Response: There are possibilities of transmission of HIV by pre-seminal fluid if the person is HIV positive. If negative, the chances are nil. The two tests done are reliable and suggest you are free from HIV. But it would be better if you can go for HIV antibodies test after three months exposure to be totally free from anxiety. The chances of tests coming positive later are almost nil" "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 got an ACL reconstruction surgery done two weeks back. There was an infection in the operated site, so they did re-surgery and lavage, three days back. After this, physiotherapy was done for 10 days. So, the pain stopped, but there is still swelling in the knee. Today, the doctor asked me to go for another surgery to wash off the infection again. I have attached all the reports. ### Response: Hi. I have seen the attached reports and photo (attachment removed to protect patient identity). This professional advice provided by me stands subject to the actual examination of report or image and is based entirely on inputs provided to me. It should be correlated with clinical findings." "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 struggling with skin problems since I was a baby. I was told I have eczema and not allowed to eat things like tin food and my body gets itchy when I play in the grass and after taking a bath. I get a rash, teary eyes, runny nose, when seasons change my skin gets dry too especially in winter. Now as a 25-year-old female my skin tone is uneven, my face is worse, at times my lips and eyelids swell up and I am not sure why. I have recently been using some products for a month and I still see no difference. Which skin repair products can you recommend? ### Response: You are suffering from atopic dermatitis. You have a family history of atopy. You have all the symptoms of atopy that is runny nose, eyes problem and now swelling. It is a condition in which a person has an inherent tendency of being allergic to so many things. We have a natural moisturizing factor in our skin but that factor is missing in atopic individuals. It is affected by different climatic conditions, whether change, clothing, infections. In some people it can get better with age, in others it continues for long periods. You have to avoid the factors that aggravate your condition and I will also suggest you take opinion from an eye specialist as well. Your medications are correct. The main thing is to moisturize the skin. Atopic dermatitis. Atopic dermatitis. Apply white soft Paraffin plus liquid Paraffin and apply over body 3 to 4 times a day, take antihistamine tablet, mild steroid preparation like 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 missed periods and a negative pregnancy test. Should I wait for another test? I tested three days back. The last LMP date was exactly a month back. This is related to my wife. ### Response: Hi. Since your urine pregnancy test is negative, there is nothing to worry about. The delay could be because of hormonal changes. However, if you do not get periods within a week or so, then get yourself checked by a gynecologist and get a pelvic scan done to rule out the exact cause. Do get back to me with reports so that I can 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: I am an 18-year-old male who is around 5 feet 5 inches. My issue is that my penis does not hang down normally, it sticks out when flaccid. Also my testes do not hang down and I am not sure if I have testes at all. ### Response: I can understand your concern for your symptoms. Testes will be inside scrotum like small balls in small sack. Depending on blood supply and temperature, the scrotum hangs and constricts. If you have doubt, warm your hands and slowly massage to find out your testes or if you are still worried, then you can always do an ultrasound scrotum and find out the pathology." "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 pain in the spine. I am taking painkillers, calcium tablets and doing exercise. I have done my HLA B27 test. Can a person suffering from ankylosing spondylitis take fat burner supplements to reduce weight? Would it have any adverse effects? ### Response: There is no study directly correlating fat burner supplements and their possible effects in patients with ankylosing spondylitis. Fat burner supplements often contain caffeine which reduces fat by increasing your metabolic rate. Caffeine also has an untoward effect in bones wherein the bone density reduces, a condition that we refer to as osteoporosis. Interestingly, osteoporosis is also frequently seen in patients with ankylosing spondylitis. Hence, it would be my assumption that fat burner supplements may worsen osteoporosis in patients with ankylosing spondylitis. It is always better to stick to natural methods of weight loss, and such supplements are usually discouraged. 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 a 38-year-old male. I have a question about my CBC report. My lymphocytes are high with 65 %. My neutrophil levels are low. My total WBC is 3200 WBC per microliter of blood. I have these levels remaining the same for about two years. I have constant body pain. I am very weak, and I do not have any weight gain. My thyroid tests are normal. My ANA panel is normal and C-reactive protein level is elevated with 14.2 mg/L. I am taking Tramadol 50 mg for pain. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). Your lymphocyte count is elevated. As the condition sustains the same for the past two years, you might need investigations like flow cytometry or bone marrow aspiration study to be done. For an initial workup, you can investigate serum calcium estimation, sodium and potassium estimation, SGOT (aspartate transaminase), SGPT (alanine transaminase), serum protein estimation, urea, creatinine estimation, and peripheral smear examination. According to the cause, specific treatment are given." "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: Dear Doctor,I have panic/anxiety disorder and was prescribed with 5mg lorazepam. I took one tablet at 8 PM but still l would wake up anxious in the morning.Is it safe to take one more tablet? ### Response: At this moment you can take another 0.5mg but do not repeat it after that. Tomorrow you can discuss your poor response to the 0.5mg lorazepam either with your physician or you can discuss with me online, if online therapy for a psychiatry consultation is fine with you. In my view, 0.5mg is a correct dose initially to manage anxiety disorder. Hope another 0.5 mg will help you at this moment." "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 problem with dandruff. My scalp is oily. I am losing hair and I feel that I will become bald. I used Candid-TV, but it did not help. Please advice. ### Response: Consider taking tablet Ketoconazole 200 mg once daily for two weeks and apply Candid B lotion (Clotrimazole) on the affected scalp twice daily. As far as shampoo is concerned, use shampoo containing Ketoconazole every alternate day to start with and then taper slowly as you feel improvement. Shampoo has to be used for a long time as dan" "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 believe I chipped my molar, but am just making sure that it is just a small chip. The molar was already calcified and has been sealed as a result of that. There is no sensitivity, pain, or any symptoms. Wondering if I would get it sealed again or just something to be cautious about. I practice good hygiene and visit the dentist every six months and have never had a cavity. ### Response: Hi. I checked the pictures (attachment removed to protect patient identity). The broken part seems to be a small part in the enamel layer, you do not have any pain or symptoms, so I believe this tooth is fine and it can be restored with composite filling to prevent any cavity forming over there. Also, we can use the help of periapical X-ray for that tooth just to make sure everything is alright. You can make an appointment with your dentist to make a filling for that tooth. Also, congratulations, keep on your good hygiene and regular checkups. Periapical X-ray." "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 cold air allergy problem. I cannot stay in an AC environment, like airport, theaters, restaurant, buses, even if I cover my mouth and ear. If I wait for a few hours, I get a cough and feel unwell. If I stay more, then I get a headache. I have been taking medicines which includes Chlorpheniramine Maleate (2 mg), Paracetamol(500 mg), Phenylephrine (10 mg) which giving little relief but not that much. Is there any way like a special mask or any medicines which can allow me in such places temporary? This is causing me big trouble when I go out for a journey. Apart from that, I have cold drinks and food allergy too. I get a cough, but I can prevent it by not having them. ### Response: What do precisely your symptoms are? Do you have any nasal problem or breathing trouble, any wheezing? Do you get the same sign when you get exposed to smoke or dust? Since when are you having the symptoms. Have you taken any inhalers and if so have you found relief?" "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 gynaecological issue. My husband and I haven\t had intercourse for more than 6 months. A few days back when we tried to have one, it hurt a lot and he withdrew. He didn\t ejaculate inside. The very next day I had a brown discharge and since then tiny blood clots ranging from red to brown have been surfacing along with light stomach cramps. Is this a sign of an internal injury. My husband\s erection lasted a few seconds and he couldn\t penetrate properly since I started to get hurt. ### Response: Hi, Hope you are doing well. 1.Were you experiencing pain during cycles previously? 2.How are your periods now-interval and amount of bleed-normal or reduced? 3.Are you breast feeding? 4.Have you ever gotten Pap smear done? Sometimes" "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 33-year-old female and I am fairly healthy and not overweight. I have been having constant nausea and stomach discomfort for several weeks now. I occasionally get a dull ache on the right side and feel full for a long time after eating. I am very worried what this could be. I have had a normal endoscopy, normal ultrasound. My blood work was normal except for elevated bilirubin with a total of 2.7 and direct 0.4. I am hoping you can give some thoughts as to what this could be. I am scared if it is cancer or something.The discomfort and nausea started about six weeks ago and has not been going away. Nothing I take seems to help. I am not on any medications except Swedish bitters. I have always had some stomach problems. I was taking Prilosec but I discontinued it. I had CBC, liver enzymes and pancreatic enzymes. Everything was normal except the elevated bilirubin. Please help. ### Response: Hello. Your symptoms are suggestive of jaundice and your report also suggests the same" "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 30 year old female. I have Hashimoto\s hypothyroidism since four years. I take Eltroxin daily and go for a thyroid sonar once a year. I went for an ultrasound yesterday and my report stated that my thyroid features are consistent with Hashimoto\s thyroiditis. But, what really freaked me out was these two comments:Prominent lymph nodes are seen within the right cervical chain, with the largest on the right measuring 4.9 mm in its short axis and on the left 3.4 mm in its short axis.A small cystic focus noted in the medial and anterior aspect of the right lobe.What does this mean? Should I be concerned? I was sick with a bad flu about four weeks ago, had a high fever and ended up on antibiotics. Could the lymph nodes still be swollen from that? Or can the lymph nodes be swollen due to an autoimmune disease? I have alopecia areata as well since I was diagnosed with Hashimoto\s. My immune system seems to be very weak. I constantly get flu, colds, and tummy bugs and I suffer badly from allergies or sinuses. ### Response: Hello. I just read your query and from the reports you have attached (attachment removed to protect patient identity), it appears that you do have some enlarged lymph nodes. Yes, there are two possibilities but it is more likely that these are due to: Hope you find my advice of some benefit. Good luck" "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: According to the lab report which was taken a week before TSH level is normal but T3 and T4 level is mildly increased. Please suggest will I be cured with medicine or without medicine. Currently, I am under medication for a chocolate cyst (Dienogest 2 mg). ### Response: I have just read your query, and from what you have mentioned, it appears that you have a normal thyroid function test results. The slightly high T3 and T4 are not a thing to worry because they can be caused by other hormonal medicine that you are taking for your chocolate cyst.You can keep checking your thyroid function test every three months. I hope you find my advice beneficial." "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 just finished six rounds of chemotherapy for breast cancer treatment. Before starting, I was diagnosed with folate deficiency and prescribed six months of folic acid tablets. However, my oncologist was not happy with me taking it during chemotherapy so I had to stop after one month. I have now finished chemotherapy and I still have a very sore red tongue and no texture to my tongue or roof of the mouth. I cannot use any toothpaste or eat anything with any strong flavor without an extremely sore tongue. I also have fatigue, shortness of breath, resting heart rate of 90 to 100 and also have angular cheilitis.I asked my general physician to re-test my hematinics. Now I have finished chemotherapy three weeks ago as I am keen to start taking supplements to help my body recover and because I am symptomatic of a deficiency of folate and/or B12?Bizarrely, my results say my folate is now 6, hemoglobin is pretty good at 11 but my B12 is 2000. How can this be? It was 500 when they tested me some months ago and told me I had low folate level. I was symptomatic with sore red tongue and loss of texture with tongue sensation. My GP does not understand and is going to ask my oncologist. I am not sure it is his area and I do not want to be fobbed off without it being properly investigated. Do you have any idea what might cause this?I have started FEC chemo four months back and had four rounds of Docetaxel. I was on Fragmin, Rivaroxaban until for PE prevention of recurrence but had to go on to Fragmin during chemo. ### Response: Hello. The folic acid tablets that you had taken for a month helped to raise your folate levels from 4 to 6. The high level of vitamin B12 can only be explained if you were given a single megadose of vitamin as an intramuscular injection during your chemotherapy. Folate levels of 6 are still low and are responsible for angular stomatitis and sore tongue" "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 I have a certain level of erectile dysfunction. My penis becomes hard but only from the left side and refrains from staying erect. What is the remedy for this situation? ### Response: I can understand your concern. If there is poor erection on one side then this cannot be ignored. This could be due to some vascular issues. Have you got any injury during sexual intercourse in the recent past? Or sudden bending during masturbation? Is there any history of hypertension or diabetes? Please provide the details in the followup." "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 23-year-old female with a height of 5 feet 3 inches and a weight of 110 pounds. I am not taking any medicine. I am having chest pain for a month and high heart rate, which is very painful in the night. I had an EKG which showed tachycardia. Can you please tell me what medicines or herbs can cure high heart rate? It is urgent. I have been to the hospital many times, but they said there is nothing they can do for me. ### Response: Hello. I hope it helps. Please feel free to ask more questions if you need further assistance. I would be happy to assist. Regards." "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 rash on the stomach. Not raised or itchy. I noticed after dehusking a coconut, but I am not allergic to eating coconut or drinking coconut products. ### Response: This is not an allergic reaction to any food (attachment removed to protect patient identity), looks rather a fungal infection (T.incognito). Use Clotrimazole cream (or newer ones) twice daily for six weeks" "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 36-year-old female. I am inquiring about thyroid issues. I am constantly exhausted (even when I do actually sleep). I cannot seem to lose weight even though I am more active and eat better than ever. I have dry skin, nails are brittle and some ridges, my hair is coming out by the handfuls, foggy brain and memory. My doctor did a thyroid test and these are my results.Thyroid peroxidase autoaby - 12.2TSH - .70Free-T4 - .9Free-T3 - 3.1.She also checked my iron levels, Ferritin - 26.She has advised me that I am in the normal range and my issue is depression and I need to exercise more. She has prescribed Wellbutrin 150 mg. I understand that according to the ranges listed on the results I do fall within normal, but I seem to be on the very low end of the range. Is it possible that my thyroid is causing my issues even though they are in the normal range? Would it be worth getting a second opinion from an endocrinologist? ### Response: Your symptoms very well fit into thyroid problems but if the thyroid reports are normal (even if it is in the low normal range) it excludes thyroid diseases. One thing that you can do is to repeat TSH (thyroid-stimulating hormone) test after two months. Depression could be the only cause in your case and with continued usage of Wellbutrin (Bupropion) you may notice improvement, but do get these tests and revert back. 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 a 26 year old male. Fordyce spots with white yellow bumps occur on the edge of my lips. ### Response: Hi. Fordyce spots can be cauterized for cosmetic reason. If left untreated there is no harm. Topical applications will not help resolve." "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 34-year-old male. I have recently done a master health check-up. One of the key observations of the checkup was TMT (stress test) is borderline positive for inducible ischemia. Upon consulting cardiologist and post-screening echo, he has suggested doing a coronary angiogram. Could you please assess the attached reports and provide a second opinion on the condition and the way forward. Kindly let me know if you need any further details on the same.Few pointers of the routine and habits1. I do mild exercise. (Play badminton once in two weeks or one week).2. I do booze (beer) once in two weeks or once in a week.3. I do not smoke. But I used to smoke 10 years back.4. I eat non-vegetarian, once or twice in a week.5. No history of cardiac problems, nor in my family.6. No abnormal pain in the chest during TMT nor any time during physical activity.7. Mild gastric pain once or twice in a week. This started about one to two weeks ago, probably due to outside food. ### Response: Hello. Although you do not have any symptoms, but your ECG and TMT shows changes. Your echo is also normal. But we cannot neglect your ECG changes which are striking. So it is better to undergo angiography and get it clarified. Also, sometimes such changes may be seen in hypertensive individuals, but you do not thave such history. So, overall, in my opinion you should undergo coronary angiography to clear the picture. I hope this helps you and get back if you have any doubts." "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 depression, feeling of failure in life, no more attraction to live life. Sad, anxious, or empty mood. Loss of interest or pleasure in activities. Thoughts of death or suicide, including suicide attempts. ### Response: I understand what you must be feeling right now. Depression is a serious but treatment illness. I can see you have thoughts of suicide and suicide attempts are also there which indicates that your depression worsened now. But do not worry, there are various treatment options available, with which your condition can be improved. Depression is a biological illness just like diabetes. It is neither your fault nor your wish to be in the pain that you are in right now and you cannot overcome these feelings and thoughts. Every disease needs appropriate treatment. I would advise you to consult a psychiatrist online or offline as soon as possible. Remember help is there please avail it. I would require more details about your problem. Thyroid function test, serum B12. May require inpatient care, medicines, therapy." "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, 32. For the past several months I have had tingling that comes and goes in my left arm. My left leg followed some time after and in the past few days also on the left side of my face.Relevant information:1. I have a slipped disc in the lower back but it always affected my right leg.2. I have had a baby last year and I carry him on my left arm and hip.3. I suffer from anxiety. No medication.4. I have very low B12 and vitamin D. ### Response: Hi. Such tingling sensation is very common to see in people with vitamin B12 deficiency. Anxiety is also one of the reasons for such tingling. I would need to know if you have any thyroid related disorder? What all medicines in total you take, please name them." "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 ringworm infection and itching from many days. When I used Terbinafine cream and tablet along with Cefadroxil tablet for 20 to 30 days, the ringworm and itching totally disappeared. But after a month, it started automatically. What to do? ### Response: I can see your ringworm infection has reoccurred. There might be some sources from which you are acquiring the infection.There are few minor precautions which you need to take as follows" "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: Six weeks ago, I had oral sex with my partner. We also had sex and condom broke while having sex with her. After a week, I went for a complete STD screening test and it came negative for all, including chlamydia and gonorrhea. After the results, I got stressed and I was struggling with depression because, I had mild burning and tingling sensation in the penis, rectum, lips, mouth, gums. I occasionally have small sores inside my lips and cheeks that last for two days. Again, chlamydia and gonorrhea results were negative. Currently, I am taking Fentanyl 50 mcg patches, Lyrica 200 mg, and Tramadol 50 mg twice a day. I had HSV 1 infection before 18 years. Did I get in contact with oral and genital HSV 2? ### Response: Hello. You have not contacted with HSV 2 (herpes simplex virus 2). In general, HSV present with painful blistering lesions and not with mild burning or tiny lesions. The symptoms usually present in a week. The most likely reason for your symptoms is stress. Stress and anxiety of getting the infection are resulting in the symptoms like burning on lip or tingling. These are not typically seen with HSV 2. If your partner had active lesions of HSV 2, you would have identified during oral sex. So this is also a reason, you are safe. Rest of STD screening is normal so you can be relaxed. You are totally safe" "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 aunt\s creatinine level is 5.7 and her kidney size of 8*3.4 cm (right and left). Currently she, is under treatment. Looking forward to know if it can be brought to normal kidney functioning? What time does it take to become normal? Her BP is 150/95 mmHg. She is under medication for TB. ### Response: To help you better I need further details. Since how long is she suffering from this? How are her blood pressure and blood sugar? How is her urine output? Where is she located? Revert with the asked details for better help." "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 suffering from alternate loose stool and constipation, with the feeling of incomplete evacuation of bowel with abdominal pain for the past five to six months. I feel it is IBS. Kindly guide. ### Response: Hello. However, further consultation with a gastroenterologist, running colonoscopy, and abdominal ultrasound are highly recommended to rule out organic problems first. Stool analysis, culture, and sensitivity testing are recommended to rule out candida overgrowth or other infectious diseases." "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 Microgestin birth control and I have been instructed to take it constantly to have no periods. About a year ago, I was treated for chlamydia and never had a problem since then. About a month ago, I missed my pill for birth control while having the flu and a week back, I have noticed white sticky discharge with no smell and very light spotting. And I am wearing a pad because it is very wet and uncomfortable. There is nothing abnormal other than the discharge. Am I ovulating or going through some sort of cycle? Please guide. ### Response: Hi. I understand your concern. Please get pap smear and update the report. Revert back with the pap smear report to 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 34 years old and I have facial droop in the lower half of the left side of my face. It has been with me for years. I would not call it a paralysis or bells palsy as I have full control of my forehead and eyebrows, but the lower part when I talk it is noticable that the lip from the left side is way lower, and the nose as well seems lower from one side. I was wondeing what this could be, all the searches online say stroke but I am young and never had any symptoms of stroke, so what else could it be? And what would you advise me to do? ### Response: I would like to know some details about your symptoms: 1. Did it happen suddenly? Or it happened slowly and gradually? 3. Did you had any weakness in left arm/ hand / left leg along with? 4. Had you any change in voice that time? 5. Have you ever undergone some tests for its evaluation? 6. Have you any symptom in left ear: hearing difficulty/ ear discharge/ hearing abnormal sound? 7. Have you any other significant medical history (apart from this facial" "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 got some bleach splash into my eye after dropping it on the floor. I have already rinsed it for 30 minutes and it is red. But I do not have pain. It feels dry, and it is not lubricating after all the rinsing. ### Response: Consult your specialist doctor, discuss with him or her and start using the medicines after 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: 50 years old, 5.8 inches, 260 lbs. On blood pressure pills. My doctor is out of town for a few weeks. I reviewed PSA test results and apparently I have one abnormal reading out of three. PSA total 0.5, PSA free 0.1, PSA % free 20. The PSA % free 20 is in red indicating abnormal. What does this mean? What causes it to be abnormal? ### Response: Free PSA should be more than 15 % to rule out prostate cancer. Free PSA is an additional tool used when PSA is above 2.5 and we want to check whether high PSA is due to benign prostate growth or due to prostate cancer. Some laboratories use 25 % cutoff, but most have 15 % cutoff value. Since your total PSA is quite low and free PSA is above 15 %, you should not worry. If in doubt, repeat after a few months." "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 gave birth a year ago. I have had problems with diarrhea ever since (periodically). I did tests for candida, Helicobacter pylori, bleeding, parasites. All negative. I have a slightly weaker blood count. I did a stomach ultrasound and everything is fine. I suffer from post-traumatic stress and the doctors told me I had diarrhea because of it. I\ve been taking post-traumatic stress therapy and I\ve been feeling slightly better, but the diarrhea hasn\t stopped in the last month. I go to the toilet 3-5 times a day. In the morning as soon as I wake up I have to go to the toilet and a few more times during the day. I am currently taking the following therapy:- Orvagyl 400 - 3 daily - Probiotic forte - 2 daily- Heferol - 2 daily- C vitamin - 2 daily- Seroxat 20mg - 1 daily- Eglonil 100 mg- 1 daily- Prazepam 10mg - 1 daily ### Response: Hello. I can understand you must be upset about your symptoms. but" "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: Hello,I am a 50 year old female who would like to have a breast reduction. However, I am high risk for vomiting from the anesthesia. I have a phobia of vomiting. I am a non smoker. I\ve had general anesthesia once before and I vomited several times. I am so scared that I have rescefuled the surger 3 times ### Response: Hi, General anaesthesia has known post aesthesia effects of nausea ,retching, vomiting etc. Also these may be due to direct effect of surgery and pain. You seem to be very sensitive and anxious to it. But usually it is seen that with each subsequent episode of administration of general anaesthesia these effects tend to decrease in severity. So if last time you had vomiting postanaesthesia this time it will be less severe in terms of no. Of episodes etc. This will reduce your discomfort. Also if you may have prexisting GERD or gastroduodenal ulcer , gastritis. These may also cause nausea vomiting postoperative. So I would advice discuss issues with your anaesthesiologist and surgeon. Nausea, vomiting can be taken care of by medicines like proton pump inhibitors, H2antihistaminics, antiemetics which will be give by your physician in recommended doses. Some pre-op anxiolytic medicines on night before surgery will help you reduce anxiety. Take a light non oily meal on day before surgery so that stomach stays relatively acid free." "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 aged 65 is diabetic for the past 9 years. Her medications are as follows. Forxiga (Dapagliflozin) - 10 mg : 0- 1- 0 (one tablet after lunch); Glucobay 50 : 1 - 1 - 1; Jalra - M 50/850 (Vildagliptin 50 mg, Metformin HCl 850 mg) : 1 - 0 - 1 and Amlopres AT - 25 : 0 - 0 - 1. We need consultation for the diet.The patient is insisting on taking a small quantity of rice for lunch. Also, how to make the medicine and diet proper during fasting months, where we usually take a good meal at 3:30 AM (early morning) and strict fasting till 6:00 PM. ### Response: In case her sugars are in control, there is no harm in giving her a little rice. I would recommend you buy a glucometer for her so that you can monitor her sugars at all times. Meet your local doctor, so that he can advise you on how to manage the dosages at the different sugar levels. This would come in handy during fasting as well. Because, in the case when your mother is not eating anything, not even water, that means she will not be able to take her medicines as well. So, you would have to check her sugars during that period and analyze if she can take her medications or not. You would have to understand; she would not be able to eat high-calorie food like the others when you break your fast. However, you can try and reverse her daily cycle in those days, and she can eat her dinner and breakfast and take her medicines accordingly to her sugar levels." "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 about syphilis.I am 29 years old, female. I am not sexually active but I got engaged recently and my fianc\xc3\xa9 had previous relationships. He only kisses me sometimes which I am worried that by kissing some disease might be transferred to me from him. I got skin rash on my palms and feet 5 days ago. And when I was searching I came across syphilis. Can syphilis be transmitted through a kiss? I went to a doctor and he told me it is a skin virus HFMV and gave me antibiotic cream. I did not mention the kissing part to him. But he took blood test, crp was normal, also blood count test was normal. I did not mention this to my partner yet. I am really worried that it could be some other disease. ### Response: Syphilis cannot be transmitted through kissing. It is only transmitted through oral, anal and genital sex. However, syphilis can cause oral ulcers. If you kissed someone with an active oral ulcer, then the risk of getting syphilis through kissing may occur." "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 noted a few blood spots in my shorts. No symptoms, though. Recently did a blood test and had high amylase. I had piles and got cured recently. I was under Ayurvedic medicine. Any connection? Is it something to worry? What precautions to be taken? ### Response: Blood in shorts in the background of piles, check for any recurrence of piles. Consult a general surgeon in person to rule out any recurrence of piles. Serum amylase elevation is not a specific finding, and it is elevated in many conditions like salivary gland abnormality, pancreas involvement, etc. Maybe that is not related to blood loss. Take a general surgeon consultation in person, and it may help you. Precautions to be taken are take plenty of water, eat foods rich in fiber like green leafy vegetables, avoid mutton for some days, do regular physical activity. See to that your stool should not be hard, if it is hard, then the chance of recurrence of piles is more. If the stool is still hard with dietary measures and exercise, take a laxative like Duphalac syrup (Lactulose). I hope this response 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 had forced gay sex before 17 days. I had an HIV rapid test after six days of having sex, and the result was negative. Am I prone to HIV and STD\s? How long it takes to detect HIV and STD in urine test after exposure? ### Response: Good, you have done a rapid HIV test, and it is negative. But normal results are negative. This means that no antibodies were found and that you may not be infected with HIV. Most people who become infected with HIV will develop antibodies to the virus within two months. During this time, you may have an HIV test, but this test cannot detect it. You will have to repeat the test more than three months after your possible exposure if your results are negative. If possible, investigate your sex partner also." "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 chickenpox one month back and my SGOT is 178 and SGPT is 251 now. Elastography is 5.3 kPa, ANA is 13.74, IgG is 2145, serum ceruloplasmin is 24.90, hepatitis E antibody IgM is 0.09, bilirubin total is 0.40, bilirubin direct is 0.10 and no fever, urine white, no weakness, and the doctor could not conclude. ### Response: Hello. Persistent elevation of liver enzymes can be due to many different causes. I would like to see the reports if possible. Also, I would like to know if you had done hepatitis B and hepatitis C testing. Also, what is the trend of SGOT/SGPT, is it downward or stable? What about alcohol intake? Are you currently on any medication? Varicella (chickenpox) can in some cases cause hepatitis. Though it should have been recovered by now. If the trend is downward, I will not worry. If still persistent, then you will need further investigation" "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 face and body color are different. My face is getting dark and black day-by-day. What should I do to increase my fairness and get glowing skin? Shall I use some night cream? ### Response: Hi. I have read your problem carefully. The most common reason is sunlight exposure. For treatment, 1. You can use a cap or umbrella when you go for an outing.2. Sunscreen (30SPF), 10-20 minutes before an outing.3. Regular washing with good face wash. Please do not use whitening cream. It may cause harm to your skin." "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 4 years old. He was only on milk diet till three years. His eight teeth got brown color, when we went to the doctor he suggested for cleaning and filling for six teeth but for two teeth, he suggeested for RCT. My son never complained about pain or swelling. Do we really need to go for RCT? ### Response: Yes, it is called pulpectomy procedure, not proper root canal treatment as done in adults. Those milk molars have to stay till 10 years of age at least. So, if you want to prevent breakdown of teeth and pain in near future, it is necessary." "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 facing partial hair loss from the front edges of my hairs. I think I have a disease called alopecia areata. But I do not wanna be so quick saying that I certainly have such disease. First, it was not that bad. So, I ignored it hoping it would get better with time. But to my surprise, it has just gone purely noticeable and now I want some home remedy or medicinal treatment for it. Also, I do not want any surgeries because I am only 18. ### Response: Hi. It would have been easier for me to diagnose the condition if you would have attached your clinical picture along with your query. Hence, the diagnosis should be confirmed before starting any treatment. Alopecia areata is an autoimmune disorder." "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 drink water after 15 to 20 minutes I feel to pass urine. So, I drink less water from one year. I suffered from OCD psychiatric disorder from five years. The doctor told me that I am passing more urine due to anxiety. My urea creatinine and blood sugar are in the normal range. I want to know why my kidneys are hyperactive. Have I any risk of developing CKD in the future? ### Response: No, not at all. If your urea and creatinine are good, there are no chances that you will develop any renal failure or CKD just because you pass excessive urine. To alleviate your anxiety, get your urine osmolality test done and if that is normal, the urine you are passing is normal. I hope it 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 was involved in a car accident which my vehicle ran reverse on my left arm and got swelling and bruises all over my arm and now when I try to lay my arm down on something, there is a lot of pain in the elbow area and around the top of the elbow area and the doctor says there is nothing broken. I am just wondering what I should do. It is warm to the touch. ### Response: Hello. There must be crushing of the tissues and what is called internal degloving and a collection of blood called a hematoma and that causes the part to be swollen and warm to touch. As long as there is no fracture then you do not need a plaster but a sling to rest the arm is mandatory till the pain comes under control and the swelling reduces. The sling will also enforce rest to the part and will help keep the forearm from swelling up. Ice the arm and elbow 20 minutes for five to six times a day. Elevate when in bed on two pillows. If no better in a week then re-visit a doctor for a review." "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 loose vagina and I am 20 years old, female and I am sexually active. I used to have sex always with toys so it became loose. Please help me. I need to tighten my vagina again. Once I used Everteen vaginal tightening gel for a month and I stopped its use as I was afraid of its use. ### Response: The Everteen vaginal gel is an herbal product used for the same purpose but the efficacy of this is not well established. This may help some but not all. Kegel exercise are a good option for you. You can do this exercise daily and will see good results. As of now stop using toys or atleast stop bigger toys so that the benefits of Kegel exercise are maintained. If the hymen is torn then there is a procedure called hymenoplasty, which can restore the hymen. This is a surgical procedure" "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 scheduled for extracorporeal shock wave lithotripsy (ESWL) to treat a kidney stone that was discovered through testing for gross hematuria. My pre-operative blood work came back with a number of readings that were flagged as high. It includes Alpha-1-acid glycoprotein (AGP) 17, blood urea nitrogen (BUN) 25, creatinine level 1.3, calcium 10.3 and Na is 148. Is this anything should I be concerned about? Should I see a nephrologist prior to the ESWL? Or do you think that it is fine to proceed with the treatment as planned? ### Response: Your high readings in kidney function tests are probably attributed to the kidney stone that you are having. Any stone present in kidney that is causing hematuria is very likely to cause transient rise in creatinine levels and alter the kidney function test too. This is the reason for the stone need to be removed else it would cause permanent kidney damage. I suppose there is no need to see a nephrologist at this point. However, I would still need to know the location of the stone? What is the size of the stone and any 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 fallen on the floor from about 130 cm high and hit my foot, however, one of my toes has swollen and it hurts so much, So I had an x-ray for my feet and the doctor said it was fine, but what I see on the x-ray photo seems to be a dislocation in a phalanx. Is that normal? Can you have a look at the x-ray? ### Response: Hello. I have seen the x-ray. (attachment removed to protect patient identity). I must agree that the second toe proximal joint does look dislocated. It is, however, difficult to confirm this without having a true AP (anteroposterior) view and true lateral view. Also, what is the toe looking like is bruised, swollen and deformed? What about the fact, do you have pain over the toe? Can you move this like the second toe on the opposite foot? If you say that there is a pain, reduced movements and swollen, then, you will need to repeat the x-ray and if it is dislocated, it needs to be reduced urgently and will need buddy strapping. 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 a 21 year old female, who weighs 56 kg and I am 164 cm tall. I have had a bad reaction to cream that I used on my face. The cream is a hair removal cream designed to be used on your face. I did a patch test on my arm (as instructed in the product instructions) and had no reactions after 24 hours, so I proceeded to use it on my face. It tells you to leave it on for 3 to 10 minutes (not exceeding 10 minutes). I checked after three minutes and decided to leave it on for a further 30 seconds, as I could not see that it was doing anything. My face started to feel like it was burning, and I could see small red dots forming on my face. I carefully removed the product and saw that the red dots were bleeding. The product was actually removing smalls chunks of my skin. The areas where I applied the cream were left red raw. I made sure my face was completely rid of the product and applied ice, soothing creams, and coconut oil. The redness went down after few hours, the pain continued until I went to sleep (but has gone down a lot since then), but the red marks remain. I do not have sensitive skin, and I have never had a reaction like this in the past. Can you please confirm, from the pictures attached, that the product has caused these reactions? What can I do to help these wounds on my face to heal properly? ### Response: Hello. I have read your concern and examined your picture (attachment removed to protect patient identity)." "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 ate a chicken kebab a week back. Next day morning, I woke with small stomach pain followed by diarrhea. By evening, I was shivering and cold. Next morning I woke up feeling fine but still had diarrhea. Six days later, I am still having diarrhea after eating meals. There has been no vomiting or nausea and I can hold fluids fine. Also, dry foods like crackers and biscuits cause no problem. Any idea what is causing this? ### Response: Hello. Due to infection, normal bacterial flora of the body which is present in the intestine is lost. That is why you are getting such symptoms. These symptoms should go away after a few weeks. If not, then you need to do some investigations to look for the cause. Post-infectious irritable bowel syn" "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 has been a week now and yet I feel like I do not get enough sleep. I would sleep from 1 AM onwards but tend to wake up every hour and my sleep feels like it is not in deep sleep. I could get a deep sleep only aound morning 5-6 AM and woke up at 10-11 AM. Please help. ### Response: Hello. Yes, this pandemic is causing a lot of stress in everybody is mind. We all processing information at the conscious subconscious and unconscious level of our brain. Sometimes that is to this kind of disturbance in biological rhythms. Along with that at times people start having anxiety of not falling asleep. So do not worry just follow some sleep hygiene measures. Try some sleep hygiene measures. 1) Wake up at the same time every day. 2) If after lying down you are not able to sleep for 10 to 15 minutes then get up from bedsit on a table chair and start reading something. 3) Do not take any tea or coffee after 6 PM. 4) Listen to some white noise or light music. Start some exercise on a routine basis that will keep you fit and will release some and will release endorphins in your brain that will relax your mind. Start Pranayama and meditation." "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 daughter is 11 months old and started having her upper teeth when she was 9 months old. And I noticed she has white spots along the gumline and some on the middle. I took a photo and showed it to a dentist here and she said its hypocalcified enamel. My question is, is it reversible? What do I do to not make it worse and what causes it? I only give fruits and vegetables as food and water. And, I also breastfeed. What can I do to prevent worsening of her teeth condition? I brush her teeth two times a day with fluoride-free toothpaste. Is there anything I can do or let her take? ### Response: I have seen the pictures (attachment removed to protect patient identity). The spots cannot be reversed. They form during fetal development inside the womb and first three months after birth. Any dietary deficiency for you or baby may cause or sometimes even genetic predisposition is found. There is nothing to do other than maintaining the teeth through brushing. Such hypocalcified enamel can break down fast if proper brushing is not done and the cavity may form soon. So, please be sure to brush every day till she can do so on her own" "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 itching and irritation in private parts. ### Response: Hi. Fungal infection is due to improper hygiene or excessive sweating. Maintaining good hygiene will help" "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 49 years old female. I have red spots all over the body. I have pain in the thigh and back. I have a fever for the past two days. I have a pain behind my ears with a headache. I am unable to eat my food. I have slight coughing and slight swelling on my face. ### Response: Hi. It is most likely a viral fever. It is better to get a full blood count done to be on the safer side. Take plenty of fluid and rest. You can take Paracetamol three tablets in a day for fever." "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: Four days ago, boiling water burnt my buttocks. I had pain only on the first day. I am using sterile gauze Silver sulfadiazine and Bacitracin antibiotic cream or spray. Today it started paining while changing the dressing. What is the level of burn? I have attached photo for your reference. What is the best treatment? ### Response: It is a first degree burn as you can see the eroded skin (attachment removed to protect patient identity). Stop Bacitracin, as it can cause sensitization in many individuals. Continue Silver sulfadiazine thrice daily. 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: After a fall slammed tailbone into cement floor. I cannot walk having much trouble during walking. Can a chiropractor help, correct and fix this? ### Response: First of all, an X-ray is a must. As the impact was on the cement floor, there might be a possibility of bone injury. Post-X-ray, we can say the possible next treatment plan. Usually with rest for the initial time and using piles pillow will allow the less compression over the injured area. Post which the exercise to strengthen the hip muscles are advised to regain the muscle strength. Please take an X-ray and share the report. X-ray to be taken is PA pelvic bones or PA coccyx." "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 misalignment and mild crowding of teeth in upper jaw and have bite issues. I have consulted a maxillofacial surgeon and advised tooth removal prior to braces and removed upper left tooth, probably molar tooth, and advised to consult orthodontist for braces. I want to know whether there will be any shifting of teeth or any other complications in the future? Please help me with your advice. ### Response: I have gone through your question. I can understand your concern. Yes, there will be shifting of teeth to fill the gaps and release the crowding by removing teeth. So you do not need to worry anything about the issue if your orthodontist consulted. The shifting will not be a complication but for the management purpose. If you mean migration in place of shifting that will be slight and will not create any issue further in your dental arch." "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 issues with hearing, pain, pressure, and sensitivity to noise. Can slough in ear be painful? I am currently using Topamax, Allegra D, Baby Aspirin, Tylenol, Aleve, and Ibuprofen. ### Response: Hello. Sorry, I need more details but I will comment on the pictures as clear as possible. (attachment removed to protect patient identity). The first picture shows a lot of shaded superficial layers of the skin. This can be painful. This may be a dermatological disease like eczema. I still do not know which ear is it, right or left? The last picture seems to be of the left 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: How to overcome premature ejaculation? Can I use any kind of ayurvedic spray during intercourse? ### Response: The best medicine for premature ejaculation is regular intercourse with a shortened period of foreplay. Also, avoid long gaps between coitus (sexual intercourse). We never suggest any type of spray, lotion or oil application during intercourse because it might harm your genital organ. But, ayurvedic oral medicines may be taken. Capsule Stresscom, two capsules to be taken twice daily with milk in the initial phase. For severe and chronic cases, other medicines are added depending upon the condition." "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 armpits are gray, itchy, and scabby. It involves my entire armpit, and it extends down to my side boob and around my shoulders. I do not know the reason for having it. I also had the same problem last year too. I always have a lot of sweating. ### Response: Hi. You may have a fungus on your skin. Maintain good hygiene. Try to avoid having sweating as much as you can. Apply deodorant regularly. Please send a picture 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: My 8 weeks ultrasound showed an irregular gestational sack. It is mostly round but sort of pointed in one location. What does this mean?Fetal pole 158, measuring 8 weeks and 1 day gestational age. Please explain. ### Response: Hi. If fetal cardiac activity is present and pregnancy is 8 weeks on ultrasound. If you do not have any pain or bleeding per vaginal than there is more chance that with medicines pregnancy has more chance for growth. Irregular gestational sac sometimes can be due to uterine contraction which can be present throughout pregnancy. If this is the case then there is more chance that pregnancy is good and there is more chance for growth. One more reason of irregular sac is also a sign of early abortion. But we can do only these things. Do take complete bed rest. Do minimum activity. Take small frequent meals. Take micronized Progesterone for 2 to 4 times a day 200 mg, Folic acid tablet, and Thiamine or multivitamin tablet. All these will be helpful for growing pregnancy. And repeat ultrasound after 10 to 15 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 have a yellow spot on the right side of the gums. I also have a pain in the back tooth. I am taking Ibuprofen and applied Bonjela. But still, I have pain in the tooth. What could it be? ### Response: I have gone through the attachment (attachment removed to protect patient identity). It looks like a traumatic ulcer or chemical burn. The reason can be due to the tissue present between the last two teeth. It is chewed during grinding causing a traumatic ulcer. The other reason can be a chemical burn. As the image is not clear, I am unable to differentiate them. Please mention about the age of the ulcer. The above information is necessary as the lesion itself can present as a nonhealing ulcer in the mouth. For the pain, you can take the following medications. Take Ofloxacin 200 mg twice daily. Take Metronidazole 400 mg thrice daily for five days. Take Ibuprofen if there is a pain." "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-20-year-old female. I am pregnant and suffering from depression and my main \trigger\ is lack of sleep and tiredness. I am aware that I am having a child. I am signing up for sleepless nights so my main concern is antidepressants and the effect they might have while breastfeeding. ### Response: I have read your post thoroughly and I have to tell you that depression during pregnancy must be dealt with carefully. Pregnancy itself causes mood swings and there are episodes of depression, as a consequence of hormonal fluctuation. The best ways to deal with this during pregnancy vary from patient to patient depending on their level of depression. Provided your history with this and the suicidal attempts, you may need to be on antidepressants, which even though are generally considered unsafe for the fetus, a few are of pregnancy safety category C. Needless to say, these are prescription medications and I recommend you to see a psychiatrist who can evaluate your present situation and decide on that. Please note, that if you ever feel like you need medication during pregnancy, do not hesitate to consider the safer options because harboring something like depression can make it worse and cause more harm to the fetus than the" "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: Almost two years back, I was diagnosed with psychosis. I improved in two months after taking treatment. I took medicine (Olanzapine) for nearly 9 to 10 months then I stopped taking the medication as I recovered from it completely. I did not consult doctors. Still, my condition is good, and I face no such psychological problems. But I had a blackout episode lately when I was heavily drunk. Should I start taking the same medicine Olanzapine? As I do not want to go to for check-up any more. ### Response: Hello. Psychosis should not be taken lightly because psychosis is a term that reflects a variety of explanation like it may be schizophrenia, it may be due to depression, may be secondary to alcohol or any other condition, so diagnosis is very important, that your primary doctor knows better. And every diagnosis has a different course of treatment, as for as you alcohol is a concern that blackout means you should be more concern and should be adequately treated. Go to your doctor and tell your history he would help you to deal with the problem and you need to have health check-up and lab investigation for sure." "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 63 years old male. I am a known case of atrial fibrillation 20 years. I had a brain hemorrhage 23 years back. I have a paroxysmal type of afib. Recently its frequency has markedly increased. I am taking Sotalol 80 mg and 80 mg. But now Sotalol increase is required which causes bradycardia when the rhythm is sinus. My cardiologist wants to implant a pacemaker to pace the heart in bradycardia. Please let me know about the role of PM in arrhythmia. My cardiologist says during abnormal rythm PM is inactive. ### Response: Hi. The rate in AF is controlled with beta blockers, calcium channel blocker or Digoxin." "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 tickly dry cough since yesterday and some nasal congestion. Please suggest me a suitable medicine as I have to go for a vacation. ### Response: Hello. It is likely a viral infection of the throat and nose. At present, you should have betadine gargles four times a day and tablet Allegra (Fexofenadine) 120 mg once a day for three to four days for nasal congestion. For cough, you can have syrup Alex (Chlorpheniramine, Phenylephrine, Paracetamol, and Caffeine) two teaspoons whenever needed up to three times a day. Avoid cold food items. If you develop fever or body aches I suggest you can have tablet Paracetamol 500 mg whenever needed up to three times a day. If your problem persists more than two to three days, then you should also have antibiotics like tablet Azithromycin 500 mg once a day along with some antacid like tablet Pantoprazole 40 mg before breakfast once a day for five days. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Hope this helps you and get back if you have any doubts" "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 questions concerning about the skin on my face. The skin next to both sides of my nose gets red and flaky with dry skin. It is itchy and appears often. I do not scratch it, and I have used shea butter and aloe vera. It helps a little bit, but so far still the same condition exists. I have been smoking occasionally for a few years and never had a problem. I stopped about three weeks ago due to this problem to see if the irritation is due to my smoking, but it is not getting better. I will be visiting a doctor in about a month. Kindly give your opinion. ### Response: Hello. It can be seborrheic dermatitis, an inflammatory response because of seborrhea, caused by a superficial fungal infection." "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 blood pressure runs at about 135/70 mg/dl and drops to about 125/60 mg/dl when I wake from sleep at night. I am on Candesartan 32 mg and Reaptan (Arginine plus Amlodipine) for blood pressure. I also take Duodart for prostate issues which contains the alpha-blocker Tamsulosin. I am concerned that my diastolic pressure gets too low, particularly when sleeping. This has been going on for few months. My blood tests are normal including the thyroid tests. If I had to drop one of my blood pressure tablets which one will increase my diastolic reading to maintain the good systolic blood pressure? ### Response: You take Reaptan (Perindopril Arginine and Amlodipine). It is completely contraindicated to take both Perindopril and Candesartan at the same time. I strongly recommend that you stop Candesartan. Tamsulosin is good for both your prostate and blood pressure. Also, it is advisable to take Reaptan in the morning and Tamsulosin in the evening" "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 failed twice in my exams. I am feeling pushed out of my own home because there is a lack of peace. I weep secretly and daily whenever I think of my future, and it all looks bleak. I am a lonely person, and my enemies are many around me, including my own younger brother. Every time I feel like to quarrel with one or the other person. I always feel depressed, and sometimes I start feeling that one or the other day, I might become mentally ill because of this depression. I do not understand how to come out of this situation. ### Response: Hello. Competitive exams are tough, and the situation in which you are is not helping you cope up. To excel in such exams, you need to concentrate and not be distracted. Maybe you can shift to a hostel for preparing if you cannot start with maintaining some distance. Try it for two days, no matter what happens, you do not react to anything and focus on your studies. If you feel sad most of the times, if you think some anxiety, I would recommend meet a Psychiatrist and check if you need medicine. You can also start counseling sessions, which would help you cope up. I need more details about your situation to help you better. But I hope this would give an idea of what you should do next. Let me know if you need anything else." "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 got dog paw scratches on his hands by his friend\s pet Labrador dog. We gave him TT the next day. Is there anything to worry? ### Response: Hello. If the scratch did not break the skin, if there was no bleeding and if the attack was provoked, a single TT shot would suffice. Although do keep the area in check for any bacterial infection that might follow. However, if the animal in question was acting strangely or if the attack was unprovoked or if the scratches are on the face or hand and caused bleeding, you may need to get a course of rabies vaccine, to be on the safe side. Since it is a pet, it may have been vaccinated against rabies, in which case there is nothing to worry. Please check with the owner about the immunization status of the pet and its health condition and act accordingly. If the pet is suspicious in any way, you should get the rabies vaccine course for your son. 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 having some allergy on the head of my penis and inner skin. I feel very irritated due to this reason. Whenever I masturbate multiple times a day, it happens. ### Response: Relax and do not worry. If possible send me images so I can see and suggest you properly. It could be a fungal infection" "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 wanted to ask I have a condition called bromhidrosis. I do not have excessive sweating but my feet tend to smell lot even when I have washed it and dried it off. I have foot odor and do not know the main cause of it. I have tried every product medically or non-medical ones but nothing is working. It is affecting my life daily and I feel embarrassed wherever I go even with my friends and family. Therefore, I have stopped going to places. I need your help with this. ### Response: Excessive sweating is always associated with feet odor or it can be due to hormones and bacterial reaction. Obesity, diabetes, thyroid, etc., also will cause this. As you are overweight must check thyroid and diabetes. Sometimes, it is natural and not associated with any disease." "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 talk to myself. I have done it for as long as I can remember, I called on my other worlds, and I play different people I make up their lives in their personalities, friends, and stuff. I run it like a movie, and I play one character make and the rest I react to. And will talk to me out loud and walk around and pick up imagery objects and makeup settings, like a movie.Last year I was in a mental hospital for a suicide attempt and cutting and stuff. And in there you do not get phones and stuff, so I was in my world a lot, but for once I was playing multiple worlds at the same time. When I am not alone, I play in my head. I still can function and get good grades and school, but I do not have friends I play in my world.I guess it started when I was 8 it bullied, and I liked my other worlds better, and other stuff happened to me. They call it trauma or whatever. But anyway you could say I got better. I play myself in my worlds with a different personality and world. The only thing staying the same is my name. But I am worried because I am 13 but do it in secret. But my brother is 9 but acts like 5 and doses it in the open. He is loud and runs around talking to himself, and my family thinks he needs to play a sport. So I am asking if this is normal or something or just another reason I am crazy. ### Response: Hello. It is good that you are insightful about your experiences and seeking out more information to empower yourself. The first thing to remember is you are not crazy. You are experiencing emotional difficulties, and you will get better gradually with support. You appear to be using fantasy as a coping mechanism to deal with problems in real life. Many people have this experience. We tend to use our imagination to visualize better scenarios. Some of us have an overactive imagination and wishful thinking and develop an elaborate fantasy world. It becomes unhealthy if fantasizing starts affecting your real life. With support, you can develop more healthy coping mechanisms. Have you tried writing down your rich imaginative fantasy world? Some find it helpful to write down their experiences into stories. You can try and see whether it is useful for you. I know that you are taking Lexapro (Escitalopram) medication, which can help with emotional problems. Are you also having any therapy? I will advise you to discuss with your parents or family and your treating doctor so that they can support you accordingly. You will get better gradually." "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 bumps at the back area of my tongue. Could this be oral herpes? I received unprotected blowjob a week back. As such, is it possible to get oral herpes although I was the one receiving the blowjob and did not engage in any kissing with my sexual partner? ### Response: Hello. I just read your query and from what you have mentioned it does not seem to be herpes infection on the back of your tongue. Those red bumps are they painful? Do you have swallowing difficulties? If not then those are your taste buds, they are present in every one. Would have been better If you attached a picture as well of these red bumps (attachment removed to protect patient identity). No it is not possible that you get oral herpes If you are the recipient of the oral sex." "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 unprotected sex, and I am not sure whether we did an ejaculation or not. Suddenly, I took four Yasmin pills on the spot today. Am I safe from unwanted pregnancy? I need your urgent advice. Please help. ### Response: You are trying the Yuzpe method. In this, a woman uses birth control pills as emergency contraception (EC) every day. By combining pills in a specific order, the estrogen and progestin present in those pills work to prevent an unplanned pregnancy before it starts. This method is most effective when used within 72 hours after having unprotected sex. To follow the Yuzpe method, you should take your birth control pills (Yasmin) in two doses, 12 hours apart. Each dose has four pills." "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 coughing since three weeks. My cough has changed from a dry hacking cough to a more productive cough with wheezing. I went to the doctor for the third time. So, my doctor decided to do a chest x-ray. Now along with a chest x-ray, the doctor advised me to have a CT scan, and breathing treatment. The doctor said to me to have an appointment with a pulmonologist. After reviewing my x-rays, the doctors informed me that I have pulmonary fibrosis. Is this indeed something that can be diagnosed by x-ray? I am taking Topamax 200 mg, Ambien 10 mg one tablet at night, Pro-Air inhaler, and Medrol dosepak. ### Response: Hi. Pulmonary fibrosis is a chronic, and progressive disease of lungs with unknown etiology. Clinical, physiological and radiological criteria diagnose it. When there is a suspicion of pulmonary fibrosis, a chest x-ray is the first investigation. To confirm the diagnosis, a high-resolution CT scan is done, which can show the abnormalities found in the airways of the lungs. An open lung biopsy is one of the useful methods. However, there may be variations in the histology, and this can make it difficult to diagnose it. In your case, the history of illness, physical findings of late wheezing after a productive cough, combined with specific findings on x-ray and CT scan have pointed to the diagnosis of pulmonary fibrosis. Kindly consult the pulmonologist before the worsening of the condition." "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 left femur midshaft fracture while playing in a garden. It was a displaced fracture. So I underwent ORIF. A titanium rod was inserted before 57 days. Can I walk like before without limping and when? And there is no sensation in the upper thigh. Why? ### Response: It has been more than six weeks so I think you can start putting partial weight on that limb. But before that, I would like to have a look at your current X-ray. Sometimes, there may be an injury to the nerve known as the lateral cutaneous nerve of the thigh. Most of the time, it will recover on its own. You can take Vitamin B12 supplements" "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 a discoloration in the urine. Whenever I am not drinking enough water my urine is turning white in color. There is no associated abdominal pain. Is there any problem with this condition? ### Response: Hello. I have gone through your query. I would like to know a few more details too. Passing cloudy/milky urine can be due to several conditions. Most commonly it is either due to some infection or due to excessive phosphate salts in urine. But can also be due to lymph in urine which needs to be evaluated. I would suggest a detailed clinical examination by a urologist with some basic urine analysis and ultrasound evaluation of the kidneys and bladder to identify the cause of the cloudy urine which then be treated appropriately." "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 a problem with my eyes. I had a black eye a month ago and it swelled and bruised. The bruise went from purple to dark purple to yellowish-green and then brown. Now it stuck with brown and I am getting worried that it won\t fade away. What do I have to do? Or what medicine do I need to take? I am getting worried. ### Response: I think it is due to any blunt trauma to the eye. As you have described it is changing color so that color change will be due to pigments change in the blood. Is there any trauma history? Kindly send a picture of your eye so that I can diagnose it properly. Without an image it is a bit difficult to say. And is there any effect on your vision? Kindly provide answers to the above queries, I will guide you for treatment." "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 constipation problem. I think my constipation is due to calcigard retard 20 mg. Other medicines are Trental 400 mg twice daily for the past twenty years for Raynauds. Five years back I underwent surgery for CSF rhinorrhea. For BP, I am taking Telsartan 40 mg and Ecospirin 75 mg. ### Response: Hello." "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: There is a girl I know from online for more than three years. I liked her before, but I was too shy to tell her. Last year she opened up that she likes me too. Last summer we talked a lot, daily had calls, movies online, shared pictures. She told me that she loves me, I told her too. Unfortunately, bad things happened to her before me (abusive ex, lost baby, lost cousin). We could not meet yet. Something happened last month, because she seems different. She says that she does not feel anything, and she does not want help nor does she want me to fix her. It feels like she does not love me anymore. I do not know what to do. ### Response: Long distance relationship has its own pros and cons. Likewise, in your case, in the beginning it was working but one to one direct interaction is always needed to have strong bonding. Especially, in such scenarios where one partner need much emotional support after experincing much losses in life. Sharing time online can be helpful, but not a long-term solution as discussed above. It might be possible that your friend is suffering much and could not share online things as before and needs physical and emotional support from you. I would suggest that try to meet her once even if she shows that she does not need help (depressed people avoid taking help quite often) and discuss the issue to better understand the core of problem. 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 turned my neck quickly to the right, and I felt pressure on my neck. Then my neck was stuck to the right for three seconds. When I was able to put my head looking straight, it came back to normal. It was painful. I had a weird taste in my mouth. I also felt dizzy and weak after it. ### Response: You have neck muscle dystonia which causes severe pain especially when you move your neck. I recommend you use local deep heat cream (Propylene glycol and Lanolin) thrice daily for one week and use Ibuprofen 400 mg as a painkiller for a few 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: My ECG report says that I have a right bundle branch block. What is it? Does it require attention? ### Response: Hello. The heart works on electrical signals/impulses that are sent through a pathway. This finally reaches the side/part of the heart that produces the heartbeat. This pathway is complicated. And when there is any abnormality along this pathway, it can result in a condition called bundle branch block. In this condition, there is a delay in the delivery of this impulse to that region of the heart (right or left), thus resulting in a delayed heartbeat. Bundle branch block (BBB) is not treated directly as it usually does not require treatment. But once observed, an elaborate evaluation has to be conducted to find the exact cause. This cause has to be treated once found." "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: Since I was pregnant with my 1-year-old son, my teeth have been chipping, cracking, very sensitive and very sore. I noticed even today. My gums are turning white. Kindly help. ### Response: From the picture which you have sent me, what I can see is that your teeth are not in a very good condition. You are suffering from a condition called fluorosis, which is caused due to the excessive deposition of fluoride in the teeth, which ultimately leads to weakening of the tooth enamel and caries. Moreover, your gums swelling could be due to plaque and tartar deposits, leading to gingivitis. My suggestion to you would be to visit a good dentist as soon as possible to get your treatment started" "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 lung cancer. It is in the fourth stage. Currently, the doctor has advised her to take targetted therapy. She is taking Gefitinib tablets every day. Is there anything serious? Please help me. ### Response: Please say about the histopathology report. Please explain the condition briefly. Please state whether there was a mutation done before starting Gefitinib. All these things are essential for deciding the response to Gefitinib. In general, on taking Gefitinib, the average survival is 13 to 14 months. But some patients have long-term survival for three to four years. Some patients do well for five to six years. Usually, Gefitinib is well tolerated. The most common side effects are skin rash and acne. I recommend doing a PET (positron emission tomography) scan every three months. Have a look over the" "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 getting a throat infection for one or two times a year. As shown in the photo, I have tiny red painless spots in the upper part of the throat. When I get throat infection, mostly upper respiratory infection from nose to throat, these tiny spots become mild painful and sensitive to breathing air. Also, my throat area will become more reddish than usual. Once the throat infection gets cured, these tiny spots again become painless and less sensitive. But, they remain dormant over there. Some doctors said that it may be pin head ulcer or some allergic spots. My blood test HSV 1 and 2 shows no recent or past infection. And, other blood tests are normal. Please suggest what it can be. How to cure those spots? ### Response: Hello. I looked through the photographs you have sent (attachment removed to protect patient identity). I must appreciate the care and patience you have taken in capturing a clear photograph of the throat and labeling it for easy understanding." "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 22 year old male. My weight is 180 lbs and height is 5\10"". I was prescribed a generic brand of Adderall 20 mg about a year ago. It truly has improved my lifestyle. Up until about two months ago everything was fine. I noticed that on the left side of my neck became red randomly. I would describe it as looking more like a heat rash that starts around my collar, goes up only on the left side of my neck. It extends to my left ear and sometimes I get some redness on my left cheek bone. It does not itch or bother me in any way, but it is very noticeable sometimes. I have not been able to find any other factor that could be causing this. I have tried not eating particular foods, changed my laundry detergent, etc. My older brother and I both get a redness in our face when we play sports and this has happened every since I can remember. I do occasionally smoke cigarettes and have tried different brands to see if that may have a factor, but nothing. I have been to my local doctor and they have said that it is probably allergies, but I just do not agree. I am not allergic to anything, but I have not got around to getting an allergy test since the redness appeared. I am very concerned about this and more embarrassed. ### Response: I have read your concern and I appreciate your effort for a detailed and meticulous history. Revert back after seven days 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 had protected sex with my partner a month ago and two days later I had a pregnancy test which showed negative results. I am having a white mucus discharge instead of periods. Am I pregnant? I have also suffered cold due to change of place and a little stress. I was supposed to have my periods yesterday but all I have got is white discharge. Please help. ### Response: Hello. If you had protected sex then the chance of pregnancy is almost nil. Four days after sex, the pregnancy test will always be negative. Your periods are late by 10 days so you can now do urine pregnancy test. Your periods may be late due to many reasons including anxiety and stress so do the test and relax" "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 31 year old male. I am unable to penetrate my partner. I have tried twice, and it did not work both the times. She is a virgin and I find it too hard to push and penetrate. This somehow kills my erection as well. I have tried foreplay also but somehow cannot get through this problem. I have tried putting my two fingers inside but she complains of immense pain. Also, though I have engaged in oral sex before this is my first penetration as well. I never had any problem in getting an erection. I am an active guy who plays a lot of sports. Can you please help me understand what is wrong here. This is making me very nervous. ### Response: You are getting good erections, but are losing them when you try to penetrate. This is happening because of tight vagina of your partner. Because of this, you are taking time during penetration and this results in loss of erection. This loss of erection is occurring because of psychological reasons. You have tried long foreplay but this did not result in improvement. She still feels pain during penetration or when you try to insert fingers. This happens when girls start engaging in sex. You should use lubrication during sex. KY jelly can be used. You can also try using Lignocaine jelly. Ask her to apply this jelly to her vaginal opening. This will reduce the sensitivity and will reduce pain to some extent. You are losing erection because you are not able to penetrate her. There is no physical issue and this is due to anxiety alone. With time, the problem will be solved" "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 semen in urine sometimes. While sitting or lying if I concentrate on my penis, I start having strokes. I cannot control in the flaccid position. While I do sit-ups there is a movement in the penis. It started from nightfall and my urge of not to masturbate. It is because of depression only and when I concentrate on something else it stops. If I have a good sleep, it stops. So is psychological problem frank? I am not sure if thinking is much of an issue. I had such erections problems earlier and it was only because of depression but I am not understanding other things. Do I need a doctor? I had a renal transplant nine months back and I was preventing masturbating from happening though I was getting excited many times. ### Response: Hello. I can understand your concern. Lack of masturbation and lack of sex results in a spontaneous flow of semen via urine. This occurs in order to allow new sperm to form. This is a normal phenomenon and this does not cause any effects on health. This will not result in weakness of any kind. The secretion which you have during talking or excitation is nothing but precum. This is a lubricating fluid and this too is a normal thing." "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 gave birth to three babies at 27, 28 and 29 weeks. What is causing me to repeat giving birth to premature babies? ### Response: Hi. Are you pregnant now, if so how many weeks? There are various reasons for preterm delivery. Recurrent preterm delivery can be seen in uterine anomalies, intrauterine infection, cervical incompetence, and tobacco use. Being underweight and young maternal age is important factors for recurrent preterm birth" "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: This query is for my father in law aged. He is 58 years old and is diabetic and currently under medication for BP also. He has a history of two major heart attacks. In the last five years, he did not have any major heart issues.Recently due to extensive amount of medications taken for a long time, he started showing signs of high amount of creatinine (currently 6.9). We did a few dialyses. Now doctors have advised doing an AV fistula on his left hand. His left hand is partially amputated from a previous septic shock treatment about four years back. His right hand is fine but an AV fistula there might terribly limit his movements and self-care. We wanted a medical opinion about where the fistula can be placed or can it be near to chest area as an alternate option? ### Response: There are three main types of AVF (arteriovenous fistula). The radiocephalic fistula is a forearm fistula created by anastomosing the side of a radial artery to the end of a cephalic vein. It is also referred to as the Brescia-Cimino fistula. The brachiocephalic fistula is an upper arm fistula created by connecting the side of a brachial artery to the end of a cephalic vein or slightly central to the level of the elbow. Finally, the brachial artery\x80\x93to\x80\x93transposed basilic vein (BTB) fistula is another upper arm fistula. This fistula is created by anastomosing the side of a brachial artery to the end of a basilic vein that has been transposed laterally and elevated superficially to make it amenable to dialysis cannulation. Other sites could be leg also. I advise you to discuss it with your doctor. The patient requires dialysis for sure or you can put a central line and replace it every 15 to 20 days. But AV fistula is the best option." "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: Below is the biopsy report of my father who is 72-year-old diabetic. He was not feeling well for past one month. Can you please help me understand what does it mean? The liver biopsy result states that:Gross: Linear cores of tissue largest measuring 1 cm-A/E (pJA/SH).Microscopy: shows liver tissue with a neoplasm composed of cells arranged in nests and cords separated by sinusoids. Cells have pleomorphic nuclei with intranuclear inclusion, prominent nucleoli, and abundant eosinophilic cytoplasm. ### Response: Hi. I am very afraid to tell you that these reports (attachment removed to protect patient identity) are suggestive of liver cancer. This needs to be evaluated by further CECT (contrast-enhanced computed tomography) abdomen and PET (positron emission tomography) scan. I suppose you should see a cancer specialist as soon as possible. I hope it 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 have a strong itching and hot feeling in the space between my left thigh and vagina. What could be causing this? I am really not able to tell if there is a color change. ### Response: Hi. Intense itching as you describe mostly indicates a fungal infection. It is possible that you might be working in a hot environment or maybe sweating too much there along with wearing tight clothes. That prevents aeration of the area and promotes fungal growth. Try using antifungal or Cotrimoxazole ointments on the area to get relief. Hope you get well soon." "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 28-day cycle my last menstrual was six months before. I have been having lower stomach cramps, lower back cramps in thighs and calf cramps. My husband ejaculated in me on the very next month, kindly tell me what is going on? ### Response: First of all, please rule out urinary tract infection by doing urine routine examination and culture sensitivity. There may be many other causes of chronic pelvic pain. 1. Ovulation pain occurs mid-cycle but self-limiting. 2. Endometriosis may cause severe painful periods. 3. Vaginal infection, vaginal discharge, foul-smelling discharge. 4. Pelvic congestion, constant pain throughout starting from a mid-cycle, may stay till periods, reduce after periods. 5. 6. Interstitial cystitis, increased frequency of urine, pain fluctuates with urination. Please consider doing a urine pregnancy test, if you miss your next periods. You can also do blood for pregnancy (hCG) test, after two weeks of unprotected intercourse." "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: How to confirm that a person is suffering from SLE (Systemic Lupus Erythematosus)? ### Response: Get ANA test (Antinuclear antibodies) done to diagnose SLE. Though ANA is positive in other autoimmune diseases too, it is strongly positive in SLE. Once this test is found to be positive, it is correlated with signs and symptoms to confirm SLE. In case of doubt, other confirmatory tests would be required." "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: How to confirm pregnancy? Please help. ### Response: Please get a urine pregnancy test done with an early morning urine sample to ensure that you are pregnant or not. However, if you have a doubt then get a blood test for pregnancy done. Do get back to me with reports so that I can 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: I am a 35 year old male. I can hear my heartbeat in my right ear when I bend towards my knee. In any other position like standing or lying down I do not hear this heartbeat sound. My hearing test is normal. Is it normal to hear this heartbeat sound when a person bends his head towards his knee? Also, I am hearing it only in my right ear. Is it normal? ### Response: We are here to help you. Most commonly such feeling of heartbeat known as palpitations is absolutely normal. However, this could be due to anxiety issues. I would recommend you to get your electrocardiogram (ECG) and thyroid profile done and write back to me with reports. Revert back with the reports to 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: My daughter underwent a root canal. She is 4. The dentist tried to do it with gas and numbing it. She sat well through the drilling, then when he was doing the pulpectomy, she screamed and choked and flailed around. The dentist seemed unable to handle it all and he said she had a hyperemic pulp. He said he could not stop the bleeding. He was worried for my daughter from the crying and choking. So, he put a temporary filling over it and stopped. He said he was concerned it may bleed and cause pressure inside the molar. Pain and or abscess or infection. I follow up with him in one week just to check it out. Is this something I should be concerned with or is it common? It sounds very scary that her tooth could be bleeding from inside. I am just wondering if I need a second opinion, she needs to see her pediatrician or what. I am nervous. Is this a common thing or do I need a new pediatric dentist? ### Response: Hello. It is normal for the pulp to bleed profusely when it is a little enlarged inside, like a polyp. He could have then removed the pulp polyp and done the remainder. As soon as the pulp polyp is scraped away, the bleeding would have stopped instantly. Do not worry. In the next appointment, he may do it. Anyway, the bleeding is nothing to worry about, as it will not cause any severe pain now due to pressure. But, next time, when he opens it, ask him to put local anesthesia" "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 daughter aged 6 years got a cut and scratch in her body while playing in a new cementing wall from a piece of old and unused iron four days ago. Does she require any toxoid injection? ### Response: I can understand your concerns. Since you are sure that the scratch is from an old iron piece, I think you should give tetanus injection to the child. I hope this will help 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 stomach was burning for three hours yesterday night. I took Gaviscon once, but the burning did not go, so I took it a second time. I have slight chills. From two days, I am eating out, which was normal, and I did not overeat. I have eaten in this place previously also. I used to get slight burning sensation before, but yesterday it was very severe. I had chills for the first time. Even now I have slight chills. Right now also I have slight chills. I have acid reflux and fatty liver grade 2. Currently, I take Nexpro RD 40 twice a day, and Ursocol twice a day. Please advise. ### Response: Hi. You seem to have developed acid reflux following intake of food from outside. In such cases, I recommend the following: I hope it helps you. If you have any further query, please ask 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: I was positive for hepatitis B four years ago, and recently I was rushed to the hospital for coughing up blood from my lungs. The CT chest shows that there are some bleeding areas in my lungs. The Gene expert test shows that I have very low tuberculosis. My kidneys are normal and my liver is normal except that the total bilirubin is 32 umol/L and conjugated bilirubin is 10 umol/L. My anti-nuclear factor is positive. I am currently being treated for TB. I need expert advise. I have some test results with me. ### Response: As your gene Xpert report (attachment removed to protect patient identity) shows you have been tested positive for MTB which is sensitive to Rifampicin. The standard treatment in this case is combination four" "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 daughter inhaled a huge breath of what turned out to be sea water when she rolled onto her back with a snorkel mask. She tried to keep swimming, but breathing was nearly impossible. There were squeaky noises as she tried to get air. Lots of coughing for about two hours afterward; the next day she was just fine. A couple of days later she had gone for a 10-mile run, but there were no problems. Next day she had gone for a 6-mile run, and there were no problems. Today she tried swimming again. She did not inhale water, but violent coughing returned and she had difficulty in breathing after getting out of the water. She was discouraged because she really wanted to swim. Should she be concerned? ### Response: Hi. I want to assure you that you need not worry as everything is going to be fine soon. I have thoroughly gone through your case and can well understand your genuine concerns. She needs not to be worried and discouraged. Seawater is salty and usually causes such problems to the swimmers. The same is happening with your daughter. She had breathed in some water in the first episode and it caused trauma to her too. The second time it may be a psychological effect of passing through the same after effects as previously. This may merely be after effects and psychological effects. Or, it may really be inhalation of a small amount of water once again and it is not uncommon that such minor water inhalation happens and remains unnoticed during sea-swimming. The swimmer gets it known only when comes out of the water with respiratory symptoms like coughing and shortness of breath. She needs a swimming guide. No doubt she is good at swimming but, he will guide her cope with the fear and therefore the psychological effects will be masked. She definitely will get better soon with this technique of management. She needs not to be worried and discouraged. Seawater is salty and usually causes such problems to the swimmers. The same is happening with your daughter. She had breathed in some water in the first episode and it caused a trauma to her too. The second time it may be a psychological effect of passing through the same after effects as previously. This may merely be after effects and psychological effects.Or, it may really be an inhalation of a small amount of water once again and it is not uncommon that such minor water inhalation happens and remains unnoticed during sea-swimming. The swimmer gets it known only when comes out of water with respiratory symptoms like coughing and shortness of breath. She needs a swimming guide. No doubt she is good in swimming but, he will guide her cope with the fear and therefore the psychological effects will be masked. She definitely will get better soon with this technique of management." "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 acute pain on the right side of my right knee. I am not able to walk as usual. The local doctor diagnosed it as a ligament tear. He suggested to take rest and wear a knee pad. One month is over, and there is no improvement seen yet. There is also little swelling and pain. I am not able to balance while walking. It pains when I walk. I have attached my x-ray. ### Response: You have not mentioned your age, profession, and how you developed the pain (like after a slip or after a fall or just by itself). When you have a limp that has not settled over one month and you do not have balance when you walk then it is not normal. You have to be personally examined, and if necessary, an MRI scan of the knee has to be done. You could have a problem in the meniscus (a washer-like structure between the bones) or the ACL, PCL, PLC, etc. (ligaments or cords that connect the two bones). These are best seen only on an MRI. Meanwhile, please continue rest, splinting, and analgesics." "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 ESR is too high that is 25 mm/hr. Granulocytes % is high and lymphocytes % is low. The main thing is the RDW is low. I am having too much body pain and leg pain in my body. Even pain-killers not working at all. Too much pain. I am having trouble to move my arms and legs when I wake up in the morning. Also having difficulty sleeping. No fever. The pain inside of the body. Cough sometime. And pain under the left ribs. Pain around neck, back and shoulder also. Do you think I have multiple myeloma? Because all my symptoms are in favour of multiple myeloma. My question is as ESR is too high is there any kind of cancer in my bodies such as leukemia or lymphoma or bone marrow cancer? Why my pain is not going away after using too many Ibuprofen? Do you want me to go to hematologist or oncologists? Please, how can I overcome from this problem? ### Response: The chronic whole body pain does not necessarily mean leukemia. Your CBC report is within limits as attached herewith (attachment removed to protect patient identity). For your condition, your physical examination first should be done in the form of liver, spleen and lymph nodes palpation. Check your calcium level as well. Your vitamin D level is slightly low below reference range and for that Cholecalciferol sachet with milk 50000 IU per ml can be prescribed once a week for six weeks. Check your liver and kidney profiles report as well. High ESR could be from inflammation or infection as well. Check your thyroid status as well by serum TSH (thyroid stimulating hormone) estimation. CT scan like higher investigation can be planned if needed. Serum protein immunofixation electrophoresis will be beneficial to rule out multiple myeloma if 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 am a 31-year-old male. I am a smoker for 12 years. I am having throat congestion, cold, and now having excess mucus production with no history of weight loss. I have taken a chest x-ray in which there is a white patch on the right side. I wanted to know if it is cancer? My father is a known case of cancer lung. All my blood test reports are normal. ### Response: I have seen your x-ray. (attachment removed to protect patient identity). The chest x-ray shows a prominent right hilar area most likely due to rotation. I mean you were rotated in position when the x-ray was taken and this might cause a false appearance of right hilar vascular prominence. To me, it does not look like cancer but thought is to be given to your symptoms. If possible please decrease and stop smoking. I will suggest a discussion of your symptoms and clinical examination by your doctor and if there is a need then a CT (computed tomography) chest can be 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: The patient is a 50 years old female. She had a burn injury on the inner side of the hand three days back. I have attached the picture. Now, the skin over the area is darkened. The thin skin over it has started peeling this morning. She has pain, burning sensation and not able to sleep. What can be done about this? It is in the inner side of hand and it keeps hurting due to constant irritation. I would like to know some medication to relieve the pain and some topical application if needed. She is having gastritis and taking Pantocid 40 mg for three days. ### Response: Hi. Consult your doctor, discuss with him or her and take the medicine with consent.1. Dermocalm lotion (Calamine) in the morning and afternoon.2. Silverex cream at night (Silver sulfadiazine and Chlorhexidine).3. Tablet Dolo 650 mg (Acetaminophen) twice daily for three days after food." "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 physician has recommended removal of all amalgam from my mouth because of concerns about mercury poisoning. Using a meter he was able to demonstrate current flows in my mouth which are the equivalent of electrolysis. Have concerns about mercury from amalgam been debunked? ### Response: Well, amalgam carries mercury which is a key product to make filling for the mouth. Electrolysis happens and mercury is not healthy for oral health and general health too. We use amalgam as it has a good strength and it is one of the oldest material used for filling in dentistry. Nowadays, amalgam is somewhat replaced by composite. Amalgam caries silver and mercury. Silver as it is a metal, it forms electrolysis in the mouth when it comes in contact with saliva. Removing all amalgam restoration is a good choice and it will help you to prevent poisoning. Wish you good health and happiness" "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 is 53-years-old, and he is taking medicine for cystic granulomatous for six years. Eptoin medicine does increase GGTP (140 now) ALP is 134. Kindly advice. ### Response: Eptoin (Phenytoin) causes many things like the slow performance of duties, confusion, and decreasing the intellect of a person. You are correct. The cause of increased GGT (gamma-glutamyl transferase) and ALP (alkaline phosphatase) is due to Eptoin only. They are liver enzymes, and they get elevated in liver disease. Please do not be alarmed. Eptoin has not injured your father\s liver. See, it is difficult to explain. The liver has many functions. The liver produces these enzymes. They elevate when liver cells are damaged. But they also raise when their production is more. Eptoin increases the production of these enzymes. It is entirely harmless, and their levels become normal when we stop Eptoin. But you cannot stop Eptoin. It is an important" "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 diabetic foot ulcer that is taking forever to heal. Yes, I am seeing a podiatrist and following my foot care to his instructions. My question is;Is using \honey\ on the ulcer alright to use and will it work? I did a lot of research and all of them report a quicker healing. Respectfully wait for your professional thoughts on this. ### Response: I just read your query and from what you have mentioned it appears that you have a diabetic foot. Hope you find my advice beneficial. Good luck" "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 this bad habit of masturbation. I have been doing it since I was in school. Now, after doing lots of masturbation, my skin color has changed near the penis. Also, above my penis, there is some skin reaction. I do not know what to do. Please help me. ### Response: Hello. Masturbation is a safe habit and it does not cause any problems to the health. This is not a cause of any skin reactions. If your skin is becoming dark around the penis, that is normal and is due to friction" "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 foot pain, and I want to get some advice on the attached x-ray. I have been using moon boot for eight weeks (non-weight bearing), but I had to walk with it over the last couple of weeks. What is the dark area at the base of the first metatarsal area? Should I be concerned about the space between that area? And should I also be worried about the spacing near the cuboid and the fifth metatarsal on the oblique view? I do have a fourth base capsular disruption, as per my surgeon. ### Response: I have seen your x-ray (attachment removed to protect patient identity). Please let me know these details. Revert with more information to an orthopaedician and traumatologist 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 having gum pain and swelling near wisdom tooth in the lower jaw for three days. I am unable to open the mouth fully and eat or bite properly. Please help. ### Response: As per the description, you are suffering from pericoronitis. As per the current outside scenario of viral outbreak, one should not visit the dental clinic unless it is an emergency. So for temporary relief, I can tell you medication and a few home remedies, but for that, I need to know a few more details. Do you have any infection/pus to that site? If possible upload the image of your concern area. Until then gargles with lukewarm water and add a little salt in it, do it for two to three times daily. Get back with the above details for appropriate medication." "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 a 13 cm complex cyst in left ovary and have a laparotomy (small 3 to 4 inches vertical incision under my belly button to get rid of ovarian cyst) coming up and I would feel so much better if I could just get a spinal block instead of general anesthesia. I have heard of multiple women getting these with similar surgeries and I want to know why my surgeon is telling me that spinal block is not possible. I have a major anxiety of general anesthesia and I know my recovery would be better with a spinal. The tests performed are an ultrasound and CT scan. ### Response: Spinal anesthesia is good for surgeries below umbilicus eg., pelvic surgeries, and ovarian cyst as in your case. But the size of your cyst is large, more than 10 cm and it is a complex cyst (not simple) which would mean surgeon may have to see other intrabdominal structures also and may take more time to complete surgery, also you may feel uncomfortable if he has to extend incision above the umbilicus. So he has advised you for general anesthesia which is the most reliable option in your case" "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 4-month-baby boy. I am doing breastfeeding. My tooth is entirely damaged. So I am planning to remove my tooth. Is it correct or not? I am taking medicine for it. Please tell me a suggestion. ### Response: Hi. It is better to remove a damaged tooth. You can take some antibiotics and painkiller medicines. Take Amoxicillin 500 mg for three days after extraction. It does not affect your kid. Ask your dentist about particular medications while breastfeeding" "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: What type of calcium blood test should I undergo to check my calcium as a part of a routine checkup? Also, provide me full details of the Folic acid blood test as I want to undergo a blood test for a routine checkup. ### Response: I went through your post. These tests are enough for ruling out any major illness. Regards" "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 losing weight rapidly. I have been taking supplements. But they are of no help. What do I do? ### Response: Hi. You are losing weight and you are taking supplements and even then you are not gaining weight. Your history is incomplete. I need to know a detailed history before I can suggest you any remedy. I would like to tell you that, if you are losing weight rapidly, then there is some underlying issue to be taken care of. Few common causes of rapid weight loss are: hyperthyroidism, tuberculosis, diabetes mellitus, and acute disease. Symptoms related to the above-mentioned diseases are: I would request you to kindly share your detailed history so that I can reach a differential diagnosis and suggest you measures to gain weight.Other than this, eat well and eat on time. Revert back with the details to a general 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 had a 4.4 PSA and had an MRI that was negative. Six months later my PSA is 5.7 and even though the MRI was negative it is suggested that I should have a prostate biopsy. I am a 73-year-old male. I am certainly not that excited to have a biopsy. Any thoughts? ### Response: I can understand your concern about undergoing an invasive investigation without any symptoms. Let me explain you what does PSA suggest. Basically, PSA is secreted by the prostate as well as some other body tissues. It does not reach circulation and hence remains low in blood as long as the barrier between prostatic tissue and blood vessel is kept intact. Rising PSA is a sign that there is some tissue alteration which has resulted in breach of this barrier. Hence, do not be under the impression that rising PSA always means malignancy. But it is better to confirm the absence of malignancy by biopsy as, at a PSA level as low as 5.7, even in a unlikely event of report being malignancy, the chances of organ confined lesion is very high, which is easy to treat and chances if cure are high. Hence, it is better to undergo biopsy and get your fears allayed. As such, the biopsy is a very small procedure and safe in experienced hands. Wish you a safe biopsy and I hope the results will be benign." "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 going to a medical check up a few days ago, a doctor notified me I had a papilloma in my tonsil. I am a 28-year-old male otherwise healthy. I had been having an itch like feeling in my throat and some inconsistent feeling when swallowing or in-ear pressure. I cannot go to a doctor at the moment, I am quarantined due to Covid pandemic overseas. Is this something that deserves immediate urgent attention? What can/should I do/expect? ### Response: Hi. I see that this is not an emergency. Use antihistamine to overcome the itching sensation. Also, chewing gum can help. After ending the quarantine period you can follow up with your physician again." "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 under tremendous stress for the past five years and I am worried about my heart. I have been having consistent early warning signs of a heart attack such as shortness of breath, nausea/indigestion, heartburn, pain in my upper abdomen, pain in my neck/jaw and pressure/tightness in my chest. I typically only experience these signs during the week when I am at work and not so much on the weekends when I am home relaxing. I have never been in a situation like this so I figured I would ask you as to how I should treat this? Should I get tests done and if so, what tests? ### Response: Hello. Firstly, considering your age, probability of heart disease is low. All these symptoms are probably related to gastritis and reflux disease rather than heart problem. But, symptoms of heart disease and reflux overlap, so I would recommend you get yourself tested. You will need ECG, followed by echo and TMT if necessary based on ECG and echo reports. Stress tend to worsen gastritis and reflux problems which may worsen your symptoms. Since you are having such symptoms frequently and one cannot have such heart attacks frequently, these episodes are unlikely to be cardiac. Also, try to relax yourself with relaxation techniques. Regular exercises also helps to relieve stress. Also, avoid fatty oily and spicy food. Avoid smoking and alcohol, if any. Avoid heavy meals and have some walk after meals rather than resting immediately. Have some antacids like Pantoprazole or Rabeprazole is available with you. Hope this helps you and get back if you have any doubts." "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 second molar in the left side of upper jaw was extracted two months back. I thought of placing an implant. So, bone grafting was done. Now, I got few opinions that implant is not required in that region. Are there any future implications due to gap being there like displacement of adjacent teeth, etc.? ### Response: Hi. Because you have done a bone graft, that means there would have been bone loss. The prognosis of the tooth will be poor after implant in that region. If your adjacent teeth are not having or showing any bone loss, you may opt for a fixed partial denture (bridge). Yes, there are chances of tooth displacement or tooth migration in this region. If the implant is not possible because of underlying bone resorption or too much vertical or horizontal bone loss, you must not opt for a bridge too. In case you have any IOPAR, X-Ray or OPG you can upload here for proper treatment plan and prognosis. Revert with more information to 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 am suffering from eye floater problem since four years, in which, I see grey shapes in front of my eyes and also observing headache. My left eye vision is -3.1, and right eye vision is -1.8. ### Response: You are near-sighted (myopic) person. Seeing floaters points to the fact that there might be early changes of vitreous degeneration in your eye which itself is not a problem but it may cause undue traction on your retina. Here is what I suggest: You have to visit a vitreoretinal expert ophthalmologist and you have to get a dilated fundus examination. We have to rule out any areas of weakness in the retina and if found, they can safely be lasered" "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 eye pain in left side eye, minor or weird feel in the left side or have mild pressure on side of the eye. It is nearly there for the past four days. It is very awkward. Please help. Is it a sign of concern or anything else? ### Response: There are different causes of mild pain in the eye. It may be due to some foreign body or decrease to increased intraocular pressure in the eye. Some times people with sinusitis feel heaviness in the back of the eye. As your vision is same there is no emergency but if the pain is persistent or worsening you should consult an eye specialist for a complete eye exam to diagnose the exact cause of pain." "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 did deep kissing like nine days ago with a girl that had HIV. Of course, I knew that after. And while it was dark, I was kissing her body too but because I did not have condom we did not have sex. Is it possible to get HIV by kissing her body or contacts with a body rash or something like it? And, is it possible to do an HIV test after nine days? I already did it though. ### Response: Hello. I have noted your concern. Kissing is safe as far as the risk of HIV is concerned unless she had oral sores or bleeding gums which may increase the risk. Kissing on the skin is also not a risk. HIV is only transmitted through unprotected sex - either vaginal, anal or oral sex. Still, if you want to get tested you may take an antigen/ antibody screening test at four weeks for a conclusive result. At nine days it is possible to take an HIV RNA PCR test as it has a short window period of nine to 13 days. Regards" "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 got toric lenses to correct my astigmatism. Can I switch to regular eye lenses? I want to have colored eye lenses, but it is not available in toric lenses. And how long will it take to correct astigmatism? ### Response: You have not mentioned how much astigmatism you got. If it is negligible, then it will be fine with the spherical lens only. If it is significantly high, then you must need toric lenses. You can get a customized contact lens from some good optician or lens dispensing shop according to your refractive error and color of your choice. Usually, refractive error changes up to 20 to 22 years of age. But you can get laser treatment for refractive error correction after 20 to 22 years of age or when your refraction is stable for up to 6 to 12 months." "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 I may have ringworm. It is located on the left side of my stomach (almost hip). I have tried putting Clotrimozol and Daktarin on it. I am afraid that it may spread to other parts of my body. Please help. ### Response: Hello." "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 3.5 month old baby is suffering from slight cold and cough for the past 15 days. The doctor suggested antibiotic syrup 3 ml twice daily. Xpect PD cough syrup 2.5 ml twice daily and Sinarest AF 10 drop twice daily. His weight is 7 kg now. When I am trying to give him cough syrup he is vomiting and not taking it. Also the amount of antibiotic prescribed is too high I hope. What shall I do now? Please guide me. ### Response: Hi. For infants with cough and cold, antibiotics are fine to give. I am not able to comment without the name of antibiotic. I would appreciate if you could provide me with the generic name of the medicine you are giving her. This would help to provide proper guidance and dosage. If the child has any respiratory distress such as chest retraction, increased respiratory rate or nasal flaring then should get a chest x-ray to make sure there is no pneumonia and get treated appropriately." "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 got 6 fillings done a while back that were causing me no pain whatsoever or sensitivity, so I found a new dentist got the filling done and by week 3 the fillings on the left top were causing me more severe pain than week 1 and my bite was off no matter how many times she adjusted it there was only 1 tooth touching and being damaged, dentist is denying she did anything, says there is no infection.I finally went to the ER and dentist visits later and I had an abcsess lanced on the roof of my mouth and need a root canal on a tooth that had a short cavity in the first place by the dentist, the pain goes away with antibiotics and I have been doing alright for the past 2 months except pain when eating on the effected side, now all of sudden the top 2 molars on the left where the infection was there are red around them and pain when pressure is applied. Mind that when I bite down on top left second to the back molar is the only tooth touching anything all the others are not touching each other no mattter how hard I try since my dental work and I am scared I am getting an infection again. ### Response: The problem with cavities are either you will find out about it when you start getting severe pain or if some dentists points it out. in your case, occlusal corrections could have been done more accurately to find out which tooth is having the high point and reduce it appropriately. If there is an abscess get root canal treatment done. I need to see X-rays and pictures to give you any definitive diagnosis and treatment plan." "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 doing Zumba for six months, three times a week. A month ago, my instructor significantly increased the intensity of choreographies and my shins started hurting after dancing. They hurt all along the tibia, all the time. It is not extremely painful, but quite annoying. I would like to continue exercising, but I am scared of potential long-term consequences. Should I just slow down and avoid some moves (like jumping)? Should I switch to pilates? ### Response: I have read your query. I would suggest you to reduce the intensity or time duration of Zumba, if possible. Do some warm up exercises before starting with high intensity Zumba dance. You can also do some low intensity Zumba dance before moving into the higher intensity every day. Start with warm-up exercises or low intensity Zumba dance before starting with high intensity Zumba dance. Take frequent brakes between the high intensity dance. You may simply stand or sit for two to five minutes in every 10-15 minutes of dance. You may use shin support braces during the dance. This may reduce the pain you get after the dance. Dip your legs in warm water for 10-15 minutes after going home or take hot pack on the shins. Rest in between the high-intensity dance. Shin supports or braces while practicing Zumba. Try the above suggestions and see, if you still feel the pain let me know. You may later opt for pilates instead of Zumba." "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 an unprotected relation two months ago, which led to urethritis three days after that was treated with a 10 days course of Levaquin. The urethritis disappeared, but at the end of the treatment, I started to feel neurological symptoms, numbness, tingling burning sensation in my arms and allodynia in my foot. Then a few weeks later, I began to experience diarrhea (muddy stools) after digestion (mainly in the morning, sometimes at night or the end of the afternoon). I lost a lot of weight (nearly 10 kg). I got an MRI (cerebral and medular) and an EMG that came back normal. I got STD (hepatitis, syphilis, HIV, gonorrhea, chlamydia) lab test 43 days after exposure, which came back negative. As I was worried about all these symptoms, I got multiple HIV fourth-generation testing at 21 days, 28, 35, 43, and 51 days that all came back negative.My doctor gave me this week a complete blood test, and everything came back healthy except slightly high albumin level (53g/L) probably due to dehydration but also a somewhat low gamma globulin with a level of 7.4g/L while the lab norms range from 8 to 13.5 g/L. The conclusion stated hypogammaglobulinemia. Now I am worried because I read that hypogammaglobulinemia can delay the seroconversion and then give false negative antibody results. Do you know if such level of gamma globulin can indeed affect HIV testing? ### Response: Hello. As you have done all the test which came normal. Hiv antibodies while detecting in initial phase generally came negative, as it is in window period for three months. So have to recheck HIV antibody test post three months of exposure. And if it comes negative after then no need to worry. As you explained, you have hypogammaglobulinemia, As lab report showing lower level, but the value not that much decreased. You go for thyroid profile testing also and connect me if you have further questions." "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 few questions which I would like to ask a professional. As I am not able to find the answers by myself, I would love to hear from a practicing professional.How is the best Insulin treatment (syringe, pen, pump and pod) selected for a type 1 diabetes patient? Generally, how long the patients need to learn the injecting technique? Why does injecting Insulin into the same location cause a hard bump in that area? Is this reaction the reason ports are not used to deliver Insulin? How common is the use of the new inhaled Insulin? Does it have to be supplemented by another method of injection? When would an islet cell transplant be recommended? When would a patient be given an entire pancreas transplant operation rather than an islet cell transplant? In both situations, what keeps the beta cells from being tagged by autoantibodies and destroyed again? ### Response: Rather than the best way, we consider more convenient and economical ways for the patient. The best is always an Insulin pump, but it is costly and requires continued patient education. Injecting Insulin into the same site will cause damage to the fat tissue which results in necrosis (cell death). Because of the fat damage, hard bump forms. New inhalation Insulin is not yet come into usage in full fledges. Also, I have not put any of my patients yet on inhaled Insulin, so cannot comment. But yes, initially it has to be supplemented with subcutaneous Insulin as dosing and efficacy is not completely established for Inhaled Insulin. Islet cell transplant is recommended for patients of type 1 diabetes who are difficult to control on Insulin (by any method). If the transplant is considered for only diabetes purpose then only islet cell transplant is sufficient. The pancreas has other functions like digestion. If the digestion system gets impaired in a patient who is requiring islet cell transplant, in such a patient\sentire pancreas transplant would be helpful. Well, if no immunosuppressant is used post-transplant, these autoantibodies can destroy the newly transplanted pancreas also." "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 25 years old. I have a little long story of typhoid.In March, I tested positive for typhoid with widal test and the report shows TO - 1:80, TH - 1:40. My doctor prescribed me some antibiotics and I took them for eight days. I tested again and all titers were negative. I immediately left all the medicines as I though I have recovered. I was fine.In May, again I tested positive for widal test and the report shows TO - 1:160, TH - 1:80, TA - 1:40. This time I took two antibiotics Oflomac 200 and Ceftas 400 mg for about one month. After one month I tested for widal and my TO titer was 1:60 and TH was 1:40. My doctor said me to leave the medicines and he told that it is normal now.Now here my concerns starts, in July and August, I took two widal tests on the interval of one month and both reports were the same as TO - 1:80, TH - 1:40. I showed this report to three doctors and they all said that it is normal. It will take some time to fall the value of titers after typhoid.Symptoms:I never had any fever during all history. I just had joint pains, leg cramps and sometimes stomach pain. My question is have I become a typhoid carrier or this is really normal? And if I have become the carrier then is it curable or not? I am very stressed about it and it has disturbed my whole life. I am asking this because, now these days, when I go for morning walks, I have leg pains whole day with a very bad taste of my tongue. ### Response: Hi. Widal test is a vague test which has limitations. It is done only to get an idea of which type of organism might be present. If you see the report again, you will not find any value for a zero level, means the level of a normal person can also not be zero. Anything less than 160 be it 20, 40 or 80 is considered normal. Only 160 and above needs treatment. You have already taken a lot of antibiotics, no need for anything now. Since you are still thinking about carrier state, do the following things: 1. Get a Typhidot IgG and IgM done. Your IgM will be positive as you had past infection. IgG should be negative as this shows present infection. So this way, you get clarity on what is the status of typhoid now. 2. Get a stool routine and culture done. This will show you if you are excreting typhoid bacteria or not and are a carrier or not. The treatment will be decided only once we find something in that. 3. Get an ultrasound of the abdomen done to rule out any swelling of the liver or intestines. Once you have this done, you will be clear with everything. 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 heart beats in my right chest for the past three days, not continuously but sometimes. I am mostly busy with work. My BP was 116/77. I was diagnosed with vitamin B12, D deficiency three months back. Now it has increased and my BP is 140/80 due to excess stress in work. Now I am going to morning walk daily but a feeling of beats in right chest is there. I think it is due to stress. How to get rid of it? ### Response: You hear your heart beats on the right side. You do X-ray of chest PA to see the heart position. You are suffering from stress and most of your symptoms are related to stress. I have gone through your reports and found it to be fine (attachment removed to protect patient identity). You should control your stress. Do breathing exercise for five minutes two times daily. Attend yoga class. All these will help you to control your stress. Make good friends with whom you can share your problem. Take a vacation from your work, go to hills or sea beach and enjoy with your family the quality times." "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 28 years old. Last night my fiance and I got intimate. While doing so, he rubbed his penis all over my genital area. I am not sure if there was any penetration. My last menstrual period started on 19 or 20th. A few hours after the closeness, I took an Unwanted-72. Could you please tell what are the chances of me being pregnant? ### Response: Hello. Since you have taken an emergency pill within 72 hours of intercourse, there is no chance of pregnancy. So relax and do not worry about it. However, if you have a doubt then get 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 husband is not available whenever I ask him. Whenever his family treats me bad, he never asks anything. He is not helping me in my work. I am really stressed. I need someone badly to talk. ### Response: You are reporting relationship problems which is quite common. Almost all couples go through difficult phases early on in their relationships. Remember there are no perfect couples and no perfect marriages. Everyone has to work proactively to maintain a healthy relationship. Try talking to your husband when things are calm. Discuss with him in a calm manner about situations you find difficult. He may have a different perspective. Both try to approach the problem without accusing each other and follow a problem solving approach. Speak to trusted family members or elders who can discuss with you both in a neutral fashion. Relationship difficulties can be very stressful for both of you. Try to do relaxing activities like walking, exercise regularly, meditation, etc. If things are really difficult, marital counselling can help. You can contact 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 am having frequent urination and tests showed up pus cells 6 to 7. I am having this for three days. I am having a feeling of voiding it even if I just urinated like one minute ago only. ### Response: Hi. Sorry to hear about your suffering. From what you mentioned, you have simple urinary tract infection. Symptoms of UTI are frequent urination, painful urination, and change in the color of urine" "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 periods will last usually for five days on average. It hurts tremendously even with pain medication and birth control. I would get horrible periods since I was about 12 years. In my 15 years age, I used to vomit on the first day of my period, but vomiting stopped in the past two years. Before one year I have been diagnosed with endometriosis and prescribed birth control to help ease symptoms. My current medication is only over-the-counter painkiller and doctor did not prescribe any medication as she felt it would not help me. I am considering switching from hormonal pill birth control to an IUD. I have researched on the internet and I would prefer a hormonal method because I have endometriosis. My heavier periods and cramps sound absolutely horrible. However, I have also read that a lot of women experience weight gain and moodiness with the hormonal methods, the two things I do not need in my life. Which method is better for me? I am 19 years old, moderately sexually active with a serious relationship, generally healthy (prone to colds and flus), no serious medical issues in the family aside from my endometriosis and no history of cancer or ectopic pregnancies. Please suggest me. ### Response: Both pills and IUD (intrauterine device) have their own advantages and disadvantages. If you are thinking of switching from hormonal pills to IUD only because of complications like weight gain and mood swing, then think twice. Studies have failed to demonstrate these complications of pills." "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 on regular birth control pills and was taking these as usual. I took the seven inactive pills and began taking the active pills. I took it for three nights as per schedule but forgot to take it on the fourth. And I had sex on the same night, with a condom, but there may have been sperm near my vagina afterward. At about 10 AM on the next day, I took the missed pill. That afternoon I vomited. Soon after this, I took an emergency contraceptive pill and continued the other active pills as usual. Considering these factors, are chances of pregnancy high? ### Response: How are you doing? You are absolutely safe and there is no chance of pregnancy. Let me explain. Birth control pills act by creating a continuous constant hormonal level. They prevent the normal hormonal fluctuations. So, ovulation will not occur. Only if you miss two or more tablets, the hormonal suppression will be lost and there will be a chance of pregnancy, especially if you miss it during the second half of the cycle. So, I do not see any chance of pregnancy in the present scenario. You have not missed a pill too, as you have taken the missed pill within 12 hours. The vomiting was only two to four hours later and not immediately. So, the hormonal suppression is not lost.The emergency pill was not required to be taken. This pill will delay the periods by one or two weeks. Hope I have clarified your query. Do write back. All the best." "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 60 year old female. I weigh 70 kg and my height is 5 feet. I am a known diabetic and hypertensive and on regular medications. I have been suffering with dry cough, fever and chest pain. When I cough my chest pain gets worse. I am unable to take deep breath, because if I inhale deeply then the chest pain increases. I have completely no appetite from last 25 days. I am feeling weak. Due to my illness I have visited at our local hospital. I have told every health issues to the doctor and he suggested me to do an x-ray of chest PA view and multiple blood tests. I am attaching the reports for your reference. After the tests I visited the doctor again and he said everything is alright. But there is a little infection. And he suggested me few antibiotics namely Azithromycin with Ofloxacin SR tablets for 5 days, a vitamin syrup named fortified vitamin B-complex, L-lysine, Zinc syrup, cough syrup Grilinctus and few more tablets. For past four days, I am taking all the medicine, but I am not getting well. Moreover my chest pain has increased and I am having stomach upset and going to washroom frequently. I have some doubts in my x-ray report. Because x-ray of healthy lungs should be clear, but there is some white appearance in x-ray. Can you please check the reports again including blood test reports? Tell me if there is anything wrong. Also give me a detailed answer in regard to my health condition. ### Response: I have read through your query in detail and gone through your reports (attachment removed to protect patient identity). Please find my observations below." "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 25 years old and unmarried. My last period was a month back. After that, I had unprotected intercourse. This month I missed my periods and found positive results on the test kit twice. I took Mifegest kit\s Mifepristone tablet yesterday night at 8.30 PM. After that, today morning I just saw a small blood clot like as of periods, later I got none of the symptoms, neither any other symptom. Just sometimes a bit abdominal cramps as experienced at the time of periods. Is everything normal? Is the medicine working? Please help and give me a further suggestion. ### Response: First of all, have you done a USG pelvis to know about the size and site of pregnancy? Once intrauterine pregnancy less than seven weeks is confirmed, only then you should use Mifegest kit, otherwise, it may cause you serious bleeding, with a need of hospitalization and blood transfusion. You need to complete the course first, that is, four Misoprostol tablets to be taken after 48 hours of Mifepristone. The final result can be known only after USG after 14 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 have felt very sad a lot of the time for the past year and a half. This has been accompanied by feeling hopeless, very low self esteem, feeling unloved and like a burden and occasional mild suicidal thoughts (although I would never act on them), being very sensitive to rejection and isolating myself. Before all of this I used to be very hungry in the mornings and now I have zero appetite during the mornings. Lately, I have had barely an appetite at all. Since five months back I am having trouble in sleeping. These feelings of sadness, worthlessness, etc., tend to worsen at night as well. What is wrong with me? ### Response: Hi. The negative thoughts which are making you feel this way are due to depression. They are not valid thoughts, they occur due to chemical imbalance in the brain called serotonin. This is how depression works. I would suggest you to meet a psychiatrist as soon as possible and start medications. Also, I would suggest you to start counseling sessions to help you with your negative thought patterns and help you with breaking the cycle of negativity." "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: With TSH between 6 and 8.9 (today 7.5) and FT4 of 1.3 (normal), is it justified to prescribe Timazol or Carbimazole (both for hyperthyroidism cure)? ### Response: Hi. But in this scenario, I do not have any idea about the current prescriptions you are taking. So, with that information and lipid profile reports, I will be happy to guide you better." "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 29 year old housewife. I am suffering from infertility since I got married seven years ago. I have PCOD, tubal block, and hypothyroidism. I am overweight. All the treatments we took for conception failed. I was advised to reduce my weight by at least 10 %. But, I am unable to lose even a few kilos. I am ready with my blood reports to start my diet. It looks like the cholesterol, HsCRP, fasting glucose and insulin levels are on the higher side. I need an advice from you. Now, in this situation, my first goal is to reduce my weight and achieve pregnancy. Kindly suggest me a remedy. ### Response: Please do not get scared about your weight. You can reduce it easily by following a good diet plan and with normal walking. I am sending you a diet chart. Please follow it and be in touch with me for the follow-up." "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 38 years old, male. Whenever I am about to get multiple sneezes just before I get burning and intense pain inside my nose and sinuses. Especially if am around the kitchen or anywhere in the house, especially if frying is happening in kitchen. My sneeze smells bad most of the time. What is the treatment? ### Response: Hi. It is clear that you have allergic rhinitis, especially for indoor substances as fried oil and maybe carpets or anything else at home. You need to use intranasal corticosteroid spray once daily as Avamys (Fluticasone furoate) spray." "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 26 years old. For the last 10 years, I am suffering from very weak hand grip strength. At the age of 16 it started and grip strength was negligible for like four years. Then I started working out with hand grippers and the condition has improved a lot. There is no pain or numbness but still, at times, I feel my gripping strength is very weak and when I perform exercise it improves for the time being as I can feel the blood rushing inside the hands.My query is that does masturbation has any link with this because I have noticed often that after performing the act the situation starts getting worse as in there is very less blood flow in hands and I feel very low gripping strength. I have no issue in lifting weights eg. bench press and there is no pain while doing any kind of lifts. Please guide me on my condition. ### Response: There is no link between masturbation and handgrip weakness. The cause of your hand grip weakness needs to evaluate further. You need an in-person neurologist consultation face to face because we need to examine your strength, reflexes, sensations of your hands. Is the weakness is more on the right or left? Do legs are involved or not? After a thorough physical examination only we can advise MRI (magnetic resonance imaging) cervical spine or nerve conduction study. But as a neurologist, I can definitely guide you that there is no link between masturbation and hand weakness." "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 leg fell asleep two weeks ago and stayed asleep for days with pins and needle feeling constant. When the pins and needles stopped, the left side of my leg stayed asleep as well as my foot. I have foot drop on that side and it has been almost three weeks with no improvement. I had urgent care ensure it was not a blood clot. it. I have been having increased anxiety and mood swings as well as body twitches. I take Gabapentin for nerve pain in an old T7 compression. ### Response: Hi. You should get a nerve conduction velocity testing done. NCV test suggests that which particular nerve is involved and treatment would be based on that. My recommendations would be to get NCV first and in case that is normal, go for MRI LS spine. Other blood tests like sugar, thyroid are mandatory" "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 itchy bumps located on right breast with blisters filled with pus. ### Response: Could you attach picture of it? Are those painful? Are you sexually active or do have close contacts with other individuals or do you share any clothes? If those are multiple small vesicles aligned or grouped together, with clear fluid inside rather than pus, then those are likely a herpes infection. Then you would antiviral like Acyclovir or Valacyclovir. Now since it is less than 72 hours, it is better to get antiviral prescribed, which gives better result with early treatment. Herpes is usually painful to begin with or may get painful later. This would be associated redness or tenderness. So, be it either ways, you will need medications. So get it prescribed after 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: I am a 26 year old male, who weighs 173 lbs. I am having severe headaches for a few days now. I am currently taking Percocet for this headache. I was told that I have hypertension. My blood pressure is 168/98 mmHg, and pulse is 120 and steady. Please help. ### Response: Your headaches are probably caused due to your high blood pressure. A headache can also increase the BP, but not this much. As you are so young, the cause of hypertension should be found out first. So, I suggest you undergo tests like kidney function test, renal artery doppler, serum cortisol, 24-hour urine metanephrines, lipid profile, and sugar level. ? As it can also cause hypertension. Till you get all the tests done, I suggest you try doing the following. Hope this helps you and get back if you have any doubts. Revert with more information 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: My 23 years old daughter has been suffering from a blocked nose for the past three months. She took Sinarest and Cefixime antibiotics tablets, and Nasivion S drops. She has only temporary relief from nose block. So, we took a CT scan of PNS (paranasal sinuses) recently. Clinical findings are deviation of nasal septum and sinusitis.I would like to know the best treatment other than surgery. ### Response: Deviation of the nasal septum has only surgical treatment. Sinusitis is an infection of sinuses present in our facial bones. The blockage of nasal sinus opening is the most common cause of sinusitis. You can try Jal nethi, which is a procedure in yoga under a trained master, which helps in revealing the blockage. Avoid allergens and taking a head bath with cold water." "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 little bit of itching on the foreskin. I had sex with my partner, and I used a condom. After the first ejaculation, I used the second condom. I started to have pain in the penis after the first ejaculation. But still, I went for the second one. After several strokes, when I was not able to ejaculate, I ended up. After removing the condom, I saw red dots on my urethral opening and glans. It was paining a lot.The next day, the dots were no more. But my foreskin had pain. Now, after three days, after sex, my foreskin is dry, and some part of the skin is peeling off. I am unable to take the foreskin back. While retaking it, it pains a lot. My urethral opening is always dry. There is no problem on my penis shaft, and my foreskin is dry. My partner is not having a problem. What can I do? Is this a serious problem? Please suggest me a solution. ### Response: Hi. You have developed an allergy to latex. You have developed redness and pain while using a condom. This is probably a hypersensitive reaction to the condom. The problem is not severe, and this will become fine within a few 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: This is in regard to my mother. She is 51 years old. Her weight is 112 kg. She has severe pain in the lumbar spine till her bottom and not the legs. She had done an MRI of her spine earlier and got detected with slipped discs. Recently, she did another MRI of her brain and whole screening of spine. I want you to explain the conclusion of the brain MRI. The report was round to oval T2 hyperintense foci in bilateral deep peritrigonal and right frontal white matter. Please explain in detail and also please tell me what treatment would it require. Also, she has slipped discs, frozen shoulder and muscle knots. Please tell a solution for muscle knots. Due to frozen shoulder, she cannot lift her right hand. She had injections, but did not get relief. From a while back, she is showing forgetfulness, no balance and cannot lead a normal life at all. I am sending the copies of the MRI and also attached her current medication list. I will be awaiting your reply. ### Response: Hello. I had gone through all the data posted (attachment removed to protect patient identity). I would like to keep my answer as simple as possible so that you can understand easily." "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 38 years old. I got my blood test done for an overall health checkup. I am attaching my reports. I can see my heart and cardiology reports are not good. Can you please tell me whether there is anything abnormal? ### Response: Hi. I have gone through your attachment (attachment removed to protect patient identity). Your urine examination is normal. Your uric acid level is high, for that you are advised to take more vegetables and fruits and less meat (take low proteins in diet). Liver enzymes are high that can be due to certain medications or liver infection due to some viruses such as hepatitis B, or hepatitis C. Thyroid profile looks normal. The lipid profile is also high and deranged. It can be managed through lifestyle changes (more physical activity and weight loss). Persistently elevated lipid levels are harmful to the heart and blood vessels. Low iron levels may lead to anemia, and it is also harmful to the heart and its pumping function. Other markers look fine. I would suggest you go for lifestyle changes and that too on an urgent basis. Persistence is the key to success here. It may or may not be an overnight change, but it is mandatory." "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 tooth has been filled and I went to the dentist and he took an x-ray and the filling was to close to to my nerve. He said he will have to do a root canal which I do not want to do. I was thinking of other ways to go around this because my nerve has nothing wrong in it. I do not think I should get one if my nerve is not infected. I was thinking he could just remove the filling and and replace it with a new one which makes sense. Anyway if we do a root canal he is going to drill in the filling anyway. So let me know if a root canal is the only option because I do not feel like going through that. ### Response: It all depends on your symptoms. Why did you visit the dentist if the filling was already done? Are you experiencing any pain or discomfort in it? If yes, then unfortunately, there is no option left but root canal treatment for it, because it might have touched the roots almost. Secondly, after the removal of filling, re-filling at the same point will not be possible because if the pulp of root is near as it cannot bear any sort of filling directly on top of it. If it is done in this way it will simply cause huge swelling or throbbing pain will start so the only way to save a tooth is to clean the pulp i.e. nerves of root canal through this treatment and then put a cap on it. You may delay this treatment until you experience any symptoms of a root canal. Can you tell me about your symptoms and provide me with a radiograph? So I can tell you exactly what you can do best." "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: What are the natural ways followed to remove tan from forehead and neck? ### Response: Hi. Use aloe vera gel two times a day. Take Multani mitti and add a half teaspoon of turmeric powder and sandalwood powder in it. Then make it a paste by adding rose water. Apply it on your face and neck for 10 to 15 minutes and then wash it off using water. Try all these things regularly, and you will have good results soon." "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 39-year-old male with a low sperm count of 1.9 million. My blood work shows that I have a high FSH. Our doctor highly suggested that I get genetic testing done before we proceed with an IVF or an ICSI. I would like to know why he would suggest that. ### Response: I hope this answers you. Feel free to write back to me if you have more questions" "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 just wonderful that you make professional opinion available for people who have nowhere else to turn. My mother has been showing weird behavior ever since I can remember. The issue is that anytime someone (from our family or otherwise) brings up the fact that she is acting unusual, she denies it. Everyone is wrong, and she is always right. I am wondering if maybe I describe her behavior here, I could get some opinion on whether or not she is indeed in need of help, and whether or not she can care of her children.She has a lot of mood swings, she is incredibly happy some days, and she has a small idea which she believes can turn her life around. And she would not let anyone\s opinion deter her. She makes rash decisions and shops a lot, spends all the money she has. Other days, you can just see how down she is. She has difficulty getting out of bed and is extremely irritable and generally in a bad mood. She will yell and get overly angry for seemingly small reasons. Also, she lies a lot, but it is strange because it is like she does not realize she is lying. It is like she changes the facts in her head, she believes that whatever she is saying really happened, even if multiple people who witnessed the same thing say otherwise. And she will get angry if contradicted. She is also very manipulative, especially concerning her children and money. She regularly uses her kids to get money from the family and brainwashes the kids (through repetition, yelling, and psychological abuse) against any member of the family that they seem to like more than her, or that refuses to cave to her manipulation.She has no friends. Her mood swings alone are enough to drive anyone away. Also, she has a surprisingly cold attitude towards her kids. She is not warm or affectionate (I sincerely cannot remember the last time she gave any of us a hug), and she will easily put us aside if bigger interest is at stake, for example, she overlooked the fact that my step-father abused me because he gave her money. Recently, seven years after the fact, she wants to defend me, since he stopped paying up. She was prepared to do it without my consent too. She just casually mentioned it in conversation, in the same way, she would tell me about how it has been raining a lot recently. The fact that I was suffering visibly for years never seemed to bother her. Well, I think that may be enough of a description. There are a lot more details, but I believe these are the main factors that always strike me as odd. I am fine now and out of her life, but I am worried about my brothers, and whether or not they are safe with her. Please help, your opinion is greatly appreciated. I would like to have some sort of professional feedback before taking any action concerning the safety and well-being of my brothers. They mean the world to me, and if they are to be removed from the care of my mother, I need to be sure that this is indeed not normal. Because she will never admit it to herself. ### Response: Hello. I can understand your concern regarding your mother and your brothers. You have given a beautifully elaborated history, clearly showing your mom is suffering from bipolar affective disorder (BPAD) and needs clinical assistance. BPAD is a mental illness, but it is treatable with mood stabilizers and antipsychotic medications. Medicines like Lithium or Valproate with Risperidone will help in early recovery. Without treatment, she cannot take decisions properly. She can even harm your siblings. Presently she is not having any insight of her illness and requires urgent treatment. I suggest you visit a nearby psychiatrist as soon as possible for her treatment. Hope my answer 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: I am a 19 year old girl, currently suffering from lumbar/lower back pain. The pain started suddenly two months back and I have never had a history of back pain. There is intense pain in my lower back. Currently, I cannot bend down, sit for a long time, squat properly and carry heavy things amongst many things. Sometimes, I feel a sharp pain and a numbing sensation on the side of my hip. I have consulted several doctors and done an MRI scan of my lumbar spine but I am not getting a proper diagnosis for my problem. I would appreciate it if I could get a second opinion on what could be the problem. ### Response: I have seen the reports (attachment removed to protect patient identity). Primarily, L5-S1 is the source of back pain. Your symptoms could also be coming from core weakness (or muscular) or could be SI joint in origin. I need more clinical information and examination findings to confirm one from the other." "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 shout or blow hard with my mouth, I get headaches or dizziness. Why? ### Response: Hello. I understand your concern. The headache you feel is due to increased intracranial pressure when shouting or blowing. Avoid such habits. If it happens without shouting or blowing, I suggest you consult a neurologist to rule out neurological problems. All the best" "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 age is 36 and I had tubectomy done 18 years back after second delivery cesarean like my first delivery. I do not know whether the fallopian tubes were tied, cut, clamped burnt, or banded.1. Is there any scanning or some other method to identify the process of tubectomy done to me? 2. Is there any chance of getting pregnant naturally after tubectomy done by whichever method mentioned above? 3. To have a child now can we go for IVF, if so at the time of delivery will gynecologist come to know that I underwent IVF process for pregnancy? Because she has to do tubectomy again, she will go through with these tubes at delivery time. ### Response: Hi. The method of tubectecomy can be identified only after opening during caeserian section or through laparocsopy. If tubal ligation is done you cannot conceive naturally, if you try there are chances of ectopic pregnancy. You can go for IVF for another baby. Course of the pregnancy through IVF and natural pregnancy will be same. In case of delivery if normal delivery, you do not have to go through tubes. If going for caesaerean section you can identify it was previous surgery." "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 taking Sibelium 10 mg from last some weeks for my migraine and last month I missed my periods. Kindly clarify the reson. Is it delaying due to this medicine? ### Response: On the aspect of missing your period can be Sibelium (Flunarizine) because it has some effect of blocking the dopamine receptor in the brain. Besides, it is a calcium channel blocking effect. So the possibility is that by blocking the dopamine receptor that will cause a central increase of prolactin. Prolactin will lead to galactorrhea and in turn, alter the menstrual cycle. So it is a possibility that is if you have done a pregnancy test and it is negative. So that dopaminergic antagonistic may cause amenorrhea." "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: Results from an HSG procedure showed that I have a bicornuate uterus or a thick septum. Both Fallopian tubes are patent. But there is an abnormal position of the uterine body, possibly due to a cystic nodularity in the right adnexa, displacing the entire uterine body toward the left side of the pelvic cavity. Currently trying to conceive and I\m pretty concerned about the complications with both fertility and pregnancy due to the potential above diagnosis. Further clinical evaluation is recommended ### Response: If it is required, the surgery is known as a Strassman metroplasty.This surgery may be recommended if a woman has repeated miscarriages and bicornuate uterus is thought to be the cause.Performing this procedure, as a solution to infertility, is controversial, as the majority of research carried out suggests that having a bicornuate uterus will not affect a woman's chances of falling pregnant.Some evidence suggests that problems, such as miscarriage and early birth, are more likely in women with the condition, though it does not rule out a successful pregnancy and natural delivery.Women with a bicornuate uterus who do become pregnant should have additional monitoring and checkups throughout their pregnancy, to minimize risk and identify any problems early on.It's not necessary that all those with this condition will get problems with fertility or pregnancy but the chances are more especially if it's septate uterus where there's full septum diving uterus into two.Sometimes it can't be established on imaging and laparoscopic view may be necessary." "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 9 weeks 3 days pregnant. My doctor has diagnosed me with gestational diabetes. At my 1 hour test, my levels were at 170, which was high, but they told me it was low. I was scheduled for 3 hours test and was told to eat sugar treats and sugar drinks three days before my test and then to fast on the day of the test. I failed all the three tests. I have been told that I was obviously going to have sugar in my system, so that is why it came out high. Was the test done right? ### Response: Let me make a few corrections in the methods done. I have not heard of the methods done. Gestational diabetes is caused by the hormones of the pregnancy, which appears in pregnancy only after 26 to 28 weeks, the time when pregnancy hormones are at the highest level. So, any diabetes occurring before 28 weeks is called pregestational diabetes. It is important to know because in gestational diabetes mellitus (GDM) by 28 weeks the baby is fully formed and abnormal sugars cannot lead to any abnormalities in babies other than an increase in birth weight and amniotic fluid. But, if the sugar rises early as in your case (before 28 weeks) this can affect the normal growth of baby\s tissue. You will need to be put on Insulin to correct sugar before any damage is done. We do not need to give such challenges in pregnancy to know that your sugar level is high. I would suggest you undergo HbA1c (glycated hemoglobin) as this checks your blood sugar level of last three months. Your level should be less than 6.5 %. If it is more than this, then you need to be treated with Insulin. Have fasting blood sugar at the morning after the overnight fast of 8 hours and postprandial sugar after 2 hours of food. These two blood levels will help you decide the doses of Insulin. Also, you can take a second opinion from another doctor." "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 30-year-old male. I am currently using phimocure silicone rings to loosen up my foreskin. Yesterday afternoon I accidentally used a large ring 26 mm by wearing it for 1 hour 30 minutes. After taking off the ring, I have this persistent pain like burning and pressure on the tip of the foreskin (majority on the left side). I still have this pain and wanted to know if it will go away by itself? I am also using Betamethasone cream. ### Response: Hello. I have gone through your queries. The only solution to phimosis is circumcision. However, you may have minor vascular injury inside the foreskin due to the use of a tight silicon ring. You can wait and watch to buy some time for natural regression of the swelling or else you can straightway go for circumcision after consulting your local urologist. By few days to weeks, the swelling will reduce. But the permanent solution of phimosis is circumcision." "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 teeth are orange in color since I was born. What is the treatment to make them white? ### Response: I have gone through your question. I can understand your concern. In case, there is any sort of stains, plaque or calculus, you need to visit a periodontist and get oral prophylaxis done with post-bleaching. In case, there is thin enamel and the yellowish discoloration is because of dentin reflection, you may need crown replacement or composite build up. I will recommend you to upload some pictures of your teeth so that I can provide you better possible diagnosis and treatment plan." "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 18-year-old 155 lb 5\5"" female that has a fever of 101\xb0, chills, chest pain, congestion, coughing, and rashes spreading to every part of my body. ### Response: Hi. By the symptoms you have stated, you probably have a viral infection. Take bed rest, plenty of oral fluids, symptomatic treatment (Paracetamol or antitussives, decongestants, analgesics, moisturizer cream, etc.,) according to your local availability. If not decreasing with these measures or any serious problem arises, you can immediately consult nearby health center for further treatment." "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 teenager and I got periods five and a half years back. In the start they were irregular. I took medicines for 21 days and I got my periods after a month but as soon as I left them after three months my periods became irregular. Then for some time I did not take any medicine, but still, my periods were irregular. I used to get two to three menses in a month. I got very sick and anemic. I stayed in the hospital for three days where I was given intravenous iron treatment, three bottles. I had regular periods after that for a year or less. But my doctor told me to consult a specialist. After that, they were again irregular and then I had them for five months without stopping. I have taken many medicines but all in vain. It has been five years and my periods are irregular. Still, I have got two menses in this month. I have become so skinny and my weight has not increased for the last five years. I will be very grateful if you suggest me something to get better. My ultrasound results do not have any problem. ### Response: I understand you are deeply troubled by your menstrual cycles. Heavy and frequent bleeding as you suggested will cause anemia and weakness and needs to be treated. On the other hand, if periods are infrequent and less flow, you can treat it without medications too. In your case, your BMI (body mass index) is very low which is not healthy at all. First, you need to eat healthily. Include lots of proteins and lots of iron-rich foods in your diet. Secondly, the cause of this bleeding is a hormonal imbalance which usually gets better as you move on to your 20s. Meanwhile, you will have to take hormonal tablets regularly for at least one to two years at a go without changing the medications. 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: This is for my husband. He is a 34-year-old athletic male. Exactly a week back, he got a fever, body pain, cold, and cough. He had a high fever for two days and then a bit high temperature for a day with tiredness. Again he started feeling tired, some fever feeling inside the body (outside no temperature), body pain, throat pain with yellow phlegm and cough. He had Dolo 650. Can you suggest some medicine? ### Response: Hi. I can understand your concern. By your history and description, the possibility of pharyngitis is more likely in your husband. Yellow phlegm is suggestive of bacterial infection. So he needs antibiotic like Augmentin for five days. Please let me know his weight so that I can guide you better about the dose of Augmentin. I will be happy to help 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: I am a 23 year old female. My BP and sugar are normal. How to treat dark circles? ### Response: Hi. This condition is very much related to lifestyle. In females it is mostly due to stress, poor sleep, poor nutrition and excessive blood loss due to menstruation and excessive work load. Other condition like fever, typhoid, malaria, thyroid and long-term chronic disease can cause it. It can be due to sun exposure and tanning. Sometime, it is also natural due to depressed eye socket face structure. Treatment are as follows:" "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 brother met with an accident 20 years ago. Now, he has some numbness in his hands. We have attached the reports of the scan had recently. Kindly suggest treatment. ### Response: I have carefully reviewed the uploaded MRI (magnetic resonance imaging) report (attachment removed to protect patient identity). It indicates cervical spinal cord compression in the cervical region. This compression is responsible for his hand numbness. For this reason, I recommend consulting a neurosurgeon and discussing a decompressive surgery and other possible treatment options. Meanwhile, it is necessary holding a cervical collar. At the lumbar spine region, there are also some similar problems. But they are not related to the hand numbness" "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 a positive ANA and Scl 70. I just do not get it. I am in shock as I am sure anyone else would be. Does this mean for sure he has scleroderma? He has no symptoms. ### Response: Hello. Positive ANA (anti-nuclear antibody) suggestive of some form of autoimmune disorder or connective tissue disorder. Anti-Scl (scleroderma) positivity suggestive of scleroderma. But provide me your report as an attachment for giving more comment as I want to know reference range of anti-Scl 70 (anti-topoisomerase antibody) for that laboratory" "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 is 13 weeks pregnant. Though she takes Doxinate tablet once a day, she still has vomiting. Also, she often gets a stomach pain which eases in five minutes. We have discussed with the gynecologist about these issues and he had suggested a full abdominal ultrasound. In the ultrasound, they found a small sludge in her gall bladder. So, the gynecologist had suggested we consult a surgeon. The surgeon recommended a surgery. If not done, he says the mother, as well as the baby, are at risk. My wife is very depressed after hearing this. He has prescribed Rablet-D and Ursodiol for 10 days. Another issue that she faced is that in the last three days, she felt a mild pain in the lower abdomen. This pain also eases by itself in 30 to 40 minutes. Though we missed discussing this with the gynecologist, the USG report shows that everything is normal. I have attached herewith the latest USG, and blood test reports. Please guide us. ### Response: I have gone through the reports (attachment removed to protect patient identity). It is good that you have consulted a surgeon and arrived at a diagnosis. It is nothing to panic about. If there are any further doubts you can always consult 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 father is diabetic and have kidney stones. Recently he saw blood in his urine after walk(exercise) what\s the reason behind it??? ### Response: " "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 33 years old and still unmarried. I am really stressed about marriage and kids. Is it very difficult to conceive after 30? ### Response: Hi. I read your query and understand your concerns. It is true that the chances of pregnancy decrease with the advancement of age but pregnancy are still possible upto 45 years of marriage. The chance depends on the number of follicles available in your ovary which varies from person to person. I also like to inform you that stress is one of the important parameters which decreases the chance of pregnancy so it is very important to keep it under control. Having stress free life is very important for your general well being as well as sexual health." "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 hypothyroidism for 24 years. I also have Sjogren\s syndrome, but I do not have autoimmune thyroid problems. I was taking .150 mcg of Levothyroxine for 23 years. Six months ago, my doctor told me that I have hyperthyroidism and lowered my dosage to .137 mcg. I had increased fatigue.Again she reduced it to .125 mcg, and I experienced extreme fatigue, weight gain, muscle weakness, and joint pain. I had increased sleeping for 20 hours on weekends. But still, my doctor told me that my TSH is high, and she reduced the dosage of Levothyroxine. My free T4 is normal. I have never tested T3. I am worried regarding the TSH. I had a TSH of 0.05 mIU/L before five months, 0.02 mIU/L before three months and 0.1 mIU/L before a month. Should I have to see an endocrinologist? Please help me. ### Response: I have gone through the attachment (attachment removed to protect patient identity). Your TSH (thyroid stimulating hormone) is in the lower normal range, just near the border. The dosage of Levothyroxine has to be reduced. Try to maintain TSH around 2 mIU/L. Please test your FT4 (free thyroxine) levels. I believe that you experience fatigue due a secondary cause. Ask your doctor to get anemia workup done, get vitamin D, and calcium levels. If your results have not shown any abnormalities, then it is better to consult a rheumatologist rather than seeing an endocrinologist in my opinion." "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 a history of hypertension for the last 13 years. My BMI is around 39 and recently I found grade 1 diastolic dysfunction. What is your advice on going out to the office? As I am working in a bank and it comes under essential services. What precautions should I take against COVID-19? ### Response: Certainly, you fall into hig-risk category and prevention is very important in your case, so ideally you should avoid going to bank or outside as much as possible. But this may not be possible for essential service providers like you, doctors. If you could not manage to stay home then take full precautions like using mask all the time, keeping distance from all the individuals, using sanitizer frequently, etc. If your BP is remaining above 140/90 mmHg for most of the times then you need to get some more medications added like tablet Cilinidipine 10 mg once or twice daily depending upon the requirement. Also, LDL cholesterol of 181 is too much elevated and you need to be on medication for it as well along with healthy lifestyle like tablet Rosuvastatin 10 mg bedtime for eight weeks. So, you need to take full precautions as you fall into high risk category. 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 itching and burning penis with a red rash which burns sometimes and it has been there for 20 days. It reduces and increases some times. I have used FourDerm and Candid B but what could be the problem? Kindly suggest. ### Response: Hello. 1. It seems you might have a fungal infection and the creams you are using are harmful in that. So stop using them at once. 2. Send me a picture of the area, if possible. 3. Meanwhile, apply the cream I am prescribing below. Tinea cruris. 1. Tablet Sebifin 250 once a day.2. Tablet Levosiz 5 mg at night.3. Cr Lulifin apply at night.For 15 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 27-year-old male. Over the past several months, I have had many sleep disturbances. I have recorded myself sleeping. Several times over the last two weeks, I have episodes that last two to three minutes and occur 10 plus times a night. During the episodes, I move my eyebrows up and down, move my nose like I am sniffing something, grind my teeth and open my eyes often looking to one side. I also move my legs up and change positions. I have also woken up with sore arms and sharp pain and numbness in my tongue. In the mornings I am often confused and can feel verytired during the day. The only medication I am currently taking is Lexapro for social anxiety. ### Response: Regarding your concern, I would explain that your symptoms could be related to a sleep disorder or epilepsy seizures. An electrolyte imbalance or vitamin D deficiency may also lead to abrupt leg movements during the night, but not typically the other movements (teeth grinding, eye deviation, etc.). Coming to this point, I would recommend performing an EEG (electroencephalogram). A polysomnogram would help investigate a possible sleep disorder. It is also necessary to check your blood electrolytes. You should discuss with your doctor on the above tests. Hope you find this answer helpful" "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 an allergic reaction (hives) to Fluconazole. What can be done to reverse the side effect of this medication? I already went to the doctor over five times in the last three weeks. This is going on for four weeks. All the doctor does is give me itching medication. I am itching really bad. ### Response: Hello. It can be a reaction to Fluconazole, but we should rule out other causes as well. As you mentioned that you are not responding to itching medicines like antihistaminics, you need to be started on steroids like Prednisolone. But before starting steroids, I suggest you visit a dermatologist for examination, confirmation of diagnosis and get some blood test done like hemogram including WBC count and ANA (antinuclear antibody) levels, liver function test and renal function tests to rule out infection as steroids may be detrimental. Until then you can have tablet Montair LC (Levocetirizine plus Montelukast combination) one at bedtime, which is a higher antiallergic medicine, and Lactocalamine lotion for topical application. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. 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 26, male and height 163 cm and weight 82 kg. I am suffering with small lump like peanut size and smooth in nature outside of the anus and it is paining and bleeding while passing the stool from the last 10 days. Earlier I did not have that lump and pain or bleeding. Could you please suggest some medication or treatment plan? ### Response: Firstly, I would like to assure you that you do not have to worry because there is always a solution to your problem. Having said that, I would like to let you know that, it is very important for a doctor to have the area inspected and examined before reaching a conclusion, as you have mentioned presence of a lump. Therefore, you need to consult a surgeon in person and allow him to examine. Do not feel uneasy or worry about it at all. As of now, use Smuth ointment at the anal region. It helps in counteracting the pain and discomfort. Do a sitz bath twice daily. Sitz bath needs filling up of a tub with warm water and mixing in some salt in the water. You need to sit in the water for about 10 minutes twice daily. These would help ease the pain and fight your problem. Again, I would like to remind you to see a surgeon in person for inspection and treatment. Stay healthy and positive." "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 baby (one and a half months old) is having red pimples in a cluster on both cheeks. It is very rough to touch and skin appears dry in that area.It does not cause him itching as far as I can see and it is not bleeding or oozing. It has black dots (like when a wound heals) in some areas.Is it a long lasting skin problem? ### Response: Hi. And skin in such cases are" "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 33 years old and married. I am not able to have sex more than once as my penis doesn not erect. I have this problem for the past 1 to 2 years.I used Confido tablets also for the same but no effect. Please help. ### Response: Two tablets two times a day for about two months will help to make your erection strong and you will be alright. You can visit a good chemist for this" "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 itching on my foreskin. I observed creamy deposit behind the foreskin reappearing every day despite washing my penis by pulling foreskin. I feel very itchy on the penis when I pull back the foreskin for washing. Now I am using Cetaphil. This problem has occurred three times in last six months. Cetaphil has helped. I am worried about frequent reccurrance. Should I meet a dermatologist? ### Response: Kindly send image and revert back. From your history, it can be candidal balanitis" "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 25 year old female, and I am trying to conceive for the last 1.5 years. My husband works for a month in another country and has 15 days of leave. So, when he goes to work, I do not accompany him. We have tried conceiving many times, but we did not have any luck. My menstrual cycle is regular, and it is of 28 days. I also got a Humog injection last month, but it did not help. ### Response: Hi. How are you doing? Let me start on a positive note that, you are at the right age for pregnancy (19 to 35 years), so never lose hope. Hope I have cleared your query, do write back. All the best." "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 interested in LASIK laser. My eye side number is R = - 1.75 and L = -2.25. My cornea focus is 590 590. Please advise me a little bit about what to do about customise Vs. bladeless technique surgery. ### Response: I think it is a good decision to go for LASIK as your refractive power and corneal thickness is within requirement, ideally, both eye numbers should be same for LASIK but you may ask your LASIK surgeon regarding this. Also, I prefer bladeless LASIK, that is femtosecond LASIK which is much better than using microkeratome. In bladeless LASIK all the steps will be done by LASER. So, it is better than customised LASIK. I hope I have solved your 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: Three months back, I had a wisdom tooth extraction. Still, I feel tongue numbness. What is the solution? ### Response: Hi. The tongue numbness is caused by nerve injury or irritation at the time of giving local anesthesia before your tooth removal or even due to the closeness of the roots of your tooth to the nerve bundle. However, this is usually transient and there is a gradual recovery of your nerve function. Since this is the only symptom, there are higher chances of restoration of nerve function. It usually takes six to nine months for complete recovery. There is a small chance that it may be permanent. Also, you can consult your dentist regarding the same. He or she can do a thorough check up of other areas and determine the extent of the numbness. You can also increase the chance of healing by taking a nerve growth factor like Neurobion. You can get it prescribed by your doctor after discussing the problem with him or her." "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 is suffering from chest pain for the last six months which is during for about 30 seconds to 1 minute and he says he is feeling like his heart is vibrating, poking during the pain. He has consulted a cardiologist four months ago and has taken ECG, echocardiogram, treadmill stress test but the report is normal except on comments it was mentioned as mildly hypokinetic mid and apical anterior septum and conducted treadmill stress test for possible ischemic but the result came as negative. And when asked about any prescription, the doctor has denied prescription suggesting it is gastric problem, nothing to worry about but again the pain has started and he is even afraid to sleep (keeping alarms once in two hours). Can anyone please suggest is this something serious? ### Response: It does not appear to be a serious problem. Cardiac pain is unlikely to occur for this short time. It typically occurs on exertion and relieves with rest, and persists for 5 to 10 minutes. Such rest occurs usually due to gastritis and reflux disease. He should avoid fatty, oily and spicy diet. Have some walk after having food instead of taking rest. Have multiple small meals instead of heavy meals. Have regular sleep habits and avoid stress. Lots of green leafy vegetables, fruits. Avoid smoking and alcohol if any. He should have tablet Pan DSR (Pantoprazole, Domperidone) 40 mg or Esomeprazole, Domperidone combination before breakfast once a day for two weeks. If not adequately relieved, then you should add syrup Sucral O (Oxetacaine, Sucralfate) or Gelusil two teaspoons three times a day for a week" "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 Listeria monocytogenes colonise and proliferate on a plate that had plain pasta on it but pasta has been taken out, and plate left out for about a week at room temperature? I am 16 weeks pregnant, and when I was washing said plate, I spilled some of the dirty water from it onto a tea towel that my husband then used to dry a cup which I then drank water out of. I am wondering how likely if at all that listeria may have contaminated my cup through the tea towel. ### Response: Hello. I understand your concern. I suggest that you get a culture for listeria from the cloth which was used. It is difficult to predict if the water was first infected with the bacteria. Then if it would have survived for the time. Follow-up if you have any fever or symptoms." "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 mild acne for years and it seems to be under control now with an occasional break out here and there, mainly just trying to fix scarring. I am a 26-year-old male. Currently, I am using the Menscience brand facial wash, Mirco scrub, and rosewater toner. I lie to keep things simple. I just started the facial wash and scrub about a couple weeks ago, alternating between the two so that I do not over exfoliate, and it has been good to me. No breakouts or irritation and I can tell slightly that my complexion is better. I also try to do some organic and natural remedies on occasion, like turmeric powder face masks to lighten the dark areas.I was intrigued by the menscience products due to the glycolic ingredient in them as well as salicylic acid. I have researched that these are good ingredients to slough away dead skin cells so I can fade these scars.Now for the big issue, my face looks pretty decent in natural lighting or inside the house but as soon as I step into direct sunlight, I look horrible. It is a complete change from what I see in my mirror at home and I am wondering if I need to add more glycolic products to my regime or what.I see other\s face and direct sunlight does not show imperfections like it does mine. It makes my face look 10 times worse and I do not know what to do. I do not want to just avoid sunlight to fix my paranoia, I want to fix the problem for good.I get regular microdermabrasion treatments monthly in conjunction with my current products that have the glycolic acid. Do I just need to give these new washes more time to slough away the scars and smooth it out or should I incorporate a glycolic pad to speed up the process? ### Response: Hi. I am glad you asked this. Could you also upload a photo of your face both indoors as well as in natural daylight? I need to have a close-up view to pinpoint the diagnosis and suggest a remedy. I appreciate your concern." "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 line going down my tooth that can only be seen under direct light. It looks a bit like a crack. I cannot feel it when I run my finger or tongue over it. Should I be worried? ### Response: Hello. The line which you have mentioned can be a fracture line which is sometimes very superficial. I would like to know about any pain or sensitivity associated with the tooth. If it is a deep fracture, it is generally painful and sensitive. On the other hand, if it is a fracture line, it can be caused by various hard foods. In case you have any associated symptoms, you can visit a dentist" "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 7 years old boy has asthma for about a few years. From yesterday night, he is suffering from cough and vomiting. He is having continuous vomiting of whatever he eats or drinks. The medication used until now is Budecort 200 and Ascoril. Please suggest some medicines for immediate relief. ### Response: Hello. The child will need nebulization with 2ml Duolin (Levosalbutamol sulphate and Ipratropium bromide) plus 2 ml normal saline. Considering that the child has not been able to keep anything in the tummy and having repeated episodes of vomiting, I would suggest an Iv (intravenous) line be put in the hospital for giving Iv ondem and Iv fluids if required after getting the child physically evaluated by a pediatrician. Take the child to the nearest hospital for nebulization and iv line administration. The saturation is also needed to be monitored for this child. An x-ray chest should be done as well." "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 tag like structure near frenulum on one out of two ducts which goes on both sides under the tongue. Kindly have a close look and advise. ### Response: In the image (attachment removed to protect patient identity), the lesion looks like either the after effect of an injury to the duct or salivary gland stone or a papilloma. Nothing to worry. This can be removed by surgical excision of the lesion. After that send the specimen for histopathologic examination for confirmed diagnosis" "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 daughter is just five and a half months old and yesterday I started her on solids. Before that, she was exclusively on breast milk. I gave her a packaged wheat and apple baby food. Two hours after she ate it, she vomited everything out. So, the rest of the day I just gave her breast milk. I had mixed one teaspoon of the powder with 30 ml of water. Is there anything to worry about? Also, what can I give as a substitute? There is no sign of weakness or discomfort. Also her neck is not yet fully stable and she still cannot sit on her own unless supported on our lap. Is this normal? ### Response: If vomiting has reduced and she is active, there is nothing to worry. Follow the instructions given. If there is vomiting even after that, please consult your pediatrician" "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 five years old, and he was suffering from fever, headache and body pain. He also had some rashes on his face and in some parts of the hands and legs. His fever was ranging from 101 to 102.5 degrees. After a couple of days, on medication, his temperature became normal between 97.5 to 99.5, degrees and he is fresh now. His platelet count went down to 160000 from 280000 in two days.His lymphocyte count is high, and neutrophils counts are low. He did not have stools for the past two days, but he passed out stools three times in normal consistency and one time with a loose stool this morning. He is feeling fresh now. We have done NS1 test for Dengue before two days, and it came out negative. Does he require any particular attention to control platelet count or is it normal? Please suggest. ### Response: Hi. The report suggests some form of viral infection (attachment removed to protect patient identity). You have ruled out dengue. He has platelets of 160000 platelets per microliter of blood, and it is in a normal range. There is no medicine available to increase platelet count. I advise you repeat CBC (complete blood count) after two to three days to see the platelet count. I am pretty sure that the platelet count will get increased." "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: Recently my neurologist diagnosed me with complex partial seizure. However, after taking two different medications and increase in doses has not helped. So here is my story: several years back I had been going through an extreme amount of stress. I had some migraines: occasional sharp pain in the frontal lobe. As time went on, I have been having strange episodes from once a month, to once a week and every day now for several years. Symptoms: Dozing off (spacing out) without realizing, lasting two to five minutes when it first started. But now it lasts less than a minute.Staring.Uncontrollable head movement from side to side.Head tilting downward.Feeling numb.Blurry vision.In some ways, I feel paralyzed as in if I want to speak there is a delay. Also, if I want to move there is a delay. I do not know when I go into these episodes but I sometimes know when I come out of it. No abnormality in blood tests, no abnormality in MRI. No abnormality in EEG testing as well. My neurologist determined based on my symptoms. I was prescribed Lamotrigine 100 mg daily increased to 200 mg. This did not help. So, I went on Carbamazepine 400 mg daily increased to 800 mg. This did not help either. So, is it actually a seizure or could it be something else? Do I need to continue trying different medications? Please help. ### Response: Hello. Based on the description of these episodes, I agree with your doctor that these episodes seem to be related to complex partial seizures. I would like to directly review your EEG (electroencephalogram) reports if you can upload it. A normal EEG is not surprising in complex partial seizures." "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 picked up a grade 3 hamstring injury from playing football around four months ago. Stupidly, I tried to play football again three to four weeks after the initial injury which caused me to pull my hamstring again. I have then left it for around two and a half months and I have slowly tried to get back into exercise. I started by cycling which I had no problems with I have also been away skiing and I have not felt any pain whatsoever. However, since I came back from skiing I went to play football yesterday and although I was fine for the majority of the game once the game had finished I noticed my hamstring felt sore. It also is still a little bit sore this morning, is this a good thing or a bad thing? I could easily run on it now no problem but it does feel slightly sore. Is there anything I should or should not do? ### Response: I read your concern. In my opinion, you had enough time to recover from tears. However, a grade 3 hamstring injury needs a bit more concentrated management. I think you should do proper rehabilitation to completely gain strength and stability. Exercises like bridging, single-leg bridges, clamshell, swiss ball jackknife, swiss ball hamstring curls, step-ups, and goblet squats will help you gain stability and strength. Slowly you should start running. If everything goes well then you should start gradual progressive running sessions. These exercises to be done for three weeks and then progress with the next level of rehabilitation. After progressing to full strength and stability and once you are confident then slowly you should return to play. 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 32 years old. I am on PEP that has to be taken for 28 days. I got my first dose around 40 hours of being contracted to HIV. PEP is not 100 % secure. My question is if I am lucky and the result shows HIV negative after the therapy, how often do I need to get antibody tested if luck showers on me and each time the result says negative? And if PEP does not work properly and I am tested positive, how long can be my lifespan if I stay on medications? ### Response: The answers to your queries are: For PEP (post-exposure prophylaxis) efficacy, adherence to the medications prescribed for PEP is the most important thing. PEP is really efficacious, To the best of my clinical practice, I have not seen any case of a patient who has completed PEP with complete adherence and then turned positive. There are recommendations to test at four weeks, three months and then at six months of last exposure. You need not be tested in between and if negative, no further test is required." "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 18 years old and I have a question. Can masturbation lead to pregnancy? I am worried about a situation like when I masturbate in my pants and if my partner touches my pant with her hands and then she goes to the washroom to do female masturbation which means that now she has my semen on her hands and that semen might enter her vagina and make her pregnant? I am not sure if sperm will survive or die and it is really a matter of concern to me. My mind is full of what if it happens. Please share your knowledge and also if there is a chance of spreading STD/STI /HIV/AIDS in this situation. ### Response: Hi. Outside of the body, sperm may die quickly when they are exposed to the air. So it is very unlikely for her to get pregnant if she touches your pants and do masturbation. Infections are usually transmitted because of direct skin to skin contact or else with unprotected sexual intercourse unless the partner had any particular sexually transmitted infection" "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 blood test shows platelets and monocytes above the normal range. Is this a sign of cancer? ### Response: There are two types of thrombocytosis, primary and secondary. Primary thrombocytosis is a disease in which abnormal cells in the bone marrow cause an increase in platelets. Secondary thrombocytosis is due to another condition the patient may be suffering from, Increase of monocytes indicates there is a chronic infection, an autoimmune or blood disorder, cancer, or other medical conditions." "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 started bleeding heavily after taking Mifepristone. It was not regular periods but thick blood clots, which lasted for a day. On the next day, I inserted a Misoprostol in the vagina, as I will be taking one tablet after every 12 hours (in total four tablets). After the first tablet, I got cramps but no bleeding. Now, I am waiting to put one more tablet after 12 hours, but I am worried since I did not bleed after the first tablet. ### Response: Hi. How are you doing? Mifepristone is a hormonal pill which will dislodge the embryo from the uterus, that is the embryo will be will be free from the walls of the uterus after 48 hours. Having four tablets of Misoprostol 200 mcg orally or vaginally at a time is simpler, easier, and can avoid all the confusion of having it at repeated intervals. But remember, if you are using vaginally, just wet it before keeping the tablets, or else they will not dissolve and will have no effect. Hope I have clarified your query, do write back." "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 30-year-old female and a mother of a six-month-old baby. My husband and I are having unprotected sex every alternate day and I am taking emergency pills on alternate days. I want some permanent solution. Can I take oral pills like Unwanted 21 pill every day after having unprotected sex? Today is the fifth day of my period and we had sex today. Can I take Unwanted 21 tablet from today onwards? ### Response: Hi. Oral contraceptives like unwanted 21 are to be started on the first day of your menstrual cycle also called D1. Then you need to take one tablet daily almost at the same time to get better results. As the pack contains 21 tablets, take it for 21 days. Then wait for seven days and then start a new package again. During this seven day break, you will get your periods." "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 6-year-old boy had an accidental fall while riding a scooter. Got a gash above the eyebrow. He was wearing spectacles, and the lens might have caused the gash. Took him to the nearby hospital, where they have given painkillers and antibiotics. They have not stitched up the gash. We are waiting for a plastic surgeon to come in the morning. Should the stitching be done immediately? Does it need to be done under local anesthesia or in OT? ### Response: Hello. It is good if the primary treatment was given immediately. As the wound is on the face, above the eyebrow, it would be advisable that a plastic surgeon does the suturing. As it would be cosmetically better in all aspect. Waiting overnight would not cause any major difference in the remission and healing of the wound. It is to be done under local anesthesia, preferably in minor OT (operation theatre)" "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 looking for a third opinion. I have positive cardiolipin IgM and IgG. Tested three times over 11 months. Keeps elevating. What should be done about this? Two current doctors say it is normal. ### Response: However, to diagnose the case as antiphospholipid antibody syn" "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 unprotected intercourse with my fiance during the first week of last month. Same week, within few days she complained about vomiting sensation but had no vomiting. Immediately the next day she had a little discharge from vagina and a little menstrual cramp. Her last menstrual period was in the last week, two months back. The local gynecologist told it is because of gas and gave an antibiotic tablet, multivitamin syrup and gas related tablet. The following day, early morning she felt headache and a body ache. Is it something to be worried about? Is she pregnant? When do the earliest symptoms of pregnancy come up? ### Response: Hello. These are not pregnancy symptoms, but rather they are symptoms of ovulation with mild abdominal ache, nausea, headache, bloating and thin mucus discharge from vagina. As her last menstrual period (LMP) was in the last week, two months back. So, it is day16 today. Hence in a 30 day cycle, this is the time for ovulation. As you had sex in the first week the following month, still she can be considered in her fertile period and hence an emergency contraceptive is advisable to be taken in 72 hours in your case to prevent pregnancy. However, the earliest you can detect pregnancy would be after 7 days post-intercourse with a serum beta-hCG test. If it shows the level of hCG more than 5 ng/dL then shall confirm pregnancy. Otherwise, she would be pregnancy safe. But, at present these are ovulation signs. Revert back after the test to 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 a thyroid patient. Some time ago I went for blood test and found my RDW-CV 18.2 and RDW-SD 60.5. Just wanted to know if there is anything serious. My ultrasound report saying border-line hepatomegaly and mildly enlarged liver. My liver test shows alkaline phosphate value is 114 and albumin protein value is 5.6. Currently, I am taking Thyroxine. ### Response: I understand your concerns. But there is nothing to worry about. RDW (red blood cell distribution width) is used to determine the type of anemia, it indicates the average size of the red blood cells. Your values are a little bit above average but nothing to worry about. Alkaline phosphatase is a substance that increases if there is an obstruction in the biliary system, your value is within normal. Level of albumin is also within normal. The hepatomegaly is most likely due to fatty changes that are most likely due to alcoholic liver disease or high blood cholesterol. I suggest that you perform complete lipid profile. Please tell me if you have any symptoms. In order to see how the thyroid condition is well controlled, please send me the last TSH (thyroid stimulating hormone) level" "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: The color of the skin on my face is too dark when compared to the skin on my nose, cheeks, and rest of my body. How can I restore the original color on my face? ### Response: The skin often darkens due to tanning under the effect of UV (ultraviolet) rays. I would strongly recommend using a sunscreen with a minimum SPF of 30. The sunscreen has to be applied at least half an hour before you go out and has to be reapplied every four hours till evening. I suggest trying skin lightening cream like Biluma (Kojic acid) at night. Alternatively, you could visit your dermatologist for chemical peels like Lactic acid or Glycolic acid peels. Whatever be the treatment, sun protection is a must. Hope this helped" "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 baby is 48 hours old now. Her bilirubin level is 9.1. Is it a cause for concern? ### Response: Hello. I will need more details to analyze the report. What was birth weight? Full-term baby or preterm baby? Blood group of mother and baby?Usually, for a full-term baby with birth weight more than 3 kg, mother blood is not Rh negative or O Rh negative, it is considered normal. But, baby needs observation.Risks for bilirubin high or in increasing trend are: If these things are taken care, you should not worry. But yes, for sure needs observation by doing blood tests for bilirubin and SOS treatment like phototherapy.Let me know after 72 hours what the bilirubin count is. Meanwhile, continue breastfeeding" "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 baby is 4 days old. He is diagnosed with jaundice. His Jaundice levels were 19.6 and post phototherapy they have come down to 13. The doctor has noticed that the baby has high Hb (22.3). The other vital parameters are like PCV- 63.7, RBC- 6.36, WBC- 11600, and platelets- 2.05. The doctor has suggested blood dilution. Please let us know if blood dilution would solve the issue and if we have to be bothered about any other parameters. ### Response: Your baby\s bilirubin is now in safe range. But as his Hb (hemoglobin) is more this may lead to hemolysis, etc. Dilution of blood means they take out blood and replace with saline. This may lead to dilution. But I think in your case if the baby is active we can wait or do a partial exchange" "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: Six months back I was diagnosed by two doctors and tests with carpal tunnel syndrome. The suggestion was to go for an operation which regretfully I delayed until recently. The symptoms got worse. Now I have an appointment next month with a specialist. Meanwhile, I have pins and needles in the most upper part of my arm, basically in the shoulder for 15 to 20 minutes. They come totally unexpected, whether I move or not. They appear up to 15 times, typically in the morning when getting up. There is no pain, it is just very unpleasant and frightening since I cannot control it. Secondly, during the night when in bed my neck becomes very stiff, causing pain to wake me. A new medical cushion has not helped. My question is that are both symptoms related to CTS since I always thought this is located to the hand only. Can I expect relief after the operation or could this be something different? Currently, I am taking Atorvastatin, Atenolol, Exforge, Tamsulosin, Allopurinol. ### Response: Hi. However, it could be due to cervical nerve compression. This could be associated with or without the carpel tunnel syn" "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: For the past three days, I am having unbearable pain in my right ear. I doubt somehow in the meantime of bath some water must have gone through it. And by my right ear, I could not able to hear anything. My right ear hearing capacity is 10-15% and it is closed. I have faced this issue twice already. Please help. ### Response: There are three possibilities for your problem. First is, impacted wax can be there which can create lots of pain, ear fullness, and decreased hearing." "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 19 year old. I have many questions in life to which I cannot find an answer. My parents ran a school and naturally, I attended the same. Even though I did not work very hard, I used to top the class. But, when I reached the fifth grade, I got distracted easily and did not study well. When I reached the eighth grade, I decided to study well and score a good percentage. But, I did not succeed. So, I started to mug up all the lessons. After I completed my schooling I somehow managed to get into a professional course. But, I scored below-average marks. That made me sad and depressed. I was advised by many to quit the course but, some of my teachers supported me and encouraged me to study. But, I repeatedly scored poor marks. Now, my question is, am I really dull-witted or do I have some psychiatric problem? I feel that I have wasted my parents\ money. I had dreams of becoming a professional and making good money. But, I am getting further and further from it. Do I really have no talent? What is the problem with me? ### Response: The main problem which I picked from your description is that you get tensed about studying. You have set up a self-image of a guy who is poor in studies and cannot succeed. I think you are too harsh on yourself. You can take the help of a clinical psychologist to learn to cope better" "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 got her periods one and a half months back. She did not get her cycle back again and then a month later, we had unprotected sex and I gave her Unwanted 72 the very next morning after breakfast. It is almost five days now and she still has not got her periods. We both are tensed and want to know why? ### Response: Hi. Mostly pill is effective if taken within 72 hrs of unprotected intercourse. So, there should not be any chances of pregnancy but still, if tensed, you can do serum beta hCG (human chorionic gonadotropin) test to confirm. You can wait for 2 to 3 days for her periods to come as mostly, it will come" "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 22-year-old healthy male. Yesterday I had my first panic attack and it was severe and lasted long. I have ended up in the emergency room. But they just gave me a Diazepam and I was feeling good again, but they never told me what triggered and I am curious. Last night I drank 110 mg of phosphate codeine (liquid) and drank one 600 ml beer and then smoked Marijuana. Once I get back home which was a couple of hours later, right after I smoked the panic attack started. But I am smoking for six years and just strong strains and concentrated and nothing ever happened before (yesterday I smoked a really non-potent one). My question is, is it possible that the weed is causing the panic attack or it was the codeine with beers? I really do not want that to happen again. ### Response: It could be a combination of Marijuana, codeine, and beer. Also, regular use of Marijuana will cause panic attacks. It is just that the effects of whatever is taken regularly and do not show up immediately. I would recommend that you at least try to reduce if not stop the quantity of the" "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 one of my wisdom teeth is growing in, and lately, it has been causing a lot of pain. I also notice that part of my gums have been growing over the tooth, and the tooth now is almost completely covered. What can I do for the pain, and should I visit a dentist? ### Response: Hello. I understand your concern. The situation you are in is very likely to be pericoronitis, a soft tissue inflammation of the tissues surrounding an erupting wisdom tooth. You should see the dentist at the earliest as the situation may or may not resolve on its own due to numerous variety of size, shape, and eruption pathway of the wisdom tooth. It may also involve occasional cheek bites and ulcerations. You may use topical anesthetic gel and painkillers until you see the doctor." "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 trying to figure out the conversation between levels on a urine drug test and a hair follicle test. For example,Urine test: 505 ng/ml THCA.Hair test: 5.95 pg/mg THCA .If there were 32.6 ng/ml cocaine metabolite detected in a urine test, how might that show in a hair drug test? There seems to be a correlation between the THCA levels, but I cannot figure out what the connection might be? ### Response: Hello. In the urine, the metabolites are detected as it is directly coming out from the blood." "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 41 year old woman and started having severe lower back pain and nausea about a week ago. Went to the ER, had a CT scan, diagnosed with a 6.5 mm kidney stone in my right ureter with mild hydronephrosis. I was given Percocet and sent home with instructions to see a urologist. I was not able to get an appointment until yesterday. Two days after my ER visit, I began having severe chills and running fever as high as 101.5. The urologist did a UA yesterday and said I did not have an infection. And also he did a KUB, which showed my stone had not moved at all. He scheduled me for lithotripsy next Tuesday. I continue to have severe chills and fever. I called his office today and he says I probably have flu. Is it possible that I have an infection in my right kidney? Because the stone is blocking the ureter. But, urine I am passing is clear and uninfected. Please help. ### Response: Though urine culture generally picks up an infection in the bladder, nephritis is more of clinical diagnosis with pain and tenderness in the renal angle and high-grade fever accompanying it. Ideally, you should be started on prophylactic antibiotics to control the infection sooner before septic features or septicemia may occur.I think you should take a second opinion from another urologist too." "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 23 years old, male, I have had thyroid issues since a young child, after a few years they concluded it was thyroiditis. Currently I take Eutirox 75 mg and have for about a year, before that I took 50 mg. Ever since 6-8 months (I am not sure about the timeframe) I have had issues with extreme sweating under armpits, for example I am in a 22\xbaC room and start sweating insanely, I go outside lay on the hot sun and I stop sweating. 2 minutes after putting on a shirt there are considerable sweat marks on my armpits, 10 minutes after it is a huge sweat mark. It is also irregular, some days it is crazy other days not so much. I have never had issues with sweat, ever.On the right side of my head I now have ~8 white hair that definitely were not there a year ago, even 6 months ago it was just ~2 hairs. Attached are my lab results, the doctor said it was normal, However, during the conversation I said my breakfast was a couple eggs, sometimes pancakes, and fresh juice, he replied it should be milk and bread, so I have began looking for another doctor for that reason. What can I do to find the best doctor and would it be ok for me to go back to Eutirox 50 mg while I look for a new doctor or can this cause a serious issue?X-ray resume says the following (translated by me):Thyroid with normal dimensions, right lobe measuring 14 x 50x13mm, and the left lobe 13 x 53 x 12mm, with lobutlated shape. Its ecostructure is diffusely heterogeneous with multiple areas hipoecogenic poorly defined, aspects to which is associated the increase of vascularisation on the Doppler color study, changes compatible with thyroiditis. Near the inferior pole of the left Lobe some reactive ganglionic can be observed, the biggest measuring about 11 x 5 mm. ### Response: You are sweating due to the increased dose of Eutirox and that is perfectly normal and expected in a person with thyroiditis being treated with medication. This only means that you are being correctly treated with respect to your thyroid function. The few white hair that you noted could be due to stress that you have in your day to day life or simply without any reason they can occur. They have nothing to do with your thyroid function. Your breakfast is good but maybe the doctor meant to decrease the calories. I do not see anything that should make you search another doctor but ofcourse it is your right to do so if you wish. Try to live a stress free life and you will find many of your symptoms resolving." "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 it true that gingival fiber does not regenerate once destroyed? Can they regenerate in certain conditions? I got scaling of teeth done recently and developed gaps. I am wondering whether the gingiva can grow into this space. ### Response: Hi. I have gone through your question. I can understand your concern. No, you are not right in this case, gingival tissue regenerates as do others except the nerve fibers, if an injury takes place. Dental scaling is good for the heath of gums and should be employed after every six months. If you have a gingival recession, that cannot be because of oral prophylaxis (scaling). So do not worry. The attachment will happen within 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 nine weeks pregnant. My problem is vomiting. I cannot drink even few sips of water. If I do, I vomit what I ate before. I cannot pass urine also. I am feeling too thirsty, but cannot drink. So, I started to take tablet Emeset 4 mg once a day for the last two days. Is there any side effects in pregnancy? Or any other solution? ### Response: Vomiting is a big problem in the first three months. Afterwards, it reduces completely. Tab Emeset (Ondansetron) is recommended in pregnancy. So, no problem. You can continue 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: I suffer from daily headaches, dizziness, lightheadedness, and fatigue. My platelet count is 514, and my iron binding capacity is 506. My doctor says it is normal and referred me to hematologist due to the high platelet count. However, all my test results show that things are high or low. ### Response: Hello. May I know since how long you are having headache and dizziness? Your platelet count is slightly high. Your Hb level slight low and iron binding capacity increased. So iron deficiency anemia could be the possible cause for dizziness and headache and for that Iron tablets can be prescribed like Ferrous ascorbate. Platelet count can be high in iron deficiency anemia, post-hemorrhage, inflammation in the body, infection, etc., like secondary cause. Your physical examination should be done. Check your blood pressure and sugar level as well. Your otological ear examination also has to be done that can lead to referred headache and dizziness. So, just now secondary cause can be the possibility for high platelet count by IL (interleukin) 6 release. After Iron therapy, repeat your CBC. Let me know if you are having any bleeding problem." "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 26 months old baby suffers from cough the whole night. She has a cold as well but no fever or spasm of the chest. Should I go for Levolin syrup? ### Response: It is better not to give it. It contains only Levosalbutamol which acts as a bronchodilator which is useful in bronchial asthma or bronchitis, etc. There is no mucolytic or antihistamine in it. It also causes palpitations and tremors. I suggest using Flucold syrup. It contains Paracetamol, Phenylephrine, Chlorpheniramine, and Sodium citrate. It acts as a decongestant and antihistamine. Depending upon the weight of your baby, you can use the above syrup. Consult your specialist doctor, discuss with him or her and start giving the medicines with their consent. Use water vapor inhalation and salt water gargling" "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: Will fertilization occur immediately after an egg is released? And will the ovulation test show positive regardless of fertilization has occurred immediately? I had sex three days ago but the ovulation test still showed positive today. Please suggest. ### Response: Hi. Ovulation test is not confirmatory for ovulation. It means LH (luteinizing hormones) hormones increased during the menstrual cycle. Fertilization can happen within 24 hours after ovulation. Once LH surge happens ovulation actually occurs after 36 hours of LH surge. Ovulation test comes positive when LH surge happens. So you should have sex after two or three days of positive ovulation test. It is the most likely time of ovulation. But it is not confirmatory. Ovulation does not always happens after LH surge. Ovulation test does not have a relation with fertilization. Fertilization may or may not occurs even after ovulation." "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 the first stage of syphilis. I came to know about this last month. From the past three weeks, I am under treatment and taking Doxycycline 100 mg capsule twice a day. I took this medication for 15 days. Yesterday, I had a blood test done for VDRL and my value is reactive (1:4). Also, the ulcer on my penis head has not yet healed. I was asked to apply povidone-iodine 10 % ointment on the ulcer. Should I go for Penicillin treatment?I got tested for HIV 1 and 2 tests and CMIA a month back with a value of 0.15 and before ten days, the value was 0.13. Currently, I am consulting a dermatologist. Should I switch to sexologist for syphilis treatment? Also, please suggest what diet should I follow to overcome this disease? ### Response: Hi. Please continue treatment with a dermatologist only. There is no medical degree which qualifies one to be a sexologist. Penicillin is the most definitive treatment for syphilis but get the allergy test done before taking the full treatment. Apply Mupirocin ointment twice a day on the ulcer. Continue your doctor\s treatment as he or she is examining you in-person so is the best judge for the line of management" "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 is suffering from menstrual cycle problem. She is bleeding too much and her period continues for 7 days. Due to this, low BP, headache and lower back problem has started. Since last two years she is feeling weak and less energetic. Kindly suggest good medicines preferably generic names. ### Response: From the details given in your query, it seems that your wife is suffering from abnormal uterine bleeding (AUB). There are several reasons for AUB. For diagnosis, you better do one ultrasonography of abdomen and serum for thyroid function test. Meanwhile, you can try tablet Tranexamic acid to control bleeding. Revert back after the investigations to 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: My fiance and I had a kind of unprotected intercourse for the first time for both of us yesterday. I did not ejaculate inside or outside the vagina. During the whole process, she did not bleed. She was not having her monthly periods, and to avoid pregnancy she took an i-pill after few hours.But a few hours later while she was urinating she noticed bleeding at the vagina (just like during her period). But her period date is far from now.Is it normal or serious? Please help. ### Response: Hello. As for the common assumption that women bleed during first sex, it is a myth. Not all women have bleeding that way. Taking an i-pill was a good idea, but it is important to know that it is 95% effective at its best and can cover only one act of sex and can be used only once in a monthly cycle. The reason for your fiance to have bleeding could be her periods, which came early or due to a urinary infection or due to minor abrasions due to intercourse. In any case, it is better to have a full physical examination by a gynecologist to clarify all of these. 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 recently suffered severe chest pains. Blood results were all fine but heart sonar indicated a 3 mm patent foramen ovale. I just want to know if there is a need for treatment. ### Response: Hi. Small PFO (patent foramen ovale) is usually silent but may cause a stroke or pulmonary embolism if thrombus travels across it from right to left or left to right respectively. Moreover, your report says aneurysm of 12 mm, that needs consideration. I would suggest transesophageal echo to study it in detail. Usually, PFO is closed by the device but an aneurysm may need surgery. So, I advise you to have a transesophageal echo done and then plan will be decided accordingly." "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 18 year old male. Three years ago, a dog slightly bit my hand. The dog died 1.5 years after he bit me. It has been three years now, but I am worried as I heard that rabies appears after years. I did not take any medicine then. I ignored it because it was a pet dog. If I take anti-rabies vaccine or boosters now, will it protect me? The dog was my neighbor\s pet dog. ### Response: I understand your worry with this situation as rabies is considered dangerous. I hope this answer helped you. Feel free to ask if you have any further questions. Best wishes" "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 give the diagnosis of the uploaded MRI brain and CSF studies with a detailed report? Please advise on the action plan as to how to get the CSF findings treated. The MRI report is enclosed. Does the enclosed report co-relate with your findings? The MRI report CSF studies report shows CSF hyperdynamic flow of absolute stroke volume of 110 microliters per second against the normal of 50 microliters per sec per cardiac cycle. Also, my treating neurologist wanted an opinion on the following. Are there signs of NPH? But do the findings of brain atrophy, ventriculomegaly, hyperdynamic CSF flows suggest of idiopathic hydrocephalus and are some intervention required? ### Response: The findings in the report and the images are matching and acceptable (attachment removed to protect patient identity). The term NPH is usually applied in cases where there is abnormal CSF hyperdynamic circulation with gait problems or without gait problems if incontinence is there. Confirming NPH without typical features is difficult in your case. There are controversies regarding NPH and CSF hyperdynamic values and different researchers have come to variable conclusions. Since gait problems are most common in NPH, therefore, most researches have mentioned the importance of gait problems when confirming NPH or incontinence if gait problem is not there. Treatment with shunting might help only when NPH is confirmed. If there is no NPH then the diagnosis is likely due to neurodegenerative disorders and the symptoms can be treated by medicines. There are many different and complicated types of neurodegenerative disorders and a clinical emphasis is more important than only MRI findings when confirming a condition." "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: In my right upper arm, I have a lipoma which grows slowly from three years. Now, I have two new lipomas in the same upper arm. There is no pain as such. Is it normal? ### Response: Firstly I want to ask you whether the diagnosis of lipoma was made by a doctor. Because swellings may be of several types. My advice is to visit a surgeon for an examination in person. The doctor will be able to tell you the best whether you need a biopsy or excision of the lesion or whether no active management is needed. It is difficult to comment without examination. 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 very much feeling depressed due to some health issues. I am having a constant headache due to abuse. ### Response: Hi. Please provide details regarding your headache and abuse. Also, provide details about your current symptoms and like how they started and how they progress over time. What are the medications you are taking currently and for how long? Once I receive this information, I will be able to help 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 had sex two weeks back. My partner used a condom. But, we had a doubt that the condom might have torn. Hence, l took an I-pill within seven hours of sex. I am not sure of bleeding after taking I-pill, but there was some white fluid discharge for few days. My menstruation cycle was very regular. But, this time l had missed it, which was due two days back. Is this normal? Am I pregnant? What should I do? ### Response: Chance of pregnancy is almost nil. The period may be late due to the pill. So, wait for a week and then do a urine pregnancy test to confirm or exclude pregnancy" "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 blood pressure of 130/80 presently. Earlier I had a BP of 160/96 after which I started taking Stamlo 5 once per day on doctors advice. However, in between, I had dizziness, nausea, and vomiting due to which I met another doctor who changed Stamlo 5 to Aquazide 12.5 biweekly (only on Sunday and Thursday). Will I have a severe problem with my BP as the dosage seems too low? He also suggested taking Stamlo 2.5 everyday instead. What should I follow? ### Response: Hi. I can well understand your worries. I have reviewed your query details. If all the side effects are just due to overdosage of Amlodipine (brand name Stamlo 5 mg) then better is to take 2.5 mg (taking a half dose). If the problem resolves, it is fine. If not, then we can go for other medications. My personal opinion is, it looks like you are having problems due to little higher dosage than you need. So keep taking Stamlo but half the dosage (that is 2.5 mg and this is all what your physician also agreed to)." "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 suffer from nocturia. I have had two TURPs done about eight years ago with not much success. Anticholinergic drugs do not work Of recent I was going to urinate about nine times at night with an urge to urinate but little urine coming out. I have been to a urologist and the following were the results:Urine test negative.Ultrasound with no blockages, prostate normal size, bladder emptying with 20 mL remaining.Flexible cystoscopy revealed not much blockage in the prostate.MRI normal after the cystoscopy, I felt burning sensation on the tip of my penis for a couple of days. When that subsided, I decided to have sex after consuming 50 mg of Viagra and while I was erect, I started to bleed. I managed to stop the bleeding.I did not bleed after that incident but I felt burning sensations in my penis and bladder and it has never been the same as before. I took a course of Nitrofurantoin and later the urine test was negative for any UTI. The burning sensation has not stopped and I am taking Imovane for the last month with Diclofenac for the past few weeks just to fall asleep.My GP thought the problem was psychogenic and prescribed Fluoxetine 20 mg because I was having anxiety. I am on fluoxetine for the past week and it has helped my anxiety. My problem is a constant burning sensation in my penis/groin area that increases in intensity after meals. Please advise. Currently, I have been on Nifedipine 20 mg, Ramipril 10 mg, Esomeprazole 40 mg twice daily and Fluoxetine 20 mg. In the past, I have been on Flomax, Cardura, Oxybutynin, Tolterodine tartrate, Mirabegron 50 mg. ### Response: How is your nocturia now? Have you had bladder diary maintained for nocturia? What is your bladder capacity on ultrasound? Burning sensation appears because of minor trauma during cystoscopy. It will take some weeks to heal. I suggest you take syrup Cital (alkaliser) 10 mL in a glass of water three times a day. This will make urine alkaline and relieve buring sensation. Tablet Flavospas (Flavoxate) one tablet three times a day in the morning, afternoon, and evening. Consult your specialist doctor, discuss with him or her and with their consent take the medicines" "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 just now noticing these patches on my skin and would like your input. My skin does not itch but I have been noticing patches on my chest and it is all over my back. ### Response: These patches are due to fungal activity. Let me suggest you some medicines. You should apply and give me feedback. Moist wet skin. Tinea versicolor. 1. Wash with Ketoconazole lotion once daily.2. Apply Terbinafine cream twice daily.3. Take capsule Fluconazole 150 mg once 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: One of my wisdom teeth is growing in at an angle. It does not feel impacted but it is digging into my cheek which resulted in a cut, and the tooth agitates the cut whenever I move my jaw. The pain is not bad but still, I was wondering if it is necessary to remove it. ### Response: Hi. Since it is causing trouble to your cheek and cuts as well, my suggestion would be to get that wisdom tooth removed. If at all you do not want tooth removal, that tooth can be checked and any sharp margins if present can be rounded off. That decreases the trouble, but it is temporary relief. Not a permanent solution. So better visit a dentist and his clinical evaluation can suggest you a better treatment plan." "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 got boiling water thrown on him. Will Taro-Mupirocin help the burns go away or help him in healing the burns? ### Response: Hello. I do not think Taro-Mupirocin will be much effective. Instead of this, you may use Silver Sulfadiazine ointment which helps to relieve the burns and give a cooling effect also to much extent. Also, apply a lot of ice over the burnt area. Ice application helps to heal much faster. Take some anti-inflammatory consisting of Ibugesic (Ibuprofen) and Serratiopeptidase combination to relieve the pain and inflammation." "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 boy of 16 years, height 5\ 11\\ and weight 78 kg. I was wondering if I could consume whey protein. ### Response: Hello. Whey protein helps in fat loss and improves muscle mass. So, if you are interested in building muscles with exercise, then after the workout, that powder can be taken. Diet sprouts and other protein-rich foods can also be taken" "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: What are the possibilities of transmitting HSV2 from an infected woman to a man and how to prevent it if they intend to enter into a relationship ### Response: I understand your concern about the HSV .. before I begin to preventive measures let me tell you it how it can spreads.. It is spread through oral, vaginal, or anal sex. It may be spread even if you do not see blisters. It can also be spread to other areas of your body, including your eyes, lips, mouth, by touching open blisters. Unprotected sex increases your risk for genital herpes. Now as you are well aware about its spreads now you just have to take precautions accordingly. Follow the following advice- Fortunately It can be treated effectively with proper medication.. let me know in the follow up if you need it. I hope this will help you. Regards! Do give your valuable feedback." "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 ankylosing spondylitis (HLA B27 positive) for the past 12 years and with pulmonary tuberculosis the very next year. And took medicine for nine months, and now I am daily taking Saaz, and I am going to plan for Biologics. The doctor suggested Etanercept 50 mg, but I am afraid of side effects as I was already affected by TB before 11 years. Shall I go for biologic Etanercept 50 mg, and what precautions I have to take during biologics? (I have enclosed the report) ### Response: Hello." "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 girlfriend got her periods 20 days back. We had unprotected sex before 14 days and she took an I-pill after an hour. Now, she is suffering from bleeding since seven days which is not too heavy. But, she has lower abdomen pain and backache. Is there a chance for pregnancy? When to expect her periods for the next month? Please guide. ### Response: As she had the pill within the time as well as there was bleeding following that, chance of pregnancy is nil. Now, it is difficult to say about her next cycle. As this I-pill contains high hormone, it can mess up her inner hormonal balance. Due to this reason, she may have late period next time." "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 these painless slightly raised pinkish flesh colored bumps in my throat. I do not know if it is normal or something. Is there any need to worry? Currently, I am taking Minocycline, Levothyroxine, and Sprintec 28. ### Response: Hi. I understand your concern. You are likely to have granular pharyngitis. It may be secondary to sinusitis or chronic tonsillitis. You should consult your ENT doctor for a thorough examination and necessary investigations to finalize the diagnosis and accordingly, treatment may be planned. Till you are waiting for the consultant, you may take the following medicines like antibiotic (broad spectrum), antihistaminic, anti-inflammatory, and steam inhalation." "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 23 years old. I usually get my periods in 23 days cycle. I had unprotected intercourse on my 24th day. I took an i-pill within eight hours of intercourse. Should I take a pregnancy test? Am I safe? ### Response: If your periods did not start by 23rd day, and you had intercourse on the 24th day and took an i-pill after eight hours, then, your cycle would be in the secretory phase, and i-pill would initiate bleeding within 72 hours of intake. If you do not get your periods in another one week, it would be advised to do a pregnancy test to confirm pregnancy or not. Secondly, i-pill may have a secondary effect of delayed periods as well. So pregnancy test is advisable after a week. Mostly you should be safe 99%. For further details, please mention your LMP (last menstrual period) and date of i-pill consumption." "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: The scan for my maid\s husband shows early liver cirrhosis. We need a consultation on the scan. He has stomach pain with water-filled abdomen. Is surgery necessary? ### Response: Hello. I have reviewed your given details. (attachment removed to protect patient identity). I agree with you that he is suffering from end stage liver disease and ultrasound is showing fatty liver. For treatment of water filled abdomen, I need further information to decide whether it can be treated 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 suffering from diarrhea for the past one year. I consulted a doctor, and I did an endoscopy, colonoscopy, and biopsy. I got to know about chronic ileitis and chronic duodenitis. The doctor gave me VSL#3, Doxil 100, and Folvite tablets. I am taking these medicines for 15 days. But I do not have any relief. I am worried. Please help me. ### Response: I have gone through the attachment (attachment removed to protect patient identity). You had done endoscopy and colonoscopy for diarrhea. You do not have chronic diarrhea because chronic diarrhea is always associated with weight loss and malnutrition. I would suggest you take Rifaximin 200 mg twice daily and revert me after a week." "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 diarrhea since three to four months. What actually is happening is I am getting large amount of water which is clear with small broken pieces of feces. Also, I can see tissue like (lace-like) mucus like things in my feces. I have abdominal discomfort when I do not defecate. My diarrhea is like expulsive and when I apply pressure at the coccyx, the water comes out explosively nevertheless, how many times I do this. After defecating, I have mild pain in my legs. I do not have obvious signs of dehydration but yes cheilosis is present and abdominal discomfort. I cannot have my meals properly. But, I feel hungry with gaps, I cannot finish my meal but then I feel hungry after an hour or so. I hope you help. ### Response: Hi. From your symptoms, you could have a chronic infection or inflammatory condition of the colon associated with malabsorption. It could be a number of things so we need to approach in a stepwise manner. If symptoms are associated with certain food intakes like dairy or gluten, it could be intolerance or allergy to these. Please get the following investigations done and let me know the results. That will help us narrow down the list and identify the cause. You have vitamin B deficiency which also suggests malabsorption." "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 22-year-old female with height 158 cm weight 65 kg. I am getting red and pink itchy spots filled with fluid all over my arm, especially elbows for five days now under my chin. Why? I do not take any medications and do not have any medical issues. ### Response: They seem like allergy rash depending on your exposure history to any new cosmetic on arms, or other. You have popped them out, (big mistake), that has caused them to spread more, and get infected with possible bacteria (white spots I can notice). Keep good local hygiene. Wash with warm water and soap, rinse with cold water. Then apply triple antibiotic ointment twice daily, anti-itching cream you find over the counter twice daily, and aloe vera several times during the 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 was given the hCG trigger shot on the 5th of last month after showing a good follicle in response to Letrozole. I first showed positive for pregnancy on the 19th of last month with an hCG result of 17. On the 2nd of this month, I had a transvaginal ultrasound with no visible gestational sac and no indication of ectopic pregnancy as well as an hCG of 806. I was told that the pregnancy was abnormal and that a molar pregnancy was suspected. A D and E was suggested and was told that if my HCG levels still increased, then I will be treated for possible ectopic pregnancy. My pathology reports came back to a normal gestational sac and no signs of a molar pregnancy. Genetic results are still pending. Looking at the reports now, they had indicated pregnancy of unknown location as the cause for the procedure. Is that the usual course of treatment based on my clinical presentation? I am afraid that they had prematurely ended what could have been a viable pregnancy. ### Response: Hello. How are you doing? I am extremely sorry for your loss. Hope I have clarified your query. Do write back if any more queries. All the best" "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 problem of premature ejaculation. I have been masturbating since I was 14. Now, when I masturbate, I am not able to last for more than 30 seconds. I was never able to last more than a minute till now and it has now reduced further. Kindly tell me the cure and immediate steps I can take for correcting this problem. I last for this much time only even if I am not turned on by porn or other stuff before masturbation. ### Response: I can understand that it is probably due to anxiety and psychological reasons you are having this problem. It is normal during masturbation to see early ejaculation, but the time will automatically increase during sex. No need to worry about that. Time during masturbation has no importance. I hope you are understanding what I mean to say. It is a herbal preparation and has no side effects and can be used safely. You can start taking one tablet twice a day and take the tablets for at least 2 to 3 months and you will see improvement in time. Try to remain relaxed during masturbation or sex, avoid thinking about premature ejaculation at that time and you will see improvement." "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 diabetes for five years and taking Metformin M2 Glimepiride 1 mg three times a day. Diabetes was under control for one month. Fasting was 180/200 and PP is 360/400. After taking Vobit M3 daily one tablet before lunch, there is no control of diabetes. Please advise. My age is 57 years. ### Response: Firstly, I would like to ask you if these readings are after stopping the medications or while you were on them. Also, are you following a strict diabetic diet and doing regular exercise? I would like to stress on the fact that even if you are taking medications, your main savior would be a good diet and regular exercise. It helps decrease your medicine dosages and also helps making your body more sensitive to the actions of the medicines. If these are your blood sugar values with medications, they are of very high values. Mainly, you would have to meet a local doctor as soon as possible. And also, you should never stop your medications without a doctor\s advice, as it will lead to more rise in your sugar levels. That can be a threat to your life. If oral medicines are no longer effective for you, you might require to be shifted to Insulin. This would be analysed best by a doctor." "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 went to an eye doctor and did an eye examination because I started feeling dizziness, loss of concentration, neck and shoulder pain, anxiety while driving, in crowds. Dizziness also rises when I am in bed and driving.Not painful, but I can feel the pressure behind the eyes, in the sinus areas. But sinus doctor said nothing is wrong. So I read about vertical heterophoria, and all the symptoms are the same as I have. So I wanted to ask is there a particular test for that? Is there any other ways to relieve while I eventually get the check up again besides prism glasses. ### Response: I understand your concerns, vertical heterophoria is a disorder of the mechanisms which maintain the balance of the eye muscles, keeping them on target. Although rare, these can lead to significant distress and dizziness as well. The best test to see if you have heterophoria in any direction is the cover or cover-uncover and alternate cover tests. These should be done with glasses first and then without them. You need the help of another person while doing this at home or can be quickly done at the doctor\s clinic. 1. Cover test or uncover test - close one of your eyes with your hand while trying to look at an image around six meters away first and then held at 50 cm apart, with both your eyes, then take away the covering hand. If you see the eye that was covered moving, then you have a phoria in the direction opposite the direction in which the eye moved. 2. Alternate cover test - is the same as the cover or uncover tests, only that the covering hand is rapidly moved from eye to eye. This gives a more accurate picture of the type or magnitude of the heterophoria. These are two of the best, safest and economical tests that you can use to diagnose heterophoria. In case you need more information about heterophoria or tests or management options, please send me a scanned copy of your doctors reports and test results. I will do my best to help you with this. I hope you get well soon." "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: Recently I have been having burning with urination and just burning in my urethra in general, sometimes even when I am not urinating. A month ago I went to the doctor\s office with UTI symptoms and blood in my urine and was told I did in fact have a bladder infection and was given Ciprofloxacin. A couple of weeks after being off the Ciprofloxacin I began having the burning that I am now. The burning got worse after intercourse and even worse once I started my menstrual cycle. I went back to the doctor\s office for a urine test, assuming it might be the same infection that just did not go away but was told my urine was perfectly healthy and there was no sign of infection. The doctor recommended seeing a urologist. I am concerned as to what sorts of tests the urologist will perform and what possible conditions I might be suffering from? What can I expect from my first visit to a urologist and what are some of the possible conditions that I might have? ### Response: From the symptoms, I feel you have a urinary tract infection. Since a course of antibiotics is given already you need a urine culture test and ultrasound abdomen. Culture-specific antibiotic has to be given. If a culture shows no growth it may be due to a condition called interstitial cystitis. One or two UTIs per year are common and need no worry. UTI. Urine culture and USG (ultra sound) abdomen. Interstitial cystitis. Ureteric stones. UTI. Another course of antibiotic." "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 aged 55 years got an MRI with an observation of \intermediate signal intensity lesion noted in the endometrial cavity measuring 19x28x24, in the fundal body region with loss of endometrial interface. Tethering of sigmoid colon with distal ileal loops to the uterus in fundus region.\ ### Response: With this report, there is a possibility of malignancy. Cancer of the uterus is more likely. Do CA 125 level, CT scan abdomen and pelvis, X-ray, sonography, PET scan and consult a gynecologist near you and also take an opinion from an oncosurgeon. Doctors will do other routine investigations also like LFT, RFT, hemogram, HIV, Au-Ag, blood group, 2D echo, ECG. All this is to be done and consultation along with clinical examination required for deciding further management of this if to directly go for surgery or not. In that case, the best option is chemotherapy or radiotherapy. But yes, you need to take steps on an urgent basis if the MRI report is like this and you suspect malignancy with some changes. I do not want to over exaggerate this but malignancy can grow way faster than you imagine. The final diagnosis will be after sending for biopsy or HPE (histopathological examination). I do not know why you have done the MRI and what complaints she has, but whatever it is, if this is what the report says, then the above things should be done as soon as possible" "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 52 year old male. I have a lump just on top of my soft palate next to uvula. The lump was pink or red, medium and painless without bleeding. Three weeks ago, I found it, and I did not notice anything before. There is no such history in my family. I visited my GP, and he referred me to an oral surgeon. Is the lump, a dangerous one? What would you recommend for it to subside? I have uploaded my lump photos. It is not painful even if I touch the lump with my tongue. After doing warm salt water gargle, the lump reduced a bit. I am not a smoker. I am a known diabetic and hypertensive. I do not have a cough or throat problem now or before. ### Response: Based on your query and attached images (attachment removed to protect patient identity), my opinion is as follows: Excision biopsy of the lesion. Squamous papilloma. Revert with the results to a geriatrician 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 could not lose weight no matter what I do. I have acne on my chin and cheeks, increased facial hair and my hips, thighs and stomach will not lean out both with exercise and diet. I was told to take Nature-Thyroid for low T3, but felt like my throat swollen up when I take it. It would make me feel short of breath. So, I have to get off that and I just feel like this is hopeless. I am honestly tired of killing myself in the gym and eating ridiculously healthy and only seeing the scale go up. Please help. ### Response: Hello. First of all I want you to take a deep breath and relax. If you could please answer these questions it would be very helpful. 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: I think I have phimosis. The foreskin does not go back and head of the penis does not come out. I am 21. I got to know just now that it should retract. Till now I did not have any problem in urinating. No infection till now. Please suggest is there any problem in future? And if yes what I can do to correct it? ### Response: You have a tight prepuce that does not retract. Your preputial orifice is not so narrow as to cause difficulty in urination. However, you run the risk of paraphimosis in which your foreskin may get retracted and form a constriction ring causing the glans to swell. This occurs after intercourse. You need to get circumcised before sexual life" "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 27 years old. I have got allergies on my inner thighs. I used all the medicines. But there is no relief. Recently, I went for sonography and found with multiple cysts in the ovary. Due to allergy, the skin of inner thighs got darker, and I have reddish marks with itching on my face. Please help me. ### Response: Hi. With your descriptions, it seems that you have developed tinea cruris. It requires a minimum of two to three months to have a complete cure. I would suggest you take tablet Itraconazole 100 mg once daily and use 2 % Miconazole gel local application twice daily for one month and use Kz 2 % soap (Ketoconazole) for bathing after consulting your GP or nearby dermatologist. Revert me after a month." "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 unprotected sex three months ago. I had all the tests except herpes done and all were negative. About every one to two weeks since the encounter, I have been getting red rashes and red small dots all over my glans penis and foreskin. They are not raised, they do not itch. They are maybe like two seconds a day and no discharge. Although sometimes penis can produce an odor.The dots will disappear on its own usually after three days and can reoccur again after a week or two. There is nothing that seems to be indicative of herpes. Penis also seems very dry and wrinkly at times. All STDs and HIV tests were all negative. ### Response: Hello. Perhaps you have a yeast infection - candida. It can manifest as redness and bumps on the glans. There is usually associated itching. I request you to kindly upload a few images of the affected area so that I am able to confirm and guide you better." "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, 42 years old, height is 160 cm, weight is 90 kg. For the past 20 years, I have skin tags in my neck, underarms, nose and around my eyes. No medications are taken till now. Kindly suggest me any tablet or an ointment to remove my skin tags. ### Response: Go for laser or RF (radio frequency) removal. No such creams and tablets are available and do not use any home remedy as it is only going to harm 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: The sebaceous granules are found on my glans. I am using some homeopathic medicines to remove it. Sometimes redness is found on the affected area. Is it safe to continue these medicines? ### Response: Hello. I have seen your attachments (attachment removed to protect patient identity). Yes, these are Fordyce spots or pearly penile papule and these are harmless and also non-transmissible. The mentioned medicines may be correct if someone has prescribed you by asking you some questions which is called case taking. Because in homeopathy there is some difference, there is no specific medicine for disease, they are specific for a set of symptoms which includes your disease and your basic nature, behavior, liking, disliking as well. If you are taking these medicines yourself then please do not take them, they may harm you in some other way. There is a good thing with these spots that they are harmless and does not transmit if they are not genital warts." "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 keratitis and after the treatment, I still have a tiny grey spot on my cornea.Here is the treatment which I had followed:Visit 1 - (October 2014) Fucithalmic eye drops 1 % - three times daily for two weeks.Visit 2 - (October 2014) Exocine 0.3 % - four times daily for a month.Visit 2 - Artelac eye drops - four times daily for a month.Visit 3 - (December 2014) Artelac eye drops - two times daily for a month.Visit 4 - (24th February 2015) - Zylet Etabonate and Prednol, Tobramycine 0.3 % for two weeks.Visit 4 - Artelac eye drops - two times daily. I have been using till now.I am really worried about my eye. Please help me. ### Response: I reviewed your history. It seems from the history that you had keratitis and following the treatment, you have a small corneal opacity. Hence no need to be worried about the use of Artelac eye" "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: Good dayMy situation started yesterday after taking a shower yesterday. I climbed out of the shower and noticed I had this high pitched ringing sound in my ears. This sound is really causing me to panic ; last night I has 3 anxiety attacks because of it and I took 50mg Sressam tablet but it did not work. I still have the ringing in my ears today and I\ve taken another stressam about 1 and a half hours ago but it\s not seeming to work. I\m afraid I might have an anxiety attack again tonight because of it. I\ve recently been placed on Acnetret for my Ance (7 days ago) but my Dr told me to stop it for a few days because I have been experiencing extreme back pain which I am still experiencing right now. I have been off the tablets for about 2 or 3 days and I dont know If this could be causing the high pitch (silence sort of noise) in my ears. Its causing extreme anxiety and unfortunately all Dr\s rooms are closed right now.Age: 15 Male176 cm 164.8 kg ### Response: Hello First of all, please know that ringing sensation is very common and prevalent. There are many suspected causes for ringing sensation in the ear. You say it started after a bath." "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 has DCIS. The doctor advised for surgery. She has been taking full extract Cannabis oil for six weeks. The initial pathology report and the follow-up reports seem to be different. The surgeon knows what my partner has been taking. I have sent both the pathology reports. I need some advice, and I need these differences explained to me. So, we can decide on doing surgery or continuing with the oil treatment. ### Response: I have gone through the attachment (attachment removed to protect patient identity). Do not try Cannabis oil as a remedy for your lesion. Your report is suggestive of ductal carcinoma in situ. You are right, in the second report, it is given that necrosis is not evident. The necrosis could not be there because, in a repeated biopsy, that necrotic portion might not be biopsied. But in both the reports, nuclear changes are suggestive of a malignant process is given. So, your report indicates ductal carcinoma in situ, and it is advisable not to take a risk. It is better to undergo surgery" "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 13 weeks pregnant. I vomit almost 10 times a day. I could not focus on regular works at home. Lost 6 kg in 20 days. Is that normal? Feel moody more at times. But will having sex affect my baby? ### Response: Hello. If you are vomiting frequently and has lost weight, you must see your local doctor as soon as possible for IV fluids and accurate management to control the vomiting. Excessive vomiting can adversely affect the baby as well as your health. And having sex does not affect the baby\s health." "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 35-year-old male. I have married about one year ago, but till now I have no hope of a child. Below is my semen analysis report. Please check it and tell me if there is any problem and suggest to me about the cure if any.Semen analysis report: Gross:Duration of abstinence: 05 daysAppearance: Creamy whiteLiquefaction time (minutes): 30 minutesConsistency: ThinVolume; 3.2 mlpH: 8.0.Sperm motility (%) (100 Spermatozoa):a) Rapid progression: 40%, b) Non-progressive motility: 10%, c) Slow progression: 20%, d) Immotile: 30%.Agglutination: count/ml: 30 million, vitality: 70%.Morphology (%): Normal: 60%, Abnormal: 40%, Head defects: 30%, Tail defects: 03%, Neck and mid piece defects: 03%, Cytoplasmicdroplets: 02%, Headless \Pinhead\ : 02%.Pus cells: 4-6Red blood cells: NilEpithelial Cells: 1-2Miscellaneous: Nil.Note: This specimen is taken at the lab. ### Response: I have seen your semen analysis report and the following is my opinion: Pus cell count (units not given) appears to be high. If the unit is 4-6 cells/hpf counted in the semen analysis chamber, it comes to 1-1.5 million cells/mL. High pus cells in semen may indicate infection. The simplest way to check infection is to do one semen culture test. If any offending organism is found, you need to take antibiotics (according to sensitivity report) for three to six weeks. Kindly do not take antibiotics if streptococcus or staphylococcus are found, as these are mostly contaminants and rarely cause semen infection. The volume of semen is a little high. High volume increases chances of all semen coming out after intercourse, but should not be a cause of concern. Coming to your problem of infertility: For pregnancy to occur, apart from normal semen, your wife\s regular ovulation and open tubes are required. Has your wife undergone any evaluation? If yes, you can get back to me with reports for further 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 am a 30-year-old male. I had a baby tooth in the left lower jaw. Beneath it, there is an impacted first permanent premolar tooth. OPG and CBCT were taken. The baby tooth was extracted before a month, and the impacted tooth was exposed. As I had some misalignment in both the jaws, I consulted an orthodontist, and I was advised to wait for two months for braces treatment. Now the exposed area of the impacted tooth has got healed and covered completely. Should I need to wait for an eruption? Can I have a cyst formation under the impacted tooth? Can I start my braces treatment now? I am attaching my OPG, CBCT reports and photos. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). You do not have a cyst formation associated with the impacted tooth according to the images. In some cases, by orthodontic treatment, the tooth can be exposed, and they are brought to a normal position. In some cases, after extraction of the retained baby tooth, the impacted tooth can come into favorable position. So the orthodontist can place braces on it to bring it into position. So the doctor advises you to wait for two months. A mucosal layer always covers the tooth, and it can be exposed. After two months, if it is not coming to a favorable position, it can also be extracted." "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 18 year old male. I am suffering from some red blisters all around my body, which are very itchy. This also spreads in my groin area and in the penile shaft. It is very itchy. Please help me. ### Response: Is the itching predominantly occurs at night? Is there any other member of your family affected? Revert back with the answers to the above questions 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 was diagnosed with urinary tract infection (E.coli) three months back. I took Ciprofloxacin for 10 days, but there is no sign of improvement. Now I have a dull pain in the back region, waist, and sometimes at flank. There is complete body weakness, mild fever, tingling sensation at hand and feet. Are these all symptoms of a kidney infection? Please guide me. ### Response: Hello. It looks like an upper urinary tract infection. Get your urine test done in a place where they check whether it is E.Coli (Escherichia Coli) or ESBL (Extended-spectrum beta-lactamases). Also, do an ultrasonography for the bladder to check post void residue. Start tablet Levoflox (Levofloxacin) 500 mg after giving urine for culture. Consult your specialist doctor, discuss with him/her and take the medicines 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 am 35 years old. About three hours ago, I was fleaing my dogs when I got a tiny bit of the flea killer in my mouth and on my lip. It was not alot. Will it harm me? ### Response: Hi. Flea killer contains ingredients that are harmful to humans but since just a tiny amount got into your mouth then its effect will not be poisonous. You need to wash your lips thoroughly with soap and water, gargle your mouth with water and spit it several times. If you experience (unlikely to happen) difficulty in swallowing, vomiting or dizziness, then you should seek medical attention." "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 got a very bad sunburn on my left leg about a week ago. I am almost certain it was a second degree even though it did not blister. It was very red and hurted for at least three days. My ankle was swollen for two days as well. I am much worried about it as I am on holiday and did not seek medical advice and also did not wrap it with a bandage. It has healed quite a lot, but now it is starting to scab around the edges and some skin is turning shiny. I am worried about the scarring. I have attached photos for your reference. The white stripe across is where I was wearing a plaster. The area has now become itchy. I just do not know what to do. Please help. ### Response: I have read your query in detail and viewed the attached pictures (attachment removed to protect patient identity) and do understand your concern Photocontact dermatitis. 1. You can take antihistamines like tablet Levocetirizine 5 mg twice daily.2. A combination of steroid like Clobetasol and antibiotic like Fusidic acid to be applied over it twice daily for one week. This will help in relieving irritation and also minimize scarring. 1. Sun protection.2. Avoid using soap over this area for a week. You can apply Calamine lotion as soothing agent.3. Apply emollients like Cetaphil Dam lotion twice or thrice a day. Revert back after a week 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: My last periods ended on the 1st. I had sex on the 5th. After 34 hours of sex, I have taken Unwanted 72 and again after nine hours, I took I-pill for more safety. But after that, I have no bleeding or vomiting but on 18th and 19th, I had a little blood in my vaginal discharge. Today is the 29th but my periods have not come. I have done urine pregnancy test on 28th but it was negative. But still, my periods have not come. I do not want a pregnancy. Please help. ### Response: Hello. The urine pregnancy test is negative which is done today on 29th, rules out pregnancy. However, the best way to conclusively rule out pregnancy is a serum beta hCG test which if less than 3 mIU rules out pregnancy conclusively." "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 saw a fleshy growth on my labia majora. I am worried about it. Can you explain to me what is this fleshy growth? ### Response: This appears to be a very small papule or bartholian cyst. It is hard to tell without a direct examination but both of these conditions are not dangerous. Please keep an eye on it, it is supposed to dissolve by itself in the next few weeks. You can use warm compressions if you have pain. No other therapy is required if the size is not increasing or it is not changing color or shape, in this situation you may have to see your Gynecologist. Make sure to get your papsmear." "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 ago, I was one of the top students I had unexpected traumatic events with my study at university. After that, I had a tough time struggling with my life. Feeling hopeless and helpless, worthless, and I want to withdraw my self from life, but I do not know how? Please help a month ago, I had been diagnosed with depression and anxiety, and I am taking medication, but it did not work. I have social withdrawal, loss of interest, loss of appetite, sleep distribution, digestive problem, and difficulty in breathing. ### Response: Hello. I completely understand that you feel depressed and anxious due to past experiences in life. Stressors, traumatic, negative experiences, failure or losses in life. Major depressive disorder with anxious distress (DSM-5 for professionals). As you have mentioned about your current state of depression and anxiety, and the use of medicines has not been proven effective for you, it clearly indicates the need for psychotherapy.Research has shown that cognitive behavior therapy (CBT) is the best treatment for long term effects and complete remission of depression and anxiety disorders.You are strongly recommended to take psychotherapy sessions from a psychologist.During the session, you will learn coping strategies to effectively deal with traumatic life experiences, to increase your academic performance, and to enhance daily life functioning. Do consult with a psychologist at your earliest. Research has shown that people who take CBT at the initial stage when symptoms arise, they have more chances of improvement and fewer chances of the depressive episode again in life. Whereas, delay in treatment may worsen the symptoms and there are more chances that depressive episode may occur again." "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 Mirena removed before a month and had what I think was a period the next day that lasted for four days. It has been 37 days with no period and three negative home pregnancy tests. I have been nauseated with cramps that are dull while some hurt good enough to stop me from moving. What is going on? ### Response: Mirena is a progesterone-containing IUCD (intrauterine contraceptive device). Its sudden removal induced you periods last month. Your current delay in periods is also because of the same. It takes time for the body to restore the normal hormonal balance after removal of Mirena. Do not worry. Wait for another week or 10 days. You should get your periods. If not we can start you on medicines to induce the period. Hope you found this information useful. All the best," "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 trying to conceive since 5 to 6 months, but I am not able to. I am not on any medication nor have any problems. I did all tests, which were all normal. My cycle is 28 days and always regular. Please help. What to do? What is a follicular study? Can I do that? ### Response: Hi. Yes, it does help increase the chances of pregnancy. In the case of difficulty in conceiving, your husband also needs to be tested. The follicular study is a vital component of in vitro fertilization (IVF) assessment and timing. It basically employs a simple technique for assessing ovarian follicles at regular intervals and documenting the pathway to ovulation. A baseline sonography is done on the second or third day of the periods. Tablets are given for inducing ovulation and follicular sonography is started from day 9 of periods, till the ovulation is confirmed" "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 unable to get an erection for a longer time. I have erection problem during intercourse. Very low feeling to have intercourse. ### Response: Hi. Since how long are you having these issues? Did the erection problem occur first or the lack of interest in sex occur first? Are you married or in a relationship? Do you masturbate? Does erection during masturbation last longer? Are you having any medical disease or are you on any medications? Any history of recent weight gain? What is the frequency of intercourse (in a week)? You can send me answers to the above questions. In the meantime, you can start tablet DuraPlus once daily at bedtime for about 10 days and see how things improve." "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 and my fiancee had an intercourse a month back. Her periods had ended three days before that. Her menstrual cycles range from 26 to 30 days (usually 28). I did not use a condom and pulled out before the climax. She took an I-pill at the 46th hour after intercourse). She got bleeding (like the last day of the period) starting three days later and continued until the fifth day. Her period was due 10 days back. She did two hCG tests using morning urine four days back (without drinking water or going to the toilet for 8.5 hours) and both the tests came negative (a deep band on control and nothing on the test).She is having cloudy, white, stretchy vaginal discharges for the past one week and no sign of period till now (no cramps, etc.). She is having a bloated stomach, nausea, and headaches along with mood swings like irritability (she has a migraine and spondylolysis). What can be done? And is there any chance of pregnancy? ### Response: Since she took the I-pill within less than 72 hours, it is nice. She is safe. For the bleeding that came, it is because the I-pill can cause menses irregularities and may induce earlier menses. The bloating, nausea and mood swings may also be the side effects of the medication. For me, you are safe and to be sure 100 %, I recommend her a blood test for hCG." "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 smoking for last 30 years. I left it 50 days ago. My weight is 78 kg. Height is 5 feet 7 inches. Currently, I am taking Emlong 5 twice daily. ### Response: Hi. I have checked all attached documents (attachment removed to protect patient identity). The lab tests show: Otherwise, all other laboratory reports are normal." "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: Will having 20 mg Fluoxetine added to my existing 375 mg of Venlafaxine help to lift my depression? I had recurring depression since 17 and have been on Venlafaxine for 12 years. ### Response: Hello. Venlafaxine is a very good anti-depressant. It has given you excellent results for 12 years but if the problem is increasing then there might be some issues like hormonal imbalance, psychosocial problems, substance abuse, etc. We need details on that. But if still persist instead of Fluoxetine I would like to add some other medicine. All psychiatrists may have different opinions. It may or may not help." "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 12 years old. Today in school another student threw a gift card (credit card size) which got stuck in his eye. He immediately experienced some internal eye bleeding and diplopia. He saw the urgent care MD who put dye in his eye and diagnosed a corneal abrasion and prescribed Erythromycin ointment four times daily. Should he consult an Ophthalmologist as well and what other treatment may be needed? ### Response: I am very sorry to hear that your son is injured. But, rest assured that such things are quite common and corneal abrasions usually heal in about five to seven days without any further harm. I suggest that you continue with the Erythromycin ointment and make sure that your son does not go out in sunny, windy or dusty environments. If necessary dark goggles can be worn temporarily for extra protection. I recommend that you see an Ophthalmologist in case of the following: 1. If there are pain and watering that does not improve with the Erythromycin Ointment. 2. If the redness is not reducing. 3. 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: My 1 and a half month old baby is having mild cradle cap and cluster of red pimples on his face. The area is quite dry even though the pimples are gone.This has left a white patch or discoloration on his cheeks. Is this atopic dermatitis or seborrheic dermatitis?How long will it last and when will the white patch disappear? This is my first baby and I am really heartbroken seeing his face like this. ### Response: Hello. I have noted your concern and I have viewed the images (attachment removed to protect patient identity). The baby has post-inflammatory hypopigmentation due to seborrheic dermatitis. It is nothing serious and will go with time. I suggest you apply Desowen lotion (Desonide) twice daily on the affected area for two weeks. For his cradle cap, I suggest you use Cetrilak (Cetrimide) 5 % shampoo. You may also use Desowen lotion on the scalp as well. Regards" "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 18 years old. I had fever some 15 days back, which lasted for two days. Now, for the past few days, blood is coming out along with running nose. Also, I am getting blood through cough. I am not having fever now and feel normal. However, I feel that something oozing in the throat. Around seven months ago, I had a little bit of blood on spitting. I had an x-ray before seven months and it was normal. ### Response: Hi I have gone through your query and can understand your health concern. 1. Sinusitis.2. Bronchitis. Complete blood count, x-ray paranasal sinuses and ESR. Revert back with the reports to a general 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 had a root canal on my 31 molar. Only a corner of my tooth was removed, not even half. I am concerned about the cost of the crown which I know could be very expensive even with insurance. Is it possible this can be filled with a simple filling instead of a crown? ### Response: I have read through your complaint and the relevant details. Crown placement after root canal treatment will happen once the tooth is particularly shaped and prepared for it. It is also followed by an impression making of that shaped tooth. If this step has been done, then you are definitely going to have a crown. If not, it is the root canal treatment which has just got completed (I am saying this because you had mentioned only a little portion of the tooth is removed). Answering the last part of your question, yes a simple filling can be done instead of a crown for a root canal treated tooth, but there are few conditions for it. It depends on how far the tooth is opened up for the root canal treatment, that is, the depth of the cavity and the extension. Since it is a molar tooth, we do not want to risk your tooth undergoing a fracture in the later days. So, a crown is always advisable. I request you to always ask your dentist which part of the treatment plan is going on and what is next. It is your right to question.You should not be signing the consent just like that but know what is happening actually" "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 daughter who is 19 years old. Her behavior is different now when compared to her childhood days. She had been an introvert. She is too emotional and over thinks a lot. From her childhood, she is having suicidal thoughts. She is suffering from depression for the past four years. She takes too much stress. Everything around her affects her very deeply. She has been sexually molested many times in her childhood and teenage as well. I tried to console her. But, she does not forget anything and always acts fearfully outside. She is becoming an anti-social person and suffers from poor health. Her studies are also affected. I really want to help her to get out of this. Please show me some ways. She is very short tempered. Sometimes she acts as the happiest person on the earth and sometimes she is the saddest soul. She never shares her thoughts and feelings with anyone. Our family situations are not good. There is no harmony, no understanding, frequent fights among the family members. Seeing all this she wants to go to some other city for her further studies. She says she does not like all these and she feels us as an extra headache. ### Response: Hi. I completely understand your concern towards your daughter. Childhood plays an essential role in the development of future personality. Her childhood was very traumatic which is troubling her from inside. But still, she can manage her life. I have seen lots of people who could not be able to deal with their stress. You are lucky to have a brave daughter" "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 want to know about Hepatitis B virus. I have been affected by this disease. Is it a contagious disease? Can others use the things which I use? Can others drink water with my used glass? How does this virus spread?In people who have already taken hepatitis B virus vaccine, is there any chance of virus affecting them? My wife has taken hepatitis B vaccine. Can we have sex? Is there any chance of hepatitis B virus affecting my wife? Can my wife breastfeed our child? Is there any chance of virus transmission from my wife to our kid? ### Response: Hepatitis B virus is transmitted through sexual contact with an infected person and through blood, mucous membranes, and wounds. You should not have sexual contact with your wife. And she should check herself for hepatitis B. Are you taking any injections for hepatitis B, like interferons? You should do the tests - HBsAg, Anti HBc and Liver Function Test (LFT). If you have already done these tests, you can upload the report here. Yes, in rare cases, it can affect a breastfed child. But, I think your wife must have been tested for hepatitis B and C before delivery. Your wife needs booster doses of hepatitis B vaccine if she had taken the vaccination during childhood. She also has to check antibodies against hepatitis B." "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 experiencing skin rashes, as shown in the attached photo, for the past three weeks. It all started with itching sensation in both hands, and then red spots came all over my arms, face, and legs. I have also itching in my head. I was given Avil injection at the hospital and Avil tablets. I also took Teczine tablet afterward. Yesterday I took L Montus tablet. I am also attaching a photo of my prescription. Today, I feel weak and dizzy, as I am fasting, and I took the injection while fasting. ### Response: Hi. I saw the picture (attachment removed to protect patient identity). This is acute urticaria. I suggest you try taking the following: Consult your specialist doctor, discuss with him or her and start taking the medicines after 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 wanna get rid of man boobs. What should I do? I do not even have time to go to the gym. ### Response: Hello. Once established these will require surgical excision. This can be done through the infra-areolar incision or liposuction. You can try to lose weight and go to the gym to improve your pectorals to see if that is acceptable to you. Otherwise, surgery is the only option" "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 gum bleeding. Please suggest some medication or toothpaste. ### Response: Hello. Gum bleeding is caused due to inflamed gums due to deposits accumulated in the teeth. Get a professional cleaning of teeth (scaling) done by the dentist and then follow proper brushing method (sulcular bass method). You can ask your dentist about it or check online. Brushing method is more important than the toothpaste you use. Use any toothpaste containing fluoride. And, if sensitivity is there, you can use Sensodyne till you have sensitivity. This was for general. If you have any medical history and regarding details of your gum bleeding like duration, teeth involved, let me know. I can accordingly make the diagnosis." "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 unprotected sex five days back. I took I-pill within 24 hours of sex (this was the first time). Now, I do have flow but no blood stains and following symptoms are there like lower body pain, unable to eat anything, as I vomit after eating anything (it started on the third day), and blackouts. Please let me know should I wait for two to three days more for the pill to show result or consult the doctor as soon as possible. ### Response: You may have stomach infection if you had unprotected sex before five days only because pregnancy symptoms do take times at least 20 days from unprotected sex to show up. Do urine pregnancy test to confirm after 20 days from the day of unprotected sex. Periods can delay due to I-pill." "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 on Ava 20 (hormonal contraceptive pill) for about three years. I recently just stopped taking it. I had sex about 3 to 4 time in my fertile period. I have missed my period by a few days. So, I took a pregnancy test and it came back negative. I have been having a few symptoms too like sore nipples and breasts, weeing a bit more than usual, acne, fatigue. ### Response: Hi. Since you have been actively trying to conceive and having unprotected sexual intercourse on fertile days does put the possibility of pregnancy high up on the list especially coupled with a missed period. A home pregnancy test can be negative in the first few days after the missed period even in case of successful fertilization owing to insufficient beta hCG hormones. I suggest you take another urine strip test after a week if you still do not get your periods. Or could get a blood test for serum beta hCG in a few days which is more sensitive. In any case, you should treat it as a possible pregnancy unless proven otherwise and take your vitamins." "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 27-year-old man. Sometimes, I feel very weak. My BP goes down and I am unable to stand properly. Also, there is a pain in my foot. Please tell me the treatment to cover this type of problem. ### Response: Hello. You have two main concerns. The weakness is not due to low blood pressure. The low blood pressure can lead to dizziness and inability to stand as described by you. You can check your blood sugar level as well. For tiredness, I suggest you investigate with serum potassium, serum sodium estimation, serum TSH (thyroid stimulating hormone) estimation, CBC (complete blood count), liver profile, and kidney profile. You can revert back with reports. For pain in the foot, avoid prolonged standing or walking. It is advisable to investigate with X-ray foot for further work up. You should get checked your serum calcium and vitamin D level as well." "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 32 years old, and I am kind of facing the issue of fantasy in my head and mind deconcentration. Whenever I am busy or in social gathering most of the time I am fine. But when I am alone, walking alone and traveling alone, my mind goes into the fantasy. I kind of see this thing becoming common in people and while observing them I noticed that whenever I am in this situation my body is at rest while facial expression is changing according to what I am thinking. As I watched a lot of fantasies movies and seasons, my mind keeps stuck in these, thinking about different scenarios along with facial expression like smiling, anger, etc. It is kind of embarrassing when someone notices me. I would like to know what it is. People are saying it as daydreaming. My question is whether it is really daydreaming, or if not what it is? How can I overcome it? ### Response: But some people do it more which becomes a kind of habit. Sometimes, we also use this kind of defense and imagination in order to avoid day-to-day stress. It becomes a form of avoidance behavior. Distract yourself with some positive and productive strategies like focus on your career, practice your hobbies, make a day-to-day schedule, try to follow it, use some aversive stimulation to prevent yourself from going deep in imagination like pinching yourself hard on the hand." "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 27 years old. I went through three IUIs, but all of them failed. All my hormonal test such as FSH, LH, TSH, and sugar are normal. Even the ultrasound is normal. My AMH is 1.14. Six months back, during my follicle study, I used to have five to six follicles SGFS on day-2. But, from the last two cycles, I have two to three follicles on each side. The doctor has suggested IVF. Is my AMH level too low? Will IVF benefit me? ### Response: Hello. I have seen your reports (attachment removed to protect patient identity)." "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 27-year-old male. I have never had an increase in moles, except for the past two weeks I have had over 50 show up on my chest. In the past two months, I moved from one country to another, and a month ago, I had a really bad sunburn in Indonesia. ### Response: Moles are genetic collection of melanocytes which go through a cycle of emerging in childhood then become darker and fade by middle ages. In fair skin up to 50 are normal more than that increase the risk for skin cancer. And change in size, symmetry, color, symptoms also is a risk factor. Mole or nevi as called in medical term appearing in adult age like in you are always a risk factor. And in such an abrupt manner more so. They need to be followed up for any change in color, size, symmetry border, symptoms, and so. All your moles that I can see in the photo are harmless. (attachment removed to protect patient identity). Mole does increase after prolonged sun exposure as you give history. I hope you do not have any other medical problems. I advise you an initial in physically examination by a dermatologist, you can wait for lockdown, not an emergency, then you can do it yourself, all the mole for the changes described earlier, at least once a month and a complete work done by a dermatologist once every six months. Lifetime risk is very low but if you have fair skin, adult moles, more than fifty you need that follow-up to be on the safer side. I hope this helps. Sun exposure. Workup for changes. Seborrheic keratosis. Screening for changes. Every six months." "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 dealing with some health issues for three years. I had an ultrasound before showing my spleen was mildly enlarged to 12.8 cm. Since then I have had on and off spleen enlargements. Last week I had an ultrasound with again a mild spleen enlargement at 12.8 cm. Sometimes the spleen returns to a normal size of 11.8cm. I have also noticed in my ultrasound that my liver was enlarged to 16.8 cm when my liver was previously normal at 15.5 cm. I have also done a bunch of blood work and my bilirubin levels went to 27 when they should be below 20 and my conjugated bilirubin was 9 when it should be below 7. I have had my ALT and AST testing and all is fine there. I have had my CBC and differential and all is good with this too. I am very concerned about what this could be and what is happening to my body. My doctor is sending me to a hematologist, please help me to understand what is happening. If this is cancer or something serious. Please help. ### Response: Hi. I hope you are safe. I reviewed your doctor\s report. (attachment removed to protect patient identity). While I can understand your concern, but as of there is no one pick and choose a reason for your case. To be frank, I am not bothered by your spleen size or liver size. Yes, they are close to the above normal range. I do not know if you have some component of fatty liver, your USG (ultrasound) may tell you that. Examples are OCPs (oral contraceptive pills), birth pills. There are many more. Just get your medicine list reviewed by your PCP. Easy bruisability over the skin, do you have gum bleeds as well? But your platelet count is well above the normal range as well. Do you have any family history of bleeding and do you have excessive menstrual bleeding?" "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 awkward spot on my lower lip. It is like a basic symptom of lip cancer. Please give your valuable suggestion. ### Response: I have gone through your case. There are many causes and clinical presentation of lip cancer. You should provide a complete history of the lesion for how long it has been there and also send picture as well. Or please see dermatologist personally." "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 50-year-old female. I have cramps and bloody diarrhea for a few weeks. How can I stop crampy diarrhea? ### Response: I think you might have got food toxins during your trip. You take lemon tea (strong tea with more lemon juice) once in four hours. Consume only curd or yogurt with salt during food. Consume lemon juice with salt, tender coconut water, and pomegranate juice." "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: Recently, a doctor said to my father that he has got age-related diffuse cerebral atrophy and it will affect the memory. Please explain what it is. Will he forget everything, even me? His age is 59. I am very frightened. ### Response: Hello. Regarding your concern, I would explain that your father\s symptoms and MRI findings are indicative of dementia or Alzheimer\s disease. This is a progressive disorder with progressive memory problems" "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 pain at the right side near the penis for 20 days. MRI done on pelvic region showing infective etiology likely, there is thickening of right side epididymis, and vas deferens, right side seminal vesicle is thickened. Mild hydrocele on the right side. A thick-walled, 22.5*21*34 mm complex cystic area seen in the right inguinal region just posterior to and abutting the spermatic cord adjacent to the root of the penis.Current medications are Naprosyn 500 mg, Omeprazole 20 mg, Chymoral forte tablet, Methylcobalamin, Alpha Lipoic Acid, Folic acid, Pyridoxine hydrochloride and Oxidation plus capsule. ### Response: It is the infection involving right testis, right sperm tube and both sides of groin lymph nodes. Please get a urine routine and culture test done. From the list of medications, I do not see any antibiotic. I suggest you start capsule Doxycycline 100 mg twice daily, to be taken for 14 days with the consent of your treating doctor. Is there any recent history of sexual exposure? You can contact me in about five to seven days after getting a sonography of right inguinal and KUB region (kidney, ureter, and urinary bladder)." "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 undergoes frequent delusions and nightmares about some men raping her. She is 20 years old now. When she was around 10 years old, she went to a wedding ceremony. She made friends with a boy much older than her. He took her to someplace on the very same day telling her something nice and all. Then she saw four to five boys standing outside a dark construction site. She fainted then and after that, she only remembers waking up. She says that all these are coming back now because she is curious about what happened to her that night. Her delusions and nightmares were triggered by a rape scene she was seeing in a daily soap recently which made her remember the incident.What is worse is that if she gets to know what happened that night, and if it is really something that bad, she might commit suicide or hurt herself. Recently while I was at her place, talking about these problems, suddenly she felt dizzy and sat down, and then she stared intently at the entrance for at least five minutes if not ten, after which again she was normal but she does not know any part of the time when she was looking at the door and thinking something. I am very much worried about her. Please I need some advice about what can I do about and how can I help her? She is in so much of pain. Please help. ### Response: It appears more of an anxiety spectrum disorder rather than an actual delusion. 25 mg Clonazepam at night, if there are severe nightmares there is also an option of Prazosin 1 mg at night, you could meet a local psychiatrist for these. I would recommend you to not actively talk about the rape thing to her or do any online therapy since it can make her focus too much on the topic. Try to distract her and keep her engaged. Yoga and muscle relaxation exercises can help. If there is a clinical psychologist near your area, she can be started on a cognitive behavior therapy but again I would recommend the above options before trying it out." "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 taken smoothening fourth time with a gap of a one-year interval between each session. But, this time I have taken keratin treatment also. My hairs from the ends are damaged, frizzy and rough. Is it possible to repair them? ### Response: Keratin treatment is for damaged, rough and frizzy hair. You should always take keratin treatment for hairs. Take biotin supplements for proper growth and good texture of hair. Avoid excessive heating procedures on hairs like straightening or dying of hair especially those that damage the hair. For now, I will suggest you do a little bit of trimming at the ends and keratin treatment will help in solving problems." "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 worried about my prostate. Urine stream is low. Often going to the toilet. Can feel pain in testicles after sex. ### Response: I have gone through your query. Can you please confirm how old you are? You have mentioned your age to be 41 years. I am asking because 41 years is pretty early to develop prostate enlargement, although not impossible, it is definitely very rare to develop significant enlargement to cause symptoms at your age. That said it is possible to have some low-grade prostate infection that can possibly cause your symptoms. To find out, a prostate examination and urine analysis are necessary to confirm. Also, an ultrasound scan to measure the size of the prostate gland and a uroflowmetry to ascertain the speed of the urinary flow will give a complete picture. If it is due to prostate enlargement, then simple daily medication should be effective if you have had symptoms only for a short duration." "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 the loss of sensitivity in my penis. I am not happy while doing sex. Previously my foreskin got removed freely at that time I did not get any sensitivity to my penis. At the time of my first sex, the foreskin got cut and it bled. So, I used a cream. My scrotum is very tight. There is no loose skin around at all at any time. Sometimes, I feel there is something in my urethral nerve. So please suggest methods to gain back sensation in the penis. ### Response: Hello." "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 fever since last night. These small spots on the back. I am sending the picture through email. Please advise what it can be. ### Response: Hello. I have gone through the images (attachment removed to protect patient identity). Are these distributed evenly on the back, also in the chest? If yes, it strongly raises the possibility of chickenpox, especially if not suffered from it in the past. If these lesions are distributed only in a small localized area then likely to be herpes infection. Please upload a few more pics from the distance. Also, check the other body parts for lesions. You will need Acyclovir based on body weight if it is chickenpox. Consult a specialist doctor, discuss with him or her and start taking the medicines with their consent. You can apply Lactocalamine lotion locally for a soothing effect. Also, I suggest Paracetamol 500 mg for fever. Are there other symptoms like sore throat, cough, burning on urination? It is better if you can get yourself examined by a local doctor in person. Hope this helps you and get back if you have any doubts" "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 worried that I may have leukemia. I have been having a lot of symptoms that correlate with leukemia symptoms. Please help. ### Response: I require details of the symptoms that you have, for a complete opinion. Leukemia is a blood disorder commonly known as blood cancer. There are two types of leukemias namely Acute and Chronic leukemia. Acute leukemia usually has bleeding manifestations while chronic leukemia rarely has bleeding manifestations. Chronic leukemia is usually seen above 40 years and acute leukemia below 40 years. Chronic leukemia could have multiple lymph nodes enlargement and also spleen enlargement. Look at the total WBC count and also for the presence of immature forms or blast cells. If they are present, leukemia may be thought of, however, complete correlation is essential. Revert back with the reports to 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 been diagnosed with schizophrenia and have been prescribed anti-psychotic medication Olanzapine. I have been taking it for 2 to 3 years. I was wondering if there is an alternate route to treatment? Or if there is another solution for a possible cure? I do not want to deal with the negative effects. I do not experience any of the positive effects for 2 to 3 years as long as I have taken Olanzapine. Can I come off the medication? ### Response: Hi. Olanzapine is an antipsychotic medicine. Yes, Olanzapine is available in injectable form. If Olanzapine is causing some effects then it can be changed to other antipsychotic like Aripiprazole, Risperidone or Ziprasidone. You need to take medicines or injectables to keep symptoms in check. I want to understand what negative things you are experiencing." "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 jaundice (hepatitis A) patient. My earlier SGOT and SGPT was 81 and 117 now it became 117 and 395 respectively and bilirubin total is 1.19. When the bilirubin count decreased, I started to eat food more to make my body look normal. Will it be dangerous? ### Response: I understand your concerns, but you should not worry. Hepatitis A is self-limiting in the great majority of patients. Hepatitis A is diagnosed clinically and laboratory (HAV IgM and G) is required for the diagnosis. If you have them, please send a copy of the results in the follow up message" "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 27 years old, female. I am taking Nilavarai powder continuously for constipation. I am 47 days pregnant. Can I continue this powder? ### Response: Hi. Nilavarai is commonly known as Senna or Sonamukhi in Ayurveda. It has laxative property. After taking for a long time, it makes habitual and mildly irritating. If you are pregnant then you should avoid taking it for a long time. You can take Haritaki powder 3 gm twice a day with warm water after meals to remove your constipation. It is completely safe to you in pregnancy too." "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 fever and cold for the past three days. I am taking Calpol and Combiflam. How can I get cured? ### Response: You have a viral or allergic upper respiratory tract infection. Calpol and Combiflam (Ibuprofen with Paracetamol) both should not be used at a time. You can also take Vitamin C 500 mg twice a day for five days. Do saltwater gargle with warm water three times a day. A decongestant like Levocetirizine can be taken additionally. Avoid excess spicy foods and" "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 about gum bleaching. I was just wondering the price range of undergoing this process. My gums cause me no harm whatsoever, by the way, just appearance purposes. ### Response: You are talking about gum bleaching but I feel it is tooth bleaching and you have a problem with the esthetics of 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: I had sex four days back with my husband and the condom leaked. I took I-pill on the same day at night but yesterday the same thing happened again. During intercourse, condom leaked. Can I take I-pill again for this? ### Response: You can take. But there is no guarantee because there is no study that two tablets in one cycle are how much effective. And secondly, if your age is 42 years then there is a decreased chance of pregnancy. So take tablet and wait for menses. Or consult a nearby gynecologist. You can put Copper-T as emergency contraception now. In two days, it will be effective. Otherwise take tablets and wait for your menses. And take precautions properly. Change the brand of condom you are using now. One plus thing is nowadays many condoms comes with spermicidal liquid so even if it breaks, the chance of pregnancy is less." "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 little brother is 20. He was previously smoking marijuana not sure what kinds in his social circles. This was about a year ago from now. Ever since then he has never been the same. We have taken him away from being able to take marijuana for a year now and still, he acts like he is high. He is very disconnected, he talks to himself a lot, he is always laughing to himself, he cannot hold a full conversation without diverting and talking about something that completely makes no sense. He is very irritated and has now become short-tempered and very defensive. He talks to no one, he can go a week without saying a word even when spoken to. Please, anything you know that can help? ### Response: Marijuana contains cannabis, cannabis cause psychosis three times more than the general population where schizophrenia is 1 % common in the general population." "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 pulmonary tuberculosis in my teen age. After a full course of ATT, I was recovered and no findings on sputum and x-ray. Now, I am 30 years old. I have left lower abdomen pain since two to three years. But, it is not severe. The pain is intermittent and often relieved by passing stool. My gynecologist advised me for Mantoux, which came out as positive. I am planning for a baby for three months. My menstrual cycle is fairly regular with an interval of 21 days and I have dysmenorrhea since my menarche. Am I suffering from genital tuberculosis? ### Response: Hi. Mantoux positive is showing sensitivity to tuberculin antigen. It is a screening test and not a confirmatory test. If it comes positive, then do TB PCR (tuberculosis polymerase chain reaction) for confirmation. If that too comes positive, then it means there is a chance of genital TB and you have to take treatment for it for around four to six months accordingly. If TB PCR is negative, then you do not have to worry." "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 24 years old single male. I stopped masturbation two months before. After that, I am getting a lot of nightfall, though did not get any wet dreams. Felt embarrassed. Please help. ### Response: Hi. It is normal. Semen is made every day, it has to come out, if not by masturbation, then by nightfall. Relax, gradually it will become less." "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 has been seven days since I have smoked a cigarette (quit cold turkey). How long will it take after quitting smoking, for the blood to be free from nicotine? Is blood viscosity reversible by simply cutting down nicotine? ### Response: Looking at the query, my opinion is as follows: The effect of nicotine is dependent upon the amount and years of cigarettes smoked and can vary from two days to two months. Yes, it is reversible as nicotine affects the platelets, red blood cells, the endothelium, and the clotting factors to increase blood viscosity. Once 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: My spouse aged 47 years has been advised laparoscopic hysterectomy as a fibroid of 80 x 70 mm is observed in USG of the uterus. She is having irregular periods from the last 9 to 10 months. Her hemoglobin has reduced to 9.5 g/dL. Is this a sufficient and strong ground for a hysterectomy? If not, what is the alternative treatment? ### Response: Yes, this is sufficient ground for hysterectomy, and I think you should go ahead. Since she has a symptomatic fibroid, she will need definitive treatment. There are medicines available, but they are not very effective. They may just keep symptoms under control, and it needs to be taken lifelong. Secondly, removing the uterus treats the problem forever, eliminates the risk of future malignancies like cervical cancer and other associated problem. Also, she has completed her childbearing age, so removing uterus will not affect her adversely. Hope this helps you and get back if you have any doubts." "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 is suffering from Aspergillus otomycosis. She has had tympanoplasty surgery. She then had a surgical ear cleaning, removing the infected skin in her middle ear. This initially worked to remove the fungus, but now her ear seems to be infected again. I am not sure if it is a fungus, but her ear seems to be infected again. She has taken Clotrimazole, and she is currently taking an alcohol or borax solution. ### Response: Hello. In one of the pictures (attachment removed to protect patient identity) sporangia seem to be there, but in the rest of the pictures, it is just wax. However, it is not likely to require debridement. It should go with the medications she is using." "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 age is 26 and I have an issue with my blood pressure. It keeps on variating. Sometimes, it is high (150/90, 140/85, 130/90) and sometimes, normal (120/80, 110/60). I want to ask that do I have to consult a doctor and have some test? If yes, can you recommend those tests? Or do you think it is fine to have this much BP? ### Response: You need to test your blood pressure on a daily basis. The first thing in the morning and night time before you go to bed. Take the readings for one week. If it is, at the majority of times, above 140 then you need to consult a doctor. Otherwise, you need to have regular exercises, reduce salt, and caffeine." "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 friend who is in very much need of an expert. He has been living with his abusive mother his whole life, she even tried to kill him multiple times. Her behavior shows symptoms of OCD, PTSD, and even bipolar. He even tried to take her for counseling, but that made matters worse. As his friend, I am really worried. And I would really appreciate your guidance and help. ### Response: Your friend\s mother is showing an aggressive and abusive behavior which indicates serious mental illness. There can be an element of delusion of persecution that is suspiciousness of being killed by her son, which is making mother so violent. I would advise you to tell your friend that he should consult a psychiatrist, his mother may require in-patient treatment. We have very good medicines available nowadays which can control every patient. More the time lapse without treatment, more resistant will be the disease. So it is better to start the treatment as soon as possible." "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: What will happen if someone eats Unwanted 72 without any reason? Will there be any withdrawal bleeding or not?. And what will be the situation of menses? ### Response: Hope it has helped you. If you require any further queries, please do not hesitate to contact 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: I had an infection in my penis like fungal. Please provide the medicine to cure that skin. ### Response: Hi. This looks more like herpes genitalis (attachment removed to protect patient identity). Can you please send details like: These details will help us come to the correct diagnosis and start treatment" "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 several teeth removed last week and was fitted with dentures. Woke up this morning and mouth was swollen and I could not talk with my dentures in. The mouth is still swollen four hours later. What should I do? ### Response: Hello. You can remove the dentures for now and use warm salt water gargle twice a day for a few days. Allow it to heal and then start wearing your dentures. You can take anti-inflammatory medication if your doctor has prescribed else take rest and it will heal soon." "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 age is 41 years. I have taken Care 3 injections of B12, after seven days, test results are greater than 1500 pg/ml. Before injections 100 pg/ml. Please suggest how to decrease and was it dangerous to my body? ### Response: Hello. Do not worry. It is not dangerous. It is a water-soluble vitamin and will be excreted in urine. You do not need to take any medicines for that, just have plenty of water. Measure level again after two weeks. Avoid injections of Vitamins, just have tablets for both Vitamin D and Vitamin B12, if necessary in future after checking levels 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: Three years ago I was diagnosed with non-alcoholic fatty liver and at that time my liver enzymes were 3 to 4 times of the upper ranges. I then lost weight and with time my enzymes got normalized. However, in last test, I have noticed a pattern where AST is greater than ALT, though they are in the normal range. AST is always greater than ALT a few points and in the last test, this increased more though the enzymes are normal. I have read the AST/ALT>1 is a sign of advanced liver disease or cirrhosis. Is this valid when the enzymes are in the normal range also? It is in the last three years that my platelet count changes in 128 to 180 range always. ### Response: Hi. No, the concept of AST: ALT is not valid when the enzymes are in normal range. However, low platelet count can be an early sign of liver cirrhosis. It is not very uncommon to get liver cirrhosis in cases of NAFLD (non-alcoholic fatty liver disease). I would recommend you upper GI endoscopy to look for any varices, a sign of chronic liver disease, fibroscan of the liver. I would also advice you to get tested for hepatitis B and C, in case you have never been tested for that." "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 19 years old. Last month, my period came 13 days late and this month it is 15 days over the date. My period lasts two days mostly which I think is not really healthy. What do you recommend doing? ### Response: Hi. Considering your age, your BMI (body mass index) is high. It means you are overweight. Sometimes, due to obesity, you have hormonal imbalance leading to irregular periods and decreased flow. You need to get your thyroid profile and serum prolactin checked and you need to work on your weight loss" "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 wolf Parkinson white syndrome. I was admitted to a hospital last week and was discharged within one day. The doctor said that first, we can check through medicine, now sometimes I am feeling nervous and minute rapid heartbeat. ### Response: Treatment options include medical and ablation. Medical: Propafenone 150 mg tablet every eight hours (control heartbeats). In severe cases ablation using a catheter is required. Beta blockers like Metalor is not suitable as it blocks the normal pathway and enhances the extra abnormal pathway. I recommend that you follow up and send me your ECG and echocardiography report in order to identify the type and severity of the arrhythmia." "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 received whiplash from a motor vehicle accident a year back and over the past year have had regular physio, pain medication, facet joint injections and now have been recommended to have C2 to C7 pulsed radio-frequency neurotomies (PRF) L and R as I still have severe neck and back pain and migraines. I am just looking for a second opinion on the procedure and any advice or recommendations on whether to go ahead from any experience you may have or have heard about, as it is hard to get long-term results where we live. I am female, 33 years, 58 kg. Currently, I am taking Temgesic 216 micrograms and Buprenorphine hydrochloride twice daily. ### Response: Hello. Kindly answer these questions and follow up as I need some more details to give an accurate 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: My age is 28 years, female, height 5 feet 4 inches, and current weight 79 kg. I have an issue of irregular periods. I am not sexually active, unmarried. I have started being physically active, do yoga, cardio and walking regularly. Two years ago when the same scenario of irregular periods for about four months happened, I consulted a gynecologist and did thyroid profile and ultrasound scan. TSH was 5.8, vitamin D 21, one 3 mm kidney stone and had one small cyst in ovary then. I was given Regestrone tablets for three days and after getting periods, asked to use Ovral pills two packs and one bottle of Eltroxin 25 mg for regularizing periods. I was also told that this is the treatment whenever periods go missing, I should repeat the same. That is why I do not wish to repeat everything again. This time I would wish to go as naturally as possible and cure myself of the roots. I have body pains all the time, I feel weakness, cannot focus on anything for a longer time, mood swings, anxiety. Also, please suggest vegetarian dietary changes, supplements related to this which solve the issue. ### Response: I have read your complaints carefully and understand your concern. All these symptoms that you are facing may be due to hormonal imbalances as you had previous PCOD history. It can be managed naturally through ayurvedic medicines and Yoga techniques. Hypothyroidism, PCOD, raised blood sugar or blood pressure, etc. Thyroid profile, lipid profile, blood sugar fasting and PP, blood pressure, USG abdomen. Inflammatory pelvic disease, irregular menstruation. Take the following medicines regularly for two months. In between medications you should provide your feedback.Rx,1. Kuberakshadi Vati two tablets twice a day after meals. 2. Hyponidd one tablet thrice a day after meals. 3. Nityanand Rasa one tablet twice a day after meals. 4. Gokshuradi guggulu one tablet twice a day after meals. 5. Ashokaristam 15 ml twice a day with an equal amount of water after meals. 1. Avoid spicy and fried junk foods. 2." "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: Four months ago, I consulted you on this platform for premature complexes which I was having without any other symptoms. Below is my query and your answer - I am a male of 48 years of age. I have a lean build and do regular exercise. Since childhood, I had a tendency for heart palpitations and premature beats. After a few tests, anxiety was found to be the main cause. You had said that most probably these premature complexes are originating from ventricles which are leading to the symptoms. These are usually benign and not life threatening. The only concern remains is that of coronary artery disease, which is also less likely as these are occurring from a long time and you are not having any other symptoms. Lack of sleep, stress, alcohol, smoking, caffeinated beverages are known triggering factors for these due to sympathetic overactivity. You should also get thyroid test done. I think, just be on a safer side, you should get one treadmill test done to rule out coronary artery disease and echo should be repeated. Afterwards, I met a cardiologist and got an ECG and echo tests done. The tests were normal. The cardiologist said that there is no need for TMT test since I do running and other exercises daily and there is no known risk factor for CAD. But the VPCs continued for a month.Then, I realized that I was taking a weight gainer supplement from the last one year which contained creatinine. Two months back, I was not doing any exercise due to a small fracture in my elbow but continued to take this supplement. The doctor advised me to stop the supplement immediately since this could be the cause of missed beats. Then I read in the internet and found out that there have been cases of irregular heart beats due to creatinine supplementation. I stopped taking the supplement although it was from a reputed firm and did not contain any steroids. The missed beats reduced after stopping the supplement and from the last two months, it has come to a normal level of one or two in a day. But somehow my mind started getting preoccupied with the thoughts of heart disease and I started reading about it from the internet and even textbooks.I have been thin and slim since my childhood, have been quite active physically, no family history of heart disease, no diabetes, no hypertension, non-smoker, rarely eat fried foods. My lipid profile is normal with HDL being about 55 whenever tested, CRP is around 0.5. But in spite of this, I was not able to free my mind from worries of CAD. A month back, I did quite a lot of pushups after a gap of four to five months. After three to four days, I started having pain in my chest here and there mostly at rest. After a week I got an ECG done which was normal. The pain subsided slowly but whenever I did some exercise which put a strain on the chest muscle I started having pain and with pain, more worries.Then I met a psychiatrist. He said that I have got into an obsessive loop, which is part of health anxiety disorder which is causing these psychosomatic symptoms of chest pain. He advised me to take some antidepressants for three months, do Yoga and meditation and take some sessions of cognitive behavior therapy. I am reluctant to take antidepressants but have already started doing some meditation and Yoga. He also prescribed Alprazolam .25 mg on SOS basis. Now the pain is subsiding slowly and obsessive thoughts are also reducing. I have stopped doing any exercise that would put a strain on the chest. I do not know how long it will take to resume it. In a recent blood test, two months back my vitamin D3 was at 28. Could it be the cause of the chest pain? Secondly, I stopped the supplement but continued some strenuous exercises without taking a proper diet. Could it be the cause of it? Please guide me. How to get rid of this unwanted health anxiety which I have got into? ### Response: Hello. Looking at the overall picture, the problem appears to be a minor one and not worrisome. All the best" "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 constantly unable to focus on anything in my life. My brain just seems like damaged. I feel alone, depressed, sudden anxiety attacks, shivering, numbness, extreme mood disbalance, fatigued, extra exhausted, strange short feeling in which I feel very bad for myself like guilty of anything. My mother always curses me and my brothers. Our family is wealthy, educated but my mother and father have some domestic issues which have never ever been closed even I have become 18 years old. I do not want to kill myself but I do not have any light ahead for living. I am not able to describe each and everything right now. I need to contact a psychiatrist or psychologist for better consultation. ### Response: Hello. You seem to have a mixed anxiety-depressive disorder. This is very common and about 10-15 percent of people have this problem. It is also very easily treatable. You will need to visit a psychiatrist and he will prescribe you SSRI type of medicines (such as Escitalopram 10 mg, or Fluoxetine 20 mg, etc) which will help with your problem. It basically happens when some neurotransmitters such as serotonin reduce in your brain leading to a problem with handling the day to day stresses of life. Medicines are usually given for two to four months and then tapered off slowly and stopped. In addition to the medicines, you can also undergo a few sessions of cognitive-behavioral therapy from a clinical psychologist. Also, do consider doing deep breathing exercises or progressive muscle relaxation daily. T. Nexito 10 mg (Escitalopram 10 mg) daily one at night after food." "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 liver is borderline enlarged 155 mm with increased echotexture. There is mild prostatomegaly with insignificant postvoid residual volume. I am currently on Udiliv 300 mg. Kindly suggest some remedy. ### Response: I need to know regarding your clinical symptoms if any" "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 30-year-old male. I am suffering from right inguinal hernia for the past two months. I have consulted a doctor, and he asked me to go for surgery. Is it possible to cure an inguinal hernia without surgery? ### Response: Inguinal hernias generally are of two types: Strangulated and non-strangulated. Nonstrangulated are simple as currently, you have. So if you do not undergo surgery, it can be converted to strangulated and complicated one. The hernia is due to muscle weakness, so better you should undergo surgery, they will apply for mash work and strengthen the muscles. Avoid heavy exercise, and work out." "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 9 months old baby boy is addicted to thumb sucking while sleeping and other time also. What to do to break the habit of thumb sucking? ### Response: The habit of thumb sucking by the babies is related to probably lack of breastfeeding, and sometimes it is seen as habitual sucking. It is reported to be due to a lack of care and insecurity are also the reasons. You can gently remove his thumb whenever you see and when he can understand, you can tell him that it is a bad habit." "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 is 59 years old. He weights 65 kilograms. He has diabetes and also has blood pressure too. Sometimes, my father gets chest pain. He feels better after taking tablet Angised. Last night, he had pain in the heart. We went to the hospital immediately. They gave two tablets to my father. After a couple of hours, he was better. So, we came back home. Please tell me medicine or home remedy to overcome these problems. ### Response: From your history, it seems that your father has angina pectoris. Angina pectoris is not a heart attack, but it is a chest pain that occurs while exerting such as walking at a high pace, climbing stairs, during emotional stress and relieved by rest or taking tablet Nitroglycerine under the tongue. If this pain occurs more and more frequently or with less exertion or at rest, then there is something to be worried. I do not know about the workups done for your father such as ECG, echocardiography, stress ECG, and angiography. I do not know about the medications taken by your father for BP, and diabetes. Please give a detailed history about it. If you send me the reports, I can guide you further. If your father is having chest pain on rest or despite taking maximum medicines, I advise your father to go for coronary angiography and angioplasty. He has to reduce intake of salt to less than one teaspoon in a 24-hour diet. He should stop taking fatty meals, junk foods, and beef. He has to quit smoking if he has the habit." "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 know a few details of the tablets which I have been taking for my scalp psoriasis.Winolap 5mg once in a while when itching is too high (without doctor\s prescription).Isotretinoin drugs/other drugs (with doctor\s prescription).I have been taking these medicines on a regular basis and were very effective. But only till I take them. If I stop the medication, I have to visit my doctor again and start medications again to get some relief from itching in scalp. I want to know if these medicines will cause harm/side-effects in future? Can these be taken continuously? ### Response: Hello. It basically contains retinoids which in simple language is a derivative of vitamin A. It is primarily used to treat severe cystic acne and I fail to understand why your doctor has prescribed it to you for psoriasis. Its side effects include: Well, I need some more information: 1) For how long have you been suffering from scalp psoriasis? 2) Exact name and exact dose of the medicines which you are taking? 3) For how long have you been taking each medicine (in detail)? 4) Any medicine which you had taken in the past but not taking now? 5) Do you feel any side effects which I have mentioned above? 6) How much relief have you got in your scalp psoriasis from these medicines or no effect at all yet? 7) Do you have psoriatic lesions anywhere else on the body or just on scalp? Kindly provide these information, so that we can evaluate your case in detail and prescribe you with the best possible treatment." "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: The past two days I have had a sore back tooth, feels like the gum is swollen on the bottom and last night it started throbbing pain in my cheek and now my cheek is swollen and sore. I have a sore throat also I am currently breastfeeding and really do not want to stop at any point. Does anyone know what this could be? ### Response: Hello. We are here to help you. As per your symptoms, you could be either suffering from impacted wisdom tooth or a tooth infection due to cavities. For the momentary relief, you can start with warm saline gargles at least 5 to 6 times a day for a week. Avoid applying anything hot from outside. Avoid covering your face and do not sleep on the affected side. You can do some ice pack application few times a day to get rid of the swelling and pain. You need to visit your dentist to get it checked and start with the required treatment as soon as possible" "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 getting a cold drop of water sensation all over my body. It is more noticeable on the legs. I often go to clean the water, but there is nothing there. It only gets triggered when clothes touch it. I also have muscle twitching all over the body and a muscle tension on my right arm. I also noticed I am losing hair from my left eyebrow. I have no weakness, tiredness or loss of balance. No diseases run in my family, not even diabetes or cancer. I am a hypochondriac, and I was panicking for almost two weeks just because I noticed my finger was a little crooked and it was just normal. But now, I have developed real symptoms. Can anxiety cause such real symptoms? I am really scared. ### Response: I appreciate you seeking help. 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: Please see below a report of my interactions with eye doctors in the last 21 months. This piece also includes further information under preambles, and questions, under the problem.Before two years, my optometrist advised that I see an ophthalmologist after examining the back of my eyes. He said my eye pressure was high, and I think 14 or 15. I also told him I had been seeing tiny flashes on waking up since about one month or two. The ophthalmologist, after examining me said my eye pressure was okay, I think it was 12, and he was comfortable with the back of my eyes. He asked me to do a CVF (copy attached). He said the CVF report is ok, the few black spots are nothing to worry about, they may also be false. He put me on Ivyxolotl (Betaxolol hydrochloride) and asked me to come back in six months.Last year I told the ophthalmologist that the flashes had stopped. My eyes were examined, I was asked to call in in 6 months again, and to continue using Ivyxolotl. He said I am a glaucoma suspect. The CVF was repeated. (The copy is attached).Before three months in the same hospital, a different doctor said I have glaucoma as the back of my eyes is cupped. Asked me to repeat CVF, and should continue using Ivyxollol. My eye pressure was 10.Before two months, I did the CVF test but now started to consider getting another hospitals opinion, since it appears this hospital is giving me contradictory opinions. 1st doc says I am not a glaucoma patient but gives me glaucoma meds, 2nd doc says I am a glaucoma patient. (Same hospital).Before two months I sought the opinion of another ophthalmologist in another hospital; After back- of- eyes examination and OCT, he told me, you do not have glaucoma and stop using Ivyxolotl in the meantime.Last month I woke up with a feeling that there is a shaded area in my vision. Second hospital doctor checked for retinal detachment, was convinced that was not happening, asked me to come back in three months. It is reiterated that I do not have glaucoma. Still the opinion that there is a shaded part of my vision, I saw the first doctor, who also reiterated that I am a glaucoma suspect, not a patient. He advised me to continue using Ivyxollol. Eye pressure was 12. Could not communicate to him that I would have stopped using Ivyxolotl, about two months earlier, before the session ended. A grandfather and his brother lost their visions in their old age, and two uncles have also been having problems with their visions. They are in their late 70s. A tennis ball hit me very hard on one eye about 20 years ago. I saw an ophthalmologist then and never had any problem with it since. The problem now is,1.\tNot knowing what to do with Ivyxollol since I now have two differing advice from two ophthalmologists.2.\tWanting to be sure that what I feel I see from the corners of my eyes when I roll my eyes one way, and the other is normal. Is there a site, or a write-up that can take one through a total spectrum of what is normal for a perfect eye to see?3.\tWanting to know if there are other tests I should be doing now since the general advice about eye health and vision is that most problems can be prevented if detected earlier.4.\tWanting to know for sure the lifestyle steps or changes I might need to take now to enhance my eye-health at this point. What are your recommendations? ### Response: Hello. Unfortunately, I was not able to see any attachments, but I understand your frustration about your diagnosis and recommendations. To start with, all the eye pressure measurements were within normal values but that might be insignificant in case they suspect normal tension glaucoma. The main problem is that suspecting glaucoma in a patient is the best way to treat it if detected before it does irreversible damage to the optic nerve. However and to suspect it, the patient must undergo a set of diagnostic tests, visual field tests, gonioscopy, and the primary test is optical coherence tomography along with measurements of the eye pressure twice a day within three days. The only way I could assist you with proper advice would be to see those tests. As for Betaxolol, I would have monitored you and your eye pressure before prescribing it. The only way to know whether it was effective is to do an OCT while using them now, stop them for three months and do another OCT for comparison." "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 25 year old male, all my life I have required about 13 hours sleep every night, regardless of the bedtime. If I get the 13 hours sleep, I am not tired the next day, but if I only get 10 hours sleep, I will be very tired that day and also get a sleep debt. I went to bed at 8 PM last night and woke up at 1 PM today, as I only slept for 11 hours the night before. I tried forcing myself to sleep for eight hours, but I was a wreck, and I slept for nearly 24 hours straight to compensate. I had blood tests and sleep tests, which were all normal. I only have kyphoscoliosis. I am certain I do not have depression or other psychological problems but have tried several antidepressants for some time. But it had no impact on the amount of sleep I require. It is quite annoying, not being able to live the same lifestyle as nearly everyone I know. I simply just sleep more than everyone. Would I benefit from something like Modafinil? Any other ideas? ### Response: I have gone through your complaint and I think Modafinil is a good option in your case. Modafinil is used to decrease excessive sleepiness and enhances memory and cognitive functions. Most of the side effects are mild and are self-limiting" "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 and I had sex on the 29th of last month. Her last periods started on the 15th of last month. We used a condom the whole time, but I was worried there could have been a leak and got her an I-pill within 18 hours of intercourse. She has had no bleeding whatsoever since then and not even had her periods yet. Is there anything to worry? She normally gets her periods in 28 days. Please help. ### Response: Hello. How are you doing? The act of sex was on day-15 of the period, that is, very close to the ovulation date. But as you said that a condom had been used all the time and you only have a doubt of spill, the chances of a pregnancy is very very low. As the pill was taken within 24 hours of sex, its success is also very high. This pill is a progesterone hormone in a high dose. So, the period would be slightly delayed. Some do get their periods within 10 days of the pill, but I would suggest you wait until seven to 10 days of the expected date. So, wait until the 25th of this month. She should get her periods by then. If still no periods, it is due to the deranged hormonal levels due to the pill. If still doubtful about condom failure, have a home urine pregnancy test. Once confirmed as negative, have tablet Duoluton-L (Ethinylestradiol and Levonorgestrel) or Intimacy plus 3 (Ethinylestradiol and Desogestrel) or Novelon or Ovral-G - one tablet twice a day for 10 days (throw away the 21st pill). No matter what the cause is (except pregnancy) she will have her periods within seven to 10 days. Hope I have clarified your query, do write back if any more queries. All the best." "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 a small renal cyst on my left kidney. I understand this is rare in my age group. Please help. ### Response: I have read your query and the first thing to know about a single kidney cyst is that it is usually harmless. You have not mentioned if this was an incidental finding (usually they are) or are you experiencing any symptoms like dull flank pain or abdominal pain or problems with voiding urine? In case of former, no need to do anything and get an ultrasound every six months to see if the cyst enlarges. In case of latter, or if size is increasing, two options exist but conservative management with medicines will only provide short term relief. Surgical intervention is the only long term solution. That said, considering your age you are a candidate for MODY (maturity onset diabetes of the young) especially if you have a family history of diabetes. Also, if on any later ultrasound you find more than one cyst polycystic kidney disease or even Wegner\s might have to be taken in to account. For now, you need to get the following tests done: 1. HbA1C (glycated hemoglobin) 2. CBC (complete blood count) and 3. U/CE (urea and electrolytes). Follow up with the test results and also do elaborate on why was ultrasound done and what were your symptoms for proper future management." "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 45-day-old nephew has not defecated for the last two days. Today is the third day. He is taking his feeds well and having a sound sleep. His urine output is good. Also, he is leaving gas as usual. Kindly help. ### Response: Hello. This is one of the common complaints received. It is absolutely normal for an infant to pass stool once in a week or 20 times a day in whatever consistency. As long as the baby is active, is feeding well and is passing adequate urine there is nothing to worry. Continue breastfeeding every two hours and keep baby warm" "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 experiencing itchiness and redness in my eyes since a few days. I have been administering eye drops twice or thrice a day since two to three days but the problem persists. The redness is more after waking up and it subsides a bit after using eye drops (Itone eye drops). A major part of my day involves using a laptop. The itchiness and redness are slight, not very extreme. Kindly suggest. ### Response: Hello." "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 month I had I-pill (within 48hours of intercourse) after 18 days of onset of my periods. I did not have any side effects like withdrawal bleeding, nausea, etc., after taking the I-pill. I got my periods on the 1st of this month. I am unsure if this is my normal period or bleeding due to the side effect of I-pill? Please help me to clarify this. If it is my regular periods, then there is no delay in it (a week before or week after than expected date). Is it normal? Is there a need to take a test or any chances of pregnancy? If yes, when to take the test? ### Response: Let me start by assuring you that you are not pregnant and need not worry. If you have had your periods 18 days before taking I-pill, your ovulation would have been around 13 to 15 days after that. Life of egg is only one day. So there is no chance of an egg being alive on that day of sex. I-pill or emergency contraception pill is a high dose of progesterone hormone. After ovulation, your ovary also will be producing the same hormone. As you have taken it after the ovulation date, the thickness of the inner uterine lining would have increased further. But would not have shed. Usually, if you take it before ovulation, your bleeding will start within a few days. So you should have had your regular periods, slightly thicker or more than usual. If you had bleeding almost like regular periods, then the inner lining of the uterus has been shed. There is no chance of pregnancy if at all, to catch inside the uterus. So do not worry, your next period will be one month from this period. I hope I have clarified your query, do write back if any more questions and for your feedback." "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 Hashimoto\s 10 years ago. I have been on Levothyroxine, and current dose is 125 mcg. During that time I have been hospitalized four times because of heart palpitations. Even though I am on medicine I still have coarse hair, hair loss, weight gain, puffy face, hoarse voice, and constipation. I was wondering if I should switch to a different thyroid medicine? The other medicines that I take are Welbutrin 150 mg, Cymbalta 90 mg, Probiotic, stool softener, and Vitamin B12. ### Response: Hello. I just read your query and from what you have mentioned it appears that you are having very good thyroid function test results. I would not recommend that you change the form of Thyroxine at any cost" "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 high and low fever for the past few days and starting from yesterday, I have sore throat. I went to pee just now and saw the color is a bit reddish brown. And one week before fever, I had a few mosquito bites which are itchy on both the legs. ### Response: It could be a viral fever followed by acute glomerulonephritis if there is blood in urine, judging from the reddish brown urine you mentioned. Or it could be a urinary tract infection. In both cases, you must get a urine routine and microscopic examination plus a complete blood count test done initially. If you have other symptoms like abdominal pain, vomiting, etc, you must let me know. If you continue to pass blood with urine, you need to go to the ER." "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 a severe headache and ear disturbances (fullness). After consultation with an ENT doctor, Augmentin antibiotic and Actifed cold were prescribed for me. In the process of taking the drugs, I started having tinnitus (ringing and buzzing in the ear), which has refused to stop for about a month and two weeks now. It is very disturbing, even more than the previous ear fullness. I find it difficult to concentrate. Since then, happiness has eluded me. I need a medical advice. So, please help me. ### Response: Hello. Please let me know the following: Please revert with these answers, so that I can help you better. Please attach your prescription as well. Revert with more information to 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 have ear tinnitus effect. There is continuous multifrequency sound persisting on which sometimes one particular frequency tone becomes significant for few seconds. Doctor told there is no cure and I have to live with it. Is there any remedy to ease it? I heard something like acoustic neuromodulation can help to cure it. Is Ginkgo biloba can ease ringing in ear with tinnitus effect. It is more neurological issue than ear. I was on Cipralex - Escitalopram for 4 years after withdrawal it really bothers me. Kindly advice. ### Response: Tinnitus is bothersome and unfortunately sometime it is difficult to treat. Acoustic neuromodulation is helpful and have shown positive results. You could try this option. Studies have shown Ginkgo is not effective for tinnitus. Revert back with the answers for the above questions to 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 had an oral sex with my partner. He ejected his semen in my mouth. The next day morning, I got a throat pain and there is a pain in my tonsils. I got a fever, cough and severe back pain. After that, I got my left knee pain and still, it is painful. Do you think I have HIV or STD? I have a little pimple on my neck. I have a feeling of vomiting and a fast heartbeat. There is no rashes or ulcers in my private part. Is this normal? ### Response: Transmission of HIV is impossible through oral sex. Saliva cannot cause the transmission of HIV. But, other STDs (sexually transmitted diseases) like herpes or HPV (human papillomavirus) or candida can spread through oral sex. But, a sore throat is not a presenting complaint in these STD\s. A sore throat is due to infection. Take a proper antibiotic course and you will be alright. Warm saline gargles can also help in quick recovery" "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 49 years old male. For the past six to seven years, whenever I am on an antibiotic course (Augmentin Duo 625 mg), it results in balanitis and smegma production which troubles me for two to three weeks and then goes away. About two months ago, I was on an antibiotic (Augmentin) for a throat infection, and I got balanitis. Now it is refusing to get cured completely. It gets cured, then it comes back again after a few days. Please advise. ### Response: I need a few details to help you in a proper manner. For what condition you are taking antibiotics? Is it a self-medication or prescribed by a doctor? Have you got your blood sugar levels checked? Any significant medical history. Are you sexually active? If yes, then is it a single partner? Does your partner have any complaint? Please provide answers" "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 lower right side impacted wisdom tooth has been extracted a week back. Till now my half tongue and jawline of the right side are numb or I am not feeling hot or cold at that side. I am so much worried. Is that normal or is it a concern of worrying? I am panicking for getting sense in my tongue back. Please advice. ### Response: Hello. If the tongue feels numb even after a day, then you may have a condition called paresthesia. It occurs when the injection injures the nerves. and such numbness can remain for a week or two, sometimes even for a month. But it will go away as the nerves heal slowly. Take capsule Becosules (Vitamin B1 and B2) once daily for 15 days. But it is better if you go back to your dentist to show him first." "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 husband, who is 49, had blood work done. It shows a WBC count of 40,000, which has been checked twice now. His doctor wants to send him to see a specialist. He has had no recent infections. There is no change in his appetite and no weight loss. He feels fine.He has been on Neurontin for 3-5 months now for neuralgia and in researching it; it says it can cause an increase in WBC count. He had been on Tegretol for neuralgia before. Could this cause it? Of course, our main concern is, could it be leukemia? ### Response: Based on your query, my opinion is as follows: Yes, Neurontin - Gabapentin is known to cause high WBC (white blood cell) count. If there is no infection, then it is common to worry about leukemia when the WBC count is high. At present, the best idea is to get a peripheral blood smear report done. If there is no increased immature form like blasts, then it is a Neurontin side effect. If immature blasts present, then he will require further evaluation.The cause is probably Neurontin; however, get a peripheral smear to calm your mind." "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: Respected doctor,My baby was born on 5th at the 36th week of pregnancy. Then he was admitted to NICU as signs of jaundice were seen and discharged on 8th. Then again on 11th, he was again admitted to NICU because of jaundice. Then on 12th (8th day) the doctor did a test of TSH, T3, and T4 (report is attached) where TSH was found 10.87 uIu/ml (report attached) and low T3. Thereafter, the doctor recommended a dosage of Eltroxin of 25 mcg for three years of life due to suspected hypothyroidism and advised us to repeat TSH level after three years and hence we have started giving the 25 mcg dosage to the baby since 12th. Meanwhile, we again tested for TSH, T3, and T4 (report is attached) on 28th. The TSH came out less than 0.05 ulu/ml. Kindly advise whether we stop the dosage of Eltroxin (25 mcg) or lower the dosage. ### Response: I suppose there is some miscommunication or misunderstanding. We never recommend a continuous dosage of Levothyroxine for three years without checking the levels periodically. So, what is usually done is that we repeat thyroid profile three monthly and adjust the dosage. Once the level falls within the normal range we keep on monitoring the levels. If they increase, we start Levothyroxine again and adjust the dosage three-monthly based on TSH levels. I hope it 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: Six months back, I had a bad sinus infection with a cough that caused a left internal carotid artery dissection. I had a stroke as well that left infarcts on my left parietal lobe and caused problems with my speech and I was not able to use my cellphone correctly. Thankfully I had no lingering damage. Two months back, I had my 3 month MRI rescan and it said the artery had healed and the infarcts were smaller. I have had a sinus infection again which started about a week and a half ago with a cough again.Earlier in the week I was having on and off dizzy spells for a few days and that has passed. Now I am having sensations in the right side of my face around my cheekbone, cheek, top of right lip, around the right side of my nose. I can also feel it around my right bicep, and sometimes my right calf. There is no drooping of my smile or eyebrows. I can raise my arms without drooping. Everything seems to work correctly. These sensations have been going on for at least four days. I have sleep apnea so I sleep with a full face mask and I lay on my right side with my right arm under my head. What could these sensations be? ### Response: Post stroke, during periods of illness, fever, cold, etc., previous symptoms of stroke may reappear but to lesser degree. They usually go away as the illness resolve. It does not mean you have new stroke. With left parietal stroke, one can expect sensory symptoms over right side and depending on your location, body part, need to see your previous MRI which can help identify if your face region was in previous stroke region or scar tissue is there. If you are very concerned, then you can go for another MRI brain to look for any new stroke. MRI brain if symptom worsen or if no scar tissue in facial region on previous MRI" "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 sticky throat always. I feel mucus is stuck in the throat. There is no pain. I can easily swallow. ### Response: Hello. If mucus is coming from your nose to the throat, then you seem to have sinusitis." "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 tongue hurts and bleeds when brushed. White spot on uvula area and white and small red dots on the roof of my mouth. Also, a yellowish color is seen on the roof of my mouth. ### Response: The condition is called aphthous stomatitis. It usually follows a brief period of stress to be emotional or physical, as a febrile sickness. You need to take a short course of antibiotics, topical analgesics, anesthetics. Multivitamin supplements and antacids can be taken. It is usually self-limiting, and the treatment is aimed at symptom relief." "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 daughter is 10 years old. For the past eight days, she has been suffering from body pain, headache, and some skin irritation. Her doctor said that it is pitta acidity. There is no improvement till date. Last year, during rainy season, she had some face and body irritation problem, which solved after taking Alerid tablet. Please help. ### Response: To understand the condition better I need to know the following things. Revert back with the answers to the above questions to 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: My sleeping time is disturbed. I wake up at 10 AM and sleep around 1.30 AM. I want to be normal again. I know that I am spoiling my health. But I do not know how to overcome this. Please help me. ### Response: Hello. All you need is just to follow a healthy sleep hygiene schedule. I would advice you to follow the above sleep hygiene practices to schedule your sleep wake cycle. If this does not work then you might be in need of therapy in the form of medications, bright light therapy." "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 noticing slight blood drops while urinating since last 2 to 3 days and irritation in the vagina. I noticed rashes on the left wall of the vaginal opening and seems to pain slightly while urinating. Please suggest the remedy. I have been consuming cital syrup on suggestions by a pharmacist. Please suggest remedies. ### Response: If there is no burning sensation while urination or there is an increased frequency of urine accompanied with red urine then unlikely that you have a urinary tract infection, instead you are likely to be suffering from vaginitis. Please get a high vaginal swab and a urine culture to rule out infection first. If diagnosed then you can be prescribed a course of antibiotics accordingly. The presence of painful rashes at the vaginal opening on one side could be herpes zoster lesions. Please send a picture of the lesions for a possible diagnosis. Are you a sexually active lady?" "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 1 and a half years old. He has pox from two days. Slowly, these are spreading all over the body. ### Response: Do not worry. I suggest giving him the following course: Give him warm water baths, not hot or else his skin will become" "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 menstrual period was on two months before. I had my intercourse on the next month of my periods. And today my UPT test was positive and beta hCG test value also positive 3716mIU/mL. Is there any way to terminate my pregnancy? ### Response: Hello. You have first to meet a gynecologist as only these centers alone are legalized for abortion services. They would first get a transvaginal ultrasound done to rule out ectopic pregnancy which is important and then if confirmed, after your hemoglobin and blood grouping would get some consent forms signed and then she or he would be able to dispense your medicines for termination of pregnancy with a medical method." "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 22 years and 1 month completed. I have the eyesight of -6 for both eyes. Am I eligible for Lasik at 22 years or 23 years of age? ### Response: The decision of whether or not you can undergo Lasik or any other refractive surgery depends on three things. Your power should not change for at least a year. That is your power needs to be stable. Your corneal thickness must be adequate for the procedure. Your corneal curvature or shape must be normal. The first criteria are self-explanatory. The next two criteria can be known by a test called corneal topography, which is available at all Lasik centers. If you have satisfied all three, then the surgeon will take you up for surgery." "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 with my partner during her menstrual cycle and she abruptly stopped bleeding few hours after intercourse. Though I did not use a condom and did not ejaculate inside but, to be on the safer side I convinced her to take an I-pill after 48 hours of intercourse. What is intriguing is that her period has not started yet and she is late by three days. What is the possibility of her getting pregnant in this scenario? ### Response: I understand your concern. Although sex during menstruation is not advisable due to hygienic purposes, it is considered a safe period during which pregnancy cannot happen. My advice would be to check using a preganacy test and practice safe sex (you can use condoms)" "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 random urine test for pheochromocytoma and I think my PCP is reading wrong. I went to the lab and gave an ambiguous report confusing people. She did say fourfold elevation normetanephrine and four-fold elevation u-metanephrine. I do have episodic severe hypertension attacks, palor, sweating, BP up to 256/131 mmHg for 20 minutes or so. Only very occasionally have these attacks. As a 50 year old I never had sustained high blood pressure but now I do and am on large doses of medicines. Do I have elevated lab work and what do you think it means? U-metanephrine total QST 196 range 149 to 603. U-normetanephrine QST 148 range 108 to 524. U-epinephrine QST was below reportable range. Rest of numbers seem normal. What is your opinion? ### Response: I understand your results showed raised urinary metanephrines but the other metabolites were within normal range. This could still indicate pheochromocytoma. I must say that your symptoms are quite suggestive of pheochromocytoma although not exclusively in favor of it. I need to know if you also get panic attacks and whether you have any other disorders associated with your thyroid or parathyroid glands, as that would pretty much go in favor of this diagnosis. Let me know so that I can advise some tests which would confirm the diagnosis so that adequate treatment can be initiated" "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 25-year-old male. I have short sight and cannot see long-distance, letters, or things. My eyesight power is -2 and -1.75. I am wearing eye glass from 3 years of age but there is no improvement in my eye problem, that is why I am not interested to wear glass. I am a computer worker. Please give me some solution. ### Response: I reviewed your history. You are having myopia of -2 and -1.75 refractive power. This requires correction by the use of spectacles. The use of spectacles will not lead to the improvement of eyesight and reduction of refractive power, but it prevents further increase in refractive power. Since you are a computer worker you need to use spectacles to prevent eye strain." "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 abdominal pain, USG shows prominent column of Bertin noted at left kidney. ### Response: Hello. I want to reassure you that this finding is not significant and most likely not related to your abdominal pain. Further assessment including detailed history and proper examination should be done to diagnose the possible reason." "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 heart palpation on and off all morning on the right-hand side of my chest, and my lower left arm and hand are sore. I am 33 years old, female. I am in good health overall, but I was told I have a heart murmur about a year and a half ago and I am on Sprintec birth control. Should I be worried about this? ### Response: Hello. It does not look like a matter of worry. However, since you told about a murmur, you should get one echo done to look for the cause for it. Have you got hemoglobin checked ever? For palpitations, low hemoglobin can cause it. It can also occur with a valve problem as you told about the murmur. Also, extra beats which are usually benign can cause this. So it does not appear to be an emergency. But, you should get yourself evaluated with an ECG, echo, and hemoglobin. Hope this helps you and get back if you have any doubts or more information to share" "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 get really bad anxiety when I have to get my blood pressure taken. I am not really sure why, but it has caused me to stop going to the dentists ever since they started taking blood pressure readings. I have a cavity that I have put off getting filled for a long time because of it. Is there any way I can get around having my blood pressure taken and get this cavity filled? My anxiety brings me to tears. I do not know what to do anymore. Any help would be greatly appreciated. ### Response: Hi. I have gone through your question and I can understand your concern. There is no need of BP reading if you do not have hypertension. Blood pressure reading is nothing but a simple instrument as is your watch. So there is nothing to worry. At the age of 34, you cannot be a hypertension patient. So enjoy the reading. In case you are further apprehensive, tell the dentist you do not want it. There is no need of BP reading in simple procedures like filling." "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 30 years old. I just want check whether my T/E2 values are proper not because I am suffering from most of the symptoms of high estrogen levels like enlarged prostate, extreme fatigue, anxiety, muscle loss, belly side fat, loss of libido, knee and joint pains, etc., for more than 10 years.Around six months back, I got checkups for gastritis, there they said it is minor gastritis only and all readings are good including thyroid, but better to check for T, e2 and PSA levels as they see enlarged prostate. Do I need to take any medicines to inhibit E2 levels like Arimidex?Please check the below readings:Testosterone 580E2 43.6 pg/mlProstate size 33 ccWeight 75 kgBMI 25.9Height 172 cmVisceral fat 10.5Body fat 27.9. ### Response: Hi. I read your query and understand your concerns. First of all, I would like to inform you that your testosterone is completely normal but not estradiol. The maximum physiological level is 40 pg/ml and the level above this rings alarm bell and should be investigated. The increased level of PSA (prostate-specific antigen) along with prostate enlargement indicates there is abnormal aromatization of sex hormones which could be due to simple overweight to sex steroid secreting tumors. Regarding the treatment, there is a definite need for treatment and Aromatase inhibitors could be the right choice for you. There are multiple options for this purpose including Arimidex. 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 recurring BV and I do not know why. I have stopped taking baths, I do not douche, I never use any scented products. I am in a monogamous relationship. I just realized that my fiance washes his penis with shampoo, and we have unprotected sex. Could this be why I cannot seem to get rid of it? ### Response: BV (bacterial vaginosis) is not a sexually transmitted disease. It is just an abnormal change in your normal bacterial flora. I would recommend using tablet Metronidazole 2000 mg once or you can use Clindamycin 5 % vaginal creams once for five days. That is available over the counter. Also, avoid using unnecessary antibiotics. Get your diabetes checked if you are gaining weight. Sometimes, use of probiotics is also helpful in some people" "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 29 year old male. I have a family history of diabetes, hypertension, and heart disease. I have been experiencing intermittent chest, left arm and left shoulder pain/discomfort with periods of breathlessness for about two years now. I have had ECGs done on a few occasions and doctors said its unremarkable and commented that the main is orthopedic or neurological in nature. I have consulted a few reputed orthopedic and neurologic doctors and had subsequent MRIs, X-Rays, EMG and NCV done and all reports were normal. The pain was intermittent meanwhile. For the last three months the discomfort became worse. One doctor advised me to get a Cardiac CT done. The result of that showed a myocardial bridge. I have a history of high cholesterol and was under statins for three years now. They have subscribed a beta blocker as well. I would like to know more about the condition. The report and CT image are attached. Looking forward to your opinion. ### Response: Myocardial bridging - In your case, one of the heart artery LAD, the mid portion, passes through the cardiac muscles instead of lying on the wall. In the activity, when your heart rate increases due to this problem the blood flow reduce and causes discomfort to you. You try to avoid strenuous activities. With medicine, you will feel better but avoid strenuous activities" "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: Over a year we are trying for a baby. But, my wife is not getting pregnant. She underwent thyroid test also and the result was negative. I think the issue is with me. So what to do? While having sex my semen leaks out early and it does not stay for long. Do I need to take any medicine? Please suggest. ### Response: Hello. If you have been trying for last one year and not conceived yet then a semen analysis is necessary, which should evaluate the sperm count and morphology. If the results are normal, then your wife can be further evaluated with an ultrasound pelvis and a hormonal profile to rule out PCOS or any organic causes of uterus like endometriosis or polyp. So, please get a review with semen analysis report, as medicines can be started later on if 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: My son is 7 months old. A few weeks ago I have started to notice some odd movement, like opening and closing his hands and mainly on the right hand (just like stimming). And when he was lying on his back sometime he will stiffen his arms and legs and grunts. My partner\s aunt\s (his mum\s sister) son has been diagnosed with autism and I do not know whether that will put my son at a higher risk. ### Response: Hi. I would like to tell you that the age of seven months is a way too early to even comment about autism. So do not worry. The movements you are describing seem like normal movements of a growing baby 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: I have contacts on and they bother me so much. If I take them out I want to scratch so bad, my eye burns and itches. ### Response: Hi. If you are having trouble with your contacts, you should discontinue wearing contacts and consult an ophthalmologist for an eye exam. So, get your eyes evaluated from an eye specialist to diagnose the exact cause and get it treated appropriately. You are welcome for any queries." "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 79 year old male. Excellent health, take no medications with the exception of an occasional Viagra. In a recent DRE, my urologist discovered two small nodules on my prostate. A PSA at the time was 6.3. Over the years, I have ranged in 2\s and 3\s. He suggested a biopsy of the prostate. I have read many negative things about this process. I have also read about nonevasive procedures to detect for cancer. ### Response: I have gone through your query. I concur with your urologist in the need for a biopsy. None of the non-invasive techniques are sufficiently accurate as a biopsy at present. The closest is an MRI which, if positive, needs to be confirmed by a biopsy, and if negative does not exactly rule out a malignancy, you will need a biopsy nevertheless. Many blood tests are available but those are only if the" "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 to know all of the differences between depersonalization disorder and just having depression. Please give me all of the differences and how to tell if you have depression or depersonalization. I believe I am experiencing depression. But I just want to make sure it is not depersonalization disorder. ### Response: Hello. Depersonalization is simply a symptom in which individual has feelings of detached from self. The individuals feel that they have changes and world has become vague and changed. Recently depersonalization has been included in dissociative disorders. This can occur in severe anxiety and even under severe stress too. Depression is a mood disorder. In depression, symptoms like low mood, reduced energy, tiredness, lack of interest in anything, bad thoughts, reduced psychomotor activity, poor desire, etc., symptoms are seen commonly. Diagnosis is not very difficult and it is easy to make difference between depression and depersonalization. In depersonalization, individual will have simple symptoms like a feeling of detachment from self and no other symptoms are seen usually. Depression patient will show a variety of symptoms." "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 penis is bend towards left. Will it affect my sexual life? Is there any medical treatment for it other than surgery?Is the shock wave therapy effective in Peyronie\s disease? Will masturbation get the penis more bend? ### Response: Hello. The penis is never straight. When it gets erected it is always been in curvature shape for effective intercourse. However, if you feel excess bending of the penis then Peyronie\s disease should be suspected for which Collagenase clostridium histolyticum can be used. The surgery is a more effective way of treating Peyronie\s disease. I suggest consulting a urologist for a detailed evaluation. 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 a 50 year old male, who weighs 240 lbs. Two weeks back, I had dizziness following an attack of severe vertigo that made me fall to the ground. My psychiatrist sent me for an EKG, I went to the cardiologist to review the reports, and he said that the EKG was abnormal. My psychiatrist wants me to follow up with my family doctor as soon as possible, but my family doctor is not available for another week. What should I do? Should I wait for a week? I currently take Depakote and Risperdal medicines. ### Response: So, you could be having the dizziness due to the side effects of the medication. If you are only having dizziness without other symptoms, you can wait for a week for your family physician. I would like you to attach the EKG (electrocardiogram) result if you have it, or tell me what changes were noted by the doctor. Revert with more information to 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: My fiance is having blood in his stool. It is bright red also. He said it hurts while wiping a little. He has had it more than twice a month. His stool is solid and very dark brown. Also, said the blood in the toilet was very noticeable and that when he wiped the toilet paper looked like when you get a bloody nose. Has been having a few stomach aches also. ### Response: I have gone through your case and can well understand your genuine health concern. Presence of blood in the stool and dark-colored stools indicate that some active bleeding is going on in the proximal part of the gastrointestinal tract. The blood gets digested in the intestine and comes out through the rectum in the form of dark colored stools. I suggest you consult a gastroenterologist as early as possible. He may need endoscopy and colonoscopy to find out the source of bleeding. If he is taking alcohol, tell him to stop it. Bleeding in the upper G.I. bleed. Endoscopy and colonoscopy." "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 43 year old female. I am thin build and have no health issues. I am a non-smoker and non-drinker. I do not have kids and not sexually active for the past 15 years.I had my hormone levels checked four months ago. The report showed no menopause and thyroid was fine. My two recent pap smears were also normal. I had a hormonal check as I missed my periods four months ago and since then I have had normal periods.Again, this time I have had cramps and brown or slightly red discharge, but no real periods. I have had two pelvic ultrasounds. The first one showed hemorrhagic ovarian cyst and this disappeared on the second ultrasound scan. But, the second once showed a cervical polyp. Ovaries were normal and there is no cancer, pcos or endometriosis.I am going to get the polyp removed after a month through hysteroscopy and D and C. Why have I missed my period? Why do I have cramps and no periods? Why was there brown discharge? Is cervical polyp the reason? My cycle is always 21 to 23 day and today is my 27th day. Please help. ### Response: Hi. This type of missed period could be due to ovarian cyst, which can also cause painful cramps with brownish spotting. Polyp can also cause pain with brownish spotting. If your hormonal profile is normal, then yes, you will get periods. Please get LH (luteinizing hormone) and FSH (follicle stimulation hormone) done to understand about delayed period if it reoccurs." "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 found out I am about three weeks pregnant. This is my first pregnancy, so I have no idea what is normal? I have lower abdominal pain, sort of like period cramps, but they more localized to the right side. Is this normal? ER stated they could not see anything on an ultrasound because it is too early in the pregnancy. ### Response: You are right to be concerned. It can either be a normal pregnancy, or the pregnancy can be ectopic (in fallopian tubes) and thus should be further evaluated. Get a serum beta hCG levels done. It is a blood test that has to be done twice 48 hours apart. If the value doubles (or increases by 66 %), it is a normal pregnancy. If the growth is less than that, there are chances of ectopic pregnancy or missed abortion. Also, by the time the value of beta hCG is 2000 or more, the sac should be visible in the uterus (happens around four weeks or more). Please get the above investigations done and do not ignore the condition. Serum beta hCG twice 48 hours apart. USG early pregnancy when hCG reaches 2000. Ectopic pregnancy missed abortion Normal intrauterine pregnancy. Pregnancy support if required." "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 white bump right behind where my wisdom tooth is and my gum is sore. It is swollen and hurts bad when I wake up then I get a stinging pain the rest of the day. ### Response: As I can see in the picture (attachment removed to protect patient identity), it seems like your upper last molar has sharp edges and these sharp edges hurt continually to lower gum tissue. Injury due to sharp edges of upper tooth cause sore or ulceration. I suggest you see your dentist, after clinical examination, he or she will smoothen up the edges and make sufficient space. Medicines will not be able to provide you relief. So please see your dentist. Have a good day. Sharp edges. Clinical examination. Ulceration due to sharp edges. Smoothing of edges. Do not take too hot and spicy food." "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 having excess phlegm for the last two weeks. It is sometimes green in color or clear color. Phlegm comes sometimes when I am talking. There is also hoarseness of voice. I smoke cigarettes, although trying to quit. Have not smoked for three weeks. Can this be throat cancer? I am worried. ### Response: Hi. Throat cancer is the last diagnosis to be expected. Firstly, you have a bacterial infection revealed by the green sputum. So you have to take an antibiotic as Targo (Levofloxacin) 750 mg once daily for 10 days plus hot fluids. You must have an endoscopic examination of your larynx to detect the cause of hoarseness. Do not speak loudly and avoid spicy and cold foods. Show me the picture of the laryngoscope when you have 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: I spoke to a dermatologist on here. I had two small bumps about 2 to 3 mm in size ever since I was younger and I am confident it is not a sexually transmitted disease. They were on the tip of the foreskin of the penis. Just two days ago, they started getting big. It never bothered me before up until now. The dermatologist said it appears to be \deep seated nodular swellings with redness and inflammation\. He said they might have been two small sebaceous cysts which have now gotten infected. He recommended I take an oral antibiotic Amoxicillin for a week and Ibuprofen. I just wanted a second opinion from someone who is more knowledgeable in this area. ### Response: I have seen the images sent by you (attachment removed to protect patient identity). Do you have pain or fever? Yes, it definitely looks like a sebaceous cyst. You should take antibiotics as prescribed. When infection and inflammation subsides you will require getting it removed surgically. If swelling and inflammation do not reduce in five days than contact a urologist or general surgeon. You may require clinical examination and they will suggest getting it removed" "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 a few of my ECG's read from my health records. I have chest pain, sharp that spreads across the chest, shortness of breath, rapid or fluttering heartbeat. Extremely low pulse rate to extremely high. At present, I have not been able to get my heart rate below 120 BMP for a few hours. ### Response: Hi. It is not relief of your chest pain only. Diagnosis of your problem and proper treatment has to be started. A beta blocker is effective in lowering fast heart rate but in case of bradycardia, it will further reduce the heart rate. To identify any sinus pause is there or not, Holter monitoring and echocardiography have to be done along with freeT4, T3 and TSH. Sometimes, thyroid function problem may give irregular heartbeat. So, do not worry, do the tests and start treatment accordingly. Attend hospital for the above tests." "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 hair has been dry and brittle and falling out for the past year, but it seems that I have been losing my hair for longer. I do have seborrheic dermatitis on my scalp, but I have had it under control for the past two months. I am only 27, and I am a picky eater, so I know my diet is not high, I also get around four to five hours of sleep and average two glasses of water a day. Could this be affecting my hair, or is it MPB? ### Response: I have gone through your case. First you need to understand hair fall once started may take six months to one year for recovery. Moreover it is true that it is often aggravated due to stress or lack of sleep and due to male harmones and different products we use for hair styling. In your case in my opinion it is male pattern baldnes. Apply five percent Minoxidil lotion on your scalp twice daily for three months at least. Please take a good diet like milk egg and protein. Avoid stress. Take six to eight hours of sleep." "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 hair fall. My hair is very thin. Then I used Mintop 10, Finasteride 1 mg tablet for one month. After starting this prescription for 20 days hair is not falling. But for the last 10 days, so much hair is falling. Can I continue or stop Mintop and Finax? ### Response: Hi. I read your query and I saw your pictures. (attachment removed to protect patient identity). It is common in this age group. It is due to hormonal changes in the body especially testosterone and DHT (dihy" "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 daughter had a little girl four years ago. About three months postpartum, she fell down a flight of stairs injuring her back. At the same time, she had a very bad cold. When her back continued to give her pain after seeing the orthopedist, she went to a neurologist. Her blood work showed an ANA of 640 and a positive anti-DNA number. She was told that she was a candidate for developing lupus. Since that time she had seen a series of rheumatologist as her ANA has remained positive, rarely 320 but generally 180. He just went for a routine rheumatology and her ANA is negative as is her anti-DNA number. Of course, she is elated, as she and her husband have wanted a second child badly. They have been afraid however because of the risk of her developing lupus, especially afraid of becoming disabled as she already has one small child who needs her care. She has also been told that the offspring of women with positive ANA with potential lupus may have children with a higher incidence of autism, another great fear in this generation.She is now very confused about how to proceed in terms of getting pregnant. On one hand, it feels like she may have dodged a bullet - and if so is there any sense in running after the bullet? On the other hand, she is trying to think positively that this may be a window during which a pregnancy might be safe. There seems to be a rise in autoimmune disorders in general, especially among childbearing age women. She is a 35 year old professional. Of course, pregnancy is a hormonal firestorm and she is afraid that it will reignite lupus. On the other hand, she and her husband desperately want a second child. In your experience, once an individual who had previously tested positive ANA for four years goes to a negative status, is it likely they will remain there? Would you advise against the pregnancy? In your practice have you seen the offspring of ANA positive having a greater incidence of neuro-developmental disabilities like autism? (she was never positive for that congenital lupus marker). Do you think it is likely that the pregnancy would put her at greater risk for developing lupus either now or in the future? ### Response: Hello. Yes, there have been cases where ANA once positive becomes negative towards the later part. Initially, it may have been induced by pregnancy or any infection but over course of time, it becomes negative. As for your friend, I would suggest we do ENA (extractable nuclear antigen) profile and antiphospholipid work up before she plans for next pregnancy. This will give us a clear idea if she has any other antibodies apart from ANA which can trigger underlying lupus. If they are negative she should be fine to go with it. But yes, with pregnancy it is difficult to predict if she will develop lupus or any other disease for that matter. But lupus in itself is not a contraindication for pregnancy. And there are no risks of autism in such patients. ANA is a mere antibody which can come positive in thyroid patients or you can even see in 5 % of the normal population without causing any symptoms. So to conclude, if her ENA is negative and antiphospholipid is negative we should not focus too much on just ANA. But yes, we cannot deny the little risk any pregnant female carries for developing new diseases. So if they really want we should not stop them. Hope the information was useful." "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 a large, soft lump on the penis, partially covered by pubic hair. It has a blister like appearance, but it is not. He says it is tender to touch. What is this? And should we do anything about it? Also, there does not appear to be any liquid coming from it. Please help. ### Response: I have gone through your case history and would help you as best as possible to get your son out of the problem that is bothering. I have had several patients with similar complaints during my practice. Our best wishes to you and your son for his early recovery! Revert back with the photographs 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 am a 25 year old male. I am a healthy person. If I want to maintain this health ever, then I understood that I should balance vata, pitta and kapha (tridoshas) in my body. I have also studied many basic principles of ayurveda for the last three years. Kindly tell me a powerful medicine that always balances tridoshas and seven dhatus in my body. I am already on Triphala. So, please tell me something useful to balance my body equilibrium. ### Response: According to Indian traditional medicines (ayurveda and siddha), one can be healthy by balancing three life humors and seven body humors. For example, amla (gooseberry), triphala, etc. But, in today\s lifestyle, these two are not sufficient as you feel and I also agree with you. Once in a six month, you need to subject you for body service. It means purgation, vomiting (vamanam) and sweating or sputum expectoration are the three procedures to balance vaatham (vata), pitham (pitta) and kapham respectively. This can be effectively done under ayurveda or siddha physicians. In ayurveda, they do it in panchakarma therapy. In siddha, it is done in two phases : Currently available Kaya kalpam" "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 went to the dentist this morning for an extraction on a bottom molar on my left side. After being completely numbed he started the extraction and I had excruciating pain. He numbed me more but no matter how much he numbed, it hurt so bad. He eventually said he would refer me to a dental surgeon so I could be sedated. He was extremely nice about it the entire time but I could tell he just thought I was anxious and misinterpreting the pressure as pain. I was extremely nervous and anxious so I understand but I have had a tooth pulled before and I know the pressure, but this was an intense pain even though I was numbed. He said the dental surgeon would give me an IV that would relax me and make the procedure easier for me. I am worried that being sedated will not stop the pain. He said because I had a bad infection in the tooth that it could be causing the pain so he prescribed me some antibiotics to get rid of the infection. My questions are is this normal to have such terrible pain even while completely numb and will being sedated even help with this pain? ### Response: Hi. It is the best question I have got in my practice and the most frequent query is how and why. This is due to two reasons. Infected tooth with much inflammation or patient\s anxious nature. So to tackle such cases it is better to prescribe antibiotics for five days then extract even if patient complaints, again it is better to give him or her tablet of Alprazolam before extraction one or two days to relieve anxiety. Moreover, before blocking the nerve, we can also give an injection of Dexamethasone which reduces inflammation." "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 injured myself when I fell from my scooter a month back. It is healing, but the doctor has said that skin grafting is required. I wanted to confirm if skin grafting is necessary or the wound would heal on its own by regular dressing. I have attached two pictures one was taken 12 days back, and the other was taken today. ### Response: After seeing both the images (attachment removed to protect patient identity), I can tell you the following. Your doctor is right in suggesting skin grafting. I think you should listen to him or her." "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 daughter has a soft spot in the middle of her forehead for the past nine months but can only be noticed when she raises her eyebrows or if the lighting is right. When sliding a finger over it you cannot feel anything, the forehead feels normal even when she has her eyebrows raised. It looks like a soft slightly raised lump when you can notice it. I have taken her to the doctors but they could not see anything. I had to show them photos as sometimes it really stands out, other times you cannot see it. What should I do? ### Response: Small spot in center of forehead is seen in some pictures (attachment removed to protect patient identity). As you know skull is made up of 16 small bones, these bones are attached with cartilages and get ossified with times. Due to some gaping, this swelling is seen. Give your kid Calcirol sachet once a week for five weeks, dissolve in two spoon water. Syrup Ostebon (Calcium) one teaspoon full twice a day. Zincovit" "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 always try to control my anger since my childhood days, but for three years, I usually lose my temper and day by day, my anger is increasing like anything. I tried all methods to control my anger, but it does not work. Is there any treatment to control anger? ### Response: Hello. Anger is an emotion. When anger rises, our animal instinct tries to protect our-self resulting in aggressive behavior. Aggressive behavior happens only when anger goes out of control. Getting angry is fine. But you should make sure that it does not cross the boundary. In my opinion, instead of controlling anger after it is triggered, you should try not to get emotional at all. Understanding the circumstances and correct perception should help you never even start the emotion. Anger management therapy is the management of anger after it got triggered. That should be useless. I could suggest some cognitive behavior therapy method in this aspect." "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 26 year old female. My LMP was on the 8th of last month. I missed my period this month. I have done a home pregnancy test on the 10th of this month, and I have seen a faint line which was confusing. So, I took a beta hCG blood test and got the result as 54.50 mlU/mL. Could you please let me know whether I am pregnant or not? I have attached the reports. ### Response: I have gone through your question and understood your concern. I have reviewed the reports (attachment removed to protect patient identity). Hope you found the answer helpful. Regards." "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 fungal ear infection yesterday.Doctor asked me to get admitted in the hospital for a microsuction to remove fungal debris.Is it mandatory to stay at the hospital overnight for a microsuction?Can microsuction be done as an out patient procedure without staying in the hospital? ### Response: I would like to tell you that fungal infection in ear is quite common and it may be treated by: Most of the times patients are treated as out door patients but some times if there are some associated complications or patient\s general condition is low due to some other associated diseases, then hospitalization becomes essential. Revert back to an ENT otolaryngologist online for further follow up" "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 27 years old. I have a problem with vehicle sounds. When I hear a loud noise, I feel very stressed. I sit on computers for long hours. I also have dry eyes problem. I went to an ophthalmologist. He gave me eye drops. Please advice. ### Response: In this case, there is a deficiency in tear film due to less frequent blinking and stress of working on a screen. Another possibility is" "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 often get a mouth ulcer which is in the form of oval shape and white in color. When I get this, I apply Mucopain gel and take Riboflavin tablet 10 mg. Can you please let me know the reason for this? ### Response: Hi. As per your complaint, you are suffering from recurrent aphthous ulcers which is causing you the eruption of ulcers on the tongue. It can be caused due to a number of reasons like: You need to consult an oral physician or a general dentist in this regard to get evaluated and treated." "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 hair loss problem for the past four years. Initially, I had taken some tablets like Follihair and applied Tugain on and off. I am using Tugain till now and I feel that hair loss is controlled when applying it continuously. Till now, I would have used six bottles of Tugain 10% and four bottles of Tugain 5%. Long back, I had applied Amexidil spray, Grocapix gel, Androanagen tablets and tablet Finax, but did not find it very useful. As of now, I am using only Tugain 10%. I am having hair loss; although not very aggressive it is still there. Please advise further treatment. How long can I continue with Tugain? I have attached couple of pictures for your reference. ### Response: I have read your query in detail and viewed the attached pictures (attachment removed to protect patient identity) and do understand your concern. Minoxidil is quite safe to use, and has to be used continuously for resumed benefit. The contraindications for Minoxidil use are: Other than that, you may continue it for as long as you desire medical treatment for your hair fall. Another point I would like to add, is that Minoxidil 5% is as good as 10% for male pattern alopecia. So, for maintenance you can well use 5% lotion twice daily. Minoxidil lotion with Finasteride combination is available and can be preferred over plain Minoxidil. 1. Take nutritious and protein rich diet such as pulses, milk products and eggs.2. Avoid routine application of gels or frequent blow" "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 week, I went to play basketball for 3 to 4 days and after playing, there was muscle pain in fibula part of the leg. And if I take one day rest, and again go to play, then again the pain resumes. Please suggest me some cure. ### Response: Hello. As this pain looks to be more of muscle fatigue. As the fatigue is going to set in because of a less muscular part in the leg region. Mostly the anterior portion of the leg pains which is the fascia pain. You can use icing to reduce the pain. For having a good sports fitness you need to do some small warm-up and stretching exercises before the game. Also doing regular jogging for 20 minutes should give a good outcome score. Most sports injury happens due to lack of fitness levels and performing warm-up and stretching before sports can help avoid pains and Injuries." "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 I-pill on the next day of my sex, but now there is bleeding on the eighth day. What does that mean? Am I pregnant or not? ### Response: Since you have taken the emergency pill within 72 hours of intercourse, there is no chance of pregnancy. So, relax and do not worry. However, if you have a doubt then get 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: I have been taking Concerta XL for ADHD for 10 days now. I have started taking 18 mg per day and after seven days I increased it to 36 mg. However, I do not feel the effects anymore, initially, when I was taking 18 mg it was working, but it no longer works. Can you develop a tolerance to Concerta XL? Please help. ### Response: Hello. Concerta XL needs to be gradually titrated up according to your age, body weight and clinical response, i.e improvement in symptoms and any side effects. I note that it is still early days since you commenced on Concerta. XL. You will not be developing tolerance in this timeframe. For your weight (92 kg), perhaps you may need a higher dose provided there are no contraindications. Discuss with your psychiatrist or treating team about titrating up to 45 mg a day or 54 mg a day. You will need to be regularly followed up, during the initial period of starting stimulants. Also, try to follow cognitive behavioral techniques alongside medication for optimal management of ADHD (attention deficit hyperactive disorder) symptoms." "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 31 years old and recently went for life insurance and they did a blood test on me. My results were normal except liver enzymes. AST 203, ALT 206, and GGT 281. Bilirubin 0.8 (apparently normal). I have been drinking heavily for a couple years, but quit about three weeks ago (the week prior to the blood test). How long would it reasonably take to get my enzyme levels back to normal ranges, and allow the liver to repair itself? Obviously, abstaining from alcohol is in my new life plan, and also eating well and trying to exercise more regularly. Should I currently be worried and seek additional help or medication or should the life changes above allow for my liver to get back to normal? ### Response: Yes, this is alcoholic fatty liver disease and hepatitis. You need to worry. Once you stop alcohol, the levels should come down to normal in 6 to 8 weeks of complete abstinence. You should discuss with your doctor to prescribe you tablet Udiliv that contains Ursodeoxycholic acid for three months. I would recommend you an ultrasound and a check-up for hepatitis B and C via blood tests. Moreover, you should exercise and avoid fat in the diet." "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 placed caps in my two teeth. Now, I got swelling around the teeth. X-ray has been taken. The doctor told me that there is some infection in the teeth, so it needs a root canal to be done. I do not have any pain in the teeth. I have only swelling in the teeth. Please suggest what to do? ### Response: Hi. Pain will come back after a few days if the root canal treatment is not done for the infected teeth. It is better to do a root canal treatment in the teeth as soon as possible as the pain can become unbearable. Such swelling come due to nerves that get rotten inside the teeth due to various reasons like putting a cap over it. You will need antibiotics and painkillers" "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 30 year old male. My height is 5 feet and 7 inches, and I weigh about 87 kg. For the past 4 to 5 years, I am suffering from indigestion. This got more serious in the recent years. It used to occur three to four times every week, especially after lunch. I sought medical help and went to see a general physician, who ordered for blood tests. It revealed most of the levels to be normal, except for a mild elevation of ALT and AST levels. Then he ordered an ultrasound which showed I have a fatty liver, though I rarely drink alcohol. Also, H. pyroli came out as negative. He asked me to take a healthy diet and avoid alcohol. For indigestion, he prescribed Rabeprazole 20 mg every day, which seemed to help, since I did not get any indigestion anymore.More recently, I developed frequent loose motions. On some days, I pass stools thrice and have excessive gas. Over this period, I had four to five blood tests, which revealed that my hemoglobin was gradually decreasing. The first blood work done three years ago, showed my Hb to be 152 g/L, then 148, 143 and now in the last month it was 137 g/L. Also, my RBC count dropped from 4.89 to 4.5 million cells. My latest ferritin level was 194 ug/L. I asked my doctor here, and he ordered FOBT test. All three samples showed negative and no blood was found in the stool. Recently, he has ordered for a colonoscopy which I am waiting on, and I am really worried that I might have colon/rectal cancer. My question is, does negative FOBT and normal ferritin rule out any cancerous growth in the bowel and intestine? I have hypothyroidism and sleep apnea. I have no family history of bowel cancer. ### Response: So, discuss the above mentioned information with your treating physician. Follow up if you need more information regarding any thing else. 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: My doctor suggested me to have cognitive testing for my problems with memory and concentration. I also cry for no reason. I was let go from work for making too many mistakes and forgetting tasks. I cannot get over that. I feel I will not be able to find other work because I have Lupus SLE arthritis and fibromyalgia. I am really depressed and crying constantly. Currently I am on Wellbutrin for anxiety, Plaquenil for lupus, Procardia for Raynaud\s, Lialda for colitis, Lisinopril for high blood pressure and Alendronate for arthritis. I have been taking the same medication for the past six years. Please help me. ### Response: Hello. I can understand your concern. The symptoms like forgetfulness, lack of focus, poor concentration, memory issues, etc., are seen commonly in depression and should be evaluated properly. You have mentioned that you also cry for no reasons and you are 53 years old. It is not very common to have dementia at this age. Secondly, memory impairment in dementia start with memory issues in day-to-day thing. Mood symptoms, crying, focus issues, etc., are seen commonly in late stage of dementia." "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 what I believe was the flu. It started end of last month. I got mostly better, still had post nasal drip and persistent weakness. Got a worsened sore throat this week. I went to urgent care (as I am traveling) and was given Amoxi 875 for 10 days. Strep was negative. Lungs were clear. Throat clearing with the antibiotic but I am still weak. Is this normal or should I be concerned? By weak I mean, I do not really feel well after doing things like shower, grocery store for supplies, etc. I am not short of breath, just a little weak and shaky. How long after the flu am I safe from deadly pneumonia? ### Response: From what you mentioned, you have experienced upper respiratory infection and you received appropriate therapy of antibiotics. Regarding pneumonia, you should not worry about it as you have no symptoms like high fever, rapid breathing or wet cough with dark phlegm, also your chest X-ray is free as you mentioned. Your weakness is most likely myalgia which accompanies the infection. It will improve within days. Have you performed CBC blood tests? I suggest: I suggest that you send me your chest X-ray if you have it in order to reassure you more" "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: As per my latest liver function test, SGOT is 45.05, SGPT is 55.17 and serum albumin is 3.43. All other parameters are in the normal range. For kidney function test, the urine sample is protein positive. All other parameters are in the normal range. For the last two-three months, I have been passing light yellow urine almost all the time. My doctor has advised me two tablets of Nusam 400 and one table of Ursodox Plus every day. I would like to know if the medicine prescribed by my doctor is appropriate. And most importantly, what is the status of my liver and kidney? ### Response: To help you better, I need to know a few things: Revert with the asked details for a better help. Revert with more information to 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: My age is 26. My teeth seem to be yellow in color from the past few years. I do not have any other dental issues. So, I want an advice from the doctor that can I go for teeth whitening? Is it safe? Will it create any teeth problems in future? Or it may affect my health in any way? How long will the teeth remain white after treatment? How much does it cost? Any experienced dentist please advice me on this. ### Response: Hello. Tooth discoloration can be caused either due to internal stains or external stains. If the discoloration in your case is due to external factors, then you can simply go for scaling or cleaning of the teeth which is very safe for everyone. Teeth whitening or bleaching can be done in cases of internal staining. It is done using certain chemicals, results are good, but you need to be little cautious while having colored food like tea, coffee, etc. But if you have teeth sensitivity, then bleaching would not be a good idea as it can lead to more sensitivity. Your teeth will remain white as long as you can maintain it with proper oral hygiene. Cost can vary according to the clinic. Otherwise, it will not affect your health in any other way." "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 heard and read about swarnaprash and I want to give my 1-year-old son the same. So, kindly give me details. ### Response: Swarnaprash is special sansakar to newly born baby according to ayurveda. It is a special preparation of gold and other ayurvedic medicines. It is administered to improve child intellect, digestion, metabolism, physical strength, immunity, complexion, fertility, etc. It can be given from 0 to 16 years old" "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 68 years old. I have just been diagnosed with macular degeneration. The doctor basically stated that there was nothing that could be done as this was just a part of aging. He did suggest to eat more green leafy vegetables. When I suggested Kale and dark leaf vegetable powder, he laughed and called me a dreamer. I simply cannot believe that there is anything else I can do. I am healthy with low blood pressure and a good weight. I would appreciate your medical opinion. ### Response: As you stated that you have been diagnosed with macular degeneration that is ARMD (age-related macular degeneration). Now, let us know what ARMD is." "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 any possibility of full recovery after detachment of severed right-hand thumb, if the detached part is found and not fully damaged? ### Response: Hi. The recovery depends on multiple factors: Whatever we do, the normal functions are never achieved. But cosmetically patient has a digit that is scarred usually. Sometimes, the reattached part is useless and patients demand amputation for better function. These days, cosmetic implantable prosthesis is a better option and is natural-looking." "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 my period, huge blood clots are seen in my sanitary napkin. Will it affect my fertility? ### Response: Passing clots on the first day of your menstrual cycle is normal. This does not affect your fertility. But, if you are passing it on all the days of your cycle, then it requires attention. You need to be treated. You may have to take medicines which will control the amount of bleeding. Consult a gynaecologist online to know the severity of the problem" "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 sex problem such as zero to one-minute timing. The second time, there is no reaction. Also, my penis is small. Please guide me. I have taken so many medications previously. When I start medicine, the reaction (I mean timing) improves, but after stopping the medicines the same problem is back. Someone said to me, this medicines if taken, can cause habitual dependence. So, please suggest a medicine that would work for me for lifetime but at the same time has no side effects. Please guide me. ### Response: It seems like you are suffering from premature ejaculation. There are several causes for this condition. Premature ejaculation is mostly psychogenic and it reflects your psychology and thoughts while intercourse. But it can be managed through ayurvedic medicines and Yoga practices. Small-sized penis does not matter but the penis should be erected for a period while intercourse. Even two to three inches of erected penis would be able to provide sufficient pleasure while intercourse. Before intercourse, foreplay is very important to improve your concern. Follow the instructions. Do these things and provide your valuable feedback after fifteen 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: My son is 14 months old and a normal baby. He has developed white patches or spot behind ear and back of the neck. According to my knowledge, it is present since birth or from the time he was three months old. My father has eczema in his leg. The patches do not spread but with time, they seem to enlarge. I am much worried. I want to know what is that patch. Is it curable? Are there any chances of it spreading and becoming a permanent patch? Is there any way to cure? I have attached the pictures for your reference. Please help. ### Response: Hello. I can notice the patches are forming lines. They are identified as birth marks. Just the way there are black moles present, similarly white moles are there. These birth marks do not cause any health problem. They do not have any symptoms and will remain forever. Since it is not present on face, it will not affect cosmetically. Keep a record of photographs taken regularly and observe the change in size and color of the patch. For better analysis, get it checked with a dermatologist." "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, who is 5.6 feet tall and weigh 172 lbs. I have head and chest pains for over five years. Currently, I take Metoprolol, Amlodipine, Losartan, and Prednisone. My pulse and heart rates are normally regular, but immediately after doing Valsalva maneuver, it becomes trigeminal pulse. This is very repeatable. It returns to normal after about 10 to 15 minutes. What could cause this? ### Response: Hi. I have carefully reviewed your case and understand that you are worried about your heart beats and pulse after doing Valsalva maneuver. Hope it helps. Please feel free to contact me back if you need further assistance. I would be happy to help. Regards." "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: Do I need an anti-rabies vaccine, because my 2 and a half-month-old puppy nipped me? It is barely a bite but I cleaned it and no symptoms seem to show up, my puppy is not vaccinated yet because it is too young. I am 18 years old. ### Response: If the bite was unprovoked and if it caused bleeding then you should get a course of anti-rabies vaccine plus a shot of tetanus immunoglobulin, to be on the safe side. Even though it is a pet, it is not immunized so the standard protocol is to get vaccinated if the above-mentioned factors are present. Also, wash the wound with soap and water thoroughly. If the skin was not broken and if the attack was provoked, then it is not necessary to get vaccinated. However, given the nil immunization status of your pet, you may want to be on the safe side and get the shots." "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 numbness in my left thigh. I have attached the region in the photograph. The red area is high in numbness and has very less sense. Only a nail or scratch can feel there. Other, green areas have mild numbness. When I sit for a long time, it worsens without pain. Sometimes, I feel that this may be due to low blood circulation. Is this very serious? Can this be a pre-stage of sciatica or peripheral nerve problem? Can this be treatable? Please advise some medicine for this. I do not have any pain in the affected site. Also, the numbness feeling is only on the surface and not in depth. ### Response: Meralgia paresthetica or radiculitis. CBC (complete blood count) and serum vitamin B12 level. Revert back with the investigation results to an orthopaedician and traumatologist 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 son\s appendix burst about four weeks ago. On the day they burst, his urine was a thick dark red color. His appendix was gangrenous and the infection had spread to all four quadrants of his abdomen. He had a catheter after surgery which became blocked with the thick urine so was removed. Last few days his urine has turned this dark red color again. Looks like blood but is not every time he wees. It happens about once a day. Is this a medical emergency? Is it related to the appendix or is it a different problem? What could it be? ### Response: Dark red colored urine means blood mixed with urine and is generally arising from the urinary tract. That means either from urinary bladder (common) ureter (less common) and kidney rarely but cannot be due to appendix unless it has locally affected the above-mentioned organs. Second is it an emergency? Yes, because losing blood is always an emergency and needs to be stopped as early as possible. Regards" "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: About four years ago, when I was self-conscious about the size of my penis, I started looking into ways to increase the size of my penis. Never long-term, but I tried penis water pump and penis extenders. A few times that I used the penis extenders, the ring may have been very tightly packed around my penis while I was using it and due to the stretch it caused, and tightness, I lost circulation to my penis tip to a point the tip went numb and cold. After that, I started noticing my erections are much weaker and sensitivity has gone down significantly. Besides that, I also became very self-conscious and psychologically worried that I may have made my ED worse.I did not have problems getting an erection, but maintaining one was more difficult and my erections were softer. I stopped having sex. After three to four years, when I masturbate, the quality of the erection is much better and I am able to keep the erection but the sensitivity is not quite back. Also, my climaxes are much weaker and they do not feel as good. In the last year that I have masturbated, I have not had issues maintaining an erection when I am masturbating but I believe the sensitivity is not back. I am worried having sex, I will begin to lose the erection fast. I have red skin marks under the skin at my penis tip that is not going away. Is this due to dead cells? Have I done irreversible damage? Is there any treatment as I now am hoping to become sexually active? Many of my problems are from using the extenders and penis pump aggressively even though it was short usage and regretful decisions. ### Response: I saw the pictures (attachment removed to protect patient identity). The penis looks almost normal. As you are able to masturbate, post-marriage, sexual activity will not be an issue (rather it is better). Aggressive stretching may have caused some damage but from your description, it appears it will not affect your married life. Feeling an orgasm is also dynamic. It may become better after marriage and is unrelated to stretching. Do not worry. If after marriage there is any issue, you can consult again at that time" "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 18 years old and I have been prone to masturbating for the past three years, and now I have erectile dysfunction. Is there any way I can treat this without any medication or any surgery? I have not consulted any doctor yet. ### Response: Hello. Masturbation is normal and does not cause physical problems or sexual problems. Also, do not give any importance to an advertisement that mentions that masturbation cause health problems or destroys life, and masturbation does not require any treatment. Erectile dysfunction can be due to stress or anxiety or due to a physical cause. For physical cause, you need to do some blood tests like sugar and hormones. Stop smoking if you smoke. If you are taking any medicine or nutritional supplement on regular basis then it may be due to the side effect of that. But general exercise will help 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 just had three wisdom teeth pulled three days back. I still have severe swelling in my face and neck. I have been having a fever since last night. I have a severe migraine for two days now. Could I have an infection? ### Response: I have gone through your question I can understand your concern. As per your history, it looks like that you may be having post extraction infection. As you said, there is swelling, pain, and fever, all these symptoms lead to a conclusion of post-extraction infection. You need to take the following medication like tablet Augmentin (Amoxicillin and Clavulanic acid) 625 twice daily for five days, tablet Zerodol SP twice daily for three 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 19 year old female weighing 100 lbs and 5.6 feet tall. I have had splinter hemorrhages that started in my index finger and now has spread to my thumb, but the pain in spreading to four fingers of my right hand. It becomes unbearable at times when I wake up or when I go into cold environments. I have no heart problems that I know of besides an abnormally high heart rate for the past two years, which has been dismissed by a doctor as nothing serious. I am concerned because of the pain it has caused me, and I am certain I have not had any trauma to my nails. It is spreading with time. I am not taking any regular medicine except Ortho Tri-Cyclen Lo (birth control). ### Response: There is a possibility of limb ischemia that is obstruction of blood flow to your hand. As it is progressive, it is likely due to an embolus (clot) getting dislodged and landing in your hand or may be due to local clot formation. I suggest you visit your specialist doctor and get the following tests done. Oral birth control pill could have a role to play, as it makes blood thicker. Limb ischemia is an emergency, and it is crucial that we rule out this possibility as the consequences may not be good. So, visit ER (emergency room) and get yourself examined as soon as possible. Is there any discoloration like bluish tinge or erythematous coloration? Can you upload the photo of your hand? Revert with more information 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: My daughter is 15 years old and she has high levels of DHEA (dehydroepiandrosterone). In the first test, it was 641 and 381 in the second test. She took her test when she had periods, normal testosterone and thyroid antibodies. She always had a deep voice and body hairs on her chest and stomach.She was taking birth control pills two months ago because of her irregular periods. Routine blood test for being on birth control revealed the results above. Her cholesterol and lipids are high as well. She is not overweight and she has a healthy diet. My concern is why there is a high level of DHEA sulfate and what does it mean? ### Response: I just read your query about your daughter. It appears that your daughter has irregular menses and hirsutism which is mostly due to polycystic ovarian disease." "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 37 weeks pregnant now. Today doctor told me to get admitted everything is fine as per scanning only head is not fixed. Are there any chances of normal delivery? ### Response: Hello. Is there any other reason why your doctor wants you to get admitted. If everything is normal with you and your baby, then we can safely wait till 40 weeks of pregnancy before taking a call for labor. There multiple factors like, 1. Whether the head of the baby has entered the pelvis (engaged head). 2. If your pelvis is roomy enough to accommodate the baby's head. 3. Any associated medical problems in you? All these are few factors which help us decide whether you can have a normal delivery." "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 83 years old. She had a right hip fracture before three years, and she was fitted with a DHS implant. She has pain, and her fracture is not healed. Her mobility got restricted, and she uses a walker to walk. Before two years, she had severe pain, and she was unable to stand. She used a walker to walk as the implant got loosened. Her two out of four cortical screws came out. Some doctors suggest a total hip replacement. Please review her X-ray and advise a partial hip replacement (fitting only the implant stock and ball whiteout acetabulum cup). If yes, should a mono or a bipolar ball be favored? I am sending her X-ray. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). Her fracture has not healed, and her fixation has got failed. I suggest seeing an experienced anesthetist to assess her fitness for having an extended operation. As her hip is painful, it is best to do a hip replacement. A monopolar hip replacement would be the best option. This operation supports her life, and the decision should be made with her." "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: Why ketogenic diet should not be done long term? Why it is not a good idea to follow a ketogenic diet for the long term and what are the potential negative effects on the body by following a ketogenic diet for the long term? Please comment. ### Response: The opinion regarding keto diet varies from many studies. Self keto diet experience is not advisable. Although it is useful, the long term keto diet is not advisable as per my opinion." "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 my wisdom tooth removed about two weeks ago and they had put dissolvable stitches. When I looked into my mouth today, the stitches are gone and there is a big hole there. Is that normal? ### Response: Wisdom tooth removal is a surgical procedure that requires suturing. Suturing can be done with resorbable (dissolvable) or non-resorbable materials. Yours is the dissolvable type as you have mentioned. The advantages of this type of suturing are: So, you do not have to worry that your stitches are missing. It is very normal. Regarding the big hole that you have mentioned: So, you need not have to worry. Until then follow these steps: Kindly follow up for further clarifications with 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 have a huge concern. I have been wanting to get a tummy tuck but I am afraid because in the past when I had my three C-sections, my blood pressure dropped. Now that I had been researching, I know that is a side effect but it seems that 10 years back my doctors were not aware because they performed X-rays, blood work, etc., to see what was going on but everything used to come back normal. So I really want to know if I have a tummy tuck, would it happen again. I also got nausea with local anesthesia, is that normal too? ### Response: By tummy tuck, you mean spinal anesthesia which you have undergone for all the C-sections, right? Note: Even though all your reports are normal, the basic nature of anesthesia is to reduce your blood pressure and heart rate. That is the phenomenon of anesthesia. It can happen to anyone and at any time. So, nothing to worry about 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: I am a 32 year old unmarried man. I recently had sex with a girl whom I met through an online dating site. It happened one week ago. I knew her from the last three months and had very good communication with her. She said to be working in a good company. We went out one day and had sex. I used a condom while doing it. But during that time I had a cut in my hand and I had once put my finger in her vagina and also the used condom. I also happened to put my tongue in her vagina. The girl is in good health and I even asked her twice if she is HIV positive but she told she is not. I had this anxiety in my mind. I searched the online sites for the early signs and found that I a had little back pain and numbness and throat is feeling little strange. I have little dizziness sometimes. When I am trying to sleep I am shaking from the inside and not able to sleep. It is just seven days since I had sex. I am too scared and not sure what to do. Yesterday, I was feeling a little bad today it is little better for me, but my hands shake a little. Do you think it is possible that I have any symptoms of HIV? Should I look for a common symptom? As I said before the girl is just fine, no noticeable health issues. Do you still think it is possible for me to get HIV from her? What step should I take now? ### Response: Hello. I have noted your concern. I would say that you have a very low risk of HIV due to unprotected oral sex. Unprotected oral sex is still less of a risk as compared to unprotected vaginal or anal sex but the risk is not zero with oral sex. Protected vaginal sex is safe and a skin cut on the finger that is not freshly bleeding is not a risk. A cut that is a few hours old is self-sealing. As far as your symptoms are concerned they are non-specific and partly due to anxiety. Anyways you should take an antigen/antibody HIV screening test (P24Ag and anti-HIV antibody test) at four weeks and at six weeks for a conclusive result. Regards" "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 is 87 years old and has been diagnosed with a benign meningioma of his brain. He had an MRI done recently and it showed that the tumor has grown. He is supposed to undergo radiation therapy soon. Do you know what would cause the tumor to grow? What is the prognosis? Is radiation therapy safe and effective in stopping the tumor from growing? What is the percentage? Would he need a certain type of radiation (like proton therapy) so that it would not affect the surrounding brain tissues and cells? ### Response: Hello. I read carefully your question and would explain that we cannot determine what made the tumor grow, but you should know that the growth speed depends on the tumor type. There are different types of benign meningioma, which grow at different speeds. A biopsy would help determine the type of meningioma and the better treatment options. Regarding radiation therapy, I would like to know if he is going to do gamma knife or just fractional radiotherapy. Gamma knife is radiation, similar to surgery. While fractional radiotherapy is usually used after surgery and helps treat tumor residual or recurrence. Open surgery may be at a higher risk compared to gamma knife, considering your father\s age. Hope to have clarified some of your uncertainties" "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 month I was bitten by some bed bugs. After pest control, they have been eradicated from the house. But my skin is very itchy and there are white and red spots on the full body. Can you suggest me some medicine or ointment, so the redness and itchiness fades? ### Response: This type of rash is seen not because of bed bugs but maybe you are allergic to something coming in contact. It may be so many things like your clothes, bedding or plants or some food items. I am not sure about your age and sex as this information is not available. Urticaria. Desloratadine 5 mg once at night, 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: My father has got a heart attack and was admitted to the hospital. He had chest pain, shortness of breath and no palpitations. He also has diabetes. I will post the picture of the medical report. Please share your opinion. ### Response: He has got heart attack and also had old asymptomatic heart attacks which were painless due to diabetes (attachment removed to protect patient identity). At present, his heart function is weak at around 30%. Normally, it is more than 55% and due to which his blood pressure was low and fluid accumulation in lungs leading to shortness of breath. From now onwards, he should be very regular in his medicine which is prescribed. The prescription is good and contains all necessary medication. He should have a strict restriction of salt and liquids intake like water, tea, and coffee. Otherwise, there may be an increase in shortness of breath." "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 34 years old, hypertensive since 18 months. A few months back, I suffered from erectile dysfunction with different groups like Amlodipine, Ramipril, Natrilix, and even Telmisartan. I am not obese and I practice three days a week. Recently, Tadalafil stopped giving an effect, while before I used to have three days of erection with one pill. ### Response: Get your blood pressure regularly checked and take your medicines to keep BP under control. Get your blood sugar levels checked in order to rule out diabetes which is one of the main causes of erectile dysfunction. This will help make your erection strong. Consult your specialist doctor, discuss with him or her and start taking the medicines 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: Why does everything look different or trippy? I recently got sports goggles for soccer with the same prescription as with my regular glasses. I feel so much more comfortable with my regular glasses that I almost want to keep playing sports with those glasses. I got the sports goggles so they won\t break (I have broken pairs of glasses in the past with sports) and so they will not fall off. Now I am scared to use them because it is almost as if I am in an adjustment period again. I know that happens when you have a different prescription but I know this is the same exact one. Will this continue to bother me when I am practicing or playing? Any tips? ### Response: Hi. It is very common for everyone to get these kinds of experience when they change glasses even with the same power glasses. This is because our eyes get adjusted to the glasses, even minor changes like the shape of the glasses, frames, interpupillary distance, a gap between glasses and eyes. After you use these glasses for a month your eyes get adjusted to the new one. You can use the sports goggles during sport and normal glass during other times." "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 has suffered from a stroke 12 years back (left hemisensory infarct) and four years back has undergone CABG. He is also a diabetic for the past 27 years. Three days back he developed high fever 103.5 with stomach ache and chills. 650 or Meftal forte SOS for high fever. He is better now but during that time he noticed frothy urine so we got his urine microalbumin test done. The levels are a little high. Six months back they were within range. He has no other problem like swelling, etc. His BP is also under control. Also, his other parameters like creatinine, etc., done two weeks back are fine. Only his HbA1c is 7.8.My query is that since the tests were just the next day after fever can they be incorrect? Can the urine be foamy due to fever? Will better sugar control help to resolve this problem? When should we repeat this test again? His current medications are Mixtard Insulin 30/70 - 48 units morning, 13 units night, Glycomet GP2 1-0-1, Linagliptin 5 mg 1-0-0, Fibator 10 mg 0-0-1, Metolar XR 25 1-0-0, Dynapress 0.4 0-0-1, Arreno 1-0-1, Ecosprin 75 1-0-0. ### Response: Yes, an acute infection is known to cause protein in the urine that can cause frothy urine. Moreover, urinary tract infection can also cause this. I would recommend you to get his urine test repeated after two weeks. A strict blood sugar and blood pressure control would control proteinuria." "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 17-year-old female. The back of my uvula starts to hurt since yesterday. It hurts only when I pretend to swallow. But when I swallow water or food, it does not hurt. It hurts only on my left side. I have checked, and it was not swollen and looks normal. I tried touching it and scratched it. Also, when I yawn or open my mouth widely, the pain slowly goes away but after a while, it comes back. Are there any home remedies to cure it? ### Response: Went through your symptoms, it would have been great if you could click a photograph and send as sometimes few minor changes go unnoticed. However, I believe that the uvula is not swollen. In this case it appears as a case of an aphthous ulcer on the uvula. Remedies that I may suggest is: 1)" "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 period was 48 days before. Till now no period. Pregnancy kit tests are negative. I have completed Meprate 10 mg five days course. Still no period. What should I do? Please help. I am very stressed. ### Response: Hello. I think you should test your blood for Hb %, sugar (fasting and postprandial), and prolactin for better 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: This is for my dad. He has epilepsy and is now 52 years old. Last Saturday, he went on his normal routine of getting ready but did not know what happened and he walked out of the house without any clothes. When we asked him if he was okay, he said yes. But after the whole episode, when we asked him if he knew what he did, he said no. We do think that his epilepsy is triggered by less sleep and the only medication he takes is Gabapentin. We think that he is getting depressed because he has a loss of appetite, loss of weight, slowness in activity, concentration problem and occasional mood swings. His current neurologist does not do anything and all he does is keep doing a blood test each time. ### Response: History of epilepsy and intermittent episodes of confusion with loss of memory of the episode (amnesia) is concerning for seizures. For the workup of seizures, he should get routine brain wave testing (EEG - electroencephalogram) or a long-term EEG monitoring to identify any abnormal brain discharges which can cause a seizure. Other things to look at it is head imaging like CT head or MRI brain (if not done already) as it is not uncommon for elderly patients to have blood collection around the brain (subdural hematoma) to present with altered awareness or confusion. I agree with blood tests as an initial test to look for metabolic encephalopathy due to deranged blood electrolytes level and body metabolites such as BUN (blood urea nitrogen), ammonia, etc. Please do not hesitate to reply if you have any other questions or concerns." "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 7 months old baby boy is dropping down his head occasionally. Sometimes, he has some mild jerks. Jerks were at the time after his feeding or after he wakes up. That time, he just swallows or lick his lips with tongue. Otherwise, his activities are very normal. He can hear us, identify us clearly, take his toys on his own choice, starts to grasping things, etc.. He started to crawl and got his milk teeth. For example, if we ask where is the fan, then he automatically sees the roof. If the fan is switched off, then he just sees it and cry. If he crosses some particular color lights or television, he will turn his head towards it and watch it. When I took him to his pediatrician, he said he is absolutely normal. Also, his health is good. He asked us not to worry. But, it makes me fear while he drop his head down or getting jerk. He is our second son and it was a cesarean. Now, he is having cold. He got his vaccinations on correct time. Is there any need to take him to a neurologist? ### Response: Hi.I have read your question with care and understand that you are concerned about few jerks your kid has. First and foremost, I would like to appreciate and congratulate you for giving detailed descriptions." "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 19 years old, male. I am prone to masturbation since a very young age, I tried to do normally and I fail to orgasm even though it seems close. I do ejaculate a bit, but I have to follow it up with prone masturbation. I do not have erectile dysfunction for now, do not know about later. I only try to do the normal masturbation for two minutes.1. How long does it normally take to ejaculate and orgasm?2. What possible effects does proceeding with prone masturbation have on me?3. What methods should I follow to stop prone masturbation? I stopped masturbation all together for 16 days and it was really hard but I still needed prone. ### Response: Following are the answers to your questions. 1. Whenever a person ejaculates, the orgasm is simultaneously achieved in most of the cases. The interval between initiation of sexual stimulus and ejaculation or orgasm is depended upon the many factors and varies from person to person. It can be from less than two minutes to more than five minutes. 2. and 3. The masturbation can be done in any position. There are no side-effects of prone masturbation. It is a psychological feeling that you can erect penis in prone position only. You need to remove that thought and you can do masturbation in any position." "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 having chest pain off and on. I also suffer acidity, although I am not on any medication. I was advised to have an ECG anyway. My ECG showed some minor variation and then was advised TMT which was normal. Please advise. Why do I have chest pains and why is my ECG not normal? ### Response: Hello. Chest pain occurs due to various causes. For example heart problem, lung problem, muscle problem, bone problem, stomach problem etc. Your TMT (treadmill test) is normal. It indicates that your heart condition is likely to be healthy. For your chest pain, the reason may be other than a heart problem. Have you done your echocardiography? If not, you can do it to rule out a structural heart problem." "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: Hello,About 5 years ago I had wire braces for my teeth.And to have the braces on, I had 4 teeth extracted because my teeth were overcrowded.As far as I know, a lot of orthodontists take out premolars to create space.But for some reason my orthodontist took out 2 premolars, 1 molar on my bottom left and 1 molar on my top left.I got my wisdom teeth removed on the bottom right.So, I have only first molar and partly seen third molar on my bottom left side.I was only 14 years at that time, so I really did not think much of it.This has caused many jaw problems for me.I have not chewed on my left side for the past five years.I heard jaw problems can make my face look weird, as of now I have not noticed anything.But I am worried that it might affect in the future.Is there any way I could put a second molar in the bottom left?I still have space where my bottom premolars were, could I move the molar with braces to fill in that space so that I will have space at the back to put on a an implant?I just really want to fix the problem.Please help. ### Response: Hi. Sometimes orthodontists do extract molars if there is very severe crowding of the teeth. In your case, as you said there was severe crowding. Now you have space present where the molars where previously present and hence you are unable to chew properly. Is your second molar on the left side tilted or upright? I assume that your second molar is upright. There are 3 treatment plans for you: For the best treatment option, attach an intraoral photograph of the upper and lower jaw and consult an orthodontist 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 29 years old. I am a male. Though I have been having healthy masturbation since past 15 years or more, the head of my penis is visible only a little bit and the foreskin not fully comes down. Will that situation hamper my married life? Having sex with a condom is possible right? For a long-term situation, shall I look at exercises or eventually get it circumcised? ### Response: Hi. If the foreskin does not retract fully, then it is difficult to perform the sexual activity because it can cause pain and can cause rupture of the frenulum. It all depends upon the severity of the condition. It is advisable that you meet a surgeon in person for an evaluation so that after evaluation he can guide you for further management. He can give you an exact answer about the operation, whether circumcision is required or not." "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 know the substitute for Melacare cream, as I got the look after using the cream and want to stop it. ### Response: Why was it prescribed to you? Wat was the complaint? How long did you apply? Because it also contains steroid and should not be used for long time. You should use sunscreen daily. Safer option like Kojiglo cream can be used." "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, and I am suffering from low libido and erection problem. I am attaching my reports of free testosterone and estradiol for your advice. Kindly guide and advise. ### Response: Your test reports (attachment removed to protect patient identity) appear absolutely normal. Hope you find my advice of some benefit. Good luck" "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 2-year-old daughter has a cough with phlegm. She is suffering for the past two weeks. She got hospitalized for pneumonia the week before. She has wheezing now. Her doctor has prescribed Levolin and Kidpred and has started Budecort inhaler too. The doctor told to continue Budecort for a year and said that she might have asthma. Usually, she is a healthy child and does not get cold or cough often. It started when she started going to day care. Earlier, she was on Levolin, Fevergo and Asthalin nebulization.Is this medication correct? Is Budecort necessary? If at all she has asthma, does she has to take medicine life long? ### Response: According to the history you have provided, it is difficult to conclude whether she has asthma. Pneumonia sometimes takes a month to completely flush out of the lungs. The doctor must have prescribed the medication according to her physical and laboratory examination. Coming to your question of Budecort (Budesonide), if the doctor has confirmed that she has asthma, then yes, the year-long inhaler is necessary. In kids who are confirmed case of asthma, there are certain parameters that we have to go through and guidelines to follow. So, taking Budecort will definitely be helpful" "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 middle back is slightly painful and stiff. I have taken some medicine and it decreased, but not completely. Also, I feel some heaviness in the forehead. Please suggest some treatment. ### Response: From the way you described, it seems that you have a locked back. So, you need a few medicines and physiotherapy.Instructions to reduce back pain and stiffness are as follows: 1. Locked back.2. Ankylosing spondylitis. Revert back if stiffness persists even after seven days to a orthopaedician and traumatologist 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: On the 8th, I felt someone prick me with a needle. Later, I was confused whether it was a needle or his nails. I am so worried from that time, that I may have HIV infection due to this. I have done rapid antibody test on the 60th day and it was negative. Next, I went for CMI (Chemiluminescence) duo (Ag/Ab) test on the 78th day and it was nonreactive. Then, I had some symptoms. So, I was more worried and again on the 92nd day, I went for CMI duo (Ag/Ab) test and it was nonreactive. Please suggest if any further test is required as I am confused. ### Response: Hello. An HIV screening test is considered conclusive at 12 weeks from a possible exposure. So, if your test is negative at 92 days after a risky exposure, it is conclusive. Regards" "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 pregnant woman aged 24 years with running the 36th week of the gestation period, undergone ultrasound given a report of looped nuchal cord around the neck twice. Is there any complication? Fetus movements are good with a normal heartbeat and raised liquor. Are there any complications? ### Response: Hi. The complication could be at labor, at contractions or during Braxton Hicks contractions. Have a strict check on fetal movements and do have recurrent fetal electronic monitoring. In case of reduced fetal monitoring, you need to evaluate electronic fetal monitoring. During labor also this could be stressed labor as cord around the neck that can press neck and can cause compression and reduced fetal hearts. During labor, you need strict and continuous monitoring. In case of abnormal graph during labor, you need to be evaluated by a senior gynecologist and to decide for delivery. Have a strict check on fetal movements and report if feel reduced." "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 30 year old male suffering from glaucoma since the last two years. I have heaviness and itching in my eyes. Please guide me on what to do. ### Response: Hi. I need a few answers from you, before deciding on the reasons for heaviness or itching. Can you please give the details for the following questions? Itching can be because of specific anti-glaucoma medications. I need to know the eye pressure to decide whether your current heaviness is due to the anti-glaucoma medications. This is to decide whether we need to change or continue the medication or decide on any other modalities of eye pressure control in relation to the severity of glaucoma." "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 underactive thyroid and on 100 mg of thyroid and had a micronutrient test as hair has been breaking and falling out. The tests came back with selenium and zinc deficiency but also severe iodine deficiency (12). My nutritionist suggested multivitamins FemForte Multi which contains 150 ug (100 % of daily intake).Nutritionist asked me to check with the general practitioner if it is fine for me to take the supplements with iodine in it and whether it is going to have a negative impact on my thyroid and my well-being or is it absolutely fine to take the supplements. ### Response: Hi. If you have iodine deficiency hypothyroidism, then it should not be a problem but you need to see if you have autoimmune thyroid disease in which case you cannot take iodine supplement" "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 sister is showing some strange attitude. She says that she is hearing a strange voice and acting strangely. Are these due to depression? What are the symptoms of depression? What are the causes of depression? Before three years, she was treated for depression, and still on medication. But, sometimes she put up strange behavior like aloud in the singing in the midnight and restless but will insist she is fine. How do I help my sister? How long does it take to cure? Does medication for depression make the patient see more than required? ### Response: Hearing a strange voice is a symptom of psychosis which can be a symptom of depression. Low mood, lack of interest in previously pleasurable activities and lethargy are some significant symptoms of depression. Genetic cause, a reaction in an unhealthy way to a life stressor, hormonal changes especially in females are some causes of depression. Recovery from depression varies with client symptoms. High mood and confusion can be a symptom leading to seeing of images. Consulting a doctor is essential." "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 34 weeks pregnant and my baby\s choroid plexus cysts did not clear. We did the genetic testing in the early stage of pregnancy and it was negative for trisomy 18 and 21. We had four growth ultrasounds, but no one reported anything else wrong with the baby. I am scared that they did not look well enough. Now we are moving to a different state and the doctor there said that they would have done additional screenings (amniocentesis, talk to a specialist for cysts), but that it is too late now to change anything. She said two cysts (one on each side) are more characteristic of Down syndrome. I have pictures that they gave me from the ultrasounds. Is there anything specific that I can look for on those ultrasound pictures that would indicate trisomy 18 and 21? ### Response: I was able to see the images and reports. (attachment removed to protect patient identity). Apart from the cysts they have not reported any frank worrying features. The nasal bone and face profile images are not very clear. In Down\s, the nasal bone may be absent or hypoplastic. The other direct features associated with Down's are hypertelorism or widely spaced eyes which is not seen in your scans. There is no neck fold thickening. Therefore at this stage of pregnancy, I would ask you not to stress out. Just make sure that on your next scan the sonographer is aware of the choroid plexus cysts finding and includes cardiac evaluation and facial evaluation in detail." "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 two episodes of psychosis in the past two years. I started treatment with Risperidone and later started Asprito 5 mg. I am getting married after two months. I want to know that if I start a family, will this treatment affect my baby\s health as only limited medicines are allowed during pregnancy? ### Response: As you are receiving only 5 mg Asprito (Aripiprazole), which is a very low dose, it is better if you stop the medication at least in the first trimester (first 3 months of pregnancy). Then, you can take medicine safely during remaining pregnancy (last 6 months). But, if not possible to stop the medication, then, take tablet Haloperidol which is safer than Asprito during pregnancy" "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 9 weeks pregnant as per my last period date. But in USS, it is showing only six weeks and six days old sac. No yolk sac found, but the decidual reaction is good. My periods were irregular. As the yolk sac is not developed, my doctor advised for abortion. Is there any hope in my case? ### Response: Hello. If someone is having irregular periods then calculating the duration of pregnancy from the last date of the menstrual period is not correct. If ultrasound is showing six weeks then probably that is your right. Duration of pregnancy. I would suggest you repeat scan after a week and also go for two blood tests for pregnancy hormone 48 hours apart to see whether the pregnancy is viable or not. It will help you to determine what to do next." "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 drank for five days heavily and was admitted to a hospital with hangover and heartburn. They took the test and my amylase and lipase were little high. Then they gave me medicines. Past one week, I am taking Panblock morning and night and Encremin. My health is alright now but my amylase and lipase is little high. Can you give me a clear answer, when does it become normal? I am anxious about it and worried a lot about this test. I have stopped drinking forever. Can it reverse? Please help me. I am attaching my reports. ### Response: Hello. I have seen the reports (attachment removed to protect patient identity). You had a mild attack of acute pancreatitis. The amylase level shoots first and slowly decreases over two to three weeks. Lipase shoots slowly. No point in checking it very often as it usually takes time to normalize. Yours looks like a mild attack only and not a severe one. Once you are symptom-free you can relax. Get an amylase (amylase only, not lipase) after a month. Get an ultrasound scan also after a month. The disease needs avoidance of precipitating factors so that further damage to the pancreas can be prevented. Hope your queries have been cleared. For more infotrmation consutl 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 am having cervical fusion 3 levels 5/17. I am on 8 mg of Suboxone daily. I told the surgeon that I do not want opioids. Can I stay on 8 mg up to the surgery morning? I do not want to stop and have withdrawals or take any opioids before or after the procedure. ### Response: . Suboxone (Buprenorphine) is given to treat opioid dependence. Prozac is an antidepressant. I think because of your disease process, cervical radiculopathy in your case, you have been taking some pain killers mostly opioids for a long time. Doctor might have prescribed Suboxone to take you off opioid dependence." "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 chronic fungal ringworm infection in the groin region. Please suggest some Ayurveda medicine. ### Response: Hi. Ringworm is a skin disease fungal infection. Mostly occurs in wetty areas. Its common symptoms are red skin rash that forms a ring-like structure. Infection of tinea group of fungus. Generally not recommended. Scabies. 1. Gandhaka Rasayana one tablet thrice a day after meals.2. Sinduradi lep- Apply externally three times a 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: Over the last few months, I am experiencing some tingling kind of sensation in muscles on a specific area below the left breast near the rib. I would like to know what it is and the cause for it. I am having that sensation mostly in the evening. ### Response: This tingling sensation can be due to transient nerve compression. This nerve compression can be due to a muscle spasm or due to abnormalities in the thoracic spine. If back pain still persists, then get back to me as you will require a prescription for medication." "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 with my fiancee using a condom but it was doubtful if the condom was broken but I could not confirm. Because one moment, while we were having sex, I felt myself without the condom but when I pulled out the condom, no drop was fallen. Because of this, I had given her I-pill and she had taken it around 48 hours after the sex. But it was on the second day from her date of the period. So, she is getting scared if any chance of pregnancy is there or not. What is the reason for the delaying period? ### Response: Hi. Since you have taken an emergency pill within 72 hours of intercourse, there is no chance of pregnancy. The delay could be because of the hormonal changes due to the pill she had taken. So relax and do not worry. However, if you have a doubt, then get a urine pregnancy test done with early morning urine sample to ensure that she is not pregnant. Do get back to me with reports so that I can guide you further on." "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 went for an ultrasound for my thyroid and the result is diffuse thyroid enlargement with small solid nodules consider adenomatous thyroid hyperplasia.My T3 result is 2.59, T4 135.4 and TSH 17.34, this result was taken before two months. After a month, I took T3, and T4 again resulting in T3 2.52 and T4 95.59. The last clinic gave me a food supplement black cumin seeds oil and vitamin D3.My question now is what does the ultrasound mean? Anyway, I am a male of 39 years old. ### Response: I just read your query and from what you have mentioned it appears that you had enlarged thyroid gland due to hyperthyroidism and the ultrasound also meant that the thyroid gland was enlarged simply because it was hyperfunctioning. And now that you are on medications which can possibly help them with normalization of their function and they might as well likely reduce the size of the gland as well. 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 36 years old and healthy. I had Vitamin D3 deficiency with back pain four years ago when I was abroad. I came back and, did physiotherapy and Ayurvedic treatment. Things got better in two years. But I still have the following symptoms.Back pain comes when sitting for a long time specifically in certain kinds of chairs. Sometimes twisting pain comes suddenly when I sit in certain chairs for long. Standing continuously in certain types of floors is an issue. Lifting weights is fine, but still, need to comfortably lift more than 6 kg. Standing is comfortable in roads, shops, etc., for a long time. Spine pain radiates to the back of the head and neck at times. When that happens I sometimes get lightheaded when seeing objects rotate. Pain comes when I sit and clean objects. If I do no fully sit pain does not come. Long scooter rides sometimes cause back pain the next day. ### Response: You have symptoms that are typical of core and back muscles weakness. I will advise you to take up some regular exercise schedule whether it is gym-based, or at home like yoga, or even at work where you do chair-based exercises that help you with core strength and back toning and flexibility exercise. You can see a good manual therapist or a physiotherapist who will be able to guide you. You should be mindful of poor posture and avoid sitting in position for any length of time." "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 69 years old male with 184 lb and 6'1"" in height. For three years, my volume averaged 0.5 ml antegrade and 1.5 ml retrograde, motility 8 to 17 %, concentration 25 to 80 million. In the past two years, the volume has been 0.2 ml, concentration 20 to 30 million, motility either 0 or < 1 or 17. In the past two weeks, I have produced 0.3 ml total 15,000 sperms w 2 % motile and 0.1 ml with 0 sperms. 1.5-year-old tests done are PSA, FSH, LH, and it is all normal. Testosterone a little low. Prostate 70 cubic cm, no suggestion of ejaculatory duct obstruction.1. What can be done to determine it?2. What can be done to increase quality?3. What is the chance that I will produce viable semen in the future?4. How long might it take?5. How many donor or fresh eggs can be inseminated using IVF, ICSI, and a frozen specimen of volume 0.5 ml 70 million / ml concentration motility 15%? Volume 0.25 ml concentration 150 million / ml motility 15%? 0.3 ml total 15,000 sperms 2% motility?I am under Atorvastatin, clopidogrel, Doxazosin, Metoprolol, and Alfuzosin. ### Response: Hello. They can be evaluated in detail, and the cause can be identified and treated upon. However, antidepressants like Imipramine have shown good results. However at 69 now, the quality of sperm has reduced" "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 3 month old son passes stool only every two days. He passes stool only after we insert a soap stick and stimulate his excretory movements. This has been happening for the past three weeks. Is this normal? ### Response: If your baby is breastfed, it is perfectly normal to pass stool less often. On the other hand, it does not seem normal for such a young kid. If it continues for more than two weeks, get him checked by a pediatrician" "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 34-year-old male. I am having a BP medicine (Telma AM 40). I am having pain in left shoulder, upper chest, back side. I had done ECG, 2D echo and a TMT and all the tests are negative. My doctor said the pain is not related to cardio. The pain is not constant it comes and goes, usually it pains in the night, and the rest of the day it is fine. I used to smoke and I quit smoking from the past three years. Please advice. ### Response: Hello. The characteristics of your pain are not typical of cardiac pain. Does this pain increases on neck movement, or any neck trauma, these may be the associated symptoms. You should get X-ray cervical spine AP or lateral view. You need to visit physiotherapist after X-ray and also orthopedician." "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 mild chest pain over the last three days. I also feel lazy and less energetic for few months. I have done routine checkup. Can you please give suggestion based on the report attached? ### Response: Get ECG (electrocardiogram), 2D echo and TMT test (treadmill test) to rule out any cardiac risk. Your homocysteine levels are little high (attachment removed to protect patient identity), which may be the factor responsible for hypercoagulable state. Repeat homocysteine after a month. Take tablet Folvite 5 mg (Folic acid) once daily. Do regular exercise as it can control your borderline raised cholesterol. Do overlook for any numbness in legs or breathing difficulty. Revert back with the reports to 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: Two years ago, I was injured while playing volleyball. I ignored the pain around my kneecap at that time, and it was fine after a week. After a year, I started getting sudden pain in my right knee. The pain is like locking the knee joint. The pain becomes severe while riding a bike. There is no particular time or prediction for the pain. I am attaching a report of digital x-ray as well as the picture. Please provide me with the interpretation and treatment. I am 33 years old. I have high BP and cholesterol. I am on Tazloc Trio 40 and Rosukem 5. ### Response: MRI knee joint. In the meantime, I suggest you tablet Dolonex DT (Piroxicam) once a day and tablet Ultracet P (Tramadol and Paracetamol) twice a day. Consult your specialist doctor, discuss with him or her and take medicine with the consent of your doctor. Revert with the details 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: I am a 27 year old female. My skin appears very dull. Can you suggest a whitening cream that does not contain steroid, which I can use on a regular basis? ### Response: Hello. You can take an oral Vitamin C supplement every day. I suggest taking one sachet of Ener-C 1000 mg in a glass of water. Use sunscreen in the morning. Apply Golite skin lightening cream over the face at bedtime" "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 chest pain very lightly in different areas of the chest. The pain was not continuous but occurs only sometimes during day or night but not in the sleep. I have taken an ECG and lipid profile test, but both are normal. My doctor advised me to take Ecosprin on daily basis life long. Kindly advise on this. I have a habit of smoking 7 to 8 cigarettes per day.Due to gastric problems, I felt this pain, but after taking gastric medicine, it will disappear. The gastric drug that I used was Atorva for cholesterol, but not now. My cholesterol level is in the normal range. Total cholestrol is 191 and triglycerides are 177. ### Response: For chest pain, I advise you to have treadmill test and exercise tolerance test (ETT), in which you have to walk and run on a treadmill and simultaneously your ECG and blood pressure recorded. If chest pain is due to heart, it will be confirmed. Keep taking Statin (atorvastatin) but no need of Ecosprin (aspirin) according to new guidelines. For on and off chest pain, take pain killers such as Paracetamol. Have an ETT done and send me the report so that further planning can be 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: Are there any chances of me getting syphilis by drinking a beverage that someone with syphilis already sipped? ### Response: Modes of transmission of syphilis are: Moreover, the bacteria causing syphilis cannot survive outside the body." "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 received a couple of faint positive pregnancy tests two weeks ago. Then, I went to my primary physician for another urine test, which came out as negative. Later, I felt some cramping on and off all day on my left side. The cramps were similar to premenstrual cramps along with sore nipples, increased saliva, and sense of taste, absent-mindedness, forgetfulness, very noticeable fatigue, occasional backache and headache, indigestion, burps and frequent urination. I was anxious and read about ectopic pregnancies and decided to test that night. It was a darker line than the previous tests and the result was pretty fast. When I tested the next morning, it was even darker and the result came very quickly. Then, two digital tests a couple of days after being positive. What can be the reason for my pain? Can it occur from a corpus luteum cyst and pregnancy? Is it safe to say that I am pregnant because of the tests becoming darker? Or were they possibly all false positives? I feel like the cramps are a bit more spaced out and less frequent now. Also, there has been no bleeding. I have my first OB/GYN appointment scheduled 15 days from now, but I am hoping for a little insight. I am currently on Vitex capsules 400 mg, GNC prenatal vitamins and Fish oil pills. ### Response: Serum beta hCG and USG early pregnancy to rule out ectopic and confirm cardiac activity. 1. Intrauterine pregnancy.2. Ectopic pregnancy. Revert back with the reports to 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 acne for around five years. Now I am using Cutein tablets. I suddenly got a burning sensation in my stomach. So, now I am using Pantoprazole tablets along with Cutein. Is that effective or injurious? ### Response: Cutein tablet contains Iron as one of the ingredients, along with some other vitamins. The iron tablets can give increased acid in the stomach and indigestion. But, if you take both Cutein and Pantoprazole tablets together, the iron will not get absorbed. Therefore, first take Cutein tablet on empty stomach in the morning, and then 30 minutes later take Pantoprazole." "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 NT scan at 12 weeks and 5 days in which was found placenta is on the right lateral wall, 1.0 cm above the os. Internal os is closed. Cervical length is 37 mm. Does this mean placenta is low lying? Is there a serious problem? ### Response: Hello. Yes, your scan indeed tells that you are having a low lying placenta. In such cases, chances of painless bleeding may be there. It would be better to avoid intercourse and heavy activities and to have a review of placental location in the anomaly scan at 19+ weeks. Almost 75 to 80 % of the times, the low lying placenta usually migrates to the upper uterine segment. So, the chances of bleeding come down by the term. So it is not something major to be worried about but yes the precautions are needed to be taken" "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 sexual intercourse on the 14th day of my cycle but took I-pill after three hours of it. I had bleeding on date similar to my period date after 16 days but it was light bleeding which lasted for three to four days. What does this mean? ### Response: Since you have taken the emergency pill within 72 hours of intercourse there is no chance of pregnancy. So relax and do not worry. However, if you have a doubt then get 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: I had this problem for three to four months when I pull back my foreskin it feels strain and kind of ticklish and itchy. I have been to the doctor and they just gave me Pevisone and it did not work. There is also a little white substance on the penis head. I do not know if it is smegma or not but it is smelly and I cannot seem to clean it. May my foreskin be dry or something? I have also done STD and test for urine infection. ### Response: Hello." "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 athlete and my period is such a hassle. I just wish I could get rid of it. It is irregular and lasts for seven to eight days. I do not want to go on the pill, because emotionally my hormones have balanced out. I am worried that if I take any form of birth control, then it will mess that up. I have started considering a hysterectomy just to get rid of it, but I cannot really take time off from my training. I just do not know what to do. I am currently on Lexapro, Wellbutrin, Midodrine, Mestinon and Trazodone. ### Response: Hysterectomy is a kind of an extreme option considering it is permanent. I understand that you may be hassled by your periods, but removing your uterus before you have completed your family or without any pathology is not the way to go. You can take the oral contraceptive pills, which will both regularize your periods as well as decrease the duration of flow, the pain and the discomfort as well. If you have an event and you need to be not bleeding, then you can manage to postpone the periods with minimal disruption to your hormones. You can take a milder form of contraception, which will not give you the side effects like bloating or migraines. I would suggest Yasmin or Yaz. It is mild and will keep your hormones in order. When you do wish to conceive you just need to stop the oral contraceptive pill. You can take it for six months on a cyclical basis as per the instructions on the back of the pack and give a break of a couple of months and then restart again with the consent of your specialist doctor. Please do not be frustrated. There are more conservative options than major surgery." "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 37 years old and my weight was 104 kg. I am having erectile dysfunction problem and tried before by using Sildenafil 50 mg tablets. Previously, I did not find any issues with this drug but nowadays, I am getting a headache and lower jaw pulling sense. Please suggest what can I do? ### Response: Hello. I can understand your problem. Sometimes, due to hypotension caused by Sildenafil, individuals might develop symptoms like a headache. This could be the reason in your case too. One option to prevent this is to" "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 writing this letter for my mother-in-law. She is 65 years old and seems to be healthy. Recently she was suffering ill (fever, sleepless at night, body pain, etc.) thus visited a doctor (physician). After a physical examination and studying certain blood tests (that he was suggested to test), the physician advised us to consult with a hematologist ASAP. Soon, we consulted with hematologist. He advised us to check certain tests such as protein electrophoresis and free light chain, HbA1c, LFT, USG abdomen and pelvis. He also pointed out that she may undergo bone marrow examination subject to test results. The reports are as follows. We shall see the hematologist by next week. Before meeting him, we wish to know an expert opinion about the interpretation of the test results and further course of action.HbA1c- 6.65, bilirubin- 1.5, bilirubin direct- 1, SGOT-54, SGPT-30, alkaline phosphatase 04-304, T protein- 7.1, S. albumin- 3.8, S. globulin- 3.3, calcium- 8.3, phosphorus- 3, uric acid- 6.1. USG remarks: Chronic liver parenchymal disease with PHT, no ascitesat present, other organs normal free kappa (light chain) serum\x80\x93 46, free lambda (light chain) serum\x80\x93 33.10, free kappa-lambda ratio\x80\x93 1.39, total protein- 6.8, serum albumin\x80\x93 3.7, alpha 1 globulin\x80\x93 0.19, alpha2 globulin- 0.46, beta 1 globulin\x80\x93 0.39, beta 2 globulin\x80\x93 0.42, gamma globulin\x80\x93 1.65, albumin-globulin ratio\x80\x93 1.19, comments\x80\x93 electrophoresis shows elevated gamma globulin. No significant change in the other fractions. No M band seen. Kindly look into the above and revert with your valuable suggestions. ### Response: Your electrophoresis report shows increased gamma globulin level (attachment removed to protect patient identity). So your doctor might suspect plasma cell dyscrasia, especially multiple myeloma like condition. So referred you to a hematologist. But in electrophoresis report, M band is not seen which is classically seen in plasma cell dyscrasia. Moreover, Kappa to Lamba chain ratio is normal in the report. So, the chance of multiple myeloma seems to be less. But increased gamma globulin need further work up in form of CBC, serum calcium level, etc. In the case of multiple myeloma, the osteolytic bone lesion is also present. For that X-ray can be done in the suspected area. The gamma globulin increased in infection or inflammation as well. So your physical examination is necessary. Moreover, your cirrhosis with portal hypertension needs treatment in the form of beta blocker to reduce portal hypertension. The elevated bilirubin can be due to liver damage by cirrhosis." "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 19 years old. What does it mean to have a low blood pressure? I often feel dizzy and I also palpitate whenever I drink caffeinated drinks or when I use the stairs. ### Response: Hello. It could be a number of things, most commonly for someone your age, anemia. However, anemia is the most probable cause of your symptoms unless proven otherwise. Hence, we need to rule this out first. If you are not moderate to severely anemic, you should not have these symptoms unless the underlying condition is something else like I mentioned above. Please get the following investigations done to confirm the diagnosis" "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 24 years old. I have stiffness and pain in thighs and knees for more than a year. I cannot sit properly and stand up instantly. I am having problem in each and every activity involving legs. I have reduced mobility and flexibility of legs. My report shows AVN stage 3 of hip joint, for which I have been suggested hip replacement surgery. My question is that, if problem is in hip joint then why I have so many problems with knees? When I stand up, my knee gets blocked and I cannot stand instantly. There is cracking sound in knees when I sit or stand up. I am worried whether I have some other problem in knees also. ### Response: Hip avascular necrosis (AVN) and hip arthritis causes pain in the affected hip and also sometimes in the knees as the same nerve which supplies the hip also supplies the knee joint. It is called as obturator nerve. This nerve supplies both the joints. So if there is hip joint pain, many patients also get pain in the knee joint. But, also to be sure if nothing is wrong with the knee joint, you should take x-rays and document it. Get x-ray of the knee joint both in anteroposterior view (AP) and lateral view and then get a follow up done to confirm your problem." "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 went to the hospital with side pain near kidney. They discovered blood in my urine. I followed up with urologist for a lot of pelvic pain. I am attaching my urinalysis results from both visits. Both show the blood and the second one says urine squamous epithelial cell mod lpf. I have to wait two weeks for scope but I do not think it could be anything but bladder or kidney cancer. Also, when this first happened, there were two episodes where I got terrible pain in bladder area and vagina and went bathroom and bright red blood came out. It did not appear to be in urine. ### Response: Hi. Your description of symptoms basically points to a possibility of left sided ureteric colic. It is unlikely to be cancer. You have mentioned that you have undergone CT scan. I could not find report of CT scan or films in the attachment (attachment removed to protect patient identity). May I know what are CT findings? If you can provide the report, it will help in making diagnosis. I would like to reassure you again, it is unlikely to be cancer. Please get back to me with CT report." "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: 11 weeks ago, I delivered my baby. I breastfed for only one day. But, my breasts continued to leak heavily for four weeks. I bled for three weeks and I still have not had my first period. I have taken a few pregnancy tests. All are negative, except one, which was a faint positive, which a minute later changed to negative. I took a test again and straight away became negative. I have PCOS and my periods do not get delay for more than a week. During my last pregnancy, I did not get positive pregnancy result until I was 2 months pregnant. ### Response: Hi. It seems that you have delivered two to three months before. It is normal that you bleed in less amount up to one and half month. It is absolutely normal. After delivery, you do not ovulate at least for three weeks and on average for three months. So, you do not have periods. Sometimes, you may have an irregular period for more than three months and that is why urine pregnancy test is negative. Your hormonal cycle can be irregular for some time after delivery because it was almost blocked for 9 months during pregnancy." "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: Dear doctor,Is intestinal abscess a possibility? I need a second opinion. Medical history: On April 1st, I underwent sigmoidoscopy, and since then, a pain started on my left side. They also diagnosed C.difficile. We started Vancomycin. Then the pain stopped. At week-3 of treatment with Vancomycin, we went from four times daily to twice daily and three days later, the pain came back. My doctor restarted over the Vancomycin treatment to four times daily and, three days later, the pain went away. I am on twice daily dose now since the last two days and the pain came back again. My Question: I suspect an abscess caused by the sigmoidoscopy (considering that this examination produced extreme pain 15/10 on me). Is it possible that abscess treated with Vancomycin temporarily is the reason that my pain comes and goes the way that I explained? ### Response: It could be one possibility that sigmoidoscopy has caused an abscess, but again to prove that a repeat sigmoidoscopy has to be done. Also, I wanted to know what was your first sigmoidoscopy finding. I advise you to get one stool culture sensitivity and one stool calprotectin test done and revert back to a general practitioner 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: This is concerning my mother, who has been having pain in her left hand and leg at times. She also has pain in her chest and breathlessness. We were concerned about this and decided to take her to a doctor. An echo was done, and the doctor found some abnormalities in the report. However, as per doctors recommendation, he has not advised any medicine as of now, since he says it is in the initial stages. We would like to have few opinions if there is something seriously wrong with the reports or how we can manage it. She is also a chronic asthmatic. I am attaching all the reports that I have of her. Request your kind help on advising what should we do next or if there is something to worry about. ### Response: Hello. I have gone through the test results." "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 daughter who is 4 years old had a frequent nosebleed in her left nose. First was last Thursday, then the second was three days later, and today also on her left nostril. I do not know if she pricked her nose, but when I asked her she said yes. I am a bit worried since it has been three times already, but she gets bleeding only on her left nostril. PIease advise me on whether I really need to have it check physically by an ENT because I am afraid of the COVID 19 situation. ### Response: Frequent nose picking: We need to ascertain the cause of the nasal bleeds as the most common cause is secondary to" "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 21 years old. Does tablet Megalis 10 mg give priapism? Will it show any harsh side effects? ### Response: Hi. It is used in erectile dysfunction (impotence), enlarged prostate gland, sometimes in pulmonary arterial hypertension. Priapism is considered rare during this treatment. Some significant side effects are dizziness, confusion, fainting, vomiting, and ear problems. This tablet is taken only during night time. You should avoid" "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: Hi,I have a problem. I am a 24 year old caucasian male.Past history:1 and a half years ago a boil - carbuncle formed on my penis, popped after 4 days. I used Framykoin for a week and it went away. A month later molluscum contagosium formed right above penis, stayed like that for 2 weeks, then doctor burned it off with liqud hydrogen, and gave me betadine to use. It healed within 2 weeks.Present complaint:11 days ago a bump appeared on my penis, near foreskin. I thought it was a boil which I had before, so I kept applying Framykoin for 5 days, it kept drying the bump. Then visited a urologist, he tried to pop it but it was not poppable. He told me to stop using Framykoin and let it heal by itself. Well, I decided to use betadine instead (I am on the 3rd day now).Symptoms:Bump hurts when I put pressure on it, and hurts only very slightly when idle. Bump was itching during first week as well, but only little bit. There is no visible head, it is approximately 10x7mm big, dome shaped, when I tighten the skin on penis, it becomes a visible bump, and is shiny. It is more like purple/red. There is no visible head and is unpoppable and is kind of firm when squeezed (but top is soft). Also, after 2-3 days I found out lymph node was swollen near groin area and I had feverish symptoms (but that could have been due to fact that I also have been using internally for 7 days oregano oil, since the bump appeared, and oregano oil is a strong natural antibiotic). It is certainly not herpes, I do not have those, and symptoms look nothing like it. I hope it is not a cancer either, we do not have it in family (so chances are reduced). It also cannot be an STD, since I have been only with my wife.I have attached pictures of the bump. What could it be, furuncle, carbuncle, molluscum contagosium, inflamed sebaceous gland or cyst, or something else? ### Response: Coming to the differential diagnosis and treatment: Chances of it being furuncle is less as it is a progressive condition and would have certainly popped out by pressing. Carbuncle is the collection of furuncle, so chances of it again is very less. Since you have a history of molluscum, it could be molluscum, but you have destroyed its classical morphology by popping it out in early stage. It can certainly be an infected sebaceous cyst or infected apocrine gland which are normally present in high number over the genital area. You were right of it not being any STD. Lymphadenopathy is a non specific finding and could be due to any infection involving the genitalia. Take Amoxicillin-Clavulanic acid 625mg twice daily for 7 days. Continue betadine lotion and do not try to pop it out. Revert back after two weeks to a dermatologist online for review" "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 18 year old female, and I have been getting severe itching at nights mostly. I have got my allergy report, but I am unable to understand it. If I eat chicken or anything that sort, my skin starts getting bumps and itchy at night. And if I scratch a little, these bumps break and spread throughout my body. When they heal, they leave a scar. I am attaching a picture of the rashes and the allergy report. ### Response: I have read your concern and examined your picture (attachment removed to protect patient identity). It seems you have developed acute urticaria. Your allergy panel test shows an allergy to certain foods, so try to avoid them. I suggest taking tablet Levocetirizine, once daily for three months after consulting your GP or a nearby dermatologist" "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 feeling of mucus or something in my throat for the last three weeks. For a week I had a feeling of swallowing issues, where I felt not all of it was sticking to my throat. Now that sensation has more or less gone away, I still do feel like grain in my throat after finishing the meal. I have a lot of dry coughs and my throat feels like irritated constantly. I am not sure if its due to GERD or LPR. I am taking Prevacid 30 mg since last week. I am not sure if that is the reason for my swallowing getting better, but the sensation is still there. Now I am worried that this could be some neurological issue. I am going to see an ENT, but that is a month from now.My question is how is muscle weakness of the throat diagnosed? Is my issue more of an indication of some neurological issues or anxiety and GERD? I also feel like the mucus or the foreign object sometimes interferes with my breathing. When I am tensed or anxious it feels like a ball, when I am calm I do seldom feel it. But when I take a big swallow I feel something in the middle of my throat.I have done an endoscopy, pH and manometry test which does not show much. My doctor diagnosed me with IBS. ### Response: The symptoms you are experiencing classically fit into globus pharyngeus. Manometric studies, endoscopy being normal, organic causes are ruled out. Hypo or hypomotility disorders would present in a typical manner and manometric studies would have shown something. Neurological or neuromuscular afflictions would have other symptoms. Globus sensation can be a headache to deal with. Nervous dyspepsia, IBS (irritable bowel disease) globus sensation are all parts of a spectrum of conditions involving gut-brain axis. Cutting down on anxiety is of prime importance." "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 problem is I have a wavering mind and am overimagining everything. If I am watching some negative scenes in movies or shows, I am imagining as if it is happening to me in my real life and am scared that it will surely happen in my life also. I am imagining myself as a bad girl and am crying and convincing myself that am not. For two days, I will behave like this. Then, I will self-motivate myself. Then once again, I will start imagining. I want my old me. I am not myself nowadays. I feel like committing suicide. I want to come out of this problem. I want to be happy with my boyfriend, my family and I want to be successful. I am a good girl but scared to come out of my home. I am very much scared tat I will go wrong. I do not have self-confidence and I do not believe me at all. Please help me to solve this problem. ### Response: You have intrusive thoughts and these are resulting in distress. The intrusive thoughts are unwanted dominating thoughts which result in significant distress. The thoughts on seeing some negative scene that you are bad or imagining yourself in such situations are part of anxiety. If these are resulting in distress and you are not able to function properly then please visit a psychiatrist for help. Please do not delay the treatment because this might complicate into anxiety or obsessive-compulsive thoughts." "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 left leg suffered from a gigantic wound. Firstly, that looked like filaria but after some time, it became yellow and full of pus. And now pus is flowing. ### Response: Hi. I have thoroughly gone through your case and can well understand your genuine health concerns. As you have developed pus inside your leg that means your leg is severely infected. So, I suggest you consult a surgeon as early as possible so as to avoid the spread of infection throughout the body, otherwise, the infection will spread through blood and can cause septicemia which is dangerous. You also need intravenous antibiotics. Please check your blood sugar so as to make sure that you do not have diabetes." "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: Kid of 6 years has a temperature of 101.5 since 40 hours. The fever is coming every four to five hours after giving Meftal. Day one he was on alternate Crocin and Meftal, but we think two medicines are harmful and planning to give only Meftal every six hours on the second day.1. Please advise if this is the right approach.2. Is fever coming back after four hours of Meftal common in first 72 hours? ### Response: Viral fever may last for 3 to 4 days. Combination of Mefenamic acid and Paracetamol are more effective in controlling high-grade fever, and it also decreases the frequency of fever. Keep the child well 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 a question about a herniated disc in my back (L5 - S1) MRI confirmed about a year ago. I went to physical therapy, the pain resolved, and I continue to do the exercises for 10 minutes every other day. No more pain though. The thing is even before the pain (years before) and still now after the pain is gone, I seem to have a slight numbness or I guess I would not call it a numbness but rather I have less feeling on the left scrotum and penis area in comparison to the right side. Maybe 25 % less. Could this be from the herniated disc? It was there years before the pain and is still there now after the pain from the herniated disc has resolved.I have also noticed other parts of my body have more sensation on the right side as apposed to the left. The more sensitive the area the more of a difference there is up to 25 %. Is that normal? Is it possible to have a herniated disc only cause slight numbness for years without any pain at all? Also it should be noted this sensation of lessened feeling on the left side compared to the right presented itself a few months after I had a varicolectomy on the left side. Maybe the incision caused a little nerve damage? I would hate to think that this lessened sensation was getting worse over time at such a slow rate that I did not notice it until it was too late. I do not think it is getting worse. Should I worry about this? Also, now that the pain is gone does that mean that the disc is back where it should be or did the exercises only get rid of the symptoms? ### Response: Hello. Varicolectomy on the left side might have damaged some nerve twigs which may be the reason for this kind of diminished sensation over left scrotum and penis. This will not cause any problem and you need not worry about it.The herniated disc is of small magnitude which is not expected to cause neurological damage except for lower back pain. It might not have gone back to its original position though pain subsided. You should avoid strenuous activities (lifting heavy weights, extreme bending, etc.). But if you have diminished sensation in whole of your left side of body, you should look into spinal cord lesion in neck region or brain lesion." "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 sore throat for more than 2 weeks now and I am done taking antibiotics (dalacin c) for 7 days but it is not going away..I feel that there\s something stuck inside my throat / esophagus. I have a mild headache but no fever. Pain scale is ranging 4-6 out of ten.I also gargle every 3 hours using difflam - C.Gender : MAge : 36Ht : 5\11Wt: 191 lbs ### Response: If this got worse after antibiotics, it is likely thrush (a yeast infection of the throat often found after antibiotic and/or steroid treatment. See if you can get your physician to prescribe fluconazole 150mg daily X 10 days (not 3 days like prescribed for female yeast infections...this would not be long enough.If it got much better after the antibiotic and has stayed level, you might consider that whatever bacteria you had was partially resistant and another should be tried. A good one to consider (if you have not had this yet) is Clindamycin 450md three times a day X 10 days)..if you have had that already, consider Amoxicillin Clavulinic acid 875mg twice a day X 10 days.If none of these are the case, see an ENT to rule out an abscess behind the tonsil, know as a peritonsillar abscess., or some other 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 had my first intercourse 10 days back and after that, I had taken I-pill within 24 hours and now it has been two weeks and I am still having some brown spots. Is it due to I-pill? How may days does it bleed? Is it normal or I should visit a doctor? Or should I wait for my next cycle? ### Response: ciom. If the bleeding is continuing, it would be best to rule out any chances of pregnancy with a serum beta hCG test first and if negative then you can opt for anti-fibrinolytic to control the bleeding." "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 unprotected oral sex with a bar pickup girl six months ago. She sucked my cock for about 10 minutes without a condom. I had only this exposure. After that, I ejaculated outside in my bed. I did not ejaculate in her mouth. After this incident, I was a little tensed. I waited for 60 days and got tested. I am fine as of now. I tested negative at 60 days after exposure with CMIA method. I also tested negative for western blot at 60 days. I also tested not detected with HIV PCR RNA after 65 days. Off late, I am feeling an inconvenience under my chin. I have probably developed a swollen node under the chin. Is it a symptom of HIV? Is it any kind of infection? Do I need further testing? Am I am at risk? ### Response: I have noted your concern. Your tests are conclusive. Most of the HIV infected will have a positive test by three to four weeks. Since you have negative tests even after eight weeks, therefore it is reliable. There is no need for further tests. Moreover, oral sex is a low risk for HIV as compared to unprotected vaginal or anal sex. Swollen neck lymph nodes could be due to another cause - perhaps a sore throat. Regards" "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 34-year-old female. Kindly expain my NT scan and double marker test result.PAAP -A - 3.37 miU/ml.HCG, free beta - 147.00 ng/ml.NT value - 1.40mm.Trisomy 21 - 1:227. ### Response: Let me explain to you first why this report is done and what it is about. Basically it is a screening test and results of that do not indicate that baby has a problem." "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 it normal to have QT Interval of 320 ms on frequency 76 bpm for a 20-year-old male? Is it possible that my level of calcium is the thing which is shortening my QT? My calcium is 2,54 mmol/L. Is it too less? I still feel something around my heart, mainly when I am in stress. Currently, I am taking Metoprolol. Previously I used to take Amlodipine. ### Response: Hello. I have gone through your ECG (attachment removed to protect patient identity). I guess you do not have any family history of sudden cardiac death or ventricular tachycardia or of electrical shocks for cardiac reasons. Your calcium is normal. Although there is no exact cut off for the diagnosis of short QT syn" "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 questions about birth control. If I take a contraceptive, will it be okay for me to have unprotected sex with my partner? And will it cause any complications in the future if we are ready to have a baby? ### Response: Hi. If you have been on contraceptives then your body would have got used to this. Most of the contraceptive methods are hormonal and all having short and long term side effects and differs in every Individual a bit. If contraceptives are taken regularly as per advised with proper timings and dosage without vomitings, then you will have protection as you required. Any contraceptives long term use can definitely give side effects like unscheduled bleeding, acne, migraine, breast and endometrial cancer, stroke, clot formation, etc. All side effects cannot occur in a single individual but that occur for which person hasa tendency and genetic history, etc. You can have sex along with proper contraceptives with or without condoms. But try to change contraceptives frequently or some time contraceptives free period to avoid side effects. Have regular contraceptives with condoms to have complete protection. Change contraceptives frequently to avoid side effects." "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 semen analysis shows:Sperm Count - 98 millions/ml,Liquefaction time - 25 minutes,Reaction - alkaline.Motility: active - 70%, slugglish - 10%, non-motile - 20%. Morphology: Normal forms - 92%, abnormal forms - 8%.Other findings: Pus Cells 40-45/HPF. Semen culture also shows no growth. Please tell me the appropriate medicine. ### Response: If you do not have symptoms of urinary infection like burning, frequency of urination, blood in urine or semen, you need not take any medicines. Immature sperms also appear like pus cells on microscopy. One good option is to repeat the semen analysis after one week. Do not keep abstinence from more than two to three days before the next analysis. If pus cells are again seen in the high count, we may have to repeat semen culture for routine bacteria, as well as tuberculous bacilli and then decide accordingly. If you have any of the symptoms described above, you can repeat semen culture once more and take antibiotics accordingly. 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 know the reason for pain in the stomach at the right side and blood in the stool. Once I had blood in stool previously and used homeopathy medicine to stop that, but it recurred after five days. ### Response: Stomach pain on the right side can occur due to a variety of reasons like stomach infection, appendicitis, infection in your intestine, and problems in your kidneys or the ureters (a tube that connects your kidneys to your urinary bladder). Stomach pain with blood in stools is something to worry about. The cause for it can be acute infectious gastroenteritis, inflammatory bowel disease, or ulcer in your gastrointestinal tract. To diagnose all of these, I need to ask you some questions. Do you have any fever? Do you have weight loss? How is the appetite? Is the blood in stools fresh blood or is it brownish red? Do you have any history of piles? Are the stools hard? Do you have any diarrhea? Does the stomach pain has any relation to food intake i.e. does it get relieved by eating food or does it increase on eating food? Once you answer these questions, I would suggest what tests to be get done and how to treat the disease. 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 having thyroid problem. I would like to use nutrigain powder. Are there any side effects in using it? ### Response: Hi. There are many ayurveda products available in the market to gain weight. All products contain the same ingredients as the nutrigain has. I do not know whether these products are expected to clear quality assurance or not and the reason is to consider the steroid mixture. To gain weight and manage your thyroid follow natural way instead of taking any kind of products." "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 45 years old and working as a senior level finance professional in a multi-partner practice owned by all of us. After going through the high levels of anxiety for several years, I consulted a psychologist who is my friend. After few months of showing little improvement, he put me on Escitalopram 10 mg. For about 2 years I took this medicine and was generally fine. When my friend moved out of the country, I shifted to a new doctor and he is a more senior person. He changed the drug to Paroxetine 25 mg which I have been on for the last nine months. I would probably say I am doing better now than before. The issue is regarding further counseling. While my friend did not feel that there is a need to continue counseling once he put me on the medicine. But, the new one seems to feel that I should resume counseling. Based on his advise, I went back to the counselor I originally saw, but somehow she seems to feel that I do not need any structured counseling.I am generally a religious person and try to follow certain regular spiritual practices like visiting a temple almost every day, reading at least a little from any scripture and do some chanting. At the same time, I still have the little odd feelings of discomfort too at times, though it does not trouble me so much like earlier. Specific cause of worry now is mostly the side effect of the long-term medication I take for anxiety, BP (Telmesartan) and for GERD (Esomeprazole). The primary concern now is that on most days I have a general feeling of boredom as though there is not anything much to do. Generally, I try to avoid associating with any new demanding assignments because I do not feel comfortable about doing things unless I am fully sure about the work. On the other side, it is also my dream to be a successful writer of fiction novels. I have finished one book, but that has not found any worthy publisher so far, which is disappointing. So, even though I have been working on my second book, I do not have too much confidence that my writing will reach anywhere.I am not a social type person and like to spend time at home. I will also confess that by nature I am known as a negative thinker, both at work and in the house. But my relationship with people are generally very cordial, because I try to lighten issues and also try my best to avoid any sort of conflict. All this leaves me with a general sense of dissatisfaction, although I am very clear that I do not want to stick my neck any further out either. Though at times, I fantasize about career and location change. I do not dare to think anything seriously, because I am sure that I will not get such a comfortable position again. But, to conclude the issue which is confusing me right now is, do I need counseling again? I am far from clear, what can I hope to achieve from therapy which I cannot get from my religious and spiritual practices? I note that online therapy is also an option on this site. Is that as effective as direct counseling? ### Response: From your detailed information, I feel that you have responded to medication. All SSRI (selective serotonin reuptake inhibitor) medications tend to over time make the person who takes them more relaxed. This could be attributed to the main task of reducing anxiety. Thus maybe a lower dose for a few months may benefit. Importantly, the absence of anxiety or motivation is more troublesome. Also, I do not think that any counseling will help you. As you are already aware and attend to the problem of not pursuing tasks to completion CBT (cognitive behavioral therapy) or NLP (neuro-linguistic programming) or coach may help." "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 22 year old woman. I took three I-pill tablets within two weeks. Will it have any side effects? Are my chances of pregnancy low? Also, I have polycystic ovaries. Waiting for your answer. ### Response: Hi. I-pill should not be taken more than once in a cycle. If you need to take it three times within two weeks, then it is better to take regular contraceptive pills for three weeks and repeat after a week gap. It will treat your polycystic disease and prevent pregnancy. Chances of pregnancy are low, but many I-pills may disturb the menstrual cycle." "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 cleaning out my ear, I forced the q-tip too deep and blood came out. There was no stream of blood, but after mostly lying on my side while sleeping, I found very small dots on my pillow (I would say the size of the tip of a pencil). There is little to no hearing loss after a full night. However, I often have to swallow to pop my ear. I did some research on my own, but I am not certain if this is damage to the bony canal membrane or to the eardrum. Do you think this is an emergency that requires a visit to the ENT or not? ### Response: Trauma. Pure tone audiogram and otoscopy. TM (tympanic membrane) perforation. TM perforation. Avoid water entry during the bath." "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 45 year old male. My height is 184 cm and weight is 97 kg. I had a cervical spine x-ray and was diagnosed with cervical spondylosis. I also have mild CAD and severe sleep apnea.Due to intermittent chest pain and breathlessness on exertion, CAD was suspected. After positive TMT, I had an angiogram. The angiogram found many minor blocks and no major blocks. The diagnosis was minor coronary atherosclerotic disease and systemic hypertension. The treatment is by medical management.I have been feeling a constriction in my neck (tightness) exactly in the throat region while walking. This happens only while walking and goes away as soon as I stop. I have been advised to consult an orthopaedician to see if the neck constriction while walking can be due to spondylosis. I occasionally have lower back pain and numbness in hand (palm) and also weak hand grip.Some months back I felt significantly light-headed and had difficulty in balancing. After some tests, I was diagnosed with uncompensated vestibular lesion. After some medication, it improved a bit. Now again I find the lightheadedness and balancing issues i.e, I feel as though I may faint but actually not.My queries are:Can the tightness in neck while walking be due to cervical spondylosis?Can the lightheadedness and balancing issues be due to the same?I would like to know the severity of the spondylosis from the attached reports and scanned copy of my x-ray.I was suggested to have an MRI of cervical spine. Based on the reports and symptoms do you feel the MRI is necessary?I would like to know the advantage of MRI compared to x-ray findings. ### Response: Hi. Tightness and neck pain can be due to cervical spondylosis. The lightheadedness and balancing issues can also occur due to spondylosis. Spondylosis is not so severe on x-ray (attachment removed to protect patient identity), it is of mild grade. If your hand grip is weak, it is better to get an MRI to see for any nerve compression. MRI cervical spine Revert back with the MRI report to an orthopaedician and traumatologist 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 suspect that I have receding gums. My molar tooth is slightly wiggly but does not affect my eating at all. There is a black line (kind of denting in) on the side of my molar. I do put on retainers, but not very regularly. Could that be why my molar is shaky? ### Response: Yes, you do have a little bit of gingival recession (attachment removed to protect patient identity) but it is not too much to be treated with surgical intervention. You need to replace your brush and use an ultra-soft brush. You also need to brush properly, check a video of modified Bass technique for tooth brushing online and do brushing accordingly. The black line may be the stain, for that you may need a dental prophylaxis (scaling)" "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: As bisexuality is defined as attraction to both men and women, however, many men who feel that way tend to not identify as that. Please explain why this is? And, why bisexuality among men has been so stigmatized in the past? And why it has not seemed to improve, even as people become more accepting of homosexuality? ### Response: Hello. Bisexuality is common and a lot of men and women have bisexual orientations at some point in their lives. This does not mean that a person will have homosexual relationship with same sex partner. A person who is happily married might have likings for same sex too. But this has been stigmatized in the past and because of cultural beliefs people never thought of accepting this in public. Since birth an individual is conditioned to behave in a particular manner like boys are supposed to be more active in competitive sports, they are encouraged to be masculine while girls are supposed to be delicate, sophisticated in most countries and most cultures. If a boy behaves like girls he faces many issues like other peers make fun of him. This conditioning is the basis of sexual orientations too. Boys are supposed to have girlfriends and girls have boyfriends. Homosexuality was considered as sin and even a lot of countries still consider homosexuality a crime and is stigmatized. Even these days media and the internet are working to reduce the stigma but in society, people make fun of homosexuals (especially of men). This is the reason things are improving but still, people do not look at bisexuality with good intentions." "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 Rh negative. I recently had an abortion of six weeks and was not given the Rh injection. Is my health status safe to prevent future complications in pregnancies? This is the third week into the abortion. Can I still go for this injection? ### Response: Injection anti-D is needed to be taken in case of bleeding within 72 hours of the event. So, it is late already. Most mothers have well-developed immunity against rhesus positive blood group in her second pregnancy if the first child had Rhesus positive blood group. But in the case of fetomaternal hemorrhage also antibodies develop. Rhesus negative issue arises if your partner is Rhesus negative. So first of all, check the blood group of your partner. If he is negative, then there are fewer chances of the fetus to have a positive blood group, so fewer chances of Rhesus isoimmunization issue in coming pregnancies. You can have antibody titer to be on safe side if the husband \s blood group is positive. But if the husband has blood group positive then in next pregnancy as per protocol you will have to get anti-D at 28 and 32, if pregnancy remains uneventful otherwise more time you could receive. Rhesus negative with a history of miscarriage. Husband\s blood group. Balanced diet. Normal BMI, weight. If the husband\s blood group is positive, then early booking for the next pregnancy to have better 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: So please advise about migraine. ### Response: For migraine, Ibuprofen can be prescribed SOS when a headache occurs. If no improvement with Brufen than Sumatriptan or Rizatriptan can be prescribed. Avoid bright light, loud noise exposure. Take atleast six to eight hours of sleep. Avoid fasting and take food both time in the afternoon and evening. Avoid constant work on the computer. You can consult nearby physician for detailed evaluation. I hope I have answered your question. Let me know if I can assist 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: I am trying to find out what the following images show (images attached). Are there nodules? If so, how many and what size? What types of nodules do you see? What are the chances of the nodule being benign (maybe a colloid)? What characteristics do the nodules show hypo or hyperechoic, any vascularity and if so, is it peripheral or intranodular flow and any other info you can provide? ### Response: I have seen the images. (attachment removed to protect patient identity). There is a larger nodule in the left lobe and a tiny one in the right lobe of thyroid. The left thyroid nodule measures 14 x 19 mm and is isoechoic and solid areas and shows peripheral vascularity with a small focus of possible cystic change within which can be cystic changes probably colloid changes. The right thyroid nodule is 4 x 4 mm and is iso to hypoechoic. It is too small to comment on vascularity. There is no calcification in the nodules. In my opinion, it is likely to be a benign condition but FNAC (fine needle aspiration cytology) from the larger left thyroid nodule is suggested for confirmation. Usually, 80 percent of thyroid nodules are benign. 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: My son is 9 months old. He had a high fever and low platelet count (70 k). We admitted him immediately and done blood platelet transfusion (100 ml). The next day, the platelets went down to 16 k. He was discharged from the hospital when it came up to 95 k. Now after a week, the count went down to 52 k again. My pediatrician suggested taking advice from hematologist to see if he requires treatment for ITP (if diagnosed as such). Please advice next steps, worrying a lot. I also had this problem when I was two and a half years old. I was given steroids as a treatment. ### Response: I have gone through the query (attachment removed to protect patient identity). Your son\s latest report shows neutrophilia. It is suggestive of bacterial infection. Further workup can be done in the form of CRP (C- reactive protein) estimation, blood culture, and flow cytometry to rule out congenital thrombocytopenia causes. ITP is a diagnosis of exclusion. If there is no other cause found, then only ITP is suspected. For that bone marrow study is essential. Please provide me the previous CBC report also to give further comment" "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 18 years old and studying for my final exams. My problem is exam phobia. I am so scared of failure during an exam and due to this, I am unable to concentrate on my studies. I am suffering from this issue for the past two years and it really affects my studies. Please help. ### Response: I completely understand that you feel concerned about your performance during exams. It might be due to the experience of failure in an exam or due to any negative experience related to your academics or school. Psychological assessment by a psychologist is needed to confirm the diagnosis and investigation related to anxiety during other social or performance is required. You need to go to a psychologist for complete psychological assessment. Then, you need counseling or psychotherapy sessions to overcome your phobia and anxiety related to exams. I appreciate that you consulted at this state of extreme anxiety. You urgently need psychotherapy sessions to prevent your symptoms increasing by the time." "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 27 years old female, weight 88.5 kg having a thyroid. I am not losing weight inspite of working out five days a week. This is making me frustrated. I really need help. I cannot see myself so stressed after working so hard. I have attached my medical reports here. ### Response: Hello. We went through your post, your main issue is excess weight. Weight reduction has two important components and both are necessary, and that are consuming fewer calories and burning more calories. If you are doing only one, nothing is going to happen. I would suggest you take only vegetarian diet that too low quantities and with minimal oil. You can add Orlistat 120 mg with each major meal like lunch and dinner. That will help further in accelerating weight loss. However, what you eat as your food is very important." "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 serious eye injury before 10 years due to cricket ball hit. At that time, my pupil got enlarged and dilated. Can it get treated now? ### Response: Hi. This just causes mild blurring or photophobia in bright light due to large aperture. But, in case of trauma, there are more important things to see that can cause decreased vision like cornea, lens, retina etc. Is everything fine in your case? Can you see normal in that eye? If everything is alright, then we can discuss about treatment options. Treatment Options: I would recommend you to visit your ophthalmologist (eye doctor). He will do a complete eye examination and give the best option accordingly." "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 18-year-old medical student and I enjoy playing rugby at a high level. I have already ruptured my ACL twice on my left leg (twice reconstruction surgery) and I am now very sure I have ruptured my right ACL as well. Would it be possible for me to carry on playing rugby in the near future when I regain strength in my right leg and the swelling subsides, if I use a brace or strap it up when I train and play? ### Response: I have read your concern. It will not be comfortable for you to play with an ACL brace if you have grade 3 ACL tear as twisting and turning will not be quick and comfortable to the level game demands. If you have kind of grade 2 then you can strengthen and then have a support and play (again depends on the level of involvement of the fibers, more than 50 % then you should consider surgical reconstruction option as you will always be at risk of progressing it to complete tear. In either case, start your rehabilitation exercises. Can use brace while training. There is a risk of loading certain areas of the joint leading to early bony erosion. It may not be a very good idea." "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 chronic gouty arthritis. It started ten plus years ago, and now progressed to every joint in my body with multiple joint attacks at once. I have contant pain in joints, even if there is no attack. The attacks jump from joint to joint nonstop. I have seen many doctors; they can only give me shots and prescription of Indomethacin, which is not working for me as it has been taken for more than 10 years.I have changed my diet to exclude a lot of food and drinks with sugar, purines, citrus, salt, etc. Right now, the pain is in my ankle, knees, and left arm (shoulder, rotator cuff, elbow, wrist, thumb, and neck). I have been very depressed and go to bed in pain and wake up in pain daily. My daily functions are limited. ### Response: Hi. I have gone through your history, and it is a bit unusual for a 40-year-old to have polyarticular gout, that is involving a lot of joints. Firstly, I would recommend you visit a Rheumatologist near you to sort it out. I would like to know your last uric acid levels and if you have ever got rheumatoid factor (RF) and Anti-CCP (anti-cyclic citrullinated peptide) done. If it is gout, then Indomethacin is just going to help the attack. You need to start on proper medications. The treatment would be to start tablet Zycolchine (Colchicine) along 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 have a history of melanoma. This spot appeared on my hand this month. I am worried it could be acral lentiginous melanoma. Does it look like it needs to be biopsied? I had a wide excision of melanoma on the other hand on the middle left knuckle. ### Response: I have gone through the image (attachment removed to protect patient identity). It is a very small papular lesion at present. It does not need biopsy at present. But, if there is: then consider a skin biopsy. At present, a test like dermoscopy would help to see the morphology of the lesion. Knowing your past history keep check on the lesions" "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 an infection in my tooth and it was treated with a filling after a course of antibiotics. After the filling, an abscess reoccurred twice which was treated with antibiotics. It seemed to settle for a while and then I could feel a pain and pressure inside the tooth. Now a small pimple like spot has developed on the inner side of my gum at the top of the tooth and it drains pus. Is this another abscess? ### Response: Hi. I have gone through your question. I can understand your concern. As per your history, it seems to me that you are having recurrent apical periodontitis. If the filling is still there, it needs to be removed. The recurrent apical abscess is because of this infectious tooth. Either it needs root canal treatment or extraction. Root canal treatment is the treatment of choice according to my opinion. If you have any X-ray or you can upload a picture too to get a proper treatment plan from my side. If you have this pimple like abscess you may need an antibiotic course too." "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 25 year old female. I have been suffering from repeated episodes of a sore throat that includes nasal obstruction and pain in the throat. I was diagnosed by the treating doctor to have a DNS for left (on the basis of a CT scan) and now granular pharyngitis has been added. The frequency of these issues ranges between two to four months. I have been visiting specialists, but getting only temporary relief. The last treatment was taken six months ago and included M-cin 400 OD for five days, Dolonex DT OD for five days, Xyzal M for two weeks, Montek 10 mg for three weeks, and capsule Rabonik DSR OD for four weeks. Now again, the episode has recurred. My chest X-ray, PFT etc. are all normal. Is there any permanent solution to the problem? The problem is more than seven to eight years old. What are the reasons for the frequent episodes? ### Response: Can you please share your CT scan reports here? If you have sinusitis, you will have a recurrent throat infection. Do revert back" "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 planning to get married. But my partner and I have the same B+ blood group. In this case, when we plan a baby, is it harmful? I have heard that the same blood group cannot conceive a baby together. Please advice me regarding the same. ### Response: Hello. Every individual has a unique ABO and Rh blood group. It remains same throughout the life. You and your partner having same blood group will not lead to any problem in conception or harm to you or the baby. If your blood was negative, and the fetus had a positive blood group than further workup is needed especially Anti D injection" "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 and half of my lower lip color has changed to pink and it looks bad. I want to bring it back to normal color. Please help. ### Response: It may be initial phase of vitiligo a hypopigmentary disorder. Avoid biting or licking lips often. Take antioxidant tablets. You can try initially with a steroid cream like Fluticasone and Tacrolimus ointment after consulting your dermatologist. Consult your dermatologist for examination and management." "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 done a bone graft on my front teeth for a dental implant. Now, I have a flipper (denture). Do I have to take the flipper out (denture) to clean it? For how many times do I have to clean it? ### Response: Hi. I have gone through your question, and I can understand your concern about your denture. You have to take it out after having meals, and you have to clean it properly or keep it in water till you wear it next time. If you feel that you have halitosis (bad breath), then you can take it out even after having meals too. Also, if you are at home, you do not need to put them on the mouth, you can keep it out at that time. You have to keep it out during the night. Please send a picture of your gum region as well as denture to guide you further because dentures may cause resorption of the ridge also." "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: Under the influence of alcohol, I committed a blunder by making intimacy with my own pet dog last year. From that day onwards, I started to develop health problems such as weakness, mild fever, headache, tingling, unexplainable inflammation and burning sensation of the genitals area. I also sense something crawling within my testicle area. I remain depressed, anxious and tense. I have sleep problems too. I have done numerous tests, but urine culture detects only an e.coli infection. I took Ciprofloxacin for ten days. After one month, twice culture was done but it was found normal. The fear of rabies has gripped me under its fist. Are the above symptoms because of rabies? Please suggest a suitable treatment. ### Response: Hello. You underwent many tests and all of them were normal except for some infection and for that, you are having ant-biotic. You can talk to your nearby doctor regarding rabies and can take antirabies course of injections to prevent rabies. Otherwise, you are doing fine. Regarding the anxiety, restlessness, etc., they are due to your health concerns. Your doctors must have told you that there is nothing to worry. Accept it and you will be peaceful. I suggest telephone or video counseling to 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 feeling too cold, and a cough is there. I am 27 years old, 169 cm height, blood group A+, and weight 61 kg. ### Response: Hi. I have read your query. It looks like you have a common cold. Please do saline water gargles several times a day to give you relief from the cough." "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 unprotected sex a week back and took an I-pill within 24 hours. He did not cum inside me but still, for protection, I took the pill. Five days later, the condom broke, although he did not cum inside me, I am not sure of how safe it is. Is there any chance of being pregnant? Should I take an Ipill again? Will my periods be early or delayed due to the pill? Please advise if I need to take an Ipill again and if it is safe. ### Response: If you have taken Ipill after first intercourse activity and it was taken properly, in proper dose and timings without vomiting, then actually ovulation or fertilization would have stopped already for this cycle. By rule, no need to take another pill if still, no bleeding is there after the previous pill. After 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 29-year-old male, weigh 90 kg, height is 182, non-smoker, non-alcohol drinker. I do not have any symptoms or signs, normal eye, and skin color. I am taking Cipralex 15 mg for the past one year. Had a history of bladder stone and it required admission for one week until it passed normally by medications without surgical intervention. When I reviewed my blood test results, I found out the bilirubin level is bit higher than normal. I was overthinking, so I kept repeating the test weekly. What do you think of my case? Could we consider bilirubin high? If yes, what might be the causes? ### Response: If Mmol means micron mol, then it is fine (attachment removed to protect patient identity). It looks like a normal variant of hyperbilirubinemia. In both the conditions, we find the unconjugated bilirubin. I hope your urine is not yellow. Another issue is you have high BMI. It is obesity. So, you may have a fatty liver disease, that could be the cause of high ALT. I want to do a fibroscan and repeat ultrasound for fatty liver and TATA box mutation for Gilbert syn" "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 taking contraceptive pills (Yasmin) without seven days break for over three years now. I have not had my period in more than six months. I did not know about the break. What would be the side effect of doing so? And, should I stop taking it immediately even though I have not finished the 21 days or should I wait to finish this pack first and then have the seven days break? ### Response: Hi. Three years is a bit longer but up to one year without break is often given to treat certain disease like endometriosis. In your case, it may not cause any problems. Only that you may get late periods. You should complete the 21 days and then stop. You can do an ultrasound of pelvis, blood tests, sugar postprandial, liver function tests and lipids. You may check breasts. Usually, the pill is safe." "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: Do adenoid glands contract after a certain age? Is it natural for all people? What to do if these glands are enlarged and result in air obstruction? ### Response: Hello. About your query regarding adenoids, I would like to say these are lymphoid tissue located at the roof of the nasopharynx and as usual, they are meant to protect the body from infections. They are always found in infants and they are at their maximum size at the age of 5 years, after that, they start regressing in size up to 8 years if the nasopharynx is free from infection. On the other hand, if an individual is having recurrent respiratory tract infections in childhood, the adenoids will grow up to a large size." "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 40 years old, 187 cm and 100 kg. I have small wounds in my foreskin and it is red in color (looks irritated). I am guessing that the cause is our swimmming pool party a few days back and I was unable to take a shower afterwards. I guess that the dried and concentrated chlorine caused some irritation and wounding in my penis foreskin (I am not circumcised). It is not really painful unless pulling back the foreskin, I have used some Aloe Vera on it but I was wondering what would help fastest for the irritation to be gone. I do not have any pain while urinating. ### Response: I have gone through the history and description. I have seen the image you have attached (attachment removed to protect patient identity). Possibility of infection is more likely. So apply Betadine cream three times a day. Please let me know: 1. Do you have any difficulty in passing urine? 2. Any pain or burning while passing urine? 3. Any fever? Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help 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: So I am experiencing a loss of sensitivity in my penis. I still get erections but it takes way to much effort. I mainly just get them at night. I have no conditions that I know of and I am 24 years old. ### Response: Hello. I have some questions. What about your blood pressure? Any sleep disorders? Any previous surgeries? Your cholesterol and testosterone level? Any other mental illness such as anxiety, depression, stress, and relationship problems? Kindly let me know the answers to the above questions." "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 my serum creatinine, serum uric acid, creatinine urine and protein urine test done. The result indicates that I have creatinine 1.37, uric acid 9.6, creatinine urine 169.84 and protein urine 31.9. My current medication is Amlovas 5 mg tablet once daily and Seloken XL 50 mg once daily. Please explain me. ### Response: It seems that you are suffering from hypertensive nephropathy. You would need to know and understand that you need strict control of blood pressure and the addition of an agent. I suggest you to take an ACE (angiotensin-converting enzyme) inhibitors like Ramipril, which helps greatly in controlling the protein in urine, as a result of nephropathy. Consult your specialist doctor, discuss with them and take the medicine with their consent. I would also suggest you for an ultrasound abdomen to check for the status of the kidneys along with the prostate. A lot many times, the enlarged prostate can also cause kidney dysfunction. I hope your blood sugar has been checked and is normal. Revert back with the test report to a nephrologist 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: Is it a bad idea to sleep with a pool noodle along your spine? I am trying to work on my posture since I am getting arm pains. I am doing lots of stretching, exercises, and foam rolling. The foam rolling made me think about sleeping on something similar to get extra benefit. A pool noodle is softer, can be cut to any size and can even be taped to a T-shirt so it does not roll around. I could then offset my neck by just using a thicker pillow. I am not too sure about the lower back area, perhaps another pillow or I can taper the edge of the noodle? I thought I would ask a professional before I went out and did something possibly very silly. ### Response: Do not try unusual methods as sleeping for six to eight hours in an unusual position may be more harmful and cannot be equated to a foam roller as its use is controlled and for a short duration. The pool noodle, being softer, will not provide the deep tissue massage that a foam roller does." "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 just diagnosed with amyopathic dermatomyositis, and I have been put through a lot of cancer screenings as this does not run in my family. All tests are normal, except regular ultrasound of the abdomen showed two non-specific liver lesions up to 3.2 cm. The previous CT scan of the abdomen for diverticulitis showed liver as normal without contrast. Can these lesions form in a year and be benign? I am stressed out. The report said hyperechogenic and likely hemangioma. I am scared to have an MRI. ### Response: I hope I have answered your question. Please let me know if you have any further questions or concerns. Kind regards" "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: On the second day after my period, I had sex with my husband. I have taken I-pill within 24 hours. What is the chance of pregnancy? Also is there any chance of bleeding after taking the pill? ### Response: Hi. If you have taken the I-pill within 72 hours of sex, the chances of you getting pregnant are slim. But you must also know that the I-pill has a 0 to 2 % failure rate. So, if you do not get a period for two weeks after your expected date, do a pregnancy test" "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 capsule endoscopy done a few months back along with a colonoscopy and endoscopy. I have symptoms of diarrhea, constipation, bloating gas, and abdominal pain. My GI doctor could not find anything significant except for acid reflux and diagnosed me with IBS. I was reading the report of the capsule endoscopy and it said there was a 5 mm ulcer in the mid ileum found, but of unknown clinical significance. Is this nothing to worry about? My GI doctor never mentioned this finding to me. Can it be causing some symptoms I am experiencing? ### Response: Your symptoms are suggestive of IBS only. Such ulcers are found incidentally. Mostly they have no value. I would need to know if H.pylori test was performed. Can you send me the report?" "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: One of my relatives is facing some psychological problems for quite some time and she is under treatment as well. She has the following symptoms:Mood swings.Everything available she wants to eat even though she is not hungry.Every time if anyone goes to washroom she also goes even without any feeling of nature\s call.Sometimes she displays an obsession with her husband and daughter. She otherwise remains normal in front of strangers but in presence of her husband and daughter she shows obsessive behavior and becomes furious over petty issues as well. She is undergoing treatment but not much improvement is seen. Following is the list of medication: Procyclidine, Clobazam, Risdon LS, Amisulpride, and Theophylline. ### Response: Hello. Her symptoms suggest some psychotic behavior but this should be evaluated in detail. Mood swings with episodes of irritation, anger outbursts could be part of some mood disorder. She eats a lot, she goes to the washroom without any need and this might be due to abnormal behavior resulted due to some psychosis. What kind of obsession she has? Please describe in details. Does she show behaviors like overspending, not listening to others, feelings that only she is right and others are wrong, argumentativeness, reduced sleep, over religious behavior, etc? These behaviors are seen in mood disorders. If she has symptoms like hearing voices which other cannot hear, suspiciousness, ideas that others are talking bad for her, etc? Her symptoms and medicines given to her suggest some psychosis. Though more evaluation 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 unprotected sex before three days. Today it is almost 72 hours completed. I have taken Mifepristone 200 mg. Are there chances of pregnancy still? ### Response: There is a less likely chance to get pregnant. As you had taken your contraceptive within 72 hours of unprotected intercourse." "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 patient of PCOD. I had my last periods before nine days. I took tablet Letrozole 2.5 mg from the second day of my periods and continued for five days. My USG findings of today as after ten days is right ovary follicle is 23.4 mm, and ET is 6.7. I will be able to meet my husband only after three days.My query is when shall I take injection hCG, as I can afford to have intercourse only after three days. My second query is with such a background, is there a possibility of cyst formation? ### Response: As the follicular size has already crossed 22 mm, there are high chances that you would ovulate in the next 24 hours naturally. However, by rule hCG dose is offered when the largest follicular size has crossed 20 mm, so you should be taking it today. After the injection, the ovulation is expected in the next 36 hours after the LH (luteinizing hormone) surge. So we advise intercourse from the very next day of hCG injection daily for the next three days to increase chances of conception. After ovulation, the egg is available for the next 24 hours when fertilization can occur as the egg starts to degenerate post 24 hours of ovulation. It has to be followed daily transvaginal ultrasound to watch for ovulation. If you ovulate by today night and see a ruptured follicle tomorrow then next 24 hours would be crucial for conception. In your case where sex is planned on three days from now if the follicle does not rupture naturally then you can take an hCG injection in the morning before the day of meeting your husband. And you expect egg after ovulation to be viable till that day and the next day when you can opt for frequent sex to increase chances of conception. All this provided follicle does not rupture until tomorrow evening." "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 tingling and numbness in the arm and hand, particularly when I wake up from sleep. The right arm evidently has significant ulnar nerve conduction problems. Is there any evidence of nerve conduction problems in the left arm as well because I also have tingling and numbness in that arm at times? Currently, I am on Aloe vera 1-0-1 for blood pressure and cholesterol and Januvia for diabetes. ### Response: To help you better, I need to correlate your attached report (attachment removed to protect patient identity) with your clinical symptoms. Also, mention if you have got your thyroid profile checked" "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 experiencing urine incontinence following a vasectomy. While my urine tests came back negative, a semen sample came back positive for a staphylococcal infection. I have been taking Bactrim for about five days. My question is this. How long should I expect it to be before my symptoms are gone? If the infection is in the prostate, will it take longer to go away? ### Response: Hi. Urine incontinence occurs due to uninhibited contractions of urinary bladder and has nothing to do with vasectomy. These uninhibited contractions can occur due to urinary tract infections or neurological causes. In your case, no obvious infection is detected in urine. Staphylococcus aureus is a bacteria seen in skin and presence of this in urine or semen means contamination of sample with skin while giving sample for culture. Usually E-coli is the bacteria in urune or semen and shall take at least 14 days to clear. If the same is in the prostate, it takes 4 to 6 weeks. If your symptoms do not subside, you may need anticholinergics to inhibit uninhibited contractions of bladder. Please get back to me if you are relieved of symptoms in two weeks" "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-25-year old married woman. I have major itching in both my breasts. It started off on the left side but now even on the right side, it has started to itch. I am not able to keep myself from scratching and the entire part below my left nipple is bruised now. There is no redness. The breast felt heavy initially. The itchy sensation in the breast is below the nipple area and spreads down. Please help me with a basic diagnosis and medication. I had a similar itching couple of years back but it disappeared on its own. I am shy to see a dermatologist in the clinic. ### Response: Perhaps you have either a fungal infection or it could be a sort of dermatitis. Treatment for both these conditions is entirely different. Therefore, I request you to kindly upload a few images of the affected areas so that I can confirm and guide you better" "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 normal healthy individual with a sedentary lifestyle. I weigh 67 kg and my height is 165 cm. I am experiencing some breathlessness of late when I walk. Hence, I am trying to understand if there is something wrong in me. My annual medical checkup (over the last 3 years) show my cholesterol levels above normal and also have higher values in the blood hemogram report. My vitamin D levels are also deficient over 3 years. I have a BP of 140/80 and my heart rate ranges between 65 and 78. Two years back, I had taken ayurveda medicine to reduce cholesterol levels. My concern is that it looks like I may have trouble with cardiovascular related issues later if I do not take notice of these higher values showing up in my cholesterol and hemogram levels and my vitamin D deficiency. I have attached my recent reports. I request you to review my reports and suggest if there is a need to take any medication to control cholesterol and hemogram levels. Do I need to take any supplements for my vitamin D deficiency? For comparative purposes and for better diagnosis, I have also attached my test results of past three years that have a high value. ### Response: Hi. I have gone through your reports (attachment removed to protect patient identity). 1. 2. Have diet with low saturated and trans fats. 3. Begin with some physical activity daily.4. Repeat lipid profile after 2 months. Revert back after two months to 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: I was looking at an almost healed canker sore under my tongue and noticed the following whitish purple lines. Are they cause for concern? ### Response: I have gone through your question and picture (attachment removed to protect patient identity). I can understand your concern. No, there is nothing to be worried, it is a normal junction between the tongue and floor of the mouth. In your case, it seems it is a little bit hyperkeratinized may be because of some stress. With age, this line gets some pigmentation and becomes appreciable but there is nothing to worry. Please answer the following: If you are a smoker or taking any other sort of tobacco? Also, if there is any hard swelling below your chin or jaw? Take multivitamins once daily for a month." "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 35 year old. I have diabetes. I had dengue infection few months back and since that day I have vaginal itching. It is usually mild but gets severe sometime. I am not sure whether it is because my blood sugar, which is not in control and nothing to do with dengue. I think it as yeast infection. It is itching too much around vagina including urinal area. There is a white deposit on my skin. For itching, I scratch it and it pains. ### Response: It seems you do have yeast infection. It looks like your blood sugar is not under control because of which you are having this problem. Dengue is unrelated to this. Try putting Canestan (Clotrimazole) ointment on the area after properly cleaning the area, four to five times a day. Also insert three Candid-CL tablets (combination of Clotrimazole and Clindamycin) daily at night into the vagina. This should help you out. If not, then we need to add oral antifungal medicines. Also, if this does not control the vaginal itching, take Allegra (Fexofenadine) tablets at night." "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 stiffness of neck and pain which continues to the back further. This often happens when a stressful situation arises, which also raises my BP. Worries related to health and other life concerns keep bothering me. Please suggest. ### Response: From your symptoms, it seems like fibromyalgia with anxiety. Whenever we are anxious, our autonomic nervous system plays a role, and hence increases the blood flow to various organs by pumping more blood at higher rates, and thus heartbeats can be felt by us. Also, when we are subjected to constant stress, those muscles become stiff. And thus, due to constant tension in them, they hurt after some time because of lactic acid accumulation. Your BP (blood pressure) is also because of stress and not medical hypertension. I would like to know more about your symptoms. Let me know about the details so that I can help you further. Revert with more information to a psychiatrist 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 sex with my fiancee on the 11th day of her cycle and only once. Are there any chances of getting pregnant and today is the 4th day. Can she have Unwanted 72? Does that have any effect on her and what is the medication to be followed in case of pregnancy to avoid it? ### Response: If her cycle is regular of around 28 days, there is 20 to 25 % chance of pregnancy. Unwanted 72 does not work effectively after 72 hours of unprotected sex, so no point in taking it now. If she misses her next period and pregnancy is confirmed, you need to consult a gynecologist for medical abortion as such medicines are not available over the counter and need a prescription. There is nothing right now (except for Cu-T insertion, which is invasive and unlikely to be acceptable), so you can just relax and wait for next period." "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 rashes all over his neck and body. His neck is very red and wet. I am attaching a photo of his rashes. The doctor said he has eczema, and he suggested to use Daktacort, Aveeno cream, and Flucloxacillin, but it is not helping. It is getting worse. Please help. ### Response: I have seen the attached photo (attachment removed to protect patient identity). Hope this answers your query. 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 am 21 years old but my skin is very loose and it looks very old get wrinkled on the upper part of my hands, feet and also in some other parts. Some areas are too stiff. I never get exposed to the sun. For these, I am using Nivea SPF30. I take proper diet with fruits and vegetables but my problem is not solved. I have consulted a lot of dermatologists but there is no improvement. I do not want any wonder results but I need some improvement. I was very depressed by this condition. Please suggest any lotion or cream to solve my problem. ### Response: This is genetic and you cannot do anything about it with lotions and medicines. There is a temporary procedure called dermal fillers which will give fullness and youth to your hands and legs but that is not cheap and the results last for nine months to one year. If you are interested in these procedures you can meet a cosmetic dermatologist or plastic surgeon who does fillers." "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 44-year-old female. After my three miscarriages, I am 13 weeks pregnant now with IVF treatment. I have got my NT scan with double marker blood test.The results are as follows: Biochemical Trisomy 22 risk: 1:249, combined Trisomy 21 risk. Using NT & Other parameters: 1:946. Trisomy 18 risk using NT: 1:10000. PAPP-A: 4.97 mIU/mL and Fb- HCG: 30.9 ng/mL. Crown Rump length: 70.3 mm, Nuchal Translucency MoM : 0.99, Nasal Bone: Present, Nuchal Translucency: 1.74 mmIs my report fine? I am really worried. ### Response: The NT (nuchal translucency) scan levels of nuchal translucency are normal with NT < 2.5 mm. However biochemical trisomy 21 risk is high but the combined NT+ biochemical risk is low at 1:946. You may upload the picture of the cutoff graph for a convincing opinion regarding whether you would need amniocentesis for karyotyping confirmation or not" "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: Hello mam,I am 22 years old and I am experiencing hair loss for more than eight years. Every time, I shampoo my hair, I would lose 50 to 100 strands of hair. I have an oily, itchy scalp and to some point, my scalp is visible (not completely bald) and my hair density has also reduced. I wash my hair with warm to hot water.I have researched a lot about this on the internet and found that stress and poor diet can cause hair loss. I consulted a doctor and she prescribed Anaphase shampoo and some vitamin pills and Minoxidil which I did not use after studying about it. My hair fall has reduced to some point after those medications, but my question is can I regrow my hair back and if so, how much time it will take if I follow a healthy diet. ### Response: Hello. You should take Minoxidil at least for six months. The normal shedding per day is 35 to 45 hairs. Of course, hair can grow again but healthy diet alone will not be enough. Send me a photo or visit a dermatologist in order to classify the stage and followup as well as to determine the appropriate therapy" "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 and my fiancee messed up. Because she did not want penetration so I just asked her to do the hand job and I ejaculated after. I wiped the fluids that was out in my penis, after a few minutes like 2 to 3 minutes. It was her turn to get satisfied so I just let her do what she wanted to do. She sat on me, we both naked. She rubbed her vagina in my penis without touching the head, she was so wet, no penetration happened. After that day she felt guilty that she might get pregnant for that, so she decided to drink Parsely 2 to 3 times a day after a week we had the fun. She drank it almost four days, the purpose to that was she wanted to get early menstruation. It did not work so she tried next week for a ginger tea 3 times a day for 3 days. I think still did not work, tried the Parsely tea again together with the Vitamin c, both three times a day for 7 days, did not work.Until she felt back pain in her lower back and cramping on her lower abdomen too, also when she urinated there were tiny white mucus in her urine. There were days she felt a fluid is getting out of her vagina, seeing her panties it is just a white fluid, thought she will get her menstruation back but no. Still she keeps on drinking the tea and taking the Vitamins hoping for her menstruation to come, everytime she is in pain she does warm compress on her lower abdomen and back hoping to induce her menstruation. Still no menstruation. So is she pregnant? What should we do to get her menstruation back? She is so worried. Or is this another problem? ### Response: Well, in this case I see that her guilt is pushing her to undergo a lot of ordeal. I feel she has contracted a urinary tract infection secondary to vaginal candidiasis which is the cause of flakes in urine and the white discharge per vaginum with lower backache and abdominal ache. If there has been no penetration, unlikely that she is pregnant, only a remote chance that sperm would have travelled from her thighs to the vagina while she was on top. My advise would be do a urine pregnancy test to confirm if there is a pregnancy. For UTI, she can start tablet Fluconazole 300 mg once a week for three weeks along with tablet Norflox-Tinidazole twice a day for seven days, with special care to" "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 daughter has been suffering from a seizure disorder from her birth and has been taking AED. She is 13 years old now and at present she has been taking Valparin Chrono 500 and Levipil 750 both twice daily. She attained puberty before two years and presently studying in sixth standard. She has a learning disability, forgets everything very quickly and needs to be treated specially. But it will not be possible on the part of that school as the school does not provide any special classes for learners with LD or does not have any provision for CWSN. On the other hand, there is no any institution in my locality which provides special education to CWSN. Under the circumstances stated above, I have left no option except to enroll her in an open school and give necessary support to her. Now my question is will it be fine for her in the future to lead a life without any social development? ### Response: Hi. Your daughter has two independent medical problems. The seizure disorder needs management with medications. Her learning disability needs appropriate assessment and remedial work. I do understand that most schools do not offer remedial teaching and they leave the parents with no option other than NIOS (National Institute of open schooling). You can look up such organizations in your town. Also, chil" "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 got married six months back. On the 1st of last month, I had menses. This month, just before my period date, I had brown discharge and still, menses has not come. My pregnancy test showed negative, but nowadays, I feel little cramps in my stomach. Am I pregnant? ### Response: Hello. You have missed cycle, and have cramps and brownish vaginal discharge. Have you taken any hormones, medications, recent illness, crash diet, strenuous exercise, had thyroid abnormalities, abnormal hair growth, sudden weight gain, etc.? These all are the causes of delayed menses. Vaginal swab also needs to be sent to a lab. My advice is to have immediate serum beta hCG twice with an interval of 48 hours. If this beta hCG of the second reading is less than first, it could be a miscarriage, if the second level of beta hCG increased only less than 60 %, it could be pregnancy outside the uterus, but if beta hCG shows increase more than 60 % in 48 hours it is a healthy pregnancy. In case of dizziness, heavy bleeding, or pain immediately report to the hospital." "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 consultation about my stress management problem. I am appointed on a management post in a public sector hospital while my actual field according to my academics is research and teaching. I am facing difficulties in adjusting myself in this job while staying for the first time in my life away from home. I am trying hard to find some job suitable to my nature but at present, I have to stay here unless I find some suitable job. I am facing a stressful situation. All the time I want to stay away from people to whom I have to deal according to my job description and I am always in search of a chance to go back to home and I do not know what to call it but my actual problem is this. Kindly give me consultation to manage this situation. ### Response: First of all, you should have the acceptance that you have a job and you must do your job irrespective of the fact that this is not your subject. If you think that this is not for you then you should have not taken this job. Once you have accepted about the job, then you will start working properly. Stop searching for any other job as of now and focus on your current job. This will definitely help 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 fear I may have contracted HIV. A month back, I had oral sex and regular sex from an unknown girl. Three days later, I started to feel very sick, headache, cold in warm weather, tired, diarrhea, sweating in bed (I thought this could be food poisoning). A week later I felt better but had breakouts on my whole back (thought maybe from sweating in bed and training in severe heat the past week). A week back, I felt fine most of the day but once 4 PM hit, my throat started to hurt, I had a severe headache, cold sweats, very tired, fever at 102 F. Felt better by the next night except for the throat which still hurts when swallowing. My neck feel kind of stiff as well. I wondered how much stress can play a factor in producing symptoms, because the first time I was extremely stressed for a couple hours about something and the second time the same thing. And I mean extremely stressed out and anxious, thinking alot, heart racing, etc. I of course will get a test but fear it is too early to show a positive result if it happens to be. ### Response: Hello. I have noted your concern. Unprotected oral is not much of a risk. The only risk factor involved here is regular sex. The breakout on your back looks like acne (attachment removed to protect patient identity). Your throat symptoms and other systemic symptoms could be just part of throat infection. I suggest you take a fourth generation HIV screening test at four weeks from your risk exposure with the girl of unknown HIV status. That would be conclusive" "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 61 years old mother underwent vestibuloplasty for lower jaws. Since she arrived, it seems to be bleeding. I know blood and saliva mixed together will seem like bleeding than it actually is. We live in an isolated area. And reaching a doctor was not possible. Could you please let us know what to do to clot the blood for now? ### Response: I understand your situation. Bleeding after vestibuloplasty or any oral surgical procedure is normal for the next two hours. There are certain instructions you can follow at home to stop bleeding. 1. Apply pressure to the surgical site. Place a thick cotton or gauze pad (probably from the first aid kit of your car) and ask your mother to bite it with pressure for the next 45 minutes. 2. Swallowing saliva. It will be difficult to swallow saliva with the blood taste. Saliva helps faster clotting. Avoid spitting which will increase bleeding and delay clotting. 3. Avoid disturbing the area frequently (to check for clotting). Leave it undisturbed. If the surgical area is disturbed after the clot formation, bleeding will start again. 4. Ask her not to disturb that area with the tongue. 5. Take some ice cubes in a ziplock. Wrap a clean cloth/ tissue over it. Give periodical and very gentle cold compress extra orally (not directly to the surgical site) after 45 minutes of gauze biting. You should seek emergency care if the bleeding is profuse even after three hours. Whereas, very mild bleeding is absolutely normal for today. And place an extra towel over the pillow before laying on the bed, which prevents pillow staining. 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 29 weeks pregnant and I have started taking a supplement to help with my acne. I wanted to know if the ingredients are safe during pregnancy. It contains burdock root, dandelion leaves, milk thistle, red clover, and cellulose. Please let me know if I can take this. ### Response: Hello. The ingredients which you have mentioned are safe during pregnancy. They will not cause any harm to your baby. At the same time, you can also apply topical antibiotic ointments containing Clindamycin to fight your acne." "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 get red marks on my testicles when it is hot outside. Is it heat rash or STD? I have attached a picture of the red lesions for your better understanding. ### Response: Hi. I have read your query and examined your picture (attachment removed to protect patient identity)" "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 my Flonase (Fluticasone) nasal spray bottle was empty which is actually was and I have no idea what suddenly changed. I started pumping it which I usually have to do when it is empty before I reached my nostril, and a puff sprayed into my left eye. As I heard the sound, I immediately closed my eye, and then rushed to the sink and rinsed it. I continued to rinse it and even made an ""eye bath"" out of a shot glass. Though the capillaries in the outer corner of my eye are slightly inflamed, it is not burning though, just a little blurry. That could also be because I was shining my phone flashlight into my eyes to see if both pupils were reacting normally, which they are. Is this emergency and should I be more concerned? Or should I be doing something more? ### Response: For how long it is blurry? Did it improve at all or not? Give a thorough wash for at least half an hour with clean water. If the vision improved after washing, then there is no need to be the worry, but if it is still blurry, then you must consult for any corneal lesion" "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 bilirubin level is 1.7, but I do not have any symptoms of jaundice. How can I bring the bilirubin level to normal? ### Response: Well, there are certain medications that can bring bilirubin down but your bilirubin is 1.7 which is within normal limits. It does not require any treatment. In case, you suppose that I should diagnose your problem then please share the complete report of liver function tests. Follow up with complete liver function tests." "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: There is swelling in my left eye upper lid. There is a pain and small pimple from inside at the corner for last two days. Currently, I am using Nevanac and Pataday eye drops. ### Response: Hi. It seems like a mild staphylococcal infection and has caused a stye (attachment removed to protect patient identity). Apart from medicines, you can do some hot fomentation two to three times a day for relief. It is usually caused by touching of the eye with dirty hands or when there is water in eyes. After this infection subsides, please get refraction done to see if you need glasses. You have to take antibiotics for 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: I woke up this morning to see a small red line or vein on the top of my left breast. I had a breast check up and mammogram 6 months ago which was clear. Is this normal? What is it? ### Response: Hello. This does not appear worrisome to me (attachment removed to protect patient identity). This appears like erythematous lesion due to inflammation. This has probably occurred due to some trauma like due to pressure of folds in clothing or bed sheet or lying over the chest. Also, rule out possibility of some bite or nail scratching. If this is generalized and also present on the other body parts then may be related to some infection. So, usually such single visible vein is not significant. It should settle in a day or two. But if continues to persist or increase in number or any other symptoms like swelling, pain, fever appears then will need examination or investigations. At present, does not appear significant or serious issue. Hope this helps you and get back if you have any doubts." "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 these questions. Can you please help me to clarify? 1) Does pausing and resuming urine while flowing, improves sexual performance in men? Please tell me the procedure of this. And does this cause any side effects to urinary system? 2) What is the kegel exercise? I read somewhere that we can do this everywhere. Like in office, home, while driving. How to do that? And how often we can do that? 3) I have only one testis, as I have undescendid testis, which was surgically removed recently. I have sexual feelings as normal. So do I need to take any extra care as I have only one testis? Or having one healthy testis also completely okay? Please answer in detail, as it is very helpful to overcome my mental fear regarding these things. ### Response: Hello. Please find following answers for your questions: 1) Pausing and resuming urine would only cause problems. This will not cause any improvement in sexual functioning. Better to avoid this completely. This could cause development of diverticula in bladder or urethra. 2) Kegel Exercise is a good option to improve the sexual performance. The exercise can be done at home or at any place without any issues. This is nothing but pelvic muscle strengthening exercise. In this one should tighten the pelvic floor muscles and hold the muscles in tightened position for around 8-10 seconds (on count to 8). After holding the muscles should be relaxed. This should be done multiple times a day. Do as if you are holding gas in your anus or as if you are lifting the anus. Try to do this and you will come to know about movement of anus. 3) One testicle does not cause any problem. No need to do any thing specific for that. Have good meals and exercise daily, you will remain healthy. Having one testis is completely okay." "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 fracture of the bone joint on my right hand ring finger which was caused by a road traffic accident were I was hit by a van pulling out of a side road. I was due surgery to repair the injury last month. The surgeon decided not to operate as under the live X-ray he was able to manipulate the bone back into the joint, therefore asked physio to splint the finger, the issue is each time I take the splint of to clean the bone is back as fracture and am not able to bend my ring finger. I am due to see my surgeon as the splinting is not working. Any advice of what I need to ask my surgeon to do is most appreciated. ### Response: Well there is intra-articular fracture of base of middle phalynx of your ring finger (attachment removed to protect patient identity). If I would be the surgeon then I would have gone for operative treatment because intra-articular fractures need perfect reduction. If he has decided to treat it non operatively then he could have applied plaster or strapping which is not removable like your current splint." "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 went to the allergist a week back and he said my nasal passages were swollen up. He prescribed QNASL. I am going to meet an ENT doctor in a day or so. I cannot breathe well or smell. What can an ENT doctor do for me? ### Response: Hi. The steroid nasal spray you are using has local steroid which helps in reducing the swelling. This spray you will have to use for around six weeks. If you have excessive sneezing you should use antihistamines also. If your problem is chronic that is from a long time I would advise you to get CT scan of paranasal sinuses done to rule out sinusitis." "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 want to know how the virus HPV type 73 is transmitted? I have heard that it can only be transmitted from sexual course but I want to be sure. My fiancee also has the virus. ### Response: Hi. I read your query and understand your concerns. It is true that HPV (human papilloma virus) 73 is transmitted through sexual intercourse. On the current date no other mechanism is known for transmission of HPV 73. Considering the fact that your fiancee has HPV, there is high possibility of transmission to you. I must inform you that even the use of condom does not ensure 100 % protection as areas such as inner thighs are not covered with use of condom." "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 8 weeks pregnant and got bad gum ache on one tooth. It is really stressing me out. Can a dentist do anything to get rid of the pain? ### Response: If it is just one tooth and there is no associated caries means that is periodontal. So what I suggest is single tooth scaling and root planning will not take much of your sitting time. I think you can go for single tooth scaling but make sure that you go to an experienced dentist. Otherwise, at-home remedy, you can try warm water and salt rinse 5 to 6 times a day. Do revert back if pain persists. Follow up after one 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 went to see my optician and my left eye had an IOP of 22 and the right had 20. These seem to be the average numbers going back six years at two-year intervals. He dilated the eyes and inspected and took photos of the optic nerves. He said everything looked healthy and said to come back in two years. Is this a normal procedure? Of note, I also had the visual field test upon request two years ago which was good as well. Should I be seeing him sooner than two years or just sit and trust that everything is good? I sometimes take Lorazepam for anxiety. Please help. ### Response: The pressure readings you told me are within normal limits. Since the ophthalmologist you saw did a detailed fundus examination and told you everything was fine and also your fields are fine. So, I think you do not have anything to worry about. Also if nobody has any history of glaucoma in your family, it would be another point that you should not worry. Get your IOP (Intraocular Pressure) checked every six months or so and a yearly fields test. I think it would be enough to keep your anxiety away" "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 18 years old male. There is not a single day when I sleep happily. And the reason is that I am not able to study. It is not that the syllabus is too tough for me. It is just that I do not sit too long and for that matter, I do not sit to study at all. I know the consequences. This semester is important for me. If I perform badly in this, my parents will kick me and throw me out of the house. I need to study well to get a good branch. Just the thought of not studying is making me lose my life. I am feeling completely frustrated and am with no hope. I also get suicidal thoughts. So, I thought of consulting someone. If I start studying, I will do miracles. But, I get deviated easily. I feel like I love buying troubles by not studying. Please guide me on how to be motivated to study regularly. Just one act of not studying is making me lose my happiness. And, I often get headaches too due to irregular sleeping habits, may be. Please help me. ### Response: Hello. First of all, I would like to mention that studying, though important, is just one of the many parts of life. Do not lose confidence or be so harsh on yourself. Study smart and not more. Study in small shifts of half an hour followed by a rest of five minutes. Set small feasible targets and try to achieve them. Praise yourself if they are achieved and if not, do not worry. Also, keep one hour daily for your hobbies to vent out daily stress.Remember every problem has a solution. You just need to try solving it and help is just a step away" "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 hypothyroid for three years, and I am taking Eltroxin 100 mg one tablet daily before two hours to my breakfast. But sometimes I feel pain over and around my thyroid gland. I feel like my neck and vocal throat are squeezed and my voice is dumpy. Please suggest any medicine or treatment for pain and vocal problem. ### Response: Hello. Your problem may be or may not be related to the thyroid problem. If your thyroid gland is enlarging it may compress your vocal cords and food pipe and cause your problems like vocal throat squeezed, dumpy voice. In this case, you need to get an ultrasound of your neck. This will confirm your diagnosis. The other possibility is some problem inside your throat like vocal cord nodules, or ulcer, or mass, etc. For this, you need to get upper GI (gastro intestinal tract) endoscopy to know what has happened. I advise first you go for ultrasound of your neck first as it is non-invasive, then revert back to me with the report." "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: 2 years and 6 months old with abnormal CBC test results (two tests seven weeks apart). First tested because of enlarged lymph node (only one side) in neck. Node has reduced in size to what appears normal. Low MCHC (just barely outside range of 32.0 to 36.0) 31.3. Low NE % of 26.1 Auto diff with range 43.0 to 65.0, high LY % 62.7 with range 20.5 to 45.5, high EO % 3.9 with range .9 to 2.9. Highly # 6.2 with range of 1.0 to 5.5. What does this indicate? I have read all the horrible possibilities. Is it possible these are indicative of something not serious? ### Response: Hello. Your CBC report is suggestive of lymphocytosis (attachment removed to protect patient identity). The common cause for lymphocytosis is viral infection. The enlarged lymph node could be due to that. Now, your enlarged node return to normal size as per history, so suggestive of infective etiology. You might be feared about leukemia like condition. But in blood cancer, total count is very much high like more than 50000. So, it is not suggestive of blood cancer. However, if you have persistent lymphocytosis, then it is advisable to investigate with peripheral smear examination report for further work up. It will be able to help in identifying any abnormal cells, if present like atypical lymphocytes, blast, etc. You can consult your pediatrician for detailed physical 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: I am living in a place, but my mother lives abroad in a country with limited access to spinal surgeons. She is 71 otherwise fit and well for her age. She slipped over and was told she has a t8 vertebral body fracture that is minimally displaced with no cord compression. She is in pain, but does not want to immobilise or stay in bed. What advice does she need to follow? Her sphincters are intact and she can control her bowels and bladder. ### Response: If she has a T8 vertebral fracture, that is I hope a compression fraction that you are talking about, which is minimally displaced and compressed. Then the treatment that is required is principally pain relief with minimal activities and physiotherapy initially to her mobilize with frame or support. She can use a TLSO brace (thoracic, lumbar sacral orthosis) and mobilize as able as tolerated by pain. Bed rest is only indicated in case of severe pain. Pain-killers like Co-codamol or Paracetamol or Morphine can be prescribed locally. Physiotherapy is given initially to get her up, and I can only give you an exact approach to this if you can send me the MRI report of the pictures. This professional advice provided by me stands subject to the actual examination of report or image and is based entirely on inputs provided to me. It should be correlated with clinical findings." "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 left foot got numb, then my left hand, and now my right leg as well. The doctor did diabetes, cholesterol and thyroid tests. All the laboratory reports were clear. There were no issues. Vitamin B12 was fine as well. Then, he performed nerve conduction studies and he told me that everything is clear. Now, please tell me what could be the issue. I am currently on Vitamin D and Calcium supplements. ### Response: Hello. Considering your symptoms, I would recommend performing a brain MRI (magnetic resonance imaging) study to investigate for possible multiple sclerosis. If the brain MRI results are normal, then you should consider anxiety as the main cause of your complaints. I would also recommend performing a cardiac ultrasound and a resting ECG (electrocardiography). You should discuss with your doctor on the above tests" "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 got a tooth pain when it is gently tapped last year. I suffered for two days. I did not consult any doctor. Now it is okay. I want the reason why I got a pain. I got the pain in a tooth beside the tooth that is already capped. ### Response: The tooth pain on tapping suggests some infection in the tooth, or any food getting stuck between two teeth, sudden biting of any hard food, maybe if any abnormal biting of teeth and so on. There are many reasons for this. So we have to make sure what caused you the so called pain on tapping. Good that you did not have any pain thereafter. Just check out if you have decay in that tooth. The best suggestion would be just to visit the dentist and explain to the doctor about your condition. They will examine and if required take a small X-ray and decide as to what causes you the pain" "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 whitish lump at the back of my throat located on the posterior wall. I suffer badly from post nasal drip but not sure if this is related, doctors seem unsure and I am worried sick. Any input as to what this could be? Suffer from GERD, post nasal drip, have had blood at the back of throat over the area of concern previously (when the lump was not visible). ### Response: I understand your concern, it is most likely submucosal lymphadenitis of the posterior pharyngeal wall. This may develop secondary to chronic infection of the nose, paranasal sinuses, and throat. To confirm the diagnosis, you may go for MRI neck and FNAC from the lump. Most of the time it is reported as non-specific reactive hyperplasia which is not a problem and maybe leave as such but if anything special comes in FNAC then that may be plan for treatment accordingly." "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 7 years old, and 20 kg. He is currently taking Taxim O Forte syrup for an infection. He has developed severe cough (dry) now. In the past, he was using the Duolin inhaler for an extreme cough. Please, could you advise if Duolin inhaler can be given to him when he is on Taxim O Forte syrup? ### Response: Hello. Yes, you can give Duolin (Salbutamol and Ipratropium bromide) inhalation along with oral antibiotics. You can give honey for a" "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 using only one eye since birth. This is a result of a medicine that my mother took when I was in her womb. My right eye is normal, but the left has a squint. I can see a little light in my left eye, but I cannot really use this eye for seeing. By this time, I got another problem with my one and only eye. I cannot clearly see things that are 10 meters away from me. I am afraid to lose my sight. I need your help. ### Response: You need to get your eyes tested for a refractive error i.e glasses/spectacles. You have become nearsighted so get this test by an ophthalmologist. Your left eye has turned inward that is esotropia. You need to consult a pediatric ophthalmologist i.e squint specialist. This eye can be straightened though it is difficult to get the sight in the left eye. If you undergo squint surgery, this can be centralized" "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 18 years old and my hands are very dry and rough. There are very deep noticeable cracks in palms and the webbed skin between the thumb and the index finger is very dry and rough. No lotions help. It is a big self-conscious thing. It has been this way since I can remember. Any help would be appreciated. ### Response: I am glad you asked this. The treatment for palmar keratoderma is different as many medications like retinoids and other medicines are not available over the counter. You will have to see your dermatologist to institute the treatment for the same. In either case, avoid excessive washing with soap. Avoid handling harsh chemicals like washing soda, detergents, bleach, car cleaners, etc., with bare hands. Use hand lotion regularly to keep the skin soft. Take omega 3 supplements to regulate the cholesterol environment in the skin." "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 17-year-old with height 5\8"" and weight 118. My doctor has clinically diagnosed me with narcolepsy. He said that I show every sign and symptom I did not meet the requirements on the MSLT. He believes that I still have it. He did blood work, and my iron and vitamin C came back low. He wants to do a spinal tap, if that comes back fine does that mean I do not have narcolepsy. Also, what does clinically diagnosed mean? ### Response: Hello. Most of the diagnosis is made based on the patient\s history of complaints, examination done by the doctor and supported by investigations. The investigations most of the time play a crucial role for example if I suspect diabetes in a patient and his blood sugar test reports come normal, then my diagnosis needs to be changed. But for certain diseases, there are no tests which will confirm or refute the diagnosis. Narcolepsy is one such disease. So what your doctor is doing is he is testing for other illnesses which mimic as narcolepsy. And if tests come normal, he concludes as narcolepsy based only on your symptoms and his examination and not on test reports. That is the meaning of clinically diagnosing. If you can tell me your symptoms, I can help you in diagnosis." "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 68 years old. Her weight is 75 kg and height is 165 cm. She has severe right leg pain from behind the knee and around the calf muscle, especially in the nerves. She has varicose veins on her thighs and has had continuous pain for nearly 35 years following her third pregnancy. She is a homemaker and does all her work herself, she feels tired every two hours to the extent where she cannot lift her leg anymore. A half an hour relaxation will give her energy to get back on her legs. She is doing yoga to manage this pain without any medication.Currently, the nerve pain keeps changing from one place to another and varies randomly. It increases when she has a hot water bath or hot water foot massage and walks as a part of her routine exercise. She also feels like there is a bubble, which keeps moving. Sometimes, she is unable to walk or walk with a help of the stick very slowly. She is applying oil on her leg, but has found no relief. She is on Topdip 5 mg for BP, B complex and Neurobion tablets. She had a kidney stone last year and removed it by taking ayurveda medication. Her thyroid and sugar levels are normal, but have vitamin D deficiency. So, she has started taking Vitamin D supplements. She is a vegetarian and will not consume any junk food or sweets. Please suggest some advice to get relief from the pain. ### Response: Hi I do understand your concern. It is not possible to make conclusions with limited information, but you can do the following things for her to get pain relief. Revert back with the report to 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 dry skin that usually becomes dull without constant care such as face masks and steaming. But my main problem is my dark under eye bags and the hyper pigmentation around my mouth area. Do you have any suggestion on what I can do to reduce the appearance of darkness around my mouth due to pigmentation? Also, please suggest a way to lighten under eye bags. ### Response: Hi. Please apply fresh cucumber around the mouth area and under the eyes as it is very safe. Also, apply little Lactocalamine lotion in the same area. Apply fresh tomatoes peelings, take vitamin E capsule once daily for a month and vitamin B complex. It would take little time, but the effects will start slowly appearing. Be patient and keep using these materials. Also, you can apply fresh aloe vera paste over this area." "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 age is 39 years. I have quit smoking, cold turkey after smoking for almost 18 years. It is my 29th day of being smoke-free. Everything was going fine until last 7 to 10 days my bowel movement has been strainful. Few days I have seen very small sized hard stools and sometimes small stool with very little water. I started taking Metamucil. However, the stomach felt bloated severely after eating anything. I sometimes feel a sudden hunger spike that becomes uncontrollable and once I eat, the stomach swells like a balloon. I also started taking one capsule of Triphala to ease out my symptoms. From past 4 to 5 days, I have started feeling fatigue and a very strong one like light handedness and no energy in my legs. I had a sore inside my mouth and that has healed significantly now. The acid reflux is there, especially while making out with my partner I felt food coming up. The consistency of stool after eating Metamucil has been more like rubber shaped long zig zag sausage with uneven and weird cracks and sometimes mucus as well. I feel gas below my stomach and sometimes have to strain hard to pass. I got my CBC done two days back (normal report), kidney, liver, thyroid (normal), Hb (normal), sugar (normal). I also got my FOBT stool test done (negative report). Are the above symptoms cigarette withdrawal symptoms? Or stomach bug? or IBS? I take the following tablets daily. one Magnesium tablet, one Menevit tablet (for sperm health and male fertility), one Omega 3 1000 mg capsule, one 64 Billion Probiotic capsule. ### Response: I went through your post, it is normal to have hard stools after quitting smoking for that you have to add a salad, do exercise, and take enough water. It is a temporary phenomenon which usually settles in three months till intestines adapt nicotine free blood. You have started laxative Metamucil which has caused gastritis. You need to stop that and continue Nexium at least 10 days daily before breakfast. There is no need to take omega, probiotics, Menevit or Magnesium tablets. Do not take unnecessary medicines. It is not IBS." "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: Hi,I just went to the dentist for a general cleaning. My dentist is great and very hygenic. Today when he came in the room he washed his hands and put on gloves. Half way through he needed to go and check on another patient. He took his gloves off and ledt the room. I dont know his he needed to treat or just talk to the other patient. He came back in my room and put new gloves on but didnt wash his hands and continued. He off couse may have washed his hands in the other room. I have anxiety about my health and worry about contracting something like HIV or Hepatitis. During my cleaning my gums were bleeding and I'm worried that maybe there was cross infection. Am i right thinking that it would be unlikely that he could have infected me with something like HIV/Hepatits this way? ### Response: Hey, That is great that you are cautious about hygiene. But its perfectly fine. Your doctor would have definitely washed hands before wearing gloves. Secondly, HIV/Hep C viruses don\t act at other person in seconds. It takes months or years to become active and then start with some symptoms after years . This won\t be the case you are healthy mA. Bleeding during scaling is very common when tartar is removed at boundaries of gums. It promotes a healthier gums production later. For being having no doubts about any viruses you can get your relevant blood tests done. Like CBC, Hiv tests done 6 monthly that will definitely rule out this thing in your mind.Stay blessed and happy. Feel free to ask any further queries." "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 taking Doxycycline for three months. After I got a haircut in third month, I noticed that I had two bald patches (it is not actually bald, they were just super thin with a little bit of hair). I got a haircut again today, and the same problem occurred. I am almost positive that the problem is alopecia areata, and I also have the symptom of nail dystrophy (it appeared around two weeks ago). Do you think Doxycycline caused this issue? How can AA be treated, and how long should I expect for my bald spots to have normal thickness again? ### Response: Doxycycline is Tetracycline antibiotic that can cause photosensitivity and photo-onycolysis (nail dystrophy) but alopecia areata is not linked with this medication. On the other hand, nail problems are common with alopecia areata. Alopecia areata," "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 unprotected sex with a call girl ten months back. Then after three months, I got my HIV test done and the test was negative. Then again I got the HIV test after six months, the test was negative. Then after eight months, I got my HIV test done again, the test result was negative.I did Elisa test, tri-dot test, Elfa test, finally western blot test. All test results were negative. I am getting some symptoms like body pain, body tiredness, bitter mouth, sore throat, tightness in neck.So, I am fully scared. My question is that are these symptoms related to HIV or again I have to take another HIV test? Recently I did a WBC count test and it is 12000.I have got Vitamin D test results as 16.6 ng/ml. Is Vitamin D deficiency related to my symptoms? I got Vitamin B12 test results as 188 pg/ml. Is this related to the beginning of HIV infection? I am totally confused.Please answer my questions. ### Response: So whatever symptoms are there, it is due to vitamin deficiency. All tests are negative so it is clear that there is no HIV infection. So do not worry. You can consult a general physician. So he will give you written prescription, even I can but a long treatment is required. You will be all right after taking treatment" "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 master\s degree and recently I have been having difficulties managing day-to-day tasks. I need to find out if I have a learning disability and how best to manage this issue. ### Response: Hello. What sort of difficulties are you facing in managing your day to day tasks? Are they only related to reading or also involve any complex mechanical activities? Have you ever had a reading disability? The best way to manage this issue will be first diagnosing what is that you are suffering from and then consult a specialist for the same" "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 unprotected sex after four days of the period this month. He did not ejaculate inside but I am not sure about pre-ejaculation. Within an hour after intercourse, I took unwanted 72 and I had bleeding for only one day. Is there a chance of pregnancy or not? Is it a withdrawal bleeding? My mensuration cycle is 30 days. Does it come under safe days or not? ### Response: Since you have taken the emergency pill within 72 hours of intercourse there is no chance of pregnancy. Yes, you had intercourse during your safe period, which is from day 1 to 10 of your period. There is nothing to worry about. So relax and do not worry.However, if you have a doubt then get 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: I am married and have no baby yet. A year ago, for the first time, I noticed blood in urine and painful urination. After two days of intercourse, I face this problem. When I was 14 years old, I suffered from hematuria. I took Pause, Mix 500 and Alkasol for relief. Please tell me the treatment now. ### Response: It is a urinary tract infection, mostly cystitis. It occurs due to unhygienic peri genital condition. In order to prevent UTI keep your perineal area clean like cleaning after intercourse and daily cleaning of the area during bathing. For the cure, you will need an antibiotic for a week. First, you should get urine routine and microscopy test done to confirm the infection. You should also get an ultrasound done to confirm cystitis and rule out other causes of bleeding. Then you will need antibiotic like tablet Nitrofurantoin 100 mg twice a day for a week along with antacid like tablet Pantoprazole before breakfast once a day for a week. Also, for pain I suggest antispasmodic tablet Tolterodine 2 mg whenever needed for up to two times a day, especially if syrup is not helping. Also, you should" "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 suffering from acute severe asthma for the last five years for which she is regularly taking treatment. But, from 10 days she felt some pain in her stomach and there were lots of red dots on her feet and back. Today, we visited a doctor who performed some tests. I am attaching the reports of the same. Kindly advise us on this. What is wrong with her? ### Response: Hello. I went through the reports (attachment removed to protect patient identity). These are called as purpuric rashes. There are a number of causes for this. Was there any fever? Where did the rashes start off? The probable diagnosis given was a meningococcal infection. This can be treated. There is no need to worry. There seems to be thrombocytosis and excess platelet count." "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 urinary tract infection. I get these once in every couple of years. I need to get an antibiotic to get rid of it. Please help. ### Response: Recurrent urinary tract infections are common in post and perimenopausal women. You need to get a urine culture and routine investigation, so that culture guided antibiotics can be given. In these cases plenty of fluids and urine alkalizer syrups are also very helpful to alleviate symptoms. Application of an estrogen ointment around the urinary meatus can also be highly helpful. Tablets of Ciprofloxacin in a dose of 500 mg can be a good empirical therapy. Consult your specialist doctor, discuss with him or her, get the urine culture done and take the appropriate tablet. 1. UTI.2. Hypoestrogenemia. Urine routine, microscopy and culture. Culture guided antibiotics." "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 24 years old, student. Recently, during a sexual intercourse I felt an acute pain after which I suddenly stopped. The next day I had swelling all around my penis. It seems like the foreskin has swollen. I was a bit worried so I visited the GP here who advised me to take anti-bacterial, anti-fungal and anti-inflammatory medicines. The dosage is over but the swelling still persists. The penis and genital area feels itchy at times and sometimes has a foul smell too. The medications recommened by the GP were as follows: Co- Amoxiclav 500/125, Aciclovir, Ibuprofen 400 mg.I have a regular partner with whom I indulge in sexual intercourse. Is this a classic case of balanitis? Please tell me what to do. ### Response: The foreskin of your glans is edematous and little inflammatory (attachment removed to protect patient identity). Possibility of balanoposthitis. So you may check blood sugar levels, complete blood picture. Wear soft cotton related innerwear. Apply Clotrimazole plus Betamethazone gel locally twice a day for five days. Use tablet Fluconazole 150 mg once a week for five weeks. If no improvement get it done local swab culture and microscopy. But do not worry, it is a simple condition, it may subside within one to two weeks." "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 29 years old. My blood sugar levels were FBS 296 and PP 441. So, I consult with doctor and they suggested to take Insulin 14 units in the morning and 8 units at night for 15 days. After 15 days, it reduced to FBS 180 and PP 230. So, they stopped insulin and then they asked to take Vysov M 50/1000 twice a day. After a month I checked my sugar level and it showed FBS 110 and PP 150. They asked to continue same tablet for next three months. My question is can I continue the same dosage? Are there any side effects if I reduce the dose? Please guide. ### Response: 1. Patient should get his eyes examined for ruling out retinal involvement as in diabetes this is one of the common and a serious complication that comes without any symptoms.2. Plus check HbA1c% every 6 months. Lipid profile and complete blood count (CBC). Revert back after the investigations to 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 am 33 years old. My testicles are the size of a grape and I experience low sex drive, and less sperm count. I have used some testosterone when I was about 16 years, the testes have never recovered since. I have been reading a lot and bought some HCG 5000 but I do not know how to use it, and I do not want to make things worse. ### Response: Hello. Basically, because of exogenous testosterone, your body has stopped production of testosterone from testis resulting in testicular atrophy and hypogonadism. I will not prefer hCG (human chorionic gonadotropin) and I would like to start you on Clomiphene citrate 25 mg every alternate day. Clomiphene is better than HCG. HCG can be given if there is no improvement with Clomiphene citrate. Exogenous steroids must be totally stopped. It will take time to recover and I will not give you 100 percent guarantee that your testis function will recover as there is severe atrophy. Recovery depends on the amount of testicular tissue left. But we will try our best." "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 25-year-old girl. My problem is that I am suffering from lower lung pain on the left side for the past 10 days. I already consulted a doctor, but he was not able to find anything abnormal in X-ray and blood reports. He prescribed me some capsules and pain killers, but it does not work. It is getting worse when I take a deep breath or sneeze. It is a pinpoint pain in the left lower lungs. Please suggest me something so that I can cure my problem. ### Response: As you said, you had left chest pain for 10 days, and all reports are normal, it is very difficult to interpret it. You should elaborate your history in detail, including your history or similar episodes in the past. Attach the x-ray with your query. If you are having some acidity issues, it can be because of gastritis. You have not specified any other symptoms like cough, history of fall or any trauma in your description. So I advise you to get back to me with all these details. Even it is related with your menses also and very common in young girls. So a good correlation of your medical history will solve your problem." "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 is diagnosed with coronary artery disease and triple vessel disease with LM. I have attached the angiogram report for your reference. Is the CABG only solution or partial stenting may work? Or is it fine to give only the medication as there are not much clinical symptoms? His TMT was strongly positive. He is a smoker and also takes alcohol. He is a blood pressure patient and takes Amlopress, Telma and Ecosprin. ### Response: Hi. I have carefully reviewed your health query and feel sorry for your father\s health issues. It is a concerning disease process. I never recommend to leave it as such and do nothing much for an advanced coronary artery disease. He has got triple vessel involvement and in such circumstances the best next step is to go for CABG surgery (coronary bypass graft) especially if there is no obvious contraindication. No, partial angioplasty is not a solution to the problem. Although he has no obvious signs or symptoms, but you should know well that the disease inside has progressed much and anytime with or without strenuous physical activity he may get a severe heart attack that can be really dangerous and lethal. I would go with the suggestion of CABG right away." "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 very cold for weeks. I have a runny nose, my body hurts, I have a cough, and a few days ago I had chest pains that lasted some minutes. ### Response: Hello. You have caught a cold alright." "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 using Kojivit plus gel as a face cream at night. Can you please suggest me a better sunscreen gel or lotion for sensitive skin? ### Response: As your skin is very sensitive, I suggest you use Himalaya herbals protective sunscreen lotion. It can be applied for half an hour before going outside. Use it always before going outside, whether it is a sunny or shady day. Because even in shady days, the ultraviolet rays can harm your skin." "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 my tooth removed and a dental implant done five months ago. About three months ago it got infected. I went to my dentist, who cleaned out the infection and prescribed antibiotics. The infection did not go away, so I was prescribed antibiotics two more times. Once again, the infection is back. So over the past two months, I have gotten an infection four times and each time had been prescribed antibiotics, which seem to only temporarily fix the situation. I am at a bit of a loss for what to do because my dentist cannot seem to get rid of this infection. ### Response: That is hard that you got infected several times. If still infection persists, now your dentist must remove the implant and let the area heal. Maybe this foreign body is not accepted well by the immunity of your body so infection had occurred. Antibiotic coverage is enough once in a month, you are already given multiple times this means ultimately we have to remove the cause to get it right. Ask your dentist to do this removal work without much cost because five months is less period and comes under warranty period of time for an implant. Give me followup of your case in a week. Stay happy and blessed." "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 21 years old and having an extensive hair loss. The middle part of my head is almost bald. I am losing a lot of hair on the left. Currently, I have taken no medical help. I am also having black spots all over my legs and arms. Also, I have these little eruptions on my head and it is itchy. The hair loss has been since there since five to six years. I have started homeopathic medication. ### Response: Hi. 1. Hemoglobin %.2. Serum ferritin.3. Thyroid profile. Please consult your specialist doctor, discuss with him or her and take the treatment with consent.1. 5% Tugain lotion (Minoxidil), to be applied as 1 mL twice daily only over the areas of thinning of hair. It has to be used regularly for at least three to six months to note some increase in the bulk of the hair.2. Tablet Hair bless (Biotin and Calcium) one tablet daily after dinner for one month. Revert back with the details 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: Half part of my left eye became red and slightly swollen near the cornea. I tried Ciplox and Ceflox and Festive D, but these are not working. There is no pain or no blurred vision, I have itchiness and allergy. Please suggest some eye drop for red-eye and itchiness. I shall be highly thankful to you. ### Response: The main symptoms of allergy include itching and redness as you mentioned. Festive D can be used four times a day for 4 to 5 days. On the other hand, if you are having lots of sticky discharge from your eye, especially if your eyes stick together when you wake up after sleep, it suggests that there is an infection. In the latter case, seeing an ophthalmologist is best." "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: Please see the attached reports. My eosinophils are 22.1 %, but a year back, it was 11.2 %. I have back pain, and my vitamin D is also very less. The vitamin D level is 12. I had a 3 mm kidney stone a year back, but it got removed without surgery. Because of the back pain, I got an MRI done. The MRI showed disk protrusion in L1 and L2. ### Response: I just read your query and the detailed reports (attachment removed to protect patient identity) that you have attached. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. Hope you find my advice of some benefit. Good luck" "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 brown discharge, and my dates came. What is that brown discharge? ### Response: Hi. If you are getting brown discharge regularly before getting periods, it is harmless. This is a normal phenomenon, which occurs due to hormonal changes. Similar hormone changes may occur during early pregnancy, and one may get such brown discharge, but there will be no periods. I guess there is no possibility of pregnancy in you and there is no history of sexual contacts. So there is nothing to get worried." "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 chronic onset of symptoms of foot drop, diagnosed by podiatrist last month. I would like to know if this could be caused by the original knee injury, which was diagnosed as a severe multi-ligament knee injury. Is it possible for a severe multi-ligament knee injury, with a complete tear of the ACL, to cause ""foot drop"" to develop years later? I am currently taking Naproxen.Actually my original knee injury happened in 1969 and got repaired in 1980. Knee remained unstable and worn a brace since 1981. I have consulted many orthopedic surgeons, who all state that repair of the ACL is not possible. ### Response: Hello. I understand that the ACL (anterior cruciate ligament) surgery was done in 1980 whereas the injury was in 1969. It must be ACL reconstruction surgery or some other augmentation surgery. The original ligament cannot be repaired after 11 years. It will be beneficial to know about the procedure performed which can suggest what was done. It is unlikely to get recent onset foot" "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 undergone skin grafting in my leg due to acid burn before three years. Now it is fine. But my skin discolors, and stitch marks are not changing significantly. So please suggest some treatment to be done to regain my skin color quickly. ### Response: Hello. I understand your concern. Though It is not possible to reverse changes back to normal completely, you can use following topicals and then follow back. 1.Contractubex cream 2. VC 15 serum. Mix both in 2:1 ratio and apply twice a day for six weeks." "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 family and I have gone vegan three months ago. We did blood tests this week to check if we are healthy and my three children show a low level of hematocrit count, although their RBC is within limits. My youngest (2 and a half years) has also a high TSH level (5.2 mIU/L). They are suggesting to repeat a blood test in six months. Is this linked to diet? ### Response: I have gone through their reports (attachment removed to protect patient identity). Hope this will help 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: Last night I went to bed after feeling fine all day, and when I laid down I got a horrible metallic taste in my mouth. When I felt the bottom gum right at the back there appeared to be a fluid-filled swelling on the top of the gum (there are no teeth in that part of my mouth), and when I looked this morning there seemed to be a whitish cream colored lesion on the inside of the gum and a couple of tiny ones on the top of the gum near to where the swelling is. I contacted my GP, who prescribed a mouthwash over a phone (Benzydamine), saying that it sounded like an ulcer with the constant metallic taste. It kept me awake the whole night. But I am not really sure if I have somehow burnt my gum without even knowing? ### Response: Hello. I read your query. 2) It can be aphthous ulcer which is normally seen in the mouth but they are painful. 3) Are you on any medication like antibiotics not specified in your question? 4) Ulcer may be due to some mouth dissolving medication which might have burnt that area. 5) It may be due to trauma by your toothbrush. 6) Any upper tooth impinging on that area can cause an ulcer. 7) Apply chlorhexidine gel twice or thrice daily locally. 8) Take a B-complex tablet or capsule twice daily for 10 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: Can a slight reduction in blood supply and poor blood circulation in both testes increase the risk of de novo single gene mutation present in a normal motile sperm? Will fertilization of this type of sperm result in a child with de novo single gene disorder with the sole reason being lesser oxygen, nutrients, and hormones being supplied to the testes? ### Response: What you have mentioned is correct. However, since the paternal DNA (deoxyribonucleic acid) is normal, the mutation will be affecting a single sperm or those derived from a single germ cell in the case of single gene mutations. It is impossible to know whether the genetic mutation has any functional significance. The scenario you mentioned is entirely possible but given the number of sperms in the ejaculate, the probability of such an event is low" "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 wondering whether conceiving a second child will be safe after having a history of blood clots with first pregnancy and postpartum. ### Response: Hello. You have a history of blood clot in the previous pregnancy. So there is more chance of blood clot in the second pregnancy as well. A thorough investigation should be done like PT, APTT, BT, coagulation profile, cardiolipin antibody estimation, etc., for you. The low dose of low molecular weight Heparin can be given in pregnancy to prevent blood clot as it does not cross the placenta. But you should discuss all these with your treating 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 take Sompraz D20 on an empty stomach every day. I also take Libotryp at night for stomach TB for the last one year. I have pain in my lower teeth while eating anything. One year ago a small cavity was also detected for which I underwent airbrushing and filling. I suspect that the filling came out from my lower teeth yesterday.I have this tooth sensitivity for the last 15 days. It pains a lot when I eat otherwise it is fine. I also take Duonase nasal spray two times. Also for dry eyes, I take I-Dew DS eye drops. My recent vitamin D is 25.48 ng/ml. Suggest me any gel or cream to cure this cavity. Also, I am highly sensitive and allergic to smell. So please prescribe me gel or cream accordingly. ### Response: See, the first thing that I need to know is that, is whether the pain is present in a single tooth or multiple teeth? As you mentioned in your question that the filling has come out, so please make it clear that is the tooth that has lost filling is painful alone or more teeth also? Also, please click the picture of your teeth that are painful and upload. Please revert back with the answer." "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 chest pain for quite a few days and have discomfort on jaws and back. I also have neck pain and arm pain. I have gone through lipid test, ECG twice, echo and TMT. All are normal. My BP remains 115/75 mmHg, my cholesterol is 163, HDL 47 and LDL 98. In TMT, I achieved 13.8 METs maximum; bpm was 181 with BP of 170/100 mmHg on TMT. I have a fear that I may still get a heart attack. I showed to my doctor, and he said that I would not have a heart attack for the next 15years. But, I am not able to get in my.mind. I use to smoke and now have quit smoking. Please help me. ### Response: Hi. I have noted all your details. Tablet Ultracet (Acetaminophen and Tramadol) twice daily for three days. X-ray AP (anteroposterior) and lateral cervical spine to rule out spondylosis." "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 child is 15 days old and is a premature baby boy. The current weight is 2.010 kg. Recently, he is passing the motion in a semi-solid form after every mother feed. And also passing urine 8 to 10 times a day. Previously, he was passing motion 4 to 5 times a day. It seems that he has loose motion. As a home remedy, we have given him Nutmeg in mother milk. Please suggest what we have to do and is there any medication for it. ### Response: I can understand your concern. Your baby is absolutely normal. Baby\s gut is in a transition phase of maturation, where motions from 0 to 8 times a day are normal. Continue breastfeeding, giving other than breastfeeding can be disastrous. Any home remedy is not recommended for six months. Mother\s milk is sufficient for the baby, and he does not need anything other than that for six months." "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 grommets as a baby, and my old ENT believed that I still had one in my left ear. I have had ringing in my ears, and it is getting to the point where I cannot hear myself think sometimes. Should I see someone new about it? ### Response: The reason you would have had this as a child is probably due to adenoid hypertrophy causing eustachian tube dysfunction. Grommets depending on the type usually fall off, and it goes unnoticed unless a long term grommet has been inserted and you are getting yourself checked regularly from an ENT specialist. Your problem is ringing sensation in the ear associated with deafness can be a result of the same issue for which grommet was primarily inserted. Other causes have to be certainly ruled out. A genuine suggestion would be to get your self examined by an ENT specialist and thereby get to know. What exactly is the issue currently?" "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 nearing 40. My partner and I are sexually very active. A year ago, I was diagnosed for PID, and pap smear revealed nothing else. We both got treated and were fine for a few months. I am very clean, often wash before and after the act. We are both into oral too. Since a few days, I am having excessive discharge (no smell or pus) which is almost white, burning at the tip of my left labia and pain in the lower abdomen.There is no burning sensation when I pass urine. After meeting the burn comes up. I do not use perfumed soaps, but I use a feminine wash. Is this PID again or something else? My partner is fine, and we use protection during this time. Can you suggest some medication? And what could this be? ### Response: Hello. Based on the symptoms you described, it appears you must be having yeast infection like candidiasis. I would suggest you take a tablet Fluconazole 150 mg by mouth single tablet for you and your husband. Clingen forte vaginal pessary to be kept vaginally every night for six nights. If there is still no improvement, you can consult your gynecologist for examination and do pap smear and ultrasound if abdominal pain persists." "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 brother is 23 years old. For the last two years he is having some pain in left hip joint area. He is unable to walk, move and feel dizzy. We consulted many doctors, some said he is having bone tuberculosis and he got treated for that. After treatment, it got cured. But, with changing weather it gets revoked and the pain will be more acute. That pain is not constant; it will come and go. We are unable to understand what the problem is. I am attaching all the prescriptions and reports for your reference. Please help. ### Response: Hello. I have gone through your reports (attachments removed to protect patient identity) and read your history and prescription. Revert back with the x-rays to an orthopaedician and traumatologist 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: A 3-year-old just begins stuttering out of the clear blue. Should we be concerned? ### Response: Hi. I have read your query. Stuttering occurs when a child is learning speech and language skills. It occurs because of the child\s language and speech ability are unable to manage the child\s verbal demands. They do not require any treatment as the stuttering stops as command over language and skills is obtained. A speech language pathologist can help diagnose stuttering. No invasive testing is necessary. Typically, you or your child can describe stuttering symptoms, and a speech language pathologist can evaluate the degree to which your child stutters. Not all chil" "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 25 years old married girl. This time, there is a heavy flow during my periods (nonstop bleeding) but there is no pain and no discomfort. Today is the second day of my periods. What should I do? It does not look like a normal period bleeding that I usually have. ### Response: When was your previous period date? Did you check HPT (home pregnancy test)? If the flow is heavier, you can take tablet Trapic (Tranexamic acid) 500 mg 1-1-1 for three days. If not, reduce it by three days. Kindly consult a gynecologist in person" "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 I get pregnant after the second day of taking birth control pill (first time taking pills) and having unprotected sex? In the normal menstrual cycle, it is my fifth day of the cycle. ### Response: As you had unprotected sex, there is a chance of pregnancy in your case (because you are not protected immediately after taking pills). Delayed menses due to hormonal imbalance caused by sex. Get your home urine test if you missed your period by seven 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 wondering if I have gingivitis or more advanced gum disease? My gums are red, a little more so than you can tell in the picture, inflamed, and somewhat sensitive. I have been brushing and flossing twice or three times a day. Is it possible for me to reverse these symptoms at home on my own? That would be preferred because I am currently unable to pay for a dentist visit. I have just started using salt water rinses to try and help reverse the gingivitis as well. Also, what mouthwash and toothpaste would be best for me to use to reverse the symptoms and restore the health of my gums? Lastly, can I take an antibiotic, such as Amoxicillin 500 mg capsules to help fight any bacteria and reverse the symptoms? I would greatly appreciate any help and guidance that you can provide. ### Response: The gingivitis is easily reversible but at least the cleaning of teeth and gums by a dentist has to be performed every six months or a year. This helps in removing calculus and plaque build up. It will not go away just by brushing or flossing. Use warm salt water gargle and yes Amoxicillin 500 mg will help but after removing the calculus build up" "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: What is LV diastolic dysfunction grade 1? Doctor suggested stress echo cardiography. And conclusion includes this line. I can show you reports. What is the treatment for this. Any medicines? ### Response: There are various causes of LV diastolic dysfunction like advanced age, hypertension, diabetes, and obesity. It has stages 1 to 4. In your case, it is grade 1, that is, mild diastolic dysfunction. Treatment for it is to treat underlying causes like hypertension, diabetes and to treat symptoms related to it like dyspnea. The doctor has suggested stress echocardiography probably to rule out blockages in heart arteries. 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: Since the beginning of this year, I have noticed a couple of moles on the left side of my head have been very itchy and burning, and when I start to itch them it causes the whole left side of my scalp to burn and feel uncomfortable. I am worried it might be something serious. This year I have also experienced a lot of left side facial pain and numbness, as well as left eye blurriness. So I am not sure if the pain on the left side of my scalp could be related. ### Response: The ABCD criteria for moles you should be aware to see for malignant changes. One should always look for the change in color, size, margin, the surface of the mole, also if it is associated with itching and bloody discharge. I have reviewed clinical photograph attached (attachment removed to protect patient identity). There are no changes of erythema around mole or discharge. In photographs, there are two moles only. If there is an increase in the number of moles or increase in size, the best would be skin biopsy for histopathology to see for malignant changes. Presently, there is no inflammation also in these two photographs which you have attached to comment on itching sensation which you are experiencing. You should consider an ophthalmologist opinion for the blurring of vision. I do not think personally from these clinical photographs that mole and other symptoms are associated. Physicians opinion should be considered for numbness over one side. If you have any fluid-filled lesions on one side then keep watch for that too. Skin biopsy for histopathology should be done if specifically mole is associated with itching." "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 tongue produces lot of saliva. How do I recover from this problem? Sometimes, my saliva is dropping down in front me. ### Response: Hello. The causes of hypersalivation include excessive starch intake, reflux disease, pancreatitis, liver disease, oral infections and decreased saliva clearance. So, before trying any medication try some lifestyle modification. If that did not help then you can use some medication. Hope this will help you and wishing you a faster recovery. 1. Avoid high starch food like potato, bread, cereals, rice and corn.2. Maintain oral hygiene.3. Avoid spicy and fried foods. Revert back for further information to 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 am asking this question on behalf of my dad, who is 60 years old, 5 feet 9 inches, and 173 lbs. He was recently diagnosed with stage three chronic kidney disease. He also recently received an abnormal result on a serum immunofixation test, which I know can be an indicator of multiple myeloma, as well as other serious health conditions. However, his urine immunofixation test came back normal. His lab results also indicated that his PTH was high (92.5), his hematocrit was at the very lowest side of normal (41.0), and his Vitamin D was low (23). I was wondering what these results indicate, particularly with a normal urine immunofixation test and an abnormal serum immunofixation test? ### Response: Hope this will help you. Consult a urologist for examination and further management of the chronic kidney disease" "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 and my fiancee had intercourse a month back with a condom and also she had an emergency contraceptive pill. I bought it from a medical. They asked her to take it before one hour of intercourse. She had a regular period. Her last period was on 7th of last month but it is 11th of next month now and till now she did not get her periods. She does not want to get pregnant now as she has her exams in a few months. She is doing heavy exercise like cycling, spot jogging, sit ups. And also she has taken two raw papayas, four pineapples and three times ginger syrup. I am sure that condom did not get broken. My doubts are will she get pregnant? Is there really a pill available to be taken before intercourse. Is that pill true? What she can do further to get her periods? Can she take Probers tablet for getting it? ### Response: Stress plays important role in periods. She might be freaking out with the fear of getting pregnant, with exams on the head causing a delay in her periods. Please consider doing a pregnancy test, most likely, it will be negative, and that will help her relax. Periods will gradually occur. No need to worry. Yes, there are medicines for getting periods, but they might worsen her condition by causing mood swings, as she already has taken an emergency contraceptive. Secondly, emergency contraceptives should be taken within 72 hours of unprotected intercourse, the earlier, the better effect. She has taken it quite early even before intercourse, so chances of pregnancy are nil." "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 had her periods last month. This month it did not happen, and she is having vomiting sensation, cramps in lower abdomen and back. Through the home test, two lines are appearing. We do not want pregnancy now. Please guide us regarding the same. ### Response: Hi. Abortion pills can only be taken under supervision because it may cause infection, severe bleeding and retained products of conception. Get your pelvic ultrasound done to see fetal well-being" "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: What is Rhesus? My wife is pregnant and started clinic today. ### Response: At first visit, the pregnant lady\s blood group needs to be checked. There are many blood groups like A, B, O, AB and another thing which we need to know is rhesus positive or rhesus negative. So on the basis of rhesus, it is A+, A-, B+, B-, O+, O-, AB+, AB -. So, every blood group have rhesus classification like rhesus positive and rhesus negative. A positive and a negative. Rhesus has to be known as there is one issue of rhesus incompatibility. If both mother and father of the child are rhesus positive or both rhesus negative, then no issue. But, if mother is rhesus negative and father is rhesus positive and developing baby is rhesus positive, then mother can develop antibodies against fetal blood that can cause lysis of blood cells most likely in next pregnancy which can lead to anemic baby. Rh negative mothers with Rh positive husbands need anti-D injections. They need to have twice at 28 and 32 weeks of gestation without any cause but in case of bleeding during pregnancy also need injection, after birth also. Check your blood group as well if wife is rhesus negative. She should have regular antenatal visits and in case of bleeding or pain report to gynecology emergency. If wife is Rh negative, have blood grouping of husband. Regular antenatal check-ups in maternal medicine unit if Rh negative and some other complications are related to it. Anti-D injections at 28 and 32 weeks. Balanced diet, weight, and BMI, folic acid. Regular antenatal check-ups. Report in case of any bleeding." "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 significant neck pain that goes out into my shoulders a bit. Pain is accompanied by severe stiffness. Also, my hands have been falling asleep about seven or eight times a week (roughly) and even ache a bit. I thought I might be dealing with a pinched nerve, but all my symptoms are fairly bilaterally equal. This last week I was put through an MRI for a lipoma in my left shoulder and neck area and they found that I also had a lower cervical syrinx at C6 about 3 mm. Could this be causing the pain and numbness that I have been dealing with? Or is the syrinx something that should be removed? I am awaiting an appointment with a neurosurgeon but I thought I would reach out in the meantime. I appreciate any information that you give me. ### Response: It may very well be the syrinx. A syrinx can cause pain and temperature sensory deficits to occur early but may not be recognized for years. Syringomyelia typically causes numbness, weakness, atrophy, and often fasciculation, and reduced reflexes of the hands and arms. The pain and/or numbness is felt as a sensation in a cakelike distribution over the shoulders, arms, and back. It may be decompressed surgically a bit for that you would need an MRI (magnetic resonance imaging) of the C-spine to look for a more detailed anatomy. 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: Around 6 PM today I had really bad back pain all of a sudden, I have a cold. So I have been texting so I thought it was just that but around 10 or 11 PM, the pain started to shoot down my leg as well, it hurts when I sit and walk and lift my leg. ### Response: Hello. Looking at your problem from very near, it would be sudden bending causing pressure on disc and protrusion to lumbar nerve causing shooting like pain on leg. The cold and even cough increase the inner disc pressure and causing nerve to more pressure which causes symptom worst. So I would recommend you to use lumbosacral belt on lumbar spine at lower back. I would also recommend some medicine to take for this problem and follow up with MRI for further improvement. Zanaflex (Tizanidine 4 mg PO bid for 1 week, capsule Neurontin (Gapapentin) 100 mg PO bid for one week, capsule Pantoprazole 40 mg once daily for one week." "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 15-year-old female, and I have put something inside my private area, and when I took it out, it started bleeding. Why? ### Response: Hello. According to your description, there is a possibility of injury to either hymen or vaginal mucosa. If the bleeding is minimal, which may be due to mild abrasion, that will subside usually. If the bleeding is persistent, better to consult your gynecologist once, get examined to find out the exact problem, and take treatment accordingly. I hope I have answered your 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: I have a lump under my skin on my arm, and it is slight my raised. It is not painful, and it is 5 mm in diameter. It has got a dark center that looks like a bruise. It has not grown in size either. What could it be? ### Response: Hello. I understand your concern, but there are no attached photographs in your message. Kindly send a picture of the affected area to help you better. I need to see the affected area to assess the condition and to suggest the appropriate diagnosis and treatment. Please send the picture of the affected area." "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 is 24 years old and her period was regular of 30 days. Before two months, we had intercourse after seven days of her periods. She had her period after some 15 days. It was normal for the first two days, but after that it was very heavy. She had abdominal cramps for approximately a month. Our local doctor gave some medications with iron tablets. Then, she did not have her periods yet. From the beginning of this month, she is having nausea and vomiting. We are not sure whether she is pregnant. Pregnancy test has not been done. Now, she had an accident and fell down from a terrace of 10 feet height. Her x-ray was normal and no bone injuries. But, she is unable to move because of pain. Does x-ray show pregnancy? Since she is unable to bear child at this stage, please suggest some medicine to terminate the pregnancy. ### Response: Hi. Without doing a urine pregnancy test it is very difficult for me to tell whether she is pregnant or not. Moreover, early pregnancy cannot be detected in x-ray. You will have to do a urine pregnancy test at home first. She need not go anywhere for this test. Once the pregnancy is proved, then we can go ahead and think of termination. So, please do the test and get back to me with the results." "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 delivered a baby five weeks back. It was a normal delivery with episiotomy. My wound has healed now. My husband and I have not resumed our sexual relationship as we are waiting for six weeks period completion as advised by the gynecologist. But last night, he was hugging me naked from the back and ejaculated near my anus. I immediately cleaned it up with water. But I have a doubt whether the sperm can go into the vagina and is there any chance of pregnancy?Also, I want to know whether I can take an emergency contraceptive pill now and within what time it must be taken? Which is the safest pill for a lactating mother and will it have side effects on the baby? Of note, I am on MA-Dha and Lactare for lactation. ### Response: Although, there are very fewer chances of pregnancy, you can go for a copper-T insertion as contraception" "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 weeks ago, I had oral sex with a man, without using a condom. A few days later, my labia was swollen and itchy. Now, I have a sore throat. My discharge is normal. Is there a possibility that I might have contracted an STD? And, I am only going to a clinic two days from now. Is it too late? ### Response: Hope your query is answered. Feel free to ask more questions. Best wishes" "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: Redness and cut like lesions on groin immediately after sex. I noticed burning and irritation immediately after sex. I do not know if it is herpes or just skin irritation from contact or friction. ### Response: Hi. These are fissures, usually in groin area infection can present in the form of fissures and cuts. Other causes can be Crohn disease but your complaint is acute one so most probably this is an infection. Do not worry, it will get better with proper medication and treatment. Try to maintain hygiene of the area and avoid sexual contact until you get better. I would like to know if your partner has any such problem? Infection. Bacterial infection. Tablet Co-Amoxiclav 1 gm BD for one week. Apply Fusidic acid ointment BD over the lesions. Take pain killer tablets like Ibuprofen for pain relief. Maintain hygiene of area, wash with soap and water, avoid using Dettol and other irritants." "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: Nails are itchy, yellow looking, break easily and it has probably been more than six months and getting worse. ### Response: It would be great if you could attach pictures of your nails for proper diagnosis and treatment. You see there can be different reasons for that, it might be onychomycosis (fungal infection of nails) or may be weathering of nails. So, please kindly attach pictures for that because treatment gets different." "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 POTS syndrome for 5 years and recently had loop recorder implanted. I have been told that I have atrial tachycardia and need ablation. Will ablation make POTS worse? ### Response: I assure you not to worry as everything is going to be fine soon. I have thoroughly gone through your case and can well understand your genuine concerns. It will rather help improve the symptoms of the disease and will lower the racing heart (tachycardia) feelings. I advise you to do aerobic exercise on a regular basis so that venous return from the lower extremities can be increased. If you experience feelings of dizziness to the extent of syncope (fainting), I advise you to wear graded compression hosiery extending up to the waist, thus helping to increase static pressure in the legs and decrease venous pooling in the lower extremities. Autonomic nervous system problems, conduction defect in heart. Take plenty of fluids with at least 3\x80\x935\x80\x85g of common salt daily. Avoid standing for long hours." "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 8 year old daughter reacts badly to mosquito bites. We try to keep her covered and give antihistamine if she reacts badly and is scratching the bites. But, she scratches them, and they form scars that leave dark marks/scars on her face and body. What can we do to reduce the scarring/marks? She is of mixed race and has dark skin. ### Response: Hi. I have gone through your case (attachment removed to protect patient identity). Keep it well moisturized by applying petroleum jelly two times a day. You can also apply a mixture of Glycerine and aqua rose on the whole body after bath without using a towel or before" "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 put to sleep and had a surgery on all my wisdom teeth to have them removed. It has been three weeks since surgery and I can only put two fingers in my mouth. My bottom wisdom teeth were impacted in my gums and bone that is why it had to be surgically removed. What can I do to get my mouth to open wider? I cannot eat a burger. ### Response: As per your query, I have gone through it and I came to a provisional diagnosis of trismus (inability to open mouth). This is the diagnosis based on your query and it may not be right. You just need to visit the dentist who removed your molars and you need to go through a clinical examination for your diagnosis. If this might be the case then you need to go through different type of physiotherapy exercises according to the severity of trismus. The cause for trismus is the injury to a muscle or muscle sheath. It is treatable. You need not worry about it. Physiotherapy exercise, heat therapy, muscle relaxant Benzodiazepine." "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: Kindly help me to understand my elder daughter\s behaviour. She was born 14 years back. At her childhood, she was very energetic and hyperactive. We had put her in pre-school at 2.5 years and now she is in class 9. She is 13.5 years old now. I am finding her maturity level is far below her classmates and she hardly have any friends. She is also very poor in study. We are in such a condition that we only expect her to pass the examination. Sometimes I am feeling guilty about the fact that she is always under pressure.She nowadays does go out and keep herself busy with mobile and TV (cartoon). I have another daughter, who is 6.5 years old and the elder one cannot get along with her sister most of the time. She always tries to attract the attention by some means or other. She is only growing physically, but I am finding the mental growth is not at par. Kindly help me. ### Response: I am sorry to hear about your situation, I can understand how difficult it might be for you. What you are describing needs a physical examination as well as a mental status examination and IQ testing. You will have to consult a neurologist or a pediatrician. You can also consult a psychiatrist and they will guide you further. The doctor will require to meet your daughter and talk to her to be able to understand whether the issue is neurological or a behaviour issue. If you are mentioning that her mental growth is not at par you will have to go for IQ testing which are available with psychiatrists as well as pediatricians." "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: According to my LMP now I am 9 weeks pregnant. I went for USG TV 20 days back and it showed that I was 7 weeks and 2 days and now it would be 8 weeks. USG shown gestational sac with no yolk sac and fetal pole. They said it is BO and to go through D&C. I am confused what to do now. Shall I wait with hope or go through D&C? Please tell me how gestational age will be calculated from LMP or conception day? I am not sure when I ovulated? Please help me out. ### Response: Hi. At 6 weeks and beyond we expect a fetal pole or yolk sac to be visualized on USG. By 7 weeks, we must see the cardiac activity. If there is no embryo and no heart beat even beyond 7 weeks, we call it a blighted ovum (BO) with only a sac and no contents inside. It can happen due to a chromosomally abnormal gestation and hence does not survive. It regresses on its own. To date your pregnancy, we calculate period of gestation by LMP (last menstrual period) and then confirm it with an earliest scan within 3 months of pregnancy. In case there is no difference between the two dates or a difference is less than a week, we consider the LMP to calculate the expected date of delivery and period of gestation. Do not worry, you can conceive again. But no hope with this pregnancy. Start Folic Acid 5 mg daily for 3 months before next conception. This will help in a healthy embryo, reduce chance of miscarriage and prevent neural defects in the fetus." "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 very bad dark circles under my eyes since I was around 7 or 8 years old and went to a dermatologist about it once which said they had something to do with a vein, but was not sure how to help. I was wondering if you could shed some light on this. I am 28 years old now and still have the dark circles which makes me look bad and would like to find the best solution to make them go away. ### Response: This is tear through deformity (attachment removed to protect patient identity). You can try dermal fillers. For this, visit your nearest dermatologist. It will give better result. Do not worry it will go. Do you have any addiction? Reduce your stress. Take proper 8 hour continuous sleep. Eat healthy food. Send your photos after taking treatment." "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 is pregnant with twins, 24 weeks now. Her Hb levels never in life had gone above 10. At the start of pregnancy, it was 8.5 but now it has touched 7.7. We did serum ferritin test and her level was 50 (normal) which I guess means no iron deficiency. She is a beta thalassemia minor as per the detailed reports. Can you please guide here? Our gynecologist would be consulting a hematologist today but if we can get an opinion here it would be great. ### Response: Hi. Thalassemia minor is hemoglobinopathy and so hemoglobin level can never be above 12 in such patient. In pregnancy, plasma is increased and so hemodilution can lead to more fall in hemoglobin level in CBC. Orofer XT like Iron tablet can be prescribed for such case. It would be great if the Hb level remains around 9 or 10 during pregnancy. The Iron infusion can be given in second or third trimester of pregnancy only if needed. You can discuss all these with your treating doctor or hematologist. No other mode of treatment is available as per my opinion. Close watch up is necessary in such case. I would like to suggest you to investigate with HB electrophoresis as well to avoid thalassemia major child." "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 20 year old medical student. I have a big problem with my studying techniques, and I find it rare compared to others. First things first, I am lazy to study, not because I am lazy in general, but because I do not understand a word. Even if I understand something, it gets evaporated from my mind within minutes. I am not able to pay attention during lectures, and I do not find it useful. Honestly, I attend lectures just for the attendance sake.But, just before the day of exams, I understand whatever I read, and I somehow manage to pass. I only fail if I could not finish reading due to any reason. My concentration power suddenly improves before exams. But once I am out of the exam hall, everything vanishes from my head. Is there any solution for this? If I am ill on the day before the exam, then I definitely flunk. Honestly, whatever I write in the exam is the result of what I read on the previous day. I know that this type of studying habit is not at all ideal for the profession I choose. So, please help me. Please provide useful information about the same. Also, suggest a way to approach and solve this problem. ### Response: I can understand your concern. You have issues of poor focus and inability to maintain focus or concentration" "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 CT heart artery scan results. I would like it analyzed for blockages. The report says 100 % occluded RCA and some LAD blockage. ### Response: I passed carefully through your uploaded coronary angio CT images (attachment removed to protect patient identity) and would like to explain that there is extensive calcification inside the RCA (right coronary artery) that seems to produce important coronary narrowing. In addition, calcified lesions appear in the proximal portion of LAD (left anterior descending artery) and some scattered calcification inside LCx (left circumflex artery). Coming to this point and considering also the presence of coronary risk factors, the best strategy is to proceed with coronary angiography exam. This will definitely clarify all the present coronary lesions and the ongoing management strategy as well. You should discuss with your attending cardiologist on the above mentioned diagnostic strategy. Hope to have been helpful to 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 always get indentations on the sides of my tongue because of my teeth, and sometimes my tongue gets cut. My middle teeth are crooked. I am attaching photos of my teeth and tongue. ### Response: I have seen the pictures you have attached (attachment removed to protect patient identity) along with the complaint" "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 3.5 years old; studying in kindergarten. He has been diagnosed with benign childhood epilepsy. There is an epileptic form discharge of 8 Hz spikes from his right occipital lobe. His MRI and CT scan reports came normal. He feels involuntary movements in his left leg when he is in a conscious state. At times when the epileptic form discharge gets severe, he loses balance and falls down. This tends to happen once in a week. With medication he is fine. We consulted a neurologist and epileptologist. Doctor has prescribed him tablet Topamac 50 mg to be taken twice a day and tablet Lobazam 10 mg for a period of three months. Will there be any side effects with long-term use of tablet Lobazam? I am very concerned. Please guide me. ### Response: Hi. It is good to know that your child\s seizures are under control with medication. Tablet Clobazam is mainly used to control acute seizures and used for a short duration. It is observed that, if the" "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 35 year old male. I am suffering from a bipolar affective disorder. Currently, I take Magnesium Valproate 400 mg BD with Amisulpride 100 mg HS. My overall mental health remains stable with the above-said dose of medicines. But, in spite of that, I have had anxiety in the past. I always want to be in bed, talk as less as possible with my family, and remain busy with my gadgets. I do not get actual sexual pleasure despite having erotic thoughts all day. My motivation levels are low. I do not spend quality time with wife any longer. I have been taking medicines for the last six years. If this dose is changed, I have so many other problems. So, I stick to this, so that my sleep and appetite remain good. Please suggest me the needful. ### Response: I can understand your concern. You are suffering from bipolar disorder and are on Magnesium Valproate and Amisulpride" "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 two extractions in a few days and I have a three-day beach trip planned two days after the procedure. Is it safe to still go? We will walk around and swim and that is probably all. I have a temporary cover over it because they drilled a hole in the tooth to find out how far the decay went. So, I do not know if I should wait and get it done after the beach or do it before. Two days should be enough time for it to stop swelling, right? Am I alright to go? ### Response: Hello. You need to be very careful for at least 24 hours after the extraction like avoiding rinsing your mouth too hard to running or jogging, eating cold and soft food, etc. Ideally, you should not be having any problem if you follow all the instructions properly 24 hours after the extraction. But some of the things you need to keep in mind for the first week are avoid smoking, brushing on the affected side, and excessive spitting. So, take proper care of your teeth after the extraction and if you feel alright then you can go for the trip." "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: Hi. I am 20 years old, and a student. I am currently having obsessive thoughts and I find it hard to control the thoughts. I have fears and getting anxious that something might happen to me yet, I am trying to convince myself to not to. But then again, i\ve been seeking for help from psychiatrists that offer free consultations because, as I said I am just a student wanting to know more about my condition. I hope someone could help me.I have ear problems and mitral valve prolapse. I for now, have medical prescriptions for mitral valve prolapse and haven\t checked up for this ear problems of mine. I am currently taking Propanolol. ### Response: hello, I can understand that you are suffering from obsessive compulsive disorder and having distressing obsessive thoughts. OCD is quite resistant illness which involve serotonin a kind of chemical in the brain. we generally prescribe antidepressants to increase level of serotonin in the brain. antidepressant require in higher amount because you know oCD symptoms are very resistant more than depression. there is also a talk therapy which is called as exposure and response prevention it\s a kind of cognitive behaviour therapy . I would suggest you to visit your psychiatrist again and ask for this talk therapy" "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 weird lesion that I just noticed in the back of my throat a few days ago. For the last couple of months, my throat has felt slightly strained after the normal conversation. I currently take Lisinopril, HCTZ, and Amlodipine for hypertension. My PCP prescribed a Z-pack and referred me to ENT since she does not know what the lesion is. So I am wondering if this is something that I should be concerned about in the meantime. Since I started taking Lisinopril, HCTZ, I have had strong cravings for acidic foods such as vinegar and hot sauce. I initially thought my diet was causing issues with my throat, so I significantly cut down on these types of foods. In addition to the lesion, I have noticed white scaly patches in the back of my throat. ### Response: Hello. The normal pharyngeal mucosa at times has a granular appearance. In addition, it may be present in acute granular pharyngitis. This is nothing sinister. Z-pack with adequate analgesia if you have pain, plenty of fluids and warm saline gargles or Chlorhexidine should help. There is nothing to be concerned about." "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: There is heaviness in the body always. I feel like bursting whenever I lay down. I am grinding teeth, have dizziness, and gastrointestinal reflux. ### Response: The bursting and acid reflux problem can be connected to each other. But dizziness might not be due to acid reflux. For acid reflux, you need to take Pantoprazole like antacid for a week. Avoid the intake of excess spicy foods. Head should be elevated by putting a pillow when going to sleep. It is advisable to go to bed two hours after taking the meal. For dizziness, your blood pressure and sugar level should be checked first. You need to get checked your detailed otological evaluation for primary workup. Beta Histidine can be taken for dizziness. The anemia also can be causative sometimes, so rule out it by CBC." "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 a fungal infection near my inner thigh area. I have been taking tablet Forcan 150 mg and applied Candid-B cream over it. But I do not have any results. Please help me. ### Response: Hi. It is a fungal infection. Stop using Candid-B (Beclomethasone topical and Clotrimazole topical) cream. Please say about the severity and the duration of the disease. Please mention about your age and marital status." "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 enclosing an MRI report of my father who is 70 years old. I want to know whether an operation is the only available option for his shoulder condition according to the report. If we go for the operation, then what is the success rate? Without an operation, how long will it take to get cure? He takes Telma 40 and Ecosprin 150 V regularly because four years back, he had a paralysis attack. ### Response: I have gone through the MRI report enclosed by you (attachment removed to protect patient identity). Degenerative condition or post injury. As per clinical 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: I had a D and C four months back after a miscarriage, and I got my last periods two months back. So, I went back to the doctor to make sure there is no continuing pregnancy. I had a vaginal ultrasound, which she said is all clear, and I am perfectly fine. She said I just have a little infection, for which she prescribed me Azomox. Does vaginal ultrasound show if I am still pregnant? I am still waiting for my periods now. Is it normal to have irregular periods? ### Response: Hi. How are you doing? Hope I have clarified your query, do write back. All the best" "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: Dear Sir, When my eye power 2 years back, My Vision was RE- SPH- +0.5 and ADD + 1.25 LE- SPH- +0.75 and ADD +1.25 But wrongly I was using a Glass of Power RE- SPH- +1.50 ADD +1.25 and LE - SPH +1.50 ADD +1.25 yesterday when I went for a test I got to find my Vision is RE- SPH- +1.50 LE- SPH--+1.75SO requesting you to guide me how can I get back my previous Vision. Regards ### Response: Com According to your Age you are having hypermteropia which is called far sightedness in which you can see distance objects clearly but near focus will be blurred without glasses. And one more thing you are 46 years old now,so this is an age for cataract. And when you will have cataract and once it will start increasing then because of lens changes there will be change in refractive index of lens which will lead to improvement of near vision and worsening of distance vision . This you can see in your case. You can compare your previous power and recent power. Now you are not having glasses or power for near vision that means you have cataracts which can be in starting stage. So you have to consult an ophthalmologist and you should undergo cataract assessment." "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 unprotected sex on the 10th and had Unwanted 72 in less than an hour of having sex. And 10 days later, that is on the 20th, I am observing some brown and dark reddish discharge. Is that normal? Also had slight lower abdominal pain. ### Response: As you took the pill on time, there is no chance of pregnancy in your case. Delayed menses and these symptoms could be due to hormonal imbalance caused by the pill. Get your home urine test if you missed your period by seven days or more" "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 now 55 years and has been suffering from irritable bowel syndrome (IBS) for over a year. Her condition was not so bad before. She was diagnosed with intestinal disease and was given some antibiotics like Flagyl or Metronidazole. After she took those pills for a month, she had frequent loose or watery stool (without blood) and could not eat spicy or fatty food, sugar or any foods containing lactose. I found a probiotic supplement called Bifina, which helped a lot in controlling her toilet routine and her diet but needed to use together with Smecta. She still cannot eat spicy or fatty food, but she can have a drink or juice with an acceptable amount of sugar, which serves as a rehydration drink. She no longer has loose or watery stool. Once in a while if she reacts with a kind of food or eat more sugar than necessary, her stool will be softer with a few bubbles. In general, her bowel movement is under control.She is starting to recover but her long-term IBS resulted in her exhaustion. As I previously mentioned, she is now still using the probiotic supplement, Bifina, which helps a lot with the intestine treatment makes her easily feel tired or a little dizzy. I asked for support from a relative who works as a nurse because the doctors in my neighborhood just told her to get a rest and give her pills that did not help a lot. So, the nurse frequently gives her some vitamin B12 shots, Glucose 5% intravenous infusion and lactated Ringer\s solution 500 ml for injection. This proves to help, but she tells me that she do not have enough energy. We went back to phlebotomy department to have her blood tested. It turned out to be fine, but every time her scores were very low. We thought the hospital could give her any session like fluid infusion or blood transfusion because she had diarrhea for over 10 months. It just stopped about 2 months ago and really has worn her out. But, they just informed me to go to another department like division of general internal medicine. We have already been there and have checked everything like x-ray, heart, liver, and kidney. Attached below are some images of her test results. I appreciate every answer. ### Response: I have gone through your query and reports (attachment removed to protect patient identity). I can understand your concern. Probiotics can help. She might have developed antibiotic induced diarrhea after taking tablet Flagyl (Metronidazole). I have seen her reports and they seem to be normal except ultrasound which is difficult to interpret as it is not clear. No need to worry she might have developed malabsorption syn" "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: Please advise me. I have blood pressure 157/77 and pulse 97, blood sugar 88. My age is 44 years, sex is male and very light pain in the heart at the same time. ### Response: Your systolic blood pressure is elevated. Do you smoke? Do you have diabetes? Are you overweight? Some advice to lower BP is as follows. Stop smoking and paan, etc. Reduce weight, adopt an active lifestyle, do a brisk walk, reduce salt intake in the diet, reduce saturated and trans fat in the diet. Check BP regularly. If after adopting all these, still, BP remains elevated, you may take medication after one month or so. Tablet Lisinopril 10 mg at bed time daily. Make sure your kidney function is normal before starting this medicine. This medicine may cause reduced BP in initial days. So, take it at bed time only. After 15 to 20 days you may switch it to day time. Check BP regularly. I recommend first to make lifestyle modifications. If BP normalizes, then there is no need to take medicine." "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 38 years old. Two days back, I was playing with my neighbor\s dog (small one), my middle finger got scratch or bitten. I am not sure, but there were very few drops of blood. So, should I take the anti-rabies vaccine? Is it completely safe to take it even without a dog bite? Any side effect in future if you take it without dog bite? ### Response: The anti-rabies vaccine should be taken if there is a dog bite or dog licks the mucous membrane like nose, eyes or mouth or wounded skin or a dog scratch. Wash the wound completely under running tap water with soap for 15 minutes. Watch and observe the dog for a period of 10 days for any unnatural behavior, activities or death. There are no dietary restrictions before or after a rabies vaccine. Vegetarian, as well as non-vegetarian food, is allowed, but do not consume alcohol while under treatment. Do not take any other vaccine other than tetanus (if required) during the treatment protocol. So, in your case, you do require the vaccine cover as a scratch requires the vaccine. So, do not worry about side-effects." "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 got my teeth cleaned with a water jet type cleaning, by a new hygienist. A few days later, my bottom front gums felt irritated. I took a look, and one gum looked as if it had been cut down toward root about 3 mm below the normal gum line like it was a mistake. I used a peroxide type mouthwash and declined follow up visits to the same dentist because I did not trust the experience of the hygienist. Ever since, I have been trying to treat the gums and also noticed an odor, greying area toward the root, and it has become difficult to manage the irritation. It also looks like a cavity may be present. I have attached a picture. ### Response: Hello. Discontinue the use of peroxide type mouthwash, use a gum paint which could strengthen your gums. Gums may move a little downward after cleaning as the inflamed gums come back to normal size after cleaning and is normal. However, in the photograph (attachment removed to protect patient identity), it looks like you still have inflamed gums and a consultation with a periodontist is recommended at this time. The probable causes of inflammation may be an injury during the procedure or incomplete removal of deposits or the use of peroxide-based mouthwash. Your gum specialist may do a thorough checkup and will be able to tell you if you require another round of cleaning." "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 fiance and I were fooling around yesterday and I had semen smeared all over my vagina. He was not wearing a condom. We did not have penetrative sex. However, after the encounter, I got nervous and got emergency pills. All this happened about 14 days after my last period. I assumed I was highly fertile and was at risk for pregnancy. P2, I took one about three hours after my vagina was smeared with semen. I took the next pill 12 hours after the first. Here are my questions:1. I really do not want a pregnancy right now. Is it wise if I take a second dose of the pill to completely reduce chances of implantation? Is it safe to take a higher dose of pills to completely eradicate any possibility of pregnancy?2. What else can I do to make sure I am completely out of the woods?3. Also, after seven days, is it okay for me to start taking antibiotics to eradicate any infections passed? Can general antibiotics like Amoxil treat the treatable STI?4. When is the most prudent time to take an HIV test?5. How effective is P2 when taken during ovulation? I did a little research and some said that P2 will not help if it is taken during ovulation. 6. How can I (in case I get pregnant) make the uterus inhospitable for the growth of the embryo? 7. When should I take a pregnancy test?8. What is the safest mode of getting rid of a fertilised egg within the first few weeks?9. My period should be in two weeks or 15 days from now. Is it guarantee that if it delays I am pregnant? Is it also possible for me to have my period yet still be pregnant?10. Lastly, what are the chances in terms of percentage that I might be pregnant without necessarily having penetrative intercourse? ### Response: How are you doing? That is a lot of questions, but all leading to the same answer. An emergency pill is high dose Progesterone, best taken within three days of sex. Best results if taken within 24 hours of sex. Being a high dose Progesterone, the uterine lining becomes very unfavorable for a possible embryo implantation. The lining suddenly becomes very thick. As it is a single dose, the lining cannot stand on its own and it falls off. But you rightly said success depends on which phase of the cycle you took it. If ovulation had just occurred that day, still there are equal chances of pregnancy and miscarriage. About the questions: 1. You should have the second dose. It will improve chance of embryo not getting implanted. 2. Only after you reach the other end you can confirm that you are out of the woods. You will have to wait for the period. 3. You can have antibiotics anyday, Azithromycin, Doxycycline would be a better choice. 4. HIV can be tested any time now and after six months repeated. 5 and 6 already answered. 7. The pregnancy test can be done earliest one day after the expected period. 8. If positive, you will need a scan to confirm intrauterine pregnancy after two weeks, then MTP (medical termination of pregnancy) can be used. 9. Emergency pill disturbs the hormones, so only the pregnancy test will give you some information. 10. Sperms can swim up even from your thighs into the vagina, so the chance of pregnancy is still there." "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 5-year-old boy has a neck mass or lump on his right side of the neck under the jaw. He feels pain while swallowing food and if he touches it. No fever, no cough, no cold, no complications. The lump is visible and was observed yesterday. We have visited a doctor and he advised to take antibiotics (Taxim-O Forte) with Paracetamol syrup for seven days. After seven days, if it does not go away, he suggested some additional tests. Could you please let me know if this is some major problem and any further diagnosis needs to be done immediately? ### Response: Hello. The mass or lump that is being felt may be inflammation of local gland due to infection or lymph node enlargement. Both of these will respond to the antibiotics given. In case that it does not resolve, then a further workup is recommended which include radiological, pathological as well as blood investigation. Followup clinical examination is necessary to delineate any kind of pathological condition.So followup visit to a pediatrician for clinical evaluation is necessary." "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 25 years old. I had unprotected sex with my fiance two months back. I took an I-pill because those were unsafe days. I got my periods but with very light bleeding. Again we had unprotected sex a month later thinking those are safe days. But to my horror I missed my dates. I took home pregnancy test which showed negative. Still my periods are due even after one month. I am suffering with severe headache, backache, and mood swings because of this. Am I pregnant? Should I consult a doctor or my period is irregularized because of the I-pill I took? Help me out please. ### Response: Hello. I-pill may give rise to irregular cycle at times. Regarding you not getting your period till date I am a little concerned here. As you have mentioned you had little bleeding during the last cycle, then your ovulation might have been delayed as well leading to mess up of your safe and unsafe days. My advise is to wait for one week more and wait for your period to come. If not, then go for a urine pregnancy test again after one week. The symptoms you are having could be due to PMS. So wait for one more week and do as advised." "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 protected sex with my fiancee a month back. She had her periods till three days before the intercourse. We used protection but I still want to rule out any chance of her getting pregnant as I may have left a drop of semen inside her but chances are less. She complained about a little bit increased breast size four days earlier. But she has no pain or swelling. Are there any chances of her getting pregnant? She has a menstrual cycle of 28 days. ### Response: She is unlikely to be pregnant as she was in her safe period, day 7 of her cycle when ovulation has still not occurred, so no chances of pregnancy even if there would have been an ejaculation. You may conclusively rule out pregnancy as on date with a serum beta hCG test. If the hCG levels are less than 3 mIU, then she is not pregnant for sure." "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: 1. I recently had full body health checkup. I am uploading the reports. Can you please review and suggest me required medical care or treatment? It seems lipid profile and ultrasound reports are not satisfactory. Please review and advice.2. And one more thing is I am suffering from urticaria (Getting red rashes on skin which scratch or apply pressure on skin. These rashes disappear in few minutes) from last 1.5 years. I am taking Desolor 5 mg tablets thrice a week. Can you advice me if any advanced and permanent treatment to this problem instead of prolonged usage of tablets? I do not have any smoking or drinking habit. ### Response: I can understand your concern. I have gone through the reports you have attached (attachment removed to protect patient identity). You are having grade 1 fatty liver. You are also having elevated cholesterol which justifies fatty liver. Get done repeat Lipid profile after 30 days. Avoid oily and spicy food. Avoid junk food. Avoid cheese, butter, etc. Do regular exercise like walking, running, cycling and swimming, etc. For urticaria, take Montelukast and Levocetirizine combination (Montek LC)." "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 33 years old. Two years back, I had an ectopic pregnancy so I lost my right fallopian tube. The doctor who did the operation told me that I would not be able to have children anymore due to the lost tube and the other tube is damaged. Can you please give me an answer? Will I still be able to conceive with the help of Staminogro and sperm-aid tablets or how is my chance to conceive naturally? Is there any help for a damaged tube? ### Response: Hi. Your tubes are damaged and ideally, if there was a possibility to repair, the doctor would have done it at that time. Your chances of conception are bright with ICSI (intracytoplasmic sperm injection); (test tube baby). Please do an AMH (anti-mullerian hormone), TSH (thyroid stimulating hormone) to find your ovarian reserve and a baseline thyroid function. Semen analysis of your husband. A transvaginal ultrasound will help and then move forward" "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: Sometimes when I use my laptop at work for too long, my vision gets a little blurry but clears up on its own. Lately, however, it has been happening more often, but it clears up when I blink. It happens when I wake up, during the day and at night it clears up when I blink. I have not been sleeping well, and I have been fatigued. I have also been using my phone and laptop a lot. I also noticed that I have dry eyelashes and most times it feels like there may be something physical in my eyes causing the blurriness. But it is happening a lot lately. My family has a history of glaucoma, and I checked my eye pressure a while back, and it was fine. ### Response: Hello. I understand your concerns. It is quite common in computer users. The best initial treatment for this is firstly to blink your eyes more often and second the thing is the use of lubricants such as 0.5 % Carboxymethylcellulose acetate eye" "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 HbA1c is 8 and fasting glucose is 140. My urine microalbumin to creatinine ratio is 116. What do these values mean? ### Response: Hello. You seem to have diabetes because both blood sugar fasting and HbA1c (glycated hemoglobin) are in the diabetic ranges. You also have microalbuminuria. You have not mentioned what medications you taking because both blood sugar and microalbuminuria can be controlled with medicines. Kindly mention what medications you are taking to make any change or modifications." "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 met with an accident one and a half years ago. I was severely injured but got cured. The problem now is the scars are raised and there is no hair growth in that area. The scar is just below my nose. What are the treatments available to remove scars completely? I have attached a picture of the area. ### Response: I have read your query and seen your picture (attachment removed to protect patient identity)" "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: Kindly shed light on some issues. I had my period two months back and I had the next once a month later, which only came for a day and I have not had it since it till now. I did home test before my period came which read negative. My two breasts ache and immediately after my period comes, the pain disappear. How many days menstrual cycle do I have? Am I pregnant? ### Response: Hello. Menstrual cycle can be 23 days to 37 days. And bleeding can be from 1 day to 10 days anywhere and all this normal. No need to worry. Sometimes due to imbalance in your body or normally also, your period can be 5 to 6 days here or there and it is absolutely normal.When there is a major imbalance or another problem in ovary than it is more irregular. Now it is also true that sometimes you only have minimal bleeding around your period date while you are pregnant called as implantation bleeding. Around the date, the test can be negative. Do urine pregnancy test once again now, if it is negative, then you are not pregnant and it was normal menses. For breast pain, many female suffer before and during menses also, it is due to hormonal (chemical) changes happening during your cycle that also affects other body parts. And it is one of it. So do not worry. In case of unbearable pain, you can take oral painkillers. You have normal menstrual cycle." "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 13 weeks pregnant. I have not felt any movement, this is the second pregnancy. I recently went to the hospital two weeks ago and did a blood test, they informed me that I needed a Down\s syndrome test done and I have straight Medicaid and no one in my area covers straight Medicaid. What else can be done? I just want to make sure my baby is fine. ### Response: Hi. These are normal screening methods, generally covered in Medicare. If you are screened positive and been suggested for some confirmatory test, I am afraid, you need to spend out of pocket. Secondly, fetal movements can be felt only as early as 15 weeks, so be patient regarding that part." "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 30 years old male. Weight is 107 kg, and height is 5\9. Not under any medications. (Not been on any medication for over a year previous medications include numerous mental health medications, various SSRIs, Clomipramine, and several anti-psychotics, most recently Olanzapine). I tried Lymecycline a couple of years ago and multiple creams for acne in the past.I have a history of mental health problems. I have a diagnosis of Asperger syndrome, OCD, anxiety, and depression. My anxiety levels have been chronic for many years due to the severity of my obsessive thoughts and compulsions etc. I think that my poor mental state has impacted on my health. I have had severe skin problems since I was about 17 or so. I get huge cysts that often recur in the same place with large boils. I have some large permanent cysts. I seem to break out at certain times.I also have a condition known as a functional neurological disorder. I will be seeing a neurologist here in the at a movement disorders clinic to deal with this in the near future. I also developed eyelash ptosis, where my eyelash in my right eye keeps growing long. My Ophthalmologist told me that it needs to be trimmed regularly with scissors or that I have to use curlers, as it can impair my visual field. The neurological or psychological aspects may be affecting my other conditions.I have had athlete\s foot for the past year. Due to my mental or neurological problems and depression, I have been housebound for most of the last year. I tend not to shower much or brush my teeth due to this (but I am trying to change my life with the help and change this). I walk around in my bare feet in the house most of the time, and when I do go out, I tend to wear crocs.The athlete\s foot has become more itchy or burning recently. Also, for the past year or two, I have two fungal nails. My big toes on both feet are very yellow looking at the front of the pins (I have ingrown nails in the past). What I am concerned about is my fingernail.I do not know how I did this? About two weeks ago, I noticed that my middle finger on my right hand was very painful when I touched it. I cannot remember if I pulled the nail, and this has caused some infection, or if it is related in some way to the fungal nail infections on my toes or my athlete\s foot.I will show you some pictures, and I would like your advice on what to do next. Due to my mental state, I have not taken good care of my body, but I am trying to address this.My athlete\s foot is entirely wrong. If I start treating this with cream, I am likely to see an improvement. Also, what can I do about the fungal nails? I also have a pilonidal cyst on my tailbone. It was initially very painful to sit down (I am overweight, spend a lot of time sitting at my desk, etc.). This cyst is intermittent, but there are times when it can be very itchy. As you can see, I am not in the best shape, but I am trying to address both my mental health and my physical health by starting to take better care of myself, eat better, exercise, etc.The main concern is the fingernail. Do I have an infection? Can it be serious to blood flow/losing limbs, or is this my anxiety and the things I\ve read on Google. I am quite concerned. I cannot see a doctor for another week or two. I have had this fingernail problem for about two weeks, and it is very sore and very red. ### Response: I have gone through your case and all treatments which you have taken so far. It is good that you have explained all your medical history as every doctor should know it in detail. However, your finger infection is not related to history. It is a new event. Regarding your finger, you need nothing to worry as it is an infection of the skin, and your finger will not go away. In my opinion, this is not a fungal infection. It is a bacterial infection. I can very well understand that it must be very painful for you as it is entirely red. You need some oral medication for its treatment. 1. Take capsule Amoxil 500 mg three times a day for seven days. 2. Take tablet Ibuprofen 400 mg two times a day for seven days. 3. Apply Pyodine solution or Fucidin acid cream two times a day for seven 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 have a history of low platelet count for the last 15 years. My latest count was 4000 cells per microliter. I have not undergone any treatment for this problem. My B12 level is 26.2 pg/ml, biological reference interval is 25.1 - 165, serum ferritin is 12.0 and hemoglobin is 11.0. I recently read that there is a relation between Vitamin B12 and platelet count.Should I start Vitamin B12 therapy to check whether it improves my platelet count? ### Response: Hello. Vitamin B12 deficiency is a very rare cause of thrombocytopenia (low platelet count) and usually, the counts are not very low as in your case. Since your vitamin B12 levels are towards the lower range of normal and bordering on deficiency, you can take vitamin B12 supplements. If your platelet count does not improve, you need to get a proper hematologic assessment done to determine the cause. Your serum ferritin levels are very low and your hemoglobin is also low. You can take iron and folic acid tablets as well to help with your anemia" "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 got an impacted wisdom tooth removed a week ago, I am still in a bit of pain and cannot open my mouth wide without a lot of pain and today I keep getting like pinching feelings in my temple, ear and neck on the same side as the extraction and I have bad breath and a yellow tongue and spitting out yellow stuff when I rinse my mouth. It worries me. ### Response: This is a case of post-extraction trismus which occurs either due to traumatic extraction or wrong injection techniques. First of all, I do not know how much you open mouth, it would have been better if you can send photograph with open mouth at highest. Coming to your problem, you need to take muscle relaxants for one week like Zerodol MR (Aceclofenac with muscle relaxant) twice daily. You are required to do some exercise like placing ice-cream sticks between teeth till gap is closed. It must be repeated two to three times daily for same period. However, if there is a very small mouth opening and you are not able to eat, then you need to consult oral medicine specialist for mechanical opening of the mouth." "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 in regards to pulmonology and exposure to crystalline silica. I have done a ton of research on the internet regarding this subject and probably know as much as anyone can know based solely on internet information. So I am hoping someone with a more advanced knowledge of this toxin can give me some information. Here is my story:I recently worked on a project involving sanded grout that contains high amounts of crystalline silica (40 -70%).Unfortunately I inhaled a substantial amount without realizing the contents of grout and the effects of silica until further research after the project.This was not an ordinary project. I am a photographer and this was a photo shoot at a studio.We used it as powder and threw it in the air to capture the dust clouds in the photos.When we purchased this, it did not even cross our minds how dangerous it was.I poured 3, 25 lbs bags (totally 75 lbs) of polyblend sanded grout on the floor and stood at about 8 feet distance away from the model.She (the model) grabbed handfuls of this stuff and tossed it towards the camera and in other different directions.The grout was tossed in the air towards me throughout the shoot.The air was quite cloudy in the room regardless of the size.I tossed the grout in front of me several times with my bare hands as well.But, I did not have problems of breathing or talking in the room.The shoot lasted for 2 hours and we stayed to clean up for 2 hours afterwards (sweeping).It was 75 pounds of sanded grout and 100 pounds of mortar in a 2100 square feet room with a little fan blowing and with little ventilation.The dust got on everything and the air was thick with dust the entire time.We had about 3-4 hours of exposure to this with no masks.My ignorance has put a huge scare on me. I have been feeling shortness of breath, throat irritation and tightening of the chest.I have been doing some thorough research myself, but the amount of silica inhaled to be considered high concentration (enough to cause lung cancer or silicosis years from now) is a little unclear.Is the amount which I have mentioned, with no respiratory mask, dangerous?I have read that these tiny particles can penetrate through the defenses of the lung and start scarring it in the long run.I have also read that it is possible to have acute silicosis through a single lethal exposure to crystalline silica.I know too much research is bad for a hypochondriac like me, but I would like some honest and thorough explanation of my chances on these long term lung issues.I have attached the details of the polyblend sanded grout and its safety data sheet. After 3 weeks from the shoot, I have been experiencing chest pains, shortness of breath and dry cough. I have had chest x-rays, EKG\s and visited urgent care doctors. Everything came back as normal, so I am not sure of what is going on. Instead I was diagnosed with sinus infection and acid reflux causing stomach pain as well. I have requested the doctor to do a PFT (Pulmonary Function Test).I have not been able to eat or sleep properly and I have been worrying about this. ### Response: I have surfed your links and understood your problem in detail. Revert back to a pulmonologist online for further follow up" "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 just recently divorced and I have children. I have not had any new sexual partners but last week I met a man and without planning it, by the weekend we had sex. I was under the influence of alcohol so my judgment was impaired. He performed oral sex on me (but I did not) and we rubbed genitals for ages to make him hard. He never penetrated me fully but his penis was around that area for a while and probably pushing around entry area. When we actually had sex, he used a condom and ejaculated into that. I am completely panicked. It is day six and I have got a sore throat, swollen lymph nodes and achy muscles and I am itchy all over. I went to the GP today and was tested for everything but in the meantime, I am going crazy. He is a bit of a stud and has had other women. Do you think I am at risk? ### Response: Hi. Receptive oral sex carries a risk of transmission of herpes simplex virus if he has a history of cold sores. Otherwise, it can be assumed to be safe. HIV is not a risk because saliva is not infectious. As far as rubbing genitals is concerned, if there was no penetration or any fluids exchanged (precum), then it carries a negligible risk of HIV though there is a risk of genital herpes and HPV especially since it was a prolonged rubbing. However, penetrative sex is not safe, and there is a risk of HIV and other STDs like herpes simplex virus infection, syphilis, gonorrhea, chlamydia, and HPV. You may take a full panel STD screening including genital herpes, gonorrhea, chlamydia, syphilis, and HIV, especially if you are not sure whether he penetrated and if he had precum." "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 months ago I had chest pain with nausea and shortness of breath. Since the BP got controlled, the sob decresed. Though they increased the Nitropatch to 0.6 and started the beta blockers, I am having a fewer episodes.I had an angiogram last week. It showed no major arteries blocked. The cardiologist mentioned thickened heart muscles are due to high blood pressure. I would like to know how to get tested for the micro angina and is there a need to go to emergency when I have severe chest pain? Why am I getting chest pain with no major blockages?I have diabetes, copd, severe arthritis in my spine, and diabetic neuropathy in my feet that could also partially be nerve pain from my spine. I have had two knee replacements and at present have carpal tunnel in both hands but have not delt with that yet. Also with the thickened heart muscle, will that be the cause for acute chest pain? ### Response: Microvascular angina can be diagnosed on nuclear stress test with perfusion defects if any and also on angiography which shows slow flow in the absence of blockages in major arteries. So, if these tests are showing any abnormalities, then we have to consider the possibility of microvascular angina. Another modality is a treadmill test which can also show changes, but another test is not necessary as two tests are normal and you were not able to complete it. And microvascular angina usually causes pain on exertion rather than severe chest pain at rest. So we have to find other causes for it. If you had been evaluated or examined and had ECG etc., at the time of chest pain, then it also rules out other causes like vasospastic angina or accelerated hypertension as a cause of chest pain, which are relatively rarer causes. So, overall appears to be noncardiac pain. I hope this helps you and get back if you have any doubts." "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 told by my primary care physician that I have some fluid in my inner ear. I have also had dizziness, nausea and feeling like the room is spinning. I also think that I have vertigo, but I am not sure. The episodes happen at night and sometimes during the day. My current medication includes Lisinopril, Gabapentin and Mecklezine. Is there something that I could do to get rid of this feel? ### Response: Do your symptoms increase on changing position? Do you have fullness in the ear, ringing sensation in ear or reduced hearing? There can be two possible diagnoses in your case, but I need to know if you have any of the above symptoms. Either it can be benign paroxysmal positional vertigo or Meniere\s disease. I would advise you to take complete bed rest for about three days (minimum) and restrict salt. I suggest any one of the following tablets for a week. Betahistine, Cinnarizine or Prochlorperazine maleate. Consult your specialist doctor, discuss with him or her and take the medicine with 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 took an I-pill after 48 hours of intercourse. Now I am experiencing brown spotting a week before my periods. Is it a sign of pregnancy? ### Response: As you took an emergency contraceptive pill within 48 hours of intercourse, you can expect around 75 % protection towards pregnancy. The protection rate decreases with a delay in the intake of pill from intercourse. So, to be sure, if you miss regular bleeding during your expected date of periods, please go for urine pregnancy test once" "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 got a fever last week. After two days my fever went and I developed flu. Today, I do not have cough no fever no flu but my mouth is sore. Why? ### Response: Hello. According to your statement, you got a fever that subsided after two days and then developed flu and mouth sore. Mouth sore is a common complication of flu. Again mouth sore may develope by a viral infection like herpes simplex virus most commonly fungal infection, nutritional deficiency like iron, zinc, vitamin B12, etc. Autoimmune disorders like lichen planus also. For your flu-like running nose and body ache you can take anti-histamine, Acetamenofen or Paracetamol, topical antiviral cream, vitamins containing B12 with zinc and iron. If any complications occur or your symptoms do not subside within seven to ten days inform me as soon as possible, I will try to help 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: I found a red dry skin on my scrotum today. What is is? Is it dangerous? How can I treat it? I am still a virgin. I have attached the pictures of the dry skin. ### Response: I have seen the pictures (attachment removed to protect patient identity). It looks like scrotal dermatitis. Try doing the following. Consult your specialist doctor, discuss with him or her and start taking medicines after 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 been diagnosed with candida albicans in the throat through an endoscopy. I had a sore throat in the beginning and was misdiagnosed and given antibiotics which made things worse. I have been on Nystatin twice a day 5 ml each and Betadine twice a day for two weeks now. I have also taken two tablets of Diflucan 150 mg over the two weeks so one a week. The endoscopy today showed an improvement but not much from last week. Overall the improvement is around 60 to 70 % over the two weeks. How long does it take to treat it and can I take another Diflucan pill? My ENT is against it as he said it is harmful for the liver but my family doctor is saying it is alright and I should take it. Another doctor advised I should take Itraconazole 100 mg twice daily for seven days. I am not sure what to do. Please advise. ### Response: Since already you have been diagnosed with candida infection there is no problem in taking one more tablet of Diflucan if you do not have any other comorbid conditions. If you want you can also try Clotrimazole oral paint for the same. The time taken depends upon your immune status. Hope that clears your doubt" "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: About three weeks ago I noticed the backs of only one of my teeth was rough. It has not gotten worse but it has not gotten any less rough after I brush it. On my third tooth forward from my 13 years old molars. ### Response: The roughness of back teeth should not be a problem. It could be a reason of aggressive tooth brushing or using any aggressive toothpaste or any trauma. If the same tooth becomes sensitive to cold or hot or sweet food then it should be concerned. If you quickly rub through your tongue and the tooth feels rough, it can be fixed by easy chairside polishing when you visit your dentist" "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 five-week pregnant woman who wanted to do an abortion with tablet Mifepristone. Will one dose of Mifepristone tablet help for my abortion? Please help. ### Response: Hello. No one dose of Mifepristone will not lead to complete abortion. It will lead to incomplete abortion. To have full and safe abortion medically, get an ultrasound early pregnancy done to see for the presence of cardiac activity (doses differ with presence and absence of cardiac activity) and also tell us whether you have had previous cesarean or abortion. Please do not take the medication without the test and in some random dose as it can cause immediate and long term complications. Review with USG report and history asked so that we can prescribe your regimen best suited for you. Unwanted pregnancy. Usg early pregnancy for cardiac activity. Routine contraception." "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 23 year old female. I have had a really bad cough and chest pains for about a month, also I have had diarrhea. I have been coughing up green and yellow phlegm. However I went to A and E just gone was give 500 mg of Amoxicillin. But since I started taking them I do not feel any better. I only have one day left on them. I have lost weight over this month and do not have any appetite. ### Response: Hello. From what you have mentioned, most probably you have a chest infection. A chest X-ray is required. Culture and sensitivity test of the phlegm is required to guide our antibiotic therapy. The diarrhea is most probably due to Amoxicillin. Do you have any problems in breathing? Do you have a high-sustained fever? I suggest: Consult your specialist doctor, discuss with him or her and start taking the medicines 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 had a crazy dog that scratched me 10 years ago. So, I want to know whether that can lead me to rabies because I have never taken any anti-virus booster. ### Response: 10 years is quite a long time. It is highly unlikely that you can get rabies by an exposure 10 years back. Usually with infection of rabies virus, (through a bite of rabid animal) shows symptoms in 20 to 90 days. The period can be as long as more than a year. But I have not come across a period more than that. Regarding immunization, rabies is one of the few diseases for which post-exposure prophylaxis is available. It is always preferred to get yourself immunized along with anti-rabies serum." "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: Hey doctor,I have bought an electric toothbrush because a dental hygienist said he would recommend it as I have gum disease. The bleeding has stopped tremendously after regular brushing and help from the dental hygiene. My question is, because I have a few loose teeth at the bottom, will using an electric toothbrush make them even looser? Just because of the power of it. ### Response: Hi. Yes, it will because it does not have the same control as your hand will do. Not till you keep it as controlled as possible but it is a mechanical device. It can make your teeth more mobile if the tooth mobility is more than grade one (that means you have a slightly loose tooth). If your teeth is much mobile it will cause damage. As per your history, you are having chronic periodontitis. You need to have regular oral prophylaxis after every three to four months. So that your loose teeth will tighten properly." "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 unsafe sex with my partner on the 21st. My menstrual cycles for the last three months have been as follows: 18th, 13th, and 9th. I usually have four to five days\ bleeding. Is there any possibility of getting pregnant? How could I avoid this chance of getting pregnant? Can I use I-pills yet? How many pills to consume? Are there any other preventive measures available? Could you please suggest me my safe period? ### Response: From day 1 to 10 of the period, it is safe period. There is no chance of pregnancy as there is no ovulation happening during this period. From day 12 to 24, it is a fertile period and there are high chances of pregnancy. Since you have not crossed 72 hours of intercourse, you can still take an emergency contraceptive pill. It is just one emergency pill within 72 hours of intercourse to prevent you from pregnancy. However, if you have a doubt then get then get 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 6 year old boy is suffering from stomach ache. He vomited 2 to 3 times already. He had mangoes yesterday, and today he is having yellow vomiting. I gave him Ondansetron syrup and Cyclopam. The vomiting has stopped now, but he still has the stomach pain. The stomach pain is so severe that he starts crying. ### Response: Consult a specialist doctor, discuss with him or her and strat taking the medicines after 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 am a 21-year-old. My question is whenever I have an orgasm, the muscles and veins on my chest goes down, my arms get weaker and give difficulties breathing at night. I am always spitting out bloody snorts and having trouble in swallowing properly for few days, or sometimes even few weeks I thought it was asthma or acid reflux, but been to different hospitals to get a check and neither one of them seem to know what the problem is. I would love to know what is going on if you can help. ### Response: Hello. First of all, I feel that there is some problem in either your lungs, heart, or blood. Weakness with difficulty in breathing after orgasm indicates that your stamina is less. The cause for low stamina can be some problem in your blood or lungs or heart. Spitting out bloody snorts and difficulty swallowing means there is some problem in your esophagus (food pipe) either an ulcer or erosion or vascular problem, for which you shall require an upper gastrointestinal endoscopy. You also need other tests, but I would like to go through the reports of the analysis done on you. Kindly upload the test reports." "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 had a heart attack three weeks ago. Now, he is under medication and in complete rest at home. But echocardiogram report says his LVEF rate is 29 %. Some cardiac enzymes are high. How can we improve the rate of LVEF? Can this percentage get improved by rest or diet or something? His blood pressure, cholesterol, and sugar levels are normal. There are no blood clots present. He feels tired if he walks at home even more than 15 minutes. ### Response: Your father had a heart attack and from his echocardiography report, (attachment removed to protect patient identity) the affected areas are thinned out and akinetic. It means that the heart muscles have lost their function in these areas. What are the medicines given? The other method is to assess if there are any other blocks present in the coronary arteries and get removed either by CABG (coronary artery bypass graft surgery) or angioplasty. But I would suggest first do a myocardial viability study to see if the thinned out akinetic areas have any living muscle present to improve his cardiac function" "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 know the benefits of using mineral sunscreen. What is a mineral sunscreen? How does mineral sunscreen differ from the chemical kind? What are the biggest benefits of using mineral sunscreen? What should you look for in a mineral sunscreen if you want to ensure you are getting a formula that is going to be both protective and cosmetically elegant? ### Response: Hello. Sunscreen are agents that give protection to the skin against harmful ultraviolet radiation. Of the sun especially UVB (ultraviolet B) radiation that is more harmful. Sunscreen are of two types. Physical sunscreen and chemical sunscreen or sunblocks. Mineral sunscreen is another name for physical sunscreen. Physical sunscreen physically blocks sun ultraviolet radiations and chemical sunscreen absorbs UV radiations and chemically disperse them. Physical sunscreen are zinc oxide, titanium oxide and iron oxide. They are cosmetically unfavorable because they have to be applied thickly and evenly so they are visible on the applied skin whereas chemical sunscreen like octocrylene, etc., are not visible. Mineral sunscreen gives better protection than chemical ones. They reflect the UV light whereas chemical sunscreen absorbs light and has more chance of photoallergy and contact dermatitis. Mineral sunscreen are better in this regard. Various cosmetics are using these mineral sunblock ingredients." "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 stand from my bed suddenly I feel dizzy for a minute. What causes this? My ECG and echo are normal. When walking, feel floating, and imbalance. Currently, I am taking Xynal, Avas 10 mg, Vertin OD, and Febuget 40 mg. ### Response: So, this is suggestive of postural hypotension, meaning when you suddenly get blood supply to brain goes down and you get symptoms till body adjusts it. This is most of the time benign and not worrisome and goes away with lifestyle changes. However, we should rule out the autonomic neuropathy. You should get your BP checked by the local doctor or yourself if having BP apparatus at home. For that, you have to check BP while lying down and then recheck it after you stand whenever you started feeling dizzy, and see the difference between the two readings. You should get your thyroid, sugar levels done if not done recently. Next if you are consuming too much alcohol then needs to reduce the consumption. Please let me the know the content of the first medicine you mentioned and if you are taking any other medicines. Is there any response to Vertin (Betahistine)? In treatment, firstly you should avoid sudden changes in posture, and you should do it more gradually like sitting for a while in bed and then standing. Later we might need to add medicines if 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 am 28 years old. I am planning to get married to a girl who is known to me. We have a very good understanding and we love each other. But, we have the same blood group that is B positive. Since blood group is a factor for having babies, do you think having the same positive blood group could create problems for future generation? My brother-in-law told me that if husband and wife have the same blood group, future generation (babies) will have to face problems like a disabled child, died baby born, etc. He told me it could create a problem and he does not want me to marry this girl. So, I am in great trouble right now. How can I give a clear explanation to my parents and my relatives about this issue? My questions are does the same blood group create a problem? If yes, then what basically create problems? And how to overcome this problem I mean the solution to this problem? Are there any precautions that need to be considered for having a baby after getting married to the same blood group? ### Response: The same blood group people can marry and can produce a normal child. The same blood group is not at all contraindication for marriage and to produce the child. So do not worry about that. But if you both are relative, then genetic counseling before conception is necessary. If you really want to investigate, then rule out thalassemia minor report before marriage, that is of utmost importance." "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 question is hypothetical. If one has suffered brain edema as a result of a stroke, is there any way to determine whether or not the transmitters or neurotransmitters in the brain have sustained any type of damage? Is there any test available that can ascertain this information? ### Response: Hi. If someone has brain edema secondary to brain injury, there is definitely a disturbance in the neurotransmitters in the brain. The only way to identify this is by a procedure called microdialysis wherein a probe is inserted into the area of the brain under consideration and the biochemical parameters analyzed." "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 smoke, and I usually avoid smoking around other people. However, I work at a hospital, and I went outside the hospital, and I lit up a cigarette. I did not notice that there was a woman with a baby, and I stood near them smoking for quite a few seconds. Now I am worried that the baby might die of SIDS, and it will be my fault. Is this possible? ### Response: Please find my observations below. Your cigarette smoking was an isolated event and unlikely to influence the health of the baby in any significant manner. Cigarette smoking in the open dilutes the harmful gases in the atmosphere and if you smoked only for a few seconds then the baby\s health will not be compromised even if the baby has inhaled a small amount of the smoke. Please be assured that your action will not harm the baby in any way. In conclusion, you can forget the incident as a small error and stop feeling guilty about the entire episode. Hope this answers your question." "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 HIV positive. These days I am having rashes on my penis foreskin (it is bad sometimes). I am on ART. But, the foreskin infection these days scare me. My foreskin seems to be rough, reddish, broken sometimes and even I do not masturbate. Please guide me. ### Response: Hi. I have gone through your query, and I have noted your concern. Firstly, I request you to kindly upload an image of the affected area so that I can have a look at the skin and guide you accordingly in the best possible way" "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 back pain for the past three years sciatica. Treatment and medicine do not reduce my pain. MRI report l4, l5, and S1 bulge excise physiotherapy did not reduce my pain now I am taking only Vitamin and Calcium tablets only. Sitting increases my pain radiating in my left leg. I am consulting a lot of doctors but still not solve my problems. ### Response: Hello. I saw your query regarding our disc prolapse resulting in back pain radiating down the legs. I need to ascertain this after examining you and looking at your MRI films. Once confirmed, you will get relief from a selective nerve root injection, along with physical therapy and lifestyle changes. Sciatica is relatively straight forward to treat with pain injections in most situations. MRI. Diagnosis is confirmed with lumbar spine MRI. Disc Prolapse L4-5, L5-S1. Selective nerve root Injections (under fluoroscopic guidance) is most likely. Avoid bending forward and lifting weights, jerky long-distance travel, Strenuous work." "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 30 year old female. My father who is 65 years old has suffered from two very severe heart attacks, one recently and another two years back. His father and brother both died in their 50s from heart attacks. Is heart attack genetic? Should my son and I get tested? ### Response: Hello. Yes, heart attack has a genetic component coupled with environmental elements like lifestyle, etc. Your chance of acquiring it depends on both of your parents. Likewise, your son acquiring it depends on you and your husband. But you are at an increased risk, so you should get periodic health checkup done. Especially blood pressure, lipid profile and blood sugar. I suggest you follow a healthy lifestyle as follows." "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: Why am I getting periods twice in a month? ### Response: This condition of getting periods more than once in a month is called polymenorrhea. There are so many causes of polymenorrhea. Most commonly it is caused due to hormonal disorders and due to fibroids. Consult a gynaecologist online to know about the investigations to be done to rule out the 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: In my penis, veins are visible and it is painful. Last month I consulted urologist, and he gave me Evion 400 tablet for 20 days. I masturbate daily. What I have to do now? Shall I keep Heparin cream on penis vein? Please help me. ### Response: Hello. There are always large veins on the upper aspect of the penis, and they transport blood back towards the heart. Since the penis is an erectile organ, the veins have to be large and zigzag (tortuous), so they can elongate when the penis becomes erect. Sometimes the pain may occur due to rough masturbation. Please do not use Heparin cream as it is not needed. Avoid rough masturbation for a few 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: One of my relatives is HIV positive. He says that it is functional and the virus is not affecting him in any way and he will not transmit the infection to anyone. As per him he does not require the antiviral medicine also but taking it as he is extra cautious.1. Please help me on how can I be sure of his claims as truth in this relation is very important for me.2. Also, can you please let me know the prognosis of this disease. As per him, he will live a normal life and there is no threat of developing AIDS as he is a special case. Please let me know if this is true and how can it be proved. ### Response: Hi. There is nothing like functional HIV infection. Confirm, whether he is HIV 1 or 2 because HIV 2 is less infectious and less violent than 1. If he is infected with 1, then there will be slow progressor or rapid progressor. If he is rapid, then he will have a low CD4 count below 350 by two years, and if he is slow progressor then it will take 4 to 5 years but inevitable to land in AIDS if he will not take medicines. 1. Get his viral load and CD4 report to know the current status to assess his claims. 2. Prognosis is very good at current age owing to very good use of HAART medication. They can live a normal life with medicine." "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 60-year-old female. I am not overweight. I exercise daily. I have episodes of enormous pain in my left thigh under the muscle. It does not look like muscle spasms. It seems to happen when I try to move my knee. It occurs mostly at night time when I am lying down or when I am sleeping. I have the pain for about 10 minutes. During these episodes, the pain starts within a minute and subsides within five seconds. The pain is severe. I am feeling exhausted. Sometimes it happens for a couple of times in a week, and it occurs in between the months too. It seems to get worse when I try to move.I have gone to many doctors and had done three MRI on my back. I have done X-rays, nerve tests, and ultrasound on both the legs. The results came negative. I do not have these episodes when I am at the doctor\s office. What could be the reason for having this pain? What is the cause? Please suggest. ### Response: I have reviewed your query. You can consider doing an epidural steroid injection for controlling the painful episodes. You should discuss the option with your physician for doing it. You can also have a hip joint issues. You can also consult an orthopedist for knowing the cause. I would recommend visiting a gynecologist for proper evaluation and try to have a second opinion on this issue. She would be in a better position to investigate you. There can be an infection or inflammation such as PID (pelvic inflammatory disease) or any other malformations related to female organs. It may also be a 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 am looking for a little advice since I cannot be seen until tomorrow by my dentist. I recently had a root canal on my bottom left tooth (last one at the back in the photo). A few weeks later, I got a temporary crown placed over it. The area beyond the tooth is inflamed and hurts badly. It is causing pain on the side of my tongue and the left side of my throat. I have no idea what could be causing it. I remember them attaching a metal piece back there to keep my mouth dry and open, but not sure if that could be the cause of anything. It did hurt when they did the procedure. ### Response: Hi. I had gone through your complaint and the relevant details (attachment removed to protect patient identity). The cause of your pain should be either of the following. 1. Check occlusion and perform coronoplasty (reducing tooth occlusion by restructuring the tooth).2. Smoothen the margins of the temporary crown. 1. Do not brush aggressively on the affected site.2. Do not rub salt on the inflamed area." "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 realize I have IBS symptoms and they seem to be related to SIBO. I need your advice on how to treat it effectively. Here are some symptoms and test results. Leaky gut or intestinal permeability with multiple food intolerances. Seems to have hydrogen sulfide based SIBO, severe farting with a foul smell of eating foods like cabbage, broccoli, cauliflower, high protein foods. I may have an overgrowth of sulfate-reducing bacteria. Rifaximin seems to help with SIBO but it is temporary. I have to eat rice as I cannot eat gluten or wheat. Some experts on SIBO say that MMC or vagal nerve dysfunction is the root cause of SIBO. I have heard a lot of patients get better when they increase gut motility. So I wanted to ask if taking prokinetic or cholinergic support will help SIBO from reccuring. ### Response: Hi. The best is to avoid eating foods that cause trouble. Secondly, for SIBO (small intestinal bacterial overgrowth), it is better to use a combination of Tetracyclines plus Metronidazole for two weeks. Effective probiotic will also help. Take the following medications: 1. Tablet Tetracycline 500 mg thrice a day two weeks. 2. Tablet Metronidazole 400 mg thrice a day for two weeks. 3. 4. Take fresh homemade yogurt twice daily in a small bowel." "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 received Propofol for my colonoscopy. As it was administered my lips felt buzzy, as though an electrical current was passing through them. ### Response: First of all you need not get anxious because of this buzzy feeling you went through after you were given Propofol. Buzzy feel or electrical current feel is all part of the any general anaesthetic agent. Propofol is a very good medicine given by your physician for making you sleep during colonoscopy. Sometimes you do have this sort of buzzy." "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 age is 8 years old. His weight is 25 kg and height 135 cm. He has problem of passing stool in his underwear for the last 6 to 7 months. He is doing this without knowing it. He suffered with the same kind of problem last year for three months and it got cured. But, that medicine did not help this time. We discussed many doctors, but not get any solution. Please help us. ### Response: I saw the attached files and your child\s history (attachment removed to protect patient identity). Revert back with the answers to the above questions to a paediatrician 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: Which OCP is better for long term use in PCOS? Krimson 35 or Crisanta 21, as my endocrinologist prescribed Krimson 35 with Glyciphage 500 twice a day for six months and my gynecologist prescribed Crisanta 21 with Glyciphage 500 twice for two years. I was very confused and started Krimson last month but I have been continuously bleeding from 5th to 6th day after starting Krimson and it is not spotting. It is flowing kind of bleeding. Sometimes, heavy bleeding. Please suggest. I should have started Crisanta. Should I switch to Crisanta from next pack? Which one is better for hirsutism and weight control? I have hair growth on the chest and stomach, weight is 64 and height 5.8. ### Response: Both Krimson 35 and Crisanta 21 are used in PCOS for long term regime. Please check if you are taking the pills at the same time or missing them? Any vomiting, diarrhea, fever in the last few days? As per various studies, Krimson has shown better control over hirsutism and acne while Crisanta has a better effect on weight control. So, it depends on what symptoms are you concerned about? As per figures, your BMI is around 21, so it is within the normal range. The irregular bleeding shall subside with regular pill usage. For heavy bleeding, you may use tablet Tranexamic acid 500 mg thrice a day for two days. It reduces the flow." "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: What makes the cheeks inside the mouth look like tear. There is no bleeding and ulcer. There is some burning during the day and it quits overnight. ### Response: Hello. As per your information, it is not a case to worry about. In cases that need attention, the cheeks become reddened painful rigid or ulcerated. Your case seems to have arisen due to cheek bite. Make sure you grind off the sharp edges of the teeth which are in contact with the cheeks. Prolonged cheek bite can cause ulceration and can cause pain. Also, if you have unerupted wisdom teeth on either side, cheek bites on those areas can also cause some sort of a burning sensation. So get in touch with your dentist to get the problem corrected. Avoid having too much spicy food in the meantime." "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 RE -0.50 and LE -0.75. Should I wear glasses all the time? I am not comfortable with my glasses and need to change contact lenses instead of glasses, if it is possible. Can I change to contact lenses? ### Response: Ideally yes, you must wear glasses all the time. Since this power is not high, you can avoid them while doing near work like while reading or working on mobile, etc. Yes, you can use a contact lens. For this, small power contact lenses will be of the same power as spectacle power." "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 frequent sneezing during cold climate. I have wheezing and cough. I used several medicines for seven years. I have no problem with the heart, and I do not have asthma. ### Response: Hi. I have reviewed your query and here is my advise. Your symptoms are suggestive of allergic bronchitis. You are having an allergy to cold as per mentioned in the history. I suggest you investigate your CBC (complete blood count) and spirometry to assess the severity and to look for eosinophilia if present." "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 25, and I have really bad anxiety about my health. I have been to therapists but nothing seems to help. Since I was 20, I have had these weird heartbeats that would last no more than a second that feels like a big thump. They would happen randomly and usually worse when I am bloated, after a huge meal. I went to the hospital for that/chest pain, and racing heart, got an EKG and blood tests and the doctor said that my EKG was all clear. I have also had four EKGs in the past (one last year), blood test for my heart, and they all came back clear. Should I be concerned? ### Response: Most probably, these are ventricular premature complexes. These are ectopic or extra beats. These are usually benign and not life-threatening. These are frequently associated with MVP (mitral valve prolapse), also caffeine, alcohol, thyroid, gastritis and acidity problems may aggravate these. Since these are not frequent, ECG may be normal. So, in that case, you will need 24-hour Holter monitoring which can diagnose these. You should also get a thyroid test done. You will need beta blockers like Metoprolol to keep these under control. Discuss with your doctor about this" "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: Sometimes when I wake up, the eye that I was sleeping on, the vision will be dark as if I pressed on it too hard, and the vision comes back within seconds of sitting up or moving my head around. What is this? ### Response: Hi. Any phenomenon like this where the vision comes back and happens on a regular basis is due to a transient break in the tear film over the eyes. It is not something to worry about. In case you think you might have pressed your eyes, you will definitely experience pain which you said you did not experience. So that is likely not the case." "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 unprotected sex a month back. I took ECP the following day. Three pills every after 12 hours. I did this for two consecutive days. It is almost a month and I have not got my period yet and there is no withdrawal bleeding. What are the odds that I am pregnant? I do not have morning sickness and no pregnancy-related symptoms except for hyperacidity which almost happened every day. ### Response: If an emergency pill is taken within the time limit, that is within 72 hours of unprotected intercourse then it is very effective in preventing pregnancy. But if your next period is delayed then pregnancy has to be ruled out. For that, blood hCG estimation can be done three weeks after LMP (last menstrual period). If you want to do urine hCG card test then get investigated after one week of thedelayed period. Sometimes, high dose Progesterone in an emergency pill can delay period for a week. So, if your period is delayed for more than a week then urine hCG card test can be done to exclude pregnancy. Usually, an emergency pill is taken as two doses of poll or high dose Levonorgestrel 1.5 mg single dose. Thee poll not recommended in any regimen" "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 experiencing a pain on the left side of my stomach with passing gas and burping in the stomach. My stool is green and there is no sign of blood and no vomiting. I have been to the doctor and he gave me Nexium and Ranitidine for three days. Also, I was feeling a little better after three days dose. On the fourth day, I felt belly discomfort and burning comes and goes mostly at night. Last night I felt a heat sensation on my neck. The next day I took the pills and the burning feel on the left side of the stomach and heat sensation a neck seems to get cooled. I feel like mucus or something is in my throat. Should I be worried? Also, I get random aches all over the body. ### Response: Hello. I understand your concern. Pain on the left side of the abdomen, along with burping and stomach pain are all suggestive of colitis. Since your stool is also green in color, it is advisable that you get your stool examined for parasites and ova. The sensation in the neck seems to be unrelated to your colitis, however, it could be due to acid reflux. Ranitidine will help and you need to continue. For such colitis, I will advise Ofloxacin and Ornidazole twice daily for five days. Random aches are also suggestive of colitis and infection. So start the medicine and get your stool evaluated. You can follow up once the reports are ready." "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 pain in my anus while passing stool, feel like have developed hemorrhoids. Please suggest. I am 37 years old. ### Response: Hello. First thing is your stool should be soft. For that, you should eat high fiber diet like fruits, apple, banana, oranges, green leafy vegetables like spinach, raw cucumber. Avoid smoking, refined food, fatty, and oily food. You should have plenty of fluids and regular exercises. Also, syrup like Cremaffin plus 15 to 30 ml bedtime to maintain your stool soft. Second, you can use 2 % Lidocaine gel before each stool so as to relieve pain. It is better if you can get examined by a local doctor to confirm the diagnosis." "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: Please give me a meaningful response as i cant aford to reply and i am scared that i am slowly losing my hearing or something. I have had tinnitus in my ears for about 7 months now and it sounds kind of like T.V. static and its not loud so its okay, but today my phone emited a very high pitch sound and i closed one ear and then opened it and closed the other ear and noticed that i could hear the high pitch sound much better in one ear then the other. Could this mean im slowly losing my hearing. About months ago i got a hearing test done, but i dont have the results, but they said my hearing was amazing. Even now i have no trouble hearing at all. So what is happeing with the high pitch noise. Why can i hear it better in one ear then the other? ### Response: Hi. There are different causes of Tinnitis (ringing in ears) like Infections, loss of cells, inflammation, advancing age or few other diseases of inner ear. At your age hearing loss is less common unless having a disease. there are two possibilities So, to two differentiate which ear is abnormal few test are done by Audiometerist/ENT specialist to make final diagnosis. i would suggest you to get examined by an ENT specialist and he will perform necessary test and manage appropriately. You are welcome for any further queries. Have a blessed 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 33 years old. I have an early stage of Crohn\s disease. Do you have treatment for Crohn\s disease? Is it a curable disease? ### Response: I can understand your concern. Crohn\s disease is a psychosomatic disorder. Its management depends on the condition. If it has no complications, then it can be managed naturally through ayurvedic medicines. You should share your detailed disease history and all relevant investigation reports and medications history regarding this concern. I would like to help 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 have a kidney stone of 4.4 mm at the joint of the left side kidney to the ureter. I also have a mild swelling in my left kidney, while the kidney function test is normal. My stone was not detected on the ultrasound, but it is visible in the CT Scan. I had blood in the urine 12 days back, but not now. A mild swelling in the left kidney is still there. I also feel a mild pain in the left side of the lower abdomen and back. The doctor is advising me to go for a surgical removal of the stone as the swelling of the kidney can itself create problems. I am taking allopathic medicines as well as Cystone. What should I do? ### Response: I just read your query. The urologist\s suggestion is right. The kidney swelling can lead to a further damage in the kidney. I hope you are satisfied with my answer. Feel free to ask more questions in case of doubts. Revert after four weeks to an ayurveda 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 height is 173 cm, weight 75 kg. I have a chronic digestive problem for 10 years. I have taken allopathy, Ayurveda and homeopathy but no successful result. Please advise me. ### Response: The symptoms of digestive problems include diarrhea, stomach cramps, bloating, gas, stomach pain, vomiting, blood in stool, reflux of food, weight changes. The treatment usually includes a combination of medication and lifestyle changes depending on what the disease is. Since you did not get any help from alternative medicine, it is best that you be checked thoroughly and tests done so that a proper diagnosis and treatment can be given. The tests that can be done depending on your symptoms include blood tests, endoscopy, abdominal X-ray, abdominal sonar. More history from you about your symptoms is needed so that an informed diagnosis can be made." "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 21-year-old female. For the past four months, my menstrual cycle was not right. It lasted a whole month and was heavy by the end, and it stopped after I took some vitamin C. Then, after one month, it started again and lasted for two weeks (stopped after I got some vitamin C again, and I was not taking any before).After that, it disappeared for two months, and started again, except this time it appears for a day, the next day it is gone, shows up every couple of days, and there was a very little of blood. None of this ever happened before, although my cycle was never exactly every 30 days, everything was fine. I am not sure what could be causing it, it might be stress related, but I do not have an opportunity to see a doctor for the next three months. Currently I am on Omep 40 g, for duodenal inflammation and Cinnabsin N for sinusitis. ### Response: Hello. At the age of 21 years, possibilities for such irregular cycles are, 1. You have severe physical or mental stress in any form, which would interfere with regular normal ovulation and periods will be haphazard. Try to reduce stress with meditation, breaks, etc. 2. If you have suddenly put on weight. This excess cholesterol will get converted into hormones and interfere with ovulation. So have a healthy lifestyle and diet. You can have cyclical birth control pills for five to six cycles. You have to take pills from day one of the periods for three weeks, then no pills for one week. After eight days start a new pack. Do not wait for next period. 3. You have not mentioned about your sexual activity. If sexually active, then infection could be a cause. If so, you and your partner need to meet a doctor and have a course of antibiotics. 4. If none of these a reason, have a pelvic scan to look for any local problem like polyp or fibroids inside the uterus. 5. Do have a serum thyroid hormone profile and serum prolactin levels to rule out, a hormonal angle. I hope I have clarified your query and do write back if any other questions, and for feedback." "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 58 years old. I have been diagnosed with hypothyroidism 20 years ago. I am on Eltroxin medication since then, 100 mcg daily and twice a week 150 mcg. My T3, T4, and TSH are normal as I do blood analysis every six months. I noticed I am gaining weight from three months although my diet has not changed. Should I increase the dose? ### Response: Since your thyroid test results are normal and considering your age, it is not advisable to increase the dose of Eltroxin just because you are gaining weight. If a person does not exercise much and after a certain age, he just keeps adding the weight every year just because aging slows the metabolism naturally. So, instead of increasing Eltroxin (Levothyroxine), I would recommend that you try to walk every day and control your diet" "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 2 year old daughter was diagnosed diabetic and I am giving four units of Lantus and two boluses Novo rapid for each meal three times. But still, her sugar levels are not in control. We give her low-carb and proper diet. What should we do now as none of the doctors we consulted are able to guide us in the proper direction? ### Response: I just read your query. From what you have mentioned, it appears that your daughter has insulin-dependent diabetes mellitus and you are concerned about her high blood sugar. Hope you will do the needful and get back. Revert with more information to an endocrinologist 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: It is about two months that I have pain in the L5/S1 region. I also have a red patch at this region. The picture of which I have attached. It is a localized pain. When I bend forward or sit down it increases. But, when I bend backward I do not have any problem. The red patch does not itch. I have frequent urination, burning sensation before or after urination and occasional pelvic pain. I do not know whether the two problems are related or not. Currently, I focused on my back pain problem. I am waiting for an MRI which will be one month later. I have some questions to you as an expert in the field. What is the red patch at L5/S1 region? What can be the cause? What could be the source of pain at L5/S1 region? I am pleased for your advice. ### Response: Hi. I have read your query. I have seen the attached photographs (attachment removed to protect patient identity) also. I understand your concern. The possibilities for the red patch on your back are lichen simplex chronicus and tinea corporis. Lichen simplex chronicus is characterized by hyperpigmented patch with roughened skin. Tinea corporis is a fungal infection of skin and characterized by red colored scaly rash. Treatment depends on the diagnosis: For back pain you visit an internal medicine specialist in person for physical 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 had a fall from a stool almost eight to nine days ago. Since then, I had a foot swelling on the right leg. As I could not get an x-ray at that point of time, it was not diagnosed. I considered it as a sprain and used some natural oil massages and scrape bandage for a while. So, the swelling has gone. I am walking with little limping. However, I have some pain while pressing hard or while doing oil massage and while walking. Today also, I had pain while walking. So, I decided to take an x-ray to check whether it is a fracture. Let me know how to manage. I am enclosing the x-ray for your reference. Please let me know your advice and help to deal with this. ### Response: Hi. Trivial injury. Conservative management. Do not put weight over the right leg for six weeks. Revert back after three weeks to an orthopaedician and traumatologist 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 months after I had my second child, I suffered hair loss. It all grew back six to seven months postpartum. Then, I went on a trip about two and a half months ago to a tropical climate and when I got back I am getting the same type of hair loss again. I believe the name for it is called telogen effluvium. My hair is also very weak in general and some strands are similar to a straw consistency. Could the trip have triggered this or could this be a thyroid issue? I also got BPPV postpartum and even now suffer from chronic dizziness. MRI is normal. Ear tests are normal. The blood test is also normal. ### Response: I just read your query and from what you have mentioned it appears that you have hair fall. Try to do the tests and get back for review. Good luck" "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 unmarried 35-year-old male. It all started last month when I experienced mid-epigastric pain one fine morning. I took some pain relievers and got rid of that. Then, after almost a week, I got lower back pain on the right side suddenly one morning, then, upper back pain middle to the right side next day afternoon, below the right shoulder blade, which is persistent till date. I did many ultrasounds and X-rays and several blood tests. The ultrasound always said grade-1 (mild fatty liver). I got CT and MRCP first done two years ago and again last year. I then got MRCP done again thrice in the last year. Every time I am seeing the tests as \normal\.I experienced a bit of testicular atrophy and muscle atrophy and weight loss (I went down to 70 kg from 78 kg) and less appetite. Then, I saw my abdomen protruding a bit. I gained some weight in between. (now 80 kg). Asymptomatic urination - sometimes normal urination, sometimes no urine for three to four hours. Last year, there was a small underarm swelling on my right underarm which still persists and it is painful if I press it hard. I got severe viral infections a month and two later and lost a little weight.Now, I have been experiencing severe back pain on my back, mostly on my middle to right side. Appetite is also very little. I have undergone several blood tests, CT, MRCP, lumbar-pelvic MRI, ultrasound, X-rays, etc, in these two years and did not get any specific diagnosis. I am not sure whether it is my liver, spine, bone marrow, lymph nodes, pancreas, gallbladder, or stomach that is causing this trouble. Early this year, I underwent upper GI endoscopy for my poor appetite, and the doctor discovered a small ulcer in my pyloric channel (caused by H.pylori). I was put on the triple therapy for the same, still no positive outcome. My liver enzymes (SGPT and SGOT are mildly elevated). This back pain and loss of appetite are killing me almost every day. I fear some kind of malignancy as my mother succumbed to gallbladder cancer and associated complications two years ago. The pain I am experiencing is as if something is pressing on my right side back, below the shoulder blade (referred pain). I am left out with more invasive procedures such as endoscopic ultrasound, liver biopsy, PET CT, FNAC, bone marrow biopsy, HIDA scan etc. My ESR and LDH are slightly elevated for almost a year. My sugar is under control. My lipid profile is a little bit abnormal, H. pylori IgG negative, vitamin D insufficient, testosterone is below the normal range, and kidney profile is normal. ### Response: The scans are suggestive of a systemic disorder rather than a focal lesion, and they perfectly correlate with your symptoms. Please send your ESR (erythrocyte sedimentation rate) levels" "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 28 years old. I had my blood test done last month. HBV was negative. When tested again 53 days later, it came out to be positive. Do I have acute or chronic? Are all HBV acute for the first six months? What are the chances that I will completely get rid of it within six months? ### Response: Hello. If your HBsAg was positive on the second occasion, but negative 53 days before that, you have acute Hepatitis B infection. Most of the time, HBsAg is discovered incidentally. It is not common for Hepatitis B to be diagnosed in the acute phase. More than 90 % of patients with acute hepatitis B recover completely and do not progress to chronic hepatitis B. Less than 10 % develop chronic Hepatitis B. I suggest you consult a medical gastroenterologist or hepatologist or an infectious diseases specialist." "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 on CPAP for two years and my AHI is in normal limits. But, the quality of my sleep is not good. My body and brain are not at all relaxing during sleep. I have aching muscles. Please guide. ### Response: Hello. It seems that you might have developed some sleep issues mounting for insomnia. As you have mentioned that you are using continuous positive airway pressure (CPAP) and your apnea-hypopnea index (AHI) is well maintained, this sleep issue might be related with some underlying psychological issues. Underlying anxiety or mood related issues can escalate such kind of sleep disturbances. Also, sleep issues can lead to physical burnout and can precipitate the psychological issues. Hence, a timely intervention should be done to prevent such psychological issues from developing. If you feel like having any such psychological issues, do provide the details. Also describe your sleep issues in detail, so that it can be dealt effectively. Revert back with the details to a sleep 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 a 60-year-old male who just received the results of a 24-hour Holter monitor.Key findings include:Sinus rhythm with frequent supraventricular ectopy (2559) which included couplets and one seven beat SVE multiplet.No complex forms.No significant pauses or periods of heart block noted.Constant feeling of missed beats coincides with frequent supraventricular ectopy.Very infrequent ventricular ectopy that was isolated and univocal.Cardiologists not concerned with findings and recommended positive affirmation, distraction, and cognitive behavioral strategies. He was very reluctant to recommend anti-arrhythmic treatment seeing this as overkill.Other matters of interest. Recent stress echo (March) indicated above average fitness for age (14 mets) and reached a maximum heart rate of 160 bpm. Moderate aortic regurgitation (grade 3-4), normal ejection fraction (60), LVEDV (138 mls), no demonstrable ischemia or arrhythmia. The recent PACs are very noticeable and I feel every one of them. I would appreciate a second opinion or advice on whether there is anything else I can do to stop them.I am currently on Atenolol 100 mg, Crestor 40 mg, Effexor 74 mg, and Valium 5 mg. ### Response: Premature atrial contractions or supraventricular ectopics are not harmful per se other than giving you symptoms. So antiarrhythmics are not usually recommended, so I do not disagree with your treating cardiologist. Beta blocker is the safest option available, although not the most effective one and other options are ablation or antiarrhrythmics. So trying behavioral techniques is a good option. Since there is no atrial fibrillation or SVT (supraventricular tachycardia), antiarrhythmics are absolutely necessary, but the benefit would be in you is just symptomatic, which comes with the risk of side effects. However, you should have Holter at regular intervals like yearly (with echo for aortic regurgitation), or if you notice sustained ectopics or irregular rhythm implying development of fibrillation. You may discuss changing Atenolol to others like Metoprolol and see if its help. You should try to identify triggers like sleep or gastric disturbances, alcohol or smoking (if any), any particular medications (which you are on), stress, etc. Also, if not had recently, thyroid should be tested. So in a nutshell, antiarrhythmics may be avoided, but if not tolerable symptomatically then may be tried. 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: My left eyes touched the wall and became red and when trying to close the eyes, I feel a little pain in the left corner of the eye. Please advise me what kind of medicine I can take now. ### Response: Hello. I understand your concern. I advise you again wash your eyes in running water for around 15 to 20 minutes. Over-the-counter medication which can be used is 0. I advise you to visit an ophthalmologist if you develop 1." "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 normal MRI and a normal tympanogram. Am I losing hearing based on both the test results? ### Response: Hello. No, you are not (attachment removed to protect patient identity). But I would like to see the graph of pure tone audiogram to pick out if there is any early hearing loss. Kindly upload the graph of your hearing test." "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 recurring tonsil stones and was on Augmentin for two weeks. But it did not help. I feel like a tonsillectomy is overdue smelly when I swab with a cotton pick. Please help. ### Response: Recurrent tonsil stones not relieved by antibiotics is an indication for tonsillectomy. It is a safe surgery with definite benefits. The surgeon may use the coablation technique, which causes the least post-operative pain and minimal bleeding. For now, complete the course of antibiotics, take some anti-inflammatory medicines like Chymoral Forte or Disperzyme in an empty stomach and also do betadine gargles. Once the acute episode is resolved, you may review it with your ENT for surgery. Revert to me if you require further support on this." "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 28 year old male and had unprotected anal-vaginal intercourse with a sex worker, me being the active partner. I was put on PEP immediately within 11 hours post exposure and the first dose of PEP was the tablet TLE (Tenofovir/Lamuvidine/Efavirenz), given to me on the morning of 10th. I was asked to follow up the next day with an HIV specialist and she changed my PEP regime to a combination of Tenofovir/Emtricitabine and Dolutegravir as they are more effective. As I was worried and had fever for two days, I did an HIV PCR RNA test qualitative exactly after 10 days from exposure. The results came back \not detected\. ### Response: I have noted your concern. Perhaps your question was not completely typed. Anyways, your PEP regime of Tenofovir/Emtricitabine and Dolutegravir is recommended one. Continue with it for 28 days. As far as the HIV PCR RNA test is concerned it is not a reliable test while on PEP. You need to wait for your PEP to be over before testing. Regards." "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: During my previous pregnancy last year, due to a Down syndrome issue, the baby\s brain was not formed properly. This was detected at the end of the fourth month. At that time, I did not go for a TORCH test. Now, I am pregnant again. At the third week check up, he did a TORCH test. IgG and IgM were negative. At 5 weeks, I went for a TORCH test again. The results were Rubella, CMV, HSV, and IgG as 23, 30, 15 and positive, and the rest were all negative including IgM. My doctor had asked me to repeat the test after 15 days and if it incresed by more than four times, it is a recent Infection. After 15 days when I tested again I got the results as 32, 32, 35 IU/ml and the rest are negative. I am now 13 weeks pregnant. I have a couple of doubts. During the third week of pregnancy, all the values were negative but, why the IgG values were increased later and all the infections were positive? Will this affect my baby? What are tests I need to do now? Shall I go for a TORCH test again? 5. What diet do I have to follow to prevent this? How often do I need to go for scans to check for my baby\s form and growth? Can I take antibodies during pregnancy? Please give me some suggestions. I am waiting for your reply. One report is in the OD ratio format and the others are in the IU/ml format. ### Response: Hello. I have gone through your query and understand the concerns. Hope you found the answer helpful" "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 transperineal ultrasound-guided prostate biopsy approximately four weeks ago. As a result of the biopsy, I have been getting a discharge of fluid from my penis when I empty my bowels. This happens usually with a hard stool. The color of the discharge is brownish. Is this a normal experience from a biopsy? Is there any further information you can point me? Blood in the urine has stopped approximately two weeks following the biopsy. ### Response: Hello. Anatomically prostate is located just in front of the rectum. The biopsy procedure would have caused some micro trauma with resultant bleeding. So, when a hard stool passes through the rectum, it puts pressure on the rectum thus causing the collected old blood to come out through urethra as brownish blood which dilutes with the urine. As such this is harmless and need not worry about this. However, if you have pain and fever associated with it, you need to consult the urologist. 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 know the ways to fix my teeth and make them better. Please explain. ### Response: Hello. Kindly ask your question in detail with your exact problem, so that I can answer your doubts to my best." "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 55 year old male, and I have been suffering from depression due to extreme guilt from 22 years. I have been taking allopathic medicines, but my depression bounces back. Actually, my childhood, teenage, and adolescent was disturbing. My father always abused me, and my parents quarrel daily. My father always neglected me and avoided paying my college fees. Other than this, I witnessed my parents having sex many times in the same room where I slept. I felt disgusted and also excited. I wanted to avoid the situation, but I did not have any option. When I was 19 years old, I happened to see my mother taking bath from the keyhole. One day, I slept with my mother in the same bed, and I ejaculated. At the time of ejaculation, my back was towards my mother. I love and respect my mother a lot, and I always feel I am a sinner. I am unable to forgive myself, and I have not able to get over it. I have been living with guilt and feeling bad about myself for 20 years. Please suggest some solution. I am taking Paxinet 37.5 mg, Lithium 800 mg, and Quetiapine 50. ### Response: Hello. I completely understand that you feel depressed and guilty due to past negative experiences in life. I hope this information is helpful for you. Do follow-up if you feel the need. Best regards" "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 like I may be pregnant. I have been constipated, bad back pains, been very fatigued, nauseous, and often feeling of having to pee. I have not fully missed a period but had a very light period a little over a week ago, it was way darker than normal also very light and lasted for maybe two days. Which is odd because I have been taking birth control for almost three years now so my period has become very regular and the same consistency each time. Also another weird thing, since I am curious if I am with child or not, I have stopped taking my birth control, and as you should know, when you stop taking it the next day you bleed. Which is what normally happens to me if I miss one. But, I have not had any blood at all and it has been four days now. A week back, I took two pregnancy tests which both came out negative. Is it possible that I have taken the tests too early? I am going to a clinic today but not sure if I should. ### Response: Learning that you have been taking your birth control since last three years regularly, the bleeding that you had a week before in form of scanty menses was a breakthrough bleed and can happen in cases with prolonged oral contraceptive pill uses. The pregnancy test is negative, which it should be. The menses should generally occur after 5 to 7 days post stoppage pill pack. So, if no menses in a week, post-pill stoppage then a serum beta hCG test may be done to rule out any pregnancy conclusively first and if negative then you should wait for the menses to occur (the symptoms experienced are then premenstrual symptoms and not for pregnancy)." "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: Recently, I had undergone chest X-ray, ECG, creatinine, fasting glucose, postprandial blood sugar, urea, uric acid, lipid profile, liver function test, thyroid stimulating hormone, TSH, urine complete analysis, complete blood count with ESR and ultrasound of abdomen and pelvis. All the reports came back normal except my urine report. My chemical examination of urine says there is blood in the urine and the microscopic examination says pus cells and RBCs are present. I contacted my doctor immediately and he suggested to go for urine culture and sensitivity. The report came after three days and it looks normal as well. It says, no growth noticed at the end of 48 hours of incubation and microscopic examination says occasional pus cells and no microorganisms were seen. The doctor said not to worry and that everything is alright. He suggested taking more water. He also mentioned that the ultrasound report is also normal. I searched on the internet about RBCs in the blood and saw some very strange articles which scared me a lot. I request you to kindly help me out and suggest what I should do. ### Response: According to your reports, it seems to be a urinary tract infection secondary to a kidney stone. Some kidney stones are not visible on the ultrasound. So, I suggest you do a CT scan of the abdomen and repeat urinalysis. If the same report persists, then we can think of nephrolithiasis. Such reports can be seen in acute kidney injury secondary to a urinary tract infection which usually subsides on its own. Do not worry" "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 fluid retention and high blood pressure which caused me multiple strokes and TIAs. My plasma renin activity is 0.12 and my aldosterone-to-renin ratio is 33.3, which qualifies clinically as primary hyperaldosteronism. My aldosterone LC/MS is 4. My potassium level 4.0. CT scan of my abdomen did not show my adrenal glands. How likely is it that I have primary hyperaldosteronism?I am currently taking Crestor 20 mg, Amlodipine 10 mg, and Aspirin 325 mg. ### Response: I just read your query and from what you have mentioned it appears that you do have primary hyperaldosteronism and it is a very high likelihood for it to be a possibility based on your results. You can try MRI (magnetic resonance imaging) scan for proper visualization of your abdomen. 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 a 22 year old female. My height is 5 feet and 6 inches, and I weigh 60 kg. A few days back, after dinner, I passed stools and while flushing, I found the stool to have mucous and blood. When I attempted to clean the anal region after defecating, I found all three tips of my fingers covered with blood. I cleaned it and checked again, and at that time, there was no blood. A few years back, I had the same complaints, but then it subsided without any treatment. I usually pass stools immediately after eating. Is this normal? What should I do? Please help. ### Response: Following are the possibilities according to your complaints: You need to consult a doctor for physical examination. You will need proctoscopy (medical examination of the anal cavity with a thin tube). If the doctor finds any piles, we will have to treat them. If he feels that there are any chance of Inflammatory Bowel Disease, he will plan a colonoscopy (examination of the inside of the colon)." "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 29 year old male. I was working out in a gym continuously a month back and turns out I overused my muscle. I had pain in my neck and traps and I can feel the stiffness in my neck and traps. I visited an urgent care and they diagnosed it to be a muscle pull and prescribed a muscle relaxer. I am still feeling the pain in my neck and traps and I can feel stiffness in my traps. I feel relaxed when I apply heat. Can you please suggest how I can recover from pain quickly? ### Response: Hello. I read your concern. I would suggest you to frequently do icing over the tight areas like 15 minutes once every two hours followed by gentle stretching. Hope this is helpful for 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: On 16th evening, I suddenly fell sick with symptoms like fever, sudden fatigue, chills, body aches (chest, legs, shoulders, head, eyes, almost all body). I was good during the day except for an itching in the throat. The weakness was so severe that I could not even walk a few steps. I felt like I was going to collapse. Yesterday, I visited a physician who advised me to undergo few blood tests. He thought I am having dengue. Today, I received my blood reports. The dengue tests were negative. But the CBC reports suggest an infection. I still have a similar weakness that I had during the onset of fever. When I walk, I feel like my head is throbbing and it would burst. I almost hold it by my hand to suppress the pain. The body ache seems to be reduced as I am taking Calpol twice a day. Do I really have dengue? Did the test turn negative as I did it before 24 hours of onset of fever? Do you suggest to undergo any other test like chikungunya and yellow fever? Or is it just \atypical\ viral fever? I am currently on Azithromycin once a day, Paracetamol twice a day, and Allegra twice a day. ### Response: I went through your post and investigations (attachment removed to protect patient identity). Regards" "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: Recently, I had intercourse with my partner. I am taking Krimson 35 regularly, and my partner used a condom also. I have PCOS. Do I have a chance to get pregnant? We are not planning for a child now. Do we have any other tests that can diagnose pregnancy early or should I have to wait for my periods? ### Response: As your partner has used a condom for sex, then there is less chance to get pregnant. As you are taking Krimson 35 (Cyproterone with Ethinylestradiol) regularly, so there is no chance to get pregnant. Take tablets regularly. Some tests can diagnose pregnancy early such as radioimmunoassay. The best and better way is to wait for periods. If you miss your periods, you can do a urine pregnancy test. If the result is positive, then you can be pregnant. If there is a negative result, then there can be a delay in periods. Wait for ten days after taking the last tablet of Krimson 35, and if you do not have your periods, then you can do a urine pregnancy test." "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 I eat cold foods when suffering from tonsilitis? I think cold is not related to tonsilitis because a virus or bacteria cannot live in cold or hot. Why is there still a misconception in that? Some doctors say you can eat and some say you cannot. What is the illusion? ### Response: Hi. If you are having a susceptibility for throat infections you need to understand why it is happening. It is not about whether the bacteria can survive in cold or not, but it is about whether your body\s immune system is able to fight the infection to neutralize it before it spreads. Viral particles and bacteria are all there in the air that we breathe and usually the body fights back to protect from getting invaded by these organisms. Everyone has one particular level of immunity, some have a weak immune system while some have very strong immunity and can still bear eating junk food and" "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 5\2"" female, 21 years old and weigh 60 kg. I have gained 10 kg in the past eight months though I was exercising. I cannot follow strict diets due to my lifestyle. My eating habits include more liquid like milk, cold coffee, water, etc. I do not eat much bread or rice but more vegetables, curd, and fruits. I eat junk food almost daily and cannot control cravings for desserts and sweets. My diet and lifestyle have been the same for years but I have started gaining weight recently. I need to lose weight and improve metabolism. Also please suggest the BMI I should maintain. I am asthmatic and cannot exercise vigorously. Currently, taking Deryphilene, Wysolone, inhaler and other medicines for asthma. ### Response: I understand your concern. Since you have asthma, I understand that you cannot do rigorous exercises. In fact, to lose weight you do not need to do rigorous exercises. You can just do a brisk walk (brisk and fast are not the same). Just walk at a moderately brisk pace which you can do without gasping for breath. Do it for 30 to 45 minutes daily. As we grow older, our metabolism slows down. Your body may not be able to process all the junk food that you may be eating. As you have already mentioned that you eat junk food regularly, it is definitely a contributing factor to your weight gain. Include natural sugars like fruits in your diet, but try to cut down on processed sugar. Processed sugar is not good for anybody. Focus on a healthy lifestyle. Increase fluid intake, increase intake of fruits and vegetables, do moderate exercise regularly, sleep and wake up on time, and try to eat home cooked food as much as possible. At your age, I think you can achieve a healthy weight by just following these tips" "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: Yesterday, my dog who is around two months accidentally scratched my leg. The scratch is negligible but I lost half a drop of blood. The dog looks healthy and has not been bitten by other dogs. He has not been given antirabies injection because my vet told us he is too young to get one. Do I have to worry? ### Response: Hello. If a dog scratches or bites you, you need to have a vaccine. As you have a history of exposure (bites or scratches), then it is better to get the vaccine for post-exposure treatment. Post-exposure treatment consists of five injections by intramuscular route on Day 0, 3, 7, 14 and 28. If you were vaccinated within five years then two injections D 0, and 3 only required. If it is more than five years then D 0, 3, 7, 14, and 28 are necessary" "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 burning sensation in my throat for last 7 days still no other symptoms..may i effected from covid 19 ### Response: Hello, I can understand your concern. As your area is facing more cases of covid19, it is good that you are seeking medical advice for your symptoms. First of all, I would like to say do not panic." "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 30 years old. For the past few years, I have been suffering with itching on my groin and surrounding areas. I usually use Cloritamazole dusting powder on and off. But, when the itch really increases, I use Quadriderm ointment for 1-2 days. Once the problem reduces, I stop using it. For one year, I have used one tube of the ointment and about 2-3 boxes of the powder. I have never consulted a doctor regarding this. But, now the problem has increased and I am looking for a right treatment. Since, six months, the itching has become severe on the groin, scrotum and penis. I can notice, there is a lot of flaking and chafing of the skin around it. Sometimes, I can find blood spots in that region. I have itching sensation even while sleeping. Generally, I wear loose clothing or no undergarments and spend most of the time at the comfort of AC. I have no other skin problems. Since a month, I am using pears soap and washing the area with lukewarm water twice a day. Occasionally I take tablet Allegra for itching. For last fifteen days, I am using Clocip dusting powder continuously. I am under homeopathic medicine for chronic sinusitis. But, need to take antibiotics once every 3-4 months. Four years back, I was diagnosed with internal hemorrhoids. As of now, I have no problem associated with it. I have attached the recent pictures. Please check and suggest a permanent treatment for the same and also let me know what precautions I need to follow. ### Response: Hi. I can very well understand what you are going through. I will give my best shot to treat your problem. I examined the photographs (attachment removed to protect patient identity) and found the original fungal lesions have been converted to the present appearance because of medicine. This is when the problem gets complicated. My advice would be to never use such products. But if already used no need to worry. Once a physical examination is done we can find a good solution." "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: Please, could you give your medical opinion on the following CT angiogram?My query would be for you to look at the jugular veins which are near C1 in the neck. Symptoms have progressed over the course of four years, dizziness, neck pain, chronic headache, and collapse. The report has come back fine but would appreciate another opinion. ### Response: Hello. Please upload your CT angiogram images. I need to go through all the images in your CD DVD and will have a detailed look at the vessels near the C1 vertebra area including the jugular veins. Regards. Revert with more information to a radiologist 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 10 weeks pregnant. I get vomiting a lot. I feel like there is a lot of acid in my stomach. Is this normal? I am worried as I am not able to give enough nutrients to my baby. ### Response: Vomiting is a normal condition experienced during pregnancy. But if it is more than three to four times a day, you can take antiemetics like tablet Doxylamine 10 mg with Pyridoxine twice or thrice a day, half an hour before food for the next two to three weeks. Usually, vomiting may continue till 14 to 16 weeks of gestation. You may get them prescribed by your obstetrician" "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 extreme chronic shoulder pain in both shoulders. It keeps me away from sleeping every night for the past eight months. It is hard taking a shower or bath. Kindly help. ### Response: I would like to know if there was any fall or hit on the shoulder. In my opinion, I would recommend getting some soft tissue work on your shoulder rotator cuff muscles. Keep icing your shoulder frequently for 15 minutes once for every two hours. Do some posterior capsule stretch, and rotator cuff regularly stretches each stretch to be held for 30 seconds. I hope this is helpful for now. Kindly revert after a week to let me know the status of your shoulder." "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-25-year-old female. I am a PCOS patient and had sex two days ago (that was after five days since my periods ended). My periods are usually irregular but it occurs sooner or later and I usually have a long cycle more than 30 days. So while sex, my condom broke and I took an I-pill immediately and also in the next day morning. I want to know if the I-pill will work irrespective of having PCOS and what are the chances of getting pregnant? ### Response: Hello. Since you have a longer than usual cycle as expected of PCOS, less likely that you are fertile on the day you had sex. It would be an even added protection that you took the I-pill. The I-pill will work whether you have PCOS or not. Comparing to a non-PCOS patient, you have lower chance of getting pregnant after taking the I-pill. If you took the first pill within 24 hours after sex, it is said to be 95 % effective." "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 42 year old male. From the past three months, I was suffering from typhoid. Now, I have pain in knees, sole, back, and wrist joints. The test reports show high sensitivity c-reactive protein (hs-CRP) 7.67, eGFR 68, folate 2, uric acid 7.7, creatinine 1.02, total cholesterol 211, triglycerides 239 , TC/HDL ratio 5.4, VLDL cholesterol 47.8, non-HDL 172.1, alkaline phosphatase 111.7, alanine transaminase (SGPT) 44.1, vitamin D 7.45, total RBC 5.25, MCHC 29.4, SD (RDW-SD) 50.3, RDW-CV 14.1, PDW 16.5, P-LCR 45.8, and MPV 12.5. ### Response: You mentioned that you had typhoid three months back, and now have features of large joint arthritis. With this profile, it seems to be reactive arthritis. Regards. Revert with more information 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: I have homocysteine value 23.6, and lipoprotein 31.5. ECG and TMT are normal. Is it serious? As I smoke, is it normal because of my smoking? Do I need to visit a doctor? ### Response: I have gone through your reports (attachment removed to protect patient identity). This is not worrisome. Lipoprotein is just borderline, and you just need to have a healthy lifestyle to control it like low oily, fat and calorie diet along with regular exercises at least 30 minutes a day. Lipoprotein correlates with cholesterol. So, once you should get your lipid profile done. Homocysteine is elevated to some extent which is usually due to vitamin B12 or folate deficiency. So, you need to get the level of vitamin B12 and folic acid done, and supplements, if either one is deficient. Thirdly, you have mild prolapse of the mitral valve in echo which is not usually worrisome but should be kept under observation. So, you get echo done every two to three years. So overall, it is not worrisome, but smoking is always injurious to health. It increases the risk of many illnesses. So, effort should be always to cut down on smoking and it is best to avoid 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: I am 25 years old. One night, when I tried to go off to sleep, I had racing thoughts that I had no control over. I did not hear any voices, just thoughts. I could not track them or process them. I was really scared as a result. This phenomenon has been happening whenever I try to go off to sleep or wake up from sleep. Now, very recently I moved abroad. I felt extremely depressed and stressed about this. I started having sleep problems all of a sudden. Being a hypochondriac, I thought this must be something fatal. This led me to be stressed, anxious and depressed. I have been searching on the internet obsessively for five months and I came across schizophrenia. I was terrified. Ever since then, I started searching for schizophrenia obsessively and my symptoms worsened.I thought I started to hear voices after reading about them. But actually at most, they are silent thoughts that occasionally mock me. I have random words pop into my mind at odd occasions. After reading about paranoias, I seem to be developing them too. I get scared or threatened by people for no reason. I am more concerned about the fact that why am I getting scared of people, rather than actually scared of them. I feel extremely detached from reality like I am just going through the motions. I am extremely tired and sleepy throughout the day. My appetite has declined completely. I cannot do anything. I visited four doctors and all told me that I have extreme anxiety and depression. Can anxiety and depression cause these symptoms? Can being a hypochondriac lead to this?When I talk to a friend on the phone, I have an engaging conversation, laugh and cheer up. And then I think, should I feel threatened by him? Am I losing control? I speak fluently and I go about my activities fine. Most of the symptoms that I have developed have been after I got to know about the symptoms on the internet and obsessed over them. I constantly cry about what has happened to my life and why did this happen to me. So, what is happening to me? Moreover, these symptoms come and go in 7-10 days. ### Response: Hi. I read your query with keen interest and understand your concerns. First of all, I must assure you that there is no evidence of disease called schizophrenia in your case. Having said this, the symptoms are more indicative of anxiety disorder with added obsessive and compulsive behavior." "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 20-years-old with 5'2 height and 65 kgs weight. I had sexual intercourse with my fiance a few days back, and I was active even before that. I did not have my periods last month, and this is going to be the second month if periods do not come. I have tested lots of times, and the result was negative. I do not want to go to any doctor please advice what should I take which can help me with my periods and even if in any case, I am pregnant how can I resolve it with quick medicine without going to any doctor. Please help. ### Response: I have read your message. If the pregnancy test is negative, then it is unlikely that you are pregnant. But to be double sure kindly do blood test beta hCG. It will give you confirm to report about pregnancy. Next thing if it comes out to be negative, then you can take medicine as I have prescribed to get menses. Take it twice daily for five days. You will get menses in 3-4 days after the last dose. If the blood test is positive, then you need to visit Gynecologist directly as a treatment for abortion is not allowed to be given on the phone." "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 34 year old male working as an engineer. Regarding my mental state, I feel lethargic and sleepy all day. I do not have the interest to do anything in life. Even if I start something, I am easily bored. I am always in a hurry. I have rapid mood swings. I cannot concentrate while reading as my mind is restless. I constantly have negative thoughts. Most of the time, I am sad. I am short tempered and my pulse rate increases rapidly. I often want to smash things or throw things at people. I ponder about doing crazy things and anticipate the outcomes of doing silly things. I have repetitive thoughts like a maniac. I do not feel like doing anything. I have lost interest even in my favorite activities. I consulted a psychiatrist and he diagnosed it as major depressive disorder with OCD traits and hypertension. But, I do not want to take medicines unless I know for sure it is really going to cure me. Please help. ### Response: Hello. The kind of thoughts that you describe and the fact that they keep coming repetitively is diagnostic of obsessive compulsive disorder (OCD). Your complaints of weakness, mood swings, anger, and a loss of interest in doing things is typical of depression. So, your doctor\s diagnosis is correct. I would suggest tablet Fluvoxamine as the first choice of medicine. For OCD and depression, the best and easiest treatment which will give early results is medication. Other therapies like psychotherapy, etc. are not effective when you suffer from a severe type of OCD and depression. So, I believe that they will prolong your suffering. The earlier you start the treatment, the better it will get. If you have any doubts or negative ideas about medicines, clear them with your doctor or with 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: I have a new mark on my forehead that has developed over the last week or so. It feels a bit crusty and is somewhat sore. But it does not look like a scab or a mole. What can it be? ### Response: " "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 49 year old female. My resting heart rate is 69 bpm. What should be my target heart rate during physical activity? ### Response: The resting heart rate can vary among the population, and it is usually 72 +/- 6. With exercise, it may go to 180 or more depending on the nature of the training, exercise tolerance, fitness, the age of the patient, etc. The fitter you are, lower your resting heart rate. Also, the ability of the heart to tolerate stress will be better. We aim to keep the heart rate during exercise within 80 percent of your maximal heart rate, which is calculated by the formula (220 minus age ). In your case, 80% of 170 is 36." "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 a biometric screening. My calcium was 10.3 and potassium was 6.1. The doctor said my calcium and potassium levels were a little over what they should be, and that my MCHC was off. I have tried to ask if I should be concerned, but they refuse to talk to me about it, until I make another payment at their office. Help. ### Response: Get back if you have any doubts. Revert with more information to a general 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 have a problem with alopecia for four months. My hair is not growing. Kindly suggest some medicine. I am on vitamins. ### Response: I saw your clinical picture (attachment removed to protect patient identity). The diagnosis is alopecia areata. The most effective treatment will be intralesional steroid injection. This is the injection given straight to the bald area. You need to meet a dermatologist for this" "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 want to go for a corrective surgery and am confused between Contoura and SMILE. I request you to please give your opinion on the following doubts of mine. People say that all LASIK surgeries involve greater cornea related risks which SMILE does not. Your view on this?While for SMILE people say that actual corneal depth removed is more and even the appearance objects after SMILE is very artificial and is not as sharp or 3D like in Contura. Your view on this? Also, is there any clause like if one is not able to focus eyes on point or concentrate (which is totally in hand of the patient in SMILE) then he should not opt for SMILE as there is a risk of hurting eye. Is that true? Also, irrespective of which one we do, are these surgeries always accompanied by halos, glares and night vision problems? Finally, I am getting married in two months and I would be required to indulge myself in all the dance rehearsals, makeup, market traveling, etc. What do you think, is it the right time to go for a surgery? And which one (that is less risky and recovers faster)? ### Response: Hello. 1. If LASIK has greater corneal risk than a SMILE? This is true. LASIK does have a greater risk of flap-related complications. In SMILE, as there is no flap created, there are no complications associated with it. 2. Corneal depth in LASIK vs SMILE. The depth in LASIK is dependent on your refractive error. The more your refractive error, the more will the tissue abated. In SMILE, the thickness of the lenticular is preset by the surgeon and does not depend on the refractive error. In both procedures, the surgeon can also take measures to conserve thickness. So the answer is that it depends on the surgeon and your refractive error. 3. The sharpness of images Contoura vs SMILE. There are various studies done on this and a majority say that SMILE offers better results in most laboratory tests, but under practical and daily life situations, it can be assumed that both are pretty much the same. 4. Can hurt your eye in SMILE if you do not concentrate on a point? I am not very sure about the exact context of the question. I can tell you that in both surgeries you will be asked to look at a pointer light and the accuracy of your correction will depend on how well you maintain a fixed gaze on the pointer. If you look any other way for even a fraction of a second the outcome will be bad in both of the procedures. 5. Glare halos and night vision problems. These will be present soon after surgery in both, but will slowly resolve. Not a major problem in a majority of the patients. 6. Right time for surgery, which surgery is less risky and has a faster recovery? Right time for surgery would be around three months from your wedding, although some do get SMILE done just one day before their wedding. 7. Less risky and has faster recovery- SMILE (small incision lenticule extraction)." "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 suffered from bipolar disorder four years back. At that time I was told to take Risperidone and Lonazap. I continued medicines for about one year and slowly stopped them as told by my doctor. Then again one year back I faced same bipolar disorder again but this time it was more severe. The doctor recommended 1000 mg Dicorate along with Risperidone and Lonazap. Now for last three months, I am taking only Dicorate 500 mg and I am absolutely fine. Please let me know how long I have to continue the medicine and am I going to face same problems to stop taking the medicine. ### Response: I read your query and understand your concerns about the ongoing medications and bipolar disorder. As per the available literature, individuals with bipolar disorder need long-term treatment as discontinuation of medication often brings further new episodes. Since you already suffered from two episodes in last four years, I do not feel you should discontinue medication as long as your doctor says so. I would also like to inform you that decision to discontinue medication depends on multiple factors such as severity of symptoms, duration of the index episode, the disruption caused during the episode, the time taken to receive medication and their effect on symptoms as well as side effects. Many of these information are not available to me in regard to your case and I think it will be an injustice if I speculate the duration of treatment without proper information" "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 0% concentration in my studies. My board exams are going on, I have become too irritable. I am also able to make myself happy again but the stress of studying is bothering me as I cannot concentrate. Also, I am motivating myself but still, I cannot. ### Response: Hello. Board exams are indeed stressful for every student and especially with this huge coronavirus scare thats going on, it is even worse I am sure. Although, now that your board exams have been suspended for the next 10 days, you may breathe a sigh of relief. I can still give you some tips on handling exam pressure. 1. Study in small clusters of time, like study for 50 minutes then take a 10 minutes break and then restart. 2. Have a proper three square homecooked meals a day with two small snacks in between. 3. Spend one hour every day in engaging in your hobby even during exam time. This will recharge your mind and you will feel more concentrated and productive in studies. 4. Keep your phone and other gadgets at bay. Switching them off until exams get over is the best thing to do. 5. Catch up on good sleep at night and keep sleep timings fixed. 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: My dad is suffering from acute pancreatitis. It started six days ago and he is getting better now but he used to take antidepressants like Escitalopram and Ezeepam and he has been taking these kinds of anxiety medicines from a long time but not continuously but from last six months the usage has increased. He is unable to sleep properly and he is getting restless. He is asking for that medicine but we think that it could be a reason for his sudden acute pancreatitis as alcohol and gallstones are ruled out. Please suggest what should we do. ### Response: I have reviewed your query and can understand your concerns. The patient cannot stop the medications at his own. It is always best to inform the treating physician before thinking of changing or stopping medications. There is a specific protocol to taper off Escitalopram. If stopped taking all of a sudden, patient may feel bad side effects. I would recommend consulting his prescribing psychiatrist for proper evaluation and management. There are other causes that may also be considered before Escitalopram. Parathyroid gland function testing and calcium levels in blood, smoking and other factors also need attention. Escitalopram is not so commonly documented cause of acute pancreatitis. But this is a very rare cause of pancreatitis. So, undue 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: Every morning I wake up and the beard area of my face is full of small red pussy bumps. This has happened for many months now. I wash my face with Cetaphil cleanser and sometimes Ketoconazole shampoo. This removes some of the pus but my face is still red and a little itchy. I took several different antibiotics for severe acne in my teenage years and early 20s. I shave using an electric shaver with a guard so the blade never touches the skin and the hair is still about 2 mm long. ### Response: Hi. I saw your pictures (attachment removed to protect patient identity). This condition is called folliculitis. It is the infection of hair follicles that form red bumps and pustules around the opening of hairs on the skin surface. Most of the time the infection is bacterial in origin, caused by Staphylococcus or Streptococcus. Sometimes the yeast in the skin can also be the cause for folliculitis. The treatment for folliculitis includes: Before applying the medication, after washing face, clean the area with warm saline water using clean cotton cloth or gauze (never cotton, because cotton gets stuck to the skin). Dip the cloth or gauze in warm saline, gently clean the area. Then apply Clindamycin lotion in the morning and Miconazole gel at night. Do not prick the lesions. Wash face very gently. Avoid close shaving or reverse shaving. If this problem is occurring repeatedly then you need to undergo swab testing for culture and sensitivity of the bacteria inside the pus. Other possibilities are acne and Rosacea. Both can have pustules. Acne involves almost whole of face, chest, and back. Rosacea involves center of the face, chin, nose, and prominence of the cheek. Trying to rule out these two conditions" "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 suffering from this problem for a few years and every year it seems to be worsening than the previous one. I am overweight and by working hard I have lost about 15 pounds. I got yearly rash outbreaks on arms, especially forearms. I have diabetes and taking many medications, but doctors say that none of my medicines are responsible for it. It happens mostly in the summer. They are very itchy and do not go away in spite of using creams. I took some pills that did not help either. It leaves horrible scars. Even a dermatologist I saw did not seem to know what was wrong. I am sure it is partially a heat rash, but it has completely scarred up my arms. I am attaching the list of medicines I am taking as well as the biopsy report. Please help. ### Response: It looks like (attachment removed to protect patient identity) polymorphic light eruptions, may be allergic contact dermatitis. You can use full sleeve cotton shirts to cover the photo exposed area. You need absolute sun protection, good quality broad spectrum physical sunscreen. It is a chronic problem and it may occur off and on. 1. Control your blood sugar.2. Go for photopatch test. 1. Polymorphic light eruptions.2. Allergic contact dermatitis.3. Photoallergic reactions to" "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 29 years old. One year back I had a miscarriage. Now I am not pregnant and not feeding. But when I press my nipples white and some times clear secretions are coming. I do not have any pain and I am having regular periods and sometimes 3 days and sometimes 5 days flow will be there and sudden fatigue is there. Is this breast cancer or any problem? Can you prefer any test? ### Response: It looks like a clear case of hyperprolactinemia. The hormone prolactin or TSH (thyroid-stimulating hormone) may be raised. Go for serum prolactin and TSH levels and further treatment will be based on the reports. You may go for a breast ultrasound also just to be more careful." "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 see a child, whether in public or at home, I always imagine them naked. I look at them and start to visualize them in sexual situations. I want to keep looking at them, even though I know I should not. I am always watching naked kid images on the internet. I do not believe I actually want to have sex with a child although I am not able to stop myself from thinking this way. What shall I do? ### Response: Hi. Yes, the problem is very much distressing. This is a type of obsession called as sexual obsession. For treatment, you should go to your nearest psychiatrist immediately. You should not delay it. Treatment includes medication plus psychotherapy and talking therapy, which a psychiatrist can provide to you. Or you can seek online appointment and discuss your problem in detail." "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 a week prior to my period and took EC pills immediately. I took a blood test the following week and it detected negative. On a day after my period, I woke up with a full pad and the blood was red with little clots and I washed up and changed so the second was almost filled up too. On the second day the flow was quite scanty with cramps. Today is the third day, my pad was filled and I saw clots and normal period tissue discharges, but there is no blood flow tonight. I am having a slight headache although I had a stressful day, but I am scared and worried. Could it be implantation bleeding? ### Response: Hi, Welcome to iclinig.com. Considering your periods to be regular in general, you had intercourse in a safe period. Secondly, you also took an emergency contraceptive pill and took a blood test to rule out pregnancy. There are nil chances of pregnancy. Your heavy periods are due to the EC (which contain high dose of progesterone) side effect. It should wane off gradually. You also have a chance of the next period to be a bit irregular and heavy." "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 pus, acne on my cheeks from a long time but I used to squeeze them off and they will not even leave a single scar, but from the past two months, I am having severe pus, acne, and even I do not touch or squeeze them. They leave a scar and the redness has increased a lot. I am using Clindamycin gel at night time but I cannot see the results. Please help. ### Response: 1. Your acne seems quite inflammatory that is they are very red and with pus formation. 2. You will need oral antibiotics along with topical gels applications. 3. Do not squeeze them, they can leave bigger scars. Check the prescription below and follow it. Acne vulgaris. 1. Capsule Doxycycline 100 mg once a day.2. Minoz-BPO gel 0.1 %. Apply tiny amount once at night on acne.3. Benzoyl Peroxide face wash. 1. Avoid too much sun exposure.2. Avoid full cream milk, chocolates.3. No hair oil.4. Do not squeeze the acne." "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 knee pain for the past one week but not much pain. Yesterday I went to the gym, and something triggered the pain under my knee. Since then under my right knee, I get a pinching pain now and then. If I rub, there is a pain in a particular spot. Would a brace or anti-inflammatory help? My main concern is the cartilage, as my dad has a problem with inflammation. I would like to know what is the best action to take. ### Response: Pain may be due to sudden lifting of heavyweight, which resulted in compression and tissue swelling. If the duration of injury is within two days, then apply ice and from the third day, go for physiotherapy treatment like ultrasound therapy on the back of the knee. Do not worry much about the pain, and just keep strengthening your front and back thigh muscles like the hamstrings. This will help with the knee pain." "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 injured my lower back while squatting about one and a half month back. I have difficulty in bending backwards. A sharp pain was felt when I used to bend backward. But, no pain in forward bending or sideway bending. Neither any pain was felt on touching the region. So, I started physiotherapy and the situation is improving. Recently, when I was playing badminton again I felt the similar pain whenever I tried to bend backward. So, I consulted a doctor. He viewed my x-ray report and said there is no such problem in it. He advised me to stay away from sports for the next 10 days. But, the pain has worsened now. I feel pain in a different region that is just above the right hip. The pain is felt on touching that part and now I have even problem in bending forward. Even sitting increases the pain now. Standing and walking makes it better. As advised by the doctor I regularly do muscle strengthening and stretching exercises, but no improvement can be seen. Please help. ### Response: Hi. The x-ray is not very clear (attachment removed to protect patient identity), but your pain will surely reduce. So, do not worry. Instructions to reduce back pain: Facet pain - lumbar spine. Revert back after five days to an orthopaedician and traumatologist 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 wife (age 33 years) has been suffering from piles related issues since last 10 years.It occurred after her delivery (in 2003) and was harmless at that time. We are having an eleven year old daughter.Recently she started experiencing pain and itching while going to toilet.Also she could notice blood in stool (occasionally).So, we decided to visit a hospital and there she had a couple of tests including rectal scanning.After investigation, doctor informed us that she has been affected by second degree piles, skin-tag and fissure and hence laser surgery is inevitable.We are really worried. Is there any alternate treatment without surgery? Presently, an ayurvedic specialist (who is located near our village) has prescribed few medicines (mentioned below) for reducing the pain and itching but not for cure, Hamamelis virginiana ointment at night (to be used on the affected area), ayurvedic medicine for internal intake like Arsohari lehyam and Smooth laxative. Could you please advise us with proper guidance? Is there any doctor to whom we can consult for a second opinion? My wife is a thyroid patient. Looking forward to your valuable suggestion. ### Response: I understand your concern. It seems like your wife has second degree hemorrhoids which has also led to her fissure. The good news is that it can be managed medically. The first line of management is medical management. Itching is a very common manifestation, which is also known as pruritus. There are certain guidelines: Before all this you need to go and get yourself examined by a good reputed general surgeon in your area. Ayurveda is outside my field of expertise and I am not convinced about you using ayurvedic medicines to treat hemorrhoids at this stage. There are other various possibilties like rubber band ligation, sclerotherapy, cryotherapy, etc. The doctor who examines her may advise a colonoscopy to find out the status of the fissure. My final advise to you is that her condition is treatable and you need not have to worry. She needs to be under a good surgeon. There are various other modalities, which can be decided based on her local findings. Hope this was helpful. consult a general surgeon online for further follow up" "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: Dear doctor,I am hearing ringing sounds in the ear. It is three weeks now. I consulted a doctor and he said that everything looks normal but gave me Neomycin and I still have the ringing. ### Response: I understand your concern regarding ringing sounds in the ear or tinnitus. This can occur due to varied reasons like: It can occur without a known cause too. I would advise you to get an audiometric testing done and share the report with me. Avoid exposure to any loud noises. If it is disturbing your sleep, use a high-speed fan or clock to mask the sounds. Hope these measures would help. Do let me know or consult an ENT specialist online, if you have any further questions" "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 lightheaded, dizzy, and off balance. There is pressure at the top of my head and back down to my neck. When lying down, there is a swaying sensation to the left side. There is ringing in my left ear. Also, a cracking noise when swallowing and fullness in the left ear. I have been to two ENT doctors, cardiologist and a neurologist. The ENT diagnosed eustachian tube dysfunction and prescribed steroids, but no relief. The neurologist performed VNG. I will attach the results. Everything is normal with the heart. What else could cause the lightheadedness and swaying sensation? ### Response: Hello. You are having positional vertigo. Your reports also suggest the same (attachment removed to protect patient identity). You should take anti-vertigo medicines and do maneuvers for vertigo relief. Please tell me if you have a history of frequent nasal or throat infection. What else other than steroids have you been taking so far (so that I can suggest you better). Any history of hypertension? Follow up with the required information." "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 58 year old female. I am suffering from both blood pressure and diabetes. I was diagnosed with endometrial cancer and undergone hysterectomy. I have also attached my reports. Please guide me. ### Response: Hello. I had verified your report (attachment removed to protect patient identity) and I must say that you have undergone hysterectomy which is the best-known treatment for grade 2 endometrial cancer. I advise you to consult your doctor regularly even after surgery and do not forget to take adjuvant therapy which is very important to prevent cancer in the future. For blood pressure and diabetes, I hope you will control them with medication and lifestyle changes." "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 these white and black-headed spots on my penis skin, and I was wondering how can I remove them. Are they bad? I can push some of them out when I do that something like the spots come out of the face. The thing is when I push them they get smaller but do not disappear. After a few weeks, they get back to normal size again. Please suggest what has to be done. ### Response: I request you to kindly upload a few images of the affected area so that I can guide you better" "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 experienced a back injury which has lasted for two months but it has gotten better lately. The event happened when I had my back extended to max(backbend training) and it was just sore afterwards, but the next day the range of motions had been very limited which I couldn't do any extension nor flexion. I felt the pain and compression around the sides of my lower back and middle back when I flex and extension degrees was limited as I felt it was at the middle of the spine prevents me to do so. I have been doing research about this which can seemingly be QL muscle spasm, thoracolumbo joint syndrome, and have tried gentle stretches also even rested but still experience the pain or discomfort. ### Response: Never try to stretch any body part or full body in a first. if given a try the same will happen. stretching needs to be done on regular while doing exercises and can be extend day by day not by once. anyways dont worry about the low back pain here i will suggest you exercises which at first you need to do slow without any pressure for a week. then after a can do little fast, this will improve your muscles strengthening of lower back. apply the ointment to the area of pain, cover it for about 10-15mins with a cloth, then clean it with warm water following hot water fermentation. then do the following exercises. all the above exercises to be done carefully atleast once a day for 10 days. do not put pressure if pain is severe. diclofenac ointment to be used twice a day. Take Accelofenac+ paracetamol ( Zerodol P) for three days. once a day. slowly the range of motion will increase after a week. follow up after a week." "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 38 weeks pregnant. According to a color Doppler scan, it was mentioned as a single loose loop of umbilical cord noted around the fetal neck. The estimated fetal weight is 3229 g. The EDD is towards the end of this month. I wanted to ask if there are any problems and kindly mention the precautions to be taken. ### Response: Hi. If the other sonography is normal, then you should not worry about it. Wait up to the expected delivery date. If pain starts before that, then let the delivery happen. Just have to monitor fetal heart rate throughout the labor. If at any stage heart rate goes down and up and the doctor thinks that it is because of fetal distress, then do an immediate cesarean section. Otherwise, normal delivery can happen. Do one ""NST"" (nonstress test) nearby at your gynecologist. If the test is good, then the baby is completely fine and there is no stress on the baby due to the loop of cord at present. So, you can wait further. If you are going to try for normal delivery, then just see that the hospital has a good fetal monitoring system." "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 taking Tadalafil as we are trying to conceive a child. I used to take Sildenafil Citrate but switched to Tadalafil a few months back. There are certain days when besides taking Tadalafil or Sildenafil I am unable to maintain an erection. This could be either due to low sex drive as this has become a routine chore or anxiety to conceive during ovulation so as to not miss the cycle.Under such circumstances is it recommended to take Tadalafil and Bupropion together? If Bupropion is advisable then how many hours before sex should I take it? Can I just take this tablet on days of conceiving? Do you suggest any other alternative besides Bupropion? Taking Tadalafil is giving me side effects like dry mouth and dry eyes, especially while sleeping. The side effects reduce a bit after a few days but continue up to the next cycle. Is there anything I can do to reduce the side effects? ### Response: First, I would like to know the frequency of intercourse and the days on which you are trying for pregnancy. I mean, do you have sex every day during those days? Once every other 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 have one-sided swelling near labia majora since one month. I am an unmarried 26 year old female. There is no pain or discharge. I tried warm compress and Candifem ointment for seven days, but there is no much improvement. I have attached photos for your reference. ### Response: From the attachments (attachment removed to protect patient identity) and your history, this seems to be a Bartholin\s cyst. It is swelling of the Bartholin gland situated in the labia majora. It is a benign condition." "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: What are the symptoms of brain cancer and colorectal cancer? One more thing, if I eat turmeric every day the chances of cancer will be reduced or not? Can it be cured in Ayurveda? ### Response: Hello. I just read your query. See there are a number of symptoms which are linked to both these cancers. Moreover, in initial stages, some patient might not feel any symptoms. As far as turmeric is concerned it has many properties including anti-cancer properties. But it can not be guaranteed that taking turmeric alone will help you in not getting any disease in future. Yes, Ayurveda has treatment for cancer but it depends on the condition of the patient" "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 59-year-old female. I have discolored patches on my hip that just recently developed. Within the last month, I have had CT stomach, routine blood work, X-ray but they all returned normal. I do have chronic stress and I have been constantly losing weight and usually go to pass stool two sometimes three times a day. The stool is usually semisolid and there is frothy pale yellow liquid in it. I am not sure what is causing this discoloration, but I am really concerned. ### Response: There are a number of causes of pigmentation, but you have not provided a picture to look that what type of pigmentation you are having. In my opinion, send a picture or see a doctor physically. Also, inform if other sites are also involved" "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 trying to fix my general teeth and gums, I have managed to get rid of the yellow plaque after a few days. However, after brushing gums excessively, ulcers have appeared, and my gums have swollen slightly and are very painful. I was wondering how to fix them and how long it will take? ### Response: Actually, you have gum infection (gingivitis). It is common and curable. First thing if there is any hard deposit then you should see your dentist for a professional dental cleaning. Maintain proper oral hygiene like two times brushing, flossing at least once a day, do not use any type of tobacco or smoking, change your toothbrush every two months and use proper brushing technique. These instructions help you to maintain healthy gum and 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: I got back from a trip yesterday, and have since had stomachache problems. I have had nausea, a stomachache (which sometimes feels like heartburn in my lower stomach), gas pains (that do not go away permanently), and a pretty severe loss of appetite (although I have gotten hungry and eaten some). I also had diarrhea, which is why I am somewhat worried, as I have not had diarrhea for years, and was somewhat constipated beforehand from eating too much. I am somewhat worried about appendicitis (it does hurt mildly when I push on my lower right stomach), but it could just be the stomach flu. I am also taking Malarone if that is at all relevant. ### Response: Hello. The symptoms you are describing are mostly suggestive of bacterial gastroenteritis (commonly called food poisoning), which is the bacterial infection of the intestine. Stool analysis and culture are required to confirm the diagnosis. Management is with antibiotics (usually a combination of Ciprofloxacin and Metronidazole) for which you will need a prescription. So, please be advised to follow up with the urgent 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 headache, back and right chest pain, nausea, vision blur, and dizzy. MRI brain suggest supravermian archanoid cyst (2.2 x 1.6 cm). MRI spine suggest straightening of the cervical spine, scoliosis of the upper dorsal spine, decreased L4-L5 disc space with mild vertebral waist probably congenital, right posterior lateral osteophytosis at the L4 and L5 level causing right neural foraminal narrowing. Please suggest. ### Response: It is fine about the report. Please explain the symptoms that you are suffering from. Then I will explain about the report." "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: The PET scan report says that the metabolic activity brain appears metastatic. Does this confirm that the patient has advance cancer? ### Response: Hi. Revert with more details. I need also pathological and treatment details. Usually, if brain is involved with multiple lesions, it is considered advanced malignancy." "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 unsafe sex with my girlfriend. I am sure that I did not ejaculate but she did take an i-pill for safety. We had sex for the second time and now I guess that I might have ejaculated and so she took one more i-pill. So, in total she had two i-pills in a time gap of two hours. Now she did miss her periods. Is there any chance that she is pregnant? ### Response: If she has taken the i-pill within 24 hours of the intercourse and in her case twice within a gap of two hours then she has doubled the concentration of progesterone. As she has taken two it may be delayed by a few days, but chance of pregnancy is minimal. If seven day period since the intercourse have been crossed then you may do a serum beta hCG test to rule out pregnancy for confirmation and to settle anxiety. If the test is negative then she is surely not pregnant and then she can wait for her 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: My wife is having a refractive error of more than 6 in both the eyes. Please suggest various treatment options available. ### Response: There are many treatment options available for management of this condition. The most popular and most frequently done are laser refractive surgeries like LASIK. The surgery is very safe and you can undergo the surgery to get rid of refractive errors. Please mention her full refractive power, whether it is plus or minus and age of the person so that I can advise if she is fit for the surgery. 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: I used cocaine for six months but for four months, I have coughs and phlegm especially in the morning. I never had throat pain. It just feels itchy. I saw a doctor who gave me allergy spray with Cortizon but I took it for just one month. I keep drinking alcohol and cold drinks which makes me feel irritated in my throat again. Only used cocaine twice in last two months 1 g each. I will stop completely as am almost there on my withdrawal. I saw another doctor, she did all TSD tests and it was all clean. I got a bacterial infection in the throat so, I do salt and hot water gargling. The symptoms are less than before but I am still worried about my coughing. I am afraid of cancer as I had taken chemotherapy two years ago for histiocytosis X. Any suggestions, please. ### Response: Hello. The picture (attachment removed to protect patient identity) that you have attached shows slightly enlarged tonsils with granular pharyngitis. There is nothing to worry. Your symptoms are due to chronic irritation of your throat which could be due to rhinosinusitis or reflux or recurrent tonsillar infection. Chronic throat irritation is a cause of a chronic cough." "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: Hello, I am 21 years old with a prominent pulmonary stenosis. My work is staying open during the COVID-19 pandemic and are wanting to know what employees will work. I feel like if I say I don't want to work they may hold it against me in the future. It is Family Video so people are constantly coming in and out and touching things. My county just had their second confirmed case and the patient was around many people during the time before she was diagnosed, therefore going to spread quickly ### Response: So if you get covid infection than course might be aggressive in you. Your country as mentioned not reach at stage where complete lockdown needed. However it\s good if you can avoid contact with other individual and if you can stay at home with your family. Surface contact, hand shaking, kissing all can also favour spread of covid. So avoid close contact and use frequent hand sanitizer." "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 28 year old male. I have a dull pain in my right testicle leading to my abdomen. I believe it started when I lifted something heavy. At the moment, it is a dull pain but, if I feel it, then it is worse. I am currently out of my home country on work and do not want to go to a local hospital as I am concerned about the hospitals here. If you could advise, I would be grateful. ### Response: I understand your concern regarding a pain in the right testicle after lifting a heavy object. Avoid lifting heavy things for now. Best wishes" "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 got scanned her thyroid by a novice user just for training purposes. She has been scanned in the hospital before, as part of an assessment of an autoinflammatory disease. At this time, they found a thyroid nodule (~12 mm) but no further investigation, as it seemed benign. Now, at the training scan, we observed the nodule had changed in shape, size, and it looks like there are some microcalcifications. But we are not the experts. We noticed it has changed. Could you give your second opinion on the attached images? ### Response: Hello. According to the american college of radiology thyroid imaging reporting and data systems (TIRADS), the nodule falls under category TR4, which defines it as moderately suspicious. However, as you mentioned, there is a change in morphology with the development of microcalcifications. Microcalcifications are the feature of papillary carcinoma of the thyroid, and therefore, it is essential to rule out that for which a fine needle aspiration cytology and biopsy (FNAC-FNAB) is recommended. Further, I would like to know if any necrotic neck nodes were detected. Let me know the results. I hope and pray that the nodule turns out to be benign and not malignant. FNAC-FNABUltrasound guided fine needle aspiration cytology and biopsy. Papillary carcinoma of thyroid and benign colloid nodule." "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 20 years of age with weight 64 kg and height 160 cm. I had my periods for three to four days with mild bleeding on the fourth day. Now for the past two to three months, I am having periods with heavy flow for two days and mild bleeding on day-3. The doctor suggested PCOD test. My hormone levels are normal with testosterone and insulin in the normal range. Also, I do not have any unwanted growth and no acne problems. Can I still have PCOD? Also, I do not have diabetes or thyroid. Please give me a conclusion as to what has happened. ### Response: A regular period can range from three to seven days duration, with bleeding being mild to heavy on all or any day. A period can also return monthly or between 21 to 35 days. Your period may have changed in length and days on which heavy bleeding occurs but it still falls well within the remit of a normal range. All of your investigations have been normal. A change in period history can be normal in young adults and can happen in response to any change in physique, as well as emotional and physical state. I would not be worried, neither is any treatment warranted based on the history you have presented. This is a normal change" "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 increased signal intensity within the cervical cord at C2 and C4 levels. The cervical discs have degenerated with some loss of normal disc height and hydration. What does this mean? I also have multiple sclerosis. My current medications are Gilenya, Amitriptyline, Omeprazole, and Venlafaxine. In the past, I have been on Lyrica. Please help. ### Response: Hello. I would like to know if you have performed any brain MRI (magnetic resonance imaging) study. These lesions in the cervical spine could be related to many possible causes. They could be MS (multiple sclerosis), cervical myelopathy, myelitis, or neuro infections, etc. The diagnosis of MS should be done based on some specific neurological criteria, which include multiple lesions like this in the white matter of the brain. Besides, the diagnosis is also based on the medical history (clinical relapses with neurological deficits which have improved). In such cases, a lumbar puncture would also be necessary. In such cases, there is also stenosis of the cervical spinal column at this level. The main differential diagnosis should be done with cervical myelopathy" "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 it possible to be color blind to the color black? Like seeing a different color other than black? ### Response: Hi. No, you cannot be color blind to black or shades of grey. They do not follow any rule like in congenital color blindness and can affect any spectrum of colors. In whatever the case, no one is blind for black or grey, and in fact, they see the colors they are blind for in shades of black and grey." "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 has received a diagnosis of borderline personality disorder. She has been suspended from work on an allegation of serious breach of health and safety which could lead to dismissal. We are trying to investigate whether her diagnosis could have impacted on her actions. She has basically sent a fitness programme to a client for them to carry out at home when the process is for them to come into the leisure center and somebody go through the programme with them. These clients have high-risk health conditions. My partner has done this but in her view was only trying to be helpful to the woman and did not realize that this was not allowed. In your opinion could her BPD have impacted on her actions? ### Response: Hello. I have gone through your problem and understand your concern. Yes, Borderline personality disorder can impact her behavior. Also, there can be micropsychotic episodes in BPD person. So, it depends whether she has such an episode or not, also sometimes, the behavior is out of proportion to that situation in BPD person. 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 do not know why but I make a virtual world for myself. I always fake things about myself, tell untrue stories. When I remember people, like my ex-boyfriend, I imagine a conversation between me and him that had never happened and I feel happy. I keep imagining all that I wanted to do but have never done. I talk to people in my mind. I meet them, I see them, I laugh and cry in my mind. I am tired of imagining and failing in everything in real life. I even sometimes imagine the conversations with dead people. ### Response: Hi. People use imagination as a defense or escape from reality. Some degree of imagination is alright because it makes us imagine a goal, feeling of happiness, if achieved, hence motivate a person for a target or goal but the use of excessive imagination can lead to wastage of time and serve as a distraction from your real life goals. You can reduce this by giving some aversive stimulation to yourself like a tyre rubber band in the hand bullet as much as possible so that you feel pain when you will stop doing this. Set a goal in real life and be passionate about it. Try to achieve it at any cost. If you still find it hard to overcome, then I would advise you to consult a local psychiatrist." "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 58-year-old man and I had a CBC with differential 10 days ago. I donate blood about every two months. I have been taking daily Metamucil for about three months and testosterone shots. My level is 930. All other tests are quite normal except HDL cholesterol which is low. I stopped drinking alcohol three months ago and anion gap was 6. I am on 12.5 mg of Atenolol, Amlodipine 10 mg, Irbesartan 300 mg once per day for hypertension. My BP is 123/76.I had flu-like symptoms at first with no congestion two weeks ago. I have bad joint and muscle aches. That went away. Now, I have fatigue, slight shortness of breath with numb hands and feet at night in bed. I have experienced symptoms of fatigue, slight shortness of breath at rest, hands falling asleep when I wake up at night. Even though the RBC is normal, do you think that the lab test below indicates iron deficiency anemia?The results of the CBC are as follows:WBC\t3.47 K/uL 4.00 - 12.00 K/uL\tLRBC\t5.70 mil/uL 4.50 - 6.00 mil/uL Hgb\t12.8 g/dL 14.0 - 18.0 g/dL\tLHct\t42.1 % 40 - 54 % MCV\t73.9 fL 80 - 98 fL\tLMCH\t22.5 pg 27 - 33 pg\tLMCHC\t30.4 g/dL 32 - 37 g/dL\tLRDW\t15.1 % 11.5 - 15.0 %\tHPlt\t183 K/uL 150 - 450 K/uL Differential type\tAutomated Abs neuts\t1.86 K/uL 1.80 - 7.80 K/uL Abs immature grans\t0.00 K/uL\t0.00 - 0.05 K/uL Abs lymphs\t1.12 K/uL 0.80 - 3.30 K/uL Abs monos\t0.37 K/uL 0.10 - 1.00 K/uL Abs eos\t0.09 K/uL 0.00 - 0.40 K/uL Abs basos\t0.03 K/uL 0.00 - 0.20 K/uL Neuts\t53.5 % Immature grans\t0.0 %\t0.0 - 0.6 % Lymphs\t32.3 % Monos\t10.7 % Eos\t2.6 % Basos\t0.9 % ### Response: From these test results, you appear to have microcytosis and hypochromia of the red blood cells. This is most commonly seen in iron deficiency anemia. I would suggest you take iron and folic acid tablets thrice daily after meals for at least a month. As for the numbness of hands and feet, this could be a sign of vitamin B12 deficiency. Are you a vegetarian? If so then this could be a reason for the numbness. The other symptoms that you have described are consistent with iron deficiency. I would also advise you to not donate blood until your blood iron levels and ferritin stores are normalized" "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 childless woman for the past six years after marriage. Recently, we went to an IVF center. All my reports and my partner\s reports were normal. The doctor prescribed me medicines such as Letrozole, Metital, Supradyn, Folmet, and Meprate. I am confused about Meprate. I am maintaining a calendar to track my menstrual cycle so that intercourse during ovulation can increase the chances of pregnancy. How are Meprate and intercourse related? Please guide me. ### Response: Most of the medications given in the process of treatment help in having a regular menstrual cycle, regular ovulation, and to get rid of irregular periods and to support conception. Meprate is progestin. It will act as progesterone which reduces the overgrowth of endometrial thickness, and they help in ovulation. They are given in patients having irregular cycles. After ovulation, it helps in conception. For quitting the medications, you have to consult your treating doctor. Have folic acid regularly." "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: Hello,I am 30 years old male. For the last 1 week, I am having severe itching inside my penis head and bottom side. And while urinating it becomes very severe. When I wash it with hot water and soap, I could not take my hand out of my penis as the itching is heavy, so I had to massage my penis head a lot to control that. After using fourderm ointment outside the itching area, it is little bit in control. But the itching everytime starts again after I urinate. I do not see any visible difference outside the penis that is causing this itching and I do not see any discharge also. I had sex with a friend 2 weeks ago and used condoms. After 2 years I used condoms this time. I am not sure whether this is caused by any infection due to the condom or any other infections such as STD from my partner. I do not know whom should I consult for this issue, an Urologist or a Sexologist? Kindly help me get rid of this itching. ### Response: First of all get one urine routine test and Fasting Blood Sugar test done. Your problem could be either a fungal infection or a reaction to the condom. I advise you to take consultation with a urologist 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 bleeding heavily from my vagina for past five days. It only happens when I either open my bowel or while urinating. I put in a tampon to confirm that the bleeding is coming from my vagina and not from rectum. When I am not using the bathroom there is no bleeding and no blood on underwear. But, as soon as I urinate and have a bowel movement I start to bleed. It is not just spotting. It is a heavy bright blood to sometimes dark heavy blood. It reminds me of my heavy days on my periods. I am nowhere close to my periods now. I am taking birth control and have been getting my periods correctly each month. This bleeding is not a consistent flow. It only happens when I use the bathroom. It is like I have blood pool above my vagina and the minute I push a little to pee or have a bowel movement it spills out. I do not have period cramping. But, the pain will be like a dull, achy to sometimes sharp pain, especially when the blood comes out. It radiates all over my pelvis, ovaries, stomach and back sometimes to my kidneys. I did consult a gynaecologist earlier today. He pressed on my stomach in which I had some discomfort. He also did a vaginal exam and said there was a lot of mucus with blood. When pressed inside, I felt little discomfort. He did a swab and sent it out to be checked for infection and prescribed me some antibiotics just in case it was an infection. He also scheduled me an ultrasound for next week and wants me back in two weeks. He told me to come back sooner if it gets worse. He seemed quite concerned. This evening, I have started to become more dizzy and lightheaded. Could this be just an infection or something else? I do not have itchy or burning vaginal symptoms that you get when you have an infection. I am really worried about this. I am scared of cancer now as I knew that the abnormal bleeding and pain are signs of reproductive cancer. So, I need a second opinion from another doctor while I am waiting for the results. ### Response: Hi I believe this is the first episode of heavy intermenstrual bleeding or polymenorrhagia for you and during the mid cycle. If the bleeding is not controlled and remains heavy causing anemia and dizziness as manifestation then to stop the bleed the best way would be to undertake a dilatation and curettage procedure. Through which can remove the endometrium and subject sample for histopathological exam to rule out any endometrial hyperplasia and accompanied atypia, which may indicate towards an endometrial cancer depending on the reports. At present, wait and watch for excessive bleeding for few more days and if it does not reduce then review with ER and get the ultrasound done sooner and further 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 had a blood sugar reading of 125 this morning. I had last eaten at 11 PM. Am I diabetic? ### Response: Take a high-fiber, low-fat diet with enough proteins. Take small meals at regular intervals of two to three hours. Avoid outside food completely" "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: Lately, I have been aroused and sexually attracted to my fiance in my head, but when we start to fool around, I feel like I do not want him to touch me. Like he is a family member and not my fiance. We have also only fooled around maybe 10 times in the past year. We have been together for two years. ### Response: Hi. Your query shows that you are experiencing mixed kind of emotions and need some help. The reported problem is different than the one you are going through. There is more to it which needs attention. The relationship is yes, a problem at present. That may be because of what you had been dealing with. It happens when we struggle with something, it takes time to come back in a normal routine. Also, you need to discuss openly with your partner if you have any questions in your mind about his life. Without them being cleared, your mind would be preoccupied." "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 trying for a baby for the last eight months. The monthly disappointments are driving me crazy. I feel so low and like a total failure. How do I ensure that I do not spiral into depression? My husband is supportive and encouraging, but I end up crying each time I see or hear news of a baby. ### Response: You should, first of all, reassure yourself that if you will have sexual intercourse in a relaxed and stress-free mind then this will yield the best results. If you will do sexual intercourse in anticipation of the baby then you will remain stressed and this will make negative results. Stress too is one cause of poor fertility. You should spend more time in foreplay with your husband. Have more sexual encounter during a fertile period of the menstrual cycle that is during 12th to 16th day of the cycle (the first day of the cycle is the first day of bleeding). Keep your both legs up while you will remain lying down after ejaculation. This will prevent the leakage of semen. Remain in this position for around 5 to 10 minutes after sex. This will also help you a lot. Just do not lose your confidence. Just keep one thing in mind that you are healthy and you will have a baby without many issues. Try to spend more time in doing constructive activities. Avoid spending more time on the internet because this increases stress only. Light exercise in the evening too will lift up your mood. Do not get irritated on your family members which could happen in depression. This will help you. If needed, visit a psychiatrist for help." "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 tonsil stones and I am very much irritated by them. Can you please tell me how to cure them and how to prevent them? I have not taken any medicines until now. ### Response: Hello. Tonsilloliths or tonsil stones are formed due to deposition of lime salts in tonsils after blockage of crypts in tonsils. Treatment involves removal of stones by an ENT (ear, nose, and throat) specialist. Recurrent stones are treated by tonsillectomy. In the meanwhile, you can start Betadine (Povidone Iodine) gargles three to four times a day. Consult your specialist doctor, discuss with him or her and with their consent take them" "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 25 years old, boy, my height is 158 cm and weight is 61 kg. I am suffering from motion problem. My motion is not proper. It is getting too hard and timing is not proper I feel, something like ulcer is there inside of my anus. Please help me. ### Response: You feel pain when you use the toilet, and always hard. You need to take enough water, fruits and vegetables in your diet to soften your stool. You need a lot of fibres in your diet. For the ulcer like symptom as if there is a wound in your anus, that may be making you to go to toilet for fear of pains after use of toilet, in turn it makes your stool get harder beause you do not go to toilet when you ought to. It is likely that you have anal fissure, which is responsible for the pains and in turn constipation is there steaks of blood too in the stool. What you can do is take Liquid Paraffin 15 ml thrice daily, that will help soften your stool. Apply topical Lignocaine local anastesia on the anus to relieve pain. Do warm sitz bath. Put plenty of salt in warm water, add a disinfectant containing Chlorhexidine to it and sit on it. Do it thrice everyday, and after using the toilet. It will help to sooth the discomfort and relax the nerves around anus." "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 period started a month back and I have a regular cycle of around 32 days. I am trying to conceive and I also noted date during ovulation and implantation dip but suddenly a few days back, I started to bleed which was dark brown in color initially and the amount was less than periods. Next day, some more bleeding with clots and on the third day. I had very dark little spotting and in my life, I never had my periods earlier than the date. What can I conclude from this? ### Response: Hello. If you are trying to conceive, there is always the possibility that you are indeed pregnant. However, it is just a month and at this point, it is too early to tell what is going on for sure. The light bleeding could be implantation bleeding or it can be regular periods, just a lighter version. However, it can also be a chemical pregnancy that did not last. What I am going to suggest is that you wait a few more days and get a home pregnancy test done. If you experience symptoms of early pregnancy like feeling tired, abdominal pain, feeling dizzy, nausea or more bleeding, get a USG 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: One day ago, my partner and I had sex. And the next morning she takes Azithral 500 mg. Will this affect her pregnancy? When do the female egg and male sperm actually connect with each other? ### Response: So, it is not going to harm in any way. Moreover, after intercourse, the sperms usually take 24 hours to fertilize the egg in the fallopian tube if it has already been released. The life of the egg is also 24 hours. So, if there is a conception, still the medicine would not affect the fetus. Regards" "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 30-year-old female. My skin is dry, rough, and having pimples. I want to know the right cream for my skin. Currently, I am using Palmolive shower cream and all clear fade milk lotion for my skin. ### Response: The skin has reduced water retention capacity, and thus, there is increased transepidermal water loss. Moreover, the skin of the outer thighs, buttocks, upper outer arms may also have keratosis pilaris, which appear as rough, conical papules or pimples and are due to keratin plugging of hair follicles. I would suggest you use a cream containing keratolytic and hygroscopic agents like ammonium lactate, urea, etc., as a moisturizer twice daily. Ammonium lactate is available as a cream by the name of Amylac cream 12%." "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 CAD patient for the past 10 years with 50% blockage. I have uploaded the image for your reference. I am taking Prolomet XL 50, Monit SR 30, Deplatt A 75, Lipicard 160 and Amixide H. I am suffering from headache since one year. My neurologist prescribed me Tryptomer 10 at first and then changed to Zapiz. But, my headache has not reduced. My scan report is normal. I am in a trouble with this continuous headache. Is it a side effect of my cardiac problem medication? How to get rid of this condition?I also suffer from mild chest pain. Recently, I had a blood test and all are fine except lipid profile, HDL cholesterol 36 and SGPT 91. Also, my red cell distribution width is 16.2 and the normal range is 11.6 to 14. So, is my value dangerous? I had Deanxit for 5 years, according to the prescription and stopped before 2 years. Is my heart disease dangerous? Please help me. ### Response: I have gone through your query in detail. There are certain things that would need more clarity for a complete diagnosis. First, it is strange that you have a blockage at such young age. I would suggest that you should get yourself revaluated for CAD (coronary artery disease). The possible reason for the headache is your medicine Monit SR (Isosorbide mononitrate) can be a cause of headache. Nitrate headaches are well known and we would need to see if this is the reason in your case. Also, since you have CAD at such a young age, there can be a possibility of carotid artery blockage which might be giving you a headache. Get that evaluated. Revert back with the reports to 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: My 49-day-old son has not passed motions for the past two days. The last time I used Glycerin for three consecutive days as he did not pass motions for three days. He is only breastfeeding. Please help. ### Response: It is very normal for a newborn or infant to not poop every day. Some of them pass motions only once in five days also and some even extend beyond that. We should intervene or treat babies who have discomfort or straining to stool else no treatment is required. Babies will pass stools themselves. Another thing you can do is you can boil raisins in water and give that water. It helps in bowel movements and helps pass stools. Glycerine suppository is rarely required and not to be used on a regular basis" "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 severe LVH due to anabolic steroid abuse the past two and a half years and training for more than three hours a day. I have made lifestyle changes and lost weight but my anxiety now gets the better of me. I have a family history of bradycardia my RHR is 40s and high 30s when I sleep or first wake up, it does not cause any symptoms other than freaking me out. My diastolic will dip into the 50s due to the Lisinopril, and that stresses me too. I live in constant fear of dying early, very early. Are my issues something you can come back from or even reverse? Would I have to stop exercising completely to make my heart shrink? ### Response: Hello. I passed carefully through your history and would like to reassure you that there is no reason to panic, as long as you have stopped physical training and anabolic steroids intake. You should know that LVH (left ventricular hypertrophy) is quite reversible in such a case after some months from stopping straining physical activity and anabolic steroids. So, there is no reason to worry about dying early. I would just recommend continuing light physical activity. 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: My HSG report says bilateral hydrosalpinx noted with a free peritoneal spill on the left side. What does this mean? Can I conceive normally? If yes, then how? I have hypothyroidism, which is under control. I take Eltroxin 100 mcg and 75 mcg on alternate days. Please help. ### Response: How are you doing? I have seen your report (attachment removed to protect patient identity). Hope I have clarified your query, do write back. All the best" "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 take a second opinion about my mother. In her ultrasound, it was diagnosed that she had gall bladder stones. There was no pain but it was accidentally observed in the ultrasound. We waited for three years, but then, later on, one of my friend's mother developed gall bladder cancer which was fatal. This incident prompted us to take a second opinion. And this time, the doctor also suggested that gall bladder should be removed because the stones might create problems in pancreas. Therefore we had her operated and the gallbladder was surgically removed. After the operation, biopsy of the gallbladder was also done. (All the relevant reports are attached the pre-operative medical tests are also there. In one of the reports in history, it is written that patient gives a history of pain in abdomen, complaints of acid peptic dyspepsia. She had no pain in the abdomen and no problem of gas or indigestion before the operation). After the operation, she had pain in the operation area which was healed later on.She has had typhoid thrice and TB once when she was young. She had chikungunya type fever last year which was negative for chikungunya tests, but the doctor said it might have been chikungunya and the tests might not have been done in the right time period that is why they came negative. She also takes medicines for blood pressure, knee and joint pain (calcium), cataract, homeopathic medicine for nose polyp infection.Here are my questions: The biopsy report says the impression of chronic non-specific cholecystitis, should we worry about it? Is chronic non-specific cholecystitis cancerous? My mother faced gas problems after the operation which became normal after a week or so and rarely she has that (like recently she had some dal paratha which was oily and caused the gas). Is this normal? Would she be frequently having gas incidents since her gall bladder is removed? We never did a biopsy of the gall bladder stones, should that also be done? ### Response: Hi. Having gone through the reports (attachment removed to protect patient identity) I just need to reassure you that the surgery was done by a world class surgeon. Reply to your queries: No need to worry about non-specific cholecystitis. It is not a cancerous lesion. If she avoids fried and fermented meals then there will be no issues of gas. Stones are analyzed not biposed but it is fine if that was not done. Type can be interpreted from the gross appearance but anyways it does not affect management. 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: Due to scratch in my eyes the white part surrounded with blood. What to do? ### Response: Hello. How did you get this? Because of the bleeding, the depth of the wound could not be perceived. If it is not severe enough just with bleeding there is not much problem. Just the point of worry is that the wound should not be open or otherwise it may be problematic and may require suturing. So you should seek emergency advice as well so that somebody can examine 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: I took an overdose of my late mother\s Morphine sulphate tablets which resulted in hypoxic brain damage and this resulted in me having these uncontrollable tremmers in both my hands and jaw. Now I have been prescribed Pregabalin 50 mg daily but have just recently been giving a few Valium which stopped my twitches in my hands and jaw and I think these would be beneficial to me but I do not know what to say to the neurologist. I do not want him thinking that I am going to abuse them which I will not. But I do not know how to go about trying to explain that they really are helping me. ### Response: In view of the symptoms you have been suffering with, your diagnosis fits into a case of essential tremor which is the most common movement disorder associated with trembling, there is sometimes shaking of fingers, hands, and head. According to guidelines, Pregabalin and other" "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 abdominal pain during urination for two days. And also having pain in abdomen lower part during sex. And after that only, I am having pain and burning sensation during urination. And also I have to go urgently for urination. I am frequently going. I already had this experience for two months. And it lasts up to four days. It gradually reduced.Why am I having this? In the future, what are the risks and causes because of getting like this. Is there any effect on pregnancy in the future? I want to cure this permanently. What should I have to do? What food I have to take? I do not want to visit the hospital for this problem. Please suggest a full solution to this problem. Please prescribe if any medicines are there. I want to get rid of this permanently. Please help. ### Response: This is most likely due to urinary tract infection. There is no risk of getting stressed due to that. UTI can occur in any female, but the risk increases after sex. But that does not mean that you should not visit a doctor. You can visit a doctor with complaints of burning micturition and for the pain in the abdomen. If you do not want to disclose your sexual history, that is your decision, urine analysis should be done to rule out infection. Antibiotic course with some precautions like avoiding sex during treatment, having plenty of water will help to improve the infection. This will not cause any risk or complications in the future if you take proper treatment. Remain relaxed. Antibiotics cannot be prescribed online due to legal problems." "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 26 year old male. I am working in the night shift since last six months due to which I have a sleep disorder and constipation problem. I cannot sleep more than three to four hours in a day and I have lost my weight. Please suggest me to recover. ### Response: Hello. Adequate sleep is essential for proper functioning of the body and as a result of prolonged lack of adequate sleep your body\s circadian rhythm has been affected. Hence constipation and even weight loss. I am assuming you may have lost a bit of appetite or cannot eat on time either. Now, it is important to get six to eight hours of sleep every day. Even if you cannot sleep at night, you must ensure at least six hours of sleep by making up during the day. Also, try to get some meditation or yoga which helps immensely in these cases and helps to restore the body\s circadian rhythm. Half an hour of meditation if done properly equals to two hours of sleep. And take your meals on time. If you have to do night shifts at a stretch, please ensure that you get to sleep during the day and also do mediation. Hopefully this will help." "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 hard swelling measuring 3/4th finger size from anus on the right side. It hurts while sitting. It started developing five days back and was worst since yesterday. The entire nearby area is sensitive and slightly painful. For your information, I underwent surgery for anal fistula on the left side 52 years back.I have type II diabetes for past five years and BP for past 12 years. I am 82 years old. Kindly suggest medicine, ointment or injection for instant relief from pain. ### Response: It looks like you have a right perianal abscess. You need to start antibiotics too as you are diabetic which increases the chance of the infection. My antibiotic preference would be Augmentin duo (Amoxicillin and Clavulanic acid) 1 gm twice daily for five days or Ciplox-TZ (Ciprofloxacin and Tinidazole) twice daily for five days. For pain, you can have tablet Ultracet (Acetaminophen) 1 three times a day or as needed. Consult your specialist doctor, discuss with him or her and take medications 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 had a dog scratch on my foot. So, I took tetanus injection on my upper arm after which I was feeling pain and swelling on my upper arm which remains to continue for four days. What is the cause of swelling and what should I do? ### Response: Hi. I understand your concern. TT (tetanus toxoid) injection can cause mild side effect, like swelling in the injection site, pain, redness. However, the side effect can last from four days to seven days. If the swelling still persists please get back to your doctor to have a look. Few things that can help decrease the pain could be taking NSAIDS like Paracetamol, rotate a warm pack off and on the injection site. 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 took 875 mg of Amoxicillin in six hours. I did not realize it was supposed to be over 12 hours until I was searching until now. It only said two times a day on the bottle. I also had 500 mg of Acetaminophen with it. Will I be fine? ### Response: Hello. A dose of Amoxycillin at 20 years of age is around 1500 mg per day. This total of 1500 mg can be divided into two of approximately 750 mg or three doses of about 500 mg." "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 used Panderm NM. After I left using it, I got scars and pigmentation on my face. Now, I am using UniWhite Cream for pigmentation. Will this work? Should I use something else? Can you suggest something without steroids and Hydroquonine and without any side effects? ### Response: Panderm NM (Clobetasol Topical, Miconazole Topical, and Neomycin Topical) cream is the most harmful cream when applied to the face. It has steroids. The steroid causes thinning of the skin, pimples, visible blood vessels, increased hair growth, secondary bacterial skin infections, and a flareup of herpes. The effect of this cream will last for a few weeks depending on the duration you have used. It is very difficult to nullify the effect of steroid on the skin. After stopping the cream, pimples, pigmentation is the most common rebound effects. I would suggest you use: It is very difficult for me to prescribe any medication without seeing your clinical picture. I have mentioned general skin care products to be used after steroid abuse. Kindly attach your clinical picture along with your query for precise diagnosis and 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 sciatica. I also have nerve pain in my face coming from my neck which stops me sleeping on my back. If I sleep on my shoulder, I get soreness on the shoulder. I have insomnia and cannot find the right position to be able to sleep. Could you give any advice? I put ice on my neck which temporarily relieves the neck pain and deep heat massage on my shoulder. Stomach sleeping is not recommended for people with back problems. Is there some solution to this problem? ### Response: Hi. In this case, there is no best position for sleeping. Instead, the way you are sleeping in every position that will help you. 1. Sleeping on the back - the pillow under the neck should be shallow enough to support the neck in one straight line. Keep a pillow under both the knees so that back is supported completely. 2. Sleeping on either side - the thickness of the pillow should be equal to how broad your shoulders are so that the head and spine be aligned. A pillow between both the arms to support the shoulder from following to either side might help. A pillow between the knees also. Keep changing the sides" "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 19. I am partly a mouth breather since childhood. I mean, I breathe through my mouth only while sleeping. Is it harmful? Will I get sleep apnea? I am a thin guy with no snoring issues. ### Response: I just read your query about mouth breathing. I would like to say that yes, eventually it causes enlarged tonsils as well as adenoids, and causes a nasal obstruction leading to obstructive sleep apnea. It can happen in any body type. If your nose is blocked because of nasal polyps or a hypertrophic nasal mucosa leading you to breathe through your mouth, then you must visit an ENT (ear, nose. and throat) specialist to correct the issue. Hope you find my advice of some benefit. Good luck" "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 24 years old. I am suffering from a neurological disease and due to this I am getting weak day by day. My toes are gone almost numb since last two years and the same things are now happening with the upper limbs. I had this disease from childhood, but in a progressive state. So, with time my health degraded constantly. It started affecting my lower limbs. Now, I cannot even walk or stand properly. Now, it started affecting my upper limb as well. I cannot lift heavy objects due to weakness in grip and cannot do any manipulation by fingers quickly such as typing, writing, etc. I have been treated in various hospitals since my childhood. Currently, it was predicted as vasculitis neuropathy and getting treatment accordingly. I have gone through various treatments till now, but unfortunately nothing worked. Now, my doctor suggested me an injection called Rituximab, which can possibly stop the growth of this disease. The two dosages of this injection are quite expensive and due to this we are worried that how much safer is this injection to me. Hence, I thought that I should take an opinion from you before taking this injection. Could you please suggest me your opinion by looking at my attached reports, Is there any possibility to cure this rare disease or at least to stop the growth of this disease? Should I go for this Rituximab injection? I know, it would be a challenging task, but please spend some time and share your thoughts. I have attached my reports, prescription and life history from childhood. Any suggestions would be really helpful to save my life. ### Response: Hi. I am here to help you. First and foremost, I would like to congratulate you for your excellent narration and detailed documentation of the prescriptions and reports (attachment removed to protect patient identity), which has enabled me to have a good understanding." "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 had an echo done a month ago. It came back normal. I was reading my finding and I saw it was an enlarged ascending aorta at 3.7. They never said anything about that. So I got an appointment to go to a heart doctor and he looked at my echo and said everything was fine. But I told him I would like a CT scan with contrast to see was this true. So I did my CT chest with contrast. It came back with no finding, no aneurysm and my ascending aorta was 3.3. Is the CT more accurate or could the contrast block it? I am just asking. This is confusing to me. ### Response: Hello. Regarding your concern, I would like to explain that contrast enhanced angio CT is very accurate at delineating the aorta anatomy, its dimensions and any possible abnormality like enlargement or aneurysm. As your CT scan has resulted within normal ranges you should relax and not worry about it any more. You may perform an angio MRI after a distant period (after several years), if it is required by your doctor, as it has no radiation." "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 22 years old, and I have no trouble in getting an erection during masturbation or foreplay. However, when I try to have sex, I cannot maintain a tough erection while during foreplay and masturbation. At some point, I feel getting softer. I have an erection right up until the end of penetration then I start to go limp. I once had the head of my penis inside her, and I accidentally removed it, and my erection was quickly lost, and without removing the condom, it is hard to get it back. ### Response: Hello. You have mentioned two essential things while describing your problem. Number one, you can achieve a proper erection and number two, you are a virgin. Keeping these facts in consideration, I would like you to know that you do not have any erectile dysfunction. The problem appears to be related to the unconscious and conscious anxiety that a person has typically while having sex for the first time. When a male is getting ready for his first ever sex he is preoccupied with the thoughts about the outcome of the forthcoming sexual act ,e.g. whether you will be able to maintain erection during sex, whether or not the partner will notice my weaknesses and lack of experience, whether the experience is going to be satisfactory or not, whether or not you will be able to last long, whether you will be looking good or ugly without clothes, etc. Such thoughts increase anxiety, and insecurity, which ultimately results in loss of erection while penetrating. Getting comfortable with the partner will help. Viagra although does not help in psychological erectile dysfunction still it is going to help you by maintaining a solid erection during penetration and thereby will boost up your confidence." "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 five months old. He has not received polio drop vaccinations as I was unaware. What should I do now? ### Response: Hi. Polio vaccination is generally done with the scheduled vaccination. If you have visited your doctor at six weeks, 10 weeks, and 14 weeks of vaccination, he must have vaccinated the child for polio as well. Still, if you feel it has not been done, visit a Paediatrician for polio immunization" "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 lips get parted when I sleep. I use a plastic retainer which keeps my teeth to be moist. I have white dehydration marks on my front teeth when I wake up. It makes my teeth to look more yellow and ugly. It is happening for years. I also grind my teeth which helps to break my foods into pieces. What can I do now? ### Response: I can understand your concern. If you have an anatomically short lip, either you have to do lip augmentation, or you have to wear a teeth guard throughout the life. The associated clenching cannot be due to the short anatomical lip. Your symptoms may occur due to DNS (deviated nasal septum) or nasal obstruction. Please provide your age, weight, and pictures of your closed teeth bite when having lips in a closed position as well as in open position." "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: Avascular necrosis was caused by a slipped capital femoral epiphysis of the left hip in a 12-year-old girl. What is the treatment apart from hip replacement? I need help. My daughter is in the middle of a bridge. ### Response: Hello. This professional advice provided by me stands subject to the actual examination of report/image and is based entirely on inputs provided to me. It should be correlated with clinical findings" "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 panic disorder and was prescribed Daxid 100, Qutipin 50, Stablon 12.5 (all one tablet per day). Can anyone take Daxid and Stablon simultaneously? ### Response: Hi. Yes; you can take both Stablon (Tianeptine) and Daxid (Sertraline) at the same time. I want to know, are you having any other disorder other than panic disorder. Qutipin (Quetiapine) is not indicated for panic disorder." "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 sister was experiencing irregular periods and sometimes bleeding was heavy during the menstrual period. We consulted a gynecologist. She suggested taking pelvis scan where they observed that endometrium line became thick. They informed that it was due to hormonal imbalance. Later we approached an endocrinologist where she has advised us some hormonal tests (prolactin, testosterone, thyroid tests). It seems the report was normal. For the past two months, she is taking Meprate 10 mg tablet from the 16th day to 25th day of menstrual cycle. And the subsequent falling period is normal. However, during the recent review with the gynecologist, she has advised taking full abdomen scan with the pelvis and there are no findings. Even the endometric layer is normal. Hence she came to an opinion like menstrual disorder is due to hormonal imbalance. The doctor advised undergoing for copper-T which is the only solution for hormonal imbalance and menstrual disorder. The endocrinologist said reports are fine. Both the statements are contrary. We are just confused to go ahead with the copper-T process. Please see the reports and kindly provide us the detailed clarification on this. ### Response: I do not think the doctor has advised copper-T. I think she would have advised intrauterine hormonal device called LNG (Levonorgestrel) which contains hormone progesterone. It will regularise the cycles and control heavy flow and need not take oral medicines. It is up to you to take the advice. As she is getting regular cycles now, you may wait. However, if the bleeding is heavier and any disturbances in the cycle, then go for the device. Also, a D and C (dilation and curettage) for endometrial evaluation and histopathology is advisable to rule out other causes like endometrial hyperplasia and the likes" "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 week, I hit myself in the eyes and although the pain had gone away, my eyes are still light-sensitive. I saw an urgent care doctor, he looked into my eyes and said they did not see anything wrong but it is now five days and although it is substantially better, it is still painful outside in the sun. ### Response: You might want to visit an ophthalmologist or an optometrist instead, considering that the emergency doctors are not equipped with all the required diagnostic machines that can see minute things in the eye." "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 my last periods 51 days back. 13 days back my home pregnancy test was positive. But, no sac seen in ultrasound. When we checked at home 10 days before, again it showed positive. Sac was not seen today too. My hCG report is 188.19 mlU/mL. Please advise what to do. ### Response: Hi. As per your history, it appears that you are in 5 weeks of pregnancy. At this time the gestational sac should be there. But, do not worry as your beta-hCG is showing pregnancy levels. You should wait for one week and get the ultrasound repeated preferably a transvaginal one. That will clarify the situation. Ultrasound transvaginal after one week. Progesterone support . Revert back after a week with the repeat tests to 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 had my two back molars on the top left side of my mouth filled about three weeks ago and after a few days, everything was fine. No pain, nothing. But a few days ago, I realized that every time I drink hot, cold, and sometimes even room temperature liquids there is a sharp almost piercing pain that lasts for a few seconds. (More so with the cold drink than hot or room temperature drink). It does not hurt to bite down but it does hurt to actually chew something on that side. Even when I take a deep breath through my mouth, the cold air hurts the tooth. The pain feels like the liquid or the air is literally going inside my tooth and releasing that sharp pain. I made an appointment to see my dentist and he said the nerve might be exposed. What does that mean? What kind of procedure needs to be done? Or what do you think is wrong? ### Response: First, get a radiograph done for those two teeth, it will tell the status of your teeth. Sometimes, if the filling is high, you experience pain. The filling might be fractured. The nerve exposure means caries has reached till the pulpal horn. Parts of teeth: Enamel: a hard mineralized structure that forms the crown part of the tooth. Dentin: calcified tissue. It is covered by enamel on the crown, cementum on the root part of the tooth and surrounds the entire pulp. Cementum: specialized calcified substance covering the outer surface of the root of the tooth. Pulp: consists of nerves. If caries are present in enamel or dentin filling is done. If caries reaches the pulp, root canal treatment has to be done. The dentist is talking about root canal treatment, in that treatment infected or dead pulp is removed and medicine is filled. Radiograph of those two teeth. Get a radiograph done and plan further. Meanwhile, do lukewarm saline mouth rinse three to four times daily. Use desensitizing toothpaste. Avoid too hot or cold food and beverages." "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 hardened cord on the top of my penis that runs centrally from the base, it has been there for three days. It is slightly to the right of the vein. The skin is slightly pink and it runs a couple of inches and is completely solid. I fear a blocked artery. What is this likely to be as I am unable to see my GP for a couple of weeks. I am 30 years old. ### Response: Hi. From your symptoms, it could be a hardened lymph vessel or an inflamed vein. Not a blocked artery as that would cause a lot of severe symptoms. A few details would help to identify the cause like, does it become prominent after vigorous sexual activity, or does it remain prominent throughout the day. Are there other symptoms of erectile dysfunction or discomfort during sexual activities? Also is the area hot and tender to the touch? I am looking at thrombophlebitis or lymphangiosclerosis but I need some more details to be close to the diagnosis. Also, I might be able to suggest an investigation depending on your symptoms if need be. Do let me know so that we can get to the bottom of this. Aspirin or Ibuprofen might be required after confirming the diagnosis." "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: As I took master health blood test and in the result, my vitamin B12 is high. How can I lower it? I am afraid of this. Please help me. ### Response: Kindly provide me any other clinical complaint if you have. Kindly mention whether you have taken any vitamin B12 supplement or tablet or injection? Attach your all reports to give more comment. Usually, liver disease, kidney disease, B12 intake, myeloproliferative neoplasm are among the causes for high B12" "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 chronic pain at the semimembranosus insertion points in both legs. I have had this for nearly 18 months. I am a runner who over-pronates. More recently I have had tightness and hyper irritation in my lower legs - shins, and calves. I have had a lumbar MRI for a bulging disc which showed a very slight disc bulge at L4-L5 on the left side but no impingement on the nerve. So, considered negative for pain in my legs. My question is, could the semimembranosus insertion point be affecting the tibial nerve and causing the tightness and irritation in my lower legs? This does not respond to stretching which often makes it worse. ### Response: I have understood your concern about the pain in the lower leg, semimembranosus. See, semimembranosus is the muscle of lateral hamstring. If you feel pain exactly at the tendon of it, our treatment will be different, like ultrasound therapy. As you mentioned you are a runner, according to me, your hamstring and calf may be shortened or tight. So, I suggest you go for physiotherapy treatment where you can be treated with ultrasound therapy of semimembranosus muscle tendon and simultaneously mild stretching of lower leg muscles, that is, calf muscle and all the hamstrings which would prevent recurrent pain" "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 going to marry A-negative girl. And my blood group is B-positive. So, is there any complication or we can go ahead? ### Response: Hello. I have reviewed your query. But when the female is of negative blood group and male is of positive blood group (as in your case), the baby has a chance of having a positive blood group. This baby blood may pass through the mother's blood through placenta, leading to formation of antibodies in mother's blood and posing risk to further babies. But this is not much a problem, because this can be avoided by taking a RhIG injection during pregnancy and immediately after delivery. To conclude, you can marry a negative blood group girl, but you need to mention her Rh-negative blood group to your doctor immediately after the conception of pregnancy so that she can get her RhIG injection during and immediately after delivery" "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 nephew is 3-year-old and had injured his eye, and now doctor said suturing is required. So please tell me what is the outcome of corneal sutures, and is this a right treatment? ### Response: Hello. I am sorry to hear about the incident that happened with your nephew. The right treatment for this condition is to repair with suturing. However, it is to be seen what the size of the injury is, and if any other structures inside the eye have been damaged. If it is a small injury then like a small perforation, it might heal on its own, but a more significant injury has to be repaired.The visual outcome depends on the site of the injury. If the damage is in the center, then the visible result is guarded, but if the injury is in the periphery, you can expect a good visual outcome. I hope this will be of help to 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 63 years old. It has been seven years since my menopause. My endometrial thickness is 10 mm now and the uterus is normal. Two years before, the thickness was 8.6 mm. I have no symptom such as bleeding. Please suggest any guideline for further tests. ### Response: Hi. I have read and understood your problem. One research concludes that in a postmenopausal woman without vaginal bleeding, if the endometrium measures more than 11 mm, then a biopsy should be considered as the risk of cancer is 6.7%. Whereas if the endometrium measures less or equal to 11 mm a biopsy is not needed as the risk of cancer is extremely low. Thickness may vary from time to time. However, if you have a family history of cancer you can go for biopsy." "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 try to masturbate or when I am thinking of it, I became very nervous, and a little fainted. I do not know why. ### Response: Well, in this case, the jerk you had in your first experience is called ejaculation. And usually, there is a" "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 did a pregnancy test last week, and it was positive. The next day at work I notice pinkish spots when I wipe. The next morning I started heavy bleeding with small clots, but I had no pain. The bleeding only lasted for three days. I need help. I am not sure if I am still pregnant or if I had a miscarriage. ### Response: Sorry to hear about that and it sounds like a miscarriage. That day when urine was tested, mostly the second line was not as dark as the first. It means the hormone level was not high enough. Once you have heavy bleeding, it means the inner lining of the uterus has gone, and so pregnancy cannot stay on. The most common cause of such an early bleeding or miscarriage is anembryonic gestation or blighted ovum. Here, the egg or the sperm had some defect, and so, the embryo or the baby had some congenital problem compromising its health. Hence, it was not producing enough of hormones to support itself in the uterus. Just for confirmation have a home urine pregnancy test after bleeding fully stops. If the pregnancy has failed, then the line will be lighter or have disappeared. Also, you cannot see anything on the scan." "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 60-year-old female, type 2 diabetic. Over the past few months I have become increasingly breathless when walking a short distance even on flat surfaces. Can you please give me some advise? ### Response: Hello. This is likely a cardiac issue. There is a possibility of ischemic heart disease. So, you should get your cardiac work-up done. You need to have ECG and echo, and may need further investigations based on the results of these. Diabetics are more prone for ischemic heart disease and may have atypical symptoms like shortness of breath rather than chest pain. Also, examination by local doctor will help to rule out respiratory problems. So, you should visit nearby doctor for these investigations." "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 nose is bleeding often. It happened six to eight times in the past 10 months. The blood is red in color. I do not feel any pain, and the bleeding is not too much. Most of the times I do not realize that my nose is bleeding. ### Response: Bleeding of the nose is quite common in some people. Do revert if you have any further queries. I will be happy to help 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 19 years old. I weigh about 70 kg and my height is 5'7"". My semen has been yellow color for the past one week and now it seems like it has urine in it (but it has no foul odor). And my penis is quite itching, also sometimes I experience discomfort when urination. I wonder what is this condition I am having right now and what is the possible treatment? ### Response: Hello. According to your statement, you are 19 years old sexually active person suffering from discharging of yellowish colored semen, itching of penis and feeling of discomfort during urination and all your symptoms indicates STD (sexually transmitted disease). Your STD is either chlamydia which is caused by chlamydia trachomatis, most common or gonorrhea which is caused by N.gonorrhea or both. Both diseases present similar clinical symptoms and treatment is almost the same. Single dose of Azithromycin is the treatment of choice. By collecting urethral swab, it can be specified either chlamydia or gonorrhea. In gonorrhea, urethral swab shows the presence of gram-negative diplococci and in the case of chlamydia, swab shows non-specific urethritis. Urine for C/S can also be done. After undergoing the investigations, please inform me about the results." "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: Hai... past underwent 3 miscarriages after taking inj.progestrone. 2 were chemical pregnancy and 1 is sac was formed but miscarriage happened. now I am having the pregnancy symptoms my last LMP was on 40 days back. ### Response: Based on your obstetric history , it is necessary to evaluate the cause for your recurrent miscarriages. But please don\t be disheartened if sometimes no cause is found which happens quite a lot of times. Dear, Progesterone injection will never cause miscarriages as progesterone is the hormone that is required for the continuation of pregnancy and act as a support for pregnancy. As per your LMP, you are exactly 6wks pregnant today, so try to get a scan to check if this is a viable pregnancy and also for dating and localisation of pregnancy, so that if viable we can start with progesterone support in the form of oral progesterone supplements to sustain this pregancy. Also I have mentioned the blood test that you need to undertake apart from the routine Antenatal investigations to look for any abnormalities I mentioned above. Please do get them done. Please feel free to contact me in case you have any queries. - Blood group and Rh Typing,- Complete hemogram,- Hb Electrophoresis,- Urine routine and microscopy,- LFT/ RFT- 75 g Oral Glucose tolerance test ( in each Trimester).- HbA1c level,- HIV, V" "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 writing on behalf of my sick father. Last year, he suffered a brain stroke on the right side of the brain, which caused paralysis on his left side of the body. A week after that, he was diagnosed with heart blockage, which needed a bypass procedure. After treatment, he started recovering and walking with a tripod, but he still not able to gain movement of the hand. We just found out that five days before the stroke, he stopped all his medications (Aspirin, cholesterol medicine, Co-diovan, and Avodart).Now, he is on other medications (Tritace 5 mg, Ramipril, Plavix, Aspirin, Feromin, Avodart, Crestor, and Rabezole). He has been suffering from constant bladder bleeding and enlarged prostate, and he is not able to do any operations as his condition does not allow it. He had 20 blood transfusions so far. The doctors are recommending to stop one of the medications after one year of the stroke, which is next week, and they are suggesting to stop Aspirin or Plavix. We would like a second opinion. ### Response: Hello. I read your query and understand your concerns. I hope this helps you. If you have more questions feel free to write 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: I am a 15-year-old male. Two months ago, I suffered second and third-degree accidental burns to my leg from scalding hot water. Burns have healed but the skin remains discolored. What are the risks going forward? Can keloids be formed and what procedures can be done in the future to improve the appearance of the skin? ### Response: I have gone through the attachments (attachment removed to protect patient identity). There are more to second degree deep burns. Scald burns heal very efficiently. However, there is a little bit higher incidence of keloid formation. That explains your doubt. But not all are supposed to have keloids and not all wounds. Just to be on the safer side, as the wounds are just three months old, I would like you to take some precautions and measures which will help in preventing the keloids and help improve the look of the scar" "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 started four years back that a patch of hair (round with about 3 cm diameter) suddenly disappeared from my lower right part of beard area (neck). I ignored this at first, but then when the hair never came back even after about six months. A doctor told me to use Tacrolimus 0.03 % for some time. I used it for two months regularly with not much success. Again, I ignored my condition, considering it to be a minor issue.A month back, I moved to a new place for work and on the very second day, I lost a patch of scalp hair (left center of my head). This seems to be a very serious issue. I started applying Tacroz 0.03 % for last three weeks and am also taking Dexamethasone 5 mcg once a day. I want the hair to regrow on my beard and also on my scalp. Also, I do not want this situation or issue to re-occur. ### Response: I have noted your concern and I have viewed the images (attachment removed to protect patient identity). You seem to have alopecia areata. I suggest you take oral corticosteroids for a few weeks if it is progressing. Tacrolimus is not a treatment of choice for alopecia areata." "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 20 years old. I have two teeth growing behind premolar teeth. I have one tooth grown a previous year, and another tooth has started growing today. ### Response: Hi. Anything other than usual is never good. First, we need to know whether it is extra teeth or natural teeth growing in a different place. Why do you have these extra teeth? Is it interrupting the other teeth and disturbing the mouth position or no issues with it? We need to know the answers to these questions, and if they are not causing any trouble, you can leave them. Visit a dentist and get yourself examined, then get an X-ray done. After checking you clinically and with the help of X-ray, then the dentist will confirm whether you have any problems with them or not." "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 an overbite and I would probably say it is pretty bad. My teeth are not that bad, but I do have large buck teeth.My two front teeth are angled on the outsides and that creates a triangle shape gap in between my top and bottom teeth.I was wondering with the information provided above, do you think I need braces, a retainer, or Invisalign? ### Response: I have read through your complaint and the relevant details. You have mentioned that your front teeth are protruded, large and that creates a space with the lower teeth. With these, I am pretty much sure that you might need braces (fixed orthodontic therapy). But a proper analysis of your teeth in position along with your skeletal outline are the factors which decide that you need braces. For beauty purpose, you can also discuss with your specialist about lingual braces or ceramic (tooth-colored) braces. Invisalign is chosen only for mild correction and cannot achieve results that as proper braces. Retainer and Invisalign almost serve the same purpose of maintaining the moved or corrected teeth through braces. They cannot be used all in all for co correction in your case I reckon" "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 couple of weeks ago I found a very small raise on my vaginal opening much like a skin tag. I noticed the raise because of the burning sensation that was coming from that area. Since then I have noticed that the bump has not grown bigger or smaller but has started burning the day I got my period and the day after sex. The only thing that makes it feel better is a cold rag or ice. What could this be? ### Response: It could be a boil that is an infection of hair follicle over pubis or it could be due to local irritation. It would be better if you share the images of the lesion so that I can suggest medicine" "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 50 years of age. I am having diabetes and high blood pressure for the last seven years and taking medicine for the same. I have a very low libido and premature ejaculation too. Please suggest some medicine to overcome this problem. ### Response: Hello. I hope your blood pressure and blood sugar levels are in the normal range. In a lot of patients with diabetes and hypertension, the main reason for poor erection is poor blood pressure and sugar control. If your blood sugar levels are not in the normal range then please get the levels in the normal range. HbA1c should be tested in your case. If the levels are normal then no need to worry. HbA1c levels tell about the long-term blood sugar control. To get a strong and hard erection, you can think of using tablet Udenafil 50 mg tablets." "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 itching inside my penis for few days. Please advise what to do. May I consult a urologist? ### Response: Hello. I have gone through your query. I would like to know a few more details too. The most possible reason would be either a urinary tract infection or infection at the top of the penis. This can be confirmed by a urologist on clinical examination and urine tests. A 29 gram prostate is slightly enlarged for your age. However, if you have no urinary complaints then it would not require any further treatment at present" "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 epilepsy in late 2016, and have been taking Levetiracetam since then (500 mg twice a day). I have been concerned that it is affecting my mental health. I have been experiencing anxiety, depression, irritability, and anger which is very out of character for me. It has taken some time to pinpoint, but it seems like these behavioral changes may correlate with when I began taking the medication.Prior to starting Levetiracetam, I had two grand mal seizures about 12-15 months apart. I frequently had what were diagnoses as epilepsy-related auras. Since I have been taking Levetiracetam, I have not had any more seizures or auras. I am happy the medication is working, but I am interested in advice about other possible medications or non-prescription treatments. ### Response: Your assumption is right, Levetiracetam causes behavioral disturbance as a side effect. There are two options now, 1. To taper off the Levetiracetam - if you have not experienced any seizure or aura in the last four years then we can go straight away with gradual tapering of the medicine, for that we need to know the last seizure/ aura episode, but with this, there is a risk of recurrence, you need to be cautious and under the watch of someone for few months. 2. Substitute Levetiracetam with Sodium valproate - in this risk of seizure is less, but still, it is there, on the fact the Sodium valproate is a mood stabilizer. Please do not do any of the above by self, you can consult a neurologist locally let him manage or get a telephonic consultation." "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 having spotting during my past two cycles on an off for days on end. I am not sure if I should be concerned. I have stopped birth control for over one year, and I am trying to conceive from the past two months. I have had a couple of urinary tract infections during these cycles. I am worried that my hormones are out of balance. ### Response: The presence of pinkish-brown spotting in the proliferative phase of your cycle does indicate that you are having inadequate endometrialization possibly due to decreased serum estradiol levels during the phase. Also if the spotting turns darkish brown in the second phase of the cycle, then the level of progesterone is also inadequate which can cause early spotting premises as well. It is suggested that you should get your hormonal profile for day-2 of cycle done and also take to sequential ultrasonographic follicular and endometrial thickness monitoring which would indicate the state of endometrialization due to estrogens and also the correct time of ovulation. This can be corrected by starting estradiol pills in the first half of the cycle followed by progesterone-only pills post ovulation, which shall prevent these bleeding episodes." "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 acne on my cheeks, forehead, and the back for the past six years. I have red and pus-filled acne. I am using Adapalene gel and Metrogyl gel. But, pimples did not go away and also spreading nearby. I have used Benzoyl peroxide too, but no improvement. I am using Acnestar S face wash twice daily. My face is so oily. Kindly suggest me some way to remove acne without leaving marks. ### Response: Hello. I understand your concerns. I have checked the attached photos (attachment removed to protect patient identity). From what you mentioned, you have severe acne that requires oral Isotretinoin for six months. I suggest: Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Double contraception is required for one year if sexually active as it is teratogenic. The treatment should be at least six months. For the first month, the lesion may flare up. So, do not worry" "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 daughter who is 4 years old had got a scratch mark three months ago. It has left a brown mark. It is a little white in the middle. Is it a scar? Will it go away soon? I have attached few images for your reference. ### Response: I have noted your concern and I have viewed the images (attachment removed to protect patient identity). Regards" "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: For the past two months, my 89-year-old husband is suffering from a painful, burning, and itchy skin disease. He has been seen by his family doctor and two trips to the emergency. At first, thought to be shingles and later pruritis. The painful episodes happen at night and early morning. I cool it down with oatmeal compresses and Gold Bond anti-itch lotion. It goes from a 10 down to a two. Sometimes it does not appear for a week and it is back again. The only medication he is on is Coumadin. He is and always has been a non-drinker and non-smoker. He has dementia but, only at night. Our environment is scent free, no chemicals and soap and laundry soap are hypoallergenic. What can this be, is it part of ageing? ### Response: Hi. From your history and description, the most common possibilities are urticaria or peripheral small fiber neuropathy. Shingles is a one-time episode and are usually localized. The complaints do not appear to be related to external factors such as scent or environment. With aging, a lot of degenerative changes set it. These processes could affect even the tiny neurons in the skin resulting in repeated episodes of itching and burning. Antihistamines, oatmeal bath and compresses could help to some extent. Do let us know if he is a diabetic, he is known to have vitamin B12 deficiency and any other comorbidities. Please upload appropriate images of any skin lesions if present." "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 unprotected sex with my fiancee on the seventh day of ending her period and she took the emergency pill within 12 hours and her period cycle is around 33 days. After 16 to 17 days of having pill she got light bleeding that lasted for around five days. Are there any chances of pregnancy? ### Response: I just want to be clear that no birth control pill or any family planning method that can give 100 % assurance that you will not get pregnant. It only decreases a significant percentage of the chances. So yes, she can be pregnant but if she took an emergency pill then it gives her only 75 % chance of getting pregnant. This is expected since the hormone Progesterone in the emergency pill is so high, it can cause spotting or bleeding after. I suggest you take a pregnancy test after one week and if it is negative, then you are safe." "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 40 year old female, and I weigh 88 kg and my height is 160 cm. I am a vegetarian but I eat eggs. I am planning to start paleo diet to reduce my weight and before starting the diet, I got a blood test done. I am attaching my reports. Please suggest a vegetarian diet chart. What type of vegetarian foods to be taken? Are there any instructions to follow while doing paleo diet? ### Response: Hi. I went through your reports (attachment removed to protect patient identity), and according to it, you can go on a paleo diet. Which is good for your weight maintenance. Follow these instructions and have patience, all the best" "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 30 year old male. My weight is 85 kg and my height is 174 cm. I am non-smoker and I do not drink alcohol. My problems are gas formation, uneasy feeling after meals and lack of energy. My bowel does not get cleared properly and I feel too much tired after hard work. My heart beat become too fast during this time. I also have breathing problems after running. I have attached my recent blood test report for your reference. Please check and help me with your suggestion. ### Response: I have gone through your reports (attachment removed to protect patient identity) and your complaints. Revert back after 15 days to a general practitioner 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 did a recent blood test, where my CBC, TLC, ALC are normal and looks fine but under DLC (differential leucocytic count) my lymphocyte is 41.2 (range 20 to 40), eosinophil is 6.6 (range 1 to 6). What does this mean? I have a very slight cold for some time and sometimes when I lift anything, my upper right arm closer to my elbow feels stressed and it hurts and the same hand between my palm and wrist space below my wrist it hurts. No stiffness. I can do all the activities. I can feel a kind of a pain in these two spots. My height is 5\4"", weight is 69.2 kg. This blood test was done exactly five days after my periods. ### Response: Your complete blood count report shows borderline lymphocytes and eosinophil. But that can be from the cold that you already have. I need to know your full CBC to check absolute lymphocytes count and absolute eosinophil count. So you can attach your reports. You can provide that reports once done. Bursa or tendon inflammation also can be possible in your case. It happens if we overuse a particular portion of the body. You can be prescribed course of nonsteroidal anti-inflammatory" "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: Our child is 12 with small face, mouth. She lost all but one milk teeth. She has severe crowding and overbite. Our orthodontist recommended removing lower jaw wisdom teeth which have not yet erupted. They are at an angle to the back teeth. ### Response: Hello. As per your history, OPG and photograph (attachment removed to protect patient identity) I can see mesially titlted last or third molars. So, there is indication for its extraction. One deciduous tooth is unexfoliated. According to me, that lower unerupted tooth should be first taken into consideration. Extraction of wisdom teeth is one of the consideration but it is not an emergency. It is fine to extract third molar after completion of treatment also. For proper detailed treatment planning and management,send me the following: Intraoral photographs, image of upper teeth after opening of jaw and clicking from down, image of lower teeth after opening of jaw and clicking from up, image of teeth from either side after occlusion." "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 woke up with the tip of my tongue numb a week back and has been since. I do drink alcohol and smoke cigarettes but have stopped since I started feeling the numbness. I can also see the sides of my tongue look scalloped. ### Response: I have gone through your question and I can understand your concern. This can be because of the transient nerve compression. If you have any grossly decayed tooth on the same side or any missing third molar. Most of the times unerupted or decayed third molar are the cause. In case you do not have any of it the reason may be the viral infection like influenza, which you had experienced recently or herpes. As precautionary measures take Vitamin B complex daily a tablet for three to four weeks. If the numbness continues more than a month and there is no organic cause which I mentioned earlier you may need further diagnostic evidence to rule out the cause. Most of the times it heals without any medical intervention" "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 BP is very high 200/75. I have made aortic valve replacement surgery with metal valve nine years ago. The BP is high for the past four days and nothing gets it down. In an emergency clinic, they gave me a Nitroglycerin patch which made my BP reach 170/75, however, it did not get the BP more down. My physician prescribed me Coversyl 5/2.5 and Concor 5. I am a chronic Coumadin user. ### Response: Hello. There are multiple options available for you. If you want to stick to the same then some other medicines like Amlodipine 5 mg and if not effective 10 mg in addition to Coversyl plus and Concor, will control your BP. Also, if BP remains elevated then tablet Prazosin XL 2.5 mg should be added which can be increased to 10 mg if necessary. So, overall, you may have tablet Coversyl plus, Concor and the third" "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 25 years old. I am willing to marry my childhood friend. She is elder than me by five months, and our blood group is same, which is AB positive.Here are my questions:Will there be any problem during pregnancy?Any tests required to be done for ensuring no problem in future?Is there any solution? ### Response: The medical condition that is troubling is due to Rh incompatibility. There is no possibility of that in your case as you both are AB positive and hence, your blood groups are compatible. There is no problem medically. You need not go for any tests too. All the best." "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 51 year old man and my wife is 28 year old. I would like to have a baby. I have normal sex life. I have been having diabetes for the last 8 years (hereditary). No BP or heart problem. Occasionally, I have kidney stone issue. I do not smoke or drink. I have a few questions: What are the tests to be conducted for checking the quality of sperm for having baby? Any effective medicine for increasing the quality and motility of sperm? Is there any chance that my diabetes will affect my baby? If so, can I have any medicine or treatment by which the diabetes does not affect my baby? Please advise ### Response: Hello. See if you have a normal erection and ejaculating normally, then I do not recommend any tests unless you have been trying for a baby for the past one year and there has been no result. In that case first get semen analysis with culture test and revert back with report. If this test shows abnormality then you need to undergo further tests which I shall recommend if needed. Yes there are effective medications to improve sperm condition but let me see your report first. Diabetes can be due to both hereditary and nonhereditary. Nothing can prevent your child if it gets as hereditary. A good lifestyle can definitely delay the onset of diabetes. Do not worry about that." "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: How to brush after removing a tooth? Two days ago I got it done. How to know if I have a dry socket and what are the ways to prevent it? ### Response: Keep usual brushing habit after the removal of your teeth. No need to worry about brushing habit. Use mouthwash twice a day after brushing your teeth. Do not do vigorous gargling. To prevent from" "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 7 and a half year old son is suffering from fever (100+), loose motions and vomiting, headache, backache. He still uses a bottle for milk and once in six months we have to face this situation. Now, we firmly decided to discontinue feeding him by a bottle. Please advise medicines. He has no allergy from any medicine and his weight is about 29 kg. ### Response: As your child is suffering from acute gastroenteritis, it is a good decision that you have decided to stop bottle feeding. I suggest: Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Maintain hygiene. Have a soft diet. In case you feel that the child is lethargic, not feeding adequately, not passing urine, visit a pediatrician for clinical evaluation immediately" "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: Why do I catch a cold with fever too often? Symptoms include head pain, body pain, coughing, etc. I am a male, age 24 years, height 5\11"", weight 72 kg. ### Response: You can have repeated upper respiratory tract infection. For that DNS (deviated nasal septum), polyp, etc., like nose pathology should be ruled out by rhinoscopy nose examination. Allergic testing can be done to find causative allergen which can lead to allergic upper respiratory tract infection. Meanwhile, for symptomatic relief, you can be prescribed decongestant like Levocetirizine for five days. Take half teaspoon ginger juice and half teaspoon honey which can be mixed and taken when having cold. You can consult otorhinolaryngologist or physician for 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: I am 79 years old male and in good health. But, since a few days, I have a few drops of blood in my urine. Please tell me the probabilities of a problem and tell me what I should do. About 7 years ago, I had an operation on my prostate to ease the urination. For about a year or more and occasionally, there was blood in the urine. But, it eventually stopped until it suddenly came back the same way. ### Response: Hi. Painless blood in the urine has two possible causes. The first is cancer bladder and the second is prostate cancer or hyperplasia. What is the nature of the operation you did in the prostate? Was it benign prostate hyperplasia? Is there any painful urination or history of stones? A urologic assessment is required and cystoscopy is required" "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 has been experiencing nosebleeding and blood whenever he spits. This has been ongoing for a month. He has no other complaints except for occasional headaches. Any advice? ### Response: For nose bleeding causes like traumatic internal nasal mucosa injury, polyp, rhinitis, sinusitis, etc., should be ruled out. For that, primary work-up, rhinoscopy, nose examination, CBC and PNS X-ray should be done. According to the cause, specific treatment is given. When bleeding occurs, the nose is pinched with index and thumb finger to stop bleeding. If no cause found then coagulopathy also should be checked. Consult otorhinolaryngologist for examination and accordingly further investigation." "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 46 years old, on no medication apart from Zinc daily that seems to help with my low testosterone. BP averages about 110/63 mmHg, resting pulse between 58 and 65 bpm. My height is 5\ 10"" and weigh about 75 kg. About five years ago, I noticed odd heart rhythms after playing two hours of badminton. I ignored them for months, but one day after stopping and bending over I had a large clonk in my heart and it took off like a rocket (about 140bpm), after five to ten minutes it clonked back to normal speed. This happened about four times over two to three weeks, and has never happened again for the past four years. I had a stress test, 12 lead ECG and echo and two weeks Holter. All was fine and no more SVT\s. I had a repeat ECG and echo a few months ago, and all is well apart from the odd strong ectopic. I do however still have an issue, every now and then (like the past two weeks) for no reason at all my heartbeat becomes very strong (still steady and not fast in the 60\s at rest), and I feel it almost all the time to the point I can see my handshake to my heartbeat whilst holding a phone, etc. I feel fine, but it is very hard to relax and sleep as it is banging really hard. I am generally aware of my heartbeat, but this is on a different level. It is not linked to stress or any external influence that I know of, and I have checked my BP whilst it feels strong and it is the usual 110/60. My question is, are there any physical reasons for this (e.g. my dad had angina and triple bypass), and is there anything I can do to help it? Also, if I had blocked arteries would the ECGs, stress test and echo\s have picked this up at all? I was offered beta-blockers by my GP which I refused as my heartbeat is not fast. ### Response: It seems that all the tests you had are reassuring. What you are describing seems to me as ectopics and a small dose of beta blockers could help. But if the resting heart rate is less then 65 bpm then better to avoid them. In this case, if the ectopics burden is very high they can be ablated. Stress tests (except exercise ECG) will pick up old infarct resulted from blocked arteries. I doubt that this is the case here." "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 8 years old and sometimes he has bloodshot eyes. This allergy was started when he was one year old. He has been diagnosed as vernal conjunctivitis. ### Response: Hello. I reviewed your history. Vernal conjunctivitis is a chronic condition and requires treatment for a long time. It usually decreases in severity by 15 years of age." "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 I fell from my bike, sometimes, I have a little pain in my shoulder. I feel my shoulder is loose. I got an MRI of the shoulder done, and I am attaching the reports. Can I try physiotherapy for the pain? Or do I need to get a surgery? Please help. ### Response: I have seen the attached report (attachment removed to protect patient identity). The MRI film is more helpful than a report on its own. Revert with more information to a fitness expert 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 left lower eyelid is swelled for more than two months, and recently a few days back, I noticed, my left upper eyelid also got swelled. I do not know why is it happening, and I need to treat this as soon as possible. I am worried. I am using contact lenses for six years, and nothing like this ever happened with me before. ### Response: This all sounds like an allergy. Have you started using some new cosmetics? You can start by not using them anymore if you are." "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 54 years old and is facing persistent low-grade fever. She had it for almost a year and nothing was diagnosed from the tests and then suddenly it got fine. Now again she got a fever from some stomach infection and it has been 15 days that the fever is there between 99 to 100 degrees. What could be the possible reason? ### Response: Hello. Low-grade fever can also be there due to chronic infections like tuberculosis. So, if a chest X-ray is not done, I suggest you do so. Lymphoma or lymphoid malignancy can often be missed as a differential diagnosis of low-grade fever. At last, some autoimmune diseases can present with a similar type of low-grade fever and diffuse musculoskeletal pain. If there is pain associated, get a blood test done for ANA (anti-nuclear antibody)" "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-in-law aged 44 years, slightly overweight, had symptoms of tightness of chest, sweaty palm and uneasiness. The tests showed blood pressure reading as 140/80 mmHg and ECG showed left ventricle irregularity. Please advise. ### Response: Left ventricular hypertrophy is because of hypertension, however, ECG is just a baseline test of cardiology. The tightness of chest associated with sweating can be stable angina. Stable angina is chest pain or discomfort that most often occurs with activity or emotional stress. The most common cause of angina is coronary artery disease. I would suggest you two baseline test of cardiology. 2D echo and treadmill test are used to rule out the cardiac cause of chest pain. If there is ischemia to cardiac muscles, then it will be reflected in it. My advice is to get a 2D echo and TMT. Follow up with the reports." "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 25 months girl who feels discomfort at sleep for a couple of days. For the time she has also lost some of her appetite. I have checked her symptoms and signs. Her body temperature is normal, around 34 but sometimes her hands get hot. She has attended all her vaccines and currently, we are on lockdown. While in the home, during the daytime, she feels bored and sometimes cries for no reason or feel discomfort with her toys. I am asking this, in this pandemic we cannot get outside to see a pediatrician or a consultant. Clinics and hospitals might lead to carrying a virus or infection. Please advice me in this regard. Thank ### Response: Hope you are safe. I appreciate your concern regarding your child. This behavior is normal because as the child grows he/she wants more attention becomes more aware of things." "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 lower back pain on and off from last two years. Two weeks before I got severe pain in my right leg. I was unable to move my leg. Physiotherapist suggested taking bed rest for four days. My trauma and orthopedic doctor asked me to do surgery if I was unable to tolerate pain. After four days, the pain in the leg and lower back pain were gone and I got mild numbness below my knee (back side of my right leg) and thumb finger of my toe. Physiotherapist asked me to do some exercise regularly and it will be cured automatically. Please advice. Do I need to consult a neurologist for numbness? ### Response: Basically, it is a nerve pain due to compression at your lumbar spine. Usually, 90 to 95 % of patients respond to conservative management. Only 5 % of patients require surgery. The ailment basically you have has waxing and waning course. A few days back you had pain and now no pain. The treatment of this has two parts. First is the treatment of your current pain or numbness and the second part is to prevent pain to appear again. Kindly answer these questions for me to decide the management. How much is your back pain now? How much distance you are able to walk comfortably? Is there any problem in urination like increased frequency or straining while urination? Are you able to walk on your toes and heels? Is there any numbness in the perineal region?" "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 my last period on the 1st of last month. I did not have sex until the 33rd day (it was protected sex) of my cycle. Now, I have not yet had my periods. It is the 39th day and I took a pregnancy test on the 38th day and it came out to be negative. I do not know what to do. I did have my exams going on during the time of my expected menses. So, I am guessing it is stress. If the test came out to be negative, then is there still a chance? And, also I am having breast secretions for which my doctor has given me the B long F tablet. She said it is hormonal but she does not yet know that I had sex because she is my family doctor. ### Response: If you had sex on the 33rd day, then the test will not come positive so early even if you have conceived. It takes around two weeks to come positive.Although the chances are very less, you should rule out pregnancy. Do a test around 47th day. Amenorrhea can be because of hyperprolactinemia as you are also having breast secretion. Get a serum prolactin and thyroid profile done. Stress is also one of the causes of delayed periods. Just relax and wait for your period" "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 23 years old male and I am a student. My height is 166 cm and weight 49 kg. Over the past five years, my weight has not increased. I feel very weak and lean. Now, what should I do? ### Response: Hello. You can eat more rice to increase your weight. Some diseases can cause hypermetabolic state like hyperthyroidism. So, get a thyroid status done. Also, anxiety and tension about being fatty sometimes restrain you from taking enough calories to gain weight. According to your weight, to increase the weight you must take 1800 calories per day and if your activities are more, then perhaps you have to take more. Take more and more carbohy" "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 panic attacks. Can it be seen in the MRI or CT scan for how many percents of my brain is being affected by it? ### Response: Panic attacks are due to molecular disturbances (in medical term known as neurotransmitters disequilibrium) in the brain. It is due to some stress or some time normally seen in type A personality or many times it is associated with people with migraine. It cannot be seen in the CT scan or MRI. It can be seen in a special type of MRI brain but it is used only for research purpose only in this time. Might be in future it will be available for routine clinical use. Now we will discuss clinical part. Panic attacks can be controlled easily with simple medications courses 1 to 2 months course for each clusters with proper mind relaxing exercises and Yoga Pranayam." "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 headache and fever for four days and I had Sumo cold and Gelusil. Now, the fever is less but the headache continues. ### Response: A headache along with fever is a common symptom of viral fever. Since your fever has come down, your headache should go away or get better in a day or so." "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 an external anal fissure. Initially, I was prescribed Hydrocortisone cream and Lidocaine/ Nifedipine gel. This did give me some relief, but not completely healed the fissure. Later, I was prescribed the Ciplox-TZ tablet with the SN plus 15 along with Duphalac Fibre (five-day course for tablets). This completely healed the fissure. This was six months ago. Recently, I am experiencing slight trouble when passing stool and then some burning sensation in the anal area. This is due to a hard bowel movement. There is no blood in stool and I do not feel any fissure. Should I take one more course of the Ciplox TZ and SN Plus 15? I am currently applying the Lidocaine/ Nifedipine gel and taking Linzess tablet 30 minutes prior to breakfast (to induce soft bowel). Appreciate if you can let me know the remedy for this. I have read that cow ghee is also a good option in addition to hot sitz baths. ### Response: Hello. You have probably got a recurrence of anal fistula.Please do as follows: If still it is not healing or recurs again and again, then you can consider a surgical option called lateral sphincterotomy.Regards." "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 five months pregnant. I am taking one glass of drumstick leaf soup daily. My neighbors tell me it will reduce the aminotic fluid. So, I am confused. Please give me a good suggestion. ### Response: How are you doing? Hope I have clarified your query. Do write back if you have any more queries. All the best" "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 21 years old, girl and I think I have genital herpes. I am full of white blisters that are very sore and burn. My lymph nodes in my groin are swollen and tender too. I generally have been feeling very poorly for the last few days. I am extremely uncomfortable. I am taking contraceptive pill. ### Response: Hello. It is better to confirm that it is herpes by having one local examination by infectious control specialist and to have high vaginal swab or biopsy from lesion to check in laboratory. If it confirms, you can have tablet Acyclovir 800 mg five times a day for 10 days but only after confirmation. Have complete treatment of any health issues you have. Have balanced diet, weight and BMI. Have a strict hygeine." "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 fell last Sunday and hit my face including my front teeth. Four teeth and top gum become numb for the past eight days. I can bite my teeth though I feel numb. Please help. ### Response: I understand your concern. Do you find any changes in the way your teeth rest? Do you find any tooth that hits when you bite on? Any tooth sensitivity? Any fractured or chipped tooth? This is not normal and you need to visit a dentist straight away and get your jaw and front teeth x-rayed. The dentist may check for the vitality of those teeth. If the teeth are vital (has sensation) and is disturbed, you will require a splinting procedure that will hold your front four teeth in position for the next two weeks. If the teeth had lost its vitality (no sensation), you may require a root canal procedure to remove the clotted blood from inside the teeth. This procedure prevents a future color change of your front teeth due to clotted blood. The injured front teeth get discolored in the future if left untreated. Please visit as soon as possible and get it checked because if there was clotted blood inside the injured teeth or if the teeth are slightly disturbed, this could cause complications like cysts or jaw issues in the future. 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 a birthmark behind the right side of my neck, which looks like a black thick mass. I had once consulted a skin specialist to check if there are any options to get this removed. I was told that even if it is removed by surgical means there are chances that it may reappear. I want to confirm this. Do we have any options to remove it by surgical or nonsurgical means? Are there laser treatments available? Will I have to remove my hair if I need to undergo treatment? I have attached a photograph of the affected area. ### Response: I have seen the photo. (attachment removed to protect patient identity). I understand your concern. The condition is known as nevus sebaceous. In case of deep surgical excision in nevus sebaceous, chances of it coming back are very less. The thing is the excision should be deep to minimize the chances of recurrences. Laser treatments are there but not very effective and chances of recurrences are more. Hair needs to be removed as the area should be devoid of it to perform surgery. Cost depends on the different doctors and their location or specialty." "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 family doctor referred me to an ENT to investigate a persistent sinus discharge problem that seemed to be causing voice hoarseness, likely from mucus building up in my throat. I thought the hoarseness might be a side effect of the Tamsulosin I take each day for BPH, but he did not think so. During the exam by the ENT, he found that my nostrils were almost completely blocked. Although I had not complained of problems breathing through my nose, so air could get through, his scope with the light and camera on the end could only be inserted part way through either nostril.As a result, I am being scheduled for (endoscopic?) surgery to reconstruct the separation between my nostrils and clear the airways through my nose. Apparently, it will take about 30 minutes and will not leave scars or require any packing or lengthy recovery time (just a few days). The ENT thinks that will clear up the nasal discharge and ultimately solve the hoarseness. Does this sound reasonable? ### Response: Hi. Have you had any complaints with nose before? Has a CT scan been done to check for sinus inflammation or pathology? How much is the nasal airway compromise? Has he given you any sprays? Has he ruled out allergy?" "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 periodontal disease and I do not know what had caused it. I do brush daily, floss and mouth wash. I even had those pink pill that showed if you brushed wrong and the results were perfect every time. So I am wondering what caused it. I do have a dead tooth. So I am wondering if I get that fixed, will my gums be healthier? ### Response: Hi. I have gone through your question. I can understand your concern. As per your history, signs, and, symptoms, it looks like you are having chronic generalized periodontitis. I want to know if you have any loose tooth or teeth, any systemic disease like diabetes, etc. Use mouthwash daily, brushing technique (modified Bass). You can take medication like Metronidazole 400 mg three times daily for a week if you do not have any allergic history to 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 mother died four months ago, due to cardiac arrhythmia which was caused by left ventricular hypertrophy. Can I know whether left ventricular hypertrophy is hereditary as I am frightened for me and for my children? ### Response: Hypertrophy is a general term and it includes multiple individual diseases. Do you have her echo report or any other medical reports of the heart? The first possibility in her case is hypertrophic cardiomyopathy, which is certainly hereditary and all the first degree relatives should be screened for the same. Also, was she hypertensive? As it can also cause hypertrophy and ventricular arrhythmias may also have other causes like blockages. There are also diseases which can cause hypertrophy and ventricular arrhythmias. So, we need some reports either echo report or autopsy report for the definitive diagnosis. If none of these is available, then you need to undergo screening" "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 71 year old male, and I am allergic to sugar and eating preparations containing sugar. If I consume sugary substances, I develop internal bleeding in the intestinal tract I presume. But I can tolerate fruits; they cause no problem. I am having this problem for the last 15 years. Lately, for the past four years, I have become lactose intolerant. I want to know whether there is any way I can overcome this sugar allergy problem. ### Response: Hi. I have reviewed your health query and can understand well that you are worried about your health due to sugar intolerance. Hope it helps. Please feel free to ask more questions if you need answers. I would be happy to assist." "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: Dear Doctor,I am a regular meth smoker. I get really bad stomach pain, vomiting almost with any food, and feel lumps in stomach. What should I do?How does smoking meth affect stomach? Does smoking meth cause gastritis? ### Response: Methamphetamine is a stimulant. Excessive brain stimulation causes hyperactivity of muscles. Because of this, hyperactive muscles can go into spasms and that is the reason you are getting vomiting and feeling lumps." "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 2 year old breathes as if he ran a marathon, coughs a lot and I hear a wheezing sound. ### Response: If your 2 year old has breathing difficulty with infection, usually it represents pneumonia. I would like to know in detail: Since how long?Any history of fever?Past similar history?What investigations were done?A family history of asthma or allergy? May I suggest: Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Follow up after two 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 have kidney related problem associated with diabetes, hypertension, and pedal edema. ### Response: Hello. Blood pressure need to be controlled more than this level to avoid deterioration of kidney functions. Need to share more details about history and level of creatinine. Measures that possibly slow the kidney damage are as follows: 1. Control of blood pressure and diabetes. 2. Low salt low fat diet. 3. Regular exercise. 4. Regular checkups. 5. Stop smoking and alcohol. Talk to the nephrologist about any new symptoms." "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 got the influenza vaccination about a week ago and have a swollen and painful lump in my armpit. ### Response: I understand your concern. You are having lymph node swelling axillary post influenza vaccination. Influenza vaccine is a very safe vaccine. Although some may have local pain, swelling, and fever. Some may have local lymphadenopathy. Lymphadenopathy is a swelling of lymph node (normal gland present in our body, which function as clearing harmful substances and providing immunity). Local and systemic reactions mostly began between day 1 and day 2. When a lymph node rapidly increases in size, its capsule stretches and causes pain. Pain is usually the result of an inflammatory process. It is a reactive response of the lymph node to the vaccination. So no need to worry. It can be managed by simple Paracetamol or anti-inflammatory medication such as Serratiopeptidase. It should resolve within a week. If it is associated with fever or any other site enlargement of lymph node you can visit your physician. I hope this helps. Reactive lymphadenitis. CBC (complete blood count), ESR (erythrocyte sedimentation rate), USG (ultrasound) axillary lymph node. Lymphadenopathy. anti-inflammatory Paracetamol 500 mg twice or thrice daily or Aceclofenac, Paracetamol, and Serratiopeptidase combination tablet twice daily for three days. Follow up after three 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 started the combined pill 12 days ago. I vomited on the 6th day after 14 hours of taking medicine. I also vomited on the 9th day after 12 hours of taking the pill. Am I still protected? ### Response: Hello. Yes, still you are protected, 1)If you vomit more than two hours after taking your pill, you are always protected from pregnancy. 2) If you vomit within two hours of taking your pill, take another medicine right away. 3)If you do not take a replacement pill within three hours of your normal time, use a backup method for the next 48 hours." "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 an MRI of the brain and received the following finding: Questionable punctate area of altered signal gray-white matter interface left parietal lobe. What does that mean? ### Response: Punctate areas could indicate many things like hemorrhage, chronic infarct, etc. Can you please mention a few things? What was the indication for MRI? In the report, they must have mentioned the area to be T2W hyperintense or hypointense, better if you can share a copy of the report. I will be glad to help." "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 54 years old. I am a diabetic patient since 24 years. I have a retina problem in both the eyes. I had a laser surgery in both my eyes two years ago. It was repeated last year with three injections of Avastin and this year, the laser surgery was done only in the right eye. But, I cannot see very well. I see something like a black point. So, I got checked for ischemic eye stroke. I checked with two doctors in my city. The first said that there is a cataract in the right eye and that three injections Eylea, Ozurdex, and Accentrix had to be given, while the left eye is well. The second said that the cataract was in the beginning stage and no removal is required. Only an injection of Accentrix and two laser treatments would suffice. So, now I am confused. Please help me. I have attached few pictures. ### Response: Hello. I have gone through your query and seen the pictures (attachment removed to protect patient identity). You have diabetic edema and diabetic retinopathy in the eye. From what I have seen, the left eye is fine but, the right eye is still swollen. The laser treatment was done because of the presence of ischemic areas" "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 pulled my tooth recently. Now, I have noticed a white patch on my gums, and the gums present on the bottom of my mouth has turned purplish. What could it be? ### Response: I have gone through the attachment (attachment removed to protect patient identity). Your extraction socket has not healed correctly. There can be a left root stump. It makes the healing process delayed. You must visit the dentist to resolve the problem. It is treated with a" "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 eat chicken every week two to three times but I did not get the fat. My weight is 60 kg and my age is 19 years but everything which I eat is like a cold drink which is helpless for me. ### Response: I understand you want to gain mass to your lean body. A combination of right diet and right exercise can help you gain mass at the right places without becoming fat also. It is important to develop mass at the right place so that you put on weight healthily and look good as well. Your BMI (body mass index) is less than what is required for your physique. However, there is no cause to worry. You are a tall young man in your teens (19 years), hence you would have attained your sudden growth spurt a year or two back. Understand that boys grow suddenly in their late teens when they do not put much weight and hence appear very slim. That is what has happened in your case. For gaining mass, your dietary intake should be more than what the body burns. Also, you must do adequate weight training to improve your muscle strength. To improve your weight follow these suggestions. 1. Take two whole eggs in the morning and two egg whites in the evening. You may increase egg whites in the morning or evenings to a maximum of four or five. 2. 3. When eating non-vegetarian food prefer boiled meat to fried items. Fish is healthier than other meat. 4." "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 21-year-old male. I have asthma and hypotension. I am below average weight (5\10\\, 117 lbs). Over the last few months, any time I exert myself beyond normal. I get really dizzy and my vision blurs and tunnels and my lungs hurt badly until I take my inhaler. About 60 seconds later, my head started to hurt. Lung pain decreases over the next 20-30 minutes. I take two inhalers, Salbutamol and Fluticasone, regularly. Is this hypoxia caused by my asthma? Is my steroid inhaler not doing its job? ### Response: As you said you are asthmatic and taking two inhalers. But you suffer exertional dyspnea and fatigue also hypotension and all this is because of hypoxia. Your asthma is not under control. So you need to increase the dose of Fluticasone inhaler or take a combination inhaler of Fluticasone and Budesonide (Symbicort 320). Your doctor will help you to give you the proper inhaler with standard strength. Using Salbutamol frequently is not good as it worsens your asthma. The goal of asthma management is no day time symptoms, no night time symptoms and able to do daily activities without symptoms. So I advise you to see your physician at earliest to increase the dose of your inhaler. 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 a 43-year-old female. I take 20 mg Trintellex, as well as bio-identical progesterone, testosterone, DHEA, and thyroid. I take a sublingual methyl B-12 as well as zinc, P5P, magnesium, Vitamin D, Glutathione and Borage oil. I received bloodworm back today with troubling results:Serum testosterone: 1049 (extremely high)Vitamin B12: 1288 (high)Folate: 13.3DHEA Sulfate 41.1 (low)Vitamin D: 170.4 (high).My other hormones:Estradiol: 62.4 (not sure which phase, very irregular if at all)Progesterone: 3.1Thyroid profile:TSH: .975Triiodothyronine, free serum: 3.4T4, free (direct): 1.09.Looking at the high or low pieces one by one is troubling from my online research. However, I do not know how to look at the whole picture of the lab results to understand what is going on. I listed every result I was given. Please suggest.I knew my hormones were off as I have been feeling extremely depressed lately. I had postpartum depression when I had my two children and experienced post partum depression, which is the same as I am feeling now. So I knew I had a hormone issue. ### Response: I do understand that your blood levels of both make and female hormones are elevated but most likely they are due to exogenous consumption. I was wondering as to why were you taking these hormones?" "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 girlfriend had morning after pill and got her period a few days later. Then we had sex after 15 days of her periods and I did not ejaculate inside her but still no period. Would she be pregnant? ### Response: So, having unprotected sex during this time, even though you ejaculated outside, still the chances of precum inside her vagina remains. Precum contains live sperms and hence there may be a chance that she may get pregnant. So, the best way to rule out pregnancy at present would be to get a serum beta hCG test. If the hCG levels less than 5 ng/dL, that indicates negative result and she is not pregnant. In that case, the deal in menses is due to the morning after pill as it is a side effect. Menses shall resume in next few days and one can wait safely. So, at present please get a serum beta hCG test 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 my periods last month and I missed my periods of this month. My urine test shows a positive pregnancy result. How to know that when I got pregnant? How long it have been that is, how many days or weeks? What are the precautions should I take now? I am living in an area where I could not get medical assistance easily. I have attached my monthly period dates for your reference. Please help. ### Response: Hi. According to the dates you have mentioned (attachment removed to protect patient identity), you have conceived during the last week of the month, as it was the fertile period for you. And, you are almost 6 plus weeks pregnant now. Please get a scan for an early pregnancy to ensure your date and fetal cardiac activity. Also, get started with Folic acid supplements with consent. Avoid having sex, lifting heavy weights and stressful exercises. Regarding food to be avoided are pineapple and papaya. Rest all vegetables and fruits you can have. Take plenty of fluids, vegetables, fruits, iron-rich foods, milk and milk products. Have a regular follow-up with 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 am suffering from ear pain, and a kind of the whole head is blocked like sensation. The left and right ears are blocked with some air or water like state. I have this ear pain for four days gradually on the same pain note.I have taken Aceclofenac with Paracetamol and Amoxicillin. I have also tried Otorex ear drops but the pain neither reduced or increased. The right ear is a kind of inflamed and not even let the drops go through.I am already on Deplatt A, Concor, and Imdur in the morning and Amlong and Rosuvastatin in the night for my angina complaint. I am also on Thyronorm 75 mcg in the morning.I am scared to go out to a hospital due to the pandemic effects, so please advise. ### Response: It looks like you have developed what we call as eustachian tube catarrh. This tube ventilates both the nose and the ear and can get blocked due to allergy or sinusitis or in any upper respiratory infection such as common flu. If you have allergic issues, it has to be adequately treated. e., 12 hours apart for one week can be considered. Otrivin nasal" "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 17 years old. In my right eye my pupil is barely visible in the centered, but it never dilates or constricts, most of the pupil seems to be covered by my iris. My left pupil is perfectly fine and dilates and constricts according to the amount of light. I can see out of the affected eye but it is not as clear as my other eye. I have this condition since birth, and it is not anisocoria. Kindly help. ### Response: I understand your concerns and have seen your photo attachment (attachment removed to protect patient identity). From the image you have attached, I can say that this may be a persistent pupillary membrane. It is a disorder of eye development that occurs during embryonic growth and development. A condition such as this is usually asymptomatic except for the appearance, but if thick can obstruct vision. There are various treatment options, including laser iridotomy which can be done as an outpatient procedure, which will change the appearance. In case you need further information, please let me know." "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 suffering from cancer of the esophagus. I have attached her reports, and she does not want to go through radiotherapy and chemotherapy. Can it be treated through surgery only? Please help. ### Response: Hi. I have reviewed your provided images (attachment removed to protect patient identity)" "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 40 years old and my leg pains while walking. Can I please know what is the reason behind this? This problem started nine years ago. But, now my leg pains after walking even 20 to 30 meters. I am currently on Thyroxine 50 mg. I have had a Doppler ultrasound. Please help. ### Response: Hello. There are many causes of leg pain. The most common is degenerative lumbar disc disease with radiculopathy due to compression of nerve root especially if the pain is only on one leg. The other causes are vitamin D and B deficiency especially if the pain is on both sides and vascular insufficiency. However, the last one is seen in smokers and elderly generally not at this age" "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 30 years old. I have completed my marriage life for three years. I have no children. I have PCOD and thyroid. I have a prolactin level of 53 ng/mL. I am taking Metformin 500 mg. I am taking Caberlin 0.25 mg weekly once. I have severe hair loss. Can I take Kalarchikai choornam along with this medication? ### Response: I can understand your concern. Nowadays, PCOD is one of the most frequent causes of infertility. But it can be managed naturally through ayurvedic medicines. Hypothyroidism also affects the period and hair fall. You should take regular medications to make it fine. You can take Kalarchikai choornam along with these medications. But have a gap of one hour between these medicines. Take Kalarchikai choornam two to three grams twice a day after meals for three months regularly." "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 vagina has cysts and a cut on the inside. I have PCOS and the cysts never hurt until now. I also never have a regular period. And I want to know how I can increase my chance of getting pregnant. ### Response: Hello. If you are planning to get pregnant at this time, you would need assistance from Ob-Gyn. She can give you pills like Progesterone to regulate your menses and have you bleed regularly. By doing this, timing interval when to appropriately have an intercourse would lead to better chance of conception. Once she has established your bleeding pattern, for a month or two, she can give you fertility pills. This are Clomiphene pils which will stimulate your ovaries to actually produce an egg or help you ovulate. Because you have to understand that PCOS patients have difficulty getting pregnant because they do not have regular periods and they do not ovulate." "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 viral infection last week. Is it normal to have increased lymphocyte levels of 52 % and decreased neutrophil levels of 35 % after having a viral infection? It got healed within a week. I was fine when I did my blood test. My RBC and WBC are considered to be normal. As I have anemia, my platelet levels are high. I am worried. Also how long should I need to wait for rechecking my blood test? When would these levels of lymphocytes and neutrophils be recovered? Would urinary infections also affect them? ### Response: After having a viral infection, lymphocytosis can persist for seven to ten days. Your low neutrophils are relative, and it is because of increased lymphocytes. Platelet can be high because of inflammation or by iron deficiency anemia as a reactive thrombocytosis. Urinary infection can also lead to such a presentation. You can repeat CBC (complete blood count) after a week. Attach your reports 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: I have a couple of skin issues. I have some sun damage on my skin and a good amount of acne scars as well. I have been trying to get rid of those stubborn areas for a long time. They are mainly on the sides of my face. I also had a horrible case of folliculitis. It has recently cleared up because of not shaving too close to the skin. I do not have much-ingrown hairs anymore.But, I am now left with all the skin damage that has taken place throughout the years. The razor bumps that I had has also considerably darkened my neck area. I have been to a dermatologist recently. I was first given Retin A prescription (0.05 %) and told to use a Hydroquinone cream along with it. I did not see much results from it. I was then given a Retin A prescription for the dark areas on my face again (the first Retin A medication was too strong % 0.05, and so I was given 0.025 % this time). However, I do not see any change in my dark areas. Along with my Retin A prescription, I was also given Hydrocortisone for the area of folliculitis too. There has not been a reversal in any of my skin condition, not in the areas where I had folliculitis or the dark areas on my face. Please help. ### Response: Hello. I understand your concern, but there are no attached photographs in your message. Kindly send a picture of the affected area to help you better. I need to see the affected area to assess the condition and to suggest the appropriate diagnosis and treatment. Please send the picture of the affected area." "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 25-year-old male. I have had muscle twitches all around my body but primarily in my legs for three months. I had the same twitches last year which lasted about a month. The twitches seemed to subside shortly after I had an EMG done as I was petrified and convinced that it could be ALS or MND. This time round with the twitches (which started again almost exactly a year later), I did not have another EMG as my doctor did not seem it necessary but instead referred me to a neurologist which deals with ALS patients. He did only a physical examination and test and did not have any concerns at all. He also looked at my EMG results and agreed they all read fine and showed benign muscle fasciculations. The twitches seem to have started again more frequently the past couple of days and I have scared myself by reading ALS blogs on the internet where people say that they first started with muscle twitches that progressed into ALS.Do you think I should be worried about ALS? Do you think I have had my EMG conducted too soon to rule out ALS? ### Response: I have gone through your history and events. I wish to know more about muscle twisting. Which parts of the body are affected? Are those twisting and painful? Is there any stiffness in limbs? Is your illness affecting your activities of daily living or occupation?" "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 daughter is 16, and she has been having periods since she was 10. They always came regular, but she almost always has mid-cycle spotting (around ovulation). Recently the spotting has become heavier (she has to wear a panty liner). She has been stressed out, and she lost some weight (on purpose) we joined weight watchers.She has also been exercising (including running). We are very close, and I am 100 % sure she is not sexually active. She is overweight started at 240 lbs and now is down to 224. Does this sound normal? Or does she need to be seen? What can we expect at the visit? She is scared. ### Response: Hello. With the symptoms mentioned here, I do not see any problem with her periods as long as she is having spotting for 1 to 2 days, and I suppose she is not bleeding like periods. And regarding her weight, reducing weight is good for cycles and getting overweight sometimes interfere with cycle regularity, but she must make sure that her BMI remains within reasonable limits as excessive weight reduction will also result in her cycle disturbance. I hope it has helped you. If you require any further queries, please do not hesitate to contact 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 nephew is 6-year-old, and weight is 20 kg, had been detected with ADHD from three years. We had started his medication and behavior therapy around 40 days back under the consultation of pediatrics and psychologist. After 10 days, we consulted a neuro-psychiatrist who recommended us EEG brain (sleep). The report of EEG was abnormal, whereby non-epileptic discharges were captured. The doctor prescribed liquid Valprol in some dosage.Since the finding was abnormal, we thought of getting a second opinion from a neurologist with video EEG this time. The video EEG (awake and asleep) under consultation with senior neurologist gave absolute normal findings. We showed this video EEG report to the previous doctor and asked him why is the difference in his (abnormal) and elsewhere video EEG (normal) report. The former doctor said that once the patient has been detected with abnormal findings, then subsequent normal findings cannot contradict the fact that the patient has the issue of non-epileptic discharge. We are confused about whether we should give him the syrup Valprol or not. ### Response: I have read your concern and seen the reports (attachment removed to protect patient identity). It seems like there is a discrepancy. It would be wise taking to account both results are true positives. It is warranted to that you go to your child neurologist to confirm if these are seizures. Most of the time, a video EEG (electroencephalography) confirms the presence of seizures. If it was not caught on video EEG, a thorough history and physical exam are warranted for your nephew. You can continue the valprol for now and let your neurologist discontinue it on the proper time." "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 17 year old girl. I am taking Depo-Provera injection. Is it good for me and how long should I take it? ### Response: Hello. This injection is to be repeated every 12 weeks. This is quite an effective method of birth control, and when a lady is not able to take oral pills. You can continue this as long as you want birth control and stop when you want to get pregnant. You can get pregnant three months after the last injection. Get regular physical checkup while on this injection, including assessment of bone mineral density. Hope this clears your concern" "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: 10 to 11 days ago I had a gastrocnemius injury on my left calf. The first four days the pain was really bad but now there is no pain. I just tried to do a little sprint, run. I can feel tightness but not pain. What do you think this is? ### Response: Usually, post any sprint or run which is done all of a sudden without reconsidering it as a regular activity there might be doms (delayed onset muscle soreness) and this stays for around 4 to 5 days of time. Post that, the pain reduces in its own without any kind of medication." "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 panic disorder. I am currently on Paroxetine CR 12.5. For anxiety, should I use SSRI or 5-HTPn? ### Response: Hi. I read your query and understand your concerns. In fact, according to available literature, SSRI is the" "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 19-year-old male, no known health problems. My only symptom is a slow resting heart rate. I have seen it as low as 45. I feel perfectly fine, no syncope or dizziness.I am not an athlete so I do not know why it is so low. Is this cause for concern? With heart block, the heart rate does not increase with exercise correct? My heart rate is low at rest but increases as expected with exercise. Does this rule out a problem? If I had clinical bradycardia would not I feel bad as well? ### Response: Hello. Normal heart rate should be between 60 to 100 beats per minute. You are having bradycardia. It can be idiopathic without any cause. But it is better to get physically examined and if needed accordingly investigation can be planned. Rule out hypothyroidism by serum TSH (thyroid stimulating hormone) estimation. Rule out any cardiac cause if present by EKG investigation. Check sodium, potassium and calcium level if needed. If no cause is found, then no need to worry. Consult a physician for 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: I did a root canal before a couple of days. But I have pain in the exact upper tooth of the root canaled tooth. I have attached the X-ray after the first sitting of the root canal. Please suggest. ### Response: I can understand your concern regarding dental health. In this condition, it will take time to have healing of the ligament and tissue at the end of the root of the root canaled tooth as it was previously affected by the infection. So do not worry and take antibiotics and analgesics prescribed by your dentist. If the pain persists even after all these, then go for check up with a radiographic investigation of the same tooth." "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 with my partner before ten days. She took Postpone 72 on the next day. She had bleeding after a week for four days. Now, she has temperature and vomiting for a week. Is she pregnant? ### Response: Hi. Just do a urine pregnancy test, if you think, that she is pregnant. But mostly it will be negative. Now, she has temperature and vomiting mostly due to something other reason. It could be due to gastroenteritis if she ate food from outside. Consult a nearby physician. You may require to do CBC or urine routine test. Taking oral antibiotics and Paracetamol will help. You have to consult a gynecologist to know whether she has a vaginal infection. We need to find the source of the infection and have to treat it accordingly. Mostly, it is due to a stomach infection. The periods can be irregular for two to three months due to the tablet Postpone." "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 mom is 63 years of age. She is getting pain under her right breastbone followed by acid reflux and burning in her stomach with a sour taste in her mouth. They did an ultrasound, which showed three gallstones. She had her gallbladder removed three months ago. Now, she is getting the same symptoms again and taking Omeprazole twice a day. But, it does not seem to be helping. Everything she eats turns to acid. She went to the ER last week and did a CBC, chest x-ray and ultrasound, which came back normal. Now, she has an appointment with gastroenterologist. She has a history of GERD and asthma. Please let me know your opinion doctor. ### Response: I have a few questions; if you would not mind answering them. 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: What are the benefits of natural remedies for chapped lips? Can almond oil, cucumber, lemon juice, coconut oil, a humidifier, sugar and honey, green tea bags and olive oil be used as natural remedies for chapped lips? I would like to know the skincare expert\s view. Please suggest. ### Response: For chapping of lips, the following can be used: 1. Coconut oil has a good emollient effect and forms a barrier over the lips that prevent further chapping. It can be used two to three times a day. 2. Olive oil is another option to treat chapped lips and help in retaining the moisture within the lips preventing further damage. It is used after washing and taking a bath. 3. Rose petals and rose water another important remedy for chapped lips. It has antioxidant properties and due to its fragrance, it is cosmetically acceptable. It can be applied three to four times a day. 4. Lemon juice is full of vitamin C that is ascorbic acid and being a very good antioxidant. 5. Aloe vera is another very important home remedy for treatment of chapped lips. It can be used along with vaseline. 6. Vaseline (petroleum jelly) is a very good and cheap method for the treatment of chapped lips. It gives good protection and provide a barrier and retain moisture. 7. Almond oil and shea butter both can be used for the treatment of chapped lips. 8. Honey has a lot of benefits for skin, apart from wound healing and its antiinflammatory properties it has 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: Is there possible of tetanus vaccination as a prevention of Covid-19? I know that tetanus is caused by bactrim but Covid-19 is caused by Coronavirus. ### Response: You must not use tetanus for Covid 19 (Coronavirus) prevention. However, you can wash your hand after touching anything which might be infected. It is advisable to stay inside the home or keep yourself isolate at least for three weeks. The vaccine is always prepared from the disease bacteria with carefully removing the virulence factor (toxin) removing that normally helps to get from that particular bacteria or virus which was used. Our researchers are trying their best to find out the possible treatment and vaccination for current illness (Covid-19), until then please keep yourself isolate and stay away from the crowd and wash your hand appropriately, avoid touching your face, nose, and mouth without washing at least one minute with running tap water (use soap for better result)." "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: Tattoo removal, can tattoo be removed without injury to the skin or creating a scar? I have gone for two sessions for laser treatment for tattoo removal, and each time there were multiple pinhole injuries, and the tattoo has not faded even a single bit. Is this treatment I am receiving appropriate? ### Response: Hello. Tattoo removal by a laser that is Q-switch laser causes these pinpoint spots as you have sent (attachment removed to protect patient identity). This is a normal phenomenon after laser. But it does not usually create scar if done correctly. Also, it would take at least six to eight sessions for the laser to take effect, so it is too early to say now. Laser tattoo removal is the best way to remove a tattoo for you than a surgical procedure." "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 bad breath problem. I really feel a bad breath in my mouth when I wake up early in the morning. ### Response: I had gone through your question. I can understand your concern. There are two main general reasons for halitosis (bad breath) related to oral cavity or teeth and the second one is related to the stomach. For oral cavity related you need to check for any cavity, accumulation of plaque and any gum problem. If there is any such issue visit a dentist and get scaling done. If it does not help, you may need gastric consultation. Try to avoid smoking and do not keep your stomach empty for a longer period. Take plenty of fluids and you can use mouth freshener till the cause is eliminated." "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 seizure for the first time in my life when I was about 19 years old. The emergency room physician did not do any tests before he put me on Keppra. After I had been put on Keppra, I went to a neurologist who did an MRI and a sleep study. Nothing showed up on either test, but he wants to keep me on the medication. The issue that I have is I think the medication is causing more problems than helping. Why would he keep me on the medication when I was not diagnosed with anything? But I was told that even if I do not need the medication and I still stopped it cold turkey, it could cause seizures. Is it true? ### Response: Hi. I read your query and understand your concern. I hope this answers you. If you have more questions feel free to write 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: About six weeks ago, I started having pain in my right index finger. It was mainly when I used my mouse. A few days after, both of my hands started hurting. It was mainly in my right-hand joints, but also in other parts of the hand too. I got scared that I got rheumatoid arthritis. I read all about the symptoms and went to an orthopedic doctor. The doctor examined my hands and said it was not rheumatoid. I have no redness or swelling or pain when the doctor examined me. And then a few days ago, I started having slight pain in my knees and I also had pain in my back. But, now pain in my hand is almost gone. ### Response: Hi. You do not have rheumatoid arthritis. There is only pain and swelling in the joints along with morning stiffness. If you have pain, you can take Tylenol (Paracetamol). But if there is swelling, fatigue or morning stiffness you can consult a rheumatologist 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 have right shoulder and posterior scapula pain. The pain began a few years ago when a huge dog suddenly tried to run while I was holding his leash, resulting in my arm being pulled. A year after that, I fell on rocks and landed with a right outstretched hand. Now, my right shoulder is lower than the left and winged scapula. My x-rays are normal. I have attached my MRI. Do you notice any abnormalities in my right shoulder MRI? ### Response: Hello. I have gone through your query and also seen the MRI images sent by you (attachment removed to protect patient identity)." "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 ejaculated hours before we had unprotected sex. According to my ovulation calendar, we had sex on the day of my ovulation. If it helps, I have a 30-day cycle, and my last menstruation started six days before. I want to ask whether I can get pregnant with the pre-cum because he withdrew on time before ejaculating in me. I am afraid of what the result would be. And, I took an emergency pill that contains Ethinylestradiol and Levonorgestrel, three days after intercourse. I know it would not affect much because it happened the day after ovulation. But I am hoping for a different approach. ### Response: Yes, pregnancy can occur with just precum as well but as you had taken I-pill within 72 hours then hopefully it would be effective and would prevent pregnancy. It does not matter if it was your ovulation day or not that you had unprotected act, but i-pill works in every circumstances. And second option which you could avail to totally eliminate the chance of pregnancy (as if you have not had taken pill within 72 hours) is to opt for coil (intrauterine device) in this cycle. It can be inserted up to 10 days after unprotected episode and can be kept as a long term contraceptive method or be removed after period gets started. It all depends on your choice. I hope it has helped you. If you have any further queries, please do not hesitate to contact 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: I am a 29-year-old male and in need of some reassurance over my serious health anxiety re MND (ALS). I am not normally anxious or depressed, married with a young daughter and a wife who is pregnant. It stared with an entire all day leg ache (left leg). Two days later my arm started to fell weird, tingles and biceps hurt. Since then (three weeks ago now) I have had the following symptoms. Numb or tingle fingers, feeling of weakness (but not actually weak), pain in hands, feeling of stiffness in fingers, lots of muscle twitches across body but mainly legs, feet, hands and arms, cramp type feeling in both big toes and calf muscles (not full on cramp), nausea and dull headache, dry throat, lump in front feeling, and a scratchy throat feeling. I keep looking for atrophy, though nobody thinks I have that. A sore skin feeling across my lower ribs and upper back like sunburn but without the burn, fatigue.I have seen three GP\s. All three have said they think I am fine, they do not have worries and one said I do not have MND. I have had a complete blood test which had come back as normal. At my third GP appointment, I was tested for strength and reflexes. She could find nothing clinically wrong, no weakness but did mention some quite brisk reflexes but they were symmetrical. Is this normal? a referal was made, she said she does not think it is MND or anything bad basically. I was diagnosed with health anxiety two weeks ago and I am currently taking each day 50 mg Sertraline.Can you please confirm that the symptoms I mentioned are not MND or ALS related? That the twitches are nothing to worry about using your expertise? Confirm that the brisk reflexes on both sides (symmetrical) are nothing to worry about. That the type of cramp I am experiencing is not related to ALS or MND using your experience. ### Response: Hello. Your symptoms are not typical of ALS (amyotrophic lateral sclerosis). You should know that at your age ALS is a very exceptional diagnosis. But there are also a lot of other conditions that may mimic this clinical situation. For this reason, I would recommend performing some tests. Complete blood count for anemia, blood electrolytes for possible imbalances, thyroid hormone levels for thyroid dysfunction, vitamin D levels and vitamin B12 levels for a possible deficiency, nerve conduction studies would help exclude ALS and calm your anxiety." "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 19 year old female. I am a virgin, but I masturbate quite a bit. Before, it was around at least once per day but it has been dying down to mainly the weekends. I use a vibrator and it is not actually a vibrator but a small hand-held massager for the back. I use it on my clitoris and use my fingers for stimulation. I started around 9 years of age but then I had a two year period where I stopped completely, but started again around 12 years and have continued from that. When I was 9 years, I broke my hymen I believe, but only when I was 12 years, I started fingering myself. I use two fingers and actually, I have been bleeding from then. It happens even when I am not on or near my period. My nails are not that sharp, but when I finger myself, I bleed most of the time. The bleeding is very light.Just yesterday I started using a dildo and I was fine. I make sure my things are clean before and after I use them. But today after pumping myself with the dildo I felt a weird liquid flow out of me. I know it was not an orgasm because it did not feel like one. But when it flowed out it was like blood. I have no idea of what is going on. Am I making myself infertile? Does my vagina have some sort of disease? Do I have any health risks from this act? ### Response: Masturbation does not generally hold a great risk but it does cause some complications. Frequent masturbation causes addiction. The mild bleeding you experience with the use of the vibrator could be due to local injury to the vaginal mucosa following a stimulating contact. This is alarming as time and again doing this could convert it to a chronic injury and cause ulcers, sores, andinfection. The dildo you are newly using can also lead to similar problems. I suggest you use them very occasionally or not use them at all. Each and everytime you pass urine, wash and" "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 right arm is numb from the elbow to the wrist and sometime I feel like getting electric shock inside. About 29 years ago, I got my C4/C5 lower disc removed. I have neck and back pain too and for which I am taking Lyrica now. I had an MRI and the report is as follows. Tight cervical spinal canal at C5/C6 disc level and posterior disc herniation seen indenting the ventral aspect of the cord. In C3/C4, C4/C5 and C6/C7 mild diffuse posterior disc bulges seen. Please guide me. ### Response: Hi. Degenerative changes. Surgical decompression. Avoid lifting weight and use cervical collar. Revert back with MRI report 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: My daughter is 1 month and 26 days old. Her birth weight was 3.05 kg. Her current weight is 4.4 kg. She spits the milk after burping also. She has been diagnosed with laryngomalacia. I wanted to know whether it a matter of concern or not. ### Response: Hi. The current weight of the child is absolutely normal according to the birth weight of the child. There is no need to worry about this. Babies often spit very little amount of milk after feeding even after burping, this is a normal thing. If it is problematic, then the weight of the child does not increase. Since the weight of the child is normal according to age, I think this is normal and we should not worry about this. Also working should be done for around 10 minutes for effective results. Laryngomalacia is a condition in which the muscles of the larynx are weak and as a result, there is stridor sound during breathing. This is not a serious issue. Laryngomalacia usually gets corrected around eight months of age. Sometimes calcium levels are low which can result in stridor like sound, so calcium level should be done in the child. If low, then calcium needs to be started." "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: for piles , am using himalaya tablets .daily 2 tablets...but cant able sit properly due to anal itching ......please give me a medicine ### Response: I have reviewed your history. The medication you are on is bascically ayervedic, which sometime may help and sometime not. I would give you some treatment but I want that you should be examined in person by a local general surgeon , if any need of surgical removal of this. Because if pile remain for so long could lead to significant pain and trouble in daily life style. At moment take following treatment. Let me know in one week time if symptoms improve ." "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 chronic neck and back pain that can cause either severe neck stiffness or sharp pain. Most of the pain seems to originate in the front of the neck (SCM muscle) or the cervical spine area. Pain radiates to mid-back and causes spasms of my shoulder blades. Lots of popping when turning my head. This also flares up every couple or few months to the point of being unbearable and requiring a visit to urgent care.Lots of other symptoms some of which include, profuse night sweats, sweating during the day for no reason (profuse), weakness in shoulders and arms (very hard to play tennis anymore), occasional stiffness in ribs, tightness in chest, jaw pain and weakness, forehead numbness, random movement of limbs during day but usually at night (kind of like little seizures but has not been diagnosed) and general neck swelling (neck looks big).I know it is a lot of symptoms, but it is so frustrating. I have a copy of a cervical MRI with me. Curious to know if these symptoms stand out as anything in particular. Working with doctor\s now, but I am mentally and emotionally drained as I have been dealing with this for years with no answer, and it is difficult for the family to understand. Being an athlete could not compete in college anymore due to this. My body could not perform anymore. ### Response: I have studied your case. Due to compression of this nerve root, there can be a sharp pain in your arm and back with a shoulder. I will advise you to send your MRI cervical spine for better diagnosis. For these symptoms, analgesic and neurotropic medication can be started. Till the time, avoid lifting weights, Sit with support to the back. You can consult a physiotherapist for help. Physiotherapy like ultrasound and interferential therapy will give quick relief. I will advise checking your vitamin B12 and vitamin D3 level. Shoulder symptoms can be due to rotator cuff injury or arthropathy. If required MRI shoulder may help in diagnosis. I hope this answers your query. If you have additional questions or follow-up queries, then please do not hesitate in writing to us. I will be happy to answer your queries." "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 29 years old female. I have two babies through C-section. I have hyperpigmentation on my face with the irregular menstrual system. ### Response: Hi. It may occur due to PCOD (polycystic ovarian disease) and CAH (congenital a" "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 46 year old male. I have a desk job where I need to be sitting for eight hours continuously at the computer. I am suffering from these problems since 27 years. When I was 19, I did heavy exercises once and suddenly the heartbeat increased to approximately 180 times per minute. It came back to the normal rate in a minute. But, from that day I have been having heart palpitations. I stopped all the exercises. I tested ECG and 2D. Both the tests were normal. The doctor said my heart is \almost\ normal. But another doctor said that it may be a valve problem. He said this just without testings. But my experiences are \heart palpitations\ and I feel some \weight\ in the heart continuously for four to five months.Then I felt normal and tried doing the exercise again. I feel the same experience. So, again I stopped exercising. So many times these repeated. Three months back, I experienced the symptoms. I felt giddy too. So, I feel very afraid. I immediately consulted the cardiologist. But ECG, 2D, and treadmill (this is first time tested) came normal. I did not test the angiogram. Now I have breathing difficulty, dizziness, and uneven heartbeats when I lie on my side. I quit exercises completely. I am only walking. I do not understand what is going on. Am I straining myself during exercise? Or is it a serious problem? Please help me. ### Response: You have done some tests already related to the heart and found it to be normal. I suggest you do free T4, T3, TSH, Holter monitoring, and Hb %. Based on the reports, the next course of action could be taken. I think you need not worry. Try to control your stress. Do breathing exercise for five minutes two times daily and Yoga for half an hour. Listen to music, spend quality times with friends and family" "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 yellowish tint to my skin and yellow patches in the outer corner of both eyes. ### Response: Yellowish skin and mucous membrane indicate conditions with raised bilirubin levels in the blood. You need to get liver function tests done like serum bilirubin and liver enzymes ALT, AST, ALP, and GGT. If you do not have any other symptoms like nausea, loss of appetite, abdominal pain or fever and if this has always been the case with you, it is probably nothing serious. However, you do need to see your healthcare provider for clinical examination if other symptoms develop. And please get those tests done. Hopefully, 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 a 68 year old male. My height is 5\4"" and weight is 142 lbs. I stopped smoking at the age of 38. I drink on an average of half bottle of beer a day at most. I do prepare my own food, which is mostly organic. I eat meat, egg, little dairy, vegetables, a fair amount of raw food, seeds, nuts, fruit, practically no sugar and very little flour. I am passing regular stools for twice or thrice a day. I am doing about 10,000 to 15,000 steps per day. Six days ago, I got stabbing chest pain on the left side just under the nipple. It was internal and not external. It has happened occasionally all my life, but very briefly and not often. This has persisted for six days. It seems to kick in with exertion, goes away entirely at night. I am mostly free of it all day today, but a very little exertion brought it back even though I walked a couple of miles with no problem. It comes and goes. It does not really hurt unless I breathe deeply. I can cough and sneeze without making it worse. And, there is no external sensitivity. I went to my dentist this week and my BP was 137/82 mmHg and pulse was 79. That was fairly consistent with what I was getting at several weeks ago. My highest BP was about 150/89 mmHg and pulse was 89 bpm. I am not on any regular medication. ### Response: Hi. As your chest pain and heaviness is related to exertion (walking) a possibility that it is of cardiac origin cannot be neglected. A very important feature of stable angina is angina on exertion. The stabbing pain and dull nature, which can better be termed as chest heaviness that starts on exertion like walking or climbing upstairs and goes away on taking rest. Your blood pressure is mostly in prehypertensive state, but your maximum systolic (upper) BP is grade 1 systolic hypertension. Your body mass index is high. Also, you were a smoker till the age of 38. Smoking is a sole risk factor for all sorts of cardiac ailments and especially coronary artery disease. As you have never checked your lipid profile, we cannot comment on your cholesterol and triglyceride level. Your age is in the late 60s and the natural presentation of coronary artery disease starts after the age of 55 in males. In short, your case can be summed up as risk based on the facts of increased BMI, ex-smoker, non-vegetarian and mild hypertension. I would consider it as angina on exertion and associated with on and off dyspnea (breathing problem) on exertion. As you have not mentioned any history of gastritis, heartburn, peptic ulcer, anxiety, lack of sleep, disturbed sleep cycle and muscular sprain (as all of them can mimic the cardiac pain), my suggestion is to get an ECG, 2D echo and treadmill test done. Consult your specialist doctor and take the above medicine. Once it gets confirmed as cardiac origin, then discuss with your doctor and take the medicines mentioned below with consent. Stable angina. ECG, 2D echocardiogram, lipid profile and treadmill test. Angina associated with dyspnea on exertion. Revert back with the reports to 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: I am a 26 year old female. I had my period on 21st and had unprotected sex 12 days later. The next day I took an I-pill. Then, I have had unprotected sex three to four times in the last four days. What are the chances of me getting pregnant? What can I do to prevent pregnancy now? Should I take another I-pill or some other I-pill? I understand that I should be more careful about this from now on. ### Response: If you have regular monthly menses, then mostly you will not have any problem. The second thing is that after four days you cannot do much more. If you have intercourse three to four times in the last four days, then you should have taken precautions or tablets before and not after four days. Now, you have to wait for your period to come. One positive thing is that, if you have regular monthly period, then your expected period is around the next two days. The last 10 days before menses are coming in safe period and you do not have chance of pregnancy if you have unprotected sex during this time. You can go to the doctor and ask for copper-T as emergency contraception today only. It can be placed up to five days after sex. It inhibits implantation of pregnancy. Also, there is no study if you take I-pill for two times in one cycle will be effective or not. So, it is not that easy and also, it can disturb your cycle for at least one or two cycles. Either go for the copper-T or wait for your period for more than four to five days. If you did not get period, then do a urine pregnancy test. If that is negative, then wait for sometime. If that is positive, then you will need early termination. Have protected sex and stay safe. I-pill is emergency contraception and it is not like you can take whenever you like." "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: Today I got my wisdom teeth pulled and they said they were gonna give me a shot in my mouth. There is no way I will be relaxed. Is there any option they would do for me to be more comfortable? ### Response: Hi. Yes, this is the only way to get local anesthesia. You can also go for general anesthesia but it will be too costly and needs hospitalization. It is a simple procedure, and you will only feel a prick like an insect bite. Do not worry, it is simple and there will be no pain during the procedure. If you are too apprehensive tell your doctor that apply some local anesthesia at the site of the prick, you will then even not feel the prick too." "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 negative HIV, ELISA test on 54th day, 108th day, 210th day and 260th days. May be all tests are second or third generation tests. I also have done an HIV test with the help of home test kit which shows result in 10 minutes. The result is negative.My questions are what are the chances of a false negative? Whether I need anymore testing like PCR, RNA/DNA test? Does three months HIV test is considered conclusive? What are the chances of transmission in case of protected sex (no anal or oral sex)? Whether deep kiss or smooch can transmit the virus? ### Response: Hi. I will answer your query specifically. In your case, the chances of false negative are almost nil. Chances of false negative are high during the window period which extends from three weeks to six months. Usually, a person having HIV has detectable antibody levels by a month. Almost 97 percent of people become seropositive by three months. By six months any person having HIV will develop antibodies. Only a few cases have been reported where seroconversion occurred late after a year. As you have done your tests at monthly intervals till six months and the results have been negative, chances of it being false negative are almost negligible. You do not need any other tests. We consider three months as conclusive but prefer to do a test at six months too. If you have used a condom, you need not worry. If only sex is unprotected chances of spreading through single contact are 0-1%. Kissing does not spread infection. 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 suffer from severe constipation for the past three years. I have undergone cervical spine surgery before two years back. Post surgery constipation problem still got worsened. Presently, I am taking Baclofen 5 mg three times a day for the spasticity in legs. Please help. ### Response: Hi. The first option for treating constipation is starting with Sennosides tablets. Take two tablets every night. If there is no improvement in two days, you can take two tablets for every 12 hours. This medication can be taken for now and on. Sometimes you may need more fiber to make bulks in the stools. Psyllium Plantago is a natural laxative, and it helps for maintaining an adequate amount of fiber. You should take at least 1.5 liters of pure water every day. You can add milk of magnesia 15 to 25 ml for every eight hours until the stool gets soft. It has to be taken when there is bad constipation once in a while (two to three days for every ten 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 37 years old and I weigh 100 kg with a height of 168 cm. I am a pre-diabetic. I m taking Metformin these days. If I lose like say 25 kg then can I stop taking medicines and control my blood sugar normally? Can this diabetes be cured? ### Response: Changing your lifestyle by regular exercise like walking at least half an hour every day and weight loss of say 30 Kg can help regulate your blood sugar levels. In addition, follow up your blood sugar by doing HbA1c (glycated hemoglobin). The HbA1c should be less than 7 every three months and if it reaches that and remains less than 7 in this time you can stop the medication but even you should still be doing the HbA1c every three months and continue a healthy lifestyle and exercise" "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 worried because my gum has been swollen and I was in on and off pain on the left side of my jaw after a filling two weeks ago. Before that two months ago, I had a crown lengthening, and I was supposed to get a crown, but the dentist two weeks ago said it is best to do a filling. Now I have what looks like a pocket or inflammation around the tooth that was placed with a filling.I saw that dentist today to get it checked, and she said it is the gum inflamed, and that I might need to lose the tooth or see the periodontist who might be able to fix it if it does not heal in a week. In that week, she told me to use mouthwash every day, floss extra diligently, and clean the area. Will this help, or am I in significant risk of losing the teeth? If I have to see the periodontist who did the crown lengthening, what would they do? ### Response: There are two conditions with your teeth, and it might be only due to overhanging filling or due to a pocket surrounding the affected tooth. In that case, you should go to the periodontist first, he will clean the area and give you a better idea of what is happening around the tooth. In the worst cases, it may happen that you will have to get your filling removed and get that tooth root canal treated. But all of this can be clear only after an X-ray. For now, warm water and salt rinse is a good option, no doubt but go to your periodontist as soon as possible." "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 35-year-old female. I checked my blood pressure today and it was 140/80 mmHg. I was told it was high. Is this normal or high. I am really worried. Please help. ### Response: Hello. It is borderline. It is not worrisome. When blood pressure is elevated above 140/90 mmHg. Then it is considered elevated. Such once in a while, elevated blood pressure readings are well accepted. You should monitor your blood pressure three times a day for a week with an electronic blood pressure apparatus. If most of the BP readings are above 140/90 mmHg, then you need to take medicines. If only some readings are elevated, then it is fine. Also, when BP is measured after exertion or in the hospital, then it may be falsely elevated. BP should be measured after a rest of five to ten minutes with arm relaxed. Anyways, you should have a healthy lifestyle like avoiding fatty oily and high-calorie diet and regular exercise, plenty of fruits, etc. 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 23 year old woman. I am 5 feet 6 inches. I have bowel issues and constipation quite often. Lately, I feel very exhausted, have severe back aches, and a metallic and soapy taste in my mouth that will not go away. I am not sure what is going on. ### Response: You can be suffering from one or all of them as these are associated with each other.Please find the cause from above and get treated and examined by a gastroenterologist soon." "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 CT scan with contrast and they found this: The noncoronary sinus of valsalva is prominent. At this level, in the coronal plane, the aortic root measures 4.0 cm in diameter. What does this mean and should I do anything about it? I am 37 years old male, exercise a lot. Resting pulse is 45. My father died in the late 40s of heart disease. ### Response: Hello. Your aortic root is mildly dilated. , then this needs no treatment at present, but just observation. At this borderline dimensions, we just observe the patients and if it increases more than 50 to 55, then needs surgery. However, if it is genetic, then surgery is done at lesser dimensions. So, you will need regular follow up and 1 to 2 yearly CT scan to keep watch over the dimensions of the aorta. This could be done with echo as well. You should also have an echo if you did not have any. You should get yourself examined by a local doctor once to rule out syn" "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 trying to understand how a Coombs test would be used to diagnose me for cold-agglutinin-disease. Can you please help explain in understandable terms what that would do? I am confused between direct and indirect tests. ### Response: I am trying to explain to you about the Coombs test. Basically, this test detects antibody-coated red blood cells. The direct Coombs test detects antibody coated on red blood cells. In cold agglutinin disease, the IgM antibody coat the red blood cells. So direct Coombs test is for testing for cold agglutinin disease in which antibody-coated red blood cells can be detected. In this procedure, Coombs serum means AHG is used to detect the antibody. So if direct Coombs test is positive at low temperature (because antibody in this disease bind to red blood cells at low temperature) then it suggests cold agglutinin disease. However, clinical correlation in the form of liver and spleen palpation should be done along with peripheral smear examination report for further workup." "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: Yesterday I consulted an orthodontist, and I was told, that to keep the changes that braces will acquire, they will have to pull out four of my healthy teeth, without including the wisdom teeth. Those are going to be four premorals, two on the upper jaw, and two on the bottom jaw. I heard that it is the only way because of my severe jaw defect. I was wondering if it can be true because nobody wants to get rid of healthy teeth. ### Response: Hello. I can tell you about treatment in the broader sense. In case of the shorter lower jaw, either a surgical and orthodontic treatment is done (in case of poor esthetics, both jaws and teeth are corrected) or orthodontic correction of only teeth. Since your question is about the second treatment plan and pertains to extractions I will answer that. Extractions are relatively common in orthodontic treatment to create space. In cases with smaller lower jaws with space requirement, upper arch extractions are mandatory. Lower arch extractions are also advised if there is space requirement or extractions needed for bite improvement or maintenance of normal bite. So it is reasonable to advise the extraction of four teeth. You can send pictures of your teeth and X-rays to confirm whether this fits your case." "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 wide midline maxillary diastema. Is it curable and what are the chances of its relapse. I have missing lateral incisors. ### Response: Midline diastema can be corrected basically by two methods. One, using a filling material or crowns which can be done in a single or few appointments. Secondly, by using braces treatment which can be relatively for a long time success depending on the severity or combination of both the above methods. Since you have mentioned that it is a large diastema the combination method would be the one I prefer. But I do not want to misguide you without even seeing what exactly the condition is. I request you to send me a picture for a more appropriate advice. Else, I advise you to visit your nearby dentist preferably a specialist in smile design to analyze your current complaint." "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 cut my gumline due to brushing too hard. I have a slight recession on my gum. I am taking good care of my teeth. But I am panic. There is no bleeding and pain present. I used a water pick to clean it. I visited a dentist before four months. ### Response: Hi. I can understand your concern. I have gone through the attachment (attachment removed to protect patient identity). You have a pathological pocket or a healed pathological pocket. The gum recedes due to the pocket or due to faulty brushing technique. I recommend you get oral prophylaxis (dental scaling) done. Use an ultra soft toothbrush. Use modified bass technique for brushing. Also, have a habit of maintaining your brushing time within three minutes. Please let me know if you have any systemic condition like diabetes or hypertension." "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: Why is it that you are supposed to take blood pressure when seated and rested for two to five minutes with your back supported? Is not it important to know what your blood pressure is when you are walking around and going about your day especially if that is what makes blood pressure rise? I never understood and I am really curious. ### Response: This is because it is a normal response to the blood pressure rise with exercise and such increments are not harmful to the body. Exercise-related blood pressure will vary with the level of exercise so we will not be able to standardize it. On the contrary, baseline blood pressure at rest predicts the future outcome and all studies are done on this basis 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 just recently started dating a man that informed me he has type 1 herpes. I want to know the risk factors and protective measures I can take if I choose to start a sexual relationship with him. ### Response: Type 1 herpes is a sexually transmitted virus. It spreads with contact with an infected person. It can lead to oro-genital infective lesions. To prevent it, avoid any kind of sexual contact with the infected person especially when the person is having active lesions. If you already had the contact, take precautionary prophylaxis of antiviral medications. Yes, you can have sexual contact with the person but there will be minimal chances of getting infected even if the partner is not running any active lesion. Condoms do not prevent the spread of infection in this case." "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 30 years old. I am so hearted psychologically because of the bad difficult odor which comes from my foot. When I wear shoes, my feet immediately feel warm and release a bad odor in just a few minutes. The worst thing is that it also has a smell without shoe whether I washed or not. This made me stay far from my friends, co-workers, family, and from my society almost. I tried some medication from nearby health centers such as Flucanozole, Decozol, Aquax and so on still using but no change. I lived with a problem for more than 10 years. Please, could you suggest me something? Why my foot smells badly with no shoes and even affect my neighbors? ### Response: Hello. Follow this prescription. Maintain hygiene of area and wash it with mild soap and water. Use Silver Zeolite powder on your feet after" "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 8 years old. In school, mostly he is good for everything. At home, he gets angry with parents and his 2 years old sister. We cannot shout at him for anything. Mostly he will not listen to us. He will be making loud sounds, taking a knife, telling he wants to die like that things. He is ADHD child. So, please help us. ### Response: Hello. Yes, your child does have some behavioral problem which can be tackled through parental counseling. So, the way you tackle with your child is the most important thingparental counseling 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: A portion of right lower number 7 tooth chipped off (the light cured section was done two years back) along with partial silver filling done in that tooth during taking food. The dentist took an X-ray and suggested RCT with a crown. I have started the RCT but she has said that the RCT will be completed in two sessions.My questions are:My previous experience with RCT is that it took 5 or 7 sittings. Can RCT be completed in two sittings? Can I go for a permanent filling after RCT rather than going for the crown as suggested? ### Response: Your first concern is regarding the number of days of your RCT. RCT can be done in a single session or 2 or 3 sittings depending upon the severity of your case. If there is severe pain or infection, the dentist may have to delay for treatment for 3 or 4 sittings. You should go for a permanent filling after RCT, which is mandatory. But, you definitely should wear a crown because your teeth are more brittle after RCT, so there is more chance to break off. You can go for a crown after six months once you make sure you have got no pain." "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 sister has chicken pox, and I have never had it before. Exam season is coming and I am worried that I might get chicken pox. My sister lives in the same house as me. Is there any way I can prevent getting chicken pox and is there a high chance of me getting chicken pox. I understand, that this virus is highly contagious but I am worried this may interfere with school. If I do get chicken pox, how long would it take for it to scab? Also, how long would it take for the scabbing to disappear, since I am very self-conscious? I look forward to a quick reply. ### Response: Hi. It is highly probable that you will get infected unless your sister has been in isolation. There first few days of the rash are most infectious. When the scabs are formed infectivity is gone. It takes about two weeks or more for all the blisters to scab off so in case you are infected, I will say off school for two to three weeks. Hope this helps. But hoping you would not get infected. Avoid sharing a room or an enclosed space" "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 floss stuck underneath my permanent retainer (had retainer for almost five years now) on my lower jaw. There is no pain, but I would like to find out how to remove the floss. ### Response: Hey. For removal of the floss, you can use a tweezer. Another option is to try the superfine interdental brush, like Stim proxa and if it is not working out, then go to a local dentist. Do not try to mess with it much as this can cause a problem with your retainers. You do not have pain or bleeding of gums, so, it is not much of an emergency. But, still, you can do lukewarm water with salt gargling. If you can send a picture of the stuck floss, I can guide you much better" "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 experiencing erectile dysfunction. Are there any over-the-counter medications for a quick solution? I am on a tour with my wife and I am not accessible to any specialist. Please help. ### Response: I suggest you can use tablets used to treat erectile dysfunctions like Sildenafil 50 mg or Tadalafil 10 mg. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. Sildenafil is to be used daily while Tadalafil can be used in an interval of three days as it stays in the body for a long time. These" "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: The lightning crotch is a pain that shoots to the pelvis during pregnancy. Does it affect the baby during pregnancy? ### Response: No, the pain is felt only by the mother, and it does not affect the baby. As the baby grows, the gravid uterus puts pressure on the lower limbs and nerves causing shooting pain. The baby is always comfortable, and it is well protected within the uterus." "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 31 years old. During my second echo with bubble test, it says that I have an interatrial septal aneurysm, but there are no holes in my heart. I was given blood thinners. I am currently taking Clopidogrel. What is the cause and cure for this? What kind of lifestyle I should be maintaining? I am scared. ### Response: Do not worry about it. It is a congenital problem, and there is no particular reason for it. It is seen in one to two percent of normal individuals. Although, there is a slightly increased risk of clot formation over the bulging of aneurysm and stroke, however, it does not cause any problems in most individuals. There is no specific lifestyle for it. In general try to have a healthy lifestyle as much as possible like avoiding obesity, etc. Usually, we do not give any treatment for it. You may continue blood thinners if your doctor advises it. 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 need some advice. I had a baby eight and a half months ago. One week after she was born I went and got the depo injection. I did not get a period at all until 17 days ago and still has not stopped. It is very heavy in the morning but light throughout the day. Please suggest. ### Response: Hi Do you mean you had only one shot of Depot, eight and a half months ago? In that case, its effect is gone. It lasts only for three to four months only. I hope you are breastfeeding. Now usually in the postnatal period, there is a long phase of no periods. Then gradually as you reduce breast milk and gradually increase the top feeds, the hormones gradually come back to normal. So you get periods. But still, it will not be fully balanced. So do not worry about the initial few periods after this long phase of no periods. You do not need any medication, it will get regularized. Your next period will be normal. If you want to reduce bleeding, have tablet Tranostat 500 mg three to four times a day depending on the severity of bleeding. It is not a hormone and has no side effects. 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 not able to overcome the past experiences I have faced due to an orthodox family background. I am trying to compete in this big IT sector in a rat race but even after trying my best, I am not content, happy and satisfied. I have quite literally fought a battle with my family to get out and have an independent life and career. I am still fighting for many things but they seem to find ways to pressurize me into one thing or other, and the issue is that even after staying out, I bother and think over all this. I try and compete with everyone but due to my anger and aggression, I fail to make a place in people\s heart. Kindly guide me on this and let me know if I can come for a session or consultation to your clinic. ### Response: Hello. Remember, every problem has a solution you just need to try solving it and help is just a step away. Feel free to ask if you have any further queries" "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 acne scars. What are the treatments followed to make the acne scars go away? ### Response: Acne scar treatment depends on the type of scar. Boxcar scar is a superficial one. It can be treated with microdermabrasion combined with peel, and dermaroller. Ice pick scar is a small deep scar. It can be treated with TCA CROSS (Trichloro Acetic Acid chemical reconstruction of skin scars) procedure. Rolling scar needs subcision (minor surgical procedure) and fractional Co2 laser. Hypertrophic scar requires treatment using an intralesional injection of Triamcinolone acetonide to flatten it. Please attach your clinical picture soon so that I can 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: I spent three nights with a girl I met online a week ago. There was no intercourse, but we had unprotected oral sex, mutual masturbation, and kissing. I later found out that she has had a pretty crazy sexual history (unprotected anal sex and vaginal sex). Am I at risk of HIV? My worry is that she tried to rub my penis with her vagina, but I stopped her. I am worried about what if it touched? Do my other activities warrant a need for a test? Please help me. I am in agony, and I cannot live like this. ### Response: Unprotected oral sex carries negligible to low risk for HIV acquisition especially if there are fresh cuts or sores or lesions or bleeding gums. Mutual masturbation and kissing are quite safe. Rubbing vagina without entry, I do not think will cause any harm. Overall, I suggest you to get tested for HIV at four weeks of the exposure and if the result is negative, get a confirmatory HIV antibody test at three months" "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 fiance and I got intimate last week. The top part of his penis was wet. I am not sure if it was urine or pre-cum. He rubbed his penis outside my vagina, but there was no penetration. I took Unwanted 72 on the next day. Are there any chances of pregnancy? ### Response: Hello. It is highly unlikely for you to get pregnant. Hope this helps you and get back if you have any doubts." "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 41 years old. I had two full term normal delivery. I do not have any menstrual problem. My cycle is regular for 28 days with three to four days of bleeding. My last menstrual period was on the 5th of this month. I have been having lower back pain and groin pain for the last 10 days. I feel more pain while sitting and severe on and off spasm in the inguinal region. My TVU showed three small fibroids, two subserosal (2.8 x 2.2 cm and 1.3 x 1.2 cm) and one submucosal (1.5 x 1.2 cm). I have been treated for UTI, but there is no relief. My mom is 66 years old and recently got treatment for early breast cancer. I need some advice on my issue. Please explain whether the cause of the pain is fibroids or not. I need some advice if fibroids could be the cause. ### Response: Hi. The fibroids can cause lower back pain and groin pain, especially around the time of period. However, if you do not have menstrual problems due to it, then no need for treatment. Usually, mild painkiller can be used for the pain at present along with simple home remedies. If the pain persists, then it would be good to get evaluated for other causes of back pain, because symptomatic fibroids would cause menstrual issues as well." "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 failed IVF cycle. None of my embryos made it to day 6. On day 5, one embryo was transfered. I am not getting proper answers from my clinic regarding the quality and growth of embryo that was transfered. Is the quality of the embryo good? Is this how it is supposed to look on day 5? ### Response: It is a poor embryo with irregular cell walls and nuclei (attachment removed to protecct patient identity). It is unlikely that it would reach towards a successful pregnancy however if it has been implanted then just follow up with scans." "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 19-year-old female. I had my wisdom teeth taken out about four days ago, and now the gum behind where the wisdom tooth used to be is very swollen and causing pain. ### Response: Hello. I have been through your query and I can understand your concern. Pain after the extraction is normal and that too for the wisdom tooth which often requires surgical intervention." "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 29-year-old male. I have been experiencing something like constipation for the past one week. I have had no abdominal pain, but I feel like I need to go to the bathroom. I have a bowel movement in the morning, but I feel constipated the rest of the day. I took some stool softeners a couple of days which helped, but I am still experiencing the need to evacuate my bowels. Also, I am passing some gas, but it is coming in little blips. Should I take a laxative or could it be like hemorrhoids or something? ### Response: Hello. The cause of IBS is not known, but this I related to some sort of stress at work, studies, etc. You could try laxatives and modify your food in terms of food low in FODMAP. FODMAP is an acronym for fermentable oligo, di, monosaccharides, and polyols. You should avoid high FODMAP diet." "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: Under normal circumstances are there any common viruses or bacteria (harmful microorganisms in general) that would be viable after three years? ### Response: It would have been better if your query had been clear about whether you meant the normal circumstances inside the human body or in the environmental condition. Inside the human body, bacteria and viruses can survive for many years without causing any clinical disease in the host and such type of hosts are called as carriers. When favorable conditions develop, these microorganisms leads to development of clinical diseases. Second about environmental condition, viruses multiply only inside living host and they cannot survive outside their host for such a long period of 3 years. The duration for inactivation of viruses in the environment is different for different viruses. About bacteria, many bacterial species can survive in the environment for a long period if they have favourable environment. It includes many non-pathogenic and some pathogenic bacteria and also some opportunistic bacteria." "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 had my thyroid test done. I am attaching the reports of the same. The note reads that a physiological rise in total T3 and T4 levels are seen in pregnancy and patients on steroids. Does it mean that I am pregnant? I am worried, as I am unmarried and have never had sex before. ### Response: Hello. I have seen your reports (attachment removed to protect patient identity). Hope this helps you and get back if you have any doubts" "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 child who is three years old. He has an abscess on his gums above his front tooth. X-rays are taken, and the dentist wants to pull out the tooth. He says that the roots are gone. So there is no need to keep it. The tooth appears perfect when you look. Is it possible to give him antibiotics to save this tooth? Because I know, as it will be around three years for his permanent tooth to come. ### Response: Since your child is only three years old, so the chances of root resorption are low which means that his roots must be intact. If the root is intact, then you can go for the procedure called pulpectomy, which can save the tooth. Even the antibiotics can help him for the time being as it is going to take three more years for him to get his new tooth. So you can consult another dentist to get the second opinion about saving his tooth" "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 go for hair transplantation. So, kindly advice me about which is the best option. ### Response: Hello. From your photos (attachment removed to protect patient identity), I can see that you have grade 7 baldness with limited donor hair. But, you have also got small, thinned-out hair in the hair loss area. So my suggestion is as follows. You should understand that the result you can expect is not a head full of hair, but enough hair to cover your baldness. It is a one-day procedure. You can get a 2000-grafts transplant in one session followed by the second session six months later if you want. You will require a review on the third day after the transplant and it can then be followed up 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 son is 20 months old. He is suffering from UTI. Since yesterday, he cries while urinating in the morning. He has fever for two days and cough and running nose for five days. The general physician gave Cefpodoxime oral syrup, but urine test has to be done tomorrow morning only. Should we start the antibiotic? No pediatrician nearby and we have to drive six hours to another town for the pediatrician. Please suggest me? ### Response: Hi. Crying while voiding urine and fever might be due to urinary tract infection (UTI). Urine routine and microscopy needs to be done for screening and if it suggests infection, then urine sample for culture and sensitivity needs to be given and oral antibiotics has to be started. The culture report, which takes two to three days will guide the further use of antibiotics, if any infection positive. Antibiotics should be started only after giving off a sample for culture and sensitivity, if UTI is suspected. Giving urine sample for testing after taking antibiotics might alter the test report and delay the infection." "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 seeking insight from a psychological professional on how awards affect us. Why we give them? Why we deny them to others? And what impact it causes to the one who is receiving them or not has on one\s career? Please explain both from the recipient or non-recipient perspective and from an employer mindset. ### Response: The topic of effects of awards is complex. The awards act as positive reinforcement to any individual and thus the probability of repetition of behavior increases. If we consider it from a psychological point, then if an individual is given award then it acts as an operant conditioner and the individual tends to seek another award. All this increase the probability of repetition of desired behavior. If an individual is showing desired behavior but is not given reward then with time the occurrence of desired behavior decreases. So, reward acts as a method to get positive results, if we consider it in a company or in an organization. If we consider it on the basis of a physiological point of view, then reward stimulates corticolimbic pathways. This cause release of Dopamine which helps in the feeling of pleasure. This pleasure results in repetition of behavior and increased work efficiency." "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 final year obstetrics and gynecology post graduation student. I am taking my MS OBG exam in the next 20 days. I have been having some issues in my marriage with my husband. Most of the issues happened because we have been staying far away since three years. It has got so poisoned that it will only get sorted out when I go back and start living with him. The present problem is that I am not able to concentrate on my studies at all. I really need to study well and I am desperate to clear this exam as fast as possible and go back home. I keep crying all the time with my books open. Fight conversations keep popping in my head all the time. I feel miserable. I have tried every conservative measure from counseling to music, but nothing works. I feel like a depression now. There is no time left. I was never this weak before. I just need some medication only for a month till my exams, to concentrate and stay focused on studies. To avoid distraction, crying and less negative thinking. It is like a do or die situation for me. Please help me. And most of the psychiatric drugs are either not available in the medical store or are prescription drugs. So, please give a common drug and make it available for me. I will be really thankful to you. ### Response: I can understand what you are going through and you have my sympathies for the same. Exams.Marital issues. Major depressive disorder. Revert back for further doubts to a psychologist counsellor 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: For the past three weeks, I have been feeling a strange sensation which seems to be a form of vertigo. When walking, it feels as if the ground is bouncing or rocking (as if on a boat). I seem to not have this sensation right away after waking. However, after an hour or so, it comes back. I have also experienced what may be migraine aura symptoms (seeing black spots occasionally) which is sometimes also accompanied by a headache or head pressure or fullness. This bouncing or rocking sensation is really starting to worry me. I am not sure if it is due to an inner ear issue or neurological. I have started taking Meclizine and Ibuprofen which do not seem to help entirely. If possible, please advise on some potential causes, I would greatly appreciate it. ### Response: Hello. I have gone carefully through your question and would explain that your symptoms could be related to an inner ear disorder. Anyway as your symptoms are not improved by Meclizine, I would recommend consulting with a neurologist and performing a brain MRI study. It is also important checking thyroid hormone levels for thyroid dysfunction." "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 and I are both 29 years old. I have been diagnosed with hemoglobin E disease. My hemoglobin A is 68.7 g/dL, hemoglobin F is 9 g/dL, and hemoglobin E and A2 are 26 g/dL. And my wife has been diagnosed with a hemoglobin E trait. Her hemoglobin A is 9.1 g/dL and hemoglobin E and A2 are 77.1 g/dL. We are planning for a baby. What is the possibility of our baby acquiring thalassemia major? What are the other complications during or after pregnancy? I have always had mild anemia, my hemoglobin always ranges from 9.5 to 11 g/dL. ### Response: I have gone through your attached reports (attachment removed to protect patient identity) and history" "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 concerned about a possible raccoon roundworm exposure. I have read that I can take a prophylactic 10-day course of Albenza to keep any eggs from entering my CNS. I might have type 2 diabetes for a while and have put off bloodwork to find out. I am a glaucoma suspect based on the last eye exam. How hard is Albenza on the body? Is it generally well tolerated for many days? Do immediate side effects get better after a few days? ### Response: Hello. Albendazole 400 mg single star dose is enough for prophylactic deworming. 10 days course is not required. Usually, it is very safe and is well tolerated. A rare side effect is a seizure, that can happen if the worm is already lying dormant in your CNS. I generally prefer a three-day course of Mebendazole 100 mg twice daily as it does not enter CNS and so there are no changes of seizures. I hope it helps. If you have any further queries, please ask 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 and I had sex and a day after, the skin on his penis was peeling. I have no clue what it means. It is still peeling and we had sex a week ago. I went to get it checked out I have not heard anything yet. He said he got checked two weeks ago and I got checked a day after. Please note, I had chlamydia two years ago. ### Response: The peeling of skin after sexual intercourse occurs in 3 to 5 % of men. The most common cause is allergic (contact dermatitis), followed by fungal infection and STD like chlamydia or gonococcal infection. However, STD is associated with pain and dysuria. The other two are possible causes in your case" "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 problem that I am a newly married person and having ambiguity with the vagina. There are two ways in the vagina of my wife and between this way, there is just a little bit clot in the vagina. How can I remove it? ### Response: Hi. If you are certain that there are two passages in the vagina, it could just be a minor vaginal septum, which is common and can be removed surgically. There are no complications. Or in some rare cases, your wife may be having two sets of a uterovaginal canal, also known as uterine didelphis. In that case, I do not want to scare you, but your wife is at risk of recurrent miscarriages, premature birth, kidney abnormalities, etc. Physical examination and USG pelvis or MRI pelvis for your wife will rule out such condition." "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: Anxiety is every day of my life. I rarely get small breaks without anxiety. It has been 10 years now. Panic attacks do come. I am taking Xanax 0.5 mg 1 to 3 days. I am a 26 years old male, and my height and weight are 5.9"" and 80 kg respectively. Please help. ### Response: With your brief description, it appears that you are suffering from some anxiety disorder most probably generalized anxiety disorder." "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 found that I had hypothyroidism 20 years ago. I delivered a baby girl four months ago. During that time, I was having 112.5 mcg of Thyronom daily. I was 79 kg before delivery and I am currently 67 kg. I have severe hair loss and my skin is extremely dry. I feel extremely low some days and I do not know whether it is due to thyroid imbalance or due to hormonal changes after pregnancy. Should I reduce the strength of Thyronorm? I had taken a blood test last month. I am attaching the same along with this query. ### Response: Yes, I suggest you lower your thyroid medication as your labs (attachment removed to protect patient identity) revealyou are now hyperthyroid and this may be contributing to some hair loss (in addition to pregnancy). I would suggest 88 mcg daily and repeat another TSH (thyroid-stimulating hormone) in six weeks" "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:Shortness of breath and ongoing anemia since giving birth.Bruising stomach, right arm and behind the chest.Painful legs.I am attaching files. ### Response: Hi. Shortness of breath can occur secondary to anemia postpartum and are interrelated. However, bruising of arm and stomach may indicate underlying coagulopathy or embolic phenomena secondary to deep vein thrombosis" "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 28 year old girl. From the last few days, I am feeling breathlessness at my hostel. I am fine when at other places like office and home. It is only at the hostel where I feel breathlessness. Can you please help me understand the exact reason for this problem? What all open solutions do I have? One more point I want to say, I do not know whether this is related: my hands and feet remain very cold, even though I have my gloves and socks on. One of the doctors said my estrogen levels are high. Please suggest a solution. ### Response: Your hostel must have some particle, like mold, pollen or some other allergen that causes you breathlessness.So, kindly go for serum IgE total. If it is higher than 1000, then go for IgE specific for Aspergillus Nothing to do with cold hand and feet. It may be due to low BP or mostly normal phenomena in winters" "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 underwent surgery for a blood clot in his brain before 10 months. Doctor said that the surgery was done twice as the clot was not removed properly for the first time.My father is totally fine now, but I want to know if there is any possibility for the clot to occur again. He is on his medication for high blood pressure. Please give an opinion. ### Response: Hello. I reviewed the scan reports of your father. The clot that he had is called chronic subdural hematoma which usually occurs in aged person due to brain shrinkage. Due to shrinkage in the brain a space is created between brain and skull. If the bridging vessels in the space got injured,hematoma can occur in due course of time. In your father\s case eventhough the hematoma has been removed, there is still some space between brain and skull which is likely (20 to 30 %) to cause hematoma. Keep him 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: About two years ago, I was playing a video game while wearing a headset with fairly loud burst sounds from time to time, and I noticed a small hissing sound was present in my ears or head when I was getting off my PC. I have always used headsets for long hours before this occurred. Ever since then this tinnitus has moved from one ear to another, and then centralized in my head. Anyhow, now whenever I put on and listen to a headset for a short period even on low volume, my ears hurt. The sides of my head around the ear and the tinnitus spikes up usually. I have tried several popular and expensive headsets with same results. Other symptoms I have are I have difficulty breathing through my nose, I feel emotionally numb, anxiety, my jaw locks sometimes when I bite on hard food and sometimes it does itself during sleep. The bones around my ear hurt. I do not know if any of the symptoms are related. But I have not been to a doctor for various reasons. ### Response: Exposure to loud sounds creates pressure over your nerve of hearing and can evoke tinnitus. Hence, I advise you to use minimal sound during games. The pain in and around your ears is due to excessive usage of headset around your ears. For your nasal obstruction, you should get a diagnostic nasal endoscopy done to rule out the cause and proceed for further investigations. Locking of your jaw can be due to the TM joint which locks more in the morning and creates pain when infected leading to pain while biting hard foods. Hence, a muscle relaxant is advised." "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 33 year old male. I am from prickling, numbness, warm sensation in my feet and hands and tingling in my lips and mouth for the past two years. I had a severe cough for around two years and recently, it got resolved. My issue, initially started with prickling and burning sensations in feet and after that both palms. Now, it has increased above knee. I visited a neurologist, but the problem was not solved. Presently, I am suffering from numbness and tingling in the mouth on lip area, prickling, burning sensations and numbness in feet, legs and palms, getting tired after moving through staircase, feeling some discomfort in chest area like heaviness for some time, gas problem and recurrent mouth ulcer. My sugar test, BP, NCV, ANA profile, TMT and ECG are normal. ACE 69, HSV1 positive, vitamin D 17 deficient and uric acid 8.2.I am completely blank now; I am not getting any hope of good treatment for my problem. I had unprotected sex 9 years ago. My CMIA test and rapid HIV test came back negative that time. I had medicine for herpes simplex for a month, vitamin D3 60K once in a week for four weeks and then once a month for six months. But, my problem remains the same. I will be highly obliged to you. I am struggling because of my present health condition. Kindly advise the treatment. ### Response: Your problem still could be due to a nerve problem, even though your NCV test is normal (nerve conduction velocity). Also, you might be having calcium deficiency, which is very common associated with vitamin D deficiency. I suggest you calcium supplements like tablet Shelcal HD daily once for three months. Apart from vitamin D and herpes medication, have you taken any medicines for your problem? Kindly let me know that. If not done, then kindly get serum vitamin B12 levels tested and revert back with the report. Revert back with the reports 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: About a month ago, I underwent a posterior cruciate ligament reconstruction surgery, and the doctors fixed two screws in my body. The doctors gave me a knee brace after 15 days. When can I walk with the knee brace? When can I walk without the knee brace? Are the screws to be mandatorily removed in the future or will they be left there? Can I bear some weight on my knee? Can I join work again soon? I am a chartered accountant. After six weeks, can I walk with the help of a knee brace but without a walker? Please answer my queries. I have also attached my MRI reports for your reference. ### Response: Hello. I have seen your MRI reports (attachment removed to protect patient identity). This professional advice provided by me stands subject to the actual examination of report or image and is based entirely on inputs provided to me. It should be correlated with the clinical findings." "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 niece is currently 6 years old and her tooth is growing up behind her milk tooth that has not fallen out yet. What should we do? ### Response: I got your chief complaint. Permanent teeth start erupting after 6 years of age and replace deciduous teeth. In this process, as deciduous teeth erupt, milk teeth fall down gradually. However, if milk teeth remain there, they are to be extracted to allow permanent tooth to erupt normally. However, it needs to be extracted if it is not falling, otherwise, it can cause malocclusion later." "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 used to masturbate regularly, and I do not care much for hygiene (I wore the same used underwears, cleaned my penis once in a while, etc.). Now from the last two months, I am unable to retract. The foreskin seems to have become tight and not allowing me to even pull it back a little. There is a kind of white patch formed at the tip of my penis as well. That is concerning. Could you please let me know what might be the issue? ### Response: Hello. Let me tell you one thing, you need not worry about your condition, as it is widespread to have phimosis, which is the case with you. The foreskin is tight in your case, and hence, retraction is painful. The white patch you are referring to is nothing but color due to fibrosis. This has nothing to do with masturbation. You can undergo a simple procedure called circumcision, which will get rid of the foreskin and your problem with it, once for all. It is a minor procedure. Though there will not be any serious health issues with cleanliness, absence of hygiene can result in fungal infection, which can be avoided by ad" "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 having stomach pain recently, low appetite, and sometimes it hurts when I eat meals. Now I am feeling slightly better. I am sticking to liquid meals like soup and I am trying to stay away from lots of dairies for a while. Now I am burping almost every minute, and I have just felt gassy for the longest time. This has been happening for maybe three days. ### Response: Hi. I can understand your concern. By your history and description, the possibility of GERD is more likely. It is due to laxity of gastroesophageal sphincter. Because of this, the acid of the stomach tends to come up in the esophagus and cause chest pain, indigestion, burning epigastric pain, burping, belching, etc. So take Pantoprazole and Levosulpiride combination on empty stomach twice daily. Avoid oily and spicy food. Avoid junk food. Avoid large meals, and instead, take frequent small meals. Please let me know if you are taking any painkiller or birth control pills. Also, let me know if you have a stressful life. I will be happy to help you further. Wish you good health." "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 29 year old female. I have been dealing with back pain for over seven years now. I have never been in any type of injury and had MRIs done of my brain, cervical, lumbar, and thoracic spine five years ago. They stated I had three bulging discs and an annular tear. My thoracic spine noted a few scattered hemangiomas and a questionable small vascular anomaly in the midthoracic vertebral body. This is where my pain hurts the most. On the cervical spine MRI, it stated that I had a narrowing of the canal with degenerative disc disease with no spinal cord abnormality. My MRI of the brain came back fine with some inflammation within the paranasal sinuses and moderate lymph nodes in the neck which may be suspicious for shotty adenopathy.My first positive ANA was four years ago with elevated antistreptolysin O Ab, but never have I had strep throat or ever been diagnosed or treated for it. I had my adenoids removed when I was young. My CBC was all normal except for a slightly deranged RBC and hematocrit levels that were lower than the normal range. My TSH was elevated at 5.870, but I believe I had that retested later on, and it was within normal limits. I was then referred to a rheumatologist due to the positive ANA and other symptoms that I was having. Their results concluded no elevation of dRVVT or a PTT and ruled Lupus screening negative due to my levels being within normal limits. My C3 is at 121, C4 is 31 and rheumatoid factor. ### Response: I went through your post. You have not mentioned what you want to know and what your current problem is. Regards" "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 diabetes type 1. My age is 18 years and I am taking Mixtard insulin twice a day. In the morning, I inject 14 units and in the evening I inject 6 units. I want to fast for religious purposes. Can I? ### Response: Hello. The patients with type 1 diabetes are advised not to fast. However, if you are healthy and having a good blood sugar control, then you can reverse the dose of insulin as in, take the night dose in the morning and morning dose at night and fast. Be prepared for breaking your fast if your sugar falls below 70 mg/dL or above 300 mg/dL. No need for vigorous exercise. Hope you find my advice beneficial." "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 wrists crack and make a crunching sound when I move them around in circular motions. I had a trauma to the wrist before two years. Now, I get pain shooting through the wrist. Is this normal or what is the problem? Please help. ### Response: I would like to have more details on the pain in the wrist and have you ever had any fall recently. The cracking sound is due to an imbalance of musculature resulting in bone on bone rubbing and pain could be (depends on the underlying pathology) from cartilage erosion to TFL (tensor fasciae latae) tear. I would like to know the place of pain and till what level is the pain getting radiated. Definitely, pain is not normal and may need an investigation to rule out the underlying reason. As much as you can keep icing your wrist and stretch your forearm muscles to receive stress and tightness" "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 pretty bad eczema. I have been using Doublebase gel that my GP gave me, but does not seem to be working. What is annoying is that I have noticed very deep wrinkles under my eyes where my skin is mostly dry. Could I get rid of these? I am only 18 and I cannot even look in the mirror or smile because of these lines. I also have allergies and my eyes water and itch a lot usually during the night. I have now tried many creams and oils including coconut oil, cocoa butter, Hydrocortisone, Doublebase gel, E45, baby oil and many more, but none seem to work. I just want answers for these. Hope you can help. ### Response: I have read your query in detail and do understand your concern (attachment removed to protect patient identity). 1. You seem to be suffering from atopic dermatitis.2. The wrinkles you are referring to could be actually Dennie-Morgan folds (folds below the lower eyelid as a result of edema) seen in atopic dermatitis. They will get better with the treatment of your eczema. 1. 2. If it still does not respond, I recommend mid potent steroids like Mometasone instead of 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 diagnosed with DVT before four months and currently on Xarelto 20 mg once a day. My hematologist has advised me to take six months of Xarelto. However, the literature says three months is enough. My all test results like protein C deficiency, protein S, factor 5, and prothrombin. OCP was the main reason for my blood clot. Should I continue taking Xarelto for three months or six months? ### Response: I should appreciate your awareness of health. For venous thrombosis, anticoagulant should be taken for at least three months. However, when the risk of thrombosis is high than duration can be extended for the next additional three months. So the clinical correlation is needed to decide the duration of treatment. If your doctor has suggested a total of six months duration of therapy, then I would suggest you take it for six months. I hope I have answered your question. Let me know if I can assist 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: I am opening up a new subscription under you, so that I can chat more easily. I request you to follow our discussions from previous records. To remind again, this query is for my mother. Age-47, she is on her regular medicines for above mentioned conditions. However, recently her hemoglobin levels fell to 7.8. After consulting a doctor in my local area, she is taking iron pills. The problem is with her fluctuations in Diabetes readings and haemoglobin levels. I am attaching the recent conducted reports below- 1.\tBlood sugar level + Hb 2.\tCbc + Lipid profile 3.\tUrine culture 4.\tThyroid panel My query is to what can be done to improve her diabetes readings and hemoglobin levels. It will be highly helpful if you elaborate the necessary steps to be taken including types of medicines that are to be taken. ### Response: Hello. I have seen the medicine list being taken by her (attachment removed to protect patient identity). BIO D 3 strong is also not needed on continuous basis, unless she has any specific neuropathy problems or any such complaints. Is there a to speak to you so that I can clarify a few things in one go. For her diabetes I feel Glycomet G2 once a day (instead of Voglibose containing tablet) once a day with DYNAGLIPT-M is enough. Rest of the medicines are to be continued." "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 real time viral load reliable for HIV test after 14 days of sex encounter? I got normal result. I also did p24 on 15th day and get negative result. Now can I be safe from HIV? I use two condoms at the same time during intercourse and I do not know my partner\s HIV status. With other partner, I just kissed her without any physical relation. ### Response: Hi. The answers to your queries are: If you had used the condom consistently and correctly, changed for each sexual act with one person, and it did not break or slipped off during the act and you removed it while the penis is still not soft, your risk of HIV is nonexistent. HIV cannot be transmitted by touching or kissing alone. The test you performed is highly sensitive and specific and gives accurate result. A negative HIV-RNA test needs to be complemented with fourth-generation HIV combo test at four weeks. If the result is negative, HIV rapid antibody test needs to be repeated at three and six months of last exposure. 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: What are the diseases that people can get from animals and which diseases can pass from animals to humans? I would like to know a few examples of these types of diseases. How they are transmitted and which animals carry them, etc? Please explain. ### Response: The disease or infection that spread from animal to human is called zoonotic disease. Here are a few examples. Rabies: it is a lethal disease if occurred, it spreads mainly from infected rabid dog to human by direct bite. Toxoplasma: the main infected animal is cat but can affect human as well through insect bite and can lead toxoplasmosis in human. Avian influenza: infection that spread from birds to human by respiratory inhalation route. HIV which spread from monkey to human by sexual relation. Although now it is being spread commonly through human to human. These are few examples of zoonotic disease." "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 19 year old male, and I have been feeling an ear blocking sensation for the past two weeks. I also have a slight loss of hearing at times in my right ear. Although it is mostly in my right ear, sometimes the sensation alternates to my left. It feels as though the sound is not coming through. It is an odd sensation to describe. I have had a doctor check me out, and they did not see any damage or signs of infection, but they are not specialists, so I am not sure what could be causing this or how to treat it if possible. Also, I have been experiencing slight dizziness or heaviness and pain in the back of my head. ### Response: It should resolve completely in about a week or two. If you need more details do revert. I will be happy to help 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 daughter is 20 years old and has tonsil problem for last six days. She took medicine for last six days but did not get any relief. She often has the problem of tonsils in two to three months interval. I have tested the CBC. Kindly suggest the remedy. I am also worried about CBC.Due to prolactin deficiency, she is taking Cabergoline as per the advice of an endocrinologist. But now, prolactin is in normal level, but the medicine is being continued. ### Response: Hello. If the tonsillar infection is not reducing with regular medical management in six days, it indicates that it is chronic tonsillitis. The treatment given may be inadequate or resistant to the organism causing infection. You need to consult an ENT doctor in person and take a throat swab for the culture of the organism and take the appropriate antibiotic. If the infection of tonsil is recurring once every three to four months since last two to three years, then you need to go for surgical removal of tonsil called tonsillectomy" "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 22 years old. My height is 5\11"" and weight is 100 kg. I had a condom on and I did not know that she was on her period. As there was blood on the condom, I removed it and had a new one. We had sexual intercourse again and again until she was bleeding badly. As far as I remember, the condom did not break both times. But, she cleaned her vagina and without proper washing she gave handjob and I ejaculated.Can I get HIV from the above act? Is there any possibility that the virus transmitted with her hand to my penis as her hands could have period blood on them and there was no lubricant involved while handjob? If so, what is the risk probability? Can blood on the condom somehow get to the foreskin of the penis? Could that blood transmit HIV?The exposure happened 48 hours ago and started PEP after 7 hours of exposure. I am on Tafero EM and Ritocom. Am I taking the correct medicine? Am I safe? ### Response: HIV does not get spread through such acts. In case there was any tear in the condom, the blood can seep through and put you at risk. There is a risk in such exposure and it may range from 0.03 % to 0.5 %. PEP (post-exposure prophylaxis) if started within 72 hours, then it would be helpful. Your PEP prescription is fine." "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 do regular health checkups and last year my test reports were normal. I had another health checkup last week. In my TMT it showed the impression as borderline ST segment response. Fair exercise tolerance. What does it mean? How serious is this? What is the next step? Tests like echocardiogram and resting ECG were normal. I am attaching my test reports. ### Response: I have gone through your reports (attachment removed to protect patient identity) very carefully. Do not worry as ST-T changes less than 1 mm are not significant in inferior leads, and in the anterior leads also the changes are less than 1 mm. You achieved the target heart rate, and exercise tolerance was also fair. The changes reverted to normal in less than a minute. I do not think you need to worry as echocardiogram was normal. The sensitivity of TMT (treadmill test) to rule out coronary artery disease is around 70 %. In 30 % of cases, it is a false positive. Are you a smoker or alcoholic? Revert with more information to 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: I am convinced that I have a lot of cavities. I was inspecting my teeth the other day and I have multiple points of concern and I am now afraid to get to the dentist. I have my six-month cleaning in days and I am anxious. I have two small smooth dots on two teeth on the side. Is this a cavity or is it possible for it to be treated with fluoride and dental cleaning? On another tooth, I am pretty sure it is a cavity because it is a tiny hole on the smooth surface on the side of the tooth. Besides, my front bottom teeth are a little shifted but my teeth look fine to others. I am also disappointed because I thought I have been doing a lot better brushing my teeth since my last appointment. I had one cavity during my last appointment. And diet wise nothing has changed much since then. I just do not understand how I could have multiple cavities now considering my diet has not changed and I feel like I have been brushing better. ### Response: Hi. The black dots would be the carious lesions. It does not matter if you take much care and do regular brushing, with time the carious lesions increase in the dental arch. You need to get it filled by a dentist as soon as possible. The brushing of teeth before sleep is the most important one" "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 tooth extraction surgery, I accidentally rinsed with salt water after two hours of the surgery. Will it effect anything? ### Response: I have been through your query and I can understand your concern. No, it will not affect the healing of the tissue unless you rinsed rigorously. However, if you rinsed gently and still are not experiencing any pain, then the clot is there only and you do not need to worry. You can use saline water (salt water) for the rinses. It is good as it will reduce the swelling and also reduce bacterial load. You do not need to worry about it. You may continue using salt water for rinses but be gentle while doing so. Also, follow your dentist's instructions. Maintain good oral hygiene as well." "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 tonsil infection last week for which I went to the doctor who gave me antibiotics and pain killer. My throat infection is healed, but still I am having pain in my throat. Again I went to the doctor and he told it is lymph swelling and he prescribed me with Cetirizine and pain killer. I am taking this medicine from the last two days but I am not getting any relief still I am having pain on one side of the throat. Please suggest. ### Response: Hello. Please take a picture of the back of the throat with open mouth showing details of the affected area and send to me. Is the lymph node palpable? Is there any fever? Did you complete the antibiotic course fully or did you stop abruptly?" "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 busted my tooth about two months ago. I tried to consult a dentist. The first dentist told me a huge cost for pulling it and the titanium screw. Went to the second dentist for a second opinion. He said I have to wait for another two to four more weeks to even get started. Does this sound normal? Actually, I had a cap on the same tooth 18 months ago, and that busted directly above. I can feel with my tongue that it protrudes lower. ### Response: Hello. You have mentioned that the present tooth problem has been there for two months. You have already had a crown in the same tooth before eight months. Have you undergone a root canal treatment for the same? It would be better if you could attach the following: 1. An intraoral photograph of the affected tooth. 2. An x-ray (intraoral periapical radiograph) of the affected tooth. The exact diagnosis and the treatment plan can be decided after going through the above. Since you have been having the busted tooth for two months, I assume that there was either no pain or very minimal pain. Because if there was any abscess or infection related to that tooth, you might have had severe pain, pus discharge or swelling. So, the chances of acute infection are very minimal. There is no emergency and may be this is the reason why your dentist had asked to wait for two to four weeks. If there was any infection at present, your dentist might have put you under medications and would have asked you to come for extraction in three to four days. May be there is gross decay of tooth or there is no scope for saving the tooth, and that is why the dentist had advised extraction (pull out the tooth). I can comment on the treatment plan only after seeing the picture and x-ray. If you are going to get the tooth extracted, then it can be replaced by either implant (screw and cap) or fixed partial denture or removable partial denture depending upon your choice. 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: What are some of the symptoms when you have blood clots in your body? ### Response: Hi. Pain is the most important symptom of clogged vessels. As a physician, we see different cases of clogged vessels mostly due to atherosclerosis. Obstructed vessels of the heart cause chest pain, obstructed vessels of the legs cause leg pain, and so on." "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 cough for almost eight days. My cough was not frequent and I have no fever till now. I feel like something is in my throat sometimes. Can it be a COVID-19? I take Azithromycin 500 mg once a day after meal and Rhinokast F before sleep. ### Response: Hello. Do you have any recent travel to countries or areas with COVID-19? How about any recent exposure to someone who is positive with COVID-19? If your answer to these questions is none, then it is least likely for you to have COVID-19. COVID-19 initial symptoms would include cough accompanied by fever. On top of that most patients would also experience difficulty breathing. Since you mentioned you did not have a fever, it is least likely you have COVID-19 at this point. However, if symptoms, persist, worsen or new onset of symptoms such as difficulty breathing, and fever further consult is advised." "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 shall be thankful to you if you please answer few of my queries. How CMIA combo for HIV testing is done? How much it is reliable at 175 and 180 post incidence. INDEX was .14 and .08, respectively. What are the chances of error in the result? (Done at two different labs). Even after three years, I have no medical issue. Please give me awareness on procedure reliability. ### Response: Below are the specific answers for your questions. CMIA is based on chemiluminescence principle and it is performed on an automated analyzer. It is the most effective technique nowadays to rule out HIV. CMIA can almost 100 % rule out HIV after 90 days of exposure. Usually, in most of the patients, CMIA can be effective after six weeks of exposure. So after 175 days of exposure, you need not to worry about HIV. The index value is cut off value based on which the result is given. The chance of error is very less. After testing for two times the chance of error is almost nil. After three years of exposure there is no medical issue, so the chances of HIV is very less." "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 might be a hypochondriac, and I do have quite severe OCD. What I wanted to ask was if I had sex while still being on a strong pill and then around a week and a half later I stopped taking it (my doctor said it is active for quite some time after quitting it) could I still be pregnant? Even if eight pregnancy tests were done in a span of three months said it is negative and I had my period as regular? I am 21 years old, always had digestive problems and a bloated belly, which is why probably I am being driven crazy but still want a professional opinion. ### Response: Hi. At the time of sex, you were on the pill so the chance of pregnancy is nil. Because sperms usually do not survive in your womb for more than three to four days after sex, and during that time you were on the pill. Moreover, eight pregnancy tests done in a span of three months were negative and you had the period as regular. So relax you are not pregnant. For digestive problems, you can do ultrasound test of the abdomen. Also, I can suggest chewing cardamom as a whole to reduce bloating." "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 query about the medication prescribed to me, and I need a second opinion. My diagnoses are bipolar 1 and ADHD. I take daily,1. Lithium 1600 mg.2. Lamotrigine 300 mg.3. Amisulpride 400 mg.4. Haloperidol 4 mg.5. Sertraline 200 mg.6. Pregabalin 400 mg.7. Propranolol 80 mg.8. Lisdexamfetamine 60 mg.9. Procyclidine 15 mg.10. Diazepam 10 mg (PRN).Is that too much medication? Do some of these counteract with each other? ### Response: Hello. The rule of thumb in psychiatry is to prescribe medicine for an adequate duration and adequate dose, before considering it ineffective or plan to change. If you are not in a depression or not a rapid cycler, Sertraline can be tapered down. If you are in remission, Lamotrigine can be slowly stopped. I found no counteracting" "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 age is 22 years old. I have many more problems in my body. My digestive system is very weak, my body has not developed. I get confused with dark colors. I get tired very fast. ### Response: I just read your query. For poor digestion, underdevelopment, and tiredness, you should perform a thyroid function test first because if the thyroid gland is not functioning properly there can be a presence of these symptoms. Take treatment only after proper diagnosis is made. Do not take random treatment. As far as color confusion is concerned, you should consult a nearby eye specialist. Because color confusion can be an underlying symptom of color blindness but diagnosis can be only made after clinical examination. So it is better that you should contact the physician and ask for the clinical 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: I am having some doubts about rabies. Will rabies spread through food, which is licked by a cat? Will rabies virus die on heating? ### Response: Hi. I am giving you my opinion regarding your doubts. Hope your concern is solved" "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 42-year-old male. My blood pressure is 158/107. I have been on blood pressure medications for some time now. I no longer have medical insurance. I was on Hydrochlorothiazide, Lisinopril 12.5/20. I was supposed to get medical benefits but my job has not given me them. The problem has been going on for a few years. I am 5\8"" and 220 pounds. I have an active lifestyle, yet I am still overweight. ### Response: Hi. I have read through your post and it seems like you really need to take the medications to keep your blood pressure in control. Particularly since the diastolic is quite high. If it is not controlled it can lead to complications like heart attack, stroke and kidney failure. Plus it would be very beneficial to lose weight as well." "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 preparing for MBBS for last three years but have not gotten selected till now. My friends got selected. So, I feel this is really harassing me. Because of this, I am very much depressed for the last year. My problem is not that I have not got selected in MBBS but my problem is that I am having headache for the past year. Sometimes it stays for four to five days. Before one year there was no problem when I travel in bus or four-wheeler but from last one year, I am having headache and vomiting feeling while traveling by four-wheeler or by bus. Because of this, I am getting more and more tension and depression. So, please suggest me if it is necessary to go to a neurologist. ### Response: You are having headache for the last one year, so definitely treatment is needed. There are two possibilities in this case. It may be a tension-type headache (as you are tensed due to preparation) or a migraine (of adolescent-onset). For making an exact diagnosis and prescribing treatment, I want to know about your headache in detail." "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 unprotected sex with my wife. After that she took Unwanted 72 within four hours. After 10 days, she bled but not heavy. It was a few spotting which was brown in color up to four days. After 12 days of sex, she took a pregnancy test. It was negative. Then please tell me if there is a chance of pregnancy or not. ### Response: Hello. Unwanted 72 is quite effective in preventing against the pregnancy and she had spotting after taking it so probably she did not get pregnant in this cycle. Please mention her cycle length and the day of the cycle you had unprotected sex on." "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 19 year old female. When my mom was pregnant, her brother had hit her tummy by mistake with a ball as he was playing cricket. My mom had felt some strong movements at that time and I feel this is the reason why I have a small bump on my head since childhood. It does not pain. It does not cause me any headache, etc. It is in skin color. The only thing is that I can feel pus inside when I touch and as I touch hardly, pus comes out it is slightly yellowish and cloudy. Can it be treated with antibiotics or creams? ### Response: Hello. There is no relation between the ball hitting your mother during pregnancy and the lesion on your head. From your history, it seems likely to be a sebaceous cyst (nothing serious). As there is pus currently, you can use antibiotics. I suggest showing it to a physician close to home and get it examined." "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: Why do I have a pale spot on my upper lip? ### Response: Hello. In my opinion, there are two main causes for this pale spot. 1. Post-inflammatory depigmentation. It means that it is normal skin response to any trauma like a previous burn or vesicle or itching to heal either with hyperpigmentation or hypopigmentation. In your case, it is hypopigmentation. This does not require any treatment. It could be permanent. 2. Vitiligo. It could be spontaneous or autoimmune." "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 13-year-old female and my height is 5 feet. I weigh about 106 pounds. I have been having stomach issues. The main issue is stomach rumbling. It happens when I wake up, after eating almost anything and before I sleep. I have tried skipping one of the meals but to no avail. It still causes the same result the best working being no dinner but having breakfast and lunch. I very rarely have soda, fast food items, or frozen dinners. I have searched up for gassy foods to avoid for example broccoli) but it still does not help. I sometimes do 35 to 45 minutes of crunches, which kind of help. Sometimes it feels uncomfortable and hurts a little but that is not my biggest concern. The rumbling starts at about 10 o\ clock onwards. It is so embarrassing to hear it go off every day during my class. Nobody is rude or talks about it, but still, it is distracting and annoying to deal with. I do not want to be dependant on gas pills unless there is literally nothing else to do.I have no food allergies, I am not lactose intolerant, and I am not a vegetarian. I eat raw almonds daily, so I do get a good amount of fiber. Same with graham crackers, is that a bad thing to eat? I am an active swimmer, usually one hour to 45 minutes four days a week. I walk my dog for about 30 minutes.Are there any foods or diets to suggest?Anything to stay away from?Anything to eat more of?Any exercises that would help?Should I be asking a doctor this? ### Response: Hello. Sometimes gluten intolerance could be causing symptoms similar to what you have described. Gluten intolerance can start at any age even if you have never had it before. I just checked the ingredients in Graham crackers and it contains flour and wheat bran. I suggest you try and avoid foods containing wheat and gluten. You do not have to skip any meal. Go gluten free for two weeks and see if that 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 traveling internationally. I am affected by traveler\s diarrhea and vomiting from three days.Day-1: Vomited four times, diarrhea five times. I could not eat anything.Day-2: I took Loperamide. The nurse at the hotel gave me some electrolytes. Took my BP - 100 (usually I am around 110). My body temperature was normal. I slowly started eating solid food. Diarrhea stopped, vomited once.Day-3: I was able to eat solid meals well. I took some electrolytes as well. Diarrhea and vomiting have stopped. However, I am feeling dizzy after basic day-to-day activities.Also, I went to the hotel downstairs to eat and I felt dizzy while eating the meal. ### Response: Traveller\s diarrhea is caused by either contaminated food or water and is generally self-limiting with complete recovery in five to seven days. If you are feeling dizzy that possibly is because of weakness and electrolyte imbalances that occur with vomiting and loose motions and sometimes fever which is associated with it. You will need to take enough fluids and juice to replace potassium and get your blood pressure checked. If all is well, you are recovering normally. Otherwise, you may need antibiotics preferably a combination of Ciprofloxacin and Tinidazole for five days. Regards" "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 was diagnosed with epilepsy seven years ago. Since then, she has had three convulsive seizures but has not had any in the past five years. She is 21 and currently on 100 mg of Epilim day and night. She had an EEG three months ago which resulted in abnormal brain activity but no current epilepsy. This medication is affecting her emotionally and physically to the point she has now got anxiety and on the verge of depression. She was on Lamictal for two years but that did the same thing. Is there really a need for her to be on the medication anymore as it is ruining her life? ### Response: Hello. I have gone through your query with diligence and would like you to know that I am here to help you. Regarding your question, is there really a need for her to be on the medication anymore as it is ruining her life, we need to do MRI Brain (plain and contrast) with MRA, MRV, MRS and whole spine screening and EEG." "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: Part of my foot has been numb for several days but I feel fine. No pain or anything. Is this any reason for concern? ### Response: I see that you need to perform the following tests to see if you have acquired diabetes and/or anemia related to vitamin B12 deficiency. In case the test results are negative and the symptoms resolve in the coming days then there is no need to worry. If the condition continues despite negative result in the tests, then I suggest taking Vitamin B complex supplement, like the one I will mention in the treatment part. FBS (fasting 8 to 10 hours), HbA1c, CBC. Neurobion tablets one tablet a day after food for two months." "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 want to ask you can I get pregnant without penetration or inserting? As I am not comfortable and I am scared to get STD, genital herpes? Even I read masturbating leads to impotecy and infertility. Can I get pregnant on my ovulation time (with clothes) just by stimulating or getting touch for short periods by my partner?Is this possible to get pregnant in this way? My grandmother told me they never did direct penetration stuff but still she got pregnant five times. How is this possible? ### Response: I can understand your concern for your symptoms. Direct penetration is the normal way of sex. Normal sex release serotonin and oxytocin. Happy and trust hormone which is very important in building relationship. If you are not allowing your male partner for normal sex or penetration, he may find other options which will be an issue in your relationship. Your worry about infection is there for every one, if you are so worried you can ask your partner to do a blood work up then have sex. Still you need to get pregnant without penetration, yes you can. It is called artificial insemination. You can meet a gynecologist to do the procedure sterile method." "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 proctocolectomy surgery one year back. It has been five months to ileostomy closure surgery. My daily stool frequency is nine to 10 times daily. The stool is not hard one. I am having a lot of burning inside and outside of the anus. There is no pain but there is itching and burning on my anus area. I am very much panicked. Is it a sign of hemorrhoids or something else? ### Response: It is normal to have increased frequency after a pouch. As the effluent is liquid and is only ileal content, it may cause itching around the anus. Hemorrhoids will be out after proctocolectomy. Things will get better with time. There is also slightly higher chance of developing pouchitis, but it is too early for pouchitis. I feel you should not worry too much and give time for the pouch function to improve. Regards" "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 18 years old and virgin. Lately, I have been having some problems down there. I have a bump or something on the right lip of my vagina. Sometimes, I feel itch and it sting unexpectedly throughout the day. It also did not heal. I am sure that it cannot be an STI or STD, because I am not sexually active. Can you help me? ### Response: Hi. Well, I do understand your dilemma. I have a few simple suggestions for you. Bear in mind though that the best method of treatment in your case is for you to visit a gynecologist and have him or her see the lesion." "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 53 years old. I have to discuss with you about my mother\s heart problem. Two years ago, we get to know that she is suffering from heart disease so we consulted a reputed cardiologist. He examined her and said that the only treatment for her problem is bypass surgery and gave her some common medicines like Aspirin, Roseday, etc. She takes the medicines for some time and left them. But three months ago, she got common cold and consulted a local physician, but she did not feel any relief. She rapidly changes four doctors and take their prescribed medicines for sometime and then left them. It resulted in damage to her kidneys. She got swelling on her whole body, my father took her immediately to the cardiologist whom she visited two years ago. He again examined her and perform all tests and tell us that she is suffering from left ventricular dysfunction and his left ventricle is only 20 percent left. After hearing this she is in a great depression and always she is thinking about it and saying to everybody that her heart is working only 20 percent. I want you to tell me some solution to this. She is weak and is also afraid of surgery. Is there any treatment that can be done with medicines alone? ### Response: As far as I understand your mother is suffering from heart failure. Unfortunately, there is not too much to be done. A definite solution would be a heart transplant. Anyway, an optimization of her therapy can help improve her situation. Aldosterone antagonists Spironolactone, and a beta blocker in case of tachycardia. If these" "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 started with a burning pain during urination, which lasted two days with no other symptoms. The doctor said I have a UTI and advised me to drink plenty of fluids, which I did. Then two days after, there was a lump on my right labia. The painful urination has gone, but this lump on my right labia is still there and it is very painful, more when I touch it. A nurse said that I have genital herpes. Could it be something else? I have taken pictures. ### Response: Hello. This is a painful blister, and a possible cause is genital herpes, with a previous history of urine infection for which you are taking treatment" "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 stray dog bit me a few hours back. I washed the wound with soap and water. And I took tetanus from a pharmacy. What to do next? Any food which I should not eat during this period? ### Response: Hello. You did a very good job of washing with soap and water. It is important to apply a soap that foams well to wash off local viruses. An antitetanus vaccine will only protect you against wound infections. It will not prevent rabies infection. If the dog is infected, you may be at risk of having rabies infection. You need to take a course of anti-rabies vaccination. It comprises five doses - Day 0 (on the day of exposure), and then days 3, 7, 14, 28. This is necessary to ensure protection against rabies infection. Go to the nearest health care facility at the earliest and start the vaccination. There are no food restrictions." "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 dental abscess, and I am 33 weeks pregnant. It is so painful that I cannot eat, sleep, drink, or do anything. My dentist cannot do anything about it until next month. I was wondering if the emergency room can do something about it. ### Response: You could ask your dentist or go to the emergency room to prescribe Antibiotics like Augmentin 625 mg thrice a day for five days along with Tylenol (paracetamol). This will help in pain relief and then go to the dentist to get the tooth extracted. Do not delay, as the pain and infection will affect your baby\s growth as you would be avoiding normal diet and infection would not allow nutrition to pass onto your baby. It is okay to take during pregnancy if so much infection and pain are there." "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 noticed that for the past three months, I have had vaginal infection. But, all the tests were negative including vaginal swab and urine, which was done last month. I would like to know whether the vagina closes due to psychological reason. For example, when one do not want to have sex with someone. Please explain. ### Response: It is called as vaginismus. It is muscle spasm causing contraction of vagina. It happens due to various psychological issues. It could be due to guilt of sexual activity and some unconscious unresolved issues. It could also be due to dislike of partner. It needs counseling and medicines." "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 27 years old male. I am a hypertensive patient, and I am taking Metosartan 50 in the morning. The blood pressure is under control. Recently, I started to have a walk in the morning. For a few days, I walked quickly for 15 minutes. After a few days, my heart rate got increased, and I felt weakness in my leg after having a walking for five to seven minutes. I did my ECG and ECHO recently. The results were completely normal. Please suggest. ### Response: Hi. It seems that you do not have stamina and endurance. Your muscles get tired due to the lack of stretch exercise. You need to start stretch exercise and cardio to gain more energy and endurance. I have gone through the attachment (attachment removed to protect patient identity). With normal investigations, your heart is working regularly. Your body muscles are causing the problem. It is mandatory for you to do body stretching exercise and cardio exercise on a daily basis." "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 toddler was sneezing continuously yesterday and her nose was runny. However, it reduced to a large extent now. We had our room painted a day before yesterday. Could it be due to paint allergy? Will the allergy symptoms show up immediately or will take a day\s time? My 2-year-old has never had a cold till now. I am just worried if she has ingested any foreign body as she has the habit of mouthing whatever she picks up. Would foreign body stuck in throat cause sneezing and runny nose? I am a paranoid mother and have subjected her to two unwanted X-rays to rule out battery ingestion so I do not want to go through another X-ray. I want to know what would be the symptoms of any foreign body like metal or plastic when stuck in the throat. She was having corn yesterday. If she had inhaled a corn granule through her nose would it pass beyond and would she be acting normally? Since today morning, she sneezed only thrice. If at all it was common cold can it get better in a day? How would I know if it was a foreign body ingestion or allergy or a viral? What would be the symptoms for each one? ### Response: Hi. I have gone through the query you posted. According to the history you have given, it is an allergy because of the paint smell. That is the reason he is getting sneezing and running nose. As you think, it is not because of some foreign body in the nose or in the throat. If the foreign body is in the throat, symptoms will be like a continuous cough, breathlessness. If the foreign body is in the nose, they will have a bad smell from nose and bleeding can happen with mucus secretions. So no need of any X-ray or investigations for the child. Differentiating between allergy and viral infection, you have to do some blood test and always viral infection will be associated with fever. So nothing major to worry." "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 a condom 100% safe? Can we get STDs through the body to body or skin to skin contact? By kissing will any std transmit? Is spa erotic massage safe? Please answer these questions it would be helpful. ### Response: The condom does not give 100 percent contraception. In fact, no contraception is 100 percent effective. Body to body and skin to skin contact will not result in STD (sexually transmitted disease), unless there are cuts over the body and body fluids get transmitted. Kissing will not cause STD. Deep throat and violent kissing might cause injuries and microbleeds and those might cause transmission of fluids across membranes and STD. Spa erotic massage is usually safe." "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 mom is above 50 years of age and she has been complaining seriously of pains for about 20 years now and it was recently diagnosed to be hypercementosis. She needs a solution. Also, she is an asthmatic and doctors have also said that the inhaler she uses increases the pain. Just for more clarity see the summary below.Summary:Doctors remove an impaired tooth as they said the root of the teeth entered the jaw bone and over time the jawbone was infected due to infections. The jaw bone where the tooth was removed is still paining and it is swollen. Doctors say that the inhaler she uses for asthma aggravates the pain as the jaw bone is sore. She has taken Augmentin, Dalacin C 150 mg, and others over time. Recently (a few months ago), she is diagnosed with hypercementosis.Status:Looking for treatment (therapy) to solve both asthma and hypercementosis. ### Response: Hello. There is no permanent treatment for asthma. It can be subsided only and if the inhaler is causing trouble you can opt for medicines. Tell her physician all the details your dentist gave her and her physician will surely give medicines. For the treatment of hypercementosis, the exact etiology needs to be diagnosed and removed, whether it is any trauma, any other disease, vitamin A deficiency, or rheumatic fever, or any other cause, which can be confirmed only after tests and observation. I am unable to open your link (attachment removed to protect patient identity), kindly resend the correct link. Else, I have tried to understand your problem, I hope my suggestions were helpful." "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 acne, and my pharmacist said that it is dermatitis. I tried every homemade mask, but it does not work out. I have not tried any medication but have used some skincare products like face washes. And apart from that, I have a terrible uneven tone (tan) on my face, neck, and arms that I do not like. What should I do? ### Response: Hello. 1. It seems that you have acne vulgaris grade 3. 2. Please do not touch or squeeze them. If you are scratch them, it will lead to the mark. 3. I have suggested the medicines below. Please consult your doctor, discuss my suggestion and take medication with consent. Acne. 1. Capsule Doxycycline 100 mg once a day.2. Adapalene gel 0.1 apply at night in a tiny amount on pimples and do not rub it.3. Use Benzoyl Peroxide face wash for 20 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 getting hemorrhoids often. Even this month, I got hemorrhoids twice. I would like to know, why is it so often for me? I do eat fruits every day, and I do not have constipation. I am 20 years old, and my weight is 59 kg. ### Response: Sorry to hear your problem. The first thing is that I need to know a few more details about your problem. Spicy food and stress. Anal examination by a general surgeon. Fissure-in-ano. 1. Sitz bath.2. Laxatives." "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 27 year old male, weight 69. Currently, I am on medication since last six days for viral fever and taking antibiotics. I am planning to have sex with my fiancee tomorrow. Can I take Viagra and antibiotics on the same day? Please suggest me a better tablet as I am doing it for the first time.Before how much time should I take the pill and for how long it lasts? If we cannot do sex after taking Viagra, is there any side effects? ### Response: I can understand your concern. Yes, it is safe to take Viagra (Sildenafil) with antibiotics. The" "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 is 61 years old known case of CKD with hypertension. He has been on dialysis for a couple of weeks, sum total of ten dialysis have been done out of which one dialysis was done using an online hemodiafiltration technique. His creatinine has subsequently reduced from 8.6 to 6.5, however, he had pneumonia patch in the right lung and took antibiotics and has recovered from that. But he has been coughing quite a lot with only secretions coming out and no sputum. There is some fluid in his lungs for which he has been advised to go for HDF and mild pericardial effusion. AFB for TB is negative. Can you please suggest what can be the cause of severe coughing, shortness of breath and the treatment for the same? If needed, I can send out the x-ray to you for evaluation.He is currently on Flavedon, Minipress XL, Metolar XR, Torsemide 40, Vitamins, and Calcium tablets. His lab report shows TLC is raised to 12 which was earlier 5. Please help. ### Response: There could be a few causes for the wet cough with phlegm. Despite taking antibiotics for pneumonia, the opacity in the lung takes a few weeks to completely disappear. The cough in such a case can last for a month. If the patient has no fever I will not worry. CHF (congestive heart failure) is also one of the causes in elderly patients in addition to environmental factors. I would advise you to continue supporting treatment for cough as advised by your doctor. If there is fever in such a case you must report back to the doctor to rule out any other cause. If the x-ray reviled plural effusion then probably other continuation like TB (tuberculosis), etc., should be considered. You can send me the chest x-ray to comment better. 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 a 20 year old engineering student. Life has been good to me for all these years. Eight months ago I met a girl, and since I met her, I have not spent a day without talking to her, and it was a long distance relationship. Now, I was very inexperienced when it comes to love as it requires to trust another human being. I have fallen for her so deep that I have forgotten myself, my life, my habits, hobbies and cause in life. It is like a mind enslavement, other than physical slavery. This person has requested more and more from me, and I was unable to set boundaries. I have become a shadow of her, pick up her habits, her beliefs and fearing that she would love me less for who I was. I would try to comfort her, even if it was something that defies my logic.For eight months, I have been living encapsulated into another person. I have failed my exams and was unhappy that I could not stay with her all the time. Every night I would struggle to fall asleep. I have been wasting my energy on planning future with her. I jumped 10 years ahead and started worrying about things. I would hear someone talk and fail to follow after a couple of words, because of daydreaming. I have been on the verge of snapping several times and felt like death was the only solution.Until a few days ago, I chose to live and be myself again. I physically felt relief. I have stopped worrying so much about others and cared about me. Life felt different all of a sudden. I am on my way to recovery now, and my past haunts me. Whenever I remember how it was, I feel terrified. I also feel that I have done significant damage to myself. My brain has become more sloppy. I have taken depression drugs in the past and sleeping pills when I could not handle the pain. I am starting to learn about myself again, I have forgotten how I used to be. And it feels so weird to be in that place, but very healthy. I am caught up in all this mess, and I would like to hear from others. ### Response: Hello, Welcome to iciniq.com. I have read the details you provided, and I can understand your concern" "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: Please help. I am a man and had an anal sex with a negative HIV, hepatitis A,B,C and non-reactive syphilis but the condom broke but thankfully the lab test result which was made in different lab a week before the intercourse and the day after the intercourse showed normal. What risks may I face? I am panicking. If she is negative with HIV, virus A, B and C and syphlis and all salmonella and typhoids and no mucus and blood in her anus. Am I still at risk of the diseases mentioned above? If not since her results are clean, am I at risk of catching other STDs like herpes, chlamydia, gonorrhea, syphilis, mycoplasma genitalium, trichomoniasis, human papilloma virus (HPV), HIV/AIDS, crabs or pubic lice, bacterial vaginosis, molluscum-contagiosum, mucopurulent-cervicitis, lymphogranuloma-venereum. Please tell me if there is any medication to take in order to prevent all this from happening. ### Response: I understand your concern. But the risk of acquiring a STD is not there if your partner does not have any one of the diseases you mentioned clinically or sub-clinically. There are STDs like herpes in which subclinical shedding can lead to herpes, but that is more common in vaginal sex. I do not think you need to worry too much at this point if she is negative for tests. Some STDs take time to become positive in blood. Molluscum, HPV, pubic lice usually spread if there is active lesions, which I suppose were not there, so no need to worry. Just repeat the tests I suggested after three months and there is no such medication to be taken when all the tests of the partner are also negative. Prophylactic medications can be given if the status of the partner is not known sometimes." "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 35 year old female, and I am currently eight weeks pregnant. I have had a tummy ache, and my stomach is burning since yesterday. I also have a backache and a burning feeling around my ribs. I feel sick. Please help me. ### Response: Hi. Most probably you are suffering from gastritis. I suggest you try doing the following." "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 the following complaints. She is feeling rotating chest pain. She has breathing difficulties while walking. I have uploaded her ECG for further investigations. ### Response: I have studied her ECG (attachment removed to protect patient identity) and there is no significant abnormality. I would like to know the following details regarding breathlessness and chest pain that she gets:" "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: Since a few months, I am feeling dizzy and weak with vomiting sensation and blurred vision. For the past two weeks, I have been feeling shortness of breath and constant headache. I also feel cold in my legs and hands. Sometime, I feel more blood flowing in my head. I am 24 years old. My height is 165 cm and weight 50 kg. I have a previous history of neck pain. I had neck pain a year ago and was treated with various medications. ### Response: I have gone through your reports (attachment removed to protect patient identity). 1. Tablet Ferrikind (Iron) once a day.2. Paracetamol as and when required." "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 unilateral submandibular lymph node swelling on the right hand side of the neck. I had an ultrasound and at this time the lymph node measure 5-6 cm and the onset were sudden with pain. After three-course of antibiotics (Augmentin two doses and Clindamycin one dose), I was referred to have another ultrasound. This was after two months of the initial appearance of the lymph node. This ultrasound scan showed the lymph node had become 3 cm but was still present. So the doctor ordered FNAC. The results of this have come back and there is no sign of metastasis or no sign of TB lymphadenopathy. The doctor has suggested yet another course of antibiotics of Doxycycline and remeasure the Lymph node after three weeks. The FNAC said it was an inflammatory lymph node. Does this mean reactive lymph node? What else could be causing this? ### Response: Hi. I want you to be completely calm because according to the course of the lymph node enlargement, symptoms, and investigations the lymph node enlargement is just an inflammatory reaction. It is not a tumor at all. Just complete your antibiotic treatment then follow up on the lymph node again just for assurance. The lymph node may decrease in size but never comes to its normal size again. This is normal. Now about causes, any neck, mouth, or pharyngeal inflammation can cause inflammatory enlargement of a submandibular lymph node. Even without the previously mentioned inflammations, a submandibular lymph node inflammation can start by itself as the lymph node works as a filter for the blood picking up pathogenic microorganisms." "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 some symptoms that worry me a lot. I have been having muscle fasciculations all over my body (hands, arms, feet, legs, chest wall, glutes, knees, and cheek), every day, multiple times, for about half a year. Recently, (for about two weeks) they have worsened and I twitch almost constantly every day. I have noticed that the twitches are not present when I am physically active (for example, when I go for a walk or when I do moderate exercise). But the moment I sit or lay down, they appear again. I have also noticed slight occasional pain in my arms, hands, sometimes legs and feet as well. I have had a few cramps in my feet. My hands also feel slightly weak and tired. I have not noticed, however, signs of atrophy or actual weakness (I am able to do everyday tasks with my hands, etc). I also do not have difficulty breathing or speaking. I have had a blood test done and I do not lack any minerals. Levels of my thyroid hormones are normal. I do not drink coffee and I do not smoke. I get enough hours of sleep every day and I also would not say that I am under an extreme amount of stress. I went to see a neurologist a week and a half ago who performed a quick test to examine my reflexes and strength, stated they were normal and said I probably have BFS (benign fasciculation syndrome). However, I am still worried that I might have motor neuron disease. The fasciculations are extremely annoying and I have no idea what might be causing (and worsening) them and I am also worried because of the newly acquired pain, cramping, and feeling of tiredness in my hands. Not a single day passes by without my muscles twitching. I am female, 21 years old. I do not have a family history of neuromuscular disease. I would like to know whether my symptoms are indicative of ALS (amyotrophic lateral sclerosis). Is it possible to get some tests or examinations that would exclude ALS? I would really like to find out the reason behind my fasciculations as they have started to interfere greatly with my peace of mind. ### Response: I read carefully your question and would explain that your symptoms do not seem to be related to ALS (amyotrophic lateral sclerosis). Besides, at your age, this diagnosis would be exceptional. Anyway, an electromyography coupled with nerve conduction studies would help definitely exclude ALS. I would also recommend checking Vitamin D and B12 plasma levels for the possible deficiency. You should discuss with your doctor on the above tests. I remain at your disposal for any other questions whenever you need" "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 ligament reconstruction on my ankle 6 months ago. The surgery went well and my stability is back to normal. However, when my surgeon did the athroscopy, he noticed mild damage to the joint, however, he said that this should heal by itself. I saw my surgeon 2 weeks ago as I have still been getting a lot of pain where the ankle joint is. Since seeing him, I have been getting bruising over the joint with no injury and I currently cannot bare any weight on the ankle. When I saw him, he recommended more physiotherapy and said that the main reason was likely to be linked to the surgery I had and it should go away within time. I am currently using Cocodamol to manage the pain as normal pain relief is not helping. I would just like to know if there could be any other reasons why I could be getting this joint pain? And if it is worth me arranging to see my surgeon again if it carries on after giving more physiotherapy a try.I am 18, 64 kg and 5\7"". ### Response: After reviewing your information provided and the picture (attachment removed to protect patient identity). There are two concerning things: 1. Are you trying not to move the leg at all? (Could be a cause of one sided cold foot). 2. Are you getting this bruise after resting the ankle on the side of bruising? In that case it could be a pressure sore developing. Here also physiotherapy will help. I think you should continue with physiotherapy as advised by your doctor. Physiotherapy can help in the following manner: 1. Reducing pain of movement and strengthening muscles for weight bearing. 2. Maintaining full movement of the joint. 3. Improving the circulation and helping with this kind of pressure sore development and also cold foot. Regarding other causes of pain, discuss it with the surgeon who did the arthroscopy (depends on the findings). Definitely see your surgeon till you are able to bear weight and do your daily life activities well. If you have cold and painful sensation in both feet or arms. or a family history of such problems, discuss with your GP, the possibility of vasculitis. Be very careful with the Cocodamol, it can be habit forming. You should not be requiring (or using) this medication for a long term. Hot fomentation can help reduce the pain as well. Please discuss with your Physiotherapist or Orthopedic surgeon." "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 20-year-old male. A few months ago I noticed a small lump on my skin directly on my tailbone. I picked it and it formed into a small dent. I did not think anything of it but for the past one week the same dent has become inflamed on the outer edge and extremely painful to touch. I struggle to get up when I sit down as it is painful. When I touch it after standing up it feels wet.I have just asked my partner to look at it (as I cannot see for myself) and I gently opened my cheeks. She told me that a thick white pus substance was coming out in large amounts. I felt again and when I looked at my hands a small amount of white pus was on my nail. Whenever I have an infection in a scab my pus usually turns out to be a yellowish-white or a yellow color so I am quite worried. This color is not normal for me. Please help. ### Response: From your description, you could be suffering from a pilonidal sinus or cyst. Color of pus, yellow or white is not of great concern. What can be concerning is a large amount of pus. It is a disease of young men, mostly hairy and sedentary lifestyles. Professional" "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: Since four years I am taking Sizodon LS medicine from a trusted doctor. Nowadays I feel sufficient response. But after consulting my same doctor, he is avoiding to stop that medicine. As per his opinion, if I stop this tablet, again I will face problem after a month. Now, I request you, is it true or false? ### Response: As you are on Sizodon LS (Risperidone) for last four years and now alright. It is true that if you are suffering from schizophrenia or related diseases, then it is advised that you continue the medicine for many years or possibly life long otherwise relapse (symptoms re-appear) can occur. So, continue your treatment according to the advise of your psychiatrist." "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 suffer from chronic migraines, and I take Gabapentin, 1800 mg daily for prevention. Recently, a GP recommended Metoclopramide, 30 mg daily to help with nausea, but I have yet to take it, as I am concerned about the combination. ### Response: Hi. I read your query and understand your concerns. I hope this answers you. If you have more questions feel free to write 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 father-in-law has a hemoglobin of 5.6 g/dL. What is the cause? Please suggest a treatment. ### Response: There are multiple reasons for having low hemoglobin. It can be due to nutritional deficiency or chronic blood loss. I recommend seeing a gastroenterologist. He needs fecal occult blood testing and colonoscopy to rule out occult bleeding. Also, give him two units of blood. HB (hemoglobin) less than 7 g/dL is dangerous. Give him iron and vitamin supplements. He can take Ferrous sulfate 325 mg one tablet three times daily and tablet Iberet-Folic-500 (Folic acid with Vitamin C) one tablet two times 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: I am a 38-year-old woman with bipolar disorder. I am taking Abilify 10 mg. I am experiencing vision issues (not blindness) that come every other day and stop only when I sleep. I used to take Artane for my vision problem that was caused by psychotic medicines, but Artane interacts with Abilify, and I can no longer take it. Can you suggest any other non-side effect medication to help with my vision problem or possibly a different antipsychotic medication? I have also tried Promethazine and it does not help. I have tried most of the antipsychotics and have had various problems with them.For instance, I was doing great on Latuda for a few years and then developed neuroleptic malignant syndrome from Latuda and had to switch to another medicine. So while I am open to changing from Abilify to another antipsychotic that hopefully does not cause vision problems, I have noticed most of the antipsychotics do in fact have vision changes listed as a side effect. Abilify works well on my bipolar symptoms and I am functioning well. I am employed full-time and feel calm, logical, motivated, and positive about life. It is the vision side effects that I desperately wish to get rid of. I looked into a new medication called Vraylar and read that it can also cause vision problems. Please advise me on what you think I should do. The vision problem is difficult to live with, I am dealing as best as I can but it is hard when it happens during work. It causes me to focus my vision on minutiae and it is hard to relax. To sum up, I am either trying to find a medication to help stop vision problems from my antipsychotic or be advised on a good antipsychotic that does not cause vision problems or changes. ### Response: So I understand that you are having ocular side effects with the use of abilify. There are a few ways to go about it. As you have mentioned that you are stable on the medication and functional, I would advise you to consult an opthalmologist and get a checkup done and see if they can suggest some symptomatic treatment to control the ocular symptoms. If it does not help you can ask your psychiatrist to either try to lower the dose which might help with the side effects, because as you said you are otherwise stable on this medication, so we have to try sticking to it. If that is also not possible, then we can think about changing the medication. Medications like Olanzapine, Quetiapine, Asenapine work well in bipolar disorder. As I see Haloperidol and Risperidone have already been tried. So we can avoid those. You can take an opinion of your current psychiatrist and start one of these medications. 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: My father has undergone CABG (bypass surgery of heart) since then he is on the medicine. During this operation, we came to know that he is also hepatitis B antigen positive. Ayurvedic treatment is continuing and things are under control. In last week accidentally he has broken bone of hip and the local doctor suggested for operation. Before operation blood test carried out and found that following are out of range: Glucose 368, urea 114, serum creatinine 3.1, C-reactive protein 59. But after operation urine discharge is low it is about 650 ml per day and creatinine level of my father has increased up to 4.6. And the hospital is suggesting dialysis. Whether it is good for dialysis or try to maintain with medicine. ### Response: Hi. From what you mentioned, your father has sustained acute kidney failure, the cause is not clear (may be due to bleeding and losing a large amount of blood). Dialysis is required if there is volume overload (lower limb edema and chest congestion), also if there is high potassium. A thorough assessment is required for a more appropriate decision. One or two sessions of dialysis does not mean that he will be on dialysis forever, assessment is required after the sessions" "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 noticed that I have a penile skin bridge. I thought it was normal at first. But after searching on the internet I found that at the age of 24 it can only be removed by surgery. Is there any other method apart from surgery to remove the penile skin bridge? Please help. ### Response: If you are talking of phimosis (inability to retract the foreskin fully over your glans penis) then yes, it can be removed only by surgery. But do you actually have phimosis is the real question. Try to retract the skin and the point where it is not possible then click a picture and send it. As it is a clinical diagnosis, I will be in a better position to tell you what to do next." "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 19 and I have white spots on my face. Actually, I have this problem since childhood. The spots occur every year on my face, especially in summer. But this time it has been two months and they are still present in my face although I am applying sunscreen and keep my face moisturized. I have not ventured out in the sun for these two months. But, I really do not like it when everyone asks me what happened to my cheeks. Can you please tell me the way to get rid of it? ### Response: The white spots you describe can be due to various causes. It may be due to a fungal infection called tinea versicolor which usually occurs in the summertime, or it may be an allergic reaction to the sun. I suggest using an antifungal cream like Clotrimazole 1 % cream twice daily. Consult a specialist doctor, discuss with him or her and start taking the medicines with their consent. Follow up with a photo of the rash. Continue sunscreen" "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 is 35 years old and is four months pregnant now. She is suffering from severe itching which is not responding to any medication. Her doctor advised to take Udiliv 150 and Cetirizine, but there is no relief. We changed the doctor, and this doc advised to take Udiplus 300, capsule Coetrie, and tablet Alivher. But, this also is not working. I suspect that it is a case of obstetric cholestasis. Kindly suggest an effective and safe remedy to control the itching. The laboratory tests performed were LFT, billirubin, and sonography. ### Response: Hi. I have gone through your query and reports (attachment removed to protect patient identity). Yes, it is obstetric cholestasis. During pregnancy, Udiliv (Ursodeoxycholic acid) 300 mg is the best and effective treatment for cholestasis. Your gynecologist has prescribed you proper medication. Also, apply some Calamine lotion to have a soothing effect on skin and prevent itching. However, if you do not find relief, then get her checked by an endocrinologist. Do get back to me with the reports after meeting the endocrinologist, so that I can 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: My four year old son, weighing 16 kg is taking medicine for benign childhood epilepsy. Medicines he is taking are namely Topamac 100 mg a day in two divided doses and Lobazam 15 mg a day (5-0-10). His MRI for epilepsy protocol is normal without abnormalities. I would like to know whether he is taking overdosed medication. Does anti-epileptic drug cause lot of side effect? Doctor suggested PET scan. Is PET scan required for epilepsy diagnosis? Please suggest. ### Response: For benign childhood epilepsy (BCE) your child is on 6.25 mg/kg/day of tablet Topiramate (anticonvulsant) which is a medium dose and is fine. For dehy" "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 know what happens biologically in the body, causing a burning sensation in the tongue when a person has HIV. ### Response: As you very well knew, HIV (human immunodeficiency virus) virus lives in a body for a very long time. It causes significant damage to the central and peripheral nervous systems. The virus affects our nervous system and causes dysfunction of nerves and muscle cells. The burning sensation is a symptom of peripheral nervous system dysfunction or disorder, and it is caused as the nerves that lead to and from the spinal cord and connect with all the various parts of the body are affected by HIV. The nerve root gets exposed, and the person feels burning sensation or numbness, starting with hands, feet, and tongue. 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 had a sore throat for eight days. I have tried over the counter throat drops, throat sprays but nothing has worked. Is there anything else I can do and is it just a sore throat? ### Response: Hi. Most of the times, a sore throat is due to a viral infection. This occurs with or without some amount of acid reflux into the throat from within the food pipe. This condition is called Laryngopharyngeal Reflux Disease (LPRD) and this may present simply with a sore throat and without any other symptoms of gastritis. I would, therefore, recommend antiseptic mouth gargles with Chlorhexidine or dilute Betadine, three times a day before and after meals along with a good proton pump inhibitor such as tablet Esomeprazole 40 mg once in the morning 15 minutes before meals for one week. I would also advise taking an anti-inflammatory medication such as Ibuprofen or Paracetamol once daily for three days after breakfast, to reduce the throat pain. In my opinion, your sore throat should subside in three to five 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 29-year-old male. I did a kidney function test today. My creatinine level is 1.06 mg/dL. Is it normal? I gave the blood sample in the morning after I had breakfast. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). On considering your weight, it is normal. Do a urine routine and a urine protein creatinine ratio" "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 could feel a lump near my anus from around 5th of December. About 3-4 days back it burst and I could see blood coming out while cleaning after passing stools.Now the bleeding has reduced, but I can still see blood oozing while I wipe the area with a tissue.I was diagnosed with internal hemorrhoids about 2 years back (had one instance of bleeding).But the doctor said I did not need any treatment then.Can you please see the picture (attachment removed to protect patient identity) and suggest the required treatment? ### Response: Hi. In this type of hemorrhoids (internal hemorrhoids), we first give medical treatment and if the condition does not improve, then we can consider for endoscopy and surgical treatment. Advice: Provide details about any other illnesses (if you have) because, we need to identify the causes of this problem. The lab tests that have to be done are CBC (Complete Blood Count) and LFT (Liver Function Test)." "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: What is the best mouth guard used for teeth grinding? What is the cheapest way available to treat underbite? ### Response: Hi. Teeth grinding affects dental health. It is a cause of attrition. If stress is the cause for grinding the teeth, then do regular exercise, yoga, and meditation. Avoid" "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 24-year-old female. I am looking for some help. I feel no doctor understands what is wrong with me. I have had epilepsy since around puberty around the age of 12 when I got my period. I had a lot of seizures until I was finally controlled on Tegratol 200 mg. Throughout my teenage years, they decreased. When I married and got pregnant, my doctor lowered my dose to one pill 200 mg only at night. This was because I had no seizures for at least six months. Then I had no seizures for five years.Now I am 24, suddenly I had three seizures in one day. I was taken to the hospital and given a Magnesium injection. This was two months after giving birth and not getting periods back due to breastfeeding. I made myself sick fearing to eat anything or stress myself as I never knew what triggered it. I visited a neurologist, he said my dose is too low. He said to take 200 mg at night and 300 mg at night because I mainly get seizures when I am awake. Anyways through all of this, I get symptoms of seizures throughout the afternoon and night and when I wake up. So I get a lot of auras but no seizures. I have had this problem since I have had epilepsy. How would I get rid of these auras? My doctor seems to be confused and says it is just anxiety but I know what I am feeling. And it is the same feeling before my seizures (electric shock feeling in my right thumb). He wanted to put me on Xanax. Do I need this much medication? When I used to have seizures I would have only one in a day but after having three in one day, I got worried. I have had multiple ECG and MRI and they never found anything. Please, if you can help me. I am sick of living life in fear. What would you advise me to do? ### Response: I read carefully your question and would explain that the aura that you explain (electric shock feeling in the thumb) are not typical of epilepsy. So, considering the fact that you have been on 200 mg of Tegretol (which is a really non-effective dose) with no seizures, I do not think that these auras are related to the seizures. Besides all your repeated EEG are normal (which would not result in case of frequent seizures). They seem to be just anxiety, especially after giving birth (depression and anxiety are quite common after giving birth). For this reason, I agree with your doctor on the recommendation of trying Alprazolam. It is fine to increase the Tegretol dose to 600 mg daily. It can help against anxiety too. I would also recommend checking Tegretol (Carbamazepine) plasma levels in order to make the proper adjustments to the dose based on its plasma levels. If Alprazolam helps, I would recommend adding low dose Sertraline or Fluvoxamine to your therapy." "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 25 year old male. I am 181 cm tall and I weigh 70 kg. All the members in my family are tall, but I am not that big when compared to my father and brother. I am mentally depressed since my childhood. It is all about my body. I was a female looking boy with very soft body, less energy and not interested in sports. Since that time my arms and legs are very long. But arms are very lean as girls.My puberty was too late at around 18 years of age. But after puberty, I have hair on face, but till now it is not much as my brother had in that age. Facial hair is also thin and not uniform everywhere.I feel my bones are like females and not very strong, arms and fingers are not as big as males. My muscles are less too. I went for gym and built up a little muscle, but forearm and fingers are still feminine. I feel my waist is a little wide.Did I have any genetic problem or hormonal imbalance at puberty stage? I am totally exhausted. I am always worried about that. Please help me. ### Response: Hi. I totally understand your anxiety. This condition can be seen in about one in 600 boys. A normal male will have a chromosomal pattern of XY." "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: The density of my hair is decreasing and I have a severe hair fall. It looks like an androgenic alopecia to me. Please suggest any natural medicine which can reduce this or block the DHT. I am currently taking Antoxid HD and Zincovit. ### Response: I read your query. Take Bhringraj oil and do gentle massage with it of your scalp on every alternate day and wash your hair with mild herbal shampoo. Take Capsule Bhringraj two capsules two times a day with water for two weeks. Consult me after two weeks regarding improvement and for further management or you can consult your nearby reputed ayurveda physician if you want to. After two weeks." "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 is 56 years old and is suffering from a low ejection fraction rate of 25%. Is there any way of recovery? ### Response: Hello. This depends on the cause. If the cause is ischemic, meaning it has occurred due to blockages and the heart muscle is already dead, then it is unlikely to improve or improve slightly. And if the heart muscle is not dead, then opening the blocked vessel will help in improving heart function. Now, the way to know whether the heart muscle is dead or not is viability assessment with PET (positron emission tomography) scan. If the cause is non-ischemic with blockages like DCMP (dilated cardiomyopathy), then there is a chance for improvement with medication. So basically, there may be some improvement with medicines, but whether marked improvement would occur or not will depend on the viability of heart muscle, which can be known on further testing with PET scan. 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 my routine body check up done in which my lipase has come elevated at 71 and amylase at 146. There is no nausea or fever, just upset stomach. Though I am not an alcoholic per se, before the test I was abroad for two weeks and was drinking two beers every day. Since childhood, I have had acidity issues and upset stomach on and off. I am very anxious after my report. Please advise what to do to lower the levels. I have completely stopped taking alcohol for the last eight days. I am on Sompraz 40, Crestor 10, and vitamins. ### Response: I have studied your reports (attachment removed to protect patient identity). They signify that your lipase and amylase are raised due to alcohol consumption. Since there is no problem in the liver echotexture, this can be well controlled by stopping alcohol. I need to know: Revert with the asked details for a better help" "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 32 year old male married for five years. My wife and I are trying for a baby for the last two and a half years with no luck. My wife had gone for an HSG and other tests and her reports are all good. My semen analysis was fine too. We had gone for IUI thrice with no luck. Now, four days back, I had gone for a computer-assisted semen analysis (DFI) and the results were shocking. I was diagnosed with asthenoteratozoospermia. Please find attached my detailed report. Please let me know if there is any chance of me becoming a dad. I am heartbroken. I did doppler scrotal, anti-sperm antibody, testosterone two years back and the reports were alright then. Should I take Zinc or Vitamin supplements? How is my chance with ICSI (IVF)? Should I do any chromosome related screening test? Please advise. ### Response: Hello. I have seen your reports (attachment removed to protect patient identity). As per your report, you have asthenoteratozoospermia." "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 4 years old son fell in the play area and got his left arm fractured (ulna and radius). We went to ER and doctors did alignment and put him on cast and sling. I am attaching the X-rays before and after alignment. In the X-ray after alignment, one of the bones was not aligned properly. The doctor said that it is fine if it is aligned more than 20 % in kids. I am attaching both the X-rays.Can you please check and confirm if it is fine? Also, since he is 4 years old, he is not keeping the sling all time and while playing (with toys inside the home), the sling is getting loosened. My worry is that will it delay the healing process. Does the kid always need to be in a sling while in the cast. Please advise. ### Response: The reduction is not appropriate in this case, the bone might join in a 4-year-old child but this is certainly taking a risk. The child requires removal of the cast, reattempt at the closed reduction, application of slab for one week followed by checking of X-ray elbow with the forearm with wrist-anteroposterior and lateral view to confirm reduction is maintained or not. If the reduction is maintained, then to undergo cast immobilization. Role of the sling is to prevent edema of the limb by keeping it elevated and gives support. The child can play with well-fitted cast provided there is no fall on the limb, the cast is not soft and broken. If there is anything else, 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: I get hypoglycemia during exercise, fasting or not, brain fog, fatigue. This has been happening daily for a month. Prior I had been exercising an hour a day five days a week, no issue. Currently still aiming for five but symptoms will start out on my bike or on the treadmill.I had a gastric bypass 11 years back. I rarely get the hypoglycemia episode when I would eat sugar. History of insulin resistance. Glucose is always under 100. Insulin was 9 six months back. It was 6 two weeks ago, glucose was 88. Ferritin 15, d-20. Currently, I am having Neurontin 800 four times a day, Vyvanse 50 once daily. ### Response: Hello. I just read your query and from what you have mentioned it appears that you have hypoglycemic symptoms. First of all I would suggest that instead of doing finger prick testing of blood sugar it is preferable to do laboratory test for blood sugar. Secondly, there is an inpatient (after admission to the hospital) test to check your blood sugar after fasting for a required number of hours under observation. C-peptide and proinsulin need to be measured as well. All these are inpatient tests to rule out any cause of hypoglycemia. Also, if you exercise it is expected that your blood sugar levels fall even though it is recent probably because you have improved in losing stored fat which was initially preventing this from happening" "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: For the last two months, I am having small swelling inside the cheek. Also, there is some stiffness in the right throat, but not now. With general surgeon prescription I have used Metrogyl, Diataal, Tinidazole and vitamin tablets. But, still swelling is there and also I am getting some red dots on and off. Today I went to the hospital and consulted a dentist. He said it as frictional keratosis and chronic generalized gingivitis. So, they offered scaling and later extraction of that tooth. For the second opinion, I have consulted an ENT doctor. As the swelling is constantly present in the last one month, he advised to go for a biopsy. What can I do now? Please explain and I have attached some files for your reference. ### Response: Hi. Cheek bite and sharp cusp of the tooth. Frictional keratosis. 1. If sharp cusp is present, then the treatment is rounding off the cusp.2. Removal of the troubling tooth, in your case it is a wisdom tooth." "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 30 years old. I am in my first trimester of pregnancy. My 10 weeks 4 days ultrasound showed a very healthy baby of 36 mm with movements and strong heart beat. It is great news. It also mentioned that anterior placenta extending on the lower end. My gynecologist did not seem concerned at all and even never mentioned it. ### Response: It is too early to judge about placental position. Secondly with growth of baby, placenta normally moves up. So, there is nothing of concern right now. Regarding precautions, low lying placenta which is also known as placenta previa may sometimes bleed (manifests as vaginal bleeding) with sexual intercourse. You have to keep this fact in mind if you experience bleeding. You can avoid intercourse to avoid bleeding, though it is not a must. Sexual abstinence not compulsory, as the placenta is just extending on the lower end and not of serious type which covers internal opening of the cervix." "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 slight bulge on my tonsillar wall which is different compared to the other side. Should I be worried? It is not a different color. ### Response: I have seen the pictures. (attachment removed to protect patient identity). You are having chronic tonsillitis. There is an enlargement of tonsils. No other abnormality is there. So you can relax. Please tell me what symptoms are you having and what medicines have you been taking so far? So that I can suggest you better. Follow up with the required information." "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 started getting Venus Viva skin resurfacing treatment for atrophic acne scars. I will be getting six sessions over the next six months. I want to complement this treatment with a healthy skin care regime. I read that aloe vera gel and certain essential oils such as carrot seed and lavender essential oil aid in skin regeneration. My question is can I apply these oils (diluted in grapeseed oil) or aloe vera gel as an overnight lotion? Will it clash with whatever process the viva treatment has initiated within my skin? I do not like the night cream offered by my cosmetologist as it appears a little too emollient and does not smell that good. Also, I would rather use something natural. ### Response: Hello. I have noted your concern. A resurfacing treatment would leave your skin red and sensitive for a few days till the epidermis regenerates fully. So, you should be judicious in using products which supposedly while aiding skin regeneration are in fact, irritating or comedogenic. I am against using essential oils on the face, particularly because they usually do not suit sensitive skin and being an oil they can flare up acne which I am sure would be the last thing in the world you would be expecting, considering that you are taking these sessions to improve the appearance of your acne scars. Aloe vera gel is a good option and you can definitely use it post resurfacing sessions. Make sure you use a good brand and not raw aloe vera extracted directly from the leaves" "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 21-year-old female with 5\7 height and 168 lbs in weight. I have a yellow bruise on the top of my areola. And when I noticed it over two weeks ago, my whole breast started to itch, and it never stopped. There is no discharge or pain. I have not done anything to bruise it. I have no idea where it came from. But the itching is killing me it never stops. ### Response: A bruise is due to tissue bleeding and is usually bluish or bluish-red. It is never yellow. Moreover, a bruise is never itchy. Therefore the condition that you have is not a bruise, and it is something else. I would keep a possibility of either eczematous dermatitis, tinea, or fungal infection. I require a picture for a confirmatory diagnosis. Both of these conditions are itchy. I would be able to help you better if you can upload a digital Image of the affected area." "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 20 year old male. My weight is 114 kg and I am 5 feet 11 inches tall. I want to reduce my acne as soon as possible. I have a few hard bumps along with normal pimples. Mostly they are painless. I need an effective cure. I have attached a relevant picture. I have been using aloe vera gel now. ### Response: I have gone through your history and attached photograph (attachment removed to protect patient identity). You should continue with Dermadew acne soap but stop using aloe vera gel. Besides this, you need oral as well as topical medications for your acne. Start with tablet Azithromycin 500 mg once daily for three consecutive days in a week for 4-6 weeks along with Nadifloxacin gel in the morning and Benzoyl peroxide 2.5 percent gel at night on the pimples. I hope it will help you. If a satisfactory response is not seen in six weeks we might need to add another capsule. You can revert back to me after six weeks for follow up. Seborrhea and hormonal imbalance. Acne vulgaris." "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 relative has taken Mifegest kit. How will she handle the heavy bleeding? Is there any medicine to reduce the pain and heavy bleeding? ### Response: Hi. After taking Mifegest Kit (Mifepristone with Misoprostol), it is normal to have pain and bleeding. If she is one to two months pregnant, she will have heavy bleeding for two to three days with the passage of products of conception followed by minimal bleeding for a week. If she is more than two months pregnant, she may have heavy bleeding for a week also. It is advisable to take medicine under the supervision of a doctor to avoid complications. She can take tablet Hyocimax MF (Hyoscine butylbromide with Mefenamic acid) three times daily for pain. Take tablet Pause 500 mg (Tranexamic acid) three times daily for heavy bleeding. Consult your gynecologist if she develops problems" "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 new mole on a toe that I have not noticed before, I know about it probably for a week, it is blackish and not round, about 3 to 4 mm wide and sort of even in color. I am 21 years old male and as far as I know we have no cancer history in my family. I can provide photos too. ### Response: I went through your case history and the photos provided by you (attachment removed to protect patient identity). I can see a dark irregular lesion of about 5 mm in size over the tip of the toe. As it is to 3 days history the first thing I want to rule out is an history of injury or bruise.They do present like this and you may have forgotten the history of trauma. Secondly, moles also appear at this age and they also present like this if you have tendency of moles this may be a normal mole you can just observe it for few days. The other thing obviously is melanoma, acral lentiginous melanosis, this can be dangerous and has to be ruled by biopsy as soon as possible. But as you do not have any family history and if you do not have any other or very few moles over other parts of the body the chances again become very less. And again such a small history of the lesion the possibility is least. But to be sure you should monitor the lesion. Observe it for 5 days. If due to trauma, it will diminish and slowly go away. If persist and grow more immediately, go for a biopsy by a dermatologist for histopathogical examination. trauma, biopsy after 5 days. Intradermal hemorrhage, nevus nevus excision. none after 5 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 would very much like a second opinion on a recent MRI of my ankle, foot and hip after a fall over four years ago. I have been wearing an air cast boot for support but I have an extremely inverted ankle or foot following the fall. However, the MRI of the foot, ankle, and hips are normal. ### Response: Hi. Your MRI of the ankle, foot, and hip seems to be normal (attachment removed to protect patient identity). Well, I am not able to understand your problem. What difficulty you have? Is it present while sitting or only on standing? Kindly elaborate more of your symptoms so that I can help you better. If possible send a photograph of both your foot while standing." "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: An episode of profuse perspiration with nausea and mild trembling legs occurred in the morning today. ECG conducted within an hour is normal. Cholesterol level is also normal. Please advice further course of action required. The other tests performed were lipid profile, KFT, LFT, and Iron profile. ### Response: Are you a diabetic? If yes, then these symptoms can be explained by low blood sugar. Otherwise, it seems to resemble a panic attack anxiety" "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 pregnant without being married. My boyfriend cheated me. I cannot contact him as he blocked me. I feel so ashamed to see my family. Until now, I never told them that I am pregnant. I want to die. I am mentally disturbed. What should I do now? ### Response: Hello. You do not need to die. Be bold and confident. Take a decision for your pregnancy/child. If you are not enough ready to take responsibility of your child, then go for medical abortion. You do not need to ask anyone for it. Take an appointment with your gynecologist. Talk to your close friend or any close family member. Do not be afraid to take help from a close one. It may be possible they may get angry at you but they will surely support you. Suicide is not a solution to your problem. Fight with your situation. Learn from this for your better future. Next time, use proper contraception or do not trust blindly. Every problem has a solution. We just have to work on it. Do not fear to talk. There is a beautiful life ahead to live. You have to talk and do. Take help from a gynecologist and meet her personally." "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 bipolar disorder, on lithosun 1200mg, fluoxetine 20mg for the last 1 year.Working night shift since last month. Unable to maintain proper sleep. Please guide me. ### Response: Fluoxetine is not the kind of medication that needs to be taken for straight one year in bipolar disorder except in some rare cases. Problem with sleep may indicate towards relapse of mania or mixed episode. At this moment you need to talk to a psychiatrist either online or in person." "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 18 years old. My problem is that I have not got my periods for the past two months. This is the first time my periods are irregular. Please recommend me something. ### Response: I understand your concern. To tackle your problem, I have to ask you some questions: 1. Are you having any thyroid problem? 2. Are you overweight or have any facial hair? 3. Any history of unprotected intercourse? If the answer is no to these questions, then I would advise you to keep a menstrual record. Wait for seven days till bleeding happens. Please revert after these tests." "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 round yellow bump or circle on the back of the arch, right above my tonsil. It is there for a month. It does not show any changes. I do not have any symptoms or soreness. ### Response: I have gone through the attachment (attachment removed to protect patient identity). It appears like a small cyst. There can be a fluid collection inside the minor salivary gland. You need not worry about it as it goes down on its own. Since you do not have any signs, we need not worry about it. Occasionally, it could be a tonsillolith which is stone formation inside the naturally occurring crypts of the tonsil. You need not worry unless it is symptomatic. Follow up after six months regarding this yellow spot" "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 22 years old. I have very small breast and I am not comfortable about it. Everyone keeps joking about it. Is there any medicine to increase my breast size? Please suggest some solution. ### Response: To be very honest, to make you happy, I can tell you oils which claim to increase the breast size but all are ineffective. Try to understand that the breast is made up of muscles and fatty tissue. So, how can any oil or cream increase the fat over the breast!! Think. To increase the breast size you need to eat healthily and increase protein in the diet. The only thing that can help you out is a protein-rich diet and chest and breast muscle weight training. You can join a gym, learn and practice breast muscle weight training. This is the thing that is going to help you the most. Idiopathic or constitutional." "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 28 year old female nurse, I have been having severe menstrual pain throughout my life, and sadly each year the pain increases. Since I was a college student, each month for all the four days of my period, I had to stay home lying in the fetal position, had to keep a heating pad on my lower abdomen and used to take some serious pills. I have seen so many doctors, and each one of them gave me the diagnosis of endometriosis. After I had done a deep search about this medical condition, I was not happy at all. I even tried contraceptive pills for six month, which reduced my pain but made me gain 9 kg due to pure water retention. So, I stopped the pills, and the pain returned more aggressively.Since I start working as a nurse, I am having problems to keep up with the working time during my periods. And my colleagues cannot always help me out to switch working days with me. So, I had a laparoscopy, and they found inflammatory things, but they could not determine what exactly it is. So, I changed my doctor and did an RMI, according to it they found some endometriosis tissues. And I also have a retroverted uterus. I am tired and sick of this issue, and lately, I started taking medicines to help me endure my pain. According to the latest doctor that I consulted, I have only two options, a medication called Visanne or an injection called Decapeptyl. I am terrified from both, because of there side effects and unknown results. And these will make my body go through menopause. Please help me. ### Response: Hello. The diagnosis is indeed endometriosis. And yes, endometriosis causes very painful periods, and the only way to stop this pain is to stop your periods, which can be done through pills, injections or surgery. Surgery is not the answer for you, as you have already had one. And chances of recurrence are high post surgery unless we remove the uterus and ovaries too. But, we cannot do that at your age. These injections will cause menopausal problems. So, Visanne (Dienogest) is a better choice. Or an intrauterine system called Mirena can be inserted, which will save you from taking medicines 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: I am taking psychiatric medicines for a long period. Recently, I had been taking Sulpitac, Xet CR plus, and Pregabid NT. A few days back, I quitted all the medicines. Now I have symptoms of paranoia and insomnia. I do not want to take many medications. I need an antipsychotic to fall asleep. Please suggest. ### Response: Hi. As you have the symptoms of paranoia and insomnia, you can take antipsychotic such as Olanzapine or Quetiapine. It is a good option. You can start taking Olanzapine with 5 mg which can also be increased to 20 mg. Amisulpride (Sulpitac) is also a good option. But it does not have much sedation. Quetiapine can give proper sedation. As you were stable on taking Sulpitac, this can be a good option, and for sleep, you can use Clonazepam." "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: For almost two months, I am having widespread fasciculations. It started from my right arm and became widespread. After some time, I began to notice my right shoulder, and knee started to get fatigued quickly. I have visited my primary doctor so many times until I was given a referral for an EMG. My EMG test was clean, no form of denervation, and the neurologist diagnosed my fasciculations as benign. But now my muscle twitching is worse. Currently, I am getting constant twitching in my right biceps, and it occurs consistently without breaks. I have sleepless nights. Please help. ### Response: Hello. I reviewed, and I am glad to confirm that we can exclude any possible motor neuron disease, neuropathy, or muscle disorder. I would recommend checking vitamin D, plasma levels for possible deficiency, and thyroid hormone levels for possible thyroid gland dysfunction. Possible treatment options would be Clonazepam that helps to reduce muscle twitching and also calm down your anxiety. You should discuss with your doctor on the above tests and treatment option. I remain at your disposal for any further questions whenever you need." "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 unprotected sex with my girlfriend and she took I-pill within two hours. She had bleeding for three to six days after having sex and she missed her periods till now.I have heard about the disease amenorrhea, it might also be the side effect of I-pill in some cases. Is this a pregnancy or a disease amenorrhea? If amenorrhea happens, then can it be easily cured or not? How she can have her regular periods? Is it a matter of fear or a common disease?Please help us. ### Response: Hi. Amenorrhea is not a disease. Amenorrhea is simply absence of the menstrual cycle. A lot of females have missed periods for one or two cycles after taking I-pill and this is normal. In most cases cycle resumes after one or two missed periods. So, no need to worry. Within one to two months her periods will resume. So, no need to do anything. As she bled three to six days after taking I-pill, there is no risk of pregnancy. The amenorrhea is the side effect of I-pill only. It is not a matter of fear. No need to do anything. Just remain relaxed and wait for her periods to resume." "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 echocardiogram reveals borderline LVH. My cholesterol is 212 mg/dL and triglyceride is 283 mg/dL. I have been prescribed with Tazloc 40 mg, Nebicard 5 mg, and Rozucor F5. I am very much anxious about my heart. What can I do now? ### Response: You can have a healthy lifestyle by avoiding fatty, oily, and high-calorie diet. Have a low salt diet and monitor your blood pressure regularly thrice a day for one week. Follow them once or twice a week. If the BP (blood pressure) is persistently more than 140/90 mmHg, then the medicines are needed to get hiked up. Do regular exercises like brisk walking, and jogging according to your capacity for at least 30 minutes a day and five days a week. Take lots of green leafy vegetables, fruits, and fish once or twice a week, and avoid taking meat. Avoid smoking and alcohol. Repeat your lipid profile after eight weeks of a healthy lifestyle and see the response of the healthy lifestyle or else get yourself started with medicines like Rosuvastatin and Fenofibrate combination." "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 tilt my head or bend over and I have a clear liquid that comes out my nose. I get dizzy if I bend down and get up. I have major headaches a lot lately, and I am scared. ### Response: cim. Collect the liquid in a clean container. Sit upright for an hour and then bend down, so that the liquid accumulates and comes down. Collect that. Considering your history we are worried the fluid could be brain fluid or CSF (cerebrospinal fluid) as we call it. If it indeed is, then you need urgent attention to plug the site of CSF leak" "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 an ultrasound scan of the uterus done in 32nd week of my pregnancy, and the report says the cord is around the neck (type A). Please help. ### Response: Hi. Cord around the baby\s neck is common in pregnancy. There are two types of this condition, type A and type B. Type B may form a true knot around the baby\s neck and can be an emergency situation causing reduced blood supply to the fetus (ischemia) and reduced oxygen supply to the fetus (hypoxia)." "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 area of redness and tenderness above and around the top of my left nipple. It is painful to touch and has a small bump under the skin (not a superficial, but a few layers under). The lump is quite hard. We were recently swimming in freshwater rivers and ocean, and hiking in rainforests. This began after we returned, about three days ago. ### Response: It looks like erysipelas, that is called the superficial skin infection. It would be helpful if you have had any recent laboratory investigations, complete blood count analysis ESR CRP that would be very helpful. I will advise you to apply Mupirocin ointment twice daily on the nipple so that will control the current infection from spreading anywhere. For pain, take Tylenol. If you need any further information, please write me back and at the same time I would also like to know about your medical history and surgical history. If you are a smoker or have a social history as well." "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 meant to be having a root canal filling in one of my teeth. I have had it temporarily filled twice and now it has fallen out but it feels like there is only one side of my tooth almost like it has broken in half. Will they still do the root canal filling? ### Response: Hi. I have gone through your question. I can understand your concern. Yes, if the root stem is strong and not resorbed, root canal treatment can be performed, after that, if the crown tissue is grossly damaged they will do another procedure called post and core treatment. So, you need not worry." "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 37 year old male, who weighs 195 lbs, and I am 5.10 feet tall. I had blisters on my penis, so I went to a clinic. The doctor said that it appears to be herpes, but because I do not have pain, fever, or any other symptoms, he believed this was from friction. He told me to get HSV-1 and HSV-2 tests, which came back negative. However, I have read that this test may have been done too soon and my body might not have enough antibodies to detect the disease. Is this correct? If you have blisters from herpes, would not your body immediately have antibodies building up to fight the virus causing this, enough to register on the blood work? I am attaching a photo of the blisters. ### Response: I have seen the attached photo (attachment removed to protect patient identity)" "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 a consultation to decide on a health issue. For the past four and a half years I have been suffering from menorrhagia and metrorrhagia due to a fibroid. I tried ayurveda for three years and homeopathy for almost a year. Ayurveda did not work only with medication and they suggested to go take panchakarma treatment. Homeopathy started working for four months and the prolonged heavy bleeding stopped now. The bleeding was there for almost five years on each and every day with few months stopped now and then.At this juncture, I just got an endometrium biopsy and an ultrasound to monitor the size of the fibroid. My gynecologist suggested immediate hysterectomy to remove the uterus and my Homeopathy doctor asked to try for three to four more months and if homeo treatment fails, then go for surgery. This gynecologist does not believe in any alternative systems. I sent my reports to my ayurvedic doctor too, and he said surgery is not needed. The biopsy report says \simple hyperplasia without atypia\. Because of prolong non-stop bleeding for years, now I have anemia and went for infusion. I need a second opinion on hysterectomy if it is needed or not. In case if it is needed, when can I go for it? ### Response: Hi. Where is your recent CBC report? If your level of hemoglobin is less than 8 gm/dL then you are at the risk of several diseases affecting the cardiovascular system." "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 found out that I am nine weeks pregnant and I tried to have an abortion. In the first day, I took three tablets of Cytotec and two I put in my vagina. I felt some cramps but only light bleeding I experienced. On the second day, I took again four tables of Cytotec, no insertion happened. Still, light bleeding was there. On the third and last day, I followed up with three tablets and inserted two. No heavy flow occurred but only light bleeding.This morning I tried to have my pregnancy test and still, it shows positive. I went to a gynecologist but did not tell her about the tablets. I only mentioned that I have light bleeding. I never told her because I was afraid. I had a transvaginal ultrasound today. Can you help me understand the result please? Is there any possibility that my baby formation will not normal? I am so depressed right now. ### Response: Hello. I have gone through the reports attached by you (attachment removed to protect patient identity). The ultrasound clearly depicts that you failed in inducing miscarriage and the fetus is live and healthy with good somatic activities" "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 husband is having very frequent headache problem for at least twice or thrice in a week. We have consulted eye specialist as well as an ENT specialist, but in the test everything is good. Now, we are worried about his problem. Can you suggest or guide us about the reason? ### Response: I want to ask a few questions related to your husband\s headache. MRI brain. 1. Migraine headache.2. Tension type headache. Revert with the report to 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: Dear Doctor, My blood sugar report says that I have readings of Fasting Blood Sugar: 145 and Postprandial Blood Sugar: 209.I am on insulin. Please advise me as early as possible. ### Response: Hi. You don\t need to panic. This is not something serious. For a good effective treatment, I need to know what medicines you are taking along with insulin. Also, there are 100 kinds of insulin, which one are you currently taking and in what dose. It might be just cured with giving some additional medicine or increasing the dose of insulin. There are chances that, it might be a case of insulin resistance which can be broken down." "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 hypertension. Please suggest some natural ways to treat it. ### Response: I understand that you are not interested in taking medications for hypertension for a long time. So I am suggesting you a natural way of dealing with hypertension. Take raisins. Soak it in rose water overnight. Chew and eat it in the morning. You have to follow this for 21 days with 1 raisin on the first day, 2 raisins on the second day, 3 raisins on the third day and so on till you have 21 raisins on the 21 st day. Then stop this and after a gap of 2 weeks, repeat this. Follow 4 to 5 cycles like this. Meanwhile, keep taking your allopathic medication during this period. Afterward, you can taper off the medication. Keep checking your blood pressure after every 21 days. This might work for you depending on your body condition. Also, try to do meditation and yoga." "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 spot appeared on the skin of my penis. Seven months later, this stain spread and my skin began to become more sensitive. Then I used a cream with corticoid (Lotrimin) and it got worse because now my skin has shrunk and lost elasticity. What should I do? Is the corticosteroid effect reversible? ### Response: Hello. I have noted your concern and I have viewed the images (attachment removed to protect patient identity). Regards" "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 husband uses Diclofenac solution (topical) for his neck pain. I am 28 weeks pregnant. He also uses a neck pillow after applying it. Will it affect my unborn baby? How long will it take for the solution to be fully absorbed in his body? I am scared that the Diclofenac solution will be absorbed in my body and will hurt the baby. Also if we have sex and he touches that hand in my vagina, will the Diclofenac solution spread into my body? Should I be worried? Please give me some advice as I am scared. ### Response: You are in the last trimester (7-9 month) of pregnancy. Most of the organs in the fetus might have developed and now it is growing. Thus, care should be taken in food and lifestyle. The rate of absorption of Diclofenac solution into blood from skin is very very less. Even if you apply the solution on your own body skin for long hours, the absorption will be less. If it is absorbed, it stays in the blood for 2 hours. Remaining 25 % will get excreted in fourth hour. Remaining 12.5 % gets excreted in sixth hour. It means, if the solution reaches blood at 8 AM, it gets completely excreted at 4 PM. Note the point that the external solution does not get absorbed through skin into blood. Thus, need not to worry. Be careful with your vagina or oral. Because the vagina or oral is made by mucus membrane containing rich minute blood vessels. Vagina is different from skin. In vaigna, the absorption rate is higher and the Diclofenac" "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 frequently use earbuds due to itching in my ears since many years. People say it is not good to use earbuds. Please suggest me what should I do when I suffer from itching inside the ear. How do I remove ear wax? I also have a problem in my throat like throat dryness and irritation in the morning and when I drink cold water. Suggest me treatment for the same. ### Response: The itching in your ear is very suggestive of a fungal infection in the ear canal. This is very common and the main symptom is itching. Impacted ear wax can also create itching along with a fungal infection. Since you use earbuds, you may have impacted wax too." "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 97 years old. She had a minor heart failure with a BNP of 110. Recently, she had a bad UTI and asthma. Up to that point, her O2 saturation levels without supplemental oxygen were 95 to 96. Now that she is recovering from UTI, her O2 levels are 97 to 98 with 2 liters of supplemental O2 and her O2 level without supplemental O2 are between 88 and 92. All of these numbers are at rest. She does not do too much activity. What can be the contributing factor to this change? She had a chest CT scan and it did not show COPD. Should she stay on the O2? It is somewhat of a hazard. The tubing is difficult for her to handle. We must have someone with her all the time even throughout the night. We are concerned if she gets up to use the bathroom her foot will get caught on the tubing. She had a complete blood workup done. All the results were normal except that she is anemic. Currently, she is using nebulizer given by the primary care physician containing Ipratropium, Levalbuterol, Budesonide and antibiotics for recurrent UTI. ### Response: Hi. I do not understand the correlation between urinary tract infection (UTI) and low oxygen saturation. Asthma is a chronic disease and does not occur suddenly. She either had pre-existing asthma that got exacerbated by UTI or she had acute bronchitis or lower respiratory tract infection. I would recommend you go for a re-evaluation of her heart by 2D echocardiogram for her ejection fraction and for any signs of pulmonary embolism. If we do not treat the basic cause of falling saturation, we will not be able to come out of this problem. I would like to know whether you are treating her at home or hospital. Also, mention if you have her latest blood counts and urine test reports." "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 dysphagia for a few months. My endoscopy and barium swallow had been normal.The manometry showed weakness halfway down the esophagus. The pH test for 24 hours showed GERD.I tried eating a burger, and every bite of it got stuck. After that, I had a hoarse voice for a while.What is causing this if all tests are normal? I have attached the reports for your reference. ### Response: I have gone through the attachments (attachment removed to protect patient identity). The pH shows a gastroesophageal reflux and the manometry shows some weakness in the mid esophagus. You need to take antireflux medications and make some dietary and lifestyle changes to overcome the problem. That should help. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. If with those measures, the problem does not resolve then we can do a CT (computed tomography) scan to see if there is any other pathology" "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: Will complete blood count test show HIV infection? Will the WBC be increased or decreased? ### Response: Hi. Hope your query is answered, but if you have any other question, please do not hesitate to ask or call anytime. Best wishes." "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: Multiple intramural uterine fibroids 30, 20,12 and small interior wall 30, 25, 12 mm posterior wall. Right ovary 37*33*12'mm volume 8.2cc. Left ovary 38*25*15 mm irregular cyst. Kindly advice. ### Response: I have gone through your query and reports. The size of the fibroid is very small and negligible, and there is nothing to worry about. Please repeat the scan after three months to know if there is any change in the size. However, if you have a doubt, then get 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: Just now I got my cardiac CT report. I seek opinion of my radiology report before I see my cardiologist in a couple of weeks. Conclusion is that the stress test and echocardiogram results were fine. The CT cardiac report is as follows: Moderate coronary calcification detected with CAC score of 134 which is more than 90th for his age and gender. There is evidence of vessel remodeling with ectasia in all three coronaries without obvious atherosclerotic change in the affected segments. There is a mild to moderate diffuse non-obstructive disease in the LAD and RCA. There is relative non-atherosclerotic luminal narrowing in the distal LAD compared with the ecstatic segment. I can provide the detailed report. Is it something that can be controlled with lifestyle change or medications? I am on cholesterol medication and my cholesterol is under control. I am also pre-diabetic, which is borderline. ### Response: Hi. We are here to help you. Your report (attachment removed to protect patient identity) is suggestive of coronary artery disease. But, the good news is that this does not require any intervention treatment if there are no symptoms associated like chest pain on exertion. I would recommend you to do regular exercises and avoid alcohol and smoking in case you do." "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 see a lump at the opening of the anus. It is been there for over a week. It is not much painful but it is uncomfortable while sitting. I am a 25-year-old male. It never happened before and no current medications. ### Response: I have seen the picture you have uploaded. (attachment removed to protect patient identity). It appears to be thrombosed piles. It takes a few days for it to settle down well, but it is not anything sinister. A few things would help to give relief. Take Sitz bath (a large basin to be filled with warm water and a couple of spoons of common salt to be added and sit in it for 10 minutes) twice a day. Take analgesics Ibuprofen or Paracetamol twice a day for five days, laxatives Fybogel for three days, and Laxido before bedtime for a week. These would sort out the pain and discomfort. You have higher chances of developing hemorrhoids (piles) in the long term. Do exercise regularly,eat high fiber diet (no restrictions in having nonvegetarian) and reduce straining while opening bowels." "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 24 years old male. I have a habit of masturbation for about nine years. Now, it became a habit in me. I have started doing it compulsively for about five to six years. I masturbate as frequently as thrice a day every day. Now, my head is programmed to wank at any time when I am alone. I feel exhausted, and I want to stop the habit or to minimize the frequency of doing it. How can I do it? Please advice. ### Response: Hi. I can understand your concern and masturbation is a safe habit. It does not result in weakness or physical fatigue. But excessive masturbation results in significant loss of time that is spent on sports or in studies. This progressively results in poor health and poor performance in academics. There is no need to stop it completely, but you should reduce the frequency. There is no medicine available to help you. You have to reduce the frequency gradually. First of all, stop watching or reading porn materials. Try to masturbate by fantasies, and it helps to reduce the severity. When you stop watching porn entirely, you can reduce the frequency to two and then to one. Try to keep yourself busy and take part in outdoor sports. Keeping yourself busy will help to reduce your habit." "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 tablet Percocet cause seizures when taken in proper dose for pain? Will the seizures occur while I am sleeping? ### Response: Hello. Percocet is a tablet with a combination of two medications namely Acetaminophen and Oxycodone. It is advisable to use this medication only in the prescribed dosage and for the prescribed time. The most common side effects of Percocet are: However, there are a few other rare side effects like (in such cases, it is advisable to visit the doctor immediately) A typical seizure would be something like this: A period of unconsciousness with uncontrolled contraction and relaxation of your muscles (often all of them) along with involuntary or unconscious passage of urine and stools and may also be associated with vomiting and often associated with tongue biting. One who has suffered the episode will usually have no recollection of the event. Once the person gains consciousness, he/she feels exhausted and only a witness could provide the observation of the symptoms. There may also be injuries over the body.If a seizure occurs during sleep, then it could be life threatening as the vomitus may be aspirated into the air passage (trachea and lungs) and may cause difficulty in breathing. However, if you have observed any such symptoms, it is advisable to visit your treating doctor and get your medication reviewed.If you are sure that it is a seizure that you had, then it would be a good idea to stop the medication right away and also get a complete evaluation by your doctor to identify the cause of the seizure." "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 tell me what is the difference between thoracic, thoracolumbar and lumbar fusion? Or are they all the same? ### Response: This professional advice provided by me stands subject to the actual examination of report/image and is based entirely on inputs provided to me. It should be correlated with clinical findings. Regards" "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 days ago (for the first time in my life) I went to the emergency room of the local hospital. I had awakened at 3 AM with severe dizziness and nausea. We determined that it was probably caused from an accidental overdose of Tamsulosin. I have gradually improved but to only about 80 % of my previous stability. I am still a bit wobbly, especially when I am tired at the end of the day. This morning my hearing seems affected. It is kind of like they feel when full of water, the sounds seem slightly muted except for sharp sounds which are almost painful. ### Response: You need to perform tympanometry and pure tone audiometry to assess the condition of your middle ears, inner ears, and cochlear nerves. The attack which you have experienced can be an acute vestibular attack but the accurate diagnosis needs initially the previous audiological investigations plus videonystagmography (VNG). Before audiological tests, you have to stop any medications for dizziness for three 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 36 years old. I have an extra foreskin in my penis. It is never retracted from my birth. I usually use a lubricant oil while doing intercourse with my partner. I do not have any discomfort due to the nonretractable foreskin. I never had any pain or discomfort during sex. But I am unable to clean below my foreskin. I want to know whether there is any non-surgical method available to retract my foreskin. ### Response: Hi. I have gone through your query and pictures (attachment removed to protect patient identity). You have a condition called as phimosis. It is a condition where you cannot retract the foreskin because the opening will be too narrow. There is no medical treatment available for this condition in adults. Non-surgical dilatation of the opening can be practiced. But it is only for very mild cases. Your treating urologist will determine it after a thorough clinical examination. It should not be tried by yourself, as the foreskin can become stuck behind the head of the penis. It is a hazardous situation. The safest and the most straightforward approach is to get a circumcision done, which is only minor surgery, and it will solve your problem permanently." "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 on my fertile days. I got a stringy line during that. Is that a sign of pregnancy or it is normal to get that during fertile period and also the day before I got the stringy line, I got back pain and stomach pain and also cramping. I am unsure if that is a sign of early pregnancy or not. ### Response: It is quite normal to have an increased amount of stringy discharge during and just prior to ovulation or your fertile days as you describe. Cramping and back pain can also be associated with ovulation, it is usually mild and temporary. 3 to 4 days before ovulation is the time to have intercourse every 1 to 2 days in order to maximize your chances of conceiving. If you miss your period, take a home pregnancy test. If it is positive, then you have your answer. If it is negative and you still have not started your cycle, repeat the pregnancy test." "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 main problem is alopecia. I had it from 2015 with several patches on the head and now they are gone, but the problem is my eyelashes are gone and never grew back. I used castor oil, garlic, and now Revitalash and other things. Two years ago a rheumatologist prescribed me Dolquine and I did not have patches but my eyelashes still fell. I have lots of problems like hypothyroidism and Hashimoto and currently on Euthyrox 100. My doctor told me it has nothing to do with alopecia because it is normal now (good T3, T4, and TSH, etc.). I newley knew that I have PCO (normal result in echo but my glucose is lowered after 1 hour of glucose 75 mg intake and my insulin was 60, plus androstenedione 3.5). And I have hyper prolactinemia for six years on its own did an IRM and no tumor and currently taking Dostinex. With all these problems I smoke water pipe (shisha, nargile) three times a day. ### Response: Hi. Your concern is genuine and you are so brave and facing all challenges very bravely. You did not mention your prolactin and thyroid hormone levels. Loss of hair can be autoimmune as you were treated for it as well and due to Hashimoto as well. If there is no skin issue involved in the loss of hair (you should consult a dermatologist for it) it may be due to your autoimmune disease. Hashimoto is autoimmune as well. What you can do is that you decrease the TSH (thyroid-stimulating hormone) target to a lower level with increasing Levothyroxine and then see if it has a better effect. 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 an issue with gum disease. There is a swollen gum present on my back tooth. It hurts when I touch it. It is not seen in front of my tooth. It is present inside my mouth. I have pain in the left jaw. Please help. ### Response: I have gone through the image (attachment removed to protect patient identity). It looks like a periodontal abscess (infection of the gums and tissues surrounding the teeth). As you have braces (molar band specifically), it can also cause it. Another possibility is gingivitis. Again the reason is the same. The third reason can be due to dental caries (but your image does not show any evidence of caries or cavities). To confirm it, a clinical examination and intra-oral X-ray is needed. You will need a professional cleaning (scaling). For pain, you can take Aceclofenac 100 mg once in the morning and once in the night after food, take Pantoprazole 40 mg once in the night before taking food (only if you have acidity as it can aggravate the acidity). You can take Amoxicillin CV (Clavulanic acid) for five days one tablet in the morning and one at night. Finish this antibiotic course for five days even if the symptoms subside. If you are allergic to any medicine, stop taking them. Let me know so that I can alter the medication. But, I prefer taking antibiotics only after the clinical examination and X-ray. Do not worry. Consult your dentist. You will be fine. Maintain oral hygiene and since you are wearing braces, be more careful with oral health. Follow the instructions given by your dentist. Do lukewarm saltwater gargling. Is there any other swelling below the angle of your jaw or any pus or blood discharge from the swelling? Or are there any other symptoms present?" "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 36-year-old wife has a urine infection. She was diagnosed with postpartum preeclampsia after two days of delivery of a female child. She had high blood pressure at the time of delivery but now it is normal. Her average blood pressure is 110/75. She had a severe urinary infection before the birth of the baby. The infection was not controlled after birth too and an antibiotic was given. As per urine culture report, blood tests, and the doctor\s prescription, antibiotic and other medicines were given but the infection has not improved at all. What should be done? ### Response: Hello. Few bacteria which cause urinary infection in women develop resistance very easily and become difficult to treat." "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 26 years old. From childhood, I have the habit of masturbation but due to excess of it, my sex organ does not get tight like earlier and size is also small. Please guide me so that it would not affect my married life. ### Response: Excessive masturbation is not a good habit, it is like an addiction. So you should limit the frequency of it. You can do it once or twice weekly. But I want to clarify that masturbation never causes a change in the size of the penis, also not known to cause erectile dysfunction. Excessive masturbation causes psychosexual dysfunction, which can affect sexual life. And it is a common condition. So keep masturbation in limit. Decrease the frequency gradually. Try to distract your mind (by taking cold water, deep breathing, talk to family members, and listening to good music), when you have urge of doing masturbation. Follow a healthy lifestyle. Do daily exercise, take healthy food, follow the routine of the day, have good sleep. If you control it, definitely your sexual life will be satisfactory. Best wishes" "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 numbness in my hands and feet for the past two years. It is worsening gradually. The last month, it has got significantly aggravated. The numbness starts with tingling. When I am trying to grab something, I am unable to grab it. I also suffer from worsening cognitive function as I have difficulty in thinking and forming thoughts. I have trouble in organizing my thoughts, and I have difficulty in retrieving my memory. I am confused most of the time. I also have this problem for about two years.But last month, I started to have difficulty to do my job, and I was unable to function normally. I also stagger sometimes, and I have trouble in balancing my feet. So I looked at my symptoms, and I thought that I have vitamin b12 deficiency. So I started taking supplements 1000 mcg a day. But even now also, I have a feeling that my condition is getting worse day by day. ### Response: Hi. You have vitamin B12 deficiency. Your symptoms are related to peripheral neuropathy. It is caused due to vitamin B12 deficiency. It is necessary to perform some tests to know the possible cause. You have to investigate vitamin D levels and vitamin B12 plasma levels for identifying the possible deficiency, thyroid hormone levels for recognizing thyroid dysfunction, complete blood count and iron levels, and nerve conduction studies to investigate possible neuropathy. If vitamin B12 deficiency is confirmed, start to have a high dose of intramuscular injections. In such case, I would also recommend performing a fibrogastroscopy and biopsy to determine the cause for the malabsorption of this vitamin. You should discuss with your doctor for doing these tests." "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: What is the time period that HIV virus will be detected in blood by using available test methods? Please give minimum and maximum time period details. ### Response: HIV can be detected as early as four days of exposure by some tests. If negative conclusive results to suggest HIV negative is after three months of exposure" "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 itching on my tip of the penis, which also becomes red due to itch. Is it safe to apply any antifungal cream on the tip of the penis? Please suggest some good antifungal cream. ### Response: Hi. I have read your query in detail and do understand your concern. This could be due to fungal infection or due to dermatitis. You may safely apply antifungal cream over this lesion. I suggest Sertaconazole cream, an antifungal cream, which can be applied over this infection. Consult your doctor, discuss with him or her and apply with consent. Revert back after one week 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 did my ECG today in which I got a first-degree atrioventricular block. What does this mean and is this a serious issue? What is its cause and treatment, please? ### Response: Hello. A first-degree heart block means there is a slight delay in conduction of heart impulse from one chamber to another, that is from atria to ventricles.This is not a serious issue. If you are having any symptoms then only you should investigate it further, otherwise, do not worry about it. This will decide your treatment. If you are not having any symptoms then do not worry." "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: Six months ago, following a mild concussion, I started to have symptoms that were vaguely consistent with bilateral cervical radiculopathy. The cervical MRI showed severe stenosis and disc herniation at the C6-7 level going right and C5-6 going left. The worst symptoms were numbness, tingling, and weakness down the left arm. These symptoms really did not follow the C5-6 dermatome, however. They were all over the place in the left arm.Six months later, the numbness and tingling have resolved. I feel stronger overall. However, I have had body-wide fasciculations for four months. And I can see wasting of the first dorsal interossei muscle of the left hand. It is subtle, but I notice it. I have trouble holding a pot or a phone with elbow bent past 90 degrees.I have seen two neurologists including one neuromuscular specialist at an academic center. Both EMGs were clean. They needed the dorsal interossei muscle and all the other major muscles of the left arm. Clinical exams were also normal though benign fasciculations were noted. How do I know that I do not have ALS? What are the chances that these fasciculations are benign given the perceived weakness, atrophy, and fasciculations (body-wide)? How long does it take after the beginning of atrophy for an EMG to pick up ALS? What else could this be? Would not it be odd to develop ulnar neuropathy, worsening rotator cuff issues and bodyside fasciculations at the same time? I am not a doctor, but these seem like system wide problems.Currrently, I am taking Lamictal, Zaleplon and Lipitor. ### Response: It is highly unlikely that the EMGs (electromyography) are clean in the presence of muscle wasting and fasciculations. I believe the symptoms and signs you are experiencing are due to cervical stenosis and not due to ALS. A C6-7 disc herniation can cause all the symptoms you have described. Is it possible for you to upload the MRI (magnetic resonance imaging) pictures? In ALS (amyotrophic lateral sclerosis), usually, EMG findings precede clinical symptoms such as fasciculations and muscle wasting. This is also the case in radiculopathy due to cervical stenosis." "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: 33 hours ago I bumped my head on the road in an accident. The right side of my head got swollen up. I felt no nausea or vomiting. I safely drove back home. I have no coordination or concentration issues. My vision is normal, and all the senses are working normally. The swelling and the intensity has also reduced much. But since then, I am having pain when I touch that point on my head. Also, the left side of my neck hurts when I move it or exert pressure over it. I took three doses of painkillers giving by the doctor. Is this pain on touch normal? ### Response: Hello. I have gone through your query with diligence and would like you to know that I am here to help you. Of this, you have pain at the site of injury and neck pain. So, please consult a neurosurgeon in person at the earliest.Best Wishes for a speedy recovery" "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 consistent acid reflux when I wake up and until I go to sleep for about three weeks now. It is so bad now that I can not just eat.My mouth tastes to have a nice and yummy food. I get upper back and chest pains when I am lying down at night. I have been checked out by my cardiologist.The doctor did a stress test, CT angiogram and CT scan of the lungs. My next step is towards the gastroenterologist. I have sleeplessness for a few days.I have a small dose of Diazepam for the pain. But it does not alleviate it. Now, I am taking Prilosec regimen and tablet Zantac. ### Response: You seem to have gastroesophageal reflux disease (GERD). I would advise you to take a combination of Pantoprazole and Domperidone for the reflux. Also, you should take a soft and balanced diet. You should also put a pillow below your head when you sleep. Make a habit to walk after all meals. Avoid alcohol and smoking in case you do. Always brush before you sleep" "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 blood work done. The tests for my liver came back deranged and I have to have another test next week. My LFTs have always been normal. The night before I had the test I drank a lot and got tipsy. There was a hangover the next day. Could this be the reason for my deranged levels? I am assuming deranged means not normal or really bad results. Can you clarify the meaning of deranged? I am currently taking Vyvanse, Strattera, and Spironolactone. Please help. ### Response: Hello. Yes, deranged in medical terms means abnormal and likely in your case there must be elevated liver enzymes like SGOT (serum glutamic oxaloacetic transaminase) and SGPT (serum glutamic-pyruvic transaminase). Likely, the cause is alcohol only. It directly affects one\s liver. In short term, such damage recovers within a week period but the chronic high consumption may lead to permanent damage. So you should repeat LFTs (liver function tests) after a week. Also, get an ultrasound of the liver done to look for chronic damage" "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 born with esophageal atresia without fistula-type A. After two days of birth, and she has a surgical intervention, but, it was unsuccessful because the gut of stomach was not developed enough or it was very short to connect. Then, the doctors have installed a gastric catheter for feeding baby for 3 to 4 months and then to treat or surgical intervention this again. My question is, is this any complicated situation and how standards treat it of medicine? Is it possible to have another anomaly with other organs or bodies? ### Response: Generally, for esophageal atresia, two to three procedures (in parts) are done for correcting the anomaly because it is almost impossible to stretch the tube so far as to reach the stomach. As far as I know, we put in a gastrostomy tube wherein food is directly poured into the stomach via a tube. Theoretically speaking if we find such an anomaly, it is essential to check for other physical anomalies in the vital organs like brain, heart, lungs, kidney, stomach, liver, etc. Generally, in such cases with proper intervention at the appropriate time, there should not be any issues." "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 destructive behavior. I break things, and I kick them when I am in anger. Please suggest. ### Response: Hi. You seem to have some severe anger issues. These type of problems are due to various psychiatric issues. It can also be due to depression, anxiety, and schizophrenia. We need to have a complete assessment of your symptoms, and the provoking factors. You can manage anger by following these techniques. Have control over yourself. Try to do relaxation exercise and deep breathing exercise. You can have counseling with your psychiatrist. You may need to take medicines depending upon the severity." "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 flowing from my left ear without pain. Please help. ### Response: Most common reason for bleeding from the ear is due to trauma. There is nothing that you need to worry about as this is extremely common. Please do not use headphones or earphones as well, until it heals. Make sure you keep the 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: Three weeks ago we had a problem with water in my apartment, so the owner gave us a second apartment to use the water while they fix the issue. What happened is that day I felt the urge to masturbate but what happened on that day is that I felt ashamed because I felt that I really dirtied the place (because of masturbation) and that the apartment was not mine for me to use it that way. That made me feel shame and telling someone did not solve it. I feel this deep shame whenever I meet anyone because I feel like nobody has ever done this in such a way in such a sequence by sort of taking advantage of the place you were given just because you did not have water which makes what I did bad and I felt if someone knew about it then they would laugh at how I took advantage of this apartment situation, etc. I felt that if I stayed there then maybe it would be something common and no shame would be present. I still have the feeling that because it is scarce that I did something bad and that I am hiding that whenever I speak to any person and that they do not know I did that because it is a taboo.P.S: I do not have problem with that act, I just feel ashamed from the situation of which it happened that is uncommon and cannot shake off remembering what happened and feeling ashamed as a person in my all to day life. Since I started discovering these sexual traits as a child, I always regarded semen as an unclean thing and tend to overwash after masturbation and regard masturbation as something that everyone hides, therefore, it is bad. What can I do to get it out of my head and not feel shame anymore? Because the thing that is bothering me is how it happened like nobody gets to get another apartment and do such a thing and that is always messing with my mind. I tried accepting it but it is just not going away and causing me heavy stress and interrupting my everyday life and happiness. ### Response: It looks like you are having obsessive thoughts, as you also have history of OCD. I would suggest you to talk to a therapist and take cognitive behavioral therapy. It would be helpful for you to have control over your obsession. You can find a local therapist or we can start counseling therapy session online via video consultation." "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 concerned about the medication that my 13 year old son is currently taking for bipolar disorder. He was diagnosed bipolar disorder at the age of 7. After trying several medications Depakote was the one that worked best. My ex-husband got custody of him 4 years ago and pulled him off from his medication. Last month my son threatened suicide and was hospitalized and placed on Zoloft. I recently spoke with my son\s counselor and she said that Zoloft is used to treat depression and that he should be on a secondary medication for bipolar. His past medicines are Intuniv and Depakote and his current medicines are Zoloft and Vyvanse. I have tried speaking with my son\s therapist. However, my ex-husband has told her not to speak to me regarding my son\s treatment. I have noticed in conversations as well as visits with my son that he sometimes seems more depressed and agitated even threatening to run away from home. Is Zoloft used to treat bipolar without any secondary medication? Is it safe for a 13 year old? ### Response: Hi. First of all, I want to inform you that Vyvanse (Lisdexamfetamine) and Intuniv (Guanfacine) tablets are indicated for Attention deficit hyperactivity disorder (ADHD). Depakote (Valproic acid) is an antiepileptic and mood stabilizer. It is useful for bipolar disorder. If your child is diagnosed with bipolar, then he should receive Depakote or other mood stabilizer. Zoloft (Sertraline) is an antidepressant and by this chance of switch to mania is there. So, in bipolar patients if depressive symptoms are prominent, then antidepressant can be given only under the cover of mood stabilizer. Antidepressant should not be used for long term in bipolar patients. Once depressive symptoms get resolve, patient should maintain only on mood stabilizer. Antidepressant should get taper off gradually." "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: From the past few weeks, I have been feeling really gassy, and I have not had my period in a few months. I think I come from a family with lots of anxiety and stress, which delays your period. I also have a phobia of throwing up and I get anxiety from that. I looked up some stuff on the internet, and I think it is my period that is causing this. I have not been hungry all day, and I have been burping and farting a lot. My stomach has been making noises for no reason, and I cannot poop. I have pain in the upper and lower part of my stomach and a few headaches here and there. I have milk, egg, and peanut allergy. ### Response: It is gastritis and acidity problem. Stress and anxiety can cause both these problems and also periods problem. I suggest you try doing the following: Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. Hope this helps you and get back if you have any doubts" "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: For a week or more I have not been able to sleep. Right before I fall asleep I wake myself up. It seems like some sort of apnoea event but I do not know if it is related to swollen tonsils or if its a bigger problem. I am going to the doctor this week but wanted an opinion online especially in relation to if my tonsils look normal or not. I am not experiencing any tonsil pain but that area does feel a little more swollen or constricted than normal. ### Response: I have seen the video (attachment removed to protect identity). Your tonsils are enlarged. Probably because of that you have apnea. Do you have any history of any chronic illness like diabetes or hypertension, etc.? Are you on any regular medications? Also, let me know your weight and height." "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 no current medications. Over the past 2 or 3 years, my hearing in my left ear only has deteriorated significantly. I would say it is less than half as good as my right. I went to an ENT doctor, with an audiologist appointment. The audiologist said I had a moderate hearing loss in my left ear. I wish I had the results of the exam for you, but they are around 300 miles away at the moment. After that exam, the ENT doctor said it sounded it was unlikely but I may have a tumor, an acoustic neuroma I believe. He said I should get an MRI or a CAT scan, pretty sure MRI, that would make more sense right? Also, I told him that I have had significant tinnitus for a while and that if I tilt my head to my right side but not my left I get mild vertigo. It seems like I may have misunderstood him and it is likely that I have an acoustic neuroma, but I am curious if there are ways I can rule out other maladies. For instance, I think the hearing loss was significantly worse after I had significant ear pain during an airplane flight. I did not notice any fluid or blood drainage but was wondering if something like an eardrum perforation could have occurred, or just if there are other diagnoses I could test for without paying for an MRI for an acoustic neuroma. Or if there are other roads I could go down beside paying for an MRI for an acoustic neuroma. If it is likely I have an acoustic neuroma, I get an MRI, it confirms I have one, I have already ha ad significant hearing loss for at least a year, can anything even be done to improve my hearing? ### Response: To rule out acoustic neuroma we do need an MRI scan. Acoustic neuroma is a tumor that grows inner to the inner ear where there are a lot of nerves passing by. If the tumor grows and involves the nerves it can cause palsies of the nerves which may be irreversible. The hearing loss you have said does not let us conclude whether it is a conductive hearing loss or a neural. This is also important. If someone can click a picture and send to you it will be really helpful. In addition, I would like to know if you have any vertigo, nausea, a fullness of ear, facial weakness, ear discharge or an earache. It is advisable to get the MRI done without much delay. If the otolaryngologist has suspected acoustic neuroma then it is better to haste the process." "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 using high quality, highly rated penis extender for two days for 8 hours a day and no for the past three weeks now. Do these things really work? Is it possible to experience penis shortening instead of enlarging? A month ago, I was 7\x80\x9d but now I am almost at 7\x80\x9d. ### Response: I want to know the reason for which you are using a penile extender. Do you have a very decent size why you want to increase it further? It is like your height is 6 feet but you want it to be 6.3. Everything you do has got side effects. If not done properly can lead to trauma and hence shortening. Are you diabetic or hypertensive? Any other chronic illness?" "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 32-year-old male. I weigh about 80 kg with a height of 5\9"". I am facing erection issues since last week though there is no change in my sex drive. Also, I feel reduced morning erections too. I feel aroused but the erection does not come as it used to before a week. Healthwise, I have sound health and have a moderately active lifestyle and pretty normal sleep pattern. Anxiety level is suboptimal due to COVID19 situation. I was using a semen volumizer herbal supplement intermittently. I am not sure if this plays any role in it too. I drink occasionally in limits and I am a vegetarian. My food habits are healthy and I avoid junk food as such. These erection problems started just a few days ago and now they are troubling me to a bigger extent. Please help. ### Response: Hi. I can understand your concern. According to your statement, you have been suffering from erectile dysfunction for the last few days. Erectile dysfunction is usually caused by low blood flow to the penis or problems of nerve of penis which control erections. Most common cause of erectile dysfunction is psychological reasons such as stress or depression. It may have resulted from the hardening of arteries, high blood pressure, high blood glucose, high cholesterol, medications, BPH, prostatitis, hormonal disturbances, etc. Usually, erectile dysfunction is common in everyone\s life due to many causes. In most cases, it goes away over time and no treatment is needed. You can do some investments like CBC (complete blood count), urine R/M/E, RBS (random blood sugar), lipid profile, USG of W/A, PSA, etc and hormonal tests such as testosterone, LH, prolactin, thyroid function test, etc., to find out the underlying the causes which are responsible for your present sufferings and then treat them accordingly." "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 blood test recently and my ESR was elevated to 22, while vitamin B12 was low. I have pain in the right armpit and also a pain in the neck. ### Response: Hello. Your B12 level is low, hence it should be treated with Folic acid tablets and Cyanocobalamin injections. Hope your concern is solved" "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 started a few months back. The symptoms are mostly neurological, eyesight, fatigue, depression, anxiety, and nausea. I am currently taking 500 mg Depakote ER and 150 mg Lamictal ER daily for seizures and have been taking them for several years now. My questions are not related to my medications necessarily. I am wondering if it is possible for the body to absorb heavy metals like lead, thallium, mercury and cadmium for example from new body piercings, specifically earlobe piercing, if the needle or jewelry is dirty or has toxic metals in them. I have been chronically exposed to puncture wounds with needles that could potentially have toxic metals in them for many months and I am worried that I may be poisoned. What should I do? More details about the presenting complaint: The symptoms were sudden and stronger originally than they are currently but I still have symptoms. The symptoms started a few months back. I had several puncture wounds before that.Previous history of the same issue: I have never experienced these symptoms before. Current medications: Depakote and Lamictal. Past medications of the same issue: I have been taking Depakote and Lamictal for several years. Lab tests performed: I had a lead blood test and a metals acute poisoning panel blood test a few days ago but I do not have the results yet. ### Response: Due to climate change, changing the brand, stress level, changing dietary patterns all can facilitate antiepileptic" "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 dad is 60 years old. Before 15 days, he met with an accident and was injured on the right side of the head. There was bleeding on both the ears and some cholesterol like thing was there in one ear. We have noticed that, but not sure what it was. We have admitted him in the hospital and he had a surgery for left FTP contusion and acute SDH. He looks like he has eyeball movement inside, but he did not open his eyes still. What is the reason? How many days will be taken to open his eyes? When we speak something to him there is no response from him. Can we expect that he will get conscious? When we give him a pain he is moving his hand and leg, but when we touch him simply, there is no response. What would be the reason? Can we expect him back as he was earlier? He is not speaking anything. The injury was on the right side head and the operation was done on the left side. Would like to know why the operation done on the opposite side? Otherwise, he is passing the urine and motion regularly. I will also attach the scan report. Please look at that and help me on my doubts and provide me the status of him. ### Response: I have gone through your query with diligence and would like you to know that I am here to help you. He is in coma. The time to recovery will be longer and we cannot predict that now. As he is in coma, he can only feel the pain and not touch. Also, he will not be able to react much while in coma. While in coma, the patient will be unconscious ans so he cannot speak. Moreover, since the injury is on the left side, the speech areas in the brain may be affected. Some injuries like fracture and EDH (epidural hematoma) occur on the same side. Some like SDH (subdural hematoma) and contusion occur on the opposite side. Since you have mentioned it as SDH and contusion, it would have happened on the opposite side." "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 tinnitus, and it is driving me crazy for the past 5.5 months. In my CTA examination, my upper cervical spine demonstrates some moderate facet arthritis primarily at c2 and c3. It also shows an incomplete fusion of the posterior arch of c1 and mild cervical spondylosis. Also, I have a deformity of the right zygomatic arch related to prior depressed fracture, and I have a small screw in the right lateral zygoma due to the previous injury. Also a mild deformity at the tip of the nasal bone from a prior injury.The paranasal sinuses demonstrate a minimal dependent mucosal thickening in the maxillary antra. This surrounds some roots of some maxillary teeth which extend into the base of the maxillary sinuses bilaterally. Also, mild swelling if the middle turbinate and moderate swelling of the inferior turbinates. Also moderate bowing of the nasal septum. With your knowledge, could any of the above be causing my tinnitus? I do not know who else to turn to or if I am missing something. I am under, 20 mg Prozac per day and 900 mg of Propafenone. ### Response: Hello. Cervical spine abnormalities can cause vertigo but not tinnitus. A zygomatic bone fracture can be a cause of tinnitus if it is impinging on the mandible. But that would be more due to chewing and movements of the lower jaw, and sinusitis can also cause tinnitus if it causes otitis media, but then the hearing is also impaired. Have you done a pure tone audiometry?" "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 suffering from anxiety, panic disorder, and perhaps OCD as well (but I have not been diagnosed with that yet) since I was 11. However, I had been completely anxiety-free for about four or five years until three months back, when I got a horrible panic attack that started it all. Technically, I had some weed muffins last year, and I got a panic attack from which it took me over a week to recover, but I was fine again afterward. Anyway, first I was obsessively worried about my physical health, but that has now shifted to mental health. I have also been suffering from derealization on and off.Anyway, just a couple of days I got this horrible intrusive thought like \what if I got psychotic and heard voices that would tell me to hurt my family or my dog or myself\ (note that I love my family, I love my dog, I love myself, and I hate and despise violence of any kind. I have never acted violently in my life) and basically, since then, I have been feeling worse and worse. I read a lot about schizophrenia, mainly real life stories and experience of people, which at first made me go \okay, now I certainly do not have this,\ but as time progressed, I started getting more and more intrusive thoughts. Like \what if I start being paranoid, what if I start believing that the posters in my room are real people, etc.\ Occasionally, I ask myself \what if these people are not real, what if I am not real?\ I have also had a blank mind, pretty much unable to think of anything else, since I got this bad last week. I get this constant picture of myself, confined to the bed and crying somewhere in a white room, all by myself. I have also been feeling this kind of gut-fear since then.On the outside, with other people, I behave normally, much kinder, actually, I think. I am a bit slower and find it a bit harder to concentrate on two things at once, which had never been a problem before, but that could as well be due to anxiety. ### Response: Remember every problem has a solution you just need to try solving it and help is just a step away. Feel free to ask if you have any further queries" "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 an issue with my anus area for a while now. The area is always red, and there is always an unpleasant smell (fish). I do not notice any drainage. I have a history of Pilonidal sinus and abscess. I was tested for a few STD\s but not all. I think it may have something to do with the pilonidal sinus, as the two issues were consecutive. I will attach an image that will hopefully help. ### Response: If possible provide me photographs of affected areas that will help me for a better understanding of your skin problem and proper treatment plan. Photographs required for more accurate diagnosis purpose because treatment given without proper diagnosis can be less helpful." "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: All my lower back teeth have started to decay. I brush my teeth twice daily, morning and before sleep. Please help me. ### Response: Hi. I would like you to go to your nearby dentist and get it confirmed if it is decay or stains. If it is decay, then your dentist might suggest you get some dental fillings done. If it is just stains that you are noticing, then the stains could be removed by dental scaling, that is, professional cleaning. Decay can be formed due to lots of food impaction in the back tooth regions which is a very common complaint. Sometimes, even though we are regular with brushing, there are areas where the brush cannot reach. So, it is advisable for you to consult your dentist at the earliest." "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 looking forward to have advice about the outcome or prognosis of nerve regeneration and repair for my son. Before 13 days, my 10 years old son fell with a bottle in his right-hand palm and had his palm triangle open. As we were in another place, the local surgeon cleaned the injury, and I took him to another place where he undertook a surgery before 10 days of nerve repair of the proper ulnar digital nerve of the median nerve. I do not know if it is the exact term, but the nerve cut was the one at the root of the index, and that goes on the inner side (facing the 3rd).Would you please advice me about the outcome of this surgery? Is this nerve responsible for some functional disabilities of the Index? Is it only sensitive? Can he flex his index and use it usually afterward? No other tissues were cut, like tendon. ### Response: I have read your concern. Can you give me more of the details of the surgery if you can still remember? How was it repaired as what you have told by your doctor? How is the finger at this moment (can he flex? can he feel anything at the tip of the finger?) I am hoping for your reply." "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 of 62 years age. I was operated for cataract five months back for both the eyes. As my cataract was only 20 %, but eye pressure was 22. My OCT was done, which showed no damage to nerves. My perimeter too is clear. No family history of glaucoma. I was put on various drops which could not bring eye pressure in the expected range for the doctor (fluctuation between 22 to 28). She suggested implant surgery to make eye pressure normal. Another doctor stopped eye drops saying I do not have glaucoma. And, do not need eye drops too. I am confused. ### Response: Hi. It is a practice that if perimetry is normal, one waits to start any antiglaucoma medication. The protocol is to graph your IOP (intraocular pressure) for 24 hours or IOP at different times of day repeatedly for a week, then one can decide if you have glaucoma or if you are just a case of ocular hypertension. Let me tell you there is no need of any implant and these many medications should not be started now. Chart your IOP, also a gonioscopy. Then, one can decide if one has to start medication" "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 taken two antirabies shots ten and three months back for a dog bite. A shrew that had entered the house bit me on my back two weeks back. There was no bleeding even on applying pressure on the area, but the next day I noticed a small clot on my back like the one we have after a scratch. In my stupidity, I only took a tetanus shot and took an antirabies vaccine only 13 days after the bite. So, I am very scared now that am I at risk. What should I do? I am very worried. Please advise if I need to take immunoglobulins or complete the five-vaccine schedule. I am very tensed because of my foolishness. Please help. ### Response: Rabies vaccination should ideally be started on day 0. But, you have not developed any symptoms. So, it is not late to start vaccination now. You should complete the five-injection rabies schedule. Since it was a category-2 exposure, the immunoglobulin is not required. Good luck." "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 terrible before periods and I cannot sleep. My tummy comes out, also my breast become heavy, and I feel no hunger at all. My periods are regular but I am just tired of this thing happening to me even though my lifestyle is good. I am a vegan. Please help me. I want to cure it naturally. ### Response: Hello. I have gone through your history and understand your concerns. You have to change your lifestyle and diet. You can take M2 tone syrup for the same. Regards" "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 with a lady and after three days my penis gets pain a lot in the night. I cannot sleep much in pain. After one week I checked with the hospital, they give me antibiotic medicine but there is no relief. I have done my HSV 1, HSV 2, VDRL, and HIV test. All test are negative. Now one year has gone, still, I have pain little inside the urine pipe when I go for urine and on the tip of my penis a red dot appears. On applying Candid cream the red dot goes away but when I stop applying the cream again that red dot appears. I am also taking AF-150. I am sending you my picture. Please help. ### Response: I have gone through your history and reviewed the attached photograph. (attachment removed to protect patient identity). According to me, there are two possibilities, one is candidal balanoposthitis and the other is herpes genitalis. Since you have mentioned that your HSV 1 and 2 tests (herpes simplex virus) were negative then chances of candida infection is more. But I would recommend you to repeat HSV 1 and 2 tests again to rule out herpes infection. Apply Sertaconazole cream on the affected area twice daily for at least two weeks and take tablet Fluconazole 200 mg twice weekly for two weeks. You can revert back to me after two weeks. Candida infection, Herpes infection. ELISA for HSV 1 and 2. Candidal balanoposthitis. As mentioned above. As mentioned above." "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 hoping someone can tell me if I have pseudocholinesterase deficiency based on the blood results below? My father has it and found out the hard way after surgery. His sister also has it. The results from my blood test were:Cholinesterase, serum Result: 2228 L Reference range: 2673-6592 IU/LCholinesterase W/DIB INH cholinesterase, serum Result: 2228 L Reference range: 2673-6592 IU/LDibucaine number Result: 81.3 L Reference range: 81.6-88.3 % Inhibit ### Response: Hello. You may have atypical pseudocholinesterase deficiency due to a heterozygous mutation which is hereditary. Your Dibucaine number is 81 that is quite normal. But still, some" "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 18 years old. I have jaw discomfort and a misaligned bite. I have not removed my wisdom tooth, and I have a habit of popping the jaw. I usually put my palm over the jaw near my ear, and there will be a pop. I have a gum tissue behind my molar, and I am unable to close my left side of my mouth completely. Please give me a solution. ### Response: Check your temporomandibular joint X-ray first. It sounds like a TMJ problem called a lockjaw. Depending upon the degree of damage, you require treatment. The most common solution is wearing a splint every day to prevent a rough sliding of joints. Since you are 18 years old, it is not mandatory to remove all the wisdom tooth. But if these cause the joint discomfort, then it is better to do an extraction of all the wisdom tooth. I advise you visit an oral and maxillofacial surgeon and the doctor will give an accurate treatment plan." "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 single male, 34 years. I currently feel before or after urinating something moving in my penis. And, just now, I noticed a whitish or yellowish liquid coming out of my penis. It started last weekend after I had unprotected sex. ### Response: Hello. As per your query, you mentioned that you had unprotected sex. You may have a urinary tract infection.You do not have to worry too much. It can be treated with antibiotics within five to seven days. Please get urine routine test." "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 aged 49 years old was diagnosed with a fibrocystic disease of breast seven years back and was subsequently operated. Since then, she has got a cyst in both breasts. Last year, she was got USG done, and the doctor found fibroadenoma along with cyst BI-RADS (2 to 3) in the left breast. The doctor asked her to review after 6 to 12 months. Recently, she discovered a lump in her left armpit which is small and can be felt only after touching. Is it anything serious? Also, please tell that does these diseases cause an increase in chances of breast cancer. She also has a fibroid in the uterus, and for that, the doctor prescribed Sevista 60 tablet twice a week, and he said that fibroadenoma would go after taking Sevista. ### Response: Based on the report (attachment removed to protect patient identity), fibrocystic disease of breast and fibroid uterus, both of them are due to hormones, mainly estrogen. When using Sevista (Ormeloxifene), the fibroid in the uterus will decrease. For breast condition, BI-RAD 2 to 3 means it is was a benign (it can regress) condition (not cancer). Treatment depends on menopause. If she has not attained menopause, then she has to use Sevista. If she has attained menopause, after some time, Sevista can be stopped. With menopause, the fibroid can disappear. Fibrocyst of the breast may persist, but malignancy is very rare. At present, no need to worry. Frequent six months or yearly once monitoring with ultrasound is enough. Further treatment depends on whether she had excessive bleeding (menstruation), her calcium levels, family history of breast or other cancer" "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 blepharitis. I also have seborrhoeic dermatitis (perhaps rosacea as well), and my condition has improved greatly. Recently, I got very bad allergy symptoms, my eyes and nose became extremely itchy, causing me to sneeze a lot. This morning when I woke up, I had trouble in opening one of my eyes due to a dark yellow eye discharge. Apart from being itchy, my eye was blood red and dry (only one eye). I have never had this much discharge before, especially after I started cleaning my eyelids for treating my blepharitis. It really terrified me. Could this be bacterial conjunctivitis due to the color of the discharge and the fact that only one eye was affected? What are other possible explanations? ### Response: I have gone through the attached pictures (attachment removed to protect patient identity). Yes, it is nothing but common bacterial conjunctivitis. Since you have blepharitis, you are more likely to get conjunctivitis. Also, blepharitis, in turn, is related to seborrhoeic dermatitis. Try using Gatifloxacin eye" "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 having headaches and dizziness for five days. The headache is around my forehead and behind my eyes. I am 30 years old. My aunt has a brain tumor. I am wondering if my headache can be a tumor as well. ### Response: Hi. I read your query and understand your concerns. I hope this helps you. Feel free to write back to me if you have more questions." "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 about a person who just fainted and bumped her head hard on concrete. Should she go to the emergency room? ### Response: I would like to know her age, other medical conditions, and present medicines. Fainting needs to be evaluated as it can recur and cause serious problems. If she is still feeling unwell, or having giddiness (a tendency to fall), or lost consciousness, you should get her to the emergency room. In the emergency room, they will be able to check your blood pressure, heart rate, and basic blood tests. If you are back to normal, then you can meet your primary care physician in the clinic at the earliest. You can also call your primary care physician office to check with them as they will be aware of your previous medical issues and current medicines. 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 suffering from sore throat. Three days ago, it initially started with pain and the redness appeared shortly after. I have had strep about three times now. It hurts when I yawn and swallow. I feel a little dry even though I have been gargling with water. I woke up this morning with a thick vertical red line going down my throat. Does it look like strep? ### Response: Hello. We are happy to help you. With the details you have provided and the photo you shared (attachment removed to protect patient identity), I have come to the conclusion that you are having an acute tonsillopharyngitis. This is the infection of pharynx (upper part of the throat) and your tonsils on each side. Now, we can conclude it as a streptococcal infection only based on the culture and sensitivity swab of the throat." "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 having some chronic abdominal discomfort in my stomach, and occasionally in my chest for several weeks. Also irritable bowels. Before this, I took a six-week course of Ampicillin for what was perceived to be prostatitis. Had an abdomen CT scan with contrast because of testicular pain and right varicocele. My question is, would colon cancer be seen on pelvic CT scan? ### Response: Hello. I do not know why you are getting worried about colon cancer? These are not symptoms of colon cancer. As far as your query is concerned, colon cancer may or may not be detected on CT scan based on the stage of cancer. But in most cases, one can see abnormal growth over there. A colon cancer diagnosis is made on biopsy done by colonoscopy. Try a good probiotic like cap VSL 3 (live freeze" "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 23 years old. I have a baby tooth. My mother also had a baby tooth when she was 19 years old. My doctor advises me to remove the baby tooth. I am not willing to have braces. Is there any option for me to have Invisalign or braces that cannot be seen or do I need to use regular braces? ### Response: Hi. Dentistry has a lot of development over these years, and there are a lot of options available. First of all, to get your braces, you need to extract your baby tooth. Apart from metallic braces, there are other types of braces also. For example, ceramic braces, it is a tooth-colored material. There are lingual braces too. It is placed on the inner surface of the tooth, and it is not visible from outside." "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 6-year-old son has a diaphragm problem. He has a heart problem post operated for VSD and having pacemaker from his 11th month. Now he have a new problem like vomiting, urine problem, fatty liver, gall bladder wall thickening, mega cardio, 30 percent heart function only. What is the main problem here? And what treatment to give? ### Response: Hello. I am very much concerned about all the problems your son is going through. Now, he has a few different issues overall not a single problem. His urinary problem looks like due to inflammation of urinary bladder called cystitis, which needs investigation of urine and if needed antibiotics for that. His heart functions are weak and that may be leading to fluid accumulation and back pressure on the liver leading to gall bladder thickening and liver congestion and enlargement. He may also be having some edema in his feet or some fluid in the abdomen. Kindly send me his ultrasound and all the reports recently done so that I can decide about his proper treatment and guide you accordingly." "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 an abortion a few months back but retained the gestational sac. After 39 days, I had my periods. Again I conceived three months back and had a miscarriage 5 weeks later. I am still bleeding and it is heavy bleeding with lots of blood. The blood is bright red in color. Along with the blood, there are large clots and tissues along with it. I do not feel any pain except when there is heavy bleeding I feel pain in my vagina. Is it a symptom of cancer? ### Response: The fact that your bleeding has not stopped even after a month of miscarriage, indicates that there is all likelihood that you may have retained products of conception. It is mandatory to get a transvaginal ultrasound pelvis to check for endometrial thickness and for possible retained products. If the products are not seen and the endometrium is thickened, then you should opt for dilatation and curettage (D and C) for controlling bleeding. I also assure you that this is not endometrial cancer, as it is uncommon at your age and you have an inciting cause (miscarriage) which initiated the heavy bleed. So, USG is a must." "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 24-year-old female. I am married for about 11 months. My weight is 77 kg and height is 5.4"". I conceived in the very first month, but unfortunately, I had a miscarriage after 10 weeks and had D and C. Till then I am trying to get pregnant but having a problem in it. My gynecologist suggested me hormonal test but I could not understand its result. Please explain to me the report and help me to find out the actual reason for infertility. According to the test report:T3: 0.7 ng/mL.T4: 5.2 ng/dL.TSH: 1.0 mIU/mL.LH: 4.8 IU/L.FSH: 8.6 IU/L.Prolactin: 5.6 ng/mL.Progesterone: 1.5 ng/mL.Testosterone: 0.2ng/mL.My menstrual cycle is of about 31-32 days and last time I had periods within 28 days. I am using Clomid and Ovafin from the last three months in two to seven days of menstruation, but I have not conceived yet. Along, with infertility, I am suffering from vaginal farts, weight increase, facial acne, mood swings, and headache. I am very stressed. Please guide me and tell me the reason for infertility. ### Response: Hi. All of your test reports are normal. You are trying for pregnancy just from last seven to eight months. Kindly give yourself some time and you can get pregnant naturally. As your periods are regular, in my opinion, you do not need ovulation induction medicines like Clomid. In fact, you do not need any medicine right now. Just continue Folic acid tablets and continue trying naturally, you should get pregnant naturally. If there was any infection after last D & C (dilation and curettage), you can get your tubes checked by HSG (hysterosalpingography) to be sure that everything is normal. You can do that test after trying naturally (without medicines) for three months. 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 36 years old, male, 6\1"", 265 lbs. I have a question about total bilirubin. I had it checked four weeks ago and it was at .41 mg/dl and one month later it jumped to .82 mg/dl. My alkaline phosphatase is at 1.173 ukat/l and four weeks ago was at 1.003 ukat/l. The doctor was not concerned by this but the highest I have seen it was three years ago when it was at .53 (total bilirubin).However, during the last month, I went from 282 lbs to 265. I have been extremely stressed out about it. Health problems and my anxiety are high. I barely slept the night before the tests and am possibly dehydrated. Could these factors have contributed to the increase? I am concerned about bile duct obstruction. ### Response: Hello. Since this question was posted under diabetology, I am wondering if you have any endocrine issues. The question asked here is about gastroenterology. The liver tests would be concerning for a liver process like gallstone if the enzymes were not coming back down or if you had pain in your right abdomen. It is important to have a follow up with your GP." "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 20 year old male. I have had speech difficulties since I was a kid. Now, it has progressed, and it is hard to say what I am thinking. I tend to have slow speech and thinking. Of late, it has been getting worse. I have to carefully think of what to say when I talk. I feel like my mouth cannot connect to my brain. I know exactly what I want to say, but when I actually try to say it, it comes out slow and unclear.My relationship with my dad is deteriorating due to this. I seem distant and absent. When he tries to talk to me, I find it hard to pay attention and it has caused me to be completely quiet. I find isolation to be relaxing. I hate this personality of mine because it can cause an anger outburst as I cannot express myself clearly. All this terrifies me. I am not sure if it is Asperger syndrome or because of head trauma. Please help me. I am not sure who I am anymore. I do not have a defined personality. I weigh 260 pounds. I work 50 plus hours a week. I am a very hard worker. I recently got health insurance at work. I played football for four years. I believe that I have a mental disorder and would appreciate help in identifying what it could be. ### Response: I can understand your concern. So please talk to a psychiatrist for treatment of the symptoms" "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: Overall tightness in right side of the body. Especially tightness in the right knee, above knee cap leading to pain front and top of knee. Also tightness in the groin both sides. Unable to feel the groin stretch on inside of the leg, more of a locking feeling at the upper inner groin and outer hip. Tight hamstring only on right side. I do not feel a stretch when stretching right quad but do feel a stretch on the left. Right shoulder/ discomfort and tightness. Tightness in the back lower right side and right hip looks to be slightly lower when standing. ### Response: It may be due to weak muscles, apply Diclofenac ointment on the pain above knee and shoulder, cover it up for 10 minutes, give it hot water therapy, try to slowly strech your thigh muscles untill you feel pain more and relax yourself, repeat it for twice a day. Take Aceclofenac tablet for a day if you have more pain and for shoulder do shoulder excercises at home. After trying these if you still feel the pain after three days, you can go for ultrasound therapy following IFT. This will surely help you get rid of the problem. Jerk while running or walking, sleep distress X-ray for shoulder IFT, ultrasound Avoid lifting heavy objects, do not bend." "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: Acne started getting bad on and off for the last 2 to 3 months, always had the occasional pimple but now it is all over my face. The dermatologist prescribed Doxycycline after Minocycline, it did not work. He also prescribed Sulfacleanse to use in the shower and Benzoyl Peroxide, Clindamycin mix, and Adapalene three gels. I found that all of that made my face worse so I used Sulfacleanse in the shower and after that, I used rose water toner alcohol-free, then hyaluronic serum then either tea tree oil, Adapalene or Benzoyl peroxide then Proactiv green tea moisturizer. I used that for a week and my face cleared up a bit then I went back to the dermatologist and he said not to use my stuff and only BP and Adapalene and that made my face break out again so I am back on my routine for three days now and noticed a bit of clearing up. I eat very healthily and I am also using supplements. ### Response: Hello. I understand your concern. You have grade 2 acne vulgaris and definitely, need oral antibiotics. The thing with anti-acne medications particularly retinoids like Adapalene is that initially, you might feel that acne is flaring and people stop them. But in time they get better. Use the following medications: Tablet Azithromycin 500 mg three consecutive days per week for four weeks. Adapalene plus Benzoyl Peroxide gel apply once at night on acne and wash after one hour and do not rub it. Benzoyl Peroxide face wash continue using the moisturizer in the morning review after one month. Besides medicines, you can do certain other things like changes in diet, which can help in curing acne. Avoid foods with high glycemic index particularly milk has been found to be associated with increased severity of ane. Also, avoid chocolates and sweets if possible. Avoid picking and scratching the lesions as it increases the chances of scarring and pigmentation. Acne medications need to be used at least for 8 to 12 weeks to see good results. So, be patient." "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 never bothered to worry about this before but someone said I should see a doctor about this. The problem I have is that my facial muscles seem to always change shape when I am under stress. I remember someone once telling me he knew what was wrong with me. He said my face needs to breathe. Also when I shave and my face gets air my facial skin gets smoother in texture and fuller. I had not eaten in a while so I was starving and I went out to eat. I ordered a hot dog and by the time I finished eating I felt a surge of energy like my blood began to rush I think and my face popped and was a lot fuller. I think after that any time I would go to the toilet my stool would come out very dark and hard and messy. I do not know what could be the cause. So please could you help? ### Response: It is very strange if your facial muscles tend to change shape on daily basis. I know of a few conditions in which facial flushing (redness) can occur due to increased blood flow, but the change in facial musculature with food intake or under stress is not a common thing. The facial flushing can occur with eating of certain foods which are rich in amines. But the above things also have certain other presenting features." "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 trying to conceive for the last 2.5 years but not successful. I was on Fertisure F and Ovabless for six months and discontinued because I did not see any results and I am diagonsed with PCOS. I am now on Carbimazole 5 mg for hyperthyroidism. ### Response: Hello. I saw your examination (attachment removed to protect patient identity). The TSH (thyroid-stimulating hormone) levels is normal. The medication you have taken are only supplements. If you have menstrual irregular bleeding you can correct it with contraception pills for two to three months and then try to conceive again. First, I would recommend you to evaluate the ovulatory process with ultrasound examination at 12 -15 days or measurement of progesterone at 21 days. And after that take some medication that induces your ovulation. But you have to be in a close follow up with a doctor." "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 female 43 years old weighing 209 lbs and height 4\11"". Medicines I am taking Metformin, Pravastatin, Omeprazole, Xanax, Sertraline, and Zantac. I have diabetes, feet ankle issues, arthritis, heavy periods, GAD, and clinical depression. My doctor performed CBC and everything was normal except platelet count 492, then months later 504. Any idea what could cause this? My doctor thinks it is because of my heavy periods. ### Response: Due to heavy period and bleeding, you can have a reactive increase in platelet count. Your count is increased mildly and do not worry about that. Even mild variation of 10 to 20 thousand can occur in two subsequent reports from the same sample. So no need to worry. For depression, consult a psychiatrist and take regular treatment with antidepressant medication like Fluoxetine" "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 brush regularly and floss, even started oil pulling with coconut oil. My bottom gums feel really tender and bleed over the smallest thing. How can I manage it? ### Response: I think you have injured the gum not because of trauma from the coconut but because of force. Now either there is calculus (hard deposit) or you have got the periodontal infection. You need to take medication like Ofloxacin and Ornidazole combination at least for four to five days. Also, you need a scaling if you feel there is calculus. You can check with a dentist for further evaluation because sometimes there are chances of fracture too" "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 34 years old. I always have regular periods with a 28 day cycle. I have pregnancy like symptoms for the past two weeks. I feel nausea, cramps, strong smell, etc. Actually, my period was ahead of due. For the past 15 days I have very light watery bleeding started and is still on. It is not heavy at all and not like my usual periods. Is this pregnancy or any other issue? ### Response: Hello. I had gone through all the data posted. Based on your symptoms, pregnancy is a possibility. But, as you said your periods are due now you can wait for another four days. If you did not get periods, then do a urine strip test for pregnancy. At this time no one can confirm pregnancy, even if you go for a hospital visit and even with ultrasound. The urine strip test will tell us the answer and we need to wait for another four to five days. Once the urine strip test is done, then we can decide further course based on its report. For now kindly avoid unnecessary medications; take proper diet 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 have health anxiety and migraines. I have started seeing after-images quite frequently, especially when inside and looking outside to a road or across the road. I am blinking and seeing a positive after-image for less than a second. This is extremely worrying for me as I am unsure why this is happening. I do not know if this is caused by something else. But, I have had my eyes checked and everything was fine. Could this be symptoms of migraine aura? I have had a sore head for a while now in both temples. ### Response: I understand your concerns. Your symptoms are most likely due to migraine which cause severe headache, mainly on one side that lasts for few hours (up to 72 hours) may be associated with other features like limb numbness, nausea, photophobia, and other different symptoms. In many cases, migraine is preceded by aura which could be auditory or visual symptoms like the one you described. The other possible causes include: Please provide me with more details in order to reach the appropriate diagnosis: I suggest: Medications are required to abort acute attacks and to prevent attacks if frequent.Follow up is required to confirm the diagnosis and to exclude any serious conditions.Neurological assessment is recommended" "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: Recently, I did an ECG. The doctor examined me and told me that I have a mild blockage. Please suggest. ### Response: I have gone through the attachment (attachment removed to protect patient identity). There is sinus bradycardia with a heart rate of 55 to 60 beats per minute, with a right bundle branch block along with left axis deviation. There are no significant ST-T abnormalities seen. It can also due to age or hypertension-related change. It needs evaluation and echo (echocardiogram) to rule out the possibility of coronary artery disease. So, you should undergo echo, and if it is normal, then stress test like stress thallium or CT coronary angiography can be done to rule out the possibility of structural heart disease. Also, do a thyroid profile." "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 and my partner are trying to get pregnant and he is a rhesus negative O and I am an O. Is there any possibility of getting pregnant or not? ### Response: Hello. Yes, there are high chances of getting pregnant but you must seek medical attention before getting pregnant to optimize your general health up to maximum so that if you end up with a healthy conception and rhesus negative is important if the mother is negative and husband is positive but in your case it is opposite. So, in my opinion, it will not hinder your chances of getting pregnant." "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 bladder leakage at night. I tested my urine. It was fine. I do not have urine leakage during the daytime. I had this problem before five months. My urologist gave me Nocitva nose spray. I have read that using Noctiva can lower the sodium present in the body. I tested my sodium level before eight months. It was 142 mEq/L. Do I need to check my sodium level now? Please suggest. ### Response: Yes, using Noctiva nasal spray (Desmopressin acetate) can cause a decrease in sodium levels in the blood. The risk is small, and it usually happens within the first month. Then your body starts coping with 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 wife is 26 years old. She is 33 weeks pregnant and detected with sugar all of a sudden. Her PP sugar level is 149 mg/dL. Can you suggest how to control it? How early baby can be delivered? ### Response: Hello. A single reading of postprandial sugar of 149 mg/dL should not be a reason to worry unless your wife has a family history of diabetes or diabetes in the previous pregnancy. She can do one oral GTT (glucose tolerance test). It is a sugar test done in fasting and every hour after giving glucose orally. If that is fine and if there are no other symptoms of diabetes like increased thirst, frequent urination, or frequent infections, then no dietary modification is needed. Normally baby can be safely delivered after 37 completed weeks (four weeks from now). 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: My baby is 6 months old and drinks only 200 ml of formula milk and unknown quantity of breastmilk per day. It is recommended to drink 600 ml per day. I am worried. How can I increase the quantity of milk in his diet? ### Response: Do not worry about how much the baby is taking. As long as the child is getting adequate weight gain and is passing adequate amounts of urine the feeds taken by the baby are sufficient. The baby decides how much to take and how much not to. There are no set guidelines as per quantity of feeds to be consumed when breastfeeding. Ensure that baby gets fed every three to four hourly" "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 female, 36 years old, 5 feet, generally healthy. I have recently found a small hard pea sized painless lump on my left collar bone, it moves around and I have had for periods of few days at a time over last few months, very sore, tender to touch breasts. I have not seen anyone about this yet as it is recent and thought it would pass. Do I have to be concerned? ### Response: Hi. Tender breasts are very common during pre-menstrual phases due to hormonal causes, so do not worry for this. The hard lump over collar bone, which is non-tender and pea sized needs to be ruled out that whether it is lipoma or an increase in supraclavicular lymphnode, which is 90 % enlarged in upper respiratory causes. Lipoma is generally not movable, soft in consistency and is very common. You can go for mammogram if you have any breast lump, if not, then no need to panic." "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 sending you the reports of my transvaginal ultrasound. Please tell me if the fibroids are to be removed and the risks of such surgery. ### Response: As the pictures are really unclear, kindly avoid sending photos of the report. You may just scan the written report and send it to me. I would like to see the ultrasound report. Revert back with the reports to 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 a 21 year old female. I suffer from very rapid up-beating and sometimes down-beating nystagmus, which exclusively occurs in the absence of visual stimulation. That is with my eyes closed and Frenzel goggles on. When the nystagmus occurs quite intensely, my eyes will bounce under my eyelids and cause quite a nuisance. My neuro-otologist provided me with goggles to record my own eyes. From the recordings, I notice my pupil constrict significantly when they nystagmus occurs intensely despite being in total darkness. Why do my pupils constrict when the nystagmus occurs despite being in total darkness? When the nystagmus stops, my pupils dilate back to the normal size.I was diagnosed with a vestibular migraine. My symptom includes vertigo, dizziness, headaches, balance issues, binaural tinnitus, and cognitive issues. I have undergone routine vestibular testing. My rotational chair and caloric test results came back hyper-responsive. VEMP testing came back normal. And my brain MRI came back unremarkable. I have been on Amitriptyline 25 mg, and I am currently on Pizotifen 0.5 mg. ### Response: I read your query and understand your concerns. I hope this answers you. If you have more questions feel free to write 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: I had my periods on 2nd of this month that ended on 6th. After having the intercourse on 9th, I ate Option 72 on 10th at 8 AM. But now my periods came on 15th again. I had clot once and bleeding is also not very much. Am I pregnant? ### Response: Hi. Since you have taken an emergency pill within 72 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. However, if you have a doubt, then get 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: I am an 18 year old female. I weigh 110 pounds, and I am 5 feet tall. I have been feeling a bit weird lately. I have been feeling tired; like no matter how much sleep I get, I still feel so tired. And when I eat any sweets, I feel weird. I do not know how to explain it. I feel like my heartbeat gets faster sometimes, but when I check my pulse, it feels normal. But today when I ate some chocolate cookies, I laid down because I felt tired and weak. My left arm felt really weak. Then when I got up, I got really dizzy, like more dizzy than I usually get when I wake up, and I had to wait a few seconds so that I can go downstairs without falling. And I always just want to lay down. I always feel so lazy and do not really want to do anything, and I do not know why. Should I be worried? ### Response: No need to be worried, but yes you need to get evaluated for the cause of your problems because at the age of 18, tiredness all the day and weakness is not common. Your problems could be due to low hemoglobin, vitamin D or B12 deficiency, or due to thyroid problems or diabetes. I advise you to get the following tests 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 am 27 years old. I am suffering from a poor quality of sleep. My body feels heavy as it resists movement and I am slothful. My sensitivity to cold is very high as I avoid bath sometimes. During daytime, fatigue and sleepiness follow me and later in the evening I feel too tired that I want to sleep but cannot sleep because if I go early to bed, then I used to get up frequently in the night. So, overall I cannot have a peaceful sleep. My concentration and attention level have dropped significantly. Please advise. ### Response: I just read your query. Hormonal imbalance or lack of proper diet for low Hb, etc. Thyroid function test, hemoglobin and peripheral blood film. Revert back after two weeks to an ayurveda 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 found a very small dark spot on my thigh today. To the best of my recollection, I have never seen it before. Now, of course, I am thinking the worse and believe I have melanoma. I am olive-skinned.I have never had an issue with moles or dark spots before. My mom had a pre-cancerous growth removed from her face years ago and she is fine. She goes to her check-ups and applies sunscreen all the time. When I was a kid, I never saw my mom applying sunscreen. It was the 70\s and it was just something we did not do. She just turned 76.I attached a photo. I am sure you will think it is something that should be looked at and so do I. I am going to make an appointment with a dermatologist. But I also suffer from health anxiety, depression and OCD so I am convinced it is melanoma and I am feeling very depressed right now. ### Response: Hello. I have seen the pictures (attachment removed to protect patient identity). No, it is not melanoma. It is a normal nevus (benign). For your confirmation, you can go for an excisional biopsy of the lesion. Histopathology reports will confirm that the lesion is benign or malignant. Do not worry it is normal nevus due to melanosis (increase in melanin pigment)." "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: MRI says mild cerebral atrophy causing impaired motor coordination for my grandfather aged 64, but diagnosed as Parkinson\s. Will there be any relation? But, another doctor who saw the report said that it is not Parkinson\s and his condition is getting worse due to the dose of PD drug taken. He is taking Syndopa since diagnosed for PD. Once he had fallen of the bike while driving, from then it has started slowly and progressing now. Only his hands are not properly functional. He can speak with analytical reasoning, so I got a little doubt and seeking out. Any advice on his condition would be helpful. ### Response: I have gone through the provided details and attached MRI report (attachment removed to protect patient identity). Although it is not enough to refute diagnosis of Parkinson\s disease as Parkinson\s disease can be diagnosed through clinical examination and there is no test to confirm or rule out." "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 horrible pain in the back of my head, and my ears feel blocked. There is no wax. I have cleaned them. I am petrified. There is a tumor that has been missed. I had an MRI brain scan three months back which came back normal (no intracranial abnormalities). I have sinusitis too. Kindly help me. ### Response: Hi. As such your symptoms fit into chronic tension headache" "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: The gum near my wisdom tooth is a little sore when I wake up from sleep. I can also feel pain when I chew food. I have attached a picture of it. I have been having this for a few years now. It is not a massive pain, so it is manageable, and I do not mind it if there are no other complications. My only worry is a fetter. Do I have any ulcers, and will this lead to further gum disease or gum cancer? ### Response: Hello. The problem mainly in your case seems to be food lodgement behind (distal) the wisdom tooth causing prolonged gum infection and discomfort for a few years. In such instances in which patient has been experiencing pain, it is suggested to remove such wisdom tooth to allow proper cleaning at the back and to prevent decay of adjacent teeth and maintain oral hygiene. It can cause abscess or gum infection, but you do not have to worry about cancer. Get an appointment with your dentist to get an X-ray done and find out if the tooth has any cavity and also if there is an abscess." "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 feeling pain in the chest sometimes so I wanted to confirm what it is. My 2D echo said to be fine. Here I am keeping findings from TMT exercise time: 6:04 minutes. Max HR attained: 148 bpm 77 % Of max predictable HR 191, max BP: 140/90, workload attended: 7.2 (fair effort tolerance). Significant ST segment changes noted during excercise or recovery. Angina, arrhythmia, S3, murmur. Final impression: Test is positive for the exercise inducible ischemia. ### Response: Could you please attach the whole TMT tracings? The final impression of the TMT says it is positive, which means your chest pain is due to blockages in the heart (attachment removed to protect patient identity). Echo shows abnormalities in later stages and severe disease only. But, considering your age and pain only sometimes, the probability of disease is usually low. Patients with cardiac pain get consistent pain on exertion and relieve with rest. So, considering both these factors, I would like to review the tracing and confirm ECG changes. And assuming this final report to be true, you will need angiography to confirm and see the extent of blockages. Another option is you may undergo CT coronary angiography to confirm or rule out TMT findings. So, firstly, TMT should be reviewed once and you should undergo further tests to confirm the findings." "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 found one small bump on my gum right before the tooth. I barely touched it and it started bleeding but it was only one bump. Should I be concerned? ### Response: Hi. As per your history, it seems to me that you are having acute apical periodontitis with a gingival abscess. For that, you need to take antibiotics for at least five days. The tenderness of the tooth is also because of the same reason. Grossly decayed infectious tooth. X-ray IOPAR (intraoral periapical radiograph). Acute gingivitis. Apical periodontitis with a gingival abscess. Tablet Amoxicillin-Clavulanic acid 625 for five 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 have stuck a q tip in my ear because it was itching and I think I may have burst my eardrum. I have some pictures. ### Response: The pictures are not completely clear but I cannot see any perforation. (attachment removed to protect patient identity)." "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 unprotected sex with my fiancee on the 27th of this month. Her period was due on the 29th. She has a yellowish-white discharge for the past few days. Does it means she is pregnant? When will she get her periods? ### Response: This really does not mean that she is pregnant. But, as the sex was unprotected and considering the possibility that she may have had a delayed ovulation, an emergency contraceptive pill is recommended" "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 my liver profile test and also I have very fatty liver and I am trying to reduce weight. ### Response: Hello. I have seen your reports (attachment removed to protect patient identity) and understand your concerns. Your SGPT (serum glutamic pyruvic transaminase) is mildly elevated. This could be due to many conditions or increased alcohol intake. You should reduce your weight by following exercise and diet regime. Your ideal BMI is below 24.5. Please send me the other lab test values in the follow-up feedback. Hope I answered your questions." "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 a lot of pimples on the scalp. Pimples are with white pus. There is a lot of pain and a lot of dandruff along with this. What should I do? ### Response: Hi. You seem to be having scalp folliculitis which is an infection of your glands on the scalp. You need to reduce your sugar and milk or milk product intake. Reduce eggs and red meat. Folliculitis can sometimes be recurrent which would then require a long term treatment. I need to know if you are on any other medications, have any known" "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 planning to marry my own cousin (my mother\s own brother\s child). Is there any precautions to avoid genetic problems for my baby or do we need to take any medication or treatment for a child. Please suggest with a better solution. ### Response: Hi. It would be better if you would send me the background of your question. Any specific family history like thyroid, diabetes or any congenital anomalies, thalassemia, sickle cell disease or any other family history, then it needs precautions and even investigations. The severity of diseases also matters. Either it is dominant or recessive in both sides blood relations as dominant will give dangerous effects as compared to recessive. Check blood group as well as if you are Rhesus negative and he is positive, then there could be a risk of development of autoantibodies and hemolysis. So check the above family history that matches his and yours can affect your offspring strongly if any." "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 symptoms concurrent with anemia. I recently had a blood test done and my hemoglobin, MCHC, RBC, and HCT are low. RDW is high. Iron saturation is at the lowest end of normal. I am having problems with shortness of breath. Can this all be attributed to some form of anemia? ### Response: I have read your concern and below is my answer to your question. You are certainly having mild degree anemia in the attached report (attachment removed to protect patient identity). It could probably be an iron deficiency anemia as you have mentioned low iron and saturation. However, such a mild degree anemia cannot cause breathlessness. So, your dyspnea complaint is most probably not related to anemia. For dyspnea, primary workup that you can investigate with is digital chest X-ray PA view and EKG." "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 21 years old, medically fit. I play football a lot. Recently, I started to have pain in my left knee, there is a pain when I sit on the ground (on bending) and I feel it is crusty when I try to open it. Also there is pain on resistance to movement. ### Response: Hi. I have thoroughly gone through your case and can well understand your genuine health concerns. Knee joint consists of two bones that are femur and tibia. In between these bones, a few structures are present which provide stability to the joint and make the joint strong. These structures are ligaments which connects the two bones and meniscus which are the fibrocartilages present between the two bones. Injury to the meniscus is a common problem faced by football players and athletes. Probably you had a meniscal injury or tear as you are having pain while bending the knee and difficulty in opening it which is called locking and unlocking of the joint. Not all meniscal tears require surgery. I would suggest you get an X-ray done to make sure that there is no bone fracture. Limit activities of the knee joint. Stop playing football for a few days. Apply ice packs to the knee joint for 15 to 20 minutes 3 to 4 times a day. Apply crepe bandage to the knee. You can take an anti-inflammatory medicine like any NSAID twice daily for five days. Avoid running and jumping. I suggest you take orthopedic opinion also. Injury to meniscus or ligament of the knee joint. X-ray knee joint: AP and lateral." "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 noticed a swollen and hard bump on the inside of my ear a few days ago. Yesterday, I noticed it was now soft and squishy almost like a pimple. But today, I touched it and it popped and began to bleed along with some pus. I was not too worried until I took a photo and saw two large holes like a spider bite and the area is a little tender after I cleaned it. Does it sound like it could be an infected spider bite? ### Response: Hi. It could very well be an infected spider bite. It could also be an infected follicle. Anyway, apply some antibiotic cream over it (Bacitracin or Fusiderm or Povidone iodine). Apply twice daily and clean the wound with warm water while bathing. Do not insert anything inside the ear though. If there are any worrisome changes please contact us. Like color change of rest of pinna, pain, tenderness, swelling, increased redness, spreading of the redness, etc. You may take Tylenol if there is pain. Oral antibiotics are not necessary. If you suffer from diabetes, hypertension, immunosuppression or cancer we need to be careful. In that case, do let us know." "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 the following symptoms.Bladder cannot be emptied fully, due to this I frequently go to the bathroom. During urination, I have to do forcefully. BP due to anxiety. Forget learning and memory skill is weak. Before taking medicine for anxiety my heart pounds during tense. After taking medicine I am comfortable. But presentation skill, memory skill is very low. ### Response: Did you have investigation related urine problem like CBC (complete blood count), renal function test, USG (ultrasound) whole abdomen (to rule our protest pathology)? Did you take any medicine for anxiety? You have mentioned High BP, now what is your BP? Any medicine for this? How long do you have all these problems?" "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 24 year old male. I am working as a software developer. Sometimes, I feel a sharp pain in my right lower part of the stomach. When I am trying to bend down, I am feeling some pain inside the pelvic bone. After eating meals and dinner, I am getting excess burping and feeling of bloating and tightness in the right lower abdomen. I am also having constipation problem for more than a year.I have consulted a gastroenterologist for physical evaluation. He diagnosed me and prescribed some medicines. After some time, I had an endoscopy and he found I have H.pylori infection. He prescribed medicine for the same. After a month, bloating and burping are less but the pain still persists. I have consulted one more gastroenterologist who evaluated me with some blood test and ultrasound of the whole abdomen and said nothing to worry as everything is normal in my report (including pancreas and kidney).Now again from last three to four days, I feel my urine flow is slow and I have a burning sensation in the penis. I have excess burping, bloating, and pain in the right chest. As I have consulted many doctors and they reported as I have nothing, I am confused with my stomach pain now and much worried as what could be the factor behind the pain? What should I do now? Please help. ### Response: Hi. I read your history. Bowel illnesses are difficult to prove medically, and mostly they are a matter of exclusion. Infection like H.pylori may be the reason for your burping, but it would not be the cause for right lower abdominal pain. After reading all this do not worry that you have any major illness. I guess your appetite is normal and your weight too. Now I would suggest you do a few things." "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 2 years old and has ROP issue in both eyes. The left eye is lasered and has -5 number. And the right eye has -1 number. I am very worried. Kindly suggest what I should do. And what precaution should I take to keep his eyes healthy? ### Response: Give your child glasses. Get his eyesight checked with glasses. If there is any amblyopia, start patching therapy. His power will increase with an increase in age. Power usually becomes stable at the age of 18 to 21 years. I am sorry, but there is no medicine or exercise to get rid of glasses. Lasik is a very good option for this but it is possible only after age of 18 years. I hope this will help 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: How does guava help boost weight loss? Can guava extract help in prostate cancer prevention? How does guava work as a remedy for cold? Why is guava recommended for better brain health? What can guava\s high vitamin A content do for our eyesight? What are the other benefits of consuming guava (if any)? ### Response: Hi. Guava helps in weight loss as it contains roughage or fibers. Fibers include both soluble and insoluble fiber. Fibers are the part of plant foods. Not all fibers are completely digested by the human body, hence they will not add to your calories, but they add bulk to the food. After consuming it fills our stomach and makes us reduce the quantity intake of other caloric foods like rice, bread, etc. Guava contains vitamin C, hence it acts as a remedy for cold. Guava contains vitamin E and C which are very much needed for good memory. Hence, it is helpful for good brain health. Guava is rich in vitamin C, A, antioxidants and lycopene which help in the prevention of prostate and other types of cancers. Other benefits of guava are: Rather than consuming an extract, it is always advisable to eat the complete fruit to get the complete benefits." "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: The tooth is sharp and cracked. It is leaving a space in the mouth. What is the treatment? ### Response: How are you doing? I saw the image, but it is not clear (attachment removed to protect patient identity). But, based on how much ever I could appreciate, it seems you have deep caries in your first molar and to some extent nearby second premolar too. The crack or sharpness is due to the loss of tooth structure because of caries (cavity). Kindly take an IOPA (intraoral periapical radiograph) of both the teeth together (in one X-ray itself) and send it to me, along with a clear image of your teeth to help you with a proper diagnosis and treatment plan. Do you have or had pain, especially during chewing or sleeping? The treatment plan will vary based on the diagnosis. If the cavity has reached the pulp (blood supply of tooth), it will need a root canal treatment followed by a crown. If it is approximating the pulp, then we will give a temporary filling, wait for a month and if there are no symptoms, then we will change it to a permanent filling (restoration). If it is not even approximating pulp and is in dentin or just enamel (hard structures of teeth), then we will straight away go for permanent restoration (tooth filling). All these will eventually treat your cavity and the sharpness and the gap will go away. Kindly send me a clear picture and the radiograph to help you precisely" "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 stepped on the head of a nail a week ago. Now, every time I step on that part of my heel, I get this sharp, searing and burning feeling. ### Response: Wishing you excellent health." "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 has been seven months since I got my braces on. I got then to treat bimaxillary protrusion. My dentist has placed thin wires and elastics and also extracted four teeth to make space. The space has not yet completely closed and he has never changed the wires. When I asked him when he would change the wires, he replied that he would not be removing the wires. For the monthly appointments, only repairments of broken braces were done. For a few appointments, he did not even change the elastics. Should I continue with the same treatment or should I change to another orthodontist? Please reply as I am extremely worried about the situation. ### Response: Hello. As per your description, you are having bimaxillary protrusion. Case told by you needs extraction. In the initial phase, alignment of the teeth occurs. Wire will proceed only when correction happen with previous wire till then the only religation has to be done. To avoid bracket debonding you have to follow certain precautions in oral hygiene measure and while taking food, i.e. avoid sticky, hard food, etc. Space closure occurs on SS (stainless steel) wire that is a stiff wire. Again, I would like to see the images of your concerned area of the upper and lower arch for a detailed discussion of your problem." "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 many years of sneezing and congested nostrils, a visit to my general doctor resulted in me being tested and told that I have very bad allergies to dust, pollen and other small allergens. After many antihistamines and masks trying to solve the problem, nothing has seemed to work. I only have discomfort within my house. I am completely fine outside in all weather. Would the use of a humidifier and air purifier together help my situation? ### Response: Hello. It seems you have triggers in your living place. Try to identify the triggers. Here, the probable cause may be dust and pollen Change the bed covers once in two days and clean the windows frequently. Avoid cool foods and avoid frequent head baths. These little things will help you lot to avoid allergies." "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 daughter is 18 months old and the doctor prescribed her Cylip P, A to Z syrup and Hemsi syrup. Is the prescription correct? I am a bit worried. ### Response: Cylip P 1. Cyproheptadine is an appetite stimulant and Hemsi is a hematinic which is used to increase blood hemoglobin. The A to Z is Multivitamins and your daughter can be given all these." "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 these spots on my pubic area for a while now. I visited an STD clinic two years ago and the woman who saw these said they are genital warts. I also had one on the shaft of my penis. She used nitrogen to freeze them and they disappeared (except for the big one that you can see in the pictures, that one did not disappear). Now I believe the spots are back. Went to my doctor and he says they are not warts and wants to scrape them away with a sharp spoon (literally what he said). He was not sure what it is but believes they are not warts. What is your opinion? I did a previous free consult and the doctor says it is follicle infection and I should use antibiotics. However, I want to have a second opinion as I looked up the images for this infection and do not think it looks the same. Also, I have used Amoxycillin about half a year ago and this did not influence the big spot, as I have it now for at least two years. ### Response: Hi. I have gone through your complaints and reviewed the attached photographs (attachment removed to protect patient identity). The bigger one is looking like a wart and needs to be removed either by chemical cauterization or electrocautery. The smaller ones seem to be either folliculitis or warts. I would recommend you to apply a topical antibiotic like Fusidic acid cream on the smaller lesions twice daily for 7 to 10 days. This should resolve them. If they do not improve in a week time consult a doctor and get them removed" "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 27 years old, 247 lb male. I have been having a problem with blood in stool for two years now. Sometimes, I have blood in stool for two or three days and sometimes goes away for months with no blood. For three months, I did not have blood in the stool. Now I started to drive a truck 12 to 14 hours a day sitting on the truck and I started having blood again. I am very scared. I may have colon cancer. My doctor did a blood test on me one month ago including vitamins and minerals and everything came back 100 %. I told her I am scared that I may have colon cancer she said no you do not and you do not need a colonoscopy. How does she know? I have blood in stool for two years now and not in normal shape. ### Response: Hi. See it is difficult to say what is the reason for blood in your stools. But definitely, this is not a normal thing. You could be having piles.Actually, piles are the most common cause of blood in stools. That is why your physician must have in general told you to relieve your stress. My recommendations would be to take a soft, and a blended diet. Take plenty of fluids. Make sure you do not strain during stools. If you still have the blood while you are not straining in stools and you are not constipated, you would definitely require a colonoscopy." "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 husband was given Zuclopenthixol injections during his stay at a psychiatric hospital and now he feels he has been done lobotomy and a part of his brain is missing. Like his intelligence, sharpness, cleverness, energy levels, etc. he feels the doctor should have diagnosed his mental state before concluding that he needs such level of treatment.His problems were stress-related. And now he feels he cannot get his brain back like before and feels like there is no point living. Kindly suggest what measures can be taken to help him? ### Response: Hello. Zuclopenthixol is an antipsychotic medication prescribed to a psychotic patient or patient of severe depression with psychotic features. It is commonly used to control aggressive behavior of the patient. A decline in cognitive features, slowly are possible with Zuclopenthixol. One thing I want to clarify whether he is sure that lobotomy was done on him or not? You have also mentioned that previously he was prescribed Risperidone. So I think he might have psychosis. A patient of psychosis can have a depressive episode. If currently, he can tolerate Zuclopenthixol depot you can ask about Olanzapine depot which is second-generation antipsychotics and has a less side effect." "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 50 years old and had a cardiac MRI dark blood, bright cone blood, and delayed enhancement images with contrast gadoterate. My doctor tells me this is a great test to rule out coronary artery disease. Only thing is it want stress MRI. He stated the coronary looked good and would predict a good result in the stress if we did one. Do you agree with this? Everything on the test looked great. ### Response: Your doctor is right. Stress CMR is highly sensitive and specific for detecting cardiac ischemia. Furthermore, it is the test of choice for cardiac morpho-functional study and tissue characterization." "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: Majority of times after I floss and then brush my teeth afterward I use cool mint Listerine mouthwash. I do not understand what is going on but my fiance says I have an unpleasant smell in my mouth. I do not have to be so close to him talking. After I had a wash with the Listerine, I do not eat anything or drink until after we meet up. I do not understand what is going on. I do all that I can to have fresh breath why am I not getting no benefits out of it? I am so frustrated. This issue is there for the past one month. ### Response: Hello. You do not need to be frustrated. It is very common. There are various factors affecting your bad breath. You can try these things to improve your oral hygiene. Brush your teeth at least twice a day. Make sure to reach the gum line as well as tooth surfaces. Floss at least once a day. Rinse with a mouthwash twice a day. If you do not like the odor of your mouthwash you could change its flavor. Sometimes when we are empty stomach for a long time, bad breath still comes out of the mouth. Have a great time." "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 purchased an NB-UVB lamp for vitiligo and I wanted to know if it is safe enough to use on my penis. I have read that normally, you cover your penis from UVB lamp radiation but in my case, I have vitiligo on my penis. Also, should I put sunscreen before or after treatment? ### Response: I have gone through your case. Your genitalia or penis should remain covered during the procedure. Do not expose even if you have a vitiligo over there. Apply Tacrolimus ointment over that area but do not expose it to light or you will get a serious reaction. Yes, it is very necessary to use sunscreen both before and after treatment. As on vitiligo skin, brown cells are lost and it may get burn if exposed to the sun." "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 married a year ago and trying for a baby with no success. I weigh 89 kg and my height is 157 cm. My periods are regular. We got checked. The doctor said no problem with my ovulation and no problem with my partner too. I have been taking Siphene and Letroz for the past four months. What could be my problem? This cycle I am having Malai Vembadi Thailam in morning. ### Response: In order to conceive you should have good quality egg and sperms and good fallopian tubes. The first step will be weight reduction, testing hormones and fallopian tubes. If everything is normal then you should plan for a baby" "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 chest pain, back pain, left arm pain, and slightly shortness of breath for the past two years. The pain remains constant all the time. I also have irritation and tingling for the last two years continuously. I have done ECG, echo, TMT, and CT angiography twice, and everything is normal. What should I do? ### Response: Hello. Your symptoms do not seem to be due to a heart problem. Tingling sensations, irritation, etc., are not caused by the heart. Your symptoms more or less seem to be due to some nerve irritation which may be localized or generalized. I advise you to consult a neurologist for proper evaluation of symptoms. Sometimes nerves got entrapped between bones in the neck or vertebral column that causes pain, tingling, numbness in fingers, arms and hands. If you are a pure vegetarian, there may be vitamin B12 deficiency, which can cause such symptoms. Apart from these, there may be a problem in the peripheral and central nervous system. Therefore I advise you to have a visit a neurologist." "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 OCD (Obsessive Compulsive Disorder) since last 10 years. Getting treated by a doctor with medicines. But I do not feel completely good. Many times I go into very sad mood.Please give me suggestions. ### Response: Your answer is as follows: OCD is manageable with the help of regular psychiatric and therapeutic work. Only medicines can never treat OCD, neither managed completely. Cognitive Behavior Therapy (CBT) is paired with medical treatment to deal with obsessions and compulsions simultaneously. Medications are only used to decrease the extreme symptoms of anxiety (because of obsessions); and once they are controlled, CBT has to be immediately started for the person. CBT is mainly used to teach the skills to the person and guide him/her to control his/her obsessions and manage compulsions (behaviors) linked with thoughts. So, you are advised to consult a CBT-therapist near you and take regular sessions to learn certain techniques including ERP(Exposure and Response Prevention), Relaxation Therapy, DIET and sleep management. 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 asking you on behalf of my friend. Here are the symptoms, which she had around three to seven days before bleeding. All symptoms of PMS along with occasional migraine with glaucoma, nausea, pain in the lower part of spine and cramps.On the first day of bleeding, she is having painful cramps of uterus, dizziness, breathlessness and nipple soreness.On the second day she will look better, but the pain will still be strong. Sometimes, she complains of right ovary pain.The doctor she consulted earlier said the solution to get rid of the pain permanently is to give birth.Please suggest an alternative solution. Her current prescription is Microgynon 21. Her weight is 44.6 kg and height is 163 cm. ### Response: If the pains are severe and symptoms are uncontrollable, then please follow the following prescription. Consult your specialist doctor, discuss with him or her and take the medicine with consent. Continue the above medicines for three cycles. Pregnancy once planned shall help decrease dysmenorrhea, but till then she can practice the above medication. Most importantly, keep her water intake high for 10 to 15 glasses per day, as that shall play an important role in keeping the progesterone 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 had my tonsils removed last year. Now, on one side, I have this red area. It can get inflamed sometimes and every now and then, I get a cyst or ulcer in that area. Why is this area red and not on the other side? Is it due to a lot of blood vessels in one area that used to supply the tonsil or what? ### Response: Hello. I have viewed the images attached by you (attachment removed to protect patient identity). Hope your query is answered. Do revert back if you need anything more. Happy to help 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 57 years old and have IgA nephropathy for the past eight years which is being treated with Cardace 10 mg, Minipress XL 5 mg, Lipitor 10 mg, and fish oil capsules. I had an ultrasound eight months back which showed normal kidneys. Also, I have a benign prostate (grade 1) and not under medication. BP is around 130/80 mmHg. My recent test results for this month are as follows:Routine urine examination showed no protein or blood ( six months back it showed protein as trace, and blood as nil).Total cholesterol: 144 mg/dl.Serum Creatinine: 1.3 mg/dl (this was 1.2 mg/dl for the past two years).My platelet count has been historically low varying from 128,000 to 150,000 cells per cubic mm of blood. The latest test shows a platelet count of 116,000 per cubic mm of blood.BUN (blood urea nitrogen): 16.3 mg/dl.PSA: 1.05 ng/ml.Albumin in urine: 68.6 mg/L with ACR at 98.18 ug/mg.I am concerned as the creatinine which was 1.2 mg/dl for the past two years (I test every six months) has increased to 1.3 mg/dl this month. My platelet count continues to be below the range. I would appreciate your views on the above regarding whether there is any cause for concern or I can continue current medication. I exercise daily for about 45 minutes. ### Response: There is a rise in creatinine, but that needs to be vigilant to check if we are missing any reason for the rise. We do not have any medicine to reduce creatinine levels. We need to keep the disease activity under control. Your blood pressure should be 120/80 mmHg. You should not be taking any painkillers. So, you should get your serum creatinine repeated on a monthly basis" "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\s periods date is 23. Last periods was on the 23rd two months ago. My partner and I were intimate on 10th last month. It was unprotected. So, she took an I-pill on the 12th. She bled on 22nd. Again we had sex on 9th this month. It was protected but the condom slipped. So, for protection, I gave her Unwanted-72 on the 10th. Till now, she did not bleed and her period date is also due. Please help. ### Response: Hello. Although you have rightly taken the emergency contraceptive pill both the time well within 72 hours after intimacy, so considering that she had her first bleed on time, it is likely that her next menses would anyhow be delayed by few days as a side effect known with I-pill. If no bleed in next seven days then get a urine pregnancy test done to rule out pregnancy, possibly due to I-pill failure and if the test is negative then you can opt for a progesterone-induced 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 have typhoid, IgG and IgM are positive even after taking the antibiotic for 14 days. So, even now I have a got fever on and off. Can typhoid be cured on its own if there is no complication? ### Response: Hi. I understand all your concerns. Typhoid fever is a common serious infection that requires specific treatment after diagnosis. The causative organisms are either salmonella typhi or paratyphi. The definitive diagnosis is through isolation of the organism by culture in the first ten days. Please let me know when the symptoms started and the name of the medications you have taken. Typhoid fever can be chronic if not treated properly. For further advice please do not hesitate to contact 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: I am a 31 year old male, and I had sex with two female partners, three months back. I had vaginal and oral sex. The intercourse lasted for about five minutes, twice with each partner. I had a condom on throughout the time. Starting a week or so later, I had a pimple-like bump at the edge of my eyelid, a boil in the lower abdomen, an oral infection behind the wisdom tooth. I got both my wisdom teeth from that side extracted. I also got a skin tag in the underarm area, which got sore, reddish, and painful. My blood pressure and triglycerides are also high. I am having diarrhea from the past 8 to 9 days. I do not have a fever, but get headaches at night. I am also getting dizzy from 5 to 6 days. Is there any probability that I might have contracted HIV? Does any of the above health issues indicate HIV infection? ### Response: Hello. The answers to your queries are as follows: Hope your query is answered, but if you still have any other question please do not hesitate to ask." "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 23 year old female. My present symptoms are feeling weak and unable to walk or stand continuously for a few minutes. My Hb% is 9 and I am anemic. I also have fever for one week and taking Oritaxim-O 200. Please help. ### Response: Looking at your complaints, your weakness is due to anemia. Nutritional deficiency. Serum ferritin level. Malarial fever or UTI. Tablet Bizfer-XT for three months." "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 4-year-old daughter has a lingering cough for the past two months. Is it true that if the child is not dewormed, symptoms of a cough and wheezing persist? ### Response: Hello. Always it is advisable that the child is dewormed every six months. Bandy-Plus (Ivermectin and Albendazole) 5 mL once in the night after meals. Since the child is having a cough for two months, it is advisable to have an X-ray of the chest. Does your child have a history of fever or breathlessness? If present, it will require evaluation. Review after two 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: Is this possible that person has normal BP and after that, when he stands more than 10 minutes or sits on a chair for more than 10 minutes, his mind becomes weighted (means not proper attentive)? Is this situation possible in lower back pain whereas the MRI test is clear? Guide me what is the matter. ### Response: Hello. Firstly, I would like to let you know that the history you have provided is insufficient and not clear. Having said that, I would like to assure you that, yes, it is possible to have lower back ache with a normal MRI report. A lower backache is caused due to multiple reasons: In your case, since MRI was fortunately clear, It is most likely just a muscle strain. You do not have to worry about it. As of now, I suggest: Follow the above advice and you will be totally fine. Do not worry. Do follow up with a more elaborate history as the query regarding BP was not clear" "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 18, and I had unprotected sex a few times last month using the pull-out method. I thought that I could not get pregnant with that method. I am stressed that I could be pregnant because I had some bleeding a week before my period. The bleeding was less than usual, but I still needed pads for two days. The bleeding was the color of my normal period, but it lasted for only three days and my period usually lasts four days. It happened eight days before my period. But, before the bleeding, I used Vitamin C 6000 mg a day for three days to induce my period. Could it have been implantation bleeding or vitamin C induced period? My period should be due tomorrow, and I am stressed that it will not come. Please help. ### Response: As the precum or pre-seminal fluid (the clear fluid that comes out before the semen) is rich in active with healthy sperms, it can be enough for you to get pregnant. I cannot tell you conclusively if that was an implantation bleeding as it is variable in different people. In some, it may just a few" "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 an NT scan and a double marker test at 12 weeks and five days of pregnancy. The report is as follows.Maternal serum screen 2: Dual test. (CLIA)HCG, Free Beta 69.00 ng/mL equivalent to 1.81 Corr.MOM\sPAPP-A 1.40 mIU/mL equivalent to 0.36 Corr.MOM\sDisorder screen positive cut offTrisomy 21 (Down) 1:250Trisomy 18/13 1:100Ultrasound DATACRL 62.9mmGestational age by CRL 12 + 4Gestation age on the day of serum taking 12 + 5Nuchal Translucency 2.00mmNT\Mom\s 1.23MomNasal Bone PresentMeasured by a radiologist.Trisomy 21 ScreeningScreen positive\The calculated risk for Trisomy 21 (with nuchal translucency) is above the cutoff, which indicates an increased risk. After the result of the Trisomy 21 test (with NT) it is expected that among 156 women with the same data, there is one woman with trisomy 21 pregnancy and 155 women with not affected pregnancies.The PAPP-A level is low.The calculated risk by PRISCA depends on the accuracy of the information provided by the referring physician.\I wanted to know about the risk if in the first-trimester screening window is positive. Please suggest. ### Response: Hello. I have gone through your question and understand the concerns. I have reviewed the report. It shows an increased risk in the first-trimester screening. You should go for amniocentesis at 16 weeks gestation to rule out any chromosomal anomalies in the fetus. Hope you found the answer helpful. Regards" "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 to tighten up my body. Is it advisable to take Whey protein or fiber powders? If so, suggest a good brand. If not, help me with foods that tighten the lower abdomen. ### Response: You can definitely get a more toned body. However, you need to work out four to five times a week, maybe around 40 minutes a day, and also give adequate rest to your muscles. Have high protein foods such as eggs (whites), chicken, turkey, etc. For protein supplements, any supplement with pure whey isolate is preferable. Working out, along with a proper diet, should be able to give you a nice toned body in a couple of weeks. Please make sure 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 17-year-old male. I have an extremely poor back posture. It came from forever not keeping my back straight and watching tv, reading, and other sedentary activities that leave my back hunched over. Now, despite being skinny, my core is lopsided, there is no tone whatsoever, and I imagine it had done a lot of mental effects as well. I would also like to mention that I cannot push out my belly and breathe deeply without hurting my lower back. When I try to stand up with correct posture, I shake uncontrollably as if I have no stability. I want to know if there is any possible program to help with this to get me back on track physically? Are there ways for me to recover from the mental and respiratory effects too? I have pictures of me to give you an idea of what I am dealing with. What exercises can I do to develop muscles here? ### Response: I have seen the pictures. (attachment removed to protect patient identity). Yes, you can get back to normal if you start now. Your back does not look too bad. You need to start an exercise program called 1. McKenzie back stretching exercises. 2. McKenzie back strengthening exercises. 3. Core strengthening exercises. 4. Shoulder deltoid strengthening and trapezius strengthening exercises. These exercises will help you with all your problems. Also, start yoga and breathing exercises slowly and then build up. Do all this under the supervision of a physiotherapist. This will really help you. I hope this helps. Exercises Follow up after one week of starting exercises to tell me about the improvement, so that I can change the level of exercises." "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 circumcision surgery was done before a month. The swelling and surrounding area seem to improve until last month. In the mid of last month when I was cleaning the area, I noticed it starting to burn around the bottom swelling area. During those couple of days, I saw the swelling lightly increase. It is now late and have not seen any drop of swelling and worried that this would never heal. Also, my tip area has some light swelling which has not changed for the past eight weeks (it was pretty bad for the first two weeks).My erection last month did not hurt, but now when I get erections, I have some discomfort due to the dryness or redness. I saw my doctor last week who did the surgery, which he did not say much. I am attaching photos on how it looked last month and how it looks now. The picture with the stitches is what it was last month. If you can help me answer the questions below, that will be great since I am stressing out. Is it normal to see this type of swelling behavior?Is it normal to have swelling around the tip? Is this expected healing based on my current photos and healthy to see swelling for three months? I started having a burning sensation which is on and off after I cleaned the area, I am assuming this is just from the irritation that I caused? When I elevate my penis when I get out of the shower, the glands and swelling area look white or tan like it is almost healed, and I see a slight decrease in swelling, is this a good sign? Can I have swelling for this great cause any long term complications or there is nothing I should be worried about? My Glands looked dry and slight red and cracked. Is applying sensitive lotion safe to this area and will it help heal? ### Response: Hello. 1. Yes, it is reasonable to have this much swelling, which will resolve over time 2. Yes, it is usually expected to heal. 3. Yes, the burning sensation is due to irritation. 4. The appearance of tan following shower has nothing to do with healing. This is due to moisture following the shower. 5. The swelling is unlikely to cause any long term complications. 6. However, you need to take the opinion of a dermatologist (skin specialist) if there is no improvement in six weeks. I hope I have answered all your queries. Please get back to me if you have any more questions." "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 been diagnosed with inappropriate sinus tachycardia nearly two years back. I have dizziness, chest pain, shortness of breath, not able to exercise, and anxiety. I am currently managing my symptoms with Ivabradine 5 mg, once a day, but the quality of life is very poor due to which I am suffering from depression and anxiety disorders. Sometimes, I feel better and can work off the medicines, but as soon as I try strenuous exercises, all the symptoms return. Please apologize for my words, but I cannot even masturbate. My questions to you are, should I consider for ablation? If yes, then what are the risks and success rate? If I have to undergo pacemaker implantation, then what may be the complications and success rate and will I be able to perform strenuous exercises with a pacemaker? Should I consider going for a pacemaker at 21 years of age? Lastly, should I continue with medicines, if there is a possibility of self-healing in the future? ### Response: Firstly, do not get depressed, this is not a life-threatening condition, and may resolve with time. The symptoms may be troublesome for some time. How much are your resting and maximum heart rate? You should get yourself evaluated by a psychiatrist for anxiety and depression, which I think is causing your poor quality of life. The echocardiogram is also normal I guess. Hope this helps you, and get back if you have any doubts" "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 age is 27 now. When I was in 14 years old, a severe hip joint pain started and the doctor diagnosed it as septic arthritis and operated right hip joint to remove fluid. Then the pain was gone. After three years, again pain started and I was diagnosed with ankylosing spondylitis by blood examination HLA-B27 positive. From then, I am taking Saaz DS 1 gm daily from the last 10 years. Shall I continue it till lifetime or is there any alternative treatment for this? ### Response: This is an autoimmune disorder which actually has no treatment. You need to take medications when there is a flare-up of the disease. You have not mentioned about your hip pain right now. You need to keep doing regular general conditioning exercises and stretching exercises to keep your body flexible otherwise this disease will affect your flexibility very fast." "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 do not know why, but I do not feel confident and cannot get a boner with this new partner I have. I am depressed and this is nothing new to me. I have dated her before and it was the same thing. She really intimidates me and this does not happen with other partners I have had. Please help me. ### Response: Probably, you are suffering from erectile dysfunction situational type. So, you can consult a psychiatrist in person to learn how to practice it. Once you learn it, it is quite an effective method." "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 constant pain in my front tooth (11). I have not had any trauma to it as of I aware and I take good care of my teeth. I do not have gum disease. There may be a tiny bit of gum recession due to over brushing. The ache is constant. I do not get any pain from cold or hot food or drinks. When I eat the pain seems to disappear, but it is present when I am not doing anything. I can feel it as pulsatile pain. Please help. ### Response: 1. Long term micro trauma or hypersensitivity.2. Deep traumatic bite with lower teeth.3. Tooth decay not visible to naked eye.4. Sinusitis referred pain. IOPA and pulp vitality test. Pulpal inflammation. After investigations, depending on results treatment plan can be formed. You might require root canal treatment and capping. Revert back with the x-ray to 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 have had three scabs or sores on my body for a few months now and they did not heal. They are on my foot, back and hip. They are purple and red with a white dry patch over the top. They are extremely itchy. I also have a permanent rash on either side of my neck and outside my elbows. It is not a bumpy rash, more of red and has a silky feeling to it. I am slightly worried about what this could be. Please see the photos attached. ### Response: I have seen your query and concern. Over the neck, it seems that you have Poikiloderma of Civatte (attachment removed to protect patient identity). Poikiloderma of Civatte refers to redness associated with a mottled pigmentation seen on the sides of the neck, more common in women. The cause is mainly chronic sun exposure. Prevention is to avoid sun exposure and to use sunscreens, avoid perfumes and cosmetics. There is no specific medical treatment exists for poikiloderma of Civatte. Avoiding sun exposure and proper use of sunscreen are most important. About sores or scab looks like lichen simplex chronicus. I suggest you HHSALIC ointment (Mometasone and Salicylic acid) twice daily for five days after consulting your GP. I can make out a few acrochordons over your neck. For them, the treatment is radiofrequency cautery." "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 TB and pneumonia patient for the last two months passed the extensive phase and gained two kg. But recently she lost two kg weight, and she feels ill and weak every afternoon. She takes her medication regularly and on time. Why does this occur? ### Response: Hello. I guess the symptoms of cough and chest pain are resolving. If she compliants with her anti koch regimen she would not be losing much weight. But it is well known that chronic illness like tb and pneumonia can cause extensive weight loss and anorexia which again add to the weight loss. You need to see a dietician for prescribed dieting to help increase your calorie intake. Multivitamin should also be taken to improve appetite. Also do a chest X-ray to see the extend of the lesion in the chest with sputum afb." "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 developed a large, hard lump on the underside of my tongue. It is grayish white in color and does not hurt at all. It feels like a hard ball in my tongue. Also, I have other small red bumps. I do not know how long they have been there and I just noticed it before two days. These are weird and seem to be growing. I have never noticed it before. I have suddenly started getting acne all over my face and I never had it before in my life. Could this be related somehow? I am 25 now. I used to smoke but stopped some months ago. I drank a lot for a couple years. Do not know if that is relevant. Please help. ### Response: The hard lump under your tongue is mostly inflammation which usually gets very hard due to the structure of tongue. The bumps are formed when the inflamed tongue presses against the teeth causing that particular pattern.The inflammation of tongue usually becomes very hard to touch and grayish in color, it will take at least a week or two to return to normal. The acne problem might be due to increased hormonal activity in your body mostly and is not related to the other. I would suggest you to wait for 10 days for the tongue to return to normal. If you could take medicines over-the-counter, I would suggest you to take anti-inflammatory medication twice for five days. Kindly answer me, so that I can diagnose any other possible condition if necessary. Revert back with the answers for the above questions to 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: My mum has angiosarcoma in the leg. Amputation would be the only option. But she is not a suitable candidate for surgery. Will radiotherapy help in this condition? Please suggest. ### Response: Hi. The usual treatment for angiosarcoma is the removal of the cancerous tumor by surgery. However, in those patients who are unfit for surgery, radiotherapy and chemotherapy are alternatives. Radiotherapy involves the use of radiations to dissolve the tumor and chemotherapy involves medicines for the same. Both these nuclear medicine treatment modalities are palliative. They may help control the spread of the tumor and also to a certain extent shrink it. However, the prognosis of these treatments depends on the stage of the disease." "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 3.6 years old daughter, who weighs 10.5 kg. She is very thin and not a foodie. She is hyperactive when she is well. Sometimes, she complains of pain in the abdomen. It is going on from 1 to 2 months. The doctor advised getting an ultrasonography. She has been complaining of having continuous pain from 10 days. She also had a 101 fever. So, we got an ultrasonography, and the report shows, few discrete right iliac mesenteric lymph nodes, which is likely to be mesenteric lymphadenitis. We consulted the doctor again with the ultrasonography report, and he prescribed the following medicines and asked for stool routine test, blood test, and Mantoux test.He prescribed Calpol 250, Cyclopam suspension, Junior Lanzol 15, one tablet in the morning for a week, and Metrogyl syrup 2.5 ml, thrice daily for five days. After having two doses of these medicines, she is not recovering from the pain and her stool is becoming loose and mucus mixed. She defecates 4 to 5 days daily. Before the medicines, she was complaining of hard stools. Now, from 2 to 3 days, she is having loose stool and the color of the stool is also not good. She is not having a fever now.We also performed the blood tests including Mantoux test and stool test, as suggested by the doctor. We got the reports, and I am attaching the same. Mantoux test result is still not out. The doctor said that it is some viral infection and prescribed the following. Zinconia syrup (2.5 ml, two times a day after food for two weeks), Tufpro or Progermina mini bottle (5 ml, two times a day for five days), and the doctor also advised stopping Lanzol 15 tablets. Now, we are in confusion whether the doctor has been able to identify the problem or not. ### Response: I went through the detailed history of your child and the attached reports (attachment removed to protect patient identity) too. Revert with more information 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: I have been having difficulties breathing. It feels like mucus is blocking my airways. I also have this feeling that something is stuck in my throat. I did a thyroid blood test, TSH, and T3 which were normal but T4 was high. I did thyroid scan, it showed a soft cyst of 10 mm \xc3\x97 8 mm in my left lobe and another one in my isthmus about 6 mm. I am having a serious stomach acid, heart palpitations, irregular heartbeat, and my pause ranges between 40 to 45 each time I check it. I always feel hot, feel tired easily when doing a hard job. I would like to know if I have hyperthyroidism and for the cyst, do you think I need a surgery or is my problem something which medication can solve. ### Response: Hi. You are likely to be having thyroid cyst with hyperthyroidism and GERD (gastroesophageal reflux disease). As far as thyroid problems are concerned, they are managed by medical treatment followed by surgery. Your other problem of thick mucous and hyperacidity can be managed by a change in lifestyle, dietary habits, and medication. You have to consult your doctor for a thorough examination and necessary investigations to manage it properly" "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: Before two months, I had protected sex on the 13th day of the cycle, and my partner also ejaculated outside the condom. There was no leakage. I got my regular periods after a month. It started on the expected date and were slightly more massive. They lasted for the average duration, and the bleeding was also usual. But this month, I was waiting for the periods around the same day, but it was about seven days late now. Why am I not getting my second menstrual cycle regularly after having sex? I have white discharge and feeling of periods. But there is no bleeding. Why is it not arriving? I am worried. Can it be an ectopic pregnancy? If it is ectopic, how is it possible to get my periods after intercourse? What will the pregnancy results show now? ### Response: Since you have got your periods after intercourse, there is no chance of pregnancy. The delay could be because of hormonal changes. However, if you have a doubt, then get yourself checked by a Gynecologist and get a pelvic scan done to rule out the exact 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: What is the difference between spine fusion and fixation surgery? ### Response: Hi. The spine fusion means we fuse one mobile segment of the spine. That means we fuse between two vertebral bodies. We put bone graft there and it fuses with time. This is usually done if there is instability at that segment or spinal canal is so narrow that while decompression we are sure that this segment will become unstable. We also put screws because it takes around six months to fuse, till that time those screws will prevent instability at that segment. In spinal fixation surgery, we only put screws and connect them with rods. This is done mainly in trauma cases where natural healing occurs with time and till that time screws are kept in place. I could help you much better if you can tell me your particular case in brief." "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 20-year-old female. I never got my periods and it hurts too much to have sex. ### Response: You should get evaluated because you are 20 years old and it is high time that you should start menstruating. Maybe ovaries are not optimally working and hormones like estrogen is deficient and other glands that should act on local genital areas to lubricate it are not working. Sometimes" "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 went to an optometrist yesterday and they gave me a contact lens prescription of -6.00 for both eyes. For 30 years, I have always had different strengths, both with astigmatism usually going up a bit each year to the last one 18 months ago which was: Left -4.50 -.75 160 8.6 14.5 and Right -5.00 -2.25 180 8.6 14.5. Now this new place is telling me I do not need any astigmatism correction. The trial lenses I left with did not work 30 minutes later. I think their test was done wrong or could they possibly be right? They are acting like they do not want to retest at all. ### Response: If someone has an astigmatism and that too upto 2.5 diopter, it is rare that it is reversed. But sometimes optometrist can add astigmatic power in spherical power that is called spherical equivalent. In such cases half the power of cylinder is added to spherical power. For small astigmatism, it works well that you can use simple spherical lens but if astigmatism is higher then spherical equivalent will not give optimal visual correction. For right eye which has 0.75 cylinder can be added to spherical and it will work but in left eye cylinderical power is 2.5 diopter. Now, if you are comfortable with simple spherical glasses then it is okay. But if it is not working then you should shift back to cylinderical contact lenses. You can visit to your optometrist or ophthalmologist again for accurate refraction and I hope your problem will be solved. You are welcome for any queries." "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 mom recently died due to heart attack. She was an asthma patient and also had depression. She was having medicines for all these. One morning, I saw her biting her tongue and was unconscious. I rubbed her chest slowly that she breathed. When I stopped rubbing, she stopped breathing after some time. After sometime I again rubbed and she breathed and stopped breathing after I stopped rubbing. A doctor came home and confirmed her death and all that he asked was whether she had any heart disease. I guess it was a silent heart attack. Please let me know how could have I saved her life or the procedure of rubbing the chest was right or wrong? Also, if I had rubbed the chest continuously whether it could have helped? (or only CPR will help in this case). Just asking this question to help someone else in future. ### Response: Hi. First of all, I appreciate your interest to know the emergency life-saving procedure. Tongue bite usually occurs in seizures and not in heart attacks. There is a possibility of a seizure in her case. Many reasons can be there for such an incident." "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 an opinion as to why the ring finger on my son's left hand is swollen, the middle finger is a little swollen and possibly some fingers on his right hand are too (but less so). They are not painful. This started about a year ago, a rheumatologist saw him then and thought that it was not arthritis. X-rays are taken last year were normal.This is what the x-ray report says:Technique: PA, lateral, and oblique views of the bilateral hands were obtained.Findings: The alignment and joint spaces are normal. There is no fracture, osseous lesion, or dislocation. The soft tissues are normal.Impression: No osseous or soft tissue lesion noted. MRI may be of value.Blood work taken a year ago was normal (images attached). ### Response: Hello. I have gone through the history and the pictures along with the reports. (attachment removed to protect patient identity). I would like to ask you a few more questions to conclude the diagnosis and how to proceed further with it. Does he complain of early morning stiffness? That he has to move his hands to open it. Anyone in the family has any degenerative arthritis like osteoarthritis? Any complaints of backache or neck pains? As of the reports, your rheumatologist are right it is not inflammatory arthritis. We are looking at some metabolic causes of these swellings or some other genetic ones." "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 months ago, I started feeling racing heartbeat and numbness in left hand and felt like I am losing control on my body. I contacted a doctor and he gave me some anxiety pills but after five days I got a strong panic attack which lasted for three hours until I take a pill name Placida. Then I contacted a psychiatrist. He gave a pill for six weeks. Now I am not taking any pill but I am feeling strange feeling in my body like I feel head is heavy and sometimes I feel a strange sensation and weakness in my chest, hand, and back area, and shortness of breath. Sometimes, I feel my heart is heavy and sometimes I feel strange weakness in my chest and muscles of hand and suffering from heavy head. Should I again consult a psychiatrist or I should consult a heart specialist? Kindly tell me what should I do. ### Response: Racing heart beat (palpitations) can be due to different causes. Excessive anxiety, panic attacks is a common cause of palpitations. If you had no prior history of anxiety and suddenly developed palpitations, it is advisable to consult a heart specialist (cardiologist) so that any heart related issues can be ruled out. If you have never consulted a cardiologist before, it will also be reassuring for you to see the specialist and take his opinion. If there are no physical health problems, then your symptoms are probably related to excessive anxiety or health anxiety and you can follow up with your psychiatrist for further treatment." "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: One year ago due to excessive consumption of turmeric and ginger juice, a lot of blood like water came from my anal opening. It was treated but after that, I faced a lot of problems in my anal area. There is a lump created in my anal area and also sometimes I feel a lot of itchiness, heaviness and rarely pain in my anal area. I consulted with many doctors but I was not able to get a proper satisfactory treatment from them. I am very confused and tensed. Please help me. Currently, I am taking constipation relief powder and Lignocaine hydrochloride gel. ### Response: Hi. I understand your concerns. There are three possible causes: I suggest you send me a photo of the lump and give me more details about the pain you feel. We can discuss management after confirming the diagnosis" "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 an unprotected intercourse last week. At that time, I took an I-pill. After a week, I got my periods. Now, again today I had an unprotected sex. Should I need to take I-pill again? ### Response: Hi. I have reviewed your query. You have taken I-pill before 10 days (before periods), and you had your menstrual cycle last week. So, I-pill will not work for you in this intercourse. If you want to avoid pregnancy, you can take another I-pill again today. But, I-pill is an emergency contraceptive pill, so it used in emergency conditions. Because of its side effects, it must not be used every time after unprotected sex. It is not a regular contraceptive pill. To avoid pregnancy, if you are sexually active, it is better to choose other alternative contraceptive methods which can be used regularly with few side effects and even lesser failure rates compared to I-pill (like oral contraceptive pills or even copper-T insertion after taking a gynecological consultation)." "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 77-year-old woman. I had lymphoma last year, but was declared in remission this month. I have gained all my weight back and am feeling fine. My Oncologist sends me for PET scans every few months to make sure no cancer has returned. During last PET scan, they saw a shadow and recommended a colonoscopy. During this, they found a noncancerous fatty lipoma and three polyps.The biopsy showed one near rectum was 10 mm polyp that was precancerous. Described as high grade glandular dysplasia arising from tubulovillous adenoma. ### Response: As such immediate surgery is not indicated. Yearly colonoscopy and biopsy should be done. If stage of lesions seems to be changing then it should be removed. A few doctors treat this aggressively and remove it surgically at this stage only. This decision is based on your doctors personal experience and opinion. What is your doctor suggesting?" "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: One year ago, I had a serious breakup with my girlfriend. It was a relationship of five years. Even today, I am not able to forget her. I keep thinking about her. I am not able to concentrate on anything. I feel lonely. What do I do? ### Response: Relationship issues need to be settled down before it starts disturbing you. You have to fully understand what it will lead to and how it will affect your life in the long run. When you get into any relationship for more than a year, you start associating and sharing your feelings with that person, which is quite obvious. In any breakup, the reason for the breakup is very important to deal with. You have not mentioned it here. If you had mentioned, it would have been even more helpful in suggestions. Suggestions: Consult a psychiatrist 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: Injured foot in football four days back, badly bruised, very little pain but now have no movement in the fourth toe. ### Response: Hello. Sorry to hear about the injury. The first thing you should do now is to take an X-ray for a safety case. Ignoring cannot be beneficial. Usually, the fracture is uncommon but still have to take an X-ray to rule out any fracture possibility. Also, for now, do icing and stabilize the part. In case if it is fracture you may find some discoloration of the skin in that area and need immediate attention. Always use the RICE protocol in injuries which can avoid major damage to soft tissue. Please take up an X-ray and if X-ray reveals no fracture then we can guide for home care therapy for the same. Please get back after taking up an X-ray. Sports injury. X-ray. Fracture. Ligament sprain. RICE. Immobilize the part." "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 wear glasses with a minimal prescription of - .25 with slight astigmatism and + 2 reading. Recently, I got a new pair of progressive lenses. I am finding that my right eye cannot focus properly and it is always blurry. First, I thought that the prescription was wrong. But after making many attempts with my new lens, I was able to notice that my old progressive lens had an incorrect pupillary distance by 2 mm on my right eye. I wore that glasses for three years, and I was unaware.I am worried whether wearing glasses with PD by 2 mm so long have caused any adjustments in my right eye? Why is my eye blurry? I was wondering why my new lenses were not focussing correctly as they were present with a correct PD. Is it possible to retrain my eye to focus accurately? Can I start wearing a single vision lens which can help me for a while? ### Response: Hi. By going through your query, I can understand that you are suffering from intolerance to progressive lenses. It can be due to an increase in near vision with age. It is not due to incorrect PD (pupillary distance). If you work on a computer, intermediate vision glasses can provide you more comfort rather than progressive. Intermediate vision glasses gives the support of vision when they are used for indoor work and reading. For distant vision, you may choose to remove your glasses. In case, if both of your eyes are not working together (binocular vision defects), a change in IPD (interpupillary distance) may develop. In that case, few tests for binocular vision can help. Also, some types of cataract or glaucoma in early stage produces glass intolerance, and it leads to a frequent change of glasses in an older age group. A slit lamp examination and dilated fundus examination are advised to rule out the causes of glass intolerance." "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: About a month ago, right below the left shoulder blade started itching. No rashes, bruising or anything abnormal. A few days ago that same area became tender to touch. Again nothing was visible. Now that area hurts all the time. It feels sore, sometimes it starts to feel like the muscle is tingling (like pins and needles) and feels numb from time to time and it itches every so often. If I put pressure on that area it hurts more. I have tried over the counter pain killers and it does not seem to help. The pain comes and goes on its own. Not taking any medication. ### Response: With the description given, it looks more of a neurological problem rather than a skin problem. If there are no rashes and only tingling sensation and pain, etc., over skin of lower shoulder blade, then most likely you are having notalgia paraesthetica. It is a superficial nerve disorder of the skin. For now, you can try a local anesthetic cream called EMLA which has Lidocaine and Prilocaine. Try it for a week or two. If no improvement, then please consult your local physician. You may need some oral medication which is not available over-the-counter." "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 tender bump on the side of my nose, which is slowly getting bigger. It is on the right side of the bridge of my nose, and it is hot to touch. It does not look red, but it is extremely painful. My eyes and forehead also hurt and is causing a very painful headache. I have chronic migraines, so this does not help. I also have a sore lymph node under my chin and a bit of a sore throat. This all started two nights ago. I am worried as it is extremely close to my brain, but I do not want to waste people\s time at the ER. But I am worried because it is not getting better. It is slowly getting worse. There is no open sore on my nose or any drainage from anywhere. It is really painful. ### Response: I went through your post, but it would have been better if you had posted a photograph of the lesion. There are three possibilities: The last two will settle with antibiotics like Flucloxacillin, but the first one will need antiviral like Acyclovir. I would suggest you consult a physician for physical examination. Regards" "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 29 years old. What would be the specific symptoms of alcoholic neuropathy? I am having some nerve issues, they conducted two separate neurological exams (no conductivity testing just the general exam) but the neurologist did not find anything abnormal. I am a mild to moderate drinker and have been drinking for about six years. I do not binge drink or drink more than a glass or two of alcohol every other day or so. I eat very healthfully and work out. I have had all sorts of bloodwork and nothing has come up (Ac1, B12, thyroid, etc.). My MRI is scheduled in five weeks to rule anything else out.Doctor says my symptoms are anxiety but want to make sure. Symptoms include some weakness in my hands when I wake up, tremors at night, feelings that have changed over time in my feet. No official pins or needles, just some general ""strange"" feelings in my feet that come and go and change from foot to foot. I only had a feeling of burning in my feet twice. Sometimes there is a region that feels like there is something in my shoe. This has all come up in the past two months. Would alcoholic neuropathy take longer? Will it have more consistent symptoms? Will it show up on a neuro exam?The neurologist insists that I do not need conductivity testing. I just want to rule out alcohol before I drink anything again. It seems like from the literature I have read that alcoholic neuropathy develops after a lot of drinking and poor nutrition. And it seems to be pain that is constant that develops first. Is it true? I am currently taking Spironolactone, Yaz, and Urex. ### Response: Hello. I read carefully your question and would explain that your symptoms are not typical of alcoholic neuropathy. Anyway, tremor is very common after years of alcohol intake. I would first recommend checking vitamin B1 plasma levels and vitamin D plasma levels for possible deficiency. I agree with your neurologist, on the fact that when reflexes are present we can exclude peripheral neuropathy. But sometimes, single-fiber EMG (electromyography) would give more information on possible small fiber neuropathy. In the meantime, I would recommend taking magnesium supplements in order to help to improve your situation. You should discuss it with your doctor on the above tests. 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: My niece is 4 years old now. A year back we realized that she was not catching up how to speak and consulted an ENT doctor. Doctor performed few tests like BERA, OAE and hearing assessment. Then he confirmed that my niece is suffering from profound hearing loss. Doctor suggested hearing aids could help her in listening temporarily but advised cochlear implant as permanent solution. Though my niece grabbed very few words to speak with the help of hearing aids, she could not completely mingle with us. We still neither could digest the news nor can imagine that she wearing external devices for her entire life. Also that none of us or our ancestors had such problem.We consulted few more doctors for further confirmation and I browsed over the internet but everyone says cochlear implant is the only solution. We would like to take a final opinion from the doctors around the world before she goes under the surgery and hence drafting this. Can we have a hope that the problem could be different and doctor identifies the actual problem (if any) while operating the ear for cochlear implant? I figured out from few blogs that research is going on few devices which do not require wearing external device. Can you please let me know if they are available outside? If not, how many yet more years to pass to get those devices into the world and save many children with this problem? I have attached the BERA, OAE and hearing assessment reports for your reference. Please have a look at them and advice. ### Response: Hi. Reports (attachment removed to protect patient identity) clearly explains about the problems. I clearly understand your concern and worries. CT and MRI scan for cochlear implant. 1. Speech therapy after cochlear implant, minimum three days in a week, only by speech language pathologist.2. Regular mapping by an audiologist." "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 with my fiancee 10 days ago. I used a condom and checked the leakage or damage after ejaculation. There was no damage involved. But, she is having yellow vaginal discharge and is three days late on her period. What may be the reason? Could it be pregnancy? ### Response: Hello. I have gone through your history and understand your concern. Pregnancy may be a chance. So, just take a pregnancy test with home urinary pregnancy kit available in the market. You can do with any urine sample or with early morning sample. Do a test as early as possible and get back with test results for further discussion." "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 missed my period even after taking Meprate. It has been eight days now, what are the chances that I might be pregnant although I have not done penetration tests? ### Response: Firstly, did you have had emergency pill post intercourse? Was there any menstrual irregularities before this like delayed menses and all. If you have had an emergency pill, then the likelihood is very less as these are highly effective. In this situation, since you have missed the period, pregnancy cannot be ruled out and need to do a urine pregnancy test. So get this done on an urgent basis. I hope this helps you and get back if you have any doubts or more information to share." "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 18 years old, 150 lbs, 5\8"" male. I am in need of advice for my possible phimosis problem. I am uncircumcised and have never attempted to pull my foreskin back until yesterday. I was able to pull the foreskin back with some struggle but hardly any pain and got a look at the whole head. I have a few questions regarding this. When my foreskin is pulled back, at the end of the glans has excessive skin or somewhat around it and was worried if that was paraphimosis? (No pain except when touching it and feels very sensitive including the glans). Is it okay to leave my foreskin back as it is able to stay retracted and will just have to wait for the sensitivity to desensitize? Now that I am able to pull my foreskin back when flaccid, I cannot pull it back when erect. So, could I retract the foreskin when flaccid and get erect as it is already retracted? ### Response: I have gone through your query, I would like to know a few more details to answer your query better. It appears that you have a tight foreskin and not phimosis, I would have to examine you to confirm the diagnosis. In either case, the treatment advised would be circumcision to avoid a possibility of paraphimosis at a later date. I would advise you to not keep your foreskin retracted as it may cause a paraphimosis, which will require surgery to correct it if left for long" "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: How long should I keep gauze in after a tooth is pulled? ### Response: Hello. After a tooth is extracted, it is advisable to keep the gauze in the site for 30 minutes, in the same position. After 30 minutes, do not spit, take the gauze through your hand and discard. This is to arrest bleeding and help in clot formation by pressure method, and spitting will lead to dislodgement of the clot. So, be careful with splitting (do not do it forcefully) for at least one day. I hope you have got the other instructions from your dentist." "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 got my last period on the 1st of last month. Two days back, I used birth control pills. But, I am 2 weeks pregnant now. Will it cause any side effect? ### Response: It depends on the number of pills you took and the duration of intake. If it was single or two pills, then chance of the pill affecting baby is low. Please remember that the chance can never be 0 or 100%. If exposure was continuous, which is less likely from the history you mentioned, then the pill can affect the baby. You may need to consider for termination of pregnancyin consultation with an obstetrician after considering other factors. Regarding side effects on the mother, there will not be any side effect." "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 18-year-old male. Do I have a potentiality for circumcision? I have maximum turgid retraction without pain depicted in the first image. Enquiring as to whether a circumcision would benefit and possible logistics of such. What would be involved in my particular instance? What ""type"" of excision would be most beneficial in terms of the amount of skin removed and the inner or outer prepuce and frenulum is retained. I have a history of frenulum tears and I am unresponsive to topical creams. Please help. ### Response: Hello. From your description, it is understood that you have had trauma and tears of the frenulum. I would suggest I consider circumcision. The standard procedure includes removal of the whole of the prepuce. There are some options like cosmetic circumcision where the foreskin on the glans alone is removed." "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 frequent recurring pains in my chest due to anxiety. I recently got a fitness watch and noticed that when I am experiencing this my heart rate goes way up. Normal for me is 65 to 70 when resting. When my chest starts hurting it has jumped as high as 135 to 140 when resting. Is this normal or should I make an appointment? I currently do not have a doctor. ### Response: I understand your concerns. From what you mentioned, most probably you have panic disorder (one of the anxiety disorders)" "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 43-year-old. I have redness on the inside of the penis foreskin and burning sensation on a small part of the penis prepuce. I had a similar condition about four years back and consulted a skin specialist and got cured. I was recommended some medicine and Pyrimon eye drops for the problem. Again, I think a similar condition. I want to consult for treatment. Of late, I see some redness remains at a particular spot on the inside of the penis foreskin. ### Response: If possible provide me photographs of the affected areas which will help me for a better understanding of your skin problem and proper treatment plan." "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 given with Polyethylene glycol for 40 days before undergoing endoscopy and colonoscopy procedures. I had symptoms of edema and consumed 200 ml of alcohol before seven days. Can I have possible adverse reactions? ### Response: Hi. Please explain about the purpose for doing colonoscopy and endoscopy. Edema can occur due to many reasons. It can occur due to nutritional deficiency." "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 unprotected sex two days ago, and there are three clustered red areas on the bottom of my shaft. They only slightly itchy, and the skin there is dried. I have heavily researched herpes, and I do not think this is it. Anything else it could be? ### Response: I understand your concern, but there are no attached photographs in your message. Kindly send a picture of the affected area to help you better. I need to see the affected area to assess the condition and to suggest the appropriate diagnosis and treatment. Please send the picture of the affected area." "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 experiencing dry lips and around my mouth which is itchy and gets red. I have used all sorts of lip balm but nothing seems to be working. I drink lots of water throughout the day as well. This is getting me really worried now. Can you help, please? ### Response: Hi. I have gone through your case. Immediately stop using all different types of lip balms and lipsticks. After that, apply only Petroleum jelly or Vaseline twice daily for the next seven days. Avoid spicy food. Maintain good oral hygiene. Avoid lip rubbing and if you are habitual of rubbing your tongue, then please avoid it as saliva also irritates the skin. Use only white-colored toothpaste. Cross-reactivity between different cosmetics." "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: Daily after my shower, my face turns red with rash. This has been happening since years. I have changed my soap and face wash several times. Besides, I have lived in many cities; this happens every time and everywhere. What could be the reason? What should I do for it? Please help. ### Response: From your history it appears that, you are suffering from cholinergic urticaria or heat hives. This condition of being hypersensitive or extremely sensitive to heat or the response of sweating. People with this condition often wonder why they feel itch when they exercise or any time they seem to get hot. It can be sensitivity to cold water also. Heat hives can occur at any age and can come and go often without treatment but in some it persists. As you said, after exposure to hot or cold water the skin will become red and sometimes itchy lesions will appear. Itching or burning sensation during the initial attack is common, and normally goes away when the overall body temperature has cooled. No effective treatment is yet available to cure cholinergic urticaria except avoidance of trigger factors. Tablets like Levocetirizine or Desloratadine are only helpful for short periods. Avoidance of trigger should be your first priority. Oxyhive treatment is sometimes helpful." "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 26 years old and have been a type-1 diabetic for 24 years. I am considering getting pregnant. Is there a specific A1C number I should aim for before trying to get pregnant? Aside from having a great A1C and taking prenatal vitamins, is there anything else I should be doing to prepare for diabetic pregnancy? Also, is there a chance of delivering vaginally? I have heard that diabetics almost always have to have c-sections, but I would like to avoid it if possible. ### Response: Hello. A diabetic patient like you should have preconception counseling regarding your sugar levels, HbA1c as for conception you need to have your HbA1c below 48 mmol/mol or 6.1 %. Even HbA1C level above 86 mmol/mol or 10 % is strongly against pregnancy. So, try to avoid it if you have this level as more chances of miscarriage, fetal congenital anomalies, etc. A diabetic patient having BMI greater than 27 kg/m2 and want to conceive is advised to reduce weight before trying for conception." "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 daughter is 2 years 8 months old and she is stuttering a lot for the last four months. Initially, it used to come and go but in the last three weeks we are noticing it very constant and she is struggling a lot to speak. She never used to have this problem before and she is a very talkative person. We wanted to know if this is temporary or it will be permanent and do we need to go for any speech therapy now itself? ### Response: Being parents overprotective is a common phenomenon that is observed. Do not point out the mistake like you have pause, oh see you struggled, by this the little one will be more conscious and surely avoid talking. Better talk to her in a normal way. Follow these points. 1. Tell her to inhale then say two to three words then again inhale to say some more. 2. Finger tapping while saying, one word one tap. 3. Tell her to count backward (20,19,18, etc). 4. Tell her to stop where she is feeling problem without trying to say it with stress. Stop then relax again start saying. Most important: It is not stuttering, it is a part of developmental process called normal non-fluency." "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: Do my spirometry results tell you anything? Are they below normal? I am a male 175 cm, 83 kg, 39 years old. I sometimes have shortness of breath. ### Response: Post-bronchodilator FEV1/FVC is less than 70. FEV 1 is more than 80 (attachment removed to protect patient identity). No reversibility indicative of asthma in the post-study. It seems to suggest mild COPD (chronic obstructive pulmonary disease). It also correlates with your symptoms. Were you or are you a smoker? It would be better if I could have the image of the actual spirometry report." "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 21 year old guy. I am just 5\5"" tall. I want to be at least 6 feet tall. Is there any way to stimulate the pituitary gland to secrete growth hormones? ### Response: Hi. Growth depends on many factors: Growth after 21 years is not possible since the growing ends of the bone would have fused. So, do not go in search of medicines to stimulate growth. Regular exercising and proper sleep is the natural way of stimulating growth hormone. But this might not be of any help at this age." "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 using Tretinoin gel for a while for my back and chest acne, and it has been fine, but one day, I decided to go to the beach and got sunburned. And my doctor prescribed me to put the gel every night so that night I applied it and my skin had a burning sensation for a few second. So I thought it was nothing then I woke up in the morning with red and very irritated skin on my back and chest with an increased amount of acne which was very irritating. And my skin is very rough. What should I do? ### Response: I understand your concern. Whenever retinoids are used proper sun protection in the form of sunscreens and other measures is necessary, while going to the beach. Use the following medications now for this, 1. Mometasone cream apply twice a day for five days for the acute irritation and stop after that, not to be used more than that. 2. Any sunscreen with SPF more than 50 use it regularly for 15 minutes before going in the sun every three to four hours." "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 24 years old. For the past two years, I have been having an irregular period cycle. My doctor recently suggested me to get my exam Pap smear. I have gained 60 pounds in the last three years. When I was younger, I had the HPV shots. I am nervous about the pap smear and having an irregular period cycle. Should I be worried about uterine cervical cancer? I have not lost weight. I do not have pain. I recently had a yeast infection, and I am still healing from that.So when I had intercourse last time I felt a little discomfort in a certain position. I started spoofing today, and I am having normal PMS symptoms sensitive boobs, and I do not bleed in between things. I read that cervical cancer takes 15 years to be invasive, and I am scared. ### Response: You should not be afraid of pap smear, having pap smear test does not mean cancer it is only a routine check-up. Your irregular cycles may be due to the hormonal problem, and there is no relation with cancer. You should do an ultrasound test of the pelvis and blood tests for sugar PP (postprandial), TSH (thyroid-stimulating), prolactin, and testosterone. Depending on the report, treatment is available." "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 weeks ago a very small part, about 1/8th part of my tooth fell and I went to the dentist. He suggested filling but I was reluctant because it involved grinding. Can I prevent any further damage to my tooth by taking proper care that is brushing twice, using mouthwash and gargling every time I eat? ### Response: Hello. As explained by you, this seems to be the case of crown fracture in which no deep part of the tooth is involved. Even simple fracture of the crown (enamel) may cause sensitivity and roughnesses caused by fracture may cause traumatic ulcers. So it is advisable to go for grinding of the tooth (enameloplasty) to remove sharp edges and filling is advisable to prevent any sensitivity. Heavy biting forces. Ellis class1 fracture. Enameloplasty and restoration." "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: Recently after watching a video of a young person dying of heart attack, I have developed a fear of death. Although I am young and have no heart problems, I tend to think about it all the time. Please help me to get rid of this. ### Response: Hello. Here are two kinds of fears or phobias. 1) Temporary. 2) Permanent. Temporary lasts for few days after you suffer or witness some traumatic thing. Permanent ones would slightly fall under some psychiatric issues worth paying attention. I would recommend you to wait for some time. Keep yourself busy with positive and productive things and try to be in the company of family or friends. Try deep breathing, meditation and running. Everything should be settled by two weeks. If it does not, then consult a psychiatrist for proper evaluation and treatment." "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 very light complected with dark red acne scars that I have had for a few years. I have some acne on my cheeks, but the acne scars are more noticeable. I have combination skin I believe because my forehead tends to be super dry to where it peels, and my nose gets oily. After any cleanser, I use my face gets very dry. Which soap do you recommend and could I use castor oil or coconut oil after for the dryness? I heard they are good face moisturizers. Kindly advice. ### Response: It is essential to avoid oily preparations on the face for acne with combination skin. It tends to develop seborrheic dermatitis. It is also advisable to avoid harsh soaps and cleansers. As they remove oil, they can also lead to skin irritation. Acne spots can be reduced by using creams like Biluma at night and sunscreen during the day. Creams do not effectively treat depressed acne scars. You may require chemical peels, micro-needling, or lasers. None Acne, seborrheic dermatitis. 1. Clindamycin gel twice a day for acne.2. A mild cleanser or soap-like Cetaphil 1-2 times a day 3. Aloe Vera containing moisturizer as required. 4. Oral medicines may be required depending on severity. 1. Do not overdo face cleansing.2. Wet wipes can be used if face washing required more than two times a day. Would like to see a picture of the acne and scars for further 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 am a 21-year-old female, 129.14 lbs. Over a year ago, I was diagnosed with anorexia (eating disorder) by my initial counselor and I have been under-recovery for the same for over a year. During the course of my recovery, I had to change my therapist. The new therapist, recently, during one of our session told me that I do not have anorexia but just an eating disorder. However, all my symptoms are that of anorexia, restricting food intake, starving and inducing vomiting. I have lost my weight from 73 kg to 58 kg. I have been confused, immensely, since then regarding what illness do I really have?My query is can a person show symptoms of anorexia but not be anorexic? Can they just have an eating disorder? What is that even supposed to mean? I have also been diagnosed with PTSD, depression (mild), anxiety. I am currently on Flunile 50 mg, T-spenzo 1 mg. ### Response: Anorexia is a type of eating disorder where the weight is 85 % or below the normal range. In addition to eating disorder symptoms like restricted food intake, self-induced vomiting, menstrual disturbances, etc., the body weight has to be 15% below normal to diagnose anorexia nervosa. Based on your reported weight and height, your body weight and BMI (body mass index) fall within the normal range. Perhaps that is why your counselor may have said it is an eating disorder and not anorexia nervosa. If you are still having self-induced vomiting discuss with your counselor /doctor about having a blood test and physical examination to ascertain your physical health status. 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: My son is 3 years old. His weight is 15 kg. He frequently throws up like once in two days or more. He often complains of a tummy ache and asks for water. Sometimes, water helps but at times it does not and he vomits after that. He is active and fine otherwise. Also, while traveling, say like for 45 minutes in the car if he travels, then he complains of nausea and tummy ache. This episode is then followed by loose motions for two to three days. ### Response: Hello. Sometimes, overeating can cause episodes of vomiting like once in two days. Or it can be just some indigestion with food. Try noticing what food he develops reactions like that to. And, most likely he has motion sickness. Most kids have such symptoms on traveling long distances. This you will slowly overcome. You can give Promethazine syrup while traveling to prevent motion sickness" "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 blood pressure is high. Can I reduce my blood pressure from 146/95 mmHg to normal, just with regular exercises? I started working out at the gym for an hour, both in the mornings as well as in the evenings, since the last two days. Do I still need to continue my medications? ### Response: I observe that your BMI (body mass index) is 28, which means you comes under BMI category overweight" "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 10 months old baby girl is having loose motion from the last five days. Sometimes she passes normal bowl, but today she is passing very loose bowls and since morning she has passed about five times, runny and loose stool. Kindly suggest me some home remedy or medicine. ### Response: Hi. Start Zinc syrup 10 milligrams once a day and a good brand of prebiotic probiotic available locally. Look around her bums area, if there is a redness rash, then apply Zinc-oxide cream locally 3 to 4 times a day. If she is looking dull, seems irritable for not passing urine, then please bring her to a pediatrician as soon as possible. If stool continues, please do stool routine and microbiology report. Above all advice will not help to stop the stool frequency but it will help to prevent the complication. Mostly it is looking like viral gastroenteritis so it will subside by itself only to just give ORS when she passed the motion to prevent dehy" "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 1.4 year old baby has a pimple like spot on his forehead.Kindly provide me the remedies for the same. ### Response: I have read through your query in detail. Please find my observations below: Please attach pictures of the affected area for better diagnosis and treatment. Kindly follow up with a paediatrician 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 suddenly feel a tingling sensation after urination and a slight prick sort of a thing. I visited a doctor for the same and had been diagnosed with a urine infection. I also have a constant urge to urinate. He gave a dose of antibiotics which I had to take for three days. But I just had it for a day and a half as I felt better and I feel the same again. Is it the urine infection itself which has continued? Also, my doctor told me that it is urine infection only and that I will have to take Norflox 400 mg for five days two times. ### Response: Based on your symptoms, you seems to have a urinary tract infection. The treatment is a full course of antibiotics which ranges from three to seven days depending on the severity of symptoms. Antibiotics usually give symptomatic relief in 24 hours but it takes minimum three days to clear the infection completely. As you had stopped the medication in between, you most likely have a persistent UTI (urinary tract infection). You will have to finish your antibiotic course and in your case, it is better to take for five days because it is a residual infection. If you still have symptoms after completing your antibiotic course, it would be necessary to further investigate with a urine culture and ultrasound" "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: Yesterday, I bent down to pick up a grocery bag, and suddenly I felt a sharp pain in the lower right region of my back. And ever since, I have had sharp pains in that area whenever I walk, bend over or if I place my weight over my right hip, and whenever I put pressure on my right leg whilst walking. It especially hurts when coming up those positions. When I am not moving, I have no pain. My mom thinks it is a pulled muscle, but it does not have an aching type of pain. The pain is more sharp and intense when moving. Please help. ### Response: Hello. Your predominant complaint is of pain in the right lower back, which is aggravated by bending forwards and walking. There are two possibilities: Regards." "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: Today I was in a fully airconditioned room with low temperature and when I returned to my room and when I spit the mucus, a pinch of blood came from my mouth. What would be the reason? One year and five months back, the same happened. Please help me. I stopped smoking one month back. I am 26 years old, and male. ### Response: The bleeding you had from your nose can be because of sneezing (forceful). There might be a small injury inside the nose that might have lead to the bleeding. I will advise you to avoid nose picking and keep your nostrils moist so as to allow the wound to heal. Regarding your acid reflux, I would like to know about your lifestyle and dietary patterns. Avoid forceful sneezing." "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 22 years old. My height is 165 cm and weight 67 kg. I have receding hairline and hair fall, for a year. I am not under any medication. Kindly advice. ### Response: Hello. I read your query and saw the attached files (attachment removed to protect patient identity). There can be many causes behind this kind of hair fall like genetic cause, nutritional deficiency or improper lifestyle, etc. If it is due to a genetic cause, then it will be hard to control with medicine. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. Follow-up after two weeks. 1. Mahabhringraj oil for local application. Apply it on every alternate day and wash your hairs with mild herbal shampoo. 2. Take tablet Asthiposhak two tablets two times a day with water after food for two weeks. Take healthy and fresh food. I hope you understand my point. For more queries, you can consult 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: What is IUI? My physician asked us to go for it apart from trying the natural process. Are there any complications involved in it? ### Response: IUI is intrauterine insemination. The doctor will place the semen inside your uterine cavity in an artificial way by using a cannula. This technique is called IUI. It is usually done in male factor infertility or cervical factors or when stimulation of follicles has been done to get a better response. There are no complications associated with this procedure. Consult a gynaecologist online to know more about IUI" "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 want to quit smoking but I cannot smoke. So suggest me some medicine so that I can quit smoking. ### Response: Hi. I hope you are doing well. I read your query and I am very proud that you have decided to take this great step. First of all, you need to understand that there is no medicine available which will make you quit smoking, it is only you who can make it happen. Its not 1 week or even 1 month process, it takes lot of time and courage. I usually recommend following steps to my patient who wants to quit smoking. 1. Set a date. Setting a date has a psychological effect and you can choose any memorable date, your birthday, your anniversary, etc. 2. Tell your family, your friends and your colleagues. Discuss with them. They are the one who will help you late on with the process. 3. Prepare yourself for the upcoming problems. It will be cough, constipation, etc. These are not serious but if you do not anticipate these, such problems will discourage you from quitting and start smoking again. Try to find a friend or partner who also wants to quit. 2 people make it easier for each other. 4. Remove smoking related products (Cigerrates, ashtray) from your house, car, workplace. 5. Now in final step, here comes a little role of doctor. Now you need to understand you have 2 types of addictions, physical i.e. of nicotine and psychological i.e of act of smoking. For physical addiction I would recommend nicotine patches and bubblegum, whatever suits you better. For psychological addiction you have to control yourself, if you think that initially you cannot tolerate that, you can use electronic cigerratte for a month or so and it will help you. This is a workplan I can share with you which will help you in quitting smoking. I would love to see you again and help you step by step in the process wherever you need 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: I got risings, itch, and redness from a cosmetic cream. Risings went off. Redness and itch are still here. It is the fourth day. And a little swelling like seems like I had botox. Is it normal to still have those? I only apply a cream for the itch. Should I take an antihistamine for the swelling and itch? Itch is manageble. ### Response: I have seen your query. With your descriptions, it seems you have developed irritant contact dermatitis to cosmetic cream which you have used. First of all, never use this cream and similar products in future otherwise on subsequent exposure may lead to fulminant reactions." "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: The query is about sanded grout exposure. I am quite concerned about my girlfriend's exposure to silica dust. We were doing a home renovation. I left for about 1.5 hours while she was removing tile in a kitchen. When I had come back I saw she was removing grout with a grinder and no dust mask. The room was filled with dust in the air. The room is about 10x9 with 12\x80\x9d tiles. This makes for a total cut distance of 1100\x80\x9d with the grinder. Assuming a 1/8\x80\x9d cut with a depth of 3/8\x80\x9d and this works out to 51.56 cubic inches of dust released into the air. Assuming an average of 25 % silica content in the grout and weight of 38 g per cu inch for the dust, that is about 490 grams of silica dust releases into the air. The room was open to adjacent rooms so I estimated about 90 cubic meter space, wich would work out to 5.4 g/m^3. She was doing this for about an hour and a half so I estimate about 1 m^3 was inhaled. From what I have read this is really high-level exposure.Is my math wrong? Did I miss something? I am making her go to the doctor and we will monitor her health closely. I am really concerned this could lead to serious problems in the near future. ### Response: Hi. If she develops symptoms of a cough, breathlessness, better to get a CT thorax to see her lungs and if possible lung function tests also. Kindly get back if you need more information." "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: Dear doctor,I had intercourse with my husband last month, after my regular periods. My last period date was 9th August and it is two months now. Till now, I did not get my periods. Suggest me what should I do. ### Response: Hi. The first step is to check for pregnancy. If the pregnancy test is negative then, we can give you tablets to induce periods. Also, we need to check your thyroid and prolactin hormone levels andscan abdomen to find out the reason for delayed periods. In case the pregnancy test is positive, please meet a gynecologist and follow them. Please do not hesitate to ask further queries to 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 experiencing numbness in my left foot. It comes and goes sometimes throughout the day and sometimes it is completely normal. This has been happening for the past year. At night, when I lay down the back of both my calves feel like they are rhythmically pulsing only when lying down. I am freaking out that it might be the start of MS. I am a 36-year-old female. I have also had a mild case of mono (age 20) and have read that can increase my chances as well as being of Scottish descent. I very occasionally have neuralgia in a spot right above my collar bone and it is always in the same spot and very random. The shock lasts for about a few seconds then disappears. This has been happening for probably for the past seven years. I have also read this can be an MS symptom. I am trying to decipher if my symptoms are anxiety-related or if I truly need to be concerned with MS? ### Response: Your symptoms are not typical of MS (multiple sclerosis). The numbness in your leg may be related to a pinched nerve. The pulsating feeling in your legs may be psychological or related to venous insufficiency. Regarding the pain in your face, it is not typical of trigeminal neuralgia which lasts for minutes and irradiates in the nerve branch territory. I recommend consulting with a neurologist for a careful physical examination. If suspicions are raised, a brain MRI (magnetic resonance imaging) may be needed. I also advise performing a nerve conduction study and a Doppler ultrasound of your legs to exclude the above-mentioned disorders. 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 got my wisdom teeth out on Tuesday. I am not in much pain but I have a horrible taste in my mouth and my breath is horrible. I have brushed my teeth twice a day, I use a salt water rinse like 15 times a day. And I use an alcohol-free mouth wash. I cannot tell if I have an infection or a dry socket and I am freaking out. The sockets look like they still have the clot but it is white, not red. ### Response: Hi. Since you do not have pain or fever or any other major symptoms, there is nothing much to freak about. Coming on to the bad taste and bad odor, it could be due to any deposits in the socket or anywhere else in the mouth. But if you feel it is really extreme, you can visit your dentist who will irrigate the socket and also find out the reason after a clinical examination. If it is a" "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: The top of my butt crack has been itching for the past two days. I decided to scratch and a bump appeared. When I woke up this morning I noticed that it was still itchy but the bump was there anymore. I reached the back to feel it, but it felt a little wet as if it popped. I do not know what happened while I was sleeping. Can you please tell me what this is? I have been reading about it online and all that keeps popping up is herpes. Is it right? ### Response: I went through the details and photo given by you. (attachment removed to protect patient identity). Though the photo is not clear it appears as excoriated vesicle. You have not mentioned your age and symptoms like pain. I do not see any pus. This is unlikely to be due to herpes. It can be due to irritant dermatitis or" "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 right eye is red and puffy. It hurts when I blink by the top of my iris. It also tears up a lot when it hurts, and when under the light. I use contact lenses that I can use for a week straight, and it started on day three. When it started, it only hurt when I blinked, and the eye would tear up a bit, the next day it was red, puffy and it reacted to light. I immediately removed the contact lenses. What is wrong with my right eye? ### Response: Hello. First of all, I would like to tell you my point of view as an ophthalmologist in and against any contact lens that stays in the eye for more than 12 hours. The puffiness is most probably related to an allergic reaction that your eyes are experiencing, and you should discontinue using these contacts. Regardless of what any manufacturer says, you should not sleep with your contact lenses, and I would advise you to use daily from now on. You can use artificial tears while wearing glasses." "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 14 years old. My problem is that when I brush my hair, I found my hair on it. My hair fall is 10 to 20 hairs a day. Is there anything to worry? ### Response: Hair is one the fastest growing cells in the body. Hair has different growth cycles like anagen (growing phase), telogen (resting phase), and catagen. Losing 50 to 100 hairs per day is considered normal. Old hairs are replaced by new hairs. If you are losing hairs on the front of the scalp and sides, leading to the receding of the hairline, then it is worrisome. If it is so, please attach your clinical picture along with your query so that it is convenient for me to comment on your condition and give you appropriate suggestions" "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: Currently, I am 14 weeks pregnant with my second baby. I am attaching my NT and double marker report for your reference. I have a 5-year-old son and no abortion in the past. I have conceived naturally both times. My doctor has asked me to do either NIPT or CVS and I am not sure if I really need to do any. She has asked me to take Ecospirin 150 immediately if not doing CVS else start after CVS.I have some queries. Do I really need to go for either NIPT or CVS? Or I can forgo these tests? Should I take Ecospirin 150 as my previous pregnancy did not have any complications and at present also I am in good condition with no health issues (also I don\t drink and smoke)? Are there any issues with my beta HCG and Papp-a value? Do you see any other concerns in my report? Please reply. ### Response: I have seen the report. (attachment removed to protect patient identity). Now every laboratory has its own calculation methods to come to a risk ratio after the test. b-HCG and PAPP-A levels are also different at different times of pregnancy and also has some effects of weight and age on it. This is a genetic screening test. And we do this test to find out what is the risk of this pregnancy having a congenital abnormal baby. This risk ratio has cut off values. Means trisomy 21 (Down's) has a risk ratio of 1:365 in your case and cut off is 1:250. Now with this report, we are calculating the risk of having a baby with Down's syn" "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 22 year old female. I am suffering from a bout of acne since a couple of weeks now. They redden and leave behind dark spots. I am not touching them and drinking plenty of water. I have used tea tree oil and lemon juice on them. I apply Betnovate but it is not helping much. Kindly advise me on how to stop more acne from surfacing and dietary precautions if any. Also, what to do about the dark spots? ### Response: I have seen the picture attached (attachment removed to protect patient identity). Please answer these questions so that we can get a better approach to the case" "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 two-year-old son who has a small hole in his ears. It started as a little spot and later degenerated into a small hole in the cartilage. Now it started spreading to another ear. I have gone to many ENT specialist and dermatologist, and they could not be able to figure out what it is. It began as a small dot or spot 17 months ago in the left ear and started becoming a hole. We noticed it in the right ear around seven months ago. The same way it started as a dot as seen in the right ear before it turned into a small hole as seen in the left ear. The one on the left ear is 17 months now. We have been to many ENT specialist and dermatologist, and they said they had not seen such thing before. They conducted a blood test on him and said everything is fine. It is disturbing me a lot and looking for a solution for it as I am scared, that it should not get bigger. I am using Fusibact ointment on the affected area. ### Response: With your description and after reviewing the pictures (attachment removed to protect patient identity), I can think of a condition called angiolymphoid hyperplasia with eosinophilia (ALHE). It is a benign harmless condition that presents with bumps in the ears. This is an idiopathic condition, meaning the cause is not yet known. This condition has to be confirmed by skin biopsy. I understand it is difficult to do a biopsy in kids, but I feel biopsy is essential because this problem is present since 17months as you have mentioned. In about 20 % of cases, there will be elevated eosinophils in the blood. You have told that the blood tests are fine. I am not sure if the eosinophils were tested" "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 vagina is red and swollen with cottage cheese discharge. Rashes extend to my buttocks area. All this showed up after I wore an innerwear. Kindly advice. ### Response: Hello. I understand your problem. What you describe is a classic case of yeast infection of vagina extending up to your anus. You need oral antifungal tablets weekly for three weeks alone with local antifungal ointment. The condition is very much infectious, so I suggest you avoid any sexual contact for the time being. I also would suggest you wear cotton panties to prevent a recurrence. If you can discard them, it would be wonderful. 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 got in a scuffle. Near my fingernails, I saw blood. I am not sure if it was mine or the offenders. I have no deep wound. Just small marks from biting nails or from handcuffs. I am worried if the offender was infected with HIV and it was his blood. Any advice? ### Response: Hello. I have noted your concern. HIV is only transmitted through a fresh, deep, and actively bleeding wound. A scratch or a paper cut would not provide direct access for the virus into the bloodstream. Regards" "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 want to start off by saying that I am a 24-year-old male. I have been diagnosed with IBS in the past, and for about a good seven months I have had stomach issues on and off. Nothing serious, no weight loss or any large amounts of blood in the stool. I had one CT scan the first time six months ago and my abdomen was fine. I did one about a month ago, and they found numerous pericecal enlarged lymph nodes measuring up to 12 mm that may represent mesenteric adenitis. I am afraid that this is stage 4 colon cancer. All my GI doctors think it is not necessary to do a colonoscopy, and that I am too young to have anything wrong with me and it is probably nothing. I did just find out that I had a grandfather who had a blockage in colon a very long time ago but received no cancer treatment for it. Should I consult a GI doctor? Are this grounds for concern? ### Response: See as such mesenteric lymphadenitis does not directly represent colon cancer. It is very commonly seen post infection. So what we do is that we give antibiotics for seven days and later repeat an ultrasound abdomen after one month to check for the size of lymph nodes. If size are decreasing in size we simply wait and watch. Actually, these lymph nodes if once increased in size may take weeks to months to come down to normal size. Even you do not have any symptoms of colon cancer. However, your suspected family history should make us little concern. So I would recommend you to take a Gastroenterologist consultation and simply get a stool for occult blood done. If this test comes out to be positive then you would need a colonoscopy." "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 intercourse with a man who used a condom and he also made sure not to ejaculate inside my vagina despite wearing a condom to avoid the risk of pregnancy as much as possible. However, to be extra safe, I wanted to take an I-pill. Unfortunately, I could not take it right away and took pill on the third day (by the 72nd hour within which the pill could be still effective). How long would I have to wait for the I-pill to work and also cause bleeding? Would I need to take another one just in case? and what about the probability of being pregnant if he has used a condom which has not expired and by not ejaculating inside me while wearing the condom? ### Response: Hello. You are safe and you really need not worry as the condom used was new and there was no rupture at all. Also, you have taken an I-pill within 72 hours. It is actually effective until five days post intercourse. So you need to be patient and wait for the bleed. The chances of pregnancy are minimal." "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 16-year-old boy. I had thick hair. Recently, I started applying conditioner on my hair. I have lost my hair after using conditioner on the scalp. My mother has thick hair. My father has a bald head. I want to get my thick hair again. I am living in depression. I am unable to concentrate on my studies. I do not know whether the hair loss is temporary or not. I also have small patches between my hairs. What can it be? What can I do to get a thick hair again? Is it right to use Minoxidil now? Please help me. ### Response: It can be a side effect of a conditioner. Sometimes, the chemicals present in the conditioners are quite strong, and they lead to a negative impact on the hair, causing hair loss. As a first step, stop using conditioners. Secondly, you have told about the small patches present between the hairs. It can be a fungal infection causing hair loss. Wash your hair twice a week with a mild shampoo. Use Ketaconazole based shampoo for every 15 days. You can take vitamin supplements for a month. Take vitamin biotin and other vitamin B complex foods. Also, take vitamin C. Eat healthy food and lots of green leafy vegetables. Also, add" "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 18 years old and I have somewhat mild acne and often oily skin. I have had acne for about two years but this year it got worse. Some topical medications I have used in the past are Trimethoprim, Sulfamethoxazole-F, Adapalene gel, Differin. I have tried almost every drugstore prosecutors out there and nothing seems to work. Products I use at this moment are Cetaphil gentle foaming facial cleanser, Witch hazel, and aloe vera plant on my face every night. I have been doing this for only three days, do not see much of a difference yet. I wrote this because I want a final solution to at least control my acne. As it messes with my self-esteem. ### Response: Hi. I have gone through your case. Well, first of all, be patient. You need to understand acne is common in your age and it is an ongoing process and you may experience frequent exacerbation due to stress and hormonal. It occurs due to hormonal activity at puberty. So you may not get final medicine or final decision. And the problem may last until your twenties. Moreover, you have taken too much of medicine which may be another reason for resistant acne. Just stick to one. Apply Clindamycin gel two times a day on the pimple. Use Cetaphil cleaner" "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: Do you have any experience in HIV 2? I have done my HIV 2 DNA/RNA PCR test and antibody test which came back both negative after three months. What I am worried is HIV 2 is a slowly replicating virus and worry that HIV 2 DNA/RNA PCR test cannot pick up even after three months. Is it true? Am I negative for HIV 2 if both tests comes negative after three months of exposure? Please advise. ### Response: The replication of the virus has no relationship in the detection of the virus. If the virus is present in the body, the immune system will detect it, and start defending the body by producing antibodies. This procedure does not need any replication of the virus. It just needs a virus in the body. So, if the fourth-generation test is negative by three months and six months, then you are negative. No need to worry about them." "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 27 years old. I had sharp chest pain on the bus. I suddenly got off from the bus and rushed to a local doctor. My BP was 150/90 and heartbeat was 140 bpm. Then doctor checked ECG and he said it was due to the acidity that I got pain. I have gone through TMT also and got a negative result. Next day, I rushed to another hospital and the doctor did a series of tests. He also concluded the same thing. I was very anxious because it happened the first time in my life. I was worried that, whether I will have a heart attack in the next coming days and always kept thinking the same. The doctor suggested me to consult a psychiatrist. Psychiatrist termed it a panic attack. Nowadays, I am trying not to get anxious and not to worry about that. Currently, I am taking the acidity tablet twice weekly. But, I still get some sharp pain in the chest. I do not know the reason and it leads to negative thinking. So, I need your suggestion on this matter. ### Response: Hello. Please give me some more information regarding your illness, so that I can help you better. Did you feel suffocated in the bus, with a sort of air hunger (feel of insufficient oxygen)? Did you feel something is going to happen to you? Is there any family history of heart disease? How active are you? Do you exercise regularly? Your tests are essentially normal. Kindly answer these clarifications. After that, I will send you a detailed answer as to how you should tackle this problem. I am sure you would be fine." "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 33 year old female. I have been getting shingles since I was 6 years old. Until high school, I would get it once a year around the same time. Then, I began getting it twice a year. As I got older, I started getting multiple outbreaks in a year. I have had shingles for 27 years. This year, I had four outbreaks that occurred once in every three months. In the past, my doctor was against vaccinating me because it was not tested on anyone under the age of 50 or 60. With the multiple outbreaks over the past two to three years, we discussed it again and we decided that it might help. Previously, I had taken Famvir and Hydrocodone. Currently, I am continuing the same medicines for shingles outbreak. I had undergone a wellness checkup a few months back and all my laboratory test results were normal. In your opinion, do you think that the vaccination would help me? Are there any concerns or issues about a person of my age getting the shingles vaccine? I am not currently pregnant, but could possibly want another child in a couple years from now. Could the vaccination have any effect on future pregnancy or children? I trust my doctor and know he has my best interest in mind; I just wanted a second opinion as this vaccine has not been tested on anyone in my age group. ### Response: From the history, it is apparent that you are getting frequent recurrences of shingles, which have increased in the recent past. Shingles occur when your body immune system is low. I am not aware if you are on medication as that may lower your immune system (except for steroids that you are taking for acute attacks). As your physician rightly said, varicella vaccine is not recommended below the age of 50. Logically, vaccination at this age may provide relief from frequent recurrences, but I do not have enough literature or evidence to support this. You may go ahead with the vaccination after detailed discussion with your doctor. The point of caution is to make sure that the vaccination is given when an acute attack is not there and when you are not on steroids or any medicines which considerably reduce body\s immune system as it is a live vaccine. As far as pregnancy is concerned, you can plan the same. But, you may require frequent visits to your obstetrician for close supervision as the effects on the fetus cannot be ruled out." "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 got dark pigmentation below my eyes which extends till the side face also, I got the marks after using the cream suggested by a skin doctor. The dark patches are in both sides of my eyes. I tried Vitamin C VC+15 Serum, it also did not work for me. Currently, I consulted another doctor, he prescribed me Clotrimazole and Beclomethasone cream. ### Response: Hello. Clotrimazole and Beclomethasone combination is not meant for pigmentation and therefore should not be used for this condition. It is an antifungal preparation. I would suggest you to use a Kojic acid based cream like Kojic cream, twice daily. The cream you are using is too irritant to be used on periorbital skin. I would suggest you to try a few sessions of Glycolic acid chemical peeling along with topical treatment." "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 vein is blocked near the heart. The doctor told that he checked up today and there is a pain in the chest when he walks far. He is 45 years old, what should be done? ### Response: Hi. Blocked artery in the heart causes pain especially when one is engaged in activities like walking due to increased heart rate during activity which reduces blood supply to the heart muscles leading to ischemia and pain. This condition is called angina pectoris. It is a problem with the coronary arteries which supplies the heart muscle. The doctor to see is the cardiologist. Do ECG, do clotting time. Take Isorsobide Dinitrate 5 mg three times daily will help to open the heart arteries and relieve the pain." "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 done a CT scan of the brain recently and found everything was normal but with mega cisterna. The report shows scalp hematoma but that was from childhood and operated. I am worried about mega cisterna. Please suggest. ### Response: I have gone through the reports (attachment removed to protect patient identity). Your CT scan is normal. Mega cisterna magna is a normal variant. So do not worry about that. Scalp hematoma is a collection of blood outside your skull (bone) and is, therefore nothing to worry about. It cannot be due to very old injury as it usually gets absorbed or calcified. It may have resulted from a minor trauma that you may have forgotten" "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 husband is a type-2 diabetic. He takes Metformin, Januvia, and Zoloft. He smokes marijuana and cigarettes. He has been on the strongest nicotine patch for the past week, but still smoking occasionally. Twice in the past week, he smelled strongly of beer or alcohol and I thought he had been drinking. He swears he was not. I am concerned he has symptoms of diabetic ketosis. He has been acting very angry and irrational. Could this be a result of using the patch and smoking? Is the alcohol smell something to be concerned about? Should he be seeing his doctor? Is it safe for him to be driving with our children in the car? If it is symptoms of ketosis does it just go away or get worse over time? ### Response: Hello. I just read your query and from what you have mentioned, it appears that your husband has diabetes and he is trying to quit smoking. Hope you find my advice beneficial. Good luck." "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 severe generalized anxiety that started 10 years ago and it has become very severe now. I have anxiety attacks, DPDR everyday, muscle stiffness, shaking hands and legs. I had changed four medicines, first on Sertraline no effect, then on Fluoxetine, it works only on specific region. It cures my DPDR, nothing else, then Venlafaxine for six months. It relieved my half GAD and now on Nexito 10 for 18 weeks. It works but not full. I am already having moderate anxiety. ### Response: I can understand your problem. Anxiety in day to day situations, even without any cause is seen in generalised anxiety disorder. I personally prefer Escitalopram or Nexito for my patients. You are on 10 mg dose and are seeing some improvement but still not complete relief. One option for your persisting symptoms is to increase the dose of Escitalopram to 15 mg. This should provide more relief to your anxiety. Apart from this, addition of Buspirone is one another option. Buspirone if taken twice a day along with Escitalopram will help to reduce the residual anxiety and will also augment the actions of Escitalopram. You can talk with your doctor for this. Anxiety takes time to go and you should understand this. With proper medicines you will be alright. Do you have any unwanted thoughts which produce anxiety? Is there any ongoing stress that is aggravating anxiety? Any symptoms like low mood, bad thoughts, negative thoughts, poor motivation, etc.?" "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 chronic hepatitis B patient, I have ulcer too. I did a blood work recently for urea, creatinine, AST (SGOT) and ALT (SGPT). The physician said the result was fine. I was given Omeprazole. A few days ago I noticed I have constant body itch, fever, back pain, pain on my right abdomen, just under my right breast, I get tired easily too. ### Response: Hello. What is the status of your liver now? You are on treatment or not? Symptoms look like biliary pain. Kindly do an ultrasound, LFT, CBC, GGT. For hepatitis B we also need HBV DNA (quantitative), fibroscan, HBeAg, anti HBe." "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: hi. I am a male aged 52yrs weight 80kg diabitic my doctor has recently advised me gabapentin nt 400 for neuropathy earlier i was on pregab150 so while checking about the reviews from the patients on net i found that 99% were against gabapentin which confused me and thought to have a 2nd opinion kindly advise ### Response: Infact it\s an elder sister of Pregabalin only. Gabapentin is little more potent then Pregabalin. Only possible side effect of that" "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 distinct white patches on the back of the throat, persistent swollen lymph node in the neck (for at least a week, possibly longer), slight soreness in throat near the node. No fever but have had headaches.Throat flared up in soreness about a week ago then subsided though lingered and lymph node has stayed swollen. Preceding this flare-up was a long period of post-nasal drip and feeling something thick in the back of the throat.Looking at photos of my throat from 2015, it looks like I had very similar white patches on the back of my throat then as well, so it is not clear if they are there permanently or chronically. I cannot find many images online that correspond to this particular shape and pattern of white blotches at the back of the throat. Please advise. I am a male of 39 years old. I take 100 mg Sumatriptan when needed. ### Response: What you are seeing are enlarged lymphatic channels in the back of your throat. (attachment removed to protect patient identity). This condition is called cobblestone throat. It is a term we use to describe irritated throat with visible bumps and lumps at the back. Remember that these bumps are due to enlarged lymphatic tissue in the tonsils and adenoids. You do not have strep throat or fungal like picture. I would suggest trying anti-histamine and Tylenol for the next few weeks and see if it improves. If not consult an ENT. 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: Having painful sex six weeks postpartum and five weeks after my obgyn had to suction blood out of my uterus because my cervix closed too soon. Wondering if this is normal or if I should set up an appointment to be checked out. I am female, 23 years old. I am 5 feet 9 inches tall and weigh 300 lbs. ### Response: Hello. Yes, it is normal, sometimes body takes a little longer time to heal especially if there was instrumentation being done with the uterus. If you do not have any pain otherwise or any never, discharge or excessive bleeding then you do not have to worry. It is just that your body is not ready yet to bear sex. I would suggest you to wait for one more week or so and see how the condition stays and even then it is the same then please do not forget to book an appointment with your local doctor." "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: Dear doctor,For a couple of weeks, I had a tingling in my left foot (under the pinky toe). Then one day after, the sensation was positioned in my right foot. It lasted for about two days, and then I had no symptoms. Now after a week, suddenly while reading, I notice the (vague) tingling sensation under my left knee. Does this sound like MS? I am really anxious. (I have health anxiety as well). I do not take any meds. ### Response: Your symptoms are not suggestive of MS (multiple sclerosis). So, you should not worry about this disorder. An electrolyte imbalance or a pinched nerve could lead to such complaints. For this reason, I would recommend performing some tests if the problem persists: Hope to have been helpful to 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 suffered from a horrible panic attack this morning which lasted over 5 hours and along with it I got painful cramps in my stomach similar to contraction pains and really bad chest pains, it felt like someone has physically squeezed my heart and I have seen my doctor about this previously although my anxiety has not been this bad before but I am not sure what to do. I have tried so many different medications and none have helped except Valium and Oxazipam but my doctor does not want to prescribe it because it is addictive and I do not know what to do because as I said my anxiety is debilitating now and I am a young mother of two I need to be able to look after them. This morning I had to get my mother over here to look after them because of how bad my anxiety was, worst part is I do not know why I had a panic attack in the first place. ### Response: Hello. I understand that high levels of anxiety and panic attacks can be debilitating and needs to be properly managed. Your doctor is correct in informing you that Valium and Oxazepam are not appropriate in this situation as they will make the situation worse. If anxiety is persistent, discuss with your doctor about trying SSRIs or SNRIs type of medication. You have mentioned about trying different medication before. There are different options like Fluoxetine, Sertraline, Escitalopram, etc. Based on your assessment and tolerability your doctor can prescribe appropriate medication and dosage. Try Jacobson\s progressive muscle relaxation exercise atleast once daily to help to manage stress levels." "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 very stubborn dark circles around my eyes especially on the inner corners and my lips have turned dark too. ### Response: Dark circles under the eye are caused by fatigue. Dark circles under may merely be shadows cast by puffy lids of eye or hollows under eyes, actually that are due to as a normal part of aging. Common causes are mainly allergies, atopic dermatitis, contact dermatitis, pigmentation irregularities, rubbing or scratching your eyes, sun exposure, heredity, etc. Treatment depends on the cause. It is not a medical problem. Self-care also needed like cold compression, elevation of the head with more pillows while sleeping, and extra sleep. Black lips are due to anemia, cyanosis, cigarette smoking, alcohol abuse and regular narcotic use may all cause discoloration of the lips. Homeopathic treatment includes Acid Phos, Ferrum Metallicum are homeopathic medicines helpful to remove the darkness of skin" "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 circumcision done at an earlier age. I am facing a problem of premature ejaculation whenever I try to have sex. Please help. ### Response: Hi. Circumcision is just the surgical method of removing the foreskin from the human penis. It does not cause premature ejaculation nor does it have any effect on sexual performance. The main reason for premature ejaculation is performance anxiety. Sometimes, decreased well being, as in poor health and general weakness also cause premature ejaculation." "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 taking Anuloma DS from the last six months with tablet Pylapy. I take it every day. Even if I miss it once, I do not get motion. Is it harmful to take it for a long time? Another problem I am facing is an irregular time of motions. It may be any time before noon. So, I cannot go out when I take Anuloma. In some occasions, I could not reach a toilet on time. ### Response: Hello. I read your query. I hope you find my answer helpful. For more queries, you can follow up with 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: I am 22 years old. I have bumps recently appeared on my genital area about two weeks ago. I am not taking any medication till now, and there are black spots in that area. But I am not sure. ### Response: I have gone through the attachment (attachment removed to protect patient identity). These white bumps are molluscum contagiosum. It is a viral infection. It is contagious and spreads from person to person through contact. You must meet your Dermatologist for treatment. Please get it treated as early as possible" "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 are not willing to use a condom. We want a natural sex without a condom. In such conditions, women take pills after sex to prevent pregnancy. But we want a pill taken before sex which can prevent pregnancy guaranteed. Is there any pill taken before sex to prevent pregnancy? Which is the best one? How much should be taken and how much time should be taken before having sex? ### Response: Hi. If the sex is the thing, then she can take I-pill or Unwanted 72 (Levonorgestrel). She can take on the day of sex or soon after the sex, just one pill. But it is needed to be taken within 72 hours of having sex. The I-pill is very high in hormones and it should not be taken more than once a month. It is an emergency pill reserved for emergency situations like sudden unplanned sex or condom breaking. If you are having sex on a regular basis, I would suggest you take the regular 28-day contraceptive pill, monthly. It is safer" "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 just finished three rounds of R-CHOP for stage 1A diffuse large B-cell lymphoma and currently receiving radiation to my hip or groin. Recently I found another lump on my elbow bone, not inside crease but outside. Two weeks ago, my elbow was red and sore. Possibly bursitis but can feel a small lump underneath the fluid. Is it common for lymphoma to spread to these parts? ### Response: As per your history, you had stage 1A DLBCL (diffuse large B-cell lymphoma) and have already completed 3 R-CHOP. On radiation currently, which is standard therapy. Regarding the lump, I would like to know since when it is present, do you have any pain or tenderness, experienced any trauma, fever or involvement in sports. Mostly, it looks like bursitis. As it is very very unlikely for stage IA DLBCL to affect this site. And if consistency is suggestive of fluid underneath, then it becomes highly unlikely. I would advise symptomatic treatment and follow up." "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 having an oral problem, most specifically teeth for over 10 years. I have faded gums, beneath my lower pre-molars, incisors and canines are yellow. I have two severe curved molars on my lower jaws which have lasted for 10 years. I resorted to removing but I was advised not to since it could lead to affect rest of the teeth and I would eventually find myself toothless. Minding my food consumption, they have not been itchy. Just for the past few weeks, one of the curved teeth started hurting me severely that I visited my doctor. I have convinced myself that it is the right time to eliminate them. Please advice on this as well how to permanently regain my white teeth. They are not very yellow but partially. ### Response: Hi. Do not worry too much about the color of the teeth. The color varies in each individual from bright white to pale yellow. There are many shades of teeth that can occur due to varied reasons. As long as the teeth and gums are healthy, nothing much to worry about the color. Regarding pain in one of the molar teeth, visit your dentist and get the suggested treatment done. (My advice is not to get the tooth removed). You can get a few sessions of teeth bleaching done to improve the teeth color to a few shades whiter. (This should be done under the supervision of a dentist)." "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 fall recently. The doctor gave me a painkiller injection on my buttocks. Now, I have developed a pain on the right side of the thigh. There is pain only when I touch it, and there is a pain in the place where the injection was given. ### Response: You had a history of fall. So, you are having a musculoskeletal pain problem. A hot compress can be applied. Avoid movements that cause pain. Take rest. If there is no improvement, then, further workup is needed. Consult an orthopedic surgeon for examination, if required" "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 problem is over-thinking a situation and also sleeping disorder.During some of my personal issues I am thinking too much.So, this leads to lack of sleep and illness causing other problems.First thing I want to know is how to control my feelings and my mind.Please suggest me a treatment for good sleep and anti-stress medications. ### Response: I would like to know the answers for the following before treating you. Revert back with the answers to a psychiatrist online for further follow up" "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 TSH level is 6.52. Can you suggest me a medicine to control it? I feel fatigue and cold intolerance. Also, I have throat pain and inability to shout. Are these because of the thyroid issues? ### Response: Hello. I just read your query and from what you have mentioned, it is not clear if you are already taking any medications for hypothyroidism or not. Hope you find my advice of some benefit. Good luck." "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 a black spot or patch on the abdomen while taking bath. I want to take your opinion on this. What kind of spot is it? Is it age spot or mole or something else? I am a 39-year-old male and I take medicines for BP and thyroid as well for quite long. I am attaching pictures. Please have a close look at it and suggest me what to do in your opinion. ### Response: I saw your picture (attachment removed to protect patient identity), need some more clear pictures. By the picture, it is a simple melanocytic naevus. No need to worry. Keep it under observation for every six months by taking a photograph and comparing it. It is very very rare for your skin type for a mole to convert into dysplastic (cancerous) mole. If you notice any changes in the mole then we can plan a biopsy for visualizing internal changes. Otherwise, no further treatment is required as of 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 am 43 years old. I am having three children. Up to February, my menses cycles were at routine (monthly normally at 10-12 th of every month). My Hbp level is at 7+, but for the first time in the March I had no cycle, and in April I just had spotting. Now from the 1st May, I am having full bleeding, till today.The same case happens with my sister at the age of 41. She faced the same issue and on consulting the doctor, she was advised Progyluton tablet 2 mg / 0.5 mg for 21 days +TriHemic 600 tablet. Due to lockdown, I cannot contact my doctor, can you please guide me? Can I follow the prescription of my sister? ### Response: I understand your concern. Normal age for menopause is 42 to 52 years during which menses become irregular with excessive bleeding sometimes. So in your case, you might be transiting into menopause. However, if you have excessive bleeding during menses then take tablet Pause MF (Tranexamic acid and Mefenamic acid) three times daily if bleeding is heavy. Also, women must take calcium supplement after 30 years. Please take tablet Calcimax once daily after food. If your bleeding does not subside with the above medication please get an ultrasound pelvis to rule out the other causes." "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 this ECG normal? I had a sudden cardiac arrest (SCA) 6 moths ago. This ECG (electrocardiography) was taken a few months before that. I have had fatigue, hair loss, stomach cramps, and dizziness for a while.I have had some trouble with hypokalemia and hypomagnesemia. After being resuscitated my serum potassium was 2.7mmol/l. They tried to fix that by giving me potassium solutions. The solutions did not really work though because of low magnesium.I am currently on Bisoprolol accord 2.5 mg, Xarelto 20 mg. ### Response: Hello. I am sorry to hear about your health condition. This is extremely strange that at 25 years of age you suffered a cardiac arrest. Have you had problems with hypokalaemia before the attack? Where you on diuretics? Do you have history of similar problem in your family? Have you always suffered low blood pressure? Or was it after the attack?" "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 taking Topiramate 300 mg, along with Zyprexa 10 mg and Wellbutrin 400 mg as well as Clonazepam 0.5 mg three times a day. I have schizoaffective disorder and need to up my Zyprexa to 15 as I have been extremely irritable lately. However my Topiramate also serves me as an appetite suppressant and I am afraid that 15 mg of Olanzapine will cause a dramatic weight gain unless I also increase Topamax. Is it safe to increase Topamax to 400 gm? ### Response: Increasing Olanzapine and Topiramate simultaneously is not a good idea. you can start with one medication at a time, or better idea would be to use Clonazepam more for the time being as I do not have details of your case, if your doctor is returning soon, you can manage the irritability with Clonazepam." "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: During my last eye exam, a couple days ago, my eye doctor stated I needed lab work drawn due to a drastic change in my eyes. The sphere was -3.25 bilateral two years back and now is -2.0 bilateral. What is the concern? ### Response: I understand that your eye power has changed quite a bit in two years. The change that we normally expect to see in you would be more on the minus side that is to say that your power must naturally progress to more on the minus side than becoming less. We see these changes occurring due to a process called nuclear sclerosis, which is part of the normal aging process of the lens inside your eye. Since the power has become lesser, this change cannot be simply ignored as due to aging and your doctor must be suspecting a cause for which he has asked for laboratory work. There are very few conditions which can cause such a change, to name a few progressive hypermetropia, retinal and choroid diseases." "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 heart patient, and I am on Plavix and Aspirin. I have multiple blockages in my legs. Is it possible for a clot to form in legs, and then it moves to the heart, causing a heart attack when I soak my legs in hot water to relieve my restless leg syndrome? Similarly, can multiple clots in the heart be a cause for my restless leg syndrome that occurs in my right leg alone? ### Response: Hello. I assume that you have blockages in arteries, and if blockages are in arteries, then they will not migrate to the heart. Instead, there will be a pain while walking, and if it is severe, it may lead to gangrene. If blockages are in veins, then they will migrate to the heart and lungs. As you have multiple clots, then we can suspect that there might be some damage to your nerves, causing the symptoms. I suggest taking a tablet, Neurobion (vitamin B complex supplements), and Pregabalin." "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 inquiring about bumps on my legs (specifically shins) that itch so bad and are always there. Sometimes more than others but always there. It looks like the skin is red and raised around my hair follicle. Is there an over-the-counter cream or moisturizer or soap, etc., that I could use to prevent irritation? Could it be something else entirely? Unfortunately, I am just not one of those people that can live with hairy legs. What to do? ### Response: I have gone through your case. Yes, these are folliculitis (attachment removed to protect patient identity) and occur when small hair is growing especially when hair removing is not done in a proper direction. For prevention, keep your leg well moisturized by applying any oil or lotion and apply only in one direction. Do not rub." "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 kidney stones problem for the past four days. I took an ultrasound scan test. In the report, it mentioned that tiny 3 mm calculus is seen in the upper pole of the left kidney. Mild hydronephrosis is noted on the left side with dilated ureter due to obstructing 4.5 mm calculus in the lower ureter. Doctor prescribed me Dytor, Aceclofenac and Paracetamol, Drotavarine Hydrochloride and Mefenamic acid tablets. But, today again my sharp abdominal pain is seen. What to do? Please suggest. ### Response: Hi. Stones smaller than 6 mm are likely to pass without any intervention. Those that are larger than 6 mm or which cause severe pain, vomiting, or fever need surgical removal (endoscopic). In your case, the stone should pass in a few days time. If pain recurs, you can go for admission and flush therapy (intravenous fluids to flush out stone) for one or two days. You can stop either Aceclofenac or Mefenamic acid as both are pain killers. Take either of the two. Also, add Capsule Urimax 0.4 mg (Tamsulosin and Dutasteride) once daily for five days, this may relax your ureter and help decrease the pain. Repeat USG (ultrasound) after five to seven days to confirm the stone passage." "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 four wisdom teeth cut out and one permanent tooth on the 25th, three teeth on one side and two things on the other side on 28th. My left ear started to hurt and is still hurting but my right ear is not. The bottom of my cheek is sore and still a little swollen and near my teeth on the inside, I kind of feel a throbbing pain. I am on an antibiotic but is this normal or not? ### Response: Some throbbing pain and discomfort are normal for a week after extraction. Also, if the ear pain is severe, you may have an active infection. Continue antibiotics. Use warm salt water gargle twice a day for a week. If the pain is unbearable, I would suggest you go for a checkup. if you could send a picture of the area, it will be good for more details and diagnosis" "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 semi-professional singer and recently, I have been dealing with some vocal problems, I think I had a vocal hemorrhage and it seems to slowly heal, I am really not sure about what it is, so it would mean the world if you could give me your thoughts on it and in how much time it is going to be okay. ### Response: Hello. Get repeat laryngoscopy done after a month. Also, there seems to be a phonatory gap in posterior third of vocal cord but to confirm if the gap is present I need to see video of of laryngoscopy. If you have a video of scoot please send that to me (a picture will not be enough). Even if gap is present it will go with the speech therapy." "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 has adenomyosis and had treatment for it. She had a miscarriage in the fifth month of pregnancy before a year. Myomectomy was done for her and laparoscopic cerclage was done last month. She is now just in vitamin tablets. Can adenomyosis be treated in ayurveda or siddha or naturopathy? ### Response: Adenomyosis can be treated through siddha medicine by the following therapy. During menstrual days, all the above three" "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 beginning to have a semi-bald spot in an area around my scalp. I have had ongoing dandruff issues for around two to three years now. I used to scratch my scalp vigorously to get rid of dandruff. I have stopped doing so ever since I have noticed that my hair is thinning. Also, I have a noticeable amount of white hair for my age (I do not know if this is related whatsoever).However, I have applied Ketoconazole Nizoral Shampoo for the first time earlier in order to fix dandruff issues. ### Response: Hi. On semi-bald spot apply Tenovate cream at night for 15 days. Tablet H.vit forte once daily for 30 days (for greying and hair fall). Keraglow AD shampoo twice weekly for six weeks. All are good effective for dan" "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 45-year-old male, the youngest of my other five siblings. All through my childhood years up to the age of 20, my parents and other four of my siblings were exposed to a very angry behavior of my elder brother, the oldest of my siblings. The age gap between him and me is 15 years difference. For all I could remember is that almost every day this brother would punch my sister (who is three years younger than him) in the face, pull her hair and drag her across the room just because of talking and laughing at home and for his sake when we were at home no one is to talk or laugh in the house. I used to come from school and hide under a sofa untill my mom got home from work.When I got to the age of 20, it was this time that my parents convinced him to get a shock therapy and was given medication for his schizophrenic behavior but after some months he refused to take any medication saying that he is not a sick person. Eventually, my parents convinced him to stay at our native place house where he still resides alone. As a result of this trauma and my silent behavior, I became an easy target to bullies in the school and my surrounding neighborhood areas. I had contemplated suicide sometimes. My sisters (three) are now all married and settled.This experience has affected me and my sister (who is six years older to me) the most as we were very young compared to the other siblings at the time of this trauma. Both of us experienced the same ridicule and sometimes our heads used to jerk suddenly for which we could not control. Now we have overcome this head jerk nervous condition after many years. The ages of my siblings now, in the order of seniority which is 60 years, brother with mental illness, 59 years, sister, 57 years, sister, 54 years, brother, 51 years, sister, 45 years, myself. Please advise on my condition so I may lead the remainder of my life as normal as possible. ### Response: After I read your history that you had a very difficult past, for your brother who is schizophrenic patient, who need proper treatment and if unable to manage, he needs institutional care. As far as your history is concerned which shows depression and anxiety, can you mention that what are the current issues? Do depression and anxiety occur nowadays? How is your sleep, appetite, mood, any addiction history?" "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: Should every root canal treated tooth get post and core and a crown? What happens if it is not done? The tooth is upper 4 with a class-2 cavity and was restored by composite. ### Response: Hello. No, all teeth are not post and core treated. However, we recommend a crown for all such teeth as the teeth become fragile after a root canal treatment. Post and core is done if there is an extensive loss of crown of tooth due to decay or fracture. In your case post and core should be done or not, I can tell you exactly if you send me a picture of your tooth and X-ray, if available. Hope this helps. Regards" "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 14 year old female. My height is 5\5"", and I weigh about 140 pounds. I experience extreme pain in my hip. It is difficult for me to walk or climb stairs. Also, it keeps me awake at night. Please help. ### Response: My worry here is that you may have a Slipped Capital Femoral Epiphysis (SCFE) and you need an urgent orthopedic opinion to help rule this out. The reason I say so is that the pain and limp from the hip in an adolescent has only a few causes one of which is SCFE. The other cause is an infection and it is equally important. I hope you ask your parents to arrange a visit to an orthopaedician for physical examination at the earliest. This will certainly help, as a full examination of the hip and x-rays and blood reports will help clear any doubts." "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 pain in left side of my chest. I consulted the cardiologists and he advised me for echo 2D and TMT. Here is the report:All cardiac chambers dimension normal in size.No regional wall motion abnormality.Normal LV systolic function.LVEF is 60 %.Grade 2 LV diastolic dysfunction.Trace MR.Trace TR (RVSP 25mmHg+RAP), trace PR. Normal pericardial effusion.No intracardiac mass or thrombus or vegetation.IVC normal in dimension and collapsing 50 % (S/o RAP 5 mmHg).The exercise test is negative for reversible myocardial ischemia. ### Response: Hello. The possibility of cardiac cause for chest pain is less likely as your tests are already negative. Now, there are two possibilities, gastroesophageal reflux disease, and muscular pain. Do you get any nausea, vomiting, bloating, burping, increase in pain on food or lying down, chest burning, if suggest acidity as the cause for pain and should have antacids. If pain increases on pressing then it is likely a musculoskeletal pain." "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 19-year-old brother was suffering from OCD and it started kicking back in, for the past 20 days. He basically has a checking problem. He is currently a freshman at a University and was doing well for the first two months. Last month he went back home and was returning back to the University and that is when he started feeling homesick. During the journey, he felt for a moment that he going back to an unsafe place. This feeling was because of a crime movie that was shot in the city his university is in. That made him feel uncomfortable and at the same time the results of his mid term were told to him and he misinterpreted them and thought he scored less, but the real scores were very good and he did the best among his class. But he was affected by all these thoughts throughout the journey and right now he fights homesickness and is scared about the place he lives in and also checks continuously if he is able to understand what he is being taught in the class rather than listening to the class. I am scared for him and his future. ### Response: His current symptoms are also probably due to OCD (obsessive compulsive disorder). He has fear due to a crime scene of a movie and is feeling very homesick. This is happening because of severe anxiety due to OCD. If he has never consulted a psychiatrist then he should visit 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 having constant eye floaters, low back and hip pain, also my rib cage hurts. I feel depressed and anxious like never before. I cannot sleep at night. MRI of brain shows tiny flair. Radiologists are saying that it is nothing to worry about. What should I do? ### Response: Hi. Eye floaters are commonly associated with some issues with the visual field. So I would recommend consulting with an ophthalmologist to rule out any issues with your eyes. It can also be associated with migraine headaches. Low back pain and hip pain are common symptoms as well but I do not feel it is related to your eye floaters. I would recommend getting a few blood tests such as vitamin D, calcium levels, thyroid and vitamin B12. If above is negative then investigating into rheumatological causes depends on your clinical exam findings. MRI brain showing flair changes is non-specific." "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 yellow stains in my teeth. I feel very bad before others. This problem has been there since childhood. I have attached the pictures of my stained teeth. Please advise. ### Response: I have gone through the attached pictures (attachment removed to protect patient identity). It is a permanent discoloration which cannot be removed by normal means like dental scaling. It needs a treatment called lamineering of the front 4 or 6 teeth as required. In this procedure, the front side of teeth will be reduced and a ceramic laminate (covering) will be fixed permanently. The other option is that you can also place a full ceramic crown (cap) over the 4 or 6 teeth for better durability. These treatments are a little expensive, but will provide a natural look to your teeth. There is no other permanent solution to your problem." "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 65 years old. She is diagnosed with stomach cancer stage 4. We consulted the situation with five top oncologists and based on their suggestions we decided not to put her under chemotherapy. We are keeping her under supportive care at home. She is not taking any medicine for cancer as of today.The current concern is that she is 45 kg in weight and is able to take only liquid food since diagnosis. She does take semi-solid (mashed) food sometimes but it maybe twice or thrice in a week. As you can see in her PET scan attached, the tumor may be causing physical obstruction for the food to pass from stomach to the path down and also from time to time she feels some liquid with stale smell raising up her stomach. She wants to eat but unable to do so because of this weird nausea-like feeling.Can you please suggest some medications to overcome the above problem? Or is there any other way she could be given enough nutrition to manage the situation? Looking for your help at the earliest possible. ### Response: Hello. I have gone through her reports. (attachment removed to protect patient identity). As per the above reports, it looks like metastatic stage 4 gastric cancer. And as I can gather from history above, the decision of supportive care only without any chemotherapy is taken. For gastric cancer, surgery remains the best palliative treatment specially if there are features of obstruction as seen in her case. But usually, surgery is not preferred in view of its invasive nature. Her symptoms can be explained by moderate luminal obstruction of the stomach. In that case, another option is to go ahead with percutaneous jejunostomy for feeding which bypasses the stomach and helps in maintaining nutrition. If such a facility is not available then an endoscopic feeding jejunostomy tube can be tried. 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: My daughter is 6.5 years old complaining of stomach pain. She vomited once. What medicine should I give for the quick relief? ### Response: Hi. I understand your concern. If deworming is not done, do it with Bandy plus syrup (5 ml is equal to 400 mg Albendazole and Ivermectin 2.5 mg). Give 5 ml once in the night. If indigestion is there, symptomatic treatment is required. Syrus Emset (Ondansetron) 5 ml twice a day to be given. Any history of fever? If the pain is persistent, you need to do USG to rule out other causes and can give Cyclopam 2.5 ml once." "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 trying to conceive for some time now. This month I was put on hCG injections and egg formation. Everything was done on time and my periods date was 30th. I did a pregnancy test at home yesterday and it gave a faint line and I am attaching the photo. Today, I got my periods three days in advance. I fail to understand what happened. Could you please help me understand how could I get a faint but visible line on my test kit and get periods the very next day? ### Response: The faint line could be because of hormonal changes due to the hCG injection you have taken. The test is to detect hCG levels in your body, which can be detected during pregnancy. However, if you have a doubt then get 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: I have a history of inflammatory myofibroblastic tumor detected at the age of 11 years, which was around 12 years back and had undergone an operation for the same. Currently, my CA-125 in serum is 125.37 U/ml. The ultrasound scan revealed large multiloculated well-defined bilateral adnexal lesions with enhancing solid component. Lesions measured about 10.0 x 9.1x 10.1 cm on the right side and 5 x 4 x 5.2 cm on the left. There was thick enhancing septae noted within the lesion. Bilateral cystic lesions abutting the iliac vessels and the ureters noted. However, there is no direct evidence of any invasion. The right ureter is displaced posteromedially by a right adnexal lesion and left ureter is displaced posteriorly by the left adnexal lesion. The CT scan revealed bilateral multiloculated well-defined adnexal complex cyst with thick enhancing septae likely of an ovarian neoplasm. There was bilateral hydroureteronephrosis, likely due to the pressure effect by the adnexal cysts with no obvious infiltration of the ureteric wall. What shall I do at this moment? Is it an ovarian tumor or a relapse of inflammatory myofibroblastic tumor? As CA-125 is very high, does it confirm that I have a cancer?Some doctors told me to operate the tumors and if after the operation malignancy is confirmed, and then they would take necessary steps. Should I take any additional precautions or test before the operation? I need your suggestion for a treatment plan and also about open cystectomy or Wertheim\s operation. Also I wanted to know, whether my CA-125 will decrease after the removal of ovaries and uterus. I have attached the necessary documents for your reference. Currently, I am taking Megestone and Ferium XT daily. ### Response: Hi. Based on your reports, there seem to be ovarian tumors on both sides. The type of tumor, either benign or malignant, can be revealed only after removal. It may be unrelated to your previous tumor. The value of CA-125 though raised does not indicate malignancy. It is marginally elevated and it is highly unlikely that you will have epithelial cancer of the ovaries at this age, for which it is an ideal marker. A Wertheim\s hysterectomy is done for cervix cancer and you would not require it. For your age, if possible fertility preserving surgery is ideal. The best line of management would be to get a CT scan or an MRI to clearly define the type of ovarian tumor as there are suspicions of dermoid and chocolate cysts. After that, a fertility preserving surgery in the form of ovarian cystectomy preserving the ovary can be planned at least on one side. It is very likely that your cysts turn out benign. Kindly get evaluated and operated with a surgical oncologist as the management should be proper especially if you require a staging procedure in case the cyst is malignant" "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 took Letroz 2.5 mg for 10 days. From day-2, I had two follicles of 2\xc3\x972.3 and 1.7\xc3\x971.8, at 13th day injected with Fertigen 5000. After 33 hours, I had IUI where my husband\s sperm after washed 21 million, 33 % motility. I am taking Progesterone 200 for 14 days. Now my period is late by three days. I did a home pregnancy test, it was negative. I have pain in one side (pelvic pain). Is there any chance for pregnancy? ### Response: Your period is delayed by three days. The urine hCG card test gives a conclusive result only after one week of delayed periods. So, if your period is delayed for one week, then a urine hCG card test is advisable to rule out pregnancy. If you want to rule out early, then a blood hCG estimation can be done. If pregnancy is negative, then for pelvic pain, per speculum examination and USG scan are advisable for further work up" "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 18 year old male. I have a girl-like voice since my childhood. I cannot speak in public loudly. The louder I speak, the more girl-like and thin the voice becomes. It affects my confidence levels. I cannot go to the university because of my voice. Girls make fun of me. I sound like a girl on the phone as well. Please help me. is there any treatment like surgery? Is this is because of my vocal cords or low testosterone level? ### Response: Hello. We are there to help you find a way to rectify the problem, but until then do not worry and fret. Looking forward to helping you overcome the problem" "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 basketball game, and someone landed on my leg. Now, I have a grade one sprained ankle. I have a basketball game next week. I want to play, and I am wondering whether my ankle will heal soon? Or if I want to play, should I need to use crutches for a bit? Currently, I am taking tablet Melatonin, Concreta, and Lovan. ### Response: Crutches are advised if you cannot be able to beat the weight. If it is the case, then you will be having more than a grade 1 sprain. I will advise you walk without crutches, ice the area, elevate and use a compression bandage. Also, take anti-inflammatory tablets" "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 daughter is 2 years old and suffering from worm disease. After taking medicines, it repeatedly occurs every three months. She was already given Mebex before one month, but it does not work out. So please suggest how to completely clear worms disease. Please advise the treatment. ### Response: In this case of recurrent worm infestation, I would advise you to do a course of Mebex (Mebendazole) for the entire family living with the child and for the child itself once a week for 10 weeks. This will be coupled with a thorough cleaning of the house, specifically doorknobs, water taps, handles, and bedsheets. The child should be given syrup Mebex 10 ml once a week for 10 weeks along with weight and age-appropriate dosing for other family members at the same time as the child is taking the medication." "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: Since last one year, I am having loose stools with a lot of gas released from the anus. Motion is not cleared fully. There is a burning sensation in stomach and somewhere in the intestines. There is a huge rambling in the stomach, especially in the evening hours. The doctor has advised taking Normaxin RT, Enbios, Rabicip D SR for two weeks. The condition improves but recurs as the course is over.Eight years ago, I was diagnosed via a colonoscopy to have terminal ileum erosion with chronic non-specific inflammatory substances. I was suspected to have IBD, IBS, Crohn\s. I had the course of Mesacol, Budez CR intermittently for nearly three years. The condition significantly improved and I consumed Bifilac capsule for some time. Is my current problem connected to the old problem?. Please suggest a suitable course of treatment. ### Response: Hello. The present symptoms look more likely due to constipation. I suggest you follow these measures: Regarding the previous issue, it is always better to get an imaging of the abdomen. An ultrasound or a CECT (high-dose contrast-enhanced computed tomography) to be done. Moreover, considering your age and previous issue, a follow-up colonoscopy is warranted. Follow up as 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 have been suffering from anal blood discharge for the past four months. But I did not take it seriously as I had been traveling. Today I consulted a surgeon and after checking he advised to go for surgery as he discovered fistula. Can you recommend me the Ayurvedic procedure of cure as I do not want to go with surgery and I have read on your website that with surgery there is a chance of recurrence? How longer does it take for the cure? What would be the process of therapy? ### Response: I just read your query. As you do not want to undergo a surgery, in Ayurveda, Kshar sutra procedure is performed for fistula in the anus. It is a procedure where a medicated thread is bound at your fistula site and after some days your treating physician will change it. Ultimately this thread will cut down the fistula tract as well as will also help in its healing. Along with this, your doctor may also prescribe you some medicines and you have to take treatment for avoiding constipation also. According to the condition of your fistula, he will let you know that for how long you have to bind this thread. Usually two to four weeks is the time period but time may vary according to patient to patient. It is a cost-effective treatment with minimal side effects and minimal chances of reoccurrence. You can know more about it from a nearby Ayurvedic hospital or Ayurvedic physician who perform this procedure" "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: Please help me out. I am 25 years old, weigh 85 kg, and height is 5\4"". I have PCOD and every time I have irregular periods. Last month for religious festival took Regestrone for five days. I got my period within two days after that. Might be withdrawal bleeding. I do not know but it was very heavy. I missed my period this month may be due to PCOD. My ovulation time was between 27th to 1st. My problem now is for my uncertainty. I got intimate with my partner on ovulation day. It was not intercourse. He did not cum as well. But his pre-semen just contacted my clitoris and opening of my vagina, later, he masturbated me. I am worried if the pre-semen which touched at opening entered my vagina due to masturbation. He did not insert or cum. It was just the pre-semen which contacted my clitoris and vaginal opening. Now I am literally tensed. Does it cause conception?Will this situation of mine lead to conception? Please help me. Do I need to take contraceptive Ipill? Can I take Regestrone for five days starting yesterday? I have already taken one. Does Regestrone act as a contraceptive? If I take Ipill will I get my period? Do I need to get a pregnancy test after a week or so? By using Regestrone can I get periods by eliminating conception? ### Response: Hello. Firstly relax. Your next menses naturally should have been expected only by the same date as the previous one after taking Regesterone, as your dates have changed now). So now you are 14 days late for your scheduled menses. Also, ideally you should get an ultrasound pelvis done to check for state of ovulation in the ovaries, as to whether you have already ovulated or ovulation is still pending secondary to PCOD (USG would be gold standard), but if we still consider that you may have ovulated late and hence no menses, considering that pre-cum got rubbed inside vagina during fingering in your case, this can logically lead to pregnancy. But chances of conception are minimal but still exists. The best would be to opt for an emergency contraceptive pill like an Ipill within 72 hours of intercourse to avoid unplanned pregnancy if at all chances occur considering even pre-cum contains live sperms. If no bleeding, then the next best step shall be to get a serum beta hCG test done after seven days post last intercourse to rule out any pregnancy. (This is a blood test and most sensitive for pregnancy). If the hCG levels are less than 3 mIU, then you can rest assured that you are not pregnant and then can wait for the 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 have a right ovarian cyst of 4 cm and left adnexal heterogeneous shadow of 6 cm. What is to be done? Is there anything to worry about? Does it require an operation on an urgent basis? I am unmarried but not virgin and have a regular conjugal life with a single partner. Do I need to stop being intimate? And my weight is 62 kg and height is 5'4''. ### Response: It is not an emergency as the right ovarian cyst is not more than 5 cm. You do a regular ultrasound to measure the cyst size. If it goes more than 5 cm that we have to operate it. There is no relationship of it with your relationship or virginity." "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 wondering if there is any specific thing to look for on an EKG to show bifascicular block? I am trying to learn EKG reading and was wondering if you can help me. ### Response: Hi. Look for right bundle branch block and axis deviation. If left anterior or posterior hemi-block is also present, this makes it bifascicular block. If AV block also, this makes trifascicular block. If left anterior and posterior blocks combine, it is called left bundle branch block, if left and right both bundles block, this is called complete heart block and third degree AV block. If you are a medical personnel, it is easy to understand, if layman, then it may take some time to get used to EKG." "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 chlamydia and I have been treated on four occasions. I have not had sex recently. I took all medicines as specified. The list of medicines and attempts as follows. First Azithromax 1g one dose, second Azithromax 2.5 g three doses, third Doxycycline 500 mg two times a day for 10 days and last Doxycycline 500 mg two times a day for 15 days. After each treatment Chlamydia was confirmed. What shall I do? And what are my options? ### Response: Hello. There are other options that can be used. I have a few questions for you if you would not mind answering them." "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 who is 2 months old sleeps longer during the night now and urinates very less during the night (one or two times only). Yesterday, he went without peeing for about five to six hours at night. Since few days he is also crying when urinating (before and after as well). His penis is also ballooning during peeing and at times it seems like he is straining or pushing. He does not cry always also when peeing. I showed a doctor about the ballooning and pain and he looked at the penis and told that his skin is too tight and the hole is small. He told to push the skin back and apply an ointment (Fusidic acid based) after bath. I just applied it once as I am not sure about pushing the back skin and the ointment itself. We also did a urine routine today and everything is nil (pus 1-2 /hpf and epithelial 2-3 /hpf). Is there anything to worry about? Please advice. It is very hot climate here right now. ### Response: Hello. Relax and do not worry. Yes, what the doctor suggested is absolutely right. He has tight foreskin called physiological phimosis. It should resolve by 3 to 4 years of age by itself. You just need to pull the skin slightly and apply ointment. Do not worry, it will not cause any harm" "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 29 years old. There are some reddish white hard spots on my scrotum. They are painless but itchy. How can I get rid of them? I have searched on the internet and it says that it is calcinosis cutis of the scrotum. Please suggest something to clear those. ### Response: I understand your concern, but you should have sent me the pictures to confirm the diagnosis. If it is calcinosis, then no cream or powder will help. The only treatment is surgery for that." "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 30 years old. I observed something on the penis. It is like it burns and is red in color. I do not have any pain and itching. I started applying Clobesym-OZ cream. Now it seems some transparent shiny skin developing on it and also other parts of skin around it started becoming shiny and scaly. I have uploaded the image. I do not have any pain and itching. My blood sugar is normal. Please tell what it is, seriousness, remedy and how long will it take to improve? ### Response: Hi. I have seen the image (attachment removed to protect patient identity). Clobesym (Miconazole) is a potent steroid based cream and whatever you are noticing now are the side effects of steroid usage." "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 kissed someone who had HPV, about three weeks ago. I have been having diarrhea, nausea, and abdominal pain for the past three days. I also threw up today. Could I have been infected? ### Response: Hello. HPV (human papillomavirus) is spread through sexual route. It is a sexually transmitted disease. The common mode of spread is through vaginal or anal sex. Sometimes, it can be spread through oral sex also. For diarrhea, symptomatic management is done as follows: Hope your doubt is cleared" "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 no sugar and BP. I am living a healthy lifestyle. I am suffering severely from ED and PE since last 10 to 12 years (it lasts for two to three minutes only). Please advise proper medicine which is not harmful to my health. ### Response: There are many reasons for this condition, so you need to be evaluated and physical examination is required. Sildenafil can be started from 50 mg for almost half an hour before the sexual activity. Similarly, Tadalafil 10 mg can be used. The effects of Sildenafil last for one day while Tadalafil lasts for three days. For managing Premature ejaculation, a" "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 unprotected sex with my partner on 24 and 25 last month and she had an ECP on 25th. In few hours, she had drop type bleeding which continued for two days and then she started bleeding. It has been eight days and she is having her periods without cramps or abdominal pain. Her last period of the previous month was on 15th. We are little worried what to do now. Is this normal? She is taking unwanted 72 from three years once in two or three months but earlier she never faced this type of problem. Please suggest us the right path. ### Response: Hi. I can understand your concern. The possible causes of your partner\s irregular spotting are as follows: 1. As her periods were delayed by last month itself means around one month ten days by the time you had sex. So, the possibility of pregnancy has to be ruled out. 2. Continuous usage of emergency contraceptive pill can lead to hormonal imbalance and menstrual irregularity. 3. It is better to consult your gynecologist once, let her get examined and go for urine pregnancy test and ultrasound. With this workup the possibility of pregnancy can be ruled out and also the possible cause of her problem can be identified and treatment can be taken accordingly." "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: Bladder biopsy shows eosinophilic cystitis with prominent eosinophil infiltration in the lamina propria with a mild lymphomonocytic cell. Urothelium shows atrophic change. ### Response: I went through your post well. Eosinophilic cystitis has been mentioned in the case reports because of its rarety. No clinical trials have been conducted on the condition, it is treated with a course of steroids or NSAIDS and occasionally with resection of the lesion by either open or transurethral resection. Before starting any treatment you need to be investigated for any parasites. As a course of steroids for a week settles the symptoms that will help in confirming the diagnosis." "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 attached my report. Can you please have a look and let me know is it a cyst or an ectopic pregnancy? ### Response: Hello. I have checked the reports (attachment removed to protect patient identity). Though the follicles in the left lower side are those of an ovarian follicle, I am afraid it cannot be commented up on accurately with serum beta-hcg (human chorionic gonadotropin) levels." "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: Will a cavity tooth that hits the nerve hurt worse than a necrotic tooth? I have two teeth that are bothering me but are next to each other. I am getting one pulled, but I am not sure on 100 % on which one is bothering me. I think it is the cavity that has hit the nerve. Kindly advice. ### Response: Necrotic roots of the tooth cause pain only if the pus formation has increased the pressure inside. The tooth which has a large cavity but nerves are vital is very painful since nerves are stimulated at the slightest touch of fluids etc. You need to ask for root canal treatment on both the tooth as soon as possible. Or else go for extraction. You will need antibiotics and painkillers." "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 protected sexual intercourse five months back. Now tested for STD and everything came back negative. I have a question around HSV. HSV index value for type 1 is 0.70 and type 2 is 0.23. It was a type specific IgG antibody test. Is this result conclusive? Or do I need to retake at any point of time in the future? Your response is most appreciated. ### Response: For that above limited information as you have not mentioned your age and sex here which is very very important for any clinician and if the question is specific about some sexually transmitted disease, because pH of male and female genital organs are different, so all bacterial and viral flora growth can be different according to sex. As you have told that you have had protected intercourse five months back, so it always decreases the chances of STDs (sexually transmitted disease) in any partner and you also mentioned that all reports of your related to STD are negative so I think no need to worry now as you have crossed the incubation period of almost all sexually transmitted diseases (five months is a big time). For your query about the HSV index, I think it is negative (I could not comment on the specificity of IgG, however even if it is nonspecific no matters, cause your index values are negative). So do not worry, results are conclusive definitely (officially, index value greater than 1.1 is considered positive and index value below 0.9 indicates a negative result). If the IgG test is negative, and at least six months have passed from the time of possible infection, you do not have herpes. Number between 0.9 and 1.1 is equivocal. Antibody to HSV-2 may or may not be present. Do not worry. Eat healthy and stay healthy." "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 42-year-old female. I am facing unexpected suddenly bleeding from yesterday. My periods are expected on 20th and it is always too regular, date to date.I want to point out my periods discharge is always thick, clotty, and very painful for four to five days. This is the first time, it is seven days earlier with no indication, no pain, and no clots too, but feeling heavy in the lower side and painful urine infection. I am also facing itching in that area. Today I consulted a gynecologist in my area. She suggested Pause 500 if needed and also suggested Codex CZ for 15 days. She said not to worry, it may be regular periods. If bleeding continues for more than seven days then go for USG.Please give your advice. Also, I am hypothyroid for the past 16-17 years and taking Eltroxin 100 mg. ### Response: Hi. The medicine your doctor has prescribed is good. Take tablet Pause 500 mg (Tranexamic acid and Mefenamic acid) thrice a day for five days. I hope your doctor also did a vaginal examination and had a look at your cervix to see for any lesion. Though mostly hormonal it may sometimes be due to cervical disease or cancer. If she has not done a vaginal examination I suggest you go to it. Also, recheck your thyroid levels to see if any dose change is needed. Go for an ultrasound seven days prior to your next expected period. It is called a premenstrual ultrasound pelvis. Test for FSH (follicle-stimulating hormone) and LH (Lutenizing hormone) too on day two of your next periods. Consult again with reports." "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 is pregnant. Her hb level is 8.7 and delivery due date is 4th may. The doctor suggested blood transfusion. Is it necessary? ### Response: Hello. Yes, it is extremely necessary to transfuse her blood otherwise you may pur her life on risk during delivery. Kindly do not delay in making this decision as delivery may occur any time now because she has already completed her term. Low Hb may cause heavy bleeding during childbirth which if become uncontrolled may even lead to death." "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 28 years old, a female and I have yellow skin and have melasma on both the cheeks and nose and its been for four years. I have shown it to 3 to 4 doctors within these years and applied many different creams which did not work much. Finally, someone suggested me to apply Tezcort 3S which has lightened my melasma but I have grown pimples because of that I think and my face is not as smooth like before. Even though I had melasma I used to have healthy and smooth skin and now I miss that skin. In order to cure my melasma I applied many different creams because of that I feel like my skin is not good now. Presently doctor prescribed me to apply Kojivit ultra gel but I did not get good result and melasma becomes prominent when I apply it. So I stoped it and now I am applying Tezcort 3S again. Please help. ### Response: The pimples and uneven skin you have developed is because you have used a strong steroid with Salicylic acid, Tezcort 3S (Clobetasol propionate). This is dangerous and not supposed to be applied over the face. It can cause acne, thinning of skin, telangiectasia and facial hair. I would suggest that you stop Tezcort immediately. You can use Benzoyl peroxide cream over your pimples at night. Once the pimples subside, you can use the Brite Lite cream at night over the melasma in small quantities or you could go for chemical peeling. Make sure you use a sunscreen in the morning which is a must." "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 brother is suffering from chickenpox. What can I do to prevent it from spreading to my family members? What type of diet can he take? He is a 10 year old boy whose weight is 51 kg. ### Response: In case all of your family members have got full blown chickenpox earlier, there is nothing to worry about. Otherwise, you need to keep your brother in a separate room until all his lesions have crusted. Wash all his utensils and clothes separately in hot water. He can be on routine food without the spices. In case he has ulcers in the mouth, give a semisolid diet." "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 heard that a high intake of protein powder will affect kidney functions (by forming kidney stones). Is it true? ### Response: Hello. Too much of any nutrient is not good for the body. But when you say \high amount\, it is a relative term. What seems \high amount\ to you may not be really high. If you think you are taking too much protein, please do mention what kind of protein you are taking and in how much quantity. Because it is also important to know the quantity and quality of protein you are consuming. As a thumb rule, it is good if your diet consists of 30% protein. If you can explain your usual food and exercise routine, I may be able to guide you better. Revert back to a urologist 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 diagnosed with OSA and parasomnia/sleepwalking. I have been on CPAP for several months now with success, but still having some episodes at night, where I act out my dreams and I am afraid and run out of the house onto the street. I was also violent and aggressive towards my partner during this time of the last episode, which was two nights ago. She has children that live with us and we are extremely concerned about their safety if I have one of these episodes. I do not drink alcohol, smoke, and try to reduce my stress level. I have been using the CPAP religiously but would like a backup method to suppress these violent episodes that may/may not happen. It is really affecting my sleep, especially since I broke my foot. Please help. ### Response: I understand your concerns. Your sleepwalking is mainly because of your OSA (obstructive sleep apnea). But as you said it is under control then sleepwalking should also be in control. You can try some measures to prevent any harm to others and yourself. 1) Always cover your window and doors before going to bed. 2) Place an alarm on door and on windows. 3) Remain away from stress you can try some pranayam and meditation as well. 4) Exercise during day time so that you feel tired physically which leads to a deep sleep. We start you on some medication as well like Clonazepam in the range of .25 mg to .5 mg. You can repeat your sleep study also." "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 chest and sinus X-ray a couple of days ago and I need help reading and explaining it. I had a runny nose and a cough with phlegm so the ENT doctor asked for a chest X-ray. I have attached the images of the reports. ### Response: Hello. I have gone through the attachments (attachment removed to protect patient identity). I am able to view your paranasal sinus X-rays. It shows mild haziness in the left maxillary sinus compared to the opposite side which can be due to a mild sinus infection. The right inferior turbinates which are a soft tissue in the nasal cavity shows mild hypertrophy. The frontal sinuses are normal. The bony nasal septum is in the midline. Probably you had a flu attack which is improving. Wish you a speedy recovery." "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 find pimples like area on my mid back for more than two weeks. Old ones fade and new ones keep coming. It is not present in any other part of my body. It is just spread in that particular region. What could it be? ### Response: I have gone through your case. There are many types of acne. Some people develop pimples on back. In my opinion, take capsule Doxycycline 100 mg once daily for two weeks. Apply Clindamycin lotion two times a day. Do not apply any oil or any home remedy. Vitamin E capsule is fine." "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 external hemorrhoids. How much quantity of Nux Vomica should I take and in which form? Liquid or powder? ### Response: Hello. External hemorrhoids should be treated through: Constipation is treated through: Nux Vomica (Strychnine, Brucine) is used as a laxative. You should see the label instruction for specific use." "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 24-year-old girl. I had my last period a month back. I have not gotten my periods in this month. I am six days late. I have taken three consecutive urine pregnancy tests after the first day of my missed period and all of them were negative. Should I trust them? I always get my period four to five days late but never this late. Should I be worried? Can I trust the test results? I had intercourse on the first and 14th day of this month. Currently, I am taking Azithromycin for minor throat infection. ### Response: Hello. Yes, these tests are trustworthy. You should repeat it after a week if there is no period. We may get done blood pregnancy test if urine pregnancy test is negative after a week. Upto a week variation in period is quite common. Were the intercourse protected or unprotected? Did you have an I-pill, if yes it can cause delay in period? So overall, if I-pill was taken then it is a likely cause for delayed period, or else we will wait and get test done after a week" "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 I have a fissure in my anal area. I do not have any constipation, rectal, or anal pain. I do not have bloating or any abdominal pain. I also do not have any piles. I do not have any straining during bowel movement. I do not have any blood in the stools. I am sending you anal pics. Is there any abnormality around it? Please tell me. ### Response: Hello. I have gone through the clinical images (attachment removed to protect patient identity). It looks like small external piles with a suspicious fissure. No active intervention is needed. Hope your queries have been cleared." "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 recent CBC showed 1+ anisocytosis and 1+ anisocytosis. My hemoglobin is 12.9. The lowest hemoglobin I ever had was I believe post my C-section. I do take multivitamin/ or prenatal almost on daily basis even now. I am concerned with these results: I know in previous blood test it showed some anisocytosis but not +1. My physician did not say anything about this. I found out because I read my tests. I am going back to see him and question these results. Any suggestions? ### Response: Anisocytosis means a difference in the size of the red blood cells. This could mean that you have a mild iron deficiency. Anisocytosis of 1+ is a very mild variation in the size of the RBCs. Your hemoglobin levels are towards the lower end of the normal range and it is possible that your iron stores are depleted. This can be determined by testing serum ferritin levels. I would suggest that you continue taking the iron and folic acid tablets for another two to three months to bring up your hemoglobin levels and replenish your iron stores. There is no need for you to worry" "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: This query is with regard to one of my friends. He got an accident five months back. He was hospitalized in ICU. Blood came from his ear and so had a CT scan done.An ENT doctor said that his ear is fine and no hearing problem. Later he was shifted to his native. He was in ICU there. His oxygen level is up to 97% and heart beat 50 bpm.He is in conscious state of mind and understands everything. He recognized everyone. Also all kind of bleeding has stopped. He is with saline and local antibiotics only. A neurosurgeon advised for an operation now. So, I need a second opinion here. ### Response: We are here to help you. Probably your friend has got head injury that is causing the brain edema which is causing the low heart rate known as bradycardia. He should get a repeat CT done. We usually give saline, antibiotics and Mannitol to reduce the swelling that is in brain edema. If no relief or edema increases that is determined by clinical signs including both the pupils we go ahead for surgery. Revert back after the repeat CT scan to 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 am a 29 year old female. I have a large pink lump on the roof of the mouth that goes through my teeth. I have attached the photos for your reference. Please give your expert opinion regarding the same. ### Response: Hi. I have gone through your attached photograph (attachment removed to protect patient identity) and understand your concern regarding your dental health. Biopsy of the lump." "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 weeks three days pregnant. I went for an ultrasound and found the uterus is bulky and anteverted. Single gestational sac is seen high up in the uterus. Yolk sac has been identified but the fetal pole is not seen. Good decidual reaction is seen. Suggestive of sonography after two weeks. However, the gynecologist said it is a reason to worry and do not have a chance of success. Please suggest. ### Response: I have gone through your query and reports (attachment removed to protect patient identity). Since your gestational sac and yolk sac are evident, there is nothing to worry about. The delay in the process could be because of late implantation. Another positive factor is that there is good decidual reaction. You can wait for a week or two and repeat the scan. Because the fetal pole and cardiac activity will be evident from six to seven weeks. Post seven weeks, if you cannot find the fetal pole or cardiac activity, then we can think. So, please do not lose hope. Continue taking Folic acid and Progesterone supplements. However, if you have a doubt then get 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: I am 38 years old male with hypothyroidism and cholesterol. However, both are under normal range since I am taking Thyronorm 112 mg in the morning and Rozat 10 after dinner in the night as advised by the doctor. I have been experiencing problems with erection since last eight months and hence not able to have sex properly. I have morning erections sometimes. Please assist how to cure this quickly. I have 68 kg weight and 5 feet 9 inches height. I am a vegetarian and eat fruits and vegetables daily. ### Response: Hi. I have gone through your problem and understand your concern. The deranged thyroid and lipid (attachment removed to protect patient identity) itself can cause a problem with erection, as you stated that both these conditions are well controlled, then there is need to get evaluated to find the cause of poor erection. The starting dose of Sildenafil is 50 mg. Meanwhile, do regular exercise, take healthy food, avoid any substance (alcohol, smoking, etc.) abuse. Regular exercise, good food, avoid substance abuse." "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: Does wearing an eyeglass for a long period of time for the sake of fashion will cause any eye problem or dependency in my life? I have purchased eyeglass from a reputed store. From my childhood, I do not have any eye problem. ### Response: Actually, it is one of the rare times that I find someone put glasses with no need for it, most of the people try to get rid of them by lenses or laser, this case makes sure my idea that eyeglasses sometimes add beauty to the person. However, while you put glasses which are called Plano (without any power) there is no problem at all unless you use sunglasses with the bad quality it causes some damage to eye because it enables more sun rays to go to the eye. So sunglasses (the good kind) no problem. Plano glasses no problem. It is as if you look through the window" "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 37 weeks pregnant and I have been having excruciating back pain since last night. It does not seem to go away no matter what I do. It hurts to move or do anything. Could I be in labor? And do I need to go to the hospital? ### Response: Hello. The sudden onset back pain in a full term pregnant patient is likely to be due to lightening when the baby\s head goes down in pelvis and the sacrum and coccyx bone extend to accommodate the presenting part. If there is no abdominal tightness and contractions which are of increasing intensity and lasting for more than 15 to 20 seconds each, then unlikely that you are in labor. But it is always recommended to go to the hospital and get yourself evaluated by the obstetrician." "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 (me and my fiancee) had unprotected sex on the 11th day of the month (mensuration). I am very sure I did not eject that day. But for safety within 24 hours, she had taken Unwanted 72. Now after 13 days of it, before 1 to 3 days of expected periods. She got bleeding for a full day and continued the next day as well. Blood is of red and brown color.1. Can you please help me? Is it implantation bleeding or withdrawal bleeding?2. When did she get her periods?3. When we will surely come to know there is no pregnancy?4. When to use a pregnancy test? ### Response: This can be confirmed by getting a serum beta hCG test (human chorionic gonadotrophin test) done which can conclusively rule out pregnancy as well, earliest by 10 days post intercourse. If the hCG levels are less than 3mIU then she is surely not pregnant and the bleed is not an implantation bleed(as it is always a retrospective diagnosis). She would get her menses now only after a month counting from the day of the start of the 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 have itching on the left side of my testicle and also two white rashes on the top end of my penis. What are they? ### Response: Hello. Well, attach some photo of the area where you are having itching so that it is easy to diagnose the condition and provide an effective treatment. From your description, it could be either scrotal dermatitis or a fungal infection" "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 missed my period for over four months. My last intercourse was three months back. If I am pregnant, how many weeks my pregnancy is? ### Response: Hi. Kindly send me your detailed history. Have one serum beta hCG (blood pregnancy test to check your pregnancy status). Before did you have regular periods? All these questions matters. If the pregnancy test comes positive, then you can go for the first pregnancy scan which could be around 8 to 9 weeks or more pregnancy. If comes negative, then you need a menstrual induction and day two sex hormonal tests and transvaginal scan to check pelvic pathology and discuss all investigations here or with a local 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 am 21 years old. Today I noticed a small black spot on my toenail, I did a little research and found out that it might be a melanoma cancer, but also it could be a fungus infection. After a bit more research, I noticed that an unusual cystic pimple between my chest that I have had for two months now might also sign of melanoma. I spend little to no time in the sun. Do I have melanoma? The black spot on my toenail might be because of the tight shoes I have been wearing lately, my toe also hurts a little bit from those shoes. The red pimple between my chest appeared five to six month ago, then disappeared and reappeared multiple times, I squeezed it, and blood and fluid came out of it. ### Response: I understand your concern. The thing on the chest looks more of a sebaceous cyst, (attachment removed to protect patient identity) which comes and goes even if you pop out the contents as it needs to be excised completely to prevent the recurrence. For the toenail spot, I am not sure that it is melanoma, it can be other things like a subungual traumatic hematoma, or pseudomonas nail infection. Nonetheless, you need to keep observing it for any color or size changes. The two conditions you mentioned do not seem to be related, though. Use the following medication for two weeks, and if it is because of infection it will improve 1. Tablet Ciprofloxacin 500 mg twice a day for two weeks. And avoid tight footwear." "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 38 years old and a little obese. I have noticed two or three cherry color spots on my chest and back. Are they something to be worried about? I hope it is not a sign of some serious disease. Secondly, I am experiencing some generalized itching on my body. Last year same time of the year, I felt the same. Is it due to winter and dry skin? I am putting coconut oil and it gets better and also having Allegra 180. ### Response: Hi. I have gone through your case. These red spots are called cherry angioma and these are nothing to worry. They are just like black moles which normally do occur on our skin. These are due to swelling of the blood vessel. Heaters do the same." "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 69 year old male. I have suffered from many types of infections several times in my life from systemic candida infection, valley fever, fungus infections and so on. I also have RA, have experienced Reynauld\s several times, I also have SLE and have tested positive for MCTD. I also have male boobs, wide hips and all around feminine shape. Three years ago, I had a mild myocardial infarction, veins are unobstructed, heart in good shape. I was on meds for about three years, to date no further coronary occurrences, no signs of heart problems. I am down to just aspirin and no additional meds. Currently, I have severe pain in my hand and finger joints and also, in the joints of my big toe on both feet.Recently, I came down with some sort of cold that has turned into bronchitis with a pain on my right side. My doctor has put me on a five-day antibiotic plan again. I had a late start into puberty, started shaving at the age of 25, had small testicles. I worked out with weights for years and was never able to ""muscle up"". I have small bones, long fingers, long legs, short torso. I have never been tested for Klinefelter\s syndrome but have been suggested by several doctors that I may have been born with this condition XXY but they seem to be reluctant to test for it. Is it possible that I am not being treated for the right cause of my illnesses? I am not sure what to do at this point, help. ### Response: Repeated infections with different organisms including fungal infection indicate severe immune deficiency which could be due to the steroid therapy you take for MCTD (mixed connective tissue disease) or due to other condition like diabetes. So, please tell me the following: The other possibility is immunodeficiency due to the autoimmune disease you have. Please provide me with your CBC (complete blood count) lab report. I also suggest that you perform karyotyping in order to diagnose Klinefelter\s.Wish you all well being" "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 is 63 years old. He is a diabetic patient and currently under diabetic medication. Now, he found blood in urine. His USG showed SOL in a urinary bag and it was measured about 44 mm x 22 mm. Please help me to understand what it is. ### Response: Hi. SOL in bladder (space-occupying lesion) means a bladder growth. Most of the times, the bladder growth will be malignant. So, your father needs early evaluation and treatment for his bladder growth. Based on CT scan and bladder biopsy, further treatment can be decided. For small and simple growths, endoscopic removal is possible. For growths which extend into the bladder wall, surgery to remove bladder or radiotherapy is needed. For growths already spread beyond the bladder, chemotherapy may be needed. No point in delaying the treatment. Also, there is no need to panic. Consult a urologist in person who deals with urological cancers and get your father evaluated." "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: Since last few days whenever I eat any spicy food or chicken, after passing stools, I am feeling a bit of burning sensation for five minutes. After that, it goes away. That too in a week I feel 1 to 2 times. Surrounding the anus also while washing sometimes I am feeling a burning sensation. I do not have any other problem of difficulty in passing the stools and it is regular and clear. I request you to suggest some medication. and I have also stopped eating spicy food. ### Response: Intake of spicy food may cause burning sensation and irritation of anal mucosa which may lead to a burning pain during defecation. It is due to the spiciness of the food. You may try yogurt, cucumber, tender coconut water, probiotic capsules, buttermilk. Use tablet Nexium before breakfast for one week. Avoid spicy food intake. If symptoms do not improve, please consult a physician or post me a 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: What is the conclusive timeline for hepatitis B and C testing? I have done the following tests.1. Normal ALT and AST at 12 weeks post possible infection.2. HBsAg at 15 weeks post possible infection.3. HBsAg, HBcAb and HBsAb at 22 weeks post possible infection.4. Hepatitis C antibody at 22 weeks post possible infection.5. Normal ALT, AST, ALP, LD, and albumin. I had slightly raised bilirubin (27 umol/L in a ref range of 8 to 24).6. HBsAg, HBcAb at 29 weeks post possible infection.7. Hepatitis C antibody at 29 weeks post possible infection.Does the test at 29 weeks (202 days) determine that my results are 100% conclusive and no further testing is needed? Why would there be elevated bilirubin? If I were infected, why the detectable elevations in bilirubin did not follow a positive hepatitis test, and why it is stuck in the middle of two negative tests (week 22 and week 29 negative tests)? ### Response: Hello. Normal bilirubin, as well as, normal ALT (alanine aminotransferase), and AST (aspartate aminotransferase), do not warranty that a person cannot have hepatitis B and C infection. A person infected with hepatitis B and C can have normal liver function tests. In a normal course, HbsAg (surface antigen) comes positive within four weeks of infection and Anti HCV (hepatitis C virus) antibody may take up to six weeks to three months to show its positivity. In general, if a person is found negative after months of exposure we consider it conclusive. In cases where there is a high risk or the diagnosis has to be early we need to get the PCR (polymerase chain reaction) test done for both hepatitis B and C. For hepatitis B we do HBV DNA and for Hepatitis C we do HCV RNA analysis. 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 a gingival polyp that has been removed three times but keeps growing back. Do I have to live with this or is there a way to permanently remove this? ### Response: I had gone through your question I can understand your concern. No, you do not have to live with it throughout your life. Make sure you get the polyp excised from a periodontist or an oral surgeon. There are chances of recurrences sometimes and because of your bad luck, you fall among them." "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 reflux and GERD. Also a hiatal hernia. Sometimes I have gurgling in the stomach and into my throat. It is like a gurgling noise and a ticking noise if I hold my mouth open. I just started medium. Would you be worried or is this normal for reflex and the PPI should help? ### Response: Hi. PPI alone will not work. Need to add some pro motility medicines too. Also dietary modifications and lifestyle changes need to be considered consistently. If symptoms are worsening, then need to think of other measures. Would like to have a look at your endoscopy report before making further specific comments. Please consider a review with your report." "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 left-sided headache and was advised an MRI. I was told by my doctor that it was a migraine. He prescribed Betacap TR in the morning, Tryptomer at night, and Naxdom 500 in the case of a severe headache. But suddenly, there is a left-sided pain with eyes and ear pain. ### Response: I read your query and understand your concerns. I hope this answers you. Feel free to write back to me if you have more questions" "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 29 years old. My ultrasound scan shows that I am 29 weeks pregnant with single transverse placental localizations is posterior, lower segment and complete, Previa liquor is moderate, fetal heart beat and movement is present. Approximate fetal weight is 1300 gm, BPD is 7.48 cm, F.L. is 5.5 cm, abdominal circumference is 24.4 cm, and intra uterine pregnancy. Is this normal? ### Response: Hello. This pregnancy is absolutely going fine till date. But let me tell you one thing that it is a high-risk pregnancy because of the placental localization, which is called Placenta Previa. So you have to be very much cautious during this pregnancy. Do not do heavy strenuous work, do not let anyone do an internal examination for you and no intercourse even. Any time you may have bleeding and report to your doctor immediately. Keep a strict watch on your baby\s movements. And the mode of delivery would be a cesarean section as normal delivery is not possible in such 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 had simple extraction of my second bottom tooth. It is day six today since I have removed. I was feeling major pain a few days ago but it is fading away day by day. I actually feel no pain in the morning but in the afternoon I feel discomfort. When can all this go away? I was expecting to be healed already. My dentist told me that I will be fine in three days and gave me only painkillers. No antibiotics. ### Response: Yes, you should have been fine till now as advised by your dentist but that was when everything post-extraction would have been fine. The pain gets aggravated third day after extraction and subsides with time but the foul smell or bad breath remains there. Are you experiencing bad breath? Kindly reply to this question. I will be waiting. Treatment is to get debridement done at a clinic and get a pack of Zinc-oxide Eugenol packet in the socket place. That is it. Change the" "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 problem is very common with statistically around 30% of men face, which is premature ejaculation. There is no erectile dysfunction. It is just that I discharge at an extremely swift pace, that is within 30 seconds to 2 minutes of sexual activity. I have tried all techniques like start stop, using a thicker condom, deep breaths, etc., but nothing worked. When I was a child, my prepuce was surgically removed due to some reason, which I assume might have increased the sensitivity. Anxiousness to perform could also be one of the reasons for quick discharge. Kindly suggest me a solution, be it a medicine, pill or lotion that could help me perform better. Please suggest something without hazardous side effects, because this medical glitch is giving invisible dents to my married life. Looking forward to get fruitful advice from your esteemed and erudite panel. ### Response: Hello. There are many ways to treat premature ejaculation if it is not possibly due to anxiety: So, to summarize, if you tried various techniques and still experience premature ejaculation, then the three medical options are, Performance anxiety and extra sensitivity. Premature ejaculation. Follow up if you have any queries to 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: My cousin stepped on a nail. It had a pointy object from the street. It got stuck in his feet. It took him from morning to evening to take the nail off his feet and he threw it at me. It hit my arm not knowing if that nail was infected or had blood on it. So when he threw it at me, it stuck my arm and pitched it like the pointy part hit my arm. Can I be infected with HIV this way? ### Response: Hello. There is no risk of HIV (human immunodeficiency virus). The virus does not survive outside the body and it is certainly not transmitted through fomites. Moreover, intact skin does not allow the virus to pass through" "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 dealing with anxiety since childhood. I am 22 years old now. I have been smoking weed for about six months and my quality of life drastically improved. Now, I could sleep at night. I went back to being myself happy. My confidence went up and my social anxiety virtually disappeared. Once, while watching videos on the internet, I came across one talking about reality and how we might be part of some sort of virtual reality. When I started thinking about that, it really freaked me out and I had a panic attack. Then, the mixture of the anxiety and being high made me really entertain the idea of this reality was fake. I was in a constant state of being on the brink of a panic attack for a few days afterwards, even while being completely sober. I am better now, through the day I am fine even thinking back on it makes me kind of laugh. But, when I am alone at night the thought comes back and no matter how hard I try, I cannot take my mind off it. I could not sleep because of the anxiety related symptoms, putting on a podcast and listening to people talk is the only way to calm me down. I hate this and I cannot stop thinking about how I may become this crazy person who truly believes were in some sort of matrix and end up in some asylum rocking back and forth. Should I be worried about this? Am I going crazy? I do not want to develop schizophrenia and lose touch with reality. I have not smoked since the incident and I have gotten better. But, I am worried that I will never be able to shake off these thoughts, although I know these thoughts are completely ludacris and I am truly fine. Will time resolve this? ### Response: I read your query and understand your concerns. Before I answer your question I like to congratulate you for taking the necessary step of stopping cannabis." "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 getting cold sores for years now, and they are always in the same place on the left side of my lower lip. Two weeks ago, I just got over a cold sore, and about two days ago, a red bump appeared on my skin, which attaches a little bit at the edge the corner of my mouth. So, I decided to try and pop it, but it was not ready at all, so it became infected and open. I have attached a picture of the sore. I have no idea if it is actually just a pimple healing or angular cheilitis or a cold sore. ### Response: Hi. I have read your concern and examined your picture (attachment removed to protect patient identity). Consult your specialist doctor, discuss with him or her and start taking the medicines after 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: The climate is hot here. I lost my skin color. I got a lot of acne. My skin is oily and sensitive. Now, what can I do? I am using Adapalene with Clindamycin phosphate gel. Is it right for me? I always use a night cream to get my color. I am using sandalwood powder with rosewater now for my skin. ### Response: Hi. I have gone through your query (attachment removed to protect patient identity). You have moderate acne. I suggest you use your current topical medications and add, Vibramycin tablet (Doxycycline) 100 mg for every 12 hours, after meals." "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 ate a cheese pizza and a chocolate bar. Eight hours later (after fasting) I tested my blood sugar and it came out at 128, and 30 minutes later it dropped to 106, and 15 minutes later it raised to 109 (without eating and drinking anything). My question is, do I have diabetes or did I initially have high sugar because I ate pizza very late at night? ### Response: Hello. Usually fasting blood glucose is 126 mg and above is considered as diagnostic for diabetes. However, it is also possible that because of the dinner, fasting glucose might have shown a higher level. So to confirm whether there is diabetes or not, you may have to get a PP (postprandial) glucose level and HbA1c %. If PP is 200 mg and above and HbA1c % 6.5 % and above, then diabetes is considered to confirm. Looking at your weight and height, another important fact is with a BMI of 42.92 kgs/Sq meter you are already in grade 3 obesity. With a significant amount of excess weight. This itself is an invitation for getting diabetes." "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 palmer erythema last year. I am 28 years old, however, I started drinking moderately from 16-20 then stayed sober for a year and a half. However started drinking again at 22 and have been more of a binge drinker consuming on average of 20-50 drinks a week over the last 5 years. I never drank everyday usually 6-10 one day during the week but would drink alot on Friday annd Saturdays. Since my PE diagnosis I have had my liver enzymes checked 3 times along with CBC and autoimmune diseases and just about every kind of blood work that could cause along with an ultrasound and everything has came back normal except my cholesterol and triglycrides were a high.Since I have gotten my triglycrides in healthy range but cholesterol is still a little high. My question is how accurate is all of this in detecting liver damage. I do not have any symptoms of disease except the red palms. And should I be concerned? Since I am now sober as I have talked to several people in the cirrohsis and and fatty liver disease community and it definitely scared the heck out of me how dangerous alcohol really is. So I am just hoping to get some advice and if there is anything else I can do to be certain? Or what is your opinion on my story? Definitely never drinking again and totally not worth the risk of developing some kind of liver disease. ### Response: Do not worry. You may have anxiety more than disease itself. For raised total cholesterol you may take low cholesterol diet with regular exercise. Quitting of alcohol may be useful. Get it done ultrasound abdomen and liver scan. Avoid alcohol intake. Use tablet Pantoprazole before breakfast for one week. Eat green leafy vegetables, do yoga and meditation. Be happy and do not worry. Please consult your physician, he will examine and treat you accordingly." "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 an oral contraceptive pill three months back, which caused a three week delay in my periods and my cycle was for only 3 days compared to normal 5 days. After that, we have not had sex. I still have not got my periods of this month, which is due. I feel puckish and dizzy most of the day. I tried the home pregnancy test and the results are negative. What do you think? I have a thyroid problem and recently changed my dose from 100 mcg to 75 mcg. ### Response: I have gone through your query and can understand your health concern. If you have taken the oral contraceptive pill within 72 hours of sex, then no need to worry. As you got your periods after that though they are delayed there is nothing to worry. As you have mentioned that you have thyroid problem also, I think it is due to hormonal imbalance as thyroid problems can also cause irregular menses. Still, I suggest you to check your serum beta hCG (human chorionic gonadotropin) levels to make sure that there is no pregnancy. I suggest you to consult a gynecologist if serum beta hCG comes to be high and periods get delayed further. 1. Premenstrual syn" "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 girlfriend is 35 years old. She is obese, exercises regularly and tries to watch her diet. In spite of these, she is prediabetic. Her fasting blood glucose is typically around 105 mg/dL. Her A1C is normally in the range of 5.7% to 6%. She takes Metformin to manage the prediabetes. Her blood pressure is checked regularly and is always good. Last time, her blood pressure was 120/80 mmHg. Her eGFR has been tested several times and is always above 90.Recently, she had a medical checkup in her office, and the report was obesity and protein in the urine. So, she went to She went to her GP who performed a 24-hour protein in the urine test. 520 mg per 24 hours was the result of this test. She was referred to an endocrinologist and a nephrologist. The nephrologist did perform an ultrasound. Neither the endocrinologist or the nephrologist were terribly concerned. My girlfriend discussed using ACE inhibitors with the nephrologist, but he did not think they were necessary as her blood pressure was normal. He recommended diet, exercise, weight loss and monitoring.The nephrologist did not tell her that she has phase 1 CKD. But, it sounds like she has. Is this correct? Both the endocrinologist and the nephrologist felt that it would not impact her ability to live a healthy life. Is this correct? If she has CKD, how long will it take to progress? What is the long-term prognosis? Is healthy pregnancy possible? Apart from diet, exercise and weight loss, are there other things you would like to recommend? ### Response: Hi. We are here to help you. Considering her prediabetes a cause of her proteinuria, yes, she would be categorized in stage 1 CKD (chronic kidney disease). However, that is very unlikely that such a prediabetes at this age is going to cause proteinuria. Yes, this is not going to impact if does not worsen further. It will not progress much as her diabetes is well controlled. The prognosis of her condition is good, and a healthy pregnancy without any complication is possible. I want to mention that she needs a repeat 24 hours protein test done after a month to reach a conclusion as a single time urine protein can occur due to many causes like heavy exercises and fever. I would recommend ACE inhibitors, ANA (anti-nuclear antibody), C3, C4 level test and ultrasound kidneys in case her urine protein persists even after one month." "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 14 years old and I weigh 220 pounds. I am 5 feet in height. I have this wound on my belly for two months and I have been trying to heal it but I put a Band-Aid on it and then it became red and swollen. Please help. I have been on growth hormones in the past. ### Response: From what you have mentioned, you have an unhealed wound in the abdomen for two months. This is considered delayed healing as the wound should heal within one week. Causes of delayed healing could be due to an infected wound, presence of a foreign body and/or diabetes. Please provide me with a photo of the wound and it will be helpful. Your blood sugar level and CBC (complete blood count) are important. I feel a local antibiotic is required. Systemic antibiotic if fever is present. Follow up is required" "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 with my fiance for four times in the last 24 hours. Some of it was unprotected but we did use a condom each time and he ejaculated into it each time as well. But, in between he does not remember there was a high possibility that the pre-ejaculatory fluid contained some active sperm. It was during my most fertile window period that I had sex. I have taken a morning-after pill within the 72 hour window and lots of online forums stated that the probability of getting pregnant is really low. My worry is that I have had an accidental pregnancy before wherein even though I had taken the morning-after pill within 6 hours; it completely failed to prevent it. Please help. ### Response: Hi. Another option besides ECP is to use an intrauterine contraceptive device like copper-T within 72 hours of intercourse which can again prevent pregnancy and it is also 98-99 percent successful but not advised for women who have not delivered yet." "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 21 years old. Before two years, I went to a dermatologist for my acne problem. He prescribed me Ziana. It helped for about three to four months. I used it for a year. I still have acne. But it got worse. I use PanOxyl at night with acne free toner and a cleanser in the morning. I want to have good results. I am having acne problem for about six years. Recently, it has got worse now. I have large multiple white and blackheads on the cheek, chin, and jawline. Please help. ### Response: Hi. It can be acne vulgaris, seborrhea, or it can be due to hormonal imbalance. You should use Benzoyl peroxide 2.5 percent gel in the morning over the affected areas and continue with Ziana (Clindamycin and Tretinoin) at night. Since your acne is not getting controlled by the topical application, I recommend you go for oral treatment. You can start with a course of tablet Azithromycin 500 mg on three consecutive days in a week for four to six weeks. Avoid applying cream or moisturizer. Avoid oiling the scalp and reduce taking sugary foods. I hope these measures will help you. Revert me after six weeks." "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 received CBC and CMP blood test results. Info points to kidney issues but dismissed as nothing by my doctor. I would like your opinion. Key points outside normal range: WBC 12.66, hematocrit 45, eosinophils .5, absolute neutrophils 8.76, absolute monocytes .91, BUN 26, creatinine 1.4, calcium 10.6, EGFR 58.29. Note that tests were performed for autoimmune disease. ### Response: Attached investigations do not show evidence of autoimmune condition (attachment removed to protect patient identity). But it shows some impairment in kidney functions as GFR is lower than normal and creatinine is 1.4. This could be an effect of longstanding hypertension or due to another factor. My opinion is to investigate this renal impairment further by doing the albumin/creatinine ratio in urine and kidney ultrasound." "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, 32 years old. Last month I got married. After marriage started having sex daily. Now my penis tip inside foreskin has become blackish and showing black patches and it is itching too. Previously I did not face such kind of problem. Now for the past eight days, I have stopped having sex. Initially, it started itching after sex, but I ignored it. Before two days itching was terrible. Now I am feeling irritation inside penis while urinating and in relax mode too. My wife having white discharge problem for the past two months and she is on medication for that. We do not use any condom nor any lubricant. Since three days started using soap for washing my penis and surrounding areas and Clotrimazole dusting powder. I think it is dermatitis and fungal infection. Which medication should I use? Shall I visit any dermatologist or with the help of medication it will be curable? For how many days I should avoid having sex or I can have sex? ### Response: It very well looks like a fungal infection (attachment removed to protect patient identity), the source could be your partner\s genitalia as she is complaining of white per vaginal discharge for a long time. You both should consult a gynecologist soon and order swab testing for urself. The gynecologist would also start you guys on some antifungals. Treatment would be comprised of 15 days to a month depending on the severity. Do not make sexual connections till the period of asepsis." "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 fell on her right arm. A few days later she noticed a wound on the dorsum of the right arm but was not sure if it was from the fall. She did not care for it nor treat it. About a week later she started disinfecting and covering it but decided to visit a dermatologist as she was afraid it might be something else. Upon the looks of it, the doctor wanted a biopsy as she said it could be cancerous too. While waiting for the results the wound closed and decreased in size and signs of inflammation are gone.Today we got the results and it says \x80\x9d hypodermis and dermis with hyperkeratosis, severe dysplasia of the squamous epithelium, chronic inflammatory changes in the dermis\x80\x9d. Now I started reading to try and understand and what confuses me is the \x80\x9d severe dysplasia of squamous epithelium\x80\x9d is that carcinoma in situ? In some literature they differentiate the two in others they claim it is the same.I also came upon the fact that when there is an ulcer or inflammation reactive atypia and dysplasia may look the same hence the dysplasia may be from the inflammation. How is that determined? Is it a wound that is in the stages of healing or is it precancerous? What should be done in this case?Can we wait for one or two weeks to see if the crust will fall as in a healing wound and then perhaps have a biopsy on clean skin or should it be removed immediately with a suspicion that it might progress to cancer? If it should be removed what is the time frame? Should it be done immediately? I also talked to a surgeon friend who thinks if it is cut immediately it would cause a bigger wound which might be slow to heal again. I have attached the progression of the wound. ### Response: Hi. I have seen the attachment. (attachment removed to protect patient identity). This could be cancer. However, there is no harm in waiting for a week or 10 days and then perhaps go for an excision if it does not heal by then. Cutaneous SCC (squamous cell carcinoma) is usually not very aggressive and in most cases excision surgery with a margin of normal skin is curative." "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 chest discomfort and upper and lower back discomfort since yesterday. I passed stool twice today and the last one was cloudy. I am a 32-year-old male. My height is 5\6"" and I weigh about 77 kg. ### Response: I reviewed your history. Do you have a burning epigastric sensation? Difficulty in breathing? Do you have hypertension or diabetes? What is your last meal? All these significant history points are important to exclude any cardiac problem or any gastric problem." "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 lot of hair loss in the past year. Mostly on top of my head. Lost half my hair. My regular doctor did not find anything wrong with my blood test and said hair loss affects a lot of women and accept it. My new Naturopath thought my numbers seemed low and suggested iron and thyroid supplements. I need another opinion.I have tested positive for Hashimoto's, and I have ankylosing spondylitis. The dermatologist did scalp bio negative for inflammation. My TSH is 3.71, T4 is 99, T3 is 110, and FSH is 8.1. The values of zinc is 82, ferritin 36, Iron 93 and TIBC 315. Please help me know what I should do? ### Response: Hello. Hair loss in females can be due to many causes, most common being 1. Telogen effluvium stress-induced, due to illness, a diet with low protein intake, surgery, post-pregnancy, and mental stress. 2. Female pattern alopecia is genetic and hormone-mediated, runs in the family. 3. Diffuse alopecia areata is autoimmune condition usually associated with other autoimmune disorders like diabetes, thyroid disorders, and ulcerative colitis. 4." "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 having left shoulder pain and it really hurts. I have not had any injury in that shoulder. I had an injury on my right shoulder in the past where the bones had got separated. I had Ibuprofen once but it did not help. Please help. ### Response: Kindly let me know the full symptoms and their increasing or decreasing factors. Do you get pain while sleeping on the same side of the painful shoulder? Any specific movement that worsen it or any sound from inside the shoulder? You might have a rotator cuff tendinitis or mild impingement for which hot water fomentation and analgesic like tablet Ibuprofen 400 thrice a day for three days will help. If the pain does not improve, kindly consult your local orthopedic surgeon for further physical evaluation. 1. X-ray shoulder - AP (anteroposterior view).2. True scapular lateral.3. Ultrasound of shoulder." "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 taken 15 Regesterone tablets at once. Now having pain. Is there any side effect of this? ### Response: Norethisterone is progesterone-like a hormone, usually used to correct menstruation-related problems. It is never taken in such high doses. Taking such a high dose can cause a lot of unexpected side effects, including breast enlargement, pain in the chest, nausea, blurring of eyes, dizziness, and fainting, etc. One should not take such high doses. These type of medications should not be taken with out proper prescriptions." "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 11 months and 25 days old. He has some gas problem for last one week. And he is not eating properly, breastfeeding is done during night and one to two times in the afternoon. He does one potty a day, sometimes four potty, and watery potties also. He releases gas very often. Potty smells very bad sometimes. Can I give Enterogermina respules twice a day for two to three days?Our pediatric doctor prescribed it before two months and also before four months. He mostly has this type of gas problem. Is any medicine available for daily medication purpose to get rid of it?He is not gaining weight for about the last three months. He is always between 7.4 to 7.6 for the last four months. Pediatric suggest Hemsi-D drops twice a day. We are giving it for the last two months but not getting results. Kindly advice. ### Response: Hello. I got your concern. No need to give Entrogermina (Bacillus Clausii) and Hemsi-D is tonic, is not for weight gain. At this age, he is more active than before so weight gain will be slower. Monitor his weight regularly give home food and breastfeeding. Give Albendazole, and do one stool report. Indigestion. Stool routine report. Syrup Albendazole (200/5) 5 ml stat at night. Follow-up after a week." "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 13 year old daughter complained late yesterday afternoon of a really bad headache and blurred vision with numbness in her arm. I gave her Ibuprofen, she then vomited not long after and said she felt better. This morning she woke saying that it was even worse. So, I took her to the local emergency department. Within 5 minutes of arriving, she had a numb arm, and the right side of her face was also numb. She could not talk properly. They administered Panadeine (Paracetamol+Codeine) and sent her to wait for the doctor. The feeling in her face returned, and we were called in. The nurse practitioner asked her questions, and she was not able to answer them properly. She seemed confused and trying really hard to find the words. They diagnosed it as viral sinusitis, and I am concerned that is not right. Please help. ### Response: Hi. I am afraid to say that the clinical history of your daughter appears to be more than just viral sinusitis. Viral sinusitis is probably an incidental finding. Abrupt onset of headache, blurring of vision, difficulty in speaking, and numbness in face and arm is very characteristic of intracranial pathology, likely a vascular etiology. She must be examined by a neurologist and must undergo a brain imaging like MRI of the brain at the earliest. Please take her to a neurologist immediately for a physical examination. This appears to be a neurological emergency. I can confidently say that viral sinusitis is not the cause of the symptoms here. Please be in follow up and keep me updated about the clinical developments. Please write a review, as it would be of help 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 age is 25. Not married yet. I recently observed I am having cryptorchidism. In scan report, it is revealed that my left testis is in iliac fossa. Doctor told it should be removed from the body. My query is, should it be removed? Or it can be moved to scrotum? And, does single testis cause any problem to my fatherhood? Please help me clarify this. ### Response: I want to know the size of the testis. Also, what is the status of opposite testis? Normal and descended completely with normal size? As you are 25 and if your undescended testis is small and atrophy then better remove it. There will be no effect if you remove one testis if the other testis is normal. You can be a father and live normal life. Practically you are on one testis 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: For the past one year, I have been suffering a pain in the middle-upper wrist area where I could not support myself while getting up from the chair. I went to an orthopedist and was given some medication and wrist brace with metal support to stabilize the movement. The pain started declining for six months, but it did not go. I did an MRI for it, and another orthopedic surgeon recommended PRP injection with a month cast as he could see it as a partial TFCC. After the injection and one month cast, 15 sessions of physiotherapy, the pain persisted, so another MRI was done to check the progress.The MRI comparison showed the following:A comparison was made with the previous MRI.The previously noted and described reactive bone marrow edema in the medial corner of the proximal lunate is progressed and also showed mild diffuse edema involving the whole lunate bone. I would highly suggest further follow-up for the lunate bone to exclude the possibility of lunate bone avascular necrosis.Minimal reactive bone marrow edema noted in the triquetral bone.The stable appearance of the lunotriquetral ligament with preserved joint space.Stable central and ulnar side intrasubstance TFCC signals with no evidence of major TFCC tears.More prominent joint fluid, especially in the recess around the ulnar styloid process.Slightly more prominent ganglion cyst measuring 4 mm noted in the dorsal aspect of the wrist at the level of the radiocarpal joint.No lunate or perilunate dislocation.Normal flexor and extensor tendons.Intact carpal tunnel and median nerve.No bony fractures.I am concerned about the avascular necrosis as the doctor mentioned we should wait another three months then reconduct the MRI to identify the need for surgery ""bone drilling"" and another cast for six weeks.It is now ten months, and I am losing most of my right-hand function, and I do not want to reach the final stage of my lunate bone dying. Please advise if there are any potential solutions without surgery, and if the surgery is needed, what is the recommendation. ### Response: I have gone through your medical history in detail. It seems that you are having stage 2-3 avascular necrosis of lunate (Kienbock\s disease). I do not feel that you should wait as the disease progresses irreversibly. So it will not come back to normal by any means. The last stage needs bone excision and fusion of other bones. If you could get the latest x ray of the wrist, I can precisely tell you which surgery 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 am 11 weeks pregnant. I had unprotected sex with my husband. Is it safe to have sex during pregnancy? ### Response: How are you doing? Hope I have clarified your query. Do write back. All the best" "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 fever found only in children with RA or can adults get this symptom also? I have had a fever (low grade) for nine days, but enough to make me feel more horrible. My rheumatologist said only children get fever from RA. I am 45 years old and was diagnosed years ago but only started with symptoms a little over a year ago. I take Cimzia and Hydroxychloroquine. My doctor said not to do my injections until I am three days without a fever. ### Response: Hello. In rheumatoid arthritis, inflammation is present. So, mild fever can occur. But mostly in adults, fever is not as high-grade like that of a child." "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 is 70 years old. He has some dental problem and that is filled with pus and blood. Local dentist checked it, but the treatment does not provide complete solution. It occurs again and again. Please check the picture and tell me what it is. Is it cancerous? Is it curable? Please guide. ### Response: A localized radiograph of that region. Inadequate oral hygiene maintenance. Deep scaling and radiograph. Revert back with the radiograph to an endodontist 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 keep having episodes of presyncope. I have been to the local ER four times and was admitted on the last time. During the course of those four visits, I had all my basic blood work done which came out normal. I had a CT scan without contrast that was normal. An ultrasound of my carotid arteries that was normal, we checked for historic hypotension and the test did not show anything abnormal, and I was cleared by a cardiologist. So, it is not cardiac related. I was released from the hospital saying everything looked fine and was told to follow up with a neurologist. My question is, from a neurological standpoint, what neurological things could be causing my pre-syncopal episodes? Again CT scan without contrast was normal and I had a basic neurological exam from a regular doctor that said everything was fine. What could it be? I do not believe I am having seizures. ### Response: I read carefully your question and would explain that your symptoms could be related to different possible causes: Coming to this point, I would recommend performing further tests to investigate the possible causes: Hope to have been helpful" "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 is pregnant with twins of 22 weeks. She has kell antigens in her blood received from a transfusion when my first son is born. I did a blood test last week, and I also have a kell group present in my blood. Do my babies are safe? What can be done to help them? Are there any permanent effects that would inhibit them from having a healthy life? I am scared after knowing it. Please help me. ### Response: Hi. Kell blood group is a minor blood group system. ABO and Rh are called major blood group system. Kell antigen can be antigenic and can create a problem during a blood transfusion or else it may not create any problem. So there is no need for having a specific treatment. Whenever your child requires a blood transfusion, the blood bank should find the right blood suitable for your child as per cross match report. Please mention the blood group of your partner and first child. If the mother is Rh negative and the child is Rh positive, then there is a chance to have a hemolytic disease of a newborn, and it requires anti D." "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 eyes for three days. What could be the reason and what is to be done? I wear contact lenses, there is no swelling, and I work in front of the computer. ### Response: There can be two reasons for red eye in your case: 1. Allergy due to contact lenses. 2. Conjunctivitis. If you have changed the brand of contacts or you have just started wearing contacts, it is allergy. Then taper to three times a day for next five days and then to twice daily for next five, then stop. Olopatadine eye" "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 32 years old female. I had unprotected intercourse 14 days back with no ejaculation from his end. I took an I-pill the next day at 8 PM for precaution. Those were my infertile days as my last period occurred 36 days ago. It has been more than a month; still I have not got my periods. ### Response: Hi. Please wait for a week for your period to start. If it does not start by then, you will have to do urine pregnancy test to rule out pregnancy. Period could have been delayed due to stress. Another rare possibility is that of pregnancy. Though you mentioned the days you had sex as your infertile days, sometimes occasionally ovulation could be delayed making the days fertile. Still you had taken emergency pill (though it is highly effective in preventing pregnancy, protection offered is not absolute). So, there can be little chance of pregnancy which you need to rule out first. If you want to rule out pregnancy earlier, you can do blood beta-hCG test, negative result of which will rule out pregnancy. Other option as I told is to wait for a week. Period generally starts within a week of last dose of tablet. It will not induce period if you are pregnant." "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 marks on my stomach for the past six months. I am scared that they will spread and never go away. I consulted a dermatologist, and she said it is noncancerous. Do I need to get surgical treatment for this? I have been applying steroids for the last two months but no changes. Please help. ### Response: I have gone through your case. In my opinion, the dark marks on your stomach are post-inflammatory hyperpigmentation or lichen planus. It does not require surgical intervention at all. But it is important to know if other body areas are also involved. Did you have any other previous lesions in the same area? Did you ever have pustules or any itching or burning symptoms? If you do not have any symptoms, then relax, it may regress after some time. Regarding treatment steroid alone is also fine." "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 body irritation and irritation in the penile area. I have body weakness and pain in the back and waist. I have a mild fever and malaise. Please go through my reports. Suggest me a suitable treatment plan. I want to know an answer. Is it safe to take Ofloxacin 400 mg for a longer time? ### Response: I have gone through the attachment (attachment removed to protect patient identity). Based on the reports, it is probably prostatitis. If there is no improvement with a short course of antibiotics, then it can be chronic prostatitis or recurring prostatitis. In such cases, you can take a course of antibiotics orally for six weeks. You can take Ofloxacin orally for six weeks." "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 3 years old and has serious tooth decay. The doctor has suggested root canal treatment and that procedure will be done under general anesthesia. The whole procedure will take three hours of time as number of tooth is eight. My question is that is it safe to go through three hours of anesthesia for such a small kid? What is the risk factor? ### Response: Hello. As a parent, I can understand your nervousness. Only a gas mask placed on face and a balanced ratio of N2O (laughing gas) and oxygen release for a conscious sedation. For continues monitoring an anesthesiologist should be present all time during procedure. After procedure within a minute child will wake up from sedation. So, please do not worry about this. It is safe and used world wide for child procedure. If you do not want a long sitting then you could ask your dentist for two or more settings but it may be more expensive." "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 hair loss on my temples from wearing tight braids. The hair loss has been there for about 10 years and it has not gotten worse or anything. Is there a treatment or prescription I can try before going the hair transplant route? I am on Nuva ring for birth control. I tried Rogaine for four months but stopped for no real reason. I just did not see any results. I do not have any lab tests for this issue. ### Response: This is traction alopecia. It is a type of alopecia due to tight braids and hairstyles that put pressure over the roots. Unfortunately due to pressure effects scarring occur and there is no such topical cream or lotion available for regrowth of hair. You have told that you are using Rogaine (Minoxidil) without effects and so, the only option left is transplantation. You can also try PRP (platelet-rich plasma) in this area along with Minoxidil spray. It can give you good results." "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 40 years old male. I am suffering from fatty liver. I have high cholesterol, and thyroid level is also high. I am not taking any medication. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). You have a high cholesterol level which is the cause of the fatty liver rather than weight. A lipid-lowering medication is required. Regarding your thyroid, the hormone levels are within normal. There is no need to worry about them, unless if you have significant symptoms. I suggest a medication take Atorvastatin 10 mg tablet once daily before dinner and repeat the lipid profile after six weeks. Liver enzymes should be done after one month as a precaution" "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 aunt is suffering from urine infection. Doctor advised her to go for a biopsy to find out the cause. My concern is, is it safe to get a biopsy? ### Response: Hi. I understood your concern. But, biopsy is not recommended for any form urinary tract infection (UTI). Biopsy is a test of a small amount of mass which is usually done when cancer is suspected." "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 intercourse with my girlfriend and it slipped. Also, my girl just started her menstrual cycle at about the same time. After about two weeks later, I noted slight wetness at the tip of my penis and had some irritation. I took Azithromycin three tablets. The irritation stopped, but slight wetness at the penis tip remained. It is very slight wetness at the tip, as during the day every few hours we go to urinate and is only on the tip. The wetness can mainly be seen in the morning when I get up after eight hours of sleep. I got blood tests and VRDL is negative. I seek your advice on medication and what could this be? ### Response: The wetness you are experiencing may not be an infection, it could be due to friction-related issue after intercourse causing some inflammation. As you have already run the tests and taken a course of antibiotics, there is not much to worry about. Observe the discharge for a week if it gets foul-smelling or you develop a fever or an itch over the area you may have to see the doctor. In the mean time get a urine microscopy and routine test to rule out any urinary tract infection. Avoid nylon undergarments and use cotton ones instead. Use a condom always during intercourse and make sure you do not have an allergy to latex." "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: There are white patches on the inner side of my mouth. There is irritation while taking chilly and hot food. I am consuming a non-tobacco pan masala for six years. ### Response: Hi. You should stop taking pan masala. The white patches look like leukoplakia (attachment removed to protect patient identity). You should consult an oral surgeon and get evaluated. A biopsy can be done. For now, apply Kenacort ointment (Triamcinolone)." "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 40 year old mother is suffering from an unknown disease from the last three months. It may be chronic because she is not feeling well at all. She feels exhausted, dizzy and her digestion is poor. She looks very pale. Her USG report is attached herewith for your reference. Please suggest the diagnosis and treatment plan. ### Response: Hello. I have reviewed your attached report (attachment removed to protect patient identity). The report is suggestive of very bad news. I suggest you sit down somewhere before you read the following. Follow up with the test reports if you need any more information." "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: This has happened to me twice now. This feeling usually lasts for about five to 10 minutes. It felt like a knife was pushed into my stomach and was being twisted. The pain is at the center of my upper stomach. Other than frequent heart burn, I am or at least I feel, healthy. I am not taking any medication. I never had any medical issue in the past. It is just these two episodes hurt so bad, it got me worried. ### Response: Hello. As you mentioned, you have a stabbing pain in the upper abdomen, that lasts for five to 10 minutes" "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 burning sensation in the penis for the last 20 days. For the first seven days, I took Terbinafine tablet and Candid cream. The next seven days I took Oflomac 400, Afdura, and Urispas. But the burning sensation is still there. I also have a little bit of swelling in the glans penis for the past 17 days.Ultrasound report shows: Mild urinary bladder wall thickness with insignificant PVRU.Urine culture - No aerobic pyogenic grown.Urine R/E - Pus cells - 0-1, WBC/hpf, Epithelial - 0-1 Epi Cells/hpf.RBC - 4.36MCH - 33.6Monocytes - 10.4Basophils - 0.00MPV - 12.5Sugar / Creatinine - normal. ### Response: Hi. I have gone through your queries. You may have complicated UTI (urinary tract infection). You have to undergo another test. Send VB3 (voided bladder 3) urine or EPS for culture and sensitivity. EPS means expressed prostatic secretion. Voided bladder sample 3 means urine after prostatic massage. For all these purposes you need to visit the office of a urologist. Please do that as soon as possible and get all these tests done and get further treatment. You need clinical examination too for further treatment." "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 ask you about long-sightedness. ### Response: I have gone through your attachment (attachment removed to protect patient identity), you have myopic astigmatism in both with the left eye having high astigmatism. If you have any doubts about this prescription then please be more specific about it, I will do my best to help 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 dental student doing my internship. I am suffering from constipation from the past one week. I have a burning sensation in the anal region which I am unable to tolerate. Sometimes, there is severe itching and pain as well. I stay in the hostel. So, can you suggest me some tips to reduce the pain? ### Response: Hello.I appreciate you seeking help. Hope this helps you to get better soon" "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 glaucoma. Last week, I had an iris scan (USG). From the iris scan, are you able to diagnose whether it is an open angle, narrow-angle or closed angle? Currently, I am taking Timolol with Latanoprost eye drops. ### Response: From the scans (attachment removed to protect patient identity), your angles seem open. But we cannot diagnose glaucoma based on this investigation alone. Here is a list of investigation that you have to get done. After that only we can reach a conclusion" "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 33 year old male. I was diagnosed to have low vitamin D thrice over a span of 5 years. My current level is 17 ng/mL, which I understand is below normal. My lifestyle does not permit me to have enough sun exposure. Hence, I think that the supplements are the only option. Could you please suggest me the supplements? One gentleman from the medical fraternity suggested Calciferol sachet once a month for six months. Is it safe? I would not prefer the one with serious side effects. Please review the attached report and let me know your comments. ### Response: Hello. I have gone through your investigations (attachment removed to protect patient identity) and you definitely have a low vitamin D levels, which is very common. Lack of exposure to sunlight and sedentary lifestyle. Revert back after three months to an orthopaedician and traumatologist." "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 and my partner had sex yesterday. We were using condoms but he had changed the condom three times already. On the last one, he took it out because he felt like he needed to ejaculate but it went away after he had pulled out. He then asked me to masturbate him and he ejaculated a little not even a lot. So I realized that the tip of the condom was ripped. I was scared of what if his precum went inside me. He says no but most guys does not even feel when their fluid comes out. I was ovulating last week I do not know if I should take plan b pill or not? I am also scared of the side affects. ### Response: Hello. You are right to state that if the condom was torn, there may have been some precum gone inside the vagina and even that can make you pregnant unless your partner is absolutely sure about it. You can choose to take the emergency contraceptive pill within 72 hours of intercourse. It would cause bleeding in the next five to seven days and may be even scanty to heavy. That should prevent any implantation and prevent fertilization by increasing the tubal motility. If you are not sure then you may consider this method of contraception. Side effects may differ in different users from headache, dizziness to nausea and delayed periods in the next cycle with heavy flow. You may choose not to use it. Ideally speaking the chances are getting pregnant cannot be ascertained or quantified as you are not sure about the ejaculate. If you want you can wait till your next periods and if you miss them by seven days, then you can do a pregnancy test done to affirm or neglect the pregnancy. And if positive then safe termination by the medical method can be opted under specialist supervision." "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 burn on the roof of my mouth which created a blister. It got burst in my mouth after a couple of hours, and I am not sure what to do. The burn is painful, and I cannot even drink a cold drink. Previously, I got a third-degree burn on the roof of the mouth which got healed. I am taking medicines for epilepsy. ### Response: Did you consume anything hot that caused it? Since you had a blister which turned into an ulcer, it can be an aphthous ulcer which is recurrent or some other lesion. I would like to see the image of that area to guide you properly. For the time being, if you have pain, you can apply Dentogel (Choline salicylate and Lidocaine) before consuming food. It will give you relief. Avoid spicy foods. Avoid alcohol and tobacco products. But if it happens often, it is better to consult your nearby dentist." "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 19-year-old male. Currently, I have a dust allergy. Sometimes, I have a sinus problem. Can I develop latex allergy if I use yoga mat made up of natural rubber material? ### Response: Hi. Allergy is genetically determined, and it can be identified by doing allergy testing. We cannot say whether you can develop an allergy or not. Even a skin prick test or a blood allergy profile can tell you whether you are sensitized to that particular allergen, or not and it is not confirmatory. Regarding the current allergies you have, dust allergy is a misconception. Anybody will sneeze when they inhale dust or polluted air. That is not an allergy. Sinus problem occurs due to allergy. Most common allergies occur due to pollens, house dust mites, and molds. Molds play an important role in allergy and chronic sinusitis patients." "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 get a an opinion regarding the attached chest radiograph. I wish to know if there are any abnormalities like scarring. ### Response: I have gone through your attached chest radiograph (attachment removed to protect patient identity). Please find my observations below. The chest x-ray is essentially normal except for slightly prominent lung markings bilaterally and especially in right lower zone. However, there is no area of patchy opacity or scarring. Prominent lung markings might be associated with a mild cough or a hyperactive airway. It is also important to keep in mind that occasionally the lung markings might also appear prominently in a normal person when seeing a digital chest x-ray like the one sent by you. There is no fluid collection. The heart is normal in size. The bones are normal. The diaphragms are normal. I would like to know the reason for which the chest x-ray was taken, for more detailed discussion because symptoms of the patient are important while discussing a chest X-ray. Hope this answers your question." "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 16 years old. I look short. My parent\s height is 5\3 and 5\4 feet. How can I increase my height? ### Response: The actual height of an individual depends to a greater extent on genetic factors. If your body is designed genetically to grow to a certain height, it is difficult to change it. You can boost your height by indulging in physical activities like skipping and playing games like basketball. The usual growing period for males is between the age of 13 to 18 years. On considering your age, you can still indulge in physical activities. It can keep you healthy and may help in gaining height. Also eat lots of natural foods like raw vegetables, fruits, and sprouts. Try to maintain a healthy weight. It can make you look lean and fit." "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 baby has undergone hospitalization many times since birth. She has been placed with tracheostomy and gastrostomy tube due to which mobility of the baby is not possible.We are consulting with renowned ENT surgeons and pediatric doctors and we had been told that \\the aspiration can be due to poor co-ordination and tracheostomy tube placement for long period. Once decannulation is tolerated by baby, then the aspiration problem will not persist\\.Now they have told us to wait and concentrate on the baby\s weight gain. But we want to take a second opinion from you. So, please suggest proper steps to be taken from our end. ### Response: The aspiration of feeds is due to the presence of bulbar palsy and palate pharyngeal muscle incoordination. As per the doctor\s advise, try to improve the nutrition of the child and weight. Once the child gains a proper weight, then decannulation (removing tracheostomy tube) can be planned depending on the child\s fitness. Be in follow-up with the doctor. The child will be fine." "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 recently contracted genital herpes. I am having an outbreak, which scared me. I have blisters (vesicles) on the penis. I had a blood test done last week and this confirmed it. Please help me. ### Response: Hi. I have thoroughly reviewed your health query and can well establish the sensitivity of issues you have." "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: In your opinion, what it the best of the three to detect a sports hernia? A dynamic ultrasound, A 3T MRI or CT scan? ### Response: Hi. I think a 3T MRI scan will be the best modality to show a sports hernia as any small sprain or tear of the muscle can be seen best on MRI rather than USG or CT scan." "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 is taking Eptoin 100 thrice in a day. Just 13 days back she delivered a baby girl. Should I be worried about this when she is feeding the baby? ### Response: Hello. Phenytoin is secreted in breast milk but the most chance of baby getting affected are in the first three months of pregnancy. But in your case, she already delivered the baby and her seizures are well controlled on Eptoin 100 mg TDS. And I hope the baby is healthy born. In such case, she can continue Eptoin as she is taking. Also, can consider switching to other medication safely (as no risk of abortion or hypoxic injury to the baby) if she develops seizure during lactation. I suggest you meet neurologist in person with all the details." "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. Well, I had an STD. It was chlamydia, but it was cured. It was months ago. I recently had sexual relationships like two months ago, after that, I started getting a yellow discharge and I went to the doctor. They told me I had UTI. They gave me pills that I am taking and my period did not come for like one month and my period usually is not regular. And now that I am taking the pills, my period has not stopped bleeding for 13 days now, and usually, it lasts a week. But, I am worried because I do not know if it is the pills or not because it does not stop coming. ### Response: The pill is not the cause of bleeding. You said your cycles are not regular. So, what happens is because the cycle duration is long, there are chances of heavy bleeding. Unless you have confirmed that pregnancy was not there (abortion can cause too much bleeding), do a urine pregnancy test just to rule out it is not an abortion. If it is just heavy bleeding due to hormonal imbalance then take tablet Pause 500 mg three times a day for five 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: My partner and I had unprotected intercourse. Her periods were due 10 days back which she unfortunately missed and the pregnancy test came positive just two days back. We have decided to abort and she has taken Mifepristone by 10.30 am. I would like to know when is she supposed to take the Misoprostol. The name of the kit is Unwanted Kit. Please advice. ### Response: I have gone through your history and understand your concerns. Abortion pills can only be taken under the supervision of a gynecologist because they may cause severe bleeding, infection and retained products of conception. We usually give Misoprostol after 48 hours of taking Mifepristone. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. Regards" "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 I am so much addicted to masturbation. It has affected me both socially and emotionally. I have problems with my self-esteem and self-confidence. I find difficult to talk to girls every time, I think it is because of my low self-esteem. I do not have a girlfriend but I really want to have one. I really want to quit this habit. I have tried to quit several times but I end up crawling back and wank a lot more. Please help. ### Response: Hi. Doing masturbation three or four days a week is completely normal. Also, it is a myth that masturbation causes weakness and loss of energy. But if you are doing it daily, try to engage your mind with something else which you like. Such as watching tv shows, playing games, eating, listening to music, etc. You can try initially to not masturbate one day in a week. Then two days after two weeks, etc. If they are of milder intensity, please do a Google search for techniques like \Thought stopping\, and use any of the methods described, such as slapping thigh, yelling stop, snapping rubber band, etc. If thoughts are extremely disturbing, I would suggest you please visit a local psychiatrist who can give you some medication for a couple of months which will help prevent excessive thoughts." "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 it possible for implantation to take place after 14 days of conception? I had flow on the exact date of my period for three days, but it was lighter. I used three sanitary pads. But next month I missed my period. I do not have any pregnancy symptoms. My TSH is 10.5. Kindly help. ### Response: Usually, it would take seven to ten days before implantation happens. The fertilized egg (conception day) will have to develop first into blastocyst stage and travel down to implantation site. The actual duration cannot be exact, but it may extend to two to four days more. So the answer is yes, it is possible that the implantation may happen 14 days after conception. In your case, it may not automatically mean implantation since you also have elevated TSH which can mess up with your hormones. I suggest you take a pregnancy test and if it is negative, then the period delay is just secondary to thyroid hormones." "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\s age is 65 years. 15 days back she got brain paralysis on both sides (autoimmune encephalitis). Now the doctor is saying treatment is over. Now take her to home and just give nursing to her. Still feeding pipe is there ### Response: Your concerns seem genuine. There are a lot of neurological conditions, medical conditions which do not get completely improved. Either they remain as such with a deficit or may have some clinical improvement with time. It is the limitations of medical science. But supportive care has to be continued for the survival of the patients. Feeding pipe for food, tracheostomy for airway protection, urinary catheter or diaper, regular nursing care, regular physiotherapy. If the patient is bed-bound, then give DVT prophylaxis. It is a little tough for a person (who has never seen or handled such) to handle these things. Luckily now a days there are professionals who can provide such care at home care or some rehabilitation centers. You can try to search out for them." "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: This is an emergency. I underwent a medical abortion at eight weeks stage and everything was going fine but suddenly since yesterday, I have been bleeding very very heavily. It happens suddenly and there are large clots as well that passed out. I took the medical pills two weeks back. Please can you help me out? ### Response: Hello. If you are having heavy bleeding then probably your abortion was not complete. You should immediately get an ultrasound scan to see if the uterus is empty or not. If the uterus is not empty then you have to get it resolved by removal of products of conception by using instruments. If you will neglect this it may lead to sepsis and adverse effects on your health." "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 56 years old, diabetic with high blood pressure. In the last four years, when I am sleeping I have multiples erections, dreams and not a calm night of sleep. My wife always complains and we argue because during day time I have no desires and it is very hard to have an erection and this makes more friction between us. Sometimes we take a month to have intercourse. We have been together for almost 22 years. The problem of erection during sleep time started with fewer times and now it is getting worse sometimes six times during a night. I really need some help to have a calm night. What do you suggest?I am currently taking medications for diabetes and high blood pressure along with Insulin and Baby Aspirin. ### Response: Firstly, you will need good control of your sugar levels. It will help with the erection problem and sleep. Start a good exercise regimen and lose some weight. Also search on the internet for Kegel\s exercises and do them daily. It will help strengthen the muscles at the base of the penis and help with good erections. Also, start a good multivitamin with a lot of B-complex group of vitamins. Finally, for a few times, you can try taking Sildenafil or Tadalafil to help with getting erections. For sleeping, you should try taking something harmless initially like Melatonin supplements, or you can try to take something which will give you sleep and also help with your stress such as Mirtazapine 7.5 or Vilazodone 20 mg which do not have any sexual side effects." "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 22 years old. My problem is that I have been suffering from depression and anxiety for the past one year. Without knowing it, I consulted a cardiologist for chest pain and anxiety. They prescribed me Pexep-CR 25, Lonazep 0.25 and Betacap. I took those medicines regularly for 1.5 years and I felt good. When I stopped the medicines, I felt chest pain and anxiety. Again, I am feeling depressed and I think that I will die because of heart attack. Again, I consulted the cardiologist and started taking the medicines regularly. After 3 hours of medicine, I feel a burning sensation, sleepy and body pain. I had a habit of masturbation before depression and I used to masturbate regularly to get rid of nightfall. Is it safe to take Bupropion? ### Response: Hi. It seems that you had a relapse of anxiety symptoms after the first time you stopped your medications. Relapses are more severe. They need a higher dose and a much longer duration for recovery. Keeping in view your sexual habits, it is preferable for you to start with Desvenlafaxine 50 mg, which will help in reducing anxiety symptoms and will not affect your sexual functioning as well. Bupropion is a good" "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 just wondering if retainers can be used to realign teeth? I have had braces off for a month and have worn mine religiously but it feels like my teeth are relapsing a little bit despite this. Is this possible? Namely, my teeth before braces were not aligned properly, had spaces, and my ortho had trouble aligning them, as they are straight but going across diagonally, but we worked on this and got it better.When my braces came off, they felt straight, I was really happy. Now, it seems like my teeth are going diagonally and not aligned anymore and is causing anxiety. I want my teeth to come straight down and not be slanted. Also, can my two front teeth be improved by filing? I have already visited my ortho once to have my essix fixed, and my Hawley\s was severely tightened during that time, so I feel like contacting them just a couple of weeks later again. ### Response: Once the braces are removed, you have to wear the retainers for at least eight months. You have to wear them literally all the time. Else there are high chances for relapse. And yes your front teeth can be filled using tooth colored composite restoration. You just have to visit the dentist every 30- 45 days to lightly activate the retainer. Please be careful regarding this. If the teeth relapse beyond an extent, then you probably will have to restart the treatment all over again. 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: My mother aged 75 years has TSH 8.12. She has adrenalism and takes Hisone 12 mg daily. Should she be administered medicine for hypothyroidism? ### Response: These both conditions can be the manifestation of the same underlying process (autoimmune). If your mother is symptomatic (weakness," "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 periods were late by six days. I had taken five pregnancy tests and all were negative. I have a dull ache in my lower back and cramps on my right side. Now, I am bleeding bright red and the flow is mild. Could this be a miscarriage or is it my normal period? I had a few pregnancy symptoms before this, but they are gone now. I still have sore breasts. My period is never late. Currently, I am taking Suboxone. ### Response: Since the five tests were negative and you have started bleeding you are not pregnant. Because, urine pregnancy test can be positive for a variable period. It can be positive from the 10th day to two months, even after an abortion. So, you are not pregnant. Symptoms may be due to hormonal changes. As the periods were delayed, you had the excitement of getting pregnant and the symptoms may be due to this also. It was just a delayed menses. There are many reasons for delayed menses. Do not take much stress. Revert back with the sonography report to 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 stepped on a rusty nail in the garage two days ago. The area around it is somewhat red and very very sore. I cannot apply any pressure. I had my tetanus and I am on antibiotics. I had an X-ray with no foreign object found. Then I had a couple MRI scans done in the area. I would like to know what the diagnosis is. ### Response: Your MRI foot shows a considerable amount of localized subcutaneous edema. The visualized plantar tendons do not show any signs of inflammation. No obvious retained foreign body is seen. However, a good antiseptic care is recommended. Keep a check on any discharge from the wound as foot injuries tend to easily get infected. Once the swelling reduces the wound can be evaluated on ultrasound to see residual edema or any collection after a week ideally" "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: One week ago, I started feeling pain in the mouth in the left side last tooth. The pain was so severe that I was unable to open mouth and also ulcer over that area was not visible to the doctor (GP). He advised me to take Becosules, Rubifol, and Zocon DT for five days. I started taking those medicines, but I started feeling pain in the full left side teeth and jaw that extends towards the ear. After searching over the net I came to know that it is a swelling of gum and something called gingivitis which may be the cause of my pain. After I have gone to the dentist, she advised me the following medicines: Augmentin 625 mg TDS for five days, Metrogyl 400 mg TDS for five days, Chymoral forte bd for five days, Zerodol P BD for five days, Rantac 150 mg od for five days.I asked the dentist to reduce so much of medicine but she told me that you cannot modulate the antibiotics as it is a course. Plus she told me that your affected teeth i.e beneath the swollen gum needs to be surgically removed once you get back to normal. I started taking these medicines leaving the above medicine advised by GP except Becosules.Now my queries are: After one day, I started vomiting. And minor flecks of blood were also visible in the vomit. Now I want to know whether I am taking the right medicines and the right dosage? Whether any of the above medicines can be removed? Since I had gone to the dentist after full five days of ulcer medicines my jaw was not opening that time, but from the next day I started reliving pain and gradually my jaw also started working and helps in chewing foods. So can I reduce the dosage of the above medicines and leave Zerodol as I think it is a pain killer and I do not have so much pain now?I am scared of hearing surgical removal of my teeth, so whether it is necessary to get it removed? Will I get back to normalcy after medicine? Whether removal is actually required in case of gingivitis? Any other suggestions? ### Response: I am sorry to hear about your problems. The symptoms and line of treatment you have described points to be normal. Though you can take painkillers as per your requirement, I advise you to not to stop the antacid (Rabeprazole and Domperidone in many cases) as they may help you prevent conditions like nausea and vomiting. The blood appearing is alarming, and the source of bleeding should be figured out. Notice if the blood is coming out along with pus of the tooth or not. You may consult or call me in this regard. It would be better if you send me a picture of the tooth and gums in questions to pinpoint the condition. It is not always necessary to go for surgical procedures." "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 numbness in my toes for approximately three months. Sometimes there is a little bit of tingling along with it. It has not affected the activity or my way of life. I also have backache and a lot of degeneration in the back. I am on Levothyroxine, Rouvostatin, and Aspirin. Occasionally I take Xanax for anxiety.Also, I had ankle surgery before four months on my right ankle, and this is the second surgery on that ankle. The numbness and tingling started just around that time. I also drank wine. I can drink anywhere from two to four glasses a day, but there have been many times when I go without alcohol for months at a time. I am getting very anxious about this, and I understand there are many many causes for numbness and tingling and that it can be very progressive. I would like to know if my liver enzymes are normal, is it possible to have alcohol neuropathy? ### Response: Hello. Alcoholic neuropathy is bilateral, and if you have on both legs, you need to stop" "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: How common is it to develop a blood clot or PE with no underlying clotting disorder, surgery, not on birth control, etc.? Like can a PE happen out of nowhere? Or is there always a culprit? ### Response: Hello. Usually, there is always an underlying risk factor for the development of deep vein thrombosis. Advanced age, genetic conditions, smoking, obesity, trauma, surgery, etc., are some of the risk factors. The genetic disease includes protein C deficiency, protein S deficiency, prothrombin gene mutation, etc. So it can be ruled out by full coagulation profile testing. Usually, there is always some risk factor present for PE." "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 is 38 years old. She had an abortion in 2012 around her six months of pregnancy due to the defects of diabetics. From that time onwards she has not taken any treatment for diabetics.As per her report, pregnancy starts from 18th February. We have started Insulin Eglucent three times and Levemir sleeping time as per doctor\s advice. Is there any problem to the baby or my wife? We are strictly following the diet and taking insulin with regular blood check-up (four times daily). ### Response: Hi. From your history, I gather that you have been taking insulin from early pregnancy and closely following it. If your blood sugar levels are well controlled with diet, exercise, and insulin, then there is nothing to worry about. There is no specific and extra chance for the baby to have any anomalies. Baby will have all the features of a normal pregnancy. The pregnancy complications rate is same as any other normal pregnancy. You do not need to worry. This is just for your satisfaction. For every lady with diabetes or previous history so, is tested with this. Do not worry your wife and baby are both doing fine. 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 a 45-year-old female. I was treated with intravenous Cortisone injection therapy for a week for having acute demyelinating symptoms for almost two months that appeared together with a new lesion at the cerebellum area of my brain. There had been three other there, supposedly migraine type. Lumbar showed oligoclonal zones both in the blood and spinal cord. My problem is that since then, and even if the cerebellum lesion has disappeared, I still experience symptoms not as acute as it had been during the episode, but quite annoying to disturb my everyday life.I have pain in my left arm and joints, left leg, and joints of both of my legs. I also have back pain and tremor but not always. I get tired very easily. But tired does not mean tired. It means that I start having problems with my balance in the left leg, tingling, eye sight problem, cannot cope with too much noise, argues and fights with family gets me worse. Nobody understands there is something going on. The last neurologist I saw said that it is a matter of stress so he suggested to consult a psychiatrist. My psychiatrist says stress does not cause this sort of pains as I already get a depression treatment for seven years. However, let me say they are gonna get me crazy with all this. Do you have any idea? How I might proceed? ### Response: Hello. I read carefully your question and would explain that your symptoms could be related to chronic lesions of multiple sclerosis MS (sometimes there is no total improvement after steroid therapy). Anyway, I would recommend starting Gabapentin for chronic pain or switch from Zoloft to Duloxetine which is better for chronic pain. I would also recommend performing a new brain and spine MRI (magnetic resonance imaging) in order to exclude possible new lesions. It is also necessary to check thyroid hormone levels for possible hormonal imbalance and vitamin D plasma levels for possible deficiency. 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: My brother having a problem. When he was 3 years old he underwent an operation in the bladder. I have attached all the summary for your reference. Now he is 25 years old, still, he cannot control the urine for sometimes. Could you please suggest what we can do for this? Please help. ### Response: Hi. I have read through your query in detail. Please find my observations below. Your brother was treated for a tethered cord with a lipoma in close proximity to the cord at the sacral region. It means that he had a fat-containing tumor in the lower end of the spinal cord. These are birth and developmental problems that cannot be completely treated. At 25 years of age, he can get another MRI (magnetic resonance imaging) scan of lower back done and discuss it with a neurosurgeon if there is any persisting area where there is pressure on the spinal cord or the nerves. Usually, if any pressure effect on the nerves or cord is present now then they can think of releasing the pressure and this might improve his symptoms. If his condition is not possible to be treated after discussing and doing an MRI scan then the only way is to pass urine at regular intervals and avoiding an over distended bladder." "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 50 year old. My height is 179 cm and weight 85 kg. Recently, I have tested for free testosterone and vitamin D. Both are on lower side. I am also taking Thyronorm 75 mg since last 7-8 years. I have attached my medical file of past health issues. After 7 PM, I feel very low and confused. My sex drive has also been affected. I am doing exercise for about 1 to 1.5 hours daily, and still I am gaining weight. I have also persisting heel pain. I am partially bald. 14 years ago TRT was done. The report and medication are attached. My doctor has prescribed Arachitol 6 lakhs units once a month for three months. Please suggest some medicine for my condition. I would also like to know whether the TRT is required again. ### Response: Well, for your low testosterone and low vitamin D you need to take supplements. For vitamin D, I recommend Cholecalciferol sachets or tablets 60000 units weekly once for three months. Also take Calcium supplements every night. For testosterone, you need to get Testosterone injections once in 15 days. But neither low vitamin D nor low testosterone can explain your forgetfulness or confusion. It needs further evaluation to know the cause of forgetfulness or confusion. In that regard, I recommend the following tests to you. Serum vitamin B12, serum sodium, and serum cortisol (8 AM and 4 PM). Regarding your inability to lose weight, you need to increase the intensity of your exercise and go on a low-calorie diet." "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 painless red bump on my scrotum. I am uploading some pictures. Kindly let me know what this could be. ### Response: I have read your query and examined your picture (attachment removed to protect patient identity). From your description and picture, it seems like you have steatocystoma multiplex (a type of sebaceous cyst) or molluscum contagiosum. The pictures do not give me an exact idea because a sebaceous cyst is soft in consistency whereas molluscum is hard. If it is a sebaceous cyst, you should get it removed. A surgical excision by needling or radio frequency cautery is the treatment of choice. Molluscum contagiosum is caused by a virus and this lesion presents with a central umbilication, a depression similar to that of the navel. A white body is present in the bump. It is a contagious and sexually transmitted infection which can spread and form new lesions. The treatment plan will be needling to extrude the material inside and TCA cautery" "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: Symptoms are heart palpitation and continuous nonstop neck crack that pains my cervical spine also. I randomly have episodes of heart palpitations, one time I jumped 3 feet out of my bed suddenly being shocked by a hard fast-beating heart palpitation that lasted for seven seconds, that was scary, it felt my heart was going to burst out of my chest and the beat reached my upper chest to my throat and neck, it is not a heartbeat that we get from playing sports, it was a weird episode of heart beats. After that incident in months, maybe a year I then got an episode of heart palpitations like that intensity but this time it lasted for 15 minutes going and coming with sweat only. Then after that, I just get them randomly while sleeping and awake for 1 or 2 seconds and now mostly when I pee standing up it also appears for a quick second and goes.I did CT scan and sonar heart tests and all doctors said my heart is fine, I also wore a Holter scan for 24 hours and still results say my heart is normal, but the issue here while doing the tests and wearing the 24-hour Holter I surprisingly had no heart palpitations. I am really worried, can you educate me on what test I have to do.When I shower I get tired a bit and have heartbeats that are not palpitations, they are just heart beating as if I am playing a sport, soccer or something, I get that quick beats when I pee, when I pray going on floor, when I walk up one simple set of stairs, and right before closing my eyes and full crashing to sleep I then suddenly wakeup having heartbeats. It is like brain telling me not to sleep as soon as I close my eyes falling into sleep it starts again, when I laugh hard it beats like I am playing sports, every small activity causes my heart to beat normal but the heartbeat speed is like when I am playing sports and running. And as I mentioned, sometimes I get quick palpitations that are different than fast heartbeats, it is like my heart is racing to get out of throat for second or so.Another really really main concern I am so worried about is that in my chest, in my lungs I feel a window of 1 to 3 seconds of tingly or bubbly feeling that reaches my throat, it has no pain and it is not heartburn, and it appears always, like every 1 minute or sometimes every 5 or 10 minutes or more and sometimes for seconds. It is a feeling of very small lighting or like a line that is slowly traveling from my chest up to my throat then back down to the chest and gives me sometimes a closed throat or cry throat feeling for a split second then goes back down to the chest. What should I do? I have incredible stress and anxiety, I sleep at 10 AM, sometimes 11 AM and wake up by 6 PM and cycle repeats. I think a lot and am afraid of what will happen. ### Response: Hello. Listening to your symptoms, the possibility which we need to rule out is of cardiac arrhythmia like atrial fibrillation or PSVT. They occur intermittently so may not be picked up on Holter monitoring as you did not have those symptoms during Holter monitoring. It is better if you can attach your ECG and other reports if you have. Most of the cases these are not life threatening although it may give uncomfortable sensations. So, firstly calm yourself and stop thinking anything bad. So, if you are having these symptoms on daily basis now, I would advise you go repeat Holter or even 48 hour Holter or may need long term monitors like implantable loop recorder if Holter is not successful. If it picks then it is fine otherwise you may need elctrophysiological studies which are invasive tests and should be a last option. So, at present, please attach your reports and go for repeat Holter preferably 48 hours. And if this not successful again then we can think of other options." "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 35 years old male. I had an episode of psychosis for the first time four months ago and is treated with Risperidone and Escitalopram. For how long should I stay on the treatment? ### Response: However, Escitalopram is given for depression. So if at present you do not have any depressive symptoms you can discontinue Escitalopram. However, Risperidone should be continued at least for a year in the first episode of psychosis. Suppose if you get one more episode of psychosis, then I will recommend continuing Risperidone for a lifetime. Please update me about the psychotic events you had and the dose of Risperidone." "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 at my first pregnancy, and I am seven months pregnant. I have been anemic all of my life, and I am still struggling to get my iron levels up. When I went to the hospitals for my checkups, they have not said anything about my anemia.I was wondering should I request a C- section or can I have e normal delivery? Because I am scared that will I bleed out during labor if I do have natural as this happened to my mom when she was pregnant. I would like to know what would be best for the baby during birth. ### Response: Hello. You still have three months to go till delivery. This is enough time to diagnose the reason for your anemia and also to build up your hemoglobin levels. Talk to your obstetrician about it. Blood loss in C- section and normal delivery are almost the same. So any mode of delivery is equally risky for anemia. You should do a deworming. Look for your blood iron stores and test for thalassemia. Sometimes marrow biopsy is needed too. Your anemia needs diagnosis for better treatment." "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 prescribed with tablet Fersolate, which is not available, for the low HB levels. I am attaching the reports. Can I replace it with Orofer XT? If yes, please tell the dosage. ### Response: Hi. Yes, you can replace it with Orofer XT (Folic acid and Ferrous Ascorbate). Initially, you can take this tablet two times a day. Then after a few days, you can replace it with a once daily dose. Take this tablet after taking food." "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: l have been taking Neurocare plus OD for the past one month but the pain on my left leg is just too much. Which neuropain killer can I take to ease the pain? ### Response: I understand your concern and would recommend taking Gabapentin or Pregabalin to help improve your situation. It is also necessary taking Vitamin B12 injection in order to help correct vitamin B12 deficiency, which is the main cause of your complaints." "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 back, after a routine blood test I was diagnosed with fatty liver due to raised liver enzymes ALT 53 ALP 66 and GGT188. I later underwent a liver scan and the conclusion was Child A Cirrhosis-possibly secondary to NASH. Advised to lose weight with no medication prescribed. Yesterday, I underwent a FibroTouch scan and result showed liver stiffness of 19.9 kPa and UAP(dB/m) of 279. Meanwhile, for the past one year I have been taking daily supplements of Milk Thistle, Gluthathione and lately Magnesium Bisglycinate, (for cramps and muscle weakness), and Vitamin E. I was also once told that I may have high inflammation due to autoimmune-related problem possibly due to a weak gut (leaky gut). All not really validated through any test. Apart from deciding to go aggressive with my weight loss initiative and eating more plant based food, I am at a loss as to what to do to reverse the stage 4 fibrosis from worsening. I am going plant based because of the testimonies of those who adopted the diet lifestyle and had a change for the better in their conditions. My family is worried that I may not have the chance to live long. I am almost 62 now. What do you advice that I should do to recover from this? ### Response: Hi. You have investigated by fibroscan report (attachment removed to protect patient identity). The 19 kpa is suggestive of grade 4 fibrosis in liver. The fibrosis can from due to chronic inflammation. The NASH is form of hepatitis due to overweight. So, fibrosis can develop in NASH as well and so liver can be more stiff. However, your high kpa and UAP are suggestive of early cirrhosis change. So, you need to lose weight first. The Ursodeoxycholic acid can be prescribed for your condition. You need to be monitored regularly by gastroenterologist. No further aggressive treatment needed just now. I suggest you consult gastroenterologist for detailed evaluation and do regular follow up." "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: Yesterday, I took the blood test because of excess gas release and in that my red blood cells showed some impressions. Please help. I have attached my report. I am afraid and shivering. Is there any problem in my blood test? ### Response: Your CBC report is normal and does not suggest a specific abnormality. The red blood cell count is within the limit so do not worry about that. In the attached report, serum amylase and lipase are elevated (attachment removed to protect patient identity). So pancreas inflammation has to be ruled out. For that, you need to investigate with ultrasonography of the abdomen. Meanwhile, symptomatic management has to be done. For stomach pain, Rabeprazole antacid has to be prescribed. For gas problem Simethicone containing tablet or syrup has to be prescribed. After one week, repeat your serum B12 level. It is water soluble vitamin, so mostly it will bring down to the normal level after a few days. I suggest you consult a nearby physician for detailed 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 have pain in the right knee for two months. While using a staircase, it used to pain initially whenever I starting walking or running. The pain is exactly on the front side of the knee and just below the left side of the kneecap. I started jogging a year back and continued for six months, during jogging or walking I was feeling a cracking sound but I thought it was normal. Recently, my weight started increasing so again I started jogging and gym workouts. In the gym, I was doing leg workouts like squats, leg extension, leg press, and deadlift. Knee pain started and I realized I was doing squats and deadlift in the wrong form. Later, I corrected and started doing workouts in proper form and pain is slightly reduced. I have consulted a doctor regarding this and he gave me some medicine and said it as early osteoarthritis. Kindly advise me whether I can continue my workouts, is this issue curable, how to manage this. Medicines which I am taking now is Fixit 300 (Nizatidine 300 mg), Loflam (Aceclofenac 100 mg), Joint free triple action (Glucosamine, Chondroitin, and MSM). ### Response: Your X-rays are normal for age (attachment removed to protect patient identity). Physiotherapy to do like closed chain exercises, leg presses with knee not bending more than 30 degrees, patellar taping, core strengthening exercises, gluteal clam shells, hamstring stretches, VMO (vastus medialis) exercise, etc. Take NSAID like Aceclofenac but I see no role of Glucosamine combination tablets. The process of relief takes a long time so do not get frustrated and believe me this is a curable condition but effort has to be yours." "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 severe rib pain since this morning and it hurts when I stand up straight or when I move or lay down. I tried putting a heating pad and ice pack on it and did not do anything. I feel extreme discomfort, cannot take deep breathes, and feel sharp stabbing pain once in a while. ### Response: Hello. There are many conditions where we can get chest pain along with ribs pain. I would like to ask a few questions. So pain in that region is costochon" "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 teenager. My problem is that I am having pain below my stomach and it is happening on a daily basis. I thought maybe it is happening because of masturbation. So, I stopped doing it but it is still paining. I am not taking any medication. ### Response: The history you have provided is not sufficient to conclude the cause of your problem. But I will try to give some solution. Is the pain in the scrotum or in the inguinal area? Is it in the suprapubic region? If you have pain in the right inguinal, there is a possibility of ureteric colic or appendicitis or ilium or cecal pain. If you have pain in the center suprapubic, it is most commonly bladder infection. Sometimes pain around other organs may radiate here. If you have pain in the left inguinal region, it may be colitis, large bowel infection, obstruction or left ureteric colic etc. Scrotal pain like orchitis, epididymitis, torsion, varicocele etc. Consult your general surgeon and get one ultrasound of the abdomen and get treated accordingly" "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 developed some sort of a rash near the bikini line (on the inner left side of the thigh). It is extremely itchy and uncomfortable. Could you please tell me what it is. The image is attached. ### Response: Hi. I have gone through your complaints and reviewed the attached photograph (attachment removed to protect patient identity). It is tinea which is a superficial fungal infection of the skin. You need to take oral and topical antifungals. If I was your treating doctor I would recommend you to take tablet Terbinafine (tablet Sebifin) 250 mg twice daily and apply Luliconazole cream (Lulifin cream) on the affected area once daily. For itching, take tablet Levocetirizine 5 mg twice daily. These need to be continued for four weeks." "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 aunt is 31 years old and had her uterus removed 11 years ago. From then she never had the periods nor any discharge. It was all alright until a month ago. She had suddenly started experiencing waterlike vaginal discharge which is little smelly, and it hurts in stomach sometimes. When she is sleeping or lying on a bed, nothing happens but when she is standing the discharge happens. Please help. ### Response: Hi. If there were few more facts about your aunt regarding the indication for uterus removal, any follow-ups, diabetic status, her sexual life, etc., would have been helpful. At the age of 31 years, the most probable cause is an infection. I put forth the possibilities and their solutions below. Hope I have clarified your query, do write back if there are any more queries. All the best." "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 30 years old. I cross dress from the age of 15. I have erections and ejaculations only while sleeping upside down on the bed. Unlike other guys, it does not happen when standing. I also have a significant breast growth as they are quite visible. I suspect that I am a transwoman, though not a transgender. How to know if I am a transwoman? I have an attraction towards men and my erections only happen imagining men. I have not had sex with a man anytime though. I tried it once with a woman, but in vain. During oral sex with a woman, I had natural erections though. Please advise. ### Response: I read your query and understand your concerns. I will be glad to help you further if required" "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 developed intermittent exotropia in late adulthood. I am 29 years old and this started about two years now. Should I concern about it? ### Response: As you have described you have started intermittent exotropia at later age right. See that is called strabismus in medical terminology usually we can treat it if it is by birth. But in your case situation is different. So there can be some neurological issues which is leading to exotropia. So my advice is you should consult strabismologist as well as neurologist also just to rule out the cause of exotropia. First you should consult strabismologist and then neurologist. So we can fine out the reason for it and depending upon that you can plan your treatment. Can be idiopathic. Can be neurological. Complete ophthalmic assessment. Cranial nerve palsy. Squint. As described above. After 1 week." "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 girl aged 18 years and I have been married for a year. I have severe dysmenorrhea. I am not getting pregnant but I do not take contraceptives or use protection. Why? ### Response: Hello. For your gynecological problem detail evaluation should be done. For that per speculum and pelvic examination done and transvaginal USG should be done. In USG report if any underlying cause present than it will be clear like for example fibroid, endometriosis, ovarian cause, etc." "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 circumcision two months ago and still have swelling around my penis. I did a CBC and urine test last week, and all came back normal. The doctor last month said all the incision have healed. Will swelling last this long? How long will it take for the swelling to disappear? Should I be concerned? Will night erections affect healing? ### Response: The healing looks fine (attachment removed to protect patient identity). The swelling is mostly an extra skin that is bunching up in a non-erect position. When you have an erection, it might be less prominent. If all excess skin were removed, sometimes there would be pain during erection due to the stretching of the skin. I think things will be fine in about another month. Night erections will not affect healing." "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 prolonged constipation almost from childhood. Now I am 26. I am afraid of getting hemorrhoids due to this. I have tried everything starting from warm water to Eno, Digene, milk of magnesia and Isabgol. Now, all these do not work effectively on me. My diet is also normal. I do not eat junk food much. Please help me. ### Response: Hello. You are using milk of magnesia since a long time which is not advisable as it can lead to laxative abuse and dependency. As your constipation is present since a long time, the organic cause should be ruled out, if present. For this, USG abdomen scan should be done. If needed, colonoscopy also can be planned." "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 is 75 years old and he is overweight.My father stays with my relatives in a remote place.Last night when he was sleeping outside, the weather was cold due to rain and the fan was on.He had felt cold at midnight and when he woke up, they found his right hand and leg were not working properly.He can feel everything, he can also move both legs and hands, but feels lack of power in the right hand and leg.He is not able to walk and not able to drink water.They reside in a place where there is no neurologist.They visited an ayurvedic doctor this morning and he has given some ayurvedic medicne and nurokind plus injection 2mL once daily. Please suggest the right treatment. ### Response: Best thing is to get a CT scan head done and share the reports as soon as possible. Delay should be avoided. Also provide the below details: 1) Is he a smoker? 2) Does he have diabetes, high blood pressure or heart disease? 3) How many hours have passed since he developed this weakness? Revert back to a neurologist online for further follow up" "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 visited the doctors as I was unable to catch my breath and was feeling strange. The doctor performed a breath test which came back fine. I had an ECG and the doctor said that my ECG showed possible left ventricle enlargement. He then asked me to perform different breathing while he checked me with a stethoscope. He said he could hear no blockages or other problems and that my blood pressure was slightly raised, usually, it is normal. He said that I was suffering from anxiety and had a panic attack. I have suffered from anxiety all my life. When I asked about the enlargement he said my ECG was borderline. I am now worrying excessively about this and whether to have another ECG just to be on the safe side. I am fit, eat a healthy diet and have not drunk since I was in my 20s. I work out regularly since the age of 25 and I am now 40. I had this ECG abroad as I was working away so I am wondering whether to have it checked back home. I sometimes feel like I cannot take deep breaths when I am stressed, but I do not feel this while exercising. I have a very tight left shoulder and my left rib is sore near the top of my left breast near the armpit, like a muscle aches that comes and goes. I am quite an anxious person, worrying about health issues particularly after losing my mother to breast cancer. ### Response: Did you ever have chest pain or symptoms of excessive sweating with pain? If your ECG is fine, then there are very fewer chances of you having a cardiac pathology. Left ventricular hypertrophy develops after prolonged hypertension in individuals, but as you have said you have normal blood pressure so I do not think LVH should be there. To relieve your anxiety you can undergo a stress echo or TMT (treadmill test) to rule out inducible angina. Also, you said you do not develop symptoms during exercise so I do not think stress echo or TMT will come out positive." "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 broke my ankle playing soccer. I went to the hospital right away and the doctors set me up and place me in a cast and told me I will have to do surgery. Six days later they told me that the next available surgery date is in the next three weeks. Is it fine to wait that long to do the surgery? Also, when I am lying down I am not in any pain, only numbness in a big toe but as soon as I stand up I start feeling an intense burning pain even though there is no weight on the feet. ### Response: Hello. I am thinking that the ankle may have been too swollen to operate and that is why they delayed the surgery to allow the swelling to go down which can take a week to 10 days. Did they not clearly say so? Three weeks itself is a long time I think. It may be a systematic issue rather than the swelling. Yes it is still safe to be operated at three weeks post-injury. The pain that you experience when the leg is down but not weight-bearing is from the blood rushing into the leg and the resultant swelling makes the tissues tense and painful. Again, this should settle with time or may persist till even after the leg comes out of the cast for sometime." "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 suffering from a cough since 15 days. There is phlegm as well. I tried using so many syrups, antibiotics and Levocetirizine with Montelukast. The X-ray and CBP (complete blood picture) are normal. But, the cough is still persisting and troubling me. What do you suggest? ### Response: Hello. I went through your post. You have a cough from two weeks along with expectoration. You have taken antibiotics and antiallergic medicines, but you have not mentioned the name of the antibiotic which you have taken. I would suggest a few things: Consult your specialist doctor, discuss with him or her and start taking the medicine with their consent. Regards" "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: This is really embarrassing as I have 10 to 12 cavities in my teeth mostly in between two teeth but still I am developing new cavities now in front teeth. It seems like my full mouth is composite filled. I have healthy eating habits and not a sugar addict. Kindly suggest some measure to save my teeth as I do not want to have denture in the next 10 years. Will oil pulling and eating Calcium-rich diet help me? ### Response: It would be better if you could start continuous brushing after every meals. Use dental floss to remove food stuck between teeth. Go to a dentist every 4 to 5 months and do cleaning of teeth to remove bacteria and plaque. See if you can get a toothpaste containing fluoride. Fill all carious teeth at the start itself. These much steps are necessary for patients with much caries risk. Avoid sticky food like biscuits, chocolate, etc. Increase intake of fibrous food." "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 got a big deep cut on the leg from a metal and got four stitches on that part. I got dressing of the wound on alternate days. On the sixth day, there formed a little pus around the wound. The stitches are expected to be removed on the eighth day. Although the doctor gave antibiotics now and said not to worry. I am worried. What to do? Please help. ### Response: I understand your concern. First, calm down. You are being treated adequately. 1. 2. Pus is due to infection of stitches and not the wound itself. 3. Keeping good local hygiene, applying Betadine and wound" "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: Before 20 days ago, I noticed an appearance of white skin on my left elbow. I thought it was due to change of weather. My left elbow had few changes in skin color when compared to the right elbow. My body is weak and lean. I have attached the picture to you. Is this a skin disease or not? Please help me. ### Response: I can understand your concern. I have gone through the attachment (attachment removed to protect patient identity). It does not look like a severe problem. So there is no need to worry. It is a simple problem 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: I am not sexually active. But my fiance did foreplay and ejaculated on my hand. I washed my hand with soap after that. I do not remember the semen going near my vagina. I am still virgin and he did not penetrate me. However, the next day I got worried and took an emergency pill. I still have not got my period and it has been a week. I also have PCOD. Have I missed my period because of PCOD? Or could I be pregnant? Please let me know. ### Response: Hello. Please do not be worried. There are no chances of pregnancy at all. Firstly, because you had washed your hand with soap which carried the sperms and sperms do not survive on contact with detergent or soap. Secondly, you have taken an i-pill within 72 hours. Hence, your menses are likely to be delayed due to high progesterone pill you have taken. So, you should be patient and wait for the 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 26-year-old male, I have observed a protrusion under my tongue from the last four days. It is on the right side and has a white dot in between. I am not on any medication and do not smoke or drink. I am very worried. Please suggest what it might be? ### Response: Could you send a picture to help us understand what it could be? It could be an abscess or an emerging ulcer etc. Is it hard? Is it filled with fluid or hard?" "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: There is a feeling of little itching inside my vagina. I noticed something weird inside. ### Response: Hi. I have gone through your history and understand your concern. It could be due to vaginitis caused by fungal and bacterial infection. You can take antifungal and antibiotics for the same." "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 1-month-old daughter. For the past two days, she passes the poop with more gas. I am breastfeeding her (no top milk). She has developed a rash over her genital area. Can you suggest something for her gas problem and frequently pooping with gas? I think pooping frequently causes rashes. So kindly help me in solving frequent pooping with gas. ### Response: Is it happening for the last two days only? Or was it from birth? If it is from birth, then you should go for a stool examination. Or else it will be transient. I hope you are not giving bottle feeding. A rash free ointment can be applied locally. An image of the rash can be sent to have a little more idea. Is the child active and feeding well? Is the stool watery? What is the frequency of the stools? Kindly suggest. Let me know these things to understand better" "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: What are my chances of getting pregnant after taking the emergency pill within 24 hours of having sex? ### Response: Hello. Your chances of getting pregnant after taking the morning pill are very low. But it also depends on what day of the cycle you had sex and how long is your cycle and was it the only episode of unprotected sex in this cycle. Your period might get delayed or you might experience spotting with morning pill." "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 started Trintellix yesterday for panic, anxiety attacks and today I felt like a lump in my throat, almost like someone is choking me. I am not sure if this is due to the drug and if this is something to worry about? Should I take my next dose today? ### Response: Trintellix is a type of selective Serotonin reuptake inhibitor which work by increasing serotonin levels in blood. The serotonin further treats the anxiety and panic attacks but sometimes SSRI may cause activation like rapid increase of serotonin in blood, which may lead to temporary increase in anxiety. To solve the issue, you can start with half tablet, a dose of 2.5 mg for initial five days, then make it 5 mg and continue it further. If it also does not help you, then contact your psychiatrist." "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 unprotected sex with my fiance. However, I was close to my periods and he had not ejaculated inside me. But, to stay on the safer side, I had taken I-pill after 24 hours. Will I get pregnant? ### Response: Hello. If you have taken I-pill within 72 hours of unprotected intercourse, then you are likely to remain safe. The success rate of the I-pill is 99.5% if taken within 24 hours. You are required to be patient now and wait for your menstrual 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: My daughter has a lot of lice and nits on her head. We tried a lot to remove them. Can you please suggest how to remove lice and nits from her head? She is 7 years old now. ### Response: Hi. Head lice are contagious. She would have got it from school. It is very important to treat the person from whom she got this. Otherwise, she will be getting lice again and again. Just make sure that her school teacher is aware of this. Now coming to the medication part, Perlice (Permethrin) 1 % creamy rinse, shampoo the hair with regular shampoo which she is using, after shampoo, apply this Perlice creamy rinse to the scalp and hair, leave it for 10 minutes, then rinse thoroughly with lukewarm water. Repeat the same process after one week" "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: Why is Chlorhexidine mouthwash used only twice and not thrice daily? ### Response: Chlorhexidine mouthwash is only used twice daily because of the following reasons: Wish you good health and happiness" "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 36 year old male. I suddenly developed sexual dysfunction, I have reduced interest, arousal, plateau, and orgasm. The triggering event seems to be the discontinuation of 150 mg Bupropion because of adverse effects. I switched to 20 mg Citalopram, and over the course of six months, I reduced Citalopram to less than 1.5 mg. However, the sexual dysfunction has remained unchanged. I previously took Citalopram in doses ranging from 10 to 20 mg, depending on the external stress, for six years, and this did not cause significant sexual side effects, except delayed orgasm. While on Bupropion, my semen production stopped, but there were no marked changes in sexual desire, arousal, or behavior. The Citalopram and Bupropion had been prescribed for anxiety and depression, which have been well controlled for many years. Six months after the onset of the sexual dysfunction, a testosterone test revealed total testosterone in the 400s and free testosterone beyond the laboratory\s ability to measure it (highly elevated >100). I do not use androgen supplements and illegal or recreational drug. There is no history of alcohol addiction or nicotine use. There is no neurological history, history of an endocrine disease, or surgery. I currently take Fexofenadine, antihistamines, and steroid nasal sprays. ### Response: Do get back to me after you have done these. Hope my advice is of some benefit to you. Revert with more information to an endocrinologist 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 constipation. Stool is so hard and has got stuck in the colon. I am on keto diet. So, fiber intake is low which may be the reason. Is there any medication or laxatives that I can take? ### Response: Hi. You seem to be suffering from constipation, and you should increase fibers in the diet" "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: The patient is 72 years old male and moderately active.Symptoms:Initially, the patient reported moderate pain in chest and weakness. The patient was given medicine for gas. Since the symptoms continued for a couple more days, he also felt pressure and discomfort in the chest, he was referred to urgent care for cardiac evaluation.Diagnoses:1. NSTEMI heart attack.2. Troponin-I was 9.14.3. Angiogram revealed a TVD (Triple Vessel Coronary Disease).4. LAD has 80% stenosis in the ostioproximal part with 90% distal disease.5. LCx has 95% stenosis in its mid part (nondominant).6. LMS has a mild disease in its distal part.7. RCA Dominant with a moderate disease in its proximal part.History:The patient does not have any history of heart disease and not ever flagged with any heart-related issue in past routine checkups.Risk factor:DM (Hba1c 8.2 ). A few months ago, Hba1c shot up to 11 / 12. Medicine was adjusted to pull it back to a reasonable range.HTN, the patient had a change in the job a couple of months ago, which added moderate stress. CKD (managed with borderline creatinine).Recommendations:CABG (Bypass surgery).Is CABG the preferred option for this case over angioplasty and stenting? What are the pros and cons of these options?We are told to perform the operation in two weeks. What is the risk of waiting longer?Assuming going with CABG, we also need to decide where to perform the procedure, in the local cardiac facility, or more reputed internal hospital within 3 to 4 hours of flight. How are the factors to consider? Is CABG a fairly common procedure with similar regimens? ### Response: Considering the blockages at multiple sites, which will require multiple stents to treat and his diabetic status says, the life of the stent is relatively shorter. CABG (coronary artery bypass grafting) is a preferred option. CABG involves the major surgery where risk is higher, say around 4 % (varies from center to center), and recovery takes longer. Stenting has a lesser risk of around 1 % but with a shorter life of stents. So CABG is the first choice, but stenting is an option if you are not willing for CABG. It is better to get it done early as there is a risk of a repeated heart attack. However, the risk of such attacks is minimum with medicines but not eliminated. CABG is a fairly common procedure nowadays and considering his age, it is better to perform at a higher center. So both options are available, but CABG is preferable. 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 27 weeks pregnant and have been detected with high SGPT 117. I have full body itiching which is getting worse, and my doctor has prescribed me Udiliv 300 mg five times a day for one month. Is it safe to take Udiliv 300 mg five times? ### Response: Hello. Based on the description you mentioned, it appears that you have this condition called intrahepatic cholestasis of pregnancy (ICP), which can cause elevated liver enzymes or bilirubin along with itching." "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 is taking Glycomet GP 2, one in the morning and one before dinner, to control her blood sugar. Now, she has developed arthritis. Is it advisable to take Oasoft two tablets twice daily? Which is the better medicine for RA? ### Response: Hello. She has probably osteoarthritis, not RA (rheumatoid arthritis). Oasoft (Glucosamine) is given for osteoarthritis, especially knee. She can take one tablet two times a day. The important is physiotherapy which can be practiced with the help of physiotherapists and weight loss to decrease stress over the joint. Also, she should use hot water fomentation, Diclofenac gel or spray whenever needed for pain. She can also use Capsaicin ointment if Diclofenac is not helpful, which is applied as a thin film two times a day. If the pain is still present, she can also use Tab Naproxen 250 mg whenever needed. So you can get these prescribed, and visit orthopedician for the same. Hope this helps you and get back if you have any doubts." "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 you have an HIV test done and it is reactive but the antibodies test is negative, what does this mean? ### Response: It might be due to the HIV test detecting the HIV antigen (p24), and the antibody test might still be in the window period (meaning, the antibodies against HIV have not been formed in the body yet). In any infection, the infection produces its antigen, and later when antigens are processed by our immune system, the body produces antibodies against the infection." "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 O negative and my husband is Rh-positive. I have a baby of 1.6 years old, Rh-positive. Now I am pregnant of six weeks and do not want to continue so I take an abortion kit but after taking all four Misoprostol pills bleeding not started yet and it is almost 24 hours gone. What to do now? Do I have life threatening risk? I am worried. ### Response: Hi. You need to do one ultrasound scan to confirm the pregnancy. If you had done scan before taking pills then wait for 12 days and if no bleeding then repeat ultrasound scan. And if you did not do ultra scan then get it done. You should bleed. But if not then either you had wrong pills or pills did not work. And will require surgical abortion. You need to consult a nearby gynecologist or abortion center. One rare chance is to have an ectopic pregnancy if you did not do an ultrasound scan. But if it was there then you should have more pain in the lower abdomen on one side. It will clear in the next ultra scan. In that case, treatment may vary. After bleeding starts you should take Rh anti D 150 ug injection within 72 hours because we do not know the fetus blood group. And if you did not do ultrasound scan then you can repeat the urine pregnancy test also. Because sometimes kits also come faulty and give false-positive results. So to compare or confirm you can repeat." "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 two teeth have fluorosis and they come outside. So, can I correct those two teeth only? ### Response: Hello. As you have mentioned about fluorosis in your two front teeth, you can get it treated either with a procedure called as bleaching or you can get veneers, that is, a layer to cover the teeth. You have also mentioned that the front two teeth are moving outside. For that, you can either go for braces or get intentional root canal treatment with a crown on both the teeth. These are the treatment options for your problem. You can visit your dentist to get the treatment 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 have attached my mother\s FNAC of the thyroid. I need your suggestion please. She has severe head and neck pain. Currently, she is taking Thyroxine 100 mcg. ### Response: Hello. I just read your query about your mother and from what you have attached (attachment removed to protect patient identity), it appears that your mother has a benign enlargement of the thyroid gland. There is nothing to worry about. The treatment is Thyroxine which she is already taking and regular monitoring of her thyroid function tests. Also, better to do a radioiodine isotope uptake scan of the thyroid gland. The prognosis is good with treatment. However, if the thyroid gland is enlarged too much and is causing compression symptoms, then it needs to be surgically removed." "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 masturbating on a daily basis for a long time. For the past two years, I have noticed a swollen hard thick cord along the shaft of my penis. It is more obvious when flaccid. It is nonpainful at all and it is pulsating and changes sizes. Help me, please. ### Response: Masturbation does not cause any such thickened cord, usually, these cord-like structures are dilated veins. It does not require treatment except in very rare cases when it is painful. Still, I would recommend you to visit a urologist once for physical examination as a condition which you have described can be best diagnosed after a physical 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: My mom met an accident with a head injury. Right FTP SDH and midline shift, craniectomy surgery is done on the same day. But still she is semi-unconscious. There are body movements, but she has not yet opened her eyes. Ventilator has been removed before 30 hours. I want to know when she can open her eyes and how long will it take to become normal. I have attached a recent CT scan. ### Response: Hello. This is the most common question we encounter in our daily practice. One thing I want you to understand is that the surgery which has been performed was a \\life-saving procedure\\. If that were not done, we would have lost her; luckily, thank God that did not happen. The rest of the recovery is actually unpredictable. Depending on the extent of the damage, the patient will recover after this sort of surgery. Positive things are she has survived, she is off the ventilator, her injury was more on the right side and not on the left side. So there are pretty good chances that she will improve eventually. If it had been more injury on the left side, we would not have expected her ever to speak again or calculate again. That is not the case with the right side. She would open her eyes in less than a week. Other functions will take time to recover up to six months. The next stage is you have to focus on rehabilitation measures." "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 enlarged circumvallate papillae from the last 45 days. How do I get rid of it? What medicines are suggested? ### Response: Normally, circumvallate papillae are enlarged structures at the base of the tongue. So it is normal to have enlarged papillae and it does not need any treatment especially if you do not have any symptoms like pain, swallowing difficulty, etc. Also, there is unlikely to be any abnormalities in them as it is unchanged since last 45 days. You upload the picture of those papillae so that I can confirm. However, with a sore throat, it may appear bulky and slightly enlarged but it settles down after it is treated, and you already took Amoxicillin for that. Hope this helps you and get back if you have any doubts" "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 48 years old married, male living with wife and one school going child. My height is 172 and weighs almost 80 kg. My main problem is that I am not able to sustain my erection or suffering from erection difficulties for a long time. I can sustain it only when I take Tadalafil type of tablets before. But, at present, I am having high BP and taking Amlopres AT tablet daily in the morning and after this medication, my BP level is 130/80 on average. Besides, I am having high TSH 6.98 when measured one month back and taking medication (Thyrox). Otherwise, I am also having enlarged prostate but till date, no major complications have arisen. Though the doctor has prescribed Tamsulosin type of medicine, I have not started yet. Also suffering a bit anxiety, however, I am not taking any other medicine except those mentioned above. Can I take Tadalafil after having such problems mentioned above to overcome the erection difficulties? Will it clash with the medicines I am taking already? ### Response: Yes, you can take Tadalafil or Sildenafil tablets for erection. It may bring blood pressure slightly less. Otherwise, it is safe. If TSH level is slightly high, how is the sugar level? Also, learn to relax as anxiety also causes erectile dysfunction." "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 I have herpes. About eight weeks ago I had a handjob in a massage parlor. There was no intercourse nor kissing. She was only wearing her pants. She climbed on top of me and rubbed her whole body against me (although her pants were on). That was it. She did not do anything else. After few weeks I had swollen armpit with some fluid coming out of it. I have a little rash on my penis. Do I have genital herpes? I am really really worried. I am also feeling a little feverish and sore throat. ### Response: Hello. Your mentioned symptoms are not consistent with herpes. You please upload the picture of penile rash. The typical symptoms of herpes include fluid-filled vesicles over the penis or nearby area which are painful. A just simple rash may be a fungal infection like candida. You may apply Candid (Clotrimazole and Betamethasone) ointment to it two times a day. Genital herpes usually does not cause armpit swelling. It can be a folliculitis. If arm swelling is still present, upload its picture as well." "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: What are the foods items that should be not given to the asthma patient? ### Response: Grossly we cannot avoid all food types because there is person to person variability to the food allergy. So you should strictly avoid food that is causing some difficulty in breathing or attack. To find out exactly we can do skin prick allergy test or blood allergy test so that you definitely know what food you are allergic to. After that, you must avoid those food items. Always check ready-made foods or processed foods for ingredients. Sometimes butter, cheese, yogurt, and milk also needs to be avoided in some cases of diagnosed allergy. Otherwise, you can enjoy fresh fruits and vegetables in your diet." "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 days ago, I was playing with my dog and unintentionally, he scratched my hand with his teeth. Nothing serious, the wound is about a third of an inch in size and it just scratched the upper layer of my skin, and it was bleeding a little bit. I immediately washed it with water and soap and then cleaned it with alcohol. It is now almost completely healed. I am wondering if I may have contracted tetanus from my dog\s saliva. I am 18 years old and I got my tetanus vaccination when I was 12. Should I go for a tetanus shot or is it unlikely that I contracted the bacterium? ### Response: Hello. You have a history of dog bite with little bleeding. For that, antirabies vaccination should be given to prevent a chance of rabies spread. Five doses at 0, 3, 7, 14, and 28 days after exposure is recommended. I suggest you consult a physician for examination. There is no need to take tetanus toxoid (TT) as you have already taken it before" "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 32 years is suffering from schizophrenia for the last six months and not accepting any treatment and since the last 10 days his symptoms got worsened and became violent and today he tried to get injured and he is suspicious on everybody thinking everyone is talking about him and plotting to harm him and asking us to kill him by giving poison and today he became very violent and after consulting a psychiatrist doctor today we gave him Risdone liquid 2 ml by mixing with fruit juice. Now he is sleeping calmly tonight. Please help us for further treatment. ### Response: Hello. I can understand your concern. A lot of patients of schizophrenia or other psychotic disorder refuse to take medicines and this becomes difficult in treatment. Risperidone liquid is tasteless and odorless and can be given without knowledge to the patient. But keep one thing in mind that he should not become suspicious that he is being given medicine by mixing with food. Most of the patients come to know about this. You will have to remain alert for this. This should be followed strictly. In coming days he will become ready to take medicines by own. Till then you can give him Risperidone liquid. He is on 2 mg per day and if needed, the dose can be increased to 3 mg per day. The second option in his case if he refuses to take even food or juices from you is long-acting injectables. Long-acting injections of Haloperidol or Fluphenazine or Risperidone or Paliperidone are available. These have actions for around 15 days and can be given to him if he refuses to take medicines. This can make treatment easy for him. You can discuss with his doctor for this treatment option." "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 51 years old female and suffering from anxiety for decades. Recently it became debilitating, and I ended up in the ER and had an EKG because of heart palpitations. My doctor prescribed me 10 mg of Escitalopram and 1.5 mg of Xanax. The Xanax was supposed to be taken as needed, but I misunderstood and have been taking it three times a day (5 mg every eight hours). After six weeks, the SSRI is not helping much. My doctor has increased the dosage to 15 mg. I took the new dose at night and felt awful nauseous, depressed, and lethargic in the morning. Is this the wrong drug for me, or should I go through the side effects? My goal is to feel well enough to start weaning myself off the Xanax. I have not been able to eat solid food for weeks. ### Response: Escitalopram is an effective medication for managing anxiety disorder. The usual dose is between 10 to 20 mg daily. You are currently on 15 mg. Side effects can occur commonly in the first two weeks of starting the medication or increasing the dose, and then it tends to settle. Take your medicine after food to minimize nausea. Depression and lethargy can take up to two to four weeks to get better. Consult your doctor and discuss the earliest to gradually taper off Xanax in a safe manner. Do breathing exercises and muscle relaxation exercises." "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 55-year-old male. Ever since I can remember I have been able to retract my foreskin fully, all the way to the base of my penis. I have always had a problem with the phimotic ring once it passes the head of my penis it is very, tight around the shaft of the penis which can be somewhat painful when the penis is fully erect. Is there any way to treat the phimotic ring to make it less rigid and more elastic? So, when it is around the girth of the shaft, it is not too tight. ### Response: Hello. By your description, it is clear that you have phimosis along with tight frenulum, which causes the pain during erection and difficulty in retracting the foreskin. It can be easily treated by circumcision, which is a day care procedure. However, you need to undergo an evaluation to rule out diabetes, as phimosis is associated with diabetes and it needs to be treated by medication before surgery. At present, there is no medication to increase the elasticity of the foreskin. Phimosis with the tight frenulum. RBS (random blood sugar). Circumcision." "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 been having throat pain while swallowing and fever since last evening. She has been advised Clavam 625 twice for five days.Her fever has not gone below 100 and after about four hours of taking Dolo 650, it goes up to 102.5.So far, she has taken three doses of Clavam.Is it normal to have such a high fever in throat infection? Could it be dengue? ### Response: Yes, it is certainly possible to have such a fever and it is likely she has an upper respiratory tract infection. I think whatever she is receiving is fine. Antibiotics will take at least 48 hours to act and initially, the infection is viral. So, antibiotics may not work for the initial two to three days. I think she should continue the same treatment. Hope this helps you. Get back if you have any doubts" "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 abscess on my top left gum that is now spreading to my cheeks. I am 19. I had an abscess in the same place at 10 or other young age. Last time I went to the dentist they did not do the cleaning in the first appointment so I did not get one, but wisdom teeth removal was suggested. I have good teeth, bad gums. Also cracked my teeth when younger. So one of my two front teeth has a fake bottom (do not know if that is relevant). I do use a gel and just learned that it could be contributing. ### Response: Immediately start with these medicines. Tablet Augmentin 625 mg twice a day for five days, tablet Gramex 400 mg twice a day for five days, tablet Brufen 400 mg twice a day or thrice a day if the pain is severe for five days. Moreover, take some mustard oil or olive oil, put 1/4th teaspoon of salt in it. Make a paste and put it on gum line having the infection. Do it three times a day for three days. When swelling regress, put this paste on gums before sleeping. And start saline water mouth rinses. Take a 1/4th teaspoon of salt in lukewarm water and do its rinses 4 to 5 times a day for two weeks. And you must know this will only subside infection for some time but will go permanently after getting treatment from the dentist. Stay happy and blessed. Give me followup after three 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 have gastroparesis, and everyday I have stomach pain, and extreme gas. I am tried working with my gastroenterologist but there are no results and no interest by them. I have tried Linzess, and Gabapetin but no result. I need help. It is destroying my quality of life. I can not go anywhere because it is so embarrassing. ### Response: Hello. Before I can give my opinion I need to know a few facts. Since how long you have had diabetes and what medications are you taking? Do you have constipation, nausea, and vomiting? What is the site of stomach pain and what is the severity? I would also like to see the clinical notes of your gastroenterologist." "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 24 year old young professional. For the last three months, I have been having this sudden pain in the right chest that would go through my armpit down to my elbow. It would be so painful that I cannot move until the pain subsides. I have a sedentary lifestyle. So, it could not be strain from exercise right? ### Response: You have musculoskeletal pain which causes severe sharp pain especially when you move or breathe. This could be caused by exposure to direct air conditioner or fan. Please let me know if you have any skin redness or vesicles. I suggest applying Deep heat cream thrice daily for two weeks plus using painkillers like Ibuprofen. Consult your specialist doctor, discuss with him or her and start taking the medicines 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 am a 14-year-old male. Last week, I had really bad pain under, which I realized was my tonsils. I went to a doctor to get it checked out. He said they were definitely infected, but they did not give me any medication. He said it would go away by itself. Now, I have a really bad cough. When I cough, it makes my tonsils hurt like crazy. Last night, I had a really bad coughing fit that I could not breathe, so I ran to the bathroom, and ended up coughing up blood.Also, when I sleep, I feel as if someone was pressing on my chest, and it is hard to breathe and it is also hard to swallow. Currently, when I cough it hurts my tonsils, my chest, and now also my head. Only when I cough, I get a sharp pain on my left temple. I feel awful. My mom said I also look really pale, and my teachers have been asking me if I am fine because I do not look well. I do not want to go see a doctor, because it is a waste of time if I do not get any medication. Please tell me what I can do to feel better. ### Response: It is surprising that you were not started on medications despite your tonsillitis and throat complaints. It may be possible that your symptoms or findings were subclinical when you saw the doctor and it may have worsened further since then. It sounds like a throat infection for which you may need a course of antibiotics. On an online portal such as this, it is not recommended for me to prescribe antibiotics without an in-person evaluation. However, I can recommend the use of antiseptic gargles such as dilute Betadine gargling (5 ml of Betadine in 50 ml of lukewarm water. Do not swallow) thrice daily before and after meals for about a week along with over the counter available anti-inflammatories such as Paracetamol 500 mg twice daily for three days. If you develop fever or your symptoms worsen, it is advised that you show yourself to a doctor or at the ER and in such a situation I am certain that you will be treated with medications appropriately." "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 tooth filling done. My dentist injected anesthesia three times to get complete numbness. The numbness from the anesthesia has subsided. But I have pain inside my tooth. I suspect that the pain in my tooth is due to the drilling done in my tooth. I have a strange pain shooting from my tooth up through the cheek into my temple and sinuses. My cheek is swollen, and the pain in my cheek is a headache type pain. Is this normal after a filling? ### Response: Hi. I can understand your concern. Yes, it is painful sometimes. But it is only related to the stimulus, that means the pain at the time of chewing or due to hot or cold fluids. If the pain is continuous and interferes with your sleep cycle, you may need to revisit the dentist and get the filling removed. Sometimes the long buccal anesthesia wound gets infected and can cause pain. But in your case, the pain looks like pulpitis, and it is not usual if it continues for more than three 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 found a yellow mark on my 2-year-old child. I did his complete blood count and have attached the reports. Kindly advice. ### Response: In the mentioned CBC report, there is nothing to worry as per my opinion (attachment removed to protect patient identity). The total count, red blood cells count, platelet count all is within the limit. The lymphocytes can be high in this age group, so you need not worry about that. So nothing is abnormal in the mentioned report. I hope I have answered your question. Let me know if I can assist 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: I and my partner were having soft sex without penetration. In the process, we just rubbed our genitals against each other. Two to three days later, she has started feeling nauseous. She is complaining of pain in the breasts, pelvic pain and swelling in the vulva region. A pale white fluid has started discharging at regular intervals from the vagina. After some time, it was gelatinous. She is frequently complaining of abdominal cramps. I am worried whether she is pregnant. ### Response: Since there was no ejaculation, there is no chance of pregnancy. This could be because of hormonal changes or anxiety or physiological. There is nothing to worry about. So relax and do not worry. However, if you have a doubt, then get yourself checked by a 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 pain in my molar tooth on lower right side and under it is a hard bump in my gum. The pain is only when I eat or touch bump or tooth. Please help. ### Response: Hi. That bump seems to be an abscess collection from your explanation and the infection in your tooth has reached pulp. You should go to your dentist at the earliest, he or she will get your X-ray done and then treatment will begin. Follow up after two 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 have red itchy bumps on both legs and ankles. They keep recurring for months. I have attached the pictures for your reference. Please help. ### Response: I have read your query in detail and viewed the attached pictures (attachment removed to protect patient identity) and do understand your concern. 1. 2. Scabies. 1. You can take antihistamines like tablet Levocetirizine 5 mg twice daily.2. A combination of steroid like Mometasone or Clobetasol and antibiotic like Fusidic acid to be applied over it twice daily for a week. 1. Avoid using soap over this area for a week.2. Apply emollients like Cetaphil Dam lotion twice to thrice a day. Revert back after a week with the asked details 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 am 26 years old. I am going to get married in another four months. I started masturbating six years back to give it a try. Later, I got addicted to it. So much so that some days I even masturbated for seven to eight times. Along with this, I am not having proper diet like skipping breakfast and dinner, sometimes skipping lunch also. This happens daily. Now I am facing weakness in my body, severe stresses, lack of concentration, dizziness. I tried hard to stop it. From morning till night I kept thinking healthy, but at night I masturbate. I will stop this for sure, but I want to make my mindset more strong. I request you to help me in this regard. I am a vegetarian. Please help me with proper medication and proper diet.Due to stress, I am unable to work at my work place. Else I had worked very efficiently in the past. Now I cannot do small things which are very easy at my work place. Please help me. What all the foods I need to take? I have heard Shilajit, as a medicine for this, but do not know. Also, please help me with early ejaculation and making the private part strong. ### Response: Hi. I understand your symptoms well. The only problem with you is you have been anxious about the whole issue. Believe me, there are no other problems with you. Physiologically or hormonally there are no problems with you. Anxiety is a vicious cycle. You become anxious, you disrupt your normal habits, then it makes even more anxious. Well, you need to start with a schedule. Either in the morning or in the evening you have to workout for at least 45 minutes. You start with this, the rest of it will follow. Because when you workout well, your physiology would be stabilized, you will get more sleep and by default, you would take enough diet. Once you are focused on other things to do definitely you will not feel like masturbating the whole day. For premature ejaculation you can take tablet Tramadol roughly three hours before sex, it delays ejaculation. But beware, this medicine causes nausea in many patients." "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 unprotected sex with a sex worker and after exactly 12 weeks of exposure, I did an HIV 1 and 2 antibodies and HIV 1 and 2 P24 combo test. It came negative. But, some guidelines advise repeating the test after six months. Should I consider my test conclusive or test again after six months of exposure? Please solve my problem. I am very anxious. ### Response: HIV antibodies are formed two to six weeks post exposure. Three months is the latest time given. If the antibodies tests are negative after three months of exposure, then it is conclusive that you are free from HIV, provided there is no further risky exposure. You need not worry about the six months references. You can allay fears of HIV" "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 got married before a month, and we are unable to have sex because of my very hard hymen. Yesterday I got bleeding during sex, and we thought it broke, but it was like a small tear from the side. My husband\s penis is above average, and it is very hard, so I get unbearable pain every time, and he is unable to penetrate as I force him to stop. Is there any medicine to tear the hymen or only surgery is the option? Please help us. ### Response: Hello. I can understand your concern. Hymen will not be hard, and your partner needs to understand your vagina, proper foreplay will dilate the vaginal region for easy access. Ask your partner to masturbate for you and increase foreplay. The hymen does not generally break in the first penetrative sex. If your pain persists, it can be due to injury, wait for a week for the hymen to heal. If your pain persists, you can use a painkiller. Increase the foreplay time or masturbation will lubricate the vagina for less painful sex. Use K-Y gel (water based lunbricant), or painkillers if you have any doubts regarding masturbation and foreplay. If all these basic things are fine, we can think of other surgical causes." "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 vocal nodules. How to treat it faster at home? ### Response: Hi. If vocal nodules are confirmed by a doctor then there are a few things which you should know. Vocal nodules are small thickenings in both vocal cords which usually occur secondary to excessive voice use and very common in singers, teachers, and any professional voice user." "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 average cycle length of 29 days with the longest being 31 days. I have never missed a period before and always got a brown discharge before my periods. I last had my periods 31 days back, then had protected sex once (with my partner wearing a condom) on the 14th day of the cycle. Today is my cycle and expected to have my periods but all I saw yesterday was a slight brown discharge on toilet paper in the morning and evening time with mild cramps (slight consistent backache from cycle day 30) with tender breasts, feeling a bit dizzy, bloated stomach, (pregnancy-related symptoms). I am on cycle day 31 and no periods yet. Could it be that I conceived after protected sex since it was my ovulation period or 14th day of the cycle? Can I go ahead and test for pregnancy? Kindly help me. I am currently 33 years old. ### Response: As you said that the sex was protected and that there was no condom misadventure, so chances of pregnancy are minimal and the symptoms are more of premenstrual rather than pregnancy. However, considering that both symptoms overlap, the best way to rule out any pregnancy would be to get a serum beta hCG test done as on date where if the hCG levels are less than 3mIU, then you are surely not pregnant and the symptoms are premenstrual." "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 dizziness, lightheadedness, nausea, fatigue, two months long upset stomach and fever at night. I am a female, 43 years old, had a hysterectomy five years ago due to cancer cells in the cervix. Currently, I am taking thyroid medication and anti-depressants. ### Response: Hi. Sorry to hear about your suffering. The symptoms you have mentioned could be due to many conditions like anemia, tension headache, infection, etc. CBC is required in order to exclude anemia and infection. I recommend that you take Paracetamol 1000 mg every six hours for the fever and headache." "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 25 year old male. My height is 177 cm, weight 63 kg. I have started workout since six months. I felt lower back pain while lifting weights. Is it a disc problem? ### Response: There are chances of disc prolapse if the following conditions are associated with the lower back pain: If these conditions are present, get an MRI scan done and revert back to an orthopaedician 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 used Caverta for recreational purposes for the past one and a half years. I used to have it once in 1 or 2 months and the dose used to be about 10 mg. What are the side-effects? ### Response: Hi. Using this for such a long time and at a young age can produce pronounced side effects like erectile dysfunction at a later stage, and low BP problems. Use a barrier contraceptive that enhances the duration of sex and you can successfully wean off the" "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 34 year old female, who weighs 97 kg, and I am 5.9 feet tall. I have extreme pain in my upper abdomen and back. I also feel nauseous. I have a fatty liver and pancreas, and gallstones. Please help. I am attaching all my reports. ### Response: Hello. I have seen all the attached reports (attachment removed to protect patient identity). Hope this helps you to some extent at least" "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 25 years old. I am having weak erections for two months. I think it is because of more masturbation so I stopped doing it since 35 days, but still, I am not having erections. I am also having a prominent vein on the top and either side of the penis even when flaccid. I do not smoke or drink. I exercise regularly. I am worried now please help. ### Response: According to your history, it looks like you have psychogenic erectile dysfunction. Stopping masturbation would not help. The best would be to start a short course of medicines and take cognitive behavioral therapy to reduce the anxiety which has caused this problem. The vein in the picture looks absolutely normal (attachment removed to protect patient identity) and it is in fact a sign of a healthy penis. Remember it is temporary and most men face this issue sometimes. Maintain a healthy lifestyle and sleep for seven to eight hours at a stretch. Use Lavender aroma in your house which helps reduce your anxiety." "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 28-year-old girl, suffering from a bad type of acne and dark color acne scars, oily skin, open pores, and blackheads for the past five years. I have regular menses and need suggestion with a good homeopathic remedy. ### Response: I just read your query. Take neem leaves if available nearby you and make a paste of it after crushing them and add a pinch of turmeric powder in it and apply this paste on your face and wash with normal water after fifteen minutes. It will give you good results. For acne scar, apply aloe vera gel two times a day regularly. It will help in lightening them. For blackheads use an oatmeal scrub and clean them regularly. Do not use harsh soap on the face. Use a good face wash. Protect the skin from direct sunlight. Cover face while going outside." "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 27 year old male.I have been masturbating since childhood.My problem is that whenever I indulge in sex, sperm comes out very soon like within a minute.Please suggest me any medicines that can increase the time of ejaculation upto half an hour. ### Response: This is not a major problem. It can be easily corrected. You have to follow the following instructions: Consult a sexologist online if the problem persists even after following these instructions" "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: Today I took blood test and found out that triglycerides, aspartate transaminase and alanine aminotransferase are high. One week back, I had taken Liv.52 DS, triphala and bael. Shall I continue them? Or should take any other medicine? I have attached my medical reports. Kindly check them. ### Response: Hello. According to your reports (attachments removed to protect patient identity), your triglyceride levels are absolutely normal. Revert back after the investigations 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: I am 35 years old. I have the symptoms of a urine infection. But five days after the beginning of the symptoms, I got a urine test, and no bacterial infection or STD were detected. I did an HIV test, which was also negative. The pain is reducing slowly, but I am still not back 100 %. I have no sex envy. What could this be? Could this be a chemical infection or allergy from using hydroalcoholic solution wipes or shampoo on the penis? Could this be a prostate issue? ### Response: By your description, it appears that you are having pain while passing urine. It could be due to infection, stone or simple inflammation. Urine shows bacteria only in case of infection. In the case of stone disease or inflammation, one can find red blood cells or white blood cells respectively. If you are getting relieved gradually with the treatment you have obtained, no need to worry. If you do not have relief even after five days of symptomatic treatment, kindly consider getting an ultrasound abdomen and pelvis with post void residue, which can identify a structural lesion such as stone." "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 bug bites that appeared as small red dots first and then turned into bigger, more normal bug bites within two days. I have washed my bed sheets twice and got more when I was away in another city for two nights. They are itchy, but there is no pus or anything. I have about a dozen of them. Do I need to go to a doctor? ### Response: Hi. I have read your query in detail and viewed the attached pictures (attachment removed to protect patient identity). The condition seems to be papular urticaria, which is due to an allergic reaction to an insect bite, fleas or bed bugs. 1. Continue with Loratidine 10 mg, you can take it twice a day for a week.2. A combination of steroids like Mometasone and an antibiotic like Fusidic acid to be applied over the lesions twice daily for one week. Wearing fully covering clothing will help. Insect repellants or sprays in your home or office." "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 trying to conceive for about 2 years now. My prolactin is 31.8 ng/mL, progesterone is 4.1ng/mL, not opacified left fallopian tube and no free peritoneal spillage of contrast noted. My partner has varicocele. I had a shot of progesterone. Please provide some advice on how we can achieve conception. ### Response: Hello. It is evident from HSG (hysterosalpingogram) that you have a left tubal block and only the right tube is patent. Secondly, considering that your partner has varicocele, it is important to get his semen analysis done to check for sperm count and quality if it is adequate or not. Thirdly, your prolactin levels are high making you hyperprolactinemic, and your progesterone levels are low indicating progesterone deficiency. Revert with the reports to 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 got a complete medical checkup done today. My lipid profile reads total cholesterol 145 mg/dL, HDL 27.5 mg/dL, LDL 93.3 mg/dL, triglyceride 195 mg/dL and VLDL 39 mg/dL. Is this very concerning? Especially, I am concerned regarding the TG/HDL ratio. Please advice. My echo, ECG, and stress test were all normal. ### Response: Most of the population has low HDL (high density lipoprotein). More than 50 is a good thing which rarely people have. Triglyceride range is up to 150. Can be more if no fasting done prior test or seen in diabetics. Overall your test is good. You do not need cholesterol medicine. Exercise can increase your HDL. So, please check your FBS (fasting blood sugar) and post prandial blood sugar too." "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 took Oxycodone and mixed it with alcohol two months ago. I did not drink a lot but ended up with the worst panic attack. I did not go to the hospital. A week later, everything was fine, but I had some stressful events in my life. Now, I am experiencing anxiety, and it is not controllable. A lot of overthinking and I am wondering if Oxycodone could be the one to blame. I have had anxiety way before, and it just went away. But, now it is occurring again. Could Oxycodone affect my brain terribly? I had a blood test a month ago, and everything was normal. ### Response: Hi. It is not due to Oxycodone because its plasma half-life is 4 to 5 hours. I would suggest you consult a physician or to take Chlordiazepoxide 10 mg two times a day. Also, include 20 minutes of exercise in your schedule apart from the daily routine activity because the body gets acclimatized to that schedule. Because, that would cause secretion of endorphin, which is an antidepressant hormone. It is very common to have anxiety episodes these days, so do not worry." "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 52-year-old male. I am suffering from decreased erectile function and decreased libido. Also, my triglyceride and estradiol levels are high. Free testosterone 11.65 pg/ml, total testosterone 649 ng/dl, serum estradiol 70.45 pg/ml, height 5'9\x80\x9d, weight 80 kg, blood pressure 140/90. Presently, on Ecospirin 0.25 and Met XL 0.75. No history of diseases. Triglycerides are 342. KFT, LFT, TFT are normal. Blood glucose and urine routine are normal. I take 5 to 6 cups of tea daily. Please suggest some safe and effective medicines to cure my problems of decreased erectile function and very high estradiol level. ### Response: Hello. I just read your query and from what you have mentioned it appears that you have erectile dysfunction. I suggest that you check your serum prolactin, FSH (follicular stimulating hormone), LH (luteinizing hormone), serum ferritin, HbA1c levels and get back for review." "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 21-year-old homosexual male. I am not sexually active. However, I kissed someone for 30 minutes. He told me he was healthy. However, I am not sure of his HIV status or if he was on any medications. I suffered mild gingivitis after the event, however, I brushed an hour before. I did not have any noticeable bleeding. I am extremely worried that I could have contracted HIV from the other person\s mouth if he had gingivitis. I am so concerned I am taking a rapid HIV test tomorrow which makes the exposure four weeks old. I am on antibiotics for my gingivitis which has now cleared up. I am not sure if it was gingivitis or a throat infection as I was able to bring the tiny spectacles of blood from my throat though now it is gone. Please help. ### Response: Firstly, your risk is unwarranted in this case. To the best of my knowledge, as per published literature, there is no case reported of HIV (human immunodeficiency virus) through kissing. Saliva itself has very low concentrations of HIV and also contains anti-HIV factors that prevent transmission. However, theoretically, there can be a risk if there is a presence of blood in the mouth of the other person like in the case if there is an active bleeding gums or sores or ulcers. It is good that your HIV test result at four weeks of exposure is negative. I suggest you get a confirmatory test at three months of last exposure" "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 24 year old son discovered a small lump in his testicle about a month ago. He saw a urologist immediately who did a physical exam, drew some blood and took a urine specimen. He said that the lump was located on the back of the testicle and most likely a benign cyst. We had a follow up today for the results of his blood work. He had a very low testosterone level and extremely low vitamin D and an elevated estrogen level. He was placed on a vitamin D supplement and 1 mg of Anastrozole per week to block the production of estrogen and raise his testosterone. He still maintains that these issues are the cause of the lump but we have had no ultrasound or anything that I would have expected to diagnose a problem. Should we push for a second opinion? ### Response: Relax and do not worry. Testicular lumps are very common in young people. As your urologist has examined you, there are high chances of it being a benign cyst arising from the epididymis. But, I will suggest an ultrasound scrotum just to be sure and confirm it is a cyst only. So, insist for ultrasound scrotum. Hormonal problem and lump of testicular cyst are two different things and as per me are not related together. If it gets confirmed on USG that it is epididymis cyst, then nothing is to be done until there is pain or increase in size" "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 getting bleeding from the gums for the past one month. It is generalized. In the morning when I get up, it is maximum blood coming out from my mouth. It is better rest of the day. I did salt water rinse and applied Tan X ointment, but nothing helped. I started taking Metrogyl 400 mg twice a day for two days, and the bleeding stopped. Still, little inflammation is there. My only worry is its recurrence. As of now, I am fine. ### Response: Inflammation of gums is called as gingivitis and bleeding gums being one of the symptoms of the gingivitis. Gingivitis is a microbial disease with many causes that cause the microbial flora to flourish in the mouth. I would advise you to have a visit to your dentist and do a cleaning i.e., scaling of your teeth. If I were your dentist, I would further prescribe you with the oral rinses. Moreover, maintain oral hygiene and use proper brushing technique" "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 ingrown toenail and it has got infected. I suffer from a lot of pain while wearing shoes. I have this pea-sized bubble like thing which bleeds on the side of my toenail. I have attached a picture of my toenail. It is a swelling, and I wonder what can I do to take it away, other than surgery? ### Response: I have seen your clinical picture and gone through your query (attachment removed to protect patient identity). It is because unless you remove the offending portion of the nail, the wound will not settle down. I would rather call it a procedure rather than a surgery, which can be done with local anesthesia (ring block) and in OPD procedure room. Other than surgery, just the debridement and 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: From the start of this month, I have been suffering hip pain and some tightness around the lumbar region. I had a steriod injection and thereafter the pain reduced to 80%. I was on Aceclofenac 100 mg two times a day after 15 days. I had an MRI and the report is attached. I have a major complaint of hip pain. There is no thigh or back pain and no tingling, no numbness. I am able to walk after taking painkillers and I am able to do physiotherapy.Kindly guide as I am still with pain and on painkillers. I am attaching MRI images and report. Also, see remarks about L3. Is it serious? What do I need to do? My current medications include a steroid injection 1000 mg Methylprednisolone, Aceclofenac 100 mg twice a day, Pantoprazole twice a day, and Etodolac400 mg twice a day, and Pantoprazole twice a day. ### Response: I have gone through the attachments (attachment removed to protect patient identity) Your MRI (magnetic resonance imaging) report suggests disc changes at L5-S1 and hemangioma of L3 body. You should understand that MRI is a very sensitive investigation and picks up many features whether they are the cause of a problem or not. Hemangioma is picked up very commonly during the MRI of the spine or abdomen. These are benign lesions from birth and are not operated unless they are the cause of symptoms, which is in very few number of cases. Disc changes too can be seen in a number of individuals as it is a sign of aging. In your case, you only have hip pain with no backache or neurological symptoms so you don\t need to be concerned of any of the findings reported on the MRI. Only when you have neurological symptoms of tingling, numbness, muscle weakness, backache radiating to then legs then repeat clinical examination and MRI might be required. I have a few questions for 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 and my fiancee had sex. I did not have a condom. I penetrated her and we had sex for a good five minutes. I pulled out way before I ejaculation. The day before she said that she was in her period. She also said that she does take the pill but it is only for her breakouts on her face. And I do not know if this matters but I do masturbate a lot like at least every day. So what is the likelyhood that she is pregnant? ### Response: Hello. The fact that she had her menses the day before the episode, so the chances of pregnancy are minimal. However, unprotected intercourse can often allow even the precum to cause pregnancy in spite of having ejaculated outside as it is known to contain live active sperms. So the chances of her being pregnant would have been good if she would not have menstruated or if she would have just spotted. The earliest and the best way to rule out pregnancy would be to get a serum beta hCG test done after eight days post intercourse. If the hCG levels are less than 3 mIU then she is surely not pregnant and her bleed is definitely that of her menses. I hope I have answered your 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: Kindly see the test report and advice what precautions or medications are required especially in the lipid profile section. ### Response: I have gone through your reports (attachment removed to protect patient identity). From your lipid profile test, variables like your total cholesterol, triglycerides, LDL (low-density lipoprotein), and HDL (high-density lipoprotein) are slightly either increased or decreased. All this is a reflection of being obese. But for now, I will recommend exercise and diet. You need lifestyle modification. No medications are needed. Start gym and get a trainer. So he can start you on a training exercise of at least three times a week. Start dieting, eat more fruits, vegetables, whole grain rice, etc. It would be best if you could get a nutritionist to make a diet plan for you. Best regards" "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 having irregular heartbeats for quite some time. I get palpitations and a feeling that my heart is missing beats. I get breathless and dizzy when this happens. Sometimes, the trigger is exercise, either walking or climbing stairs, other times it occurs when at rest. I am currently taking Aripiprazole and Citalopram. The heart problem began before I started taking these medications. I was recently given a heart monitor to record episodes. I can send you pictures of the episodes for you to read if possible. I would like some answers as my local cardiology department is taking some time. ### Response: I understand your concern and would recommend performing some tests to investigate for possible cardiac arrhythmia or other metabolic causes that may trigger this situation. If these tests result normal, you should consider anxiety as the main cause of your complaints" "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 20 years old. I had an unplanned pregnancy. I and my partner decided to have an abortion. I was not sure whether I am pregnant or not because I did not take a pregnancy test. Without taking the pregnancy test, I took an abortion kit, which is similar to Mifegest kit, on the third week. On the second day, I had heavy bleeding and I saw a piece of flesh. I wanted to make sure that whether I was pregnant or not. It has been a week after taking the abortion pills, I am still having bleeding. ### Response: Hello. You should have confirmed intrauterine pregnancy and then after doctor\s advise, abortion kit can be used. Anyway, now you can get checked your blood beta hCG level to confirm whether you were pregnant or not. It can be still elevated slightly if you were pregnant. For your heavy bleeding, Tranexamic acid tablet can be prescribed. I suggest you investigate with transvaginal ultrasonography just now as it is necessary to confirm whether complete abortion occurred or not." "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 39 years old, female, 5\4"", 120 lbs. Healthy, no illnesses to note. Curious if CBC values are anything of worry as some have declined although in normal range over the past four years. ### Response: You have got very good reports (attachment removed to protect patient identity). Your Hb,TLC,TPC counts are in normal range. In addition, you have got a very good lipid profile with good cholesterol HDL being high and bad one LDL being low." "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 a genital wart a few months ago. This wart looked like a dark brown flat mole with a lesion next to it. It was located in the middle and underside of my penis. The dermatologist removed the wart.Recently, I noticed a few fleshy-looking masses near the area of circumcision. I am not sure if these masses were always there or if they were genital warts or if they are just a side effect of the Aldara cream I used for my diagnosed wart. Please note that the Aldara cream caused a rash on my scrotum and other areas of my penis. However, the rash is completely gone with the possible exception of the spot near my circumcision.In addition to the fleshy masses, it looks like there are areas where the skin has silver streaks as if the skin has pulped too tightly. I would like to submit a picture to understand what these fleshy masses are. Are they genital warts? Are they skin tags? Are they an effect of the Aldara cream? ### Response: I have gone through the images (attachment removed to protect patient identity). Kindly send a good quality image" "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 PCOS and I visited a dermatologist for acne and hirsutism profile. She suggested me Krimson 35 for 21 days and Aldactone 50 for three months. I am on my fourth day of my periods and my bleeding had reduced but when I consumed Krimson 35 before going to sleep my bleeding increased. I had clitoris simulation after taking Krimson. Is it because of that I have high bleeding or is it usual to have it while taking Krimson. Please help. ### Response: Hi. Krimson is an Estrogen-Progesterone medicine. It requires some time to balance your hormones. Relax, do not worry about the bleeding until it is heavy like changing pads often like two hours. Instead, clitoris stimulation may have caused some mild uterine contraction, amounting to squeeze out of some blood remnants inside the uterine cavity." "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 vomiting in the early morning. I consulted a doctor, and the doctor told that it is due to allergy. I want to know the reason for having vomiting. Please suggest. ### Response: Hi. Vomiting can occur due to allergy. Causes of vomiting are extensive. It can also happen due to gastritis. If you are having hyperacidity and indigestion, then you can have frequent vomiting. I suggest you take PPI (proton pump inhibitor) with Domperidone combination like Nexpro-RD capsule (Domperidone with Esomeprazole) in the morning in empty stomach. When your symptoms get reduced, you can do an upper gastrointestinal endoscopy to know the cause for vomiting. Avoid having an empty stomach for a prolonged period and avoid taking water immediately after taking food during lunch and dinner." "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 all the four wisdom teeth taken out. But my bottom jaw of teeth is still crowded. I have also read somewhere that drilling out teeth as the answer is a mutilating act against your body, even wisdom teeth. So I would like to know what you think about getting my teeth less crowded and either straightened out or any advise would help? ### Response: If there is still crowding after wisdom teeth extraction you need to get braces by an orthodontist. I need to see a picture of your inside mouth to suggest a treatment plan. Sometimes, the orthodontist may suggest extraction of premolar teeth just behind the canines for creating more space. It all depends on how your teeth are arranged, size of teeth and spaces between teeth. Send some pictures for more details" "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: Actually I had my periods two months back. 15 days later, I had unprotected sex but I took the I-pill on the same day. I took a pregnancy homekit test after 10 days and it came negative. Then I got bleeding for a week which I considered my periods. So, I thought I was supposed to get my periods on the same date this month but did not have any sign of them. I took the homekit pregnancy test a week back and it was negative. Why are my periods late? Can I be pregnant? Should I be worried? ### Response: With I-pill, sometimes periods gets irregular for 2 to 3 cycles. If there is any history of sexual intercourse after last month periods, then you can do blood test serum hCG. If it is negative then no chance of pregnancy at all. You can simply wait for 1 to 2 weeks for periods. But if bhCG is positive then pregnancy is there. And treatment will be accordingly." "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: Which face pack is better to get fair skin naturally? ### Response: I just read your query. See it is not possible to change the natural skin color. However, you can use a face pack to improve your skin luster. In modern medicine, there are options available that can lighten your skin tone and you can ask from a skin specialist about them. As far as the face pack is concerned, you can take Multani mitti (Fuller\s earth) and add a pinch of turmeric powder and sandalwood powder in it and then make a paste using rosewater. Apply this on your face two to three times a week." "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 some queries on HIV. I had protected sex with a call girl four weeks back and do not know about her HIV status. I heard from her, she lost weight in recent months and also has cough. After two weeks, I got diarrhea, itching and feverish feeling. I then consulted a doctor and he said it is food poisoning. I checked HIV through P24 combo test and the result was negative. Again, on the 23rd day, I checked through Rapid test and result is negative. From the last four days, I am having itching, twice bowel movement, and headache from yesterday. Again, the doctor told it is food poisoning. I am worrying, is this sign of HIV? When do I need to be tested again? What are the symptoms? ### Response: Hi. Call girls are high-risk group for HIV infection. Your complaint of diarrhea and fever may be due to anxiety causing increased bowel movements and increased core temperature causing fever. Rapid tests will be negative for 45 to 90 days. It is too early to have diarrhea and fever from HIV infection. Get tested for fourth generation HIV tests after 45 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 29-year-old male, and have stomach pain for around a week (mostly after eating). The pain starts in epigastric regions, and then to lower abdomen. I started noticing changing stool color to more darker stool. There is no diarrhea or vomiting, no fever. I am taking Omeprazole for two days without a relief. What could be the reasons? And what should I do? ### Response: Hello. Darker color stools are not a good sign. Kindly do a stool examination and visit your family physician for a thorough check-up, so that he can determine the exact cause for your discomfort. There are many reasons like peptic ulcer, a bacterial infection of the stomach, inflammation of the stomach or intestines, amebic or parasitic infestation and many other causes which could be diagnosed only after a check-up and investigations. I have named just a few common ones. Kindly do not ignore and meet up with your family physician at the earliest" "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 a male, 27 years old. I got blood while pooping without pain today morning twice but without any pain. ### Response: Blood in stools can have multiple reasons from simple hemorrhoids to some serious ailments. I would advise you to visit a gastroenterologist and get a sigmoidoscopy done. It is a simple test and takes hardly 10 minutes. It involves passing a small tube-shaped soft camera from the anus into the large intestine and trying to find the source of bleed. It is a painless procedure with the only sensation being mild bloating." "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 22-year-old man. I have suffered for two years with chronic, nearly debilitating fatigue. Doctors initially suspected a vitamin deficiency or autoimmune illnesses as the cause, but all tests came back negative or normal. However, when I started this summer to notice myself waking up and gasping in the night, my doctors decided to evaluate me for a sleep breathing disorder. I underwent a home test and then an in-lab test. My in-lab test results were as follows: my AHI was normal, but my Respiratory Disturbance Index was 11.3/hour. My lowest oxygen level was 82%, and my REM sleep accounted for just 10 % of total sleep time. Based on these results, my doctor diagnosed me with mild obstructive sleep apnea.My doctor has recommended an oral appliance as the first step for treating this condition, but I know that CPAP is a more common solution. I am really not sure what the best course of action is. All I want is to reduce my fatigue levels and get my life back. What is the best option at this point? ### Response: As per your medical history it looks like sleep apnea with obstruction. We all can agree that it is a disorder which takes away the quality of life and it is very frustrating at times. Good news is that you have been diagnosed so early. Current treatment with CPAP is the best treatment for medical conditions and things will improve over a period of time. Other things to be seen are overweight, sleeping position, stress mangement and any surgical cause of this obstruction which would require a operative correction. Check your blood pressure regularly." "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 7-month-old baby does not want to feed on the bottle. I am currently breastfeeding and I want to feed her Enfamil. What can I do about it? She is not gaining weight. Her weight is consistent at 7.5 kg since she was 4 months old. But she is good. No illness. But my main complaint is that she does not want to drink from her bottle and I do not want to breastfeed anymore. ### Response: Hi. I understand your concern. Bottle feeding is not recommended to any child for long term. You can try spoon feeding. Yes, it will not be easy to shift from breastfeeding to top feed. Should try gradually. As per WHO, the baby should be continued on breastfeeding for a minimum of 1 year of age. It is good for overall long-term growth of the baby." "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 get bruising easily. My blood reports are fine, and the bruise gets clear with vitamin C and K tablets but occurs again when I stop the medicine. Why? ### Response: Kindly mention since how long you have such problem? And mention the duration of the treatment. In such easy bruising case, the causes like liver disease, low platelet count, and coagulation abnormality have to be ruled out. You have investigated for that, and all the parameters are within the range. So if your problem is since a few days, then you can continue oral vitamin C that is Limcee and topical vitamin K. If the problem continues, then consult nearby hematologist for detailed evaluation. Hematologist might evaluate further in the form of fibrinogen estimation and full coagulation profile testing. I hope I have answered your question. Let me know if I can assist 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: I have shoulder tendonitis, and it has been three months already without significant results. I want to know the fastest way possible to heal it, I tried physical therapy, but it did not have much of an impact. ### Response: Hello. It will be useful if you share the MRI reports. Well, I would like to know what movements are so painful for you and in which position the pain is highest. Once you let us know, we can provide you the accurate exercise prescription. In general, for any tendonitis, it is must that the shoulder girdle stability exercises are to be done. Post which there will be a set of passive or active-assisted ROM exercises. As once we get a good range which comes closer to pain-free, we can look forward to holding relax activities and contract to relaxation exercises. On the later stage, we need to look forward to deltoid strengthening exercises, scapular muscle strengthening exercises, and arm strengthening exercises. Also, if the MRI report shows that there is a partial or complete tear of the tendon, then the treatment has to be changed. In most cases with proper physical therapy guided exercises, the improvement should come in 2-3 weeks. In case if you have more queries, please feel free to contact me, and I will assist you for the same." "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: Hello,I had sex and took i-pill. My periods started around 12 days later and lasted for 4 days. I got my periods next month around the same date, which lasted for just one day. So, I took a urine pregnancy test, which was negative. I got my regular periods on the third month as well and it lasted for 3 days. My next periods lasted for just 2 days. I have read on the internet sources that many women get periods during their pregnancy. What are the chances of me being pregnant? I am doubtful because I always used to have regular periods which last for 5 days. ### Response: Hi. How was your bleeding during the cycles? Was the flow scanty when compared to your previous cycle (I am not talking about the duration of flow here)? Revert with the details to 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 having a bunch of bumps on my dick. I think it is because I jerk off a lot but I am not exactly sure what it is. I have no discomfort, no itching, no discharge. ### Response: Hello Are you having any pain or burning sensation? These lesions look like herpes simplex virus infection. It may cause lesions on face and genitals also. Use Acivir cream (Acyclovir), and tablet Acivir 400 mg thrice a day for five days. If symptoms are not improved, please consult your doctor. He will examine and treat you accordingly." "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 8 months and 10 days pregnant. I am having itching in my whole body from the last eight days. I also tried Aloe Vera lotion for it. Is taking Atarax tablets safe for me at this time? ### Response: Do you have itching with rash or without rash? And do you have itching palms and soles as well? You may have obstetric cholestasis and you must see your obstetrician immediately and do not self treat the condition. You need liver function tests. Get checked to see if the liver is working properly because it is a serious condition in pregnant women and may have adverse effects on your baby as well if left untreated." "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 dad is 78 years old. Recently, (one month back) he had acute left medullary infarct with hyperacute infarct of the midbrain. After which he is unable to open both of his eyelids on his own but can see when we lift the eyelids, also his voice was very low.After a month now his speech has improved but the eyelids issue is still there. Can you please suggest any treatment for his eyelids to open? ### Response: Hello. As you have described, your father had brain infarct after that he developed all symptoms related to eye right. So let me explain you that in case of stroke or infarct in the brain there will be involvement of cranial nerves also. The cranial nerve which is responsible for elevation of eyelid will also get affected in such situations like stroke. So the same thing has happened here in your father\s case. So for treatment of his eyelids, only surgery you can plan but you should consult oculoplastic surgeon for that. He is the one who will measure all the parameters and depending on that he will tell you which surgery he should undergo. So my advice is you should take your father to an oculoplastic surgeon for this problem. 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 having heart palpitations. I have low blood pressure and low heart rate. ### Response: I understand your concern. You should know that some palpitations are quite normal in every healthy individual, especially during physical activity and anxiety. Anyway, as you are feeling them more frequently lately, I would recommend consulting with your attending physician and performing some tests like a resting ECG, complete blood count for anemia, blood electrolytes for possible imbalance, thyroid hormone levels, an ambulatory 24 to 48 hours, ECG monitoring in order to examine your heart rhythm trends for a prolonged time and investigate for possible arrhythmia. You should discuss with your doctor on the above tests. Anxiety or cardiac arrhythmia. Holter monitoring, blood electrolytes, thyroid hormones level." "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 masturbating in the shower with soap, I had a slight itch at the bottom left side of the penile meatus. I continued to masturbate in the next two days, and the tip became very irritated. I have been treating an irritated penile gland (feels like sandpaper at the tip when rubbing against clothes) with an antifungal cream for about 14 days. It is 98 % gone. There is no discharge or pain or itching when urinating or ejaculation. I live in a place with high heat and humidity. I also have a lot of sweating during sports-related activity. Is this a fungal infection or could it be something else? ### Response: Hi. The changes are due to irritation with soap as well as due to frequent rubbing. Any soothing and moisturizing cream or lotion would help to resolve. Were there any white patches to suggest fungal infection? Did you have any sexual contact recently to suspect any infections? We cannot rule out the possibility of superimposed fungal infection as the fungus is usually present in that area. Trauma to the mucous membranes helps their proliferation leading to worsening of the symptoms. The possibility of any other STD (sexually transmitted diseases) appears to be less if you did not have any recent sexual encounters" "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 daughter has acne on her face for the past one month. I think that is hormonal acne because it is in her chin and jawline as per my knowledge. She is taking Cabergoline .25 mg per week for an increased level of prolactin as prescribed by an endocrinologist for the past three years. There is no acne on her face for the last three years but now suddenly it appears on the face. Sometimes it is white and small and it often occurs on a daily basis. Kindly suggest. ### Response: I have gone through the history and prescription you have attached (attachment removed to protect patient identity). Honestly speaking, I cannot understand what is written in the prescription. Can you send me a picture of individual medication so that I can get an idea of what is she taking? It will be of great help to guide you further with new medicines and creams." "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 21 years old. How to control masturbation because I am daily doing it alone, and how to manage my health? ### Response: Hello. Masturbation is a natural process which occurs in hands in spite of the vagina. But having sex and inserting penis in vagina is also associated with increased arousal and sexual feelings and a sense of love and affection, whereas masturbation is opposite, masturbation is a self-pleasure technique in which you try to achieve the same sense of sexual pleasure being alone. Remember, all the same hormones are never involved as it does give pleasure, but it is not the same. Along with that, please remember doing anything in excess can harm 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 an 18-year-old girl. I have been a patient of beta thalassemia major. Recently allogenic bone marrow transplant was conducted (70 days since transplant). Before this, I had no history of any allergy or rash or another disease other than thalassemia. Recently, I have felt itchy throat-stuffy nose only on one side of the nose that is open and closes when I lie down. Moreover, due to an itch, there is a cough. No nasal drippings. ### Response: Hi. Your symptoms are suggestive of upper respiratory tract infection, possibly allergic inflammation. I suggest you investigate with CBC for primary work up. Meanwhile, a decongestant can be prescribed for your symptoms. Salt added lukewarm water gargle can be beneficial. Avoid the intake of excess spicy foods." "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: Day before yesterday my lens got lost in my right eye. I thought it must have fallen. Later, my eye turned red and started mucus discharge and the next day the lens was expelled. So the redness got reduced but now there is mild drooping of the eyelid of that eye. Please help. ### Response: Hello. Most probably you have infection of the eye, due to lens being there for a long time. You should start putting some antibiotic eye" "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 5 year old son has poor vision -2.0. He improves his eyesight by doing eye exercises himself. Should he wear eyeglasses? ### Response: I do not know whether you have got his cycloplegic refraction or not. Is this just auto refractometer finding or final refractive power? Anyways, I will suggest you get a repeat cycloplegic refraction done at a good center by an optometrist who is experienced. Secondly, this refractive power is significant enough to cause symptoms. Your son may be able to correct it because of high accommodation at this age but this is not good. He may develop squint or many more other problems if not treated. So get his refraction done as soon as possible and use appropriate glasses" "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 bowel movements a lot more than normal for a week and today it has gone to the point where I went and came back after 10 minutes. I eat salads all of the time. I have the feeling that I really have to go and most of the time only a little comes out sometimes, a lot comes out and there is no consistent form in it. I had Clostridium difficile colitis before two years. ### Response: Hi. Hope, you did not have any recent change in your diet habits and you are not taking any medicines which can potentially alter the bowel frequency. Transient changes in bowel frequency is a normal phenomenon. Nothing to worry much. Keep a close watch. You need to worry only, if you have watery stools, blood in stools or if you have pain associated. Other precipitating factors like anxiety, stress is needed to be ruled out. I suggest you a probiotic capsule (Darolac) once daily. Have a good diet with more salads and adequate water" "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 having tooth pain for about six weeks. It is only when pressure is applied when I eat. No sensitivity to cold or hot. I went to the dentist and he took X-rays and compared them to routine X-rays taken a couple of months prior. He said the two sets were the same and saw no reason for the pain.He tested my bite with that blue paper and thought the issue might be related to my bite. So, he filed down one of my teeth ever so slightly and thought that would do the trick. Two weeks later, the pain had not subsided, I went back and this time he performed a CT scan. He thought maybe there was a crack or something that was not picked up by the X-ray. The scan was also normal, and he could find no reason for the pain.He said he thinks the best option at this point would be to perform a root canal. Is this the best course of action? ### Response: As per your history, there is no pulp cavity exposure or even if there is a crack that will not cause the pain. The reason I think is the filling, which may be high (high point). The second reason may be a periodontal problem. I do not think RCT (root canal treatment) is the best possible cause. If you would have any sort of sensitivity, root canal could have been the option. I think it is purely pressure-related. For that get your filling trimmed a little bit. Wait for two to three weeks, I think it will be over" "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 newly married groom. While having sex I ejaculate too quickly. I want to stay long. I have tried doing the Kegel exercise and start-stop method but that too does not help me stay longer. Please help. I am 27 years old. ### Response: I do understand the problem that you are going through. But you need to understand this. Normal intravaginal ejaculation latency is 1 to 2 minutes. If someone ejaculates within 60 seconds of vaginal penetration, that also persistently over last six months, then he can be said to have premature ejaculation. Besides, yes Kegel exercises do help in improving the timings but gradually. Also, try changing your position while having sex (cowboy or reverse cowboy is helpful)" "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 nose feels partially obstructed, and my head feels swollen. What to do? Please help. ### Response: Hi. Nasal obstruction most commonly occurs due to nasal congestion secondary to allergy or infection. But sometimes it could be due to Deviated Nasal Septum (DNS), which requires examination or x-ray of PNS for confirmation. Most likely in your case, it is nasal congestion with sinusitis. I suggest you try taking tablet Allercet-DC (Cetirizine and Phenylephrine) twice a day for 3 days. Take steam inhalation thrice a 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 terrified of preterm labor. I am obsessed with checking for signs that I will go into labor early. I am currently 24 weeks pregnant. I had my last cervix checked maybe three to four days ago through digital examination by a doctor. It was long, closed and thick.Does this mean I am in the clear at least for the next week or so? I also had a transvaginal ultrasound done on the 20th of last month, and my cervix was over 4 cm, with no funneling. ### Response: Do not worry. You have developed prepartum anxiety, no need to worry, and funneling is not there kindly go for regular prenatal checkups once in four weeks." "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 bruxism and TMJ, and I just started using a mouth guard that I got from my dentist. I am concerned because when I wake up in the morning, I feel that my bite is different. My back teeth do not touch. However, after 1 or 2 hours my bite goes back to normal. Is this normal? ### Response: Hi. Do you wear your nightguard properly at night? If yes, then it is normal that you feel the gap between teeth. As it is the prime function of giving you nightguard that it does not let your teeth overlap firmly and deeply. This tray does not allow teeth of both arches to meet another and creates a gap of about 0.5 mm to 1 mm while you are wearing it. When you keep wearing it for a long time like 4 or 6 months it eventually creates this 0.5 mm gap in your TMJ that is the real achievement, now even when you do not wear the tray your teeth will not overlap deeply and will maintain some space in between. That is a good sign. Stay happy and blessed." "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 21-year-old male and I have a partner of 19 years. We go along well. But my problem is that I overreact a lot on her actions. Like if she does not text me, my mood gets changed and I will be angry. But, I want to change myself. I want to change my attitude. I want to be more friendly. Please help. ### Response: The first important thing in a relationship is that do not force her for anything and accept her however she is. Do not try to change her. Give her personal space. If you overreact then you may lose the love and respect for you. Spend some quality time with her and try to know her likes and dislikes. Be a man. Do not make her cry and do not get possessive for anything. Trust her. Let her know that you are waiting for her response" "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 some help with the prognosis of my friend\s father, who is in a coma due to a road accident, while he was on a bike. He is 76 years old, and his heart stopped, which was resuscitated after some time. His coma score is minimal, and he is in this state from the past 13 days, with no changes. We would like to find out the prognosis and possible likelihood of coming out of the coma. I am attaching all his test reports. ### Response: Hi. I have seen all the attached reports (attachment removed to protect patient identity). Please do write back with more doubts. Praying for a quick recovery of the patient. Regards" "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 two small white spots on the lower portion of my front tooth. Can it be removed by microabrasion? Is the procedure worth? Please guide. ### Response: There are several reasons for the white spots on your teeth. Usually, white spots appear when the mineral content in the outer part of the teeth (enamel) is less. Are the white spots only on the front teeth? Or do you have them on other teeth as well? Microabrasion certainly does not help whatever the cause of the white spots may be. It just makes the surface of the teeth rough and gives rise to other problems. You could consult your dentist and ask whether bleaching can be done. There are other options like placing a veneer on the surface of the teeth. However, a small part of the tooth surface needs to be abraded to place the veneer." "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 on the first day of my period. I took an ECP on the same day eight hours after the act. It is one month now and I am six days late for my period. Previously, I had a regular cycle of 30 days. I had taken two pregnancy tests, one on the first day of the missed period and the other four days later and both are negative. Please suggest. ### Response: I have gone through your history and understand your concerns. As you had an I-pill, the chances of pregnancy are not there in your case. The delayed periods could be due to hormonal imbalance caused by I-pill. You can just wait and watch for your menses for three more days and repeat your home urine pregnancy test to rule out pregnancy. Hope you found it useful, feel free to ask more information" "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 problem in my front upper tooth. It is brown since childhood. I do not know what to do. I need suggestions. I got into an accident a couple of years ago. Since then, it is in this condition. ### Response: I have read through your complaint and the relevant details along with the picture attached (attachment removed to protect patient identity). The upper front tooth has the brown discoloration because of no blood supply to the tooth. The accident you had before two years would be the reason for the tooth's trauma. Because of the sudden impact the tooth, it has lost its vitality and slowly changed color. You would have no pain at all in this particular tooth. The treatment procedure is a root canal treatment followed by a tooth-colored ceramic crown (cap) that matches your adjacent teeth. This should take a maximum of four appointments totally. An X-ray will also be taken prior to root canal treatment. I am sure you will be happy after this treatment is 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: Yesterday, my puppy has bitten on my finger. It is vaccinated, should I take injections? ### Response: Hello. If your dog has been vaccinated, your dog is immune against rabies. So, you do not need to take rabies vaccination if your dog is immune against rabies. Take tetanus toxoid (TT) injection if not taken." "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: Ropinirole to boost dopamine after Paliperidone treatment for schizophrenia?I am a 46-year-old male. I have been in hospital a couple of times recently, in their judgment I was quite unwell (paranoid about spooks after certain events), diagnosed with schizophrenia (though I am not sure, although I was extremely paranoid), and they put me on a CTO for injections of Paliperidone, which I have been on for the last 18 months or so. 100mg I believe for 6 to 12 months, then 75 mg for six months, and now on the lowest dose that it comes in and have been completely free of thoughts of spooks for nine months, so I am well. But I notice that I seem to be a little zombified due to the effects of the drug, and am worried about Dopamine impact (an important chemical), and frankly, I would like to try to help restore Dopamine to a healthier level. I am not sure that is going to happen naturally, so was wondering about a low dose of a Dopamine agonist like Ripinirole for perhaps a year or so, to get things moving in the right direction. Whether this would actually help restore dopamine function though I am not sure. Also, it can increase the chance of psychosis, hence the preference for low dosage. What I am after then is some brief comment on whether you would recommend this or not (at a glance), or something else. Any comment would be appreciated. ### Response: Hi. Taking Dopamine agonist to restore dopamine level in the brain after giving antipsychotics for schizophrenia is not a suitable choice because of relapse of psychotic symptoms or exacerbation of symptoms not only psychotic symptoms but mood symptoms, these side effects are called extrapyramidal symptoms which can be managed to give anticholinergic medications along with antipsychotics, better to visit your treating doctor to have healthy discussion on this." "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 3-year-old son. He has mild puffy upper eyes often. It seems to show variations in both the eyes, occurring in one or other day. On one day, it is not puffy. I can see his eyelids looking good. On the other day, it seems puffy involving one or both eyelids which are covered by the skin above them.He usually wakes up with puffy eyes, and it remains throughout the day. Then the next morning, when he wakes up, they will look good. It happens like this, again and again, a couple of times in a week. He does not have itching in his eyes. What could be the cause for it? ### Response: I have gone through your query (attachment removed to protect patient identity). I feel that your son is suffering from blepharochalasis. It is a recurrent swelling of the lids which subsides on its own. However, there are no trusted tests to confirm the diagnosis or any other effective treatment for the disease. Consult an Ophthalmologist to be on the safer side. It can be done at your convenience, and it is not an emergency. My advice is to see an Ophthalmologist in case 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: I get pain when my husband inserts, but I am not sure it is because of fear or physical pain. I contract my muscles and thighs, and he is not able to do it. We are not having proper sexual intercourse. I get highly wet too but contract myself when he inserts. Please help. I feel it is more of mental blockage. ### Response: Hello. It might be mental stress or fear. But you must get checked up from gynecologist to ensure there is no physical problem. Some women do have strong constrictions and pain during sexual intercourse. If you still feel it is a mental issue than following tips may help, 1. Discuss with your husband before having sexual intercourse. 2. Read about female sexual stimulation process and the reproductive system. Learning about your body also reduces fear. 3. Learn and discuss sexual intercourse process through reading or consulting an expert." "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 underwent breast cancer surgery a year back. She was then prescribed Arimidex 1 mg tablet daily. She developed sciatic neuralgia which made bending and walking extremely painful. The ayurvedic doctor who cured her ascribed it to Arimidex which robs calcium of bones.Can you recommend other medicines which can substitute for Arimidex? ### Response: Sciatica is usually due to local compression over the nerve supplying legs like the one with disc prolapse. Arimidex (Anastrozole) is a hormone used for the treatment of breast cancer and can cause diffuse bone loss. That is why we give calcium and Vitamin D with these hormones to maintain the bone density. So my suggestion is to continue Arimidex till the response is there. Discuss this issue with your oncologist, and I am sure he will add calcium and Vitamin D" "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 side headache. How to cure it? Will you please give your suggestion? During maigrane headache, I have vomiting. ### Response: You seem to be suffering from migraine. Treatment of a migraine is mainly prophylactic, that is, the medicine reduces the episodes of a headache. Tablet Flunarin 5 to 10 mg HS should be taken daily. There are other prophylactic medicines also available. Further, you better see a neurophysician, get all the routine investigations done including MRI and EEG. Avoid triggers of a migraine like taking proper sleep, avoid bright lights, loud noises and it could be any other source." "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 12 year daughter has been suffering from seizures since birth. The cause of the seizure was not known, that is, idiopathic. She is now taking Valparin 500 Chrono and Levipil 750 both two times daily. Last seizure occurred four years ago. Developments are slow although attained puberty last year at the age of 11 years. Academic achievements are fairly poor seemed to be dysgraphic. Can I expect any improvement in the future? ### Response: Hello. Both these conditions, indicate that her brain is not like other girls of her age. On the other hand repeated seizures, lead to important neuronal (brain cell) damage to her brain. For this reason, we cannot expect her to have the same development as others. But, as she is still young, there is still hope for improvement in the future. You should just try to be more patient. The most important thing is that her seizures seem to be under control with her current therapy. Regarding her current therapy, you should know that Valparin can lead to ovarian cysts and menstrual cycle irregularities. For this reason, I would recommend performing periodically an abdominal ultrasound to check her ovaries. Hope you will find this answer helpful" "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 8 months, weighing 8.5 kg) is suffering from fever frequently once in 10 days for last two months. We have got urine (culture and routine) and blood tests (CBC, CRP, IgE total) done for my son. The urine report is normal. However, as per the blood report, there is some infection in the blood and Hb is low (attached reports). So, the doctor prescribed some medicines (Lacktrum powder) and we started giving the medicine from last week. We have been also giving Vita Nova D3 and Bevon since his birth. Today also he got a fever. Why is the fever still continuing despite being on medication? Is the medication enough for him? Any other tests required? Please provide your opinion on this. Also, he is falling down frequently while trying to stand or sit. Will it be an issue? ### Response: As per the blood investigations, you have shared (attachment removed to protect patient identity), it suggests that there is some bacterial infection in the blood. I suggest you start a course of antibiotics for your child at least for five days, preferably Amoxyclav (Amoxicillin and Clavulanic Acid) or Taxim (Cefixime) depending on your paediatrician\s recommendation. Rest is fine in the report. You need not worry. It is common in this age group" "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 took Invega for one week. It changed my nervous system and caused erectile dysfunction. My question is, will my body return to their previous state? My movement is not as fluid, and I still have mild erectile dysfunction. Has Paliperidone caused permanent damage to my nervous system? ### Response: Hello." "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 unprotected sex with my girlfriend and she took the pill(Unwanted 72) within an hour. Two days later, after taking second pill accidentally we had unprotected sex. But, in both the cases I did not ejaculate in her vagina. Now, five days got over and she did not get her periods yet. What are the chances of pregnancy? ### Response: Hi. Firstly, I would like to inform you that taking an I-pill will not cause periods. The periods will come at its own time, maybe slightly late too. Delay in periods after I-pill is a common and expected side effect. Secondly, I would suggest you not to take more than one pill a month as one pill can cause serious hormonal changes. Also, it is best to take it only in emergency. Casual and frequent use can cause long-term problems." "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 18 weeks pregnant and have symptoms of severe anxiety and insomnia. Can I take anxiety medicine in pregnancy? Please help. I used to take Melzap 0.25 mg and Etilam 0.25 mg. ### Response: Hello. Melzap (Clonazepam) and Etilam (Etizolam) which is used for anxiety are not really safe during pregnancy. But, the benefits of taking the medicine, have to be weighed against the effects of anxiety over pregnancy, if not treated at all. This has to be done by you and the treating doctor where the severity of your anxiety matters. So, I suggest you consult a psychiatrist in reach of you, as, if at all you start the medicine, it should be started with a low dose and regular follow up. Also, I suggest you try relaxation exercises to control your anxiety. Regards" "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 having undiagnosed flares for the past five years. The symptoms are usually similar, but during each flare I have a few different ones that seem to take the lead. They almost always start with pain in my legs. First it starts with shin, then calfs, thighs and butt. The pain usually spreads randomly, but this time it started and sets in as a longer crushing pain.The pain spreads to the joints, muscles and the eyes. It seems like organ pain. I also get muscle spasms throughout the body. I get very strong headaches that usually start behind one eye and feel like a tension headache. I also get long and short stabbing pains in my head. During my current episode and two previous ones, I also have very apparent neurological symptoms such as vertigo, brain fog, etc.I have gastro symptoms as well, such as constipation, diarrhea, abdominal pains and upper right quadrant pain. I also have frequent urinary symptoms and sharp random pains in my groin, testicle and penis. I have also had blood in my urine. I have heart palpitations too. This is not happening with this flare for some reason.My random symptoms are hives, especially in one patch on my left rib cage only, rapid weight loss (I have lost 10 lbs in one week and 30 total during the first episode), interrupted sleep, red irritated eyes, occasional sore throat, nasal drip, strong fatigue and occasional mouth sores. I have had MRIs, ultrasounds and CT scans, which were all negative. I am going for another brain MRI and ECG by next week.My blood test shows ESR - 3 x negative, CRP - 3 x negative, CBC - 7 x always in range, metabolic panel - always in range, cortisol - negative, RA and lupus serum - negative, Lyme (ELISA) - negative, HIV - negative, ANCA - negative, ENAS - negative, Ferritin - slightly elevated, celiac panel - all negative except gliadin AB, IgG positive, TSH and free T4 - in range. Biopsies for celiac and Crohn\s were negative. Do you have any ideas of what this syndrome could be? Please help. ### Response: I am sorry that you have been through so much in such a young age. It is a relatively rare disorder that causes blood vessel inflammation throughout the body. Unfortunately, there are no classical laboratory tests in Behcet's syn" "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 my first tonic clonic (grand mal) seizure seven days ago at work. It lasted 1 minute 30 seconds. I bit my tongue badly, but did not have any incontinence. Beforehand, I was shaking, had a loud beating heart and had a feeling of vertigo and anxiety. Afterwards, I was confused for approximately 15 minutes. I was being very active at the time and was bending down and rising several times to tidy up a room, which may have contributed to feeling faint or having a head rush.I am a 27 year old obese woman. My height is 5\6"" and weight is 266 lbs with untreated bulimia that comes and goes in phases since the age of 15. For the previous three months, I alternated between low carbohydrate days, the days I accept as good days and bad days where I may binge and purge up to three times a day. I vomited 12 hours before my seizure and did not eat or drink anything after that. I had 5 hours of sleep and then drove an hour to work. After my seizure, my employer, who happens to be a doctor, gave me lots of water and tea and sent me to a GP. An hour later, I had a blood test and the results came back all normal, but borderline low potassium. My ECG scan is normal and nothing wrong with reflexes or balance. I do not have diabetes. I have also seen a neurologist, who has put the seizure down as isolated and unprovoked.I have not told my GP or my neurologist about my bulimia. My MRI and EEG scans are pending, but my neurologist said that they will probably come back clear. I have never felt my aura before as any indication of epilepsy, minor seizures or myoclonic jerks. I have also scared of my bulimia now, which is a positive. I realize that I am probably clutching at straws or in denial that I may have adult onset epilepsy. ### Response: Hi. I have gone through your query with diligence and would like you to know that I am here to help you. Your neurologist has labeled this as unprovoked seizure since he was not aware of this. Because of this, they may diagnose this as epilepsy, when it is all the more possible that you had a episode of fits due to hypoglycemia and messed up electrolytes due to bulimia. By hiding your bulimia (eating disorder) to the neurologist and GP, you make it a risk of another worse diagnosis of epilepsy. Bulimia is a much simpler disease than epilepsy. My suggestion would be to tell the GP and neurologist the truth and get treated for bulimia and save your future." "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 24-year-old with type 1 diabetes looking to conceive. I am currently 145 pounds and 5\6"" tall. What do I need to do? Currently, I am taking Insulin. ### Response: Hi. How are you doing? Before you plan to conceive, just try to lose some weight. For the height of 152 cms, ideal weight is 52 to 57 kg. I am sure this will reduce your requirement of Insulin too. As pregnancy progresses the dose of Insulin will need titration. Try to lose that weight not by changing your diet, but by increasing or changing your daily exercise schedule (a lot of cardiac exercises). One month before you start trying, start on tablet Folic acid 5 mg per day, as this will reduce the risk of fetal anomalies, early pregnancy loses. Have a baseline HbA1c. Only when it is < 6.5 %, which signifies the blood sugars of the previous three months, then you try for pregnancy. You can have a complete blood count to rule out any underlying anemia, etc. All the best." "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 30 weeks pregnant. Went to doctor with three thrombosed hemorrhoids. Doctor gave me cream and suppositories. I am in agony and cannot move without being in pain so went back to doctor today who said they need to be drained. I spoke with the surgeon in the hospital who advized that because I am 30 weeks pregnant they will not give me general anesthesic to drain them. And instead keep doing the cream and suppositories and also ice packs and rest.My question is that the piles are easily the size of two grapes in one and I cannot even sit down. I have to lay down and cannot do anything. Has anyone experienced this size of piles before and will they just decrease in size and if so what is the normal timeline as I am finding the pain hard. ### Response: Piles in pregnancy can happen due to increased intraabdominal pressure. For patients who have hemorrhoids before pregnancy they increase more. Now as it is 30 weeks you can wait for another 6 to 7 weeks. They may decrease in size once delivery is over or else you can go for surgery. Now use cream locally. Increase fibre in food." "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 a second opinion on getting a surgery done for breast cancer after chemotherapy. ### Response: Hello, Welcome to ilciniq.com. There is are multifilament lesion (attachment removed to protect patient identity). I suggest total mastectomy, which is complete removal of the breast. The chances of recurrence will be low in this approach." "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 boil near my anus for the past two years. Kindly advice. ### Response: From what I can see, it appears to be an abscess. The fact that it is reoccurring means that it has never adequately been dealt with. I would like you to answer a few questions before we go forward. 1. Apply an antibacterial cream, and have antibiotics. 2. Get an incision and" "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 25 years old. I am 6 feet tall and my weight is 86 kg. Basically my entire problem starts at night while lying down. Three to four years back, I had mild pain. While lying down I feel acute pain or some tingling in my left chest sometime it goes down around my body. When I am about to get sleep I feel short of breath then I had to wake up and sit for a while. And also my nostrils are too often blocked. For few days I had Levocetirizine and currently just using nasal drops. Consulted many doctors over the years. As per the doctors I have nasal muscle swollen or increased which is blocking the way. I had undergone some tests of heart (ECG) and took chest x-ray. Everything was pretty normal. But from last 3-4 days my nights are hell. I could not sleep at all. I am a smoker (half cigarette per day) and drinks alcohol twice a week. Please tell me which doctor to consult? Is it something serious? ### Response: I have checked your x-ray reports (attachment removed to protect patient identity). 1. You have deflected nasal septum with C-shaped deformity of the septal bone and cartilage. Due to this reason you are getting sleep apnea, breathless nights that makes you to wake up and sit for a while to catch the breath.2. Chest pain is an additional symptom that may be due to smoking and it is giving bad impact on your lungs.3. Smoking keeps lung tissue irritated and causing inflammation and then healing. This gets repeated in your case.4. You need to curb smoking and alcoholic beverages.5. Consult a sleep apnea specialist for better management. If felt necessary he will advise medication or will refer you to an otorhinolarngologist for nasal defects. That may need surgical correction. Consult your doctor for prescription of :1. Prednisone by mouth.2. Ibuprofen oral.3. Ebastine (Evastine) oral.4. Use saline nasal spray for better relief." "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 tissue transglutaminase IgA are high but I have not done any biopsy but done only an endoscopy (normal). If my TTG IgA is high then I must be having celiac disease because this level only goes high with celiac disease, am I right? Then why do I need to go for biopsy as it is a painful procedure? ### Response: It is useful for comparison of severity of bowel involvement in raised antibody status. Raised IgA TTG level grade according to Marsh classification if your antibody level less on Marsh stage you may need a biopsy. If the patient is suffering from hypoglobulinemia present with less IgA level may present even though positive results but severity of bowel involvement is high. So, in that case, we need confirmation. I think I answered your question. If you have more questions feel free to ask" "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 noticed a skin colored bump on the underside of my penis. It is round and a little less than one inch in diameter. It feels to be hard when pressed and pains a little when pinched. Could this be syphilis? ### Response: Hi. I saw your picture (attachment removed to protect patient identity). Your concern is furuncle. Start using T-bact ointment twice daily on the lesion and have plenty of water. This will help you. It is not syphilis." "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 21-year-old female, 1.75 m and 70 kg. For the past two to three months, I have been under quite a lot of stress due to an ongoing internship and various school commitments. I am experiencing dull, persistent aches and pains (at times these are sharp pains) on my right abdomen, and I am suspecting it is related to my womb or uterus. I also have sharp and dull pains along my backbone. I have been deferring a visit to the doctor as I had dismissed it earlier thinking that it was due to my frequent dance practices (three times a week). However, after many online searches and having a paranoid mind that causes me to overthink, I ran out of options except to seek for your professional advice online before seeking the help from a physical venue. Could you kindly help diagnose my ailments? ### Response: According to your complaints, it seems you may be suffering from muscular pain if your pain is not related to any signs like change in bowel habits or related to any abnormality in periods or menstruation or any kind of change in stool or urine and any other associated symptom like nausea or vomiting or relief of pain after bowel movement. If any of the above is present and/or if your pain does not subside in two days or if it recurs anytime again, please get yourself examined by a surgeon" "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 an episode of severe palpitations early this year, following which I went through ECG, 2D echo, stress test, and troponin. All the tests were normal. I have been experiencing intermittent chest, neck, and back pain since two yrars. The doctor started with Nebicard SM 5 mg, which he recently halved to 2.5 mg. Both the cardiologists I visited, have ruled out the possibility of a cardiac problem. I am anxiety-prone. I often feel like I may die of a heart attack. The thoughts of death have increased in the past two weeks. My pulse rate seems to be between 55 to 65 bpm at rest and does not seem to rise beyond 80 bpm even while walking. The chest, neck, and back pain still persists. At times I feel dizzy, weak, and very occasionally feel short of breath. ### Response: Hello. I understand your concern. Anxiety is widespread amongst healthy young adults these days. Most often, palpitation is not as a result of a heart problem. I usually advise my patients to engage in exercises like Yoga or deep breathing exercises. Getting adequate sleep of six to seven hours, avoiding coffee, alcohol, and smoking will help your situation. If you stick to these changes, there should be an improvement in four to six weeks. If you do not get better, you will have to see a psychologist. Best regards." "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 brief interaction with a woman who is very likely to have STD, specifically herpes, and I have a few questions about herpes testing. The full story is that about three weeks ago, after a bad breakup, I went to a massage parlor. The parlor was the type that is sort of seedy and known for extras and the masseuse assumed I wanted sex and was immediately ready to go. I sort of talked her down to a handjob and the masseuse took off her clothes, straddled my legs, and did her thing while I lay on my back. For about 10 seconds during the hand-job, her genital area was pressed against my scrotal area, and she also kissed the shaft of my penis twice. There was no intercourse, and I did not see any herpes lesions on her, but I also was not able to look inside her or get more than a few brief looks between her legs before she was on top of me.After the experience, I was very worried about having contracted herpes from the genital contact, so I got some tests done. An IgM plus a full STD screen at three days after the incident, and an IgG and a second IgM at 10 days after the incident. Everything was negative. I have had no symptoms other than a bump on the inside of my thigh, and I have had bumps before in the same spot due to thigh chafing when I walk. I actually had one on the other thigh before the incident. Currently, it is about 22 days after the incident, and I am planning on getting a third IgM done to be extra sure there has been no change. What worries me is that I have read online that the IgM test is unreliable and that 50 % give false negative results. So basically, my questions are, with no symptoms, three negative IgM for HSV 1 and 2, and a negative IgG, is it safe to assume I do not have herpes? Is the IgM completely unreliable or are three negatives taken at different times conclusive? And is it fine to continue with dating and sexual activity given my current circumstances? Or should I abstain from sex completely for another nine weeks and wait till I can take a more accurate IgG? I started a new relationship a couple weeks after the incident, and I do not want to risk infecting her, but I also do not want to ruin the relationship if I do not need to. I also suffer from generalized anxiety disorder. So, any concrete information you have would be helpful. Lately, I have been having especially bad panic attacks and hot flashes. Currently, I am taking Effexor 75 mg. ### Response: I have gone through your case in detail. And after detailed analysis of your contact, it is concluded that you basically are not sure whether the woman actually had any herpes or not. Moreover, all your test results till now are negative. So, in absence of any symptoms of herpes and negative tests both for IgM and IgG, it means you are not having any herpes. So just stay relax. A false negative is said when you have a clinical lesion of herpes and clinician is quite sure of that but your tests turn out to be negative.In addition to this, if herpes had to appear it would have been evident within 10 to 14 days of your contact. As long as you are herpes free, both clinically and pathologically, you are free to go ahead" "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 back I have got a ring-like itchy patch on my lower abdomen, I applied Hydrocortisone cream for about three weeks, but there is no relief other than itchiness, then I used an over the counter medicine for a week and still no relief meanwhile I noticed several other patches around my groin area and black big itchy patch nearby my thigh join, as I searched it looks like jock Itch.I went to a doctor he told to take Terbinafine hydrochloride (Lamisil) cream, initially three to four days it seems like it was working then suddenly due to long drive patches became redder, and this cream was no longer working. Then the doctor prescribed the same Terbanfine 250 mg by mouth, and I took for two weeks no relief. Meanwhile, the infection spreader into another side of thigh corner (groin) as well. Now in third visit doctor has prescribed me Flucanozole 100 mg by mouth for eight days as he thinks my fungus has developed resistance to the earlier drug. It has been four days, and Flucanozole is not working, I am very scared and under trauma that nothing is working for me. My immunity has been very weak since my childhood, and even a coughing infection takes a month to cure. Please help. ### Response: Hello. I understand your concern, but there are no attached photographs in your message. Kindly send a picture of the affected area to help you better. I need to see the affected area to assess the condition and to suggest the appropriate diagnosis and treatment. Please send the picture of the affected area." "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 recently had a renal angioplasty and the sedation did not work. She had Versed and Fentanyl. It seemed to get her wired. ### Response: I recommend her to go for MAC (monitored anesthesia care) or if she is very apprehensive she can be given GA (general anesthesia). The anesthetist has to assess for airway, if not in difficult intubation category. He or she can give Remifentanil infusion with Propofol infusion as well. Airway can be supported by LMA (laryngeal mask airway)" "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 44 year old female, mother of 2, 165 cm tall and 75 kg weight. Two months ago, I fell ill with a bad flu (may have been also an acute viral infection) with high temp (39 degrees), probable inflammation in the sinuses, nose, and throat and sinuses pain. The first antibiotic (Klacid) did not help much and low temp of 37.3 to 37.5 persisted for weeks. Then a throat swab analysis showed the presence of streptococcal pneumonia. However, X-rays of sinuses and lungs did not show any problems.In the meantime, a month ago, the nose cleared, and the pain in sinuses subsided. However, the right ear got clogged for a week, and as it unclogged, the left one got clogged. In the meantime, local doctors gave the diagnosis of post-viral infection-caused inflammation of the eustachian tubes. A second antibiotic was prescribed and taken two weeks ago - Augmentin. After the second antibiotic, temperature normalized. However, the left ear clogging persisted.Additionally, three weeks ago, shortly after the clogging of the left ear, a high-pitched noise in the left ear appeared (tinnitus ?), which is particularly audible at night and has caused me sleeplessness, stress, and depression. Audio tests performed by local doctors have proved that the hearing and hearing nerves are intact for both ears.I have taken for two weeks now Flixonase spray (corticosteroid like Nasonex), spraying once per nostril every morning. However, as a result, I developed an extreme dryness in my mouth and throat, and after three days, I stopped that. Now, my left ear feels better but is still clogged and ringing. What would you advise us to do? ### Response: Hello. The clogging of ears and ringing sensation (tinnitus) are probably due to accumulation of fluid in your middle ear post eustachian tube blockage, as a result of the upper respiratory tract infection you had had previously, a condition known as serous otitis media. I suggest doing tympanometry (if not already done) to confirm the diagnosis. If tympanometry confirms the diagnosis, then I suggest: Consult your specialist doctor, discuss with him or her and start taking the medicines 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 and my partner had intercourse two days ago. He used a condom but can I still have a chance with pregnancy. But two days after intercourse my stomach starts to hurt and I am spotting blood. I have read about spotting to be a sign of pregnancy but after a week after intercourse can it just be my period? My period had to start in nine days, but my periods are irregular. Can they come up to more than a week early or late? Please suggest I do not know what is going on. ### Response: I have gone through your query with diligence and would like you to know that I am here to help. Based on the information provided, I would like to rightfully start by saying that condoms are 98.9 % effective in preventing conception. The 1.1 % is due to a poorly manufactured condom or due to inadequate care taken to follow the instructions of use. In my opinion, if you followed the instructions of use, there should be nothing to worry about. As for the spotting, this could purely be due to the sexual act itself. Many women have mild spotting after sexual intercourse, some simply due to the excessive contraction and relaxation of the muscles and some due to rough sexual intercourse. As for an implantation bleed, this takes place quite a few days after the sexual act, so it cannot be assumed to be a sign of pregnancy. This, in my opinion, is most probably due to the sexual act itself, or due to an early onset of your period. Wait and watch for a few more days, and if the spotting subsides then this was purely due to the sexual act. If it gets heavier then this is an early-onset period triggered by sexual intercourse. Please also make sure you keep track of your menstrual cycle if at all you do not experience your period now. If there is a delay in your periods, then conduct a home pregnancy test around two weeks after the sexual act and write back to me for further guidance. Do not worry, pregnancy is unlikely. 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 a 30-year-old unmarried male. I am sexually active and I have been using commercial sex workers for the past few years. However, from last year, I started myself getting tested regularly for different STD infections etc. and all my reports have come negative. I have got HIV 1 and 2, hepatitis B, syphilis (VDRL) and HSV 1 and 2 tests done. The point of attention is the recent test result that I just got today. My HIV, hepatitis B, VDRL are all negative as usual. My HSV 1 IgG, HSV 1 IgM, HSV 2 IgM are all negative but my HSV 2 IgG is positive with a value of 3.61. Also, another problem is this specific jock itch type of infection that I am facing for the past two months. It itches terribly. I have tried all creams like itch guard, ring guard etc. but I get relief only by applying Betadine ointment on it two times a day. Betadine is helping me to ooze off my terrible itch in that area but the condition of the skin and symptom of the infection is continuously going on. I have clicked snaps of all my test reports and also I have clicked about three pictures of my infection in my thighs close to my penis. I am sending all these pictures in a hope that you would treat me only to have let me get a kind true genuine consultation. Please go through these pictures of my infection and all my test reports and then please answer my queries. Do I have active herpes? Can I transmit herpes to my future wife? Can this infection go to my child when I impregnate my wife? Can this herpes IgG count of 3.61 be forced to roll back to below 1.20 so that I can become normal using some medicines? What is this infection in my thigh area? Can it be cured permanently? What medicines and ointments etc. will I have to take to solve my problem? Please go through my questions, reports, and snaps nicely and then let me have your expert opinion. ### Response: I have gone through your reports and clinical photographs (attachment removed to protect patient identity). Best regards" "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 got a sedative filling done after a filling that was done a week ago became very painful. A day after the sedative filling, I am still experiencing a lot of pain. Is this normal? When should I consider going back to the dentist? ### Response: Hello. I have gone through your issue. Since you have pain after sedative/temporary filling, this indicates the tooth is either non-vital or the cavity has reached the pulp (blood supply of tooth). So, kindly visit the dentist, take an X-ray (intraoral periapical radiograph) of the tooth. Get the filling removed and get root canal treatment done. You can take antibiotics too based on the X-ray and clinical findings, which will be prescribed by your dentist. Once the canals are exposed and the compression from the filling is removed, the pain will be relieved. If you have an X-ray, send that along with a photo of the tooth to guide you better. Also, we need to check whether the pain is from somewhere else or due to food lodgement between teeth or gum pain and treatment will vary accordingly. If the cause is that filled tooth, then removal of filling and root canal treatment will help. Do not worry, you will be fine" "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 -9 spherical and -2 and -1.5 cylindrical power in my eyes. I have a border line eye pressure. Doctor said I cannot take laser or ICL surgery but can have ReLex Smile for that power. But it also needs some cornea tissues which is a risk factor for glaucoma. I do not know what to do now? Which treatment is better for me and the doctor just gave normal lubricant drops? Is there any treatment for me for refractive surgery by controlling eye pressure? ### Response: How much is your eye pressure? Did the doctor measure it with an instrument that puffs out air at you or was it a blue light instrument that he used to touch your eye with? From what you have told me, I understand that you are interested in refractive surgery. But the doctor refused to operate on you saying your pressures are high and that your power is too high for lasik. It is true that your power is on the higher end of the patients we usually consider for surgery so doing lasik and PRK (photorefractive keratectomy) is not possible on the eye with -9D but can be done on the eye with -2 and -1.5D. Putting an ICL (implantable contact lens) in your eye might increase your eye pressure. So I will not recommend that. ReLex SMILE can be tried in both your eyes if the surgeon is confident. I am guessing that he would have asked you to come for a follow up to re-check pressures. If the pressures were too high, he would have asked for visual fields and a few other tests for glaucoma. In either case, it all depends on the surgeon\s experience and your eye pressures. If you can tell me about your eye pressure and your vision in each eye with -9D and -2/-1.5D, I could help you better." "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 19 weeks pregnant, since one week I had swelling on the vagina, yesterday I have consulted doctor, she told that is Bartholin cyst. She told me to clear it we have to give anesthesia for treatment and that will not affect the baby. My family is very confused, whether is it safe for baby or not? ### Response: Hello. Bartholin cyst requires excision or marsupialization. It is a short term procedure and does not take much time. Usually, the medications used does not affect the baby. Do not worry, get it 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 have not had a fever for many years (around 15 years or more if I remember correctly). I read somewhere that I should get immunoglobulin checked because I have not got a fever for years. Will it be useful to do this test? If yes, then which ones should I get done as there are multiple tests for immunoglobulin-like G, M, and A? Please advice. ### Response: I really do not understand who has given you this information. If you did not get a fever since the last 15 years, is it not a good thing? Fever is a body\s defense mechanism when you acquire any infection. Not getting fever means you have been taking good care of yourself and you are healthy. I do not think that you need to get any tests done. Please meet a local doctor or your family doctor and discuss your concerns with them personally. If you want to get some tests done, you can do a general full body health check. It will definitely tell you a lot about how you are doing health wise. Much more recommended considering the current stress at workplaces and personal lifestyle. Feel free to get back to me in case you have any other queries" "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 chest pain less than a year ago. I went to the emergency department and they did an angiogram and I was told that the arteries are clear. My question is how long before I have another angiogram as I have similar pain again? I am currently taking Lisinopril 10 mg. ### Response: You need to lower risk factors such as blood pressure, diabetes, and blood cholesterol levels. Do regular exercise. If you feel chest pain, have TMT (treadmill test) done. If there are high-risk features in it then do angiography. No need for angiography otherwise." "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 hypertensive from the past 2 years. I forgot to take the morning dose of my antihypertensive pill, tablet Teleact. Can I take it now? ### Response: Hi. Take the dose immediately whenever you remember that you forgot to take the morning dose. This approach is better than not taking the dose at all." "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 about total protein count in blood, urine, and saliva. My question is, does someone\s total protein count change significantly based on how much protein rich food they eat? Or does someone\s total protein count not change unless they have an illness like muscle damage? When I say total protein count I am referring to what is calculated in a biuret test. ### Response: Hi. The protein is digested in our human body but is sometimes excreted when not digested properly or in excess quantity. The term which you are referring to, which is total protein count in blood, urine and saliva has totally different meaning in all the three mediums. Total protein count in blood changes with increased protein ingestion and already present muscle protein or any other protein breakdown inside the body whereas protein in urine or any excretory product is always when the degradation of protein has increased, which can be possible because of higher intake of protein or increased muscle breakdown due to some pathology inside the body. I hope that I have answered your question. Let me know if you have any other doubts." "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 wisdom tooth extraction pain. I got my wisdom tooth removed a month ago. I feel a lump along my jawbone that hurts on and off. ### Response: Get an X-ray done to find out if the wound is healing fine or some root is remaining inside. Usually, after a week, the wound should have healed adequately and there should be no swelling or pain unless it is infected. Start taking an antibiotic and painkillers for a week to reduce infection. Use warm salt water gargle twice a day for a week or two." "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 33 year old male. Today, I had a surgical sperm retrieval procedure at a reputable fertility clinic here. They could not find a single sperm anywhere, motile or otherwise, in my testes, and they said I simply was not producing sperm, for reasons unknown. Before my wife and I give up and start looking for a sperm donor, I wanted to get a second opinion. Is that truly the final word or is there some next step I could take, however unlikely the odds of success? I eat mostly fruits and vegetables, work out every other day, have no history of trauma to the groin or exposure to extreme environmental toxins. Testicle size and firmness, as well as hormone (testosterone, prolactin, and thyroid function) levels, were all normal. ### Response: I have gone through your query. I would like to know a few more details to answer your query better. Were your serum gonadotropin levels measured during the evaluation? What was the exact procedure performed? The chances of sperms appearing naturally in semen is next to impossible. If just a normal testicular biopsy has been performed, an intra-op microscopic testicular biopsy may give you an additional chance of finding sperms. If it has been already performed, then a sperm donor will be the next choice for you. Hope this was helpful. Revert with more information to a urologist 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: A 29 year old female had an abortion through pills. She took Mifepristone initially, and Misoprostol tablets 800 mcg sublingually 26 hours later. She had severe pain and contraction immediately after taking Misoprostol. Two hours later the placenta and blood clots came out. She had heavy bleeding. So, I thought the abortion was over, but two days later, the fetus came out in a rotten stage with a bad smell. Please help. I am worried about an infection. ### Response: Hello. The dosing schedule was wrong. The basic mistake was you did not know the age of the fetus. This medical abortion is recommended for pregnancies that are less than 63 days. Now, you definitely need an ultrasound of the lower abdomen. It is fortunate that she is not having any fever, bleeding or abdominal pain. I suggest you meet a gynecologist as quickly as possible. He/she will advise you after a clinical 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: I have a question about twitching in my legs. ### Response: Hello. Muscle twitching can be related to differential medical disorders: For this reason, I would recommend consulting with a neurologist for a physical exam and performing some tests: Further tests may be needed. You should discuss with your doctor on the above tests" "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 daughter has a cavity and was told by the dentist that she needs a root canal on her 6 years molars. Is there any option we could fill the cavity vs having a root canal? She is in a lot of pain. ### Response: Well, the condition of the tooth decides its treatment. If the dentist has suggested her root canal that means there is nothing that can save her tooth but only root canal. I suggest you go for that. Filling the tooth is only done when there is a small cavity and has not damaged the pulp of that tooth. For stopping pain temporarily, you can consult your dentist for medications. I can suggest Paracetamol or Ketorol-DT (Ketorolac) tablet in low concentration" "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 17 years old. I understand things late, and my medicines are going on. Please tell me some good medicine or syrup for having healthy weight and body. ### Response: A healthy body has a healthy mind. To have a better brain function, you should have a healthy body. You are quite young with no other medical conditions. Instead of resorting to medicines, I recommend you improve your diet. It should be wholesome, with a well-balanced diet. It should include a good mix of carbs, proteins, and fats. You can take help from an expert nutritionist. In addition to a good diet, you should have a proper blood circulation in the body. For that, you should follow a good workout routine. Have a 30 to 40 minutes exercise daily. You have to check your Vitamin B12, and TSH (thyroid stimulating hormone) levels to make sure that there are no deficiencies. You can take a good multivitamin supplement." "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 28-year-old female. I have been on Nucynta for over a year. I take Nucynta ER 50 mg BID and Nucynta IR 50 mg once a day. For the last two months, my urine tests (immunoassay and lab testing) have come back negative. Two weeks ago a blood test was done and it was also negative. I religiously take these medicines as prescribed by my pain management doctor. Due to these negatives he is now refusing to prescribe any oral medications (including my Flexeril, Gabapentin, and oral Ketamine). I understand his need to be able to prove to Nucynta in my system but he is also refusing to try anything else.I am a walking genetic defect. I also have known pharmacogenetic and pharmacokinetic issues. I also have EDS, CRPS, POTS, MCAS, gastroparesis (severe enough that EGD showed food in my stomach 18 hours after last eating), endometriosis. Could any of this be causing the problem? Could any of the medicines I take be causing the problem? My medicines are Lopressor, Trazadone, Fetzima, Zyrtec, Ketamine, Magnesium Citrate pills, Melatonin, Gabapentin, Flexeril, Nucynta, Junel Fe. What suggestions do you have? Is there any research to help me? ### Response: Hi. Nucynta is an opioid analgesic, that has high first-pass metabolism when administered orally. It means only 32 % of orally administered dose reaches blood. After it produces its effect, 97 % gets metabolized in gastrointestine and liver and gets excreted out from body through urine. Hence, I think it is not detectable in blood or urine. Another possibility is very less amount 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: I am a 26 year old female. I have some backbone problem. I feel slight pain in my backbone from two to three years when I was in a desk job. I used to sit most of the time on a chair. ### Response: From the complaints you had described, mostly it could be related to poor posture at your workplace. Lack of exercise could also be one of the causes. I would suggest you consult an orthopaedician online for further follow up" "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 baby is 2.5 months old. He used to spit up a lot so we switched him to Enfamel AR formula. After that he stops vomiting but still spits up through mouth and nose almost once after every feed and whenever he does he wakes up from sleep and screams for few minutes. Spitting up bothers him a lot and it seems he is in pain after every feed. It disturbs his sleep a lot. I found that Hylands Natrum phos 6x helps with this, so I started giving him half tablet with every feed since last night. I have not observed any change yet. Should I keep on giving him? How much dosage? How long does it take to work? ### Response: Natrum Phos is a good remedy for babies suffering from acid reflux related problems. You can continue giving him one tablet twice a day (one in the morning and one at night). You will be able to see the gradual improvement in next 4 to 5 days. If your baby does not settle down in next seven days then I would advise you to seek the help from pediatrician to rule out any gastric disorder." "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 not getting good sleep. I have stress, mental pain, irritation, agony, and bullshit thinking. I am diabetic, and I need a rest for a few days. I am taking Amixide, Mirtaz 30 mg, Lonazep MD 0.25 mg, Teneligliptin 1000, Zoryl MV 2, Rejuveron active, and Sunvit gold. After taking these tablets also, I am not getting strength and sleep. Please prescribe me some medicine and help me. ### Response: Hi. Along with medicines, you need to maintain sleep hygiene. Sleep hygiene includes fixing a time for going to bed and getting out of the bed at a set time after sleeping. Go for a regular morning walk for 35 minutes and follow it five times a week. Do some deep breathing exercise or Jacobson progressive muscle relaxation exercise. You can practice it, and if you feel some difficulty even after following these steps, then you can consult a doctor nearby. Also, you can ask your psychiatrist for changing the medicine or add Quetiapine 50 mg which can help you to get good sleep as well as for anxiety too." "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 premature baby girl who was born at 800 g. She is now 6 months old by actual age and 4 months by adjusted. We have to attend a very close family wedding at a nearby hill station which is very cold at this time of the year. She weighs 4.82 kg now. Being born premature and this being her first winter, should we take the baby there? The function will take place at night. ### Response: There is no absolute contraindication to attend the wedding. A premature baby is more susceptible to infections (common cough and cold) as the immunity is low. At present, her weight is within the normal range considering premature nature of birth. Take utmost care. Cover the head portion and leg with extra cloth so that the baby does not catch a cold" "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 5\7"" and I weigh about 159 pounds. I am a male with anemia. I got a colonoscopy but they could not stop the bleeding, so I got a transfusion, and I also got another colonoscopy to make sure that the bleeding stopped. I have to get another colonoscopy between 3-6 months from the first colonoscopy. I went to see my primary care doctor and they gave me some iron pills to be taken for three months which are over the counter called Ferrous Sulfate. I went to see the gastroenterologist last month, and they told me to come back this month to make an appointment to get another colonoscopy. I cannot get in touch with my doctor right now because of the COVID 19. I wanted to know that if I still have symptoms of anemia, could I take some more iron pills or three months is enough? ### Response: Hi. You have mentioned that you had bleeding per rectum and you had gone for the colonoscopy. Can you share the report of colonoscopy so that I can know what was the cause of bleeding? It is perfectly safe for you to continue the iron medicines until the time you get an appointment with your regular doctor." "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 any way that I can treat BV while being 34 weeks pregnant? I had Metronidazole gel and suppositories and they did not work. The smell is pretty uncomfortable plus I have HPV. So, I do not know if that is associated with the smell too. BTW is BV contagious? ### Response: Hi. BV (bacterial vaginosis) is not a sexually transmitted infection. You must be having associated fungal infections causing itching. Take tablet Metronidazole 400 mg three times daily for one week. Take capsule Clotrimazole vaginal pessary at bedtime for a week. Keep your perineal area" "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 27 year old male. I would like to get your opinion on my CBC report. Shall I attach my report? ### Response: Please do attach the report of the CBC (complete blood count). I will be able to comment further once I see it. Revert with the report to 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 pain in the joints. ### Response: Hello. I went through your post, you have not mentioned which joints are paining and whether you have swelling of joints also. Your vitamin D level is low (attachment removed to protect patient identity) so you need to start taking supplements for it (capsule Lumia 60k) once a week for eight weeks. Do RF (rheumatoid factor) and anti-CCP to rule out arthritis." "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 red, swollen and infected ingrown toe nail. It is speeding quickly and painfully. Yesterday I saw Dermatologist for the first time and she wrote me a prescription antibiotic of Ciprofloxacin 500mg/Thrice/day for one week and then do a partial toe nail surgery. Later, my last lab test was done and it was showing that my liver functions (SGPT / ALT (KINETIC) 96.70 U/L) while the normal rate is from 10 to 50 U/L and an ultrasound report on my liver says: ""Diffuse severe fatty infiltration of the liver."" I did not purchase the antibiotic because I am worried for my liver since I am on seven other medications daily.My question is: Can my liver sustain 7 different drugs while taking a 500 mg of antibiotic? ### Response: Hello. My question is that, is it the first time that the liver fatty infiltration has been discovered? Did you have had a test called FIBROSURE or liver MRI/ biopsy? Cipro is relatively safe with liver disease but honestly it will not be my first choice for treatment of ingrown toe nail infection." "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 unprotected sex with my partner. I am not sure about ejaculation. She took I-pill within three to four hours after having sex. She had her previous period before 20 days. Is she safe from pregnancy and how to confirm it? Please suggest. ### Response: If she has taken I-pill (Levonorgestrel) in a proper advised dosage, within 48 to 72 hours of unprotected penetrative sex, then she will have an interruption in her normal menstrual cycle to prevent ovulation or fertilization and even conception to have a pregnancy. The regular menstrual cycle will get disturbed for some time until the body gets out of the effects of the externally induced hormones (I-pill). Then it will become normal gradually." "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 inflammation of the penis head and small red bumps on the outer edge of the penis after sex and masturbation. The bumps occur and disappear after a few days. I have been using antifungal cream for about a month and also took antibiotics. It looks like it has vanished but occurs back very irritated after masturbation. I believe it could be balanitis, but that is a self-diagnosis. ### Response: Hello. I understand your concern, but there are no attached photographs in your message. I need to see the picture of the affected area to make an appropriate diagnosis and to suggest the proper treatment. Kindly send the images." "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 fertility blood test and scan. All came out fine except it said I had slightly raised plasma levels in comparison to LH. Does this mean I have problems, and what does it mean? ### Response: Raised plasma levels of LH or Leutinizing Hormone indicates a premature ovarian failure in women less than 35 years. And in a woman above 40, it indicates perimenopausal status (if she is still menstruating) or menopausal (is she has not menstruated for a year). However, one needs to be transparent with regards to the day on which the blood sample was collected. If it was received on day 12 to 16 th day of your cycle, then this could be an ongoing LH surge before ovulation. But if it is on day 2 of your period, (the day on which test should ideally be done), then it gives a status of your ovarian functionality. Please share your reports if possible and mention the menstrual day of collection of your blood sample." "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 are trying from past two years for a baby. I am facing an ED problem, and I am advised to take Penegra 50mg tablet. I also, have vitamin D deficiency and taking Eficent plus tablets. And taking Paternia tablets, for less sperm count. I have teratozoospermia. Kindly advice as we are planning for the second baby. ### Response: Please share your semen analysis report as that would help evaluate your teratozoospermia and the degree of it. Unless teratozoospermia is treated the chances of pregnancy are limited." "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 continuously taking Nilavarai choornam (2 grams after food in the night). I have been taking this for the past 2 years. Is there any side effect in taking this choornam? ### Response: Hi. I appreciate your regularity in taking Nilavarai choornam regularly. You need to have a break in between in taking this choornam. If you continuously take, it may alter (destroy) the intestinal beneficial bacteria, which are essential for producing some vitamins and help in local intestinal immunity. This \purgative abuse\ may also injure your intestinal villi, which will lead to malabsorption and improper digestion. The anthroquinone present in the senna plant (nilavarai) can cause black pigmentation in intestine or other mucosal parts. It also can cause inflammation in the colon. Hence, my advice is as follows; Hope this helps. Revert back to a siddha medicine specialist online for further follow up" "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 protected oral sex with transgender yesterday. Before we started the oral sex, she showed me her STD and HIV test results and they were negative (I have doubts about the results as it was sent to here by SMS and there was no date on it). At the start of the oral sex, I sucked her cock with a condom (she was wearing a condom) and then she sucked my cock and I was wearing a condom as well. There was no pre-cum, no cums, no transmission of body fluid, nothing, just the scenario above. I have a simple blood clot in the sublingual salivary glands for the past six months and I am still taking medicine for it. Is there any chance to get STDs or HIV based on the scenario above? I need a direct answer to my situation and no general information, please. ### Response: Hi. To be clear, HIV will not transmit through oral sex. No possibility for HIV infection. Coming to STDs, there is no transmission of STDs through a protected act. So, there is no possibility for STDs also (including syphilis, chlamydia, gonorrhoea, herpes). Finally, no chances of transmission of either STDs and HIV." "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 boyfriend\s father has schizophrenia. What are the odds that my boyfriend or my future child would get the disorder? Is it risky to marry him? Please help. I am confused. ### Response: Schizophrenia is a complex psychiatric disorder and sometimes tend to run in families. However, it does not imply it is a monogenic disorder, where the inheritance rate of disease is higher and more easily predictable. Currently, there is no scientific evidence to support your doubt that whether marrying your boyfriend will increase the risk of schizophrenia in your to be child very significant. So, let us not get too worried." "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 iron level was tested, and it was 6.2, after which I was sent home from the ER. What can I do to raise it fast? ### Response: Your iron level is very low. For that, I suggest you take Orofer XT like ferrous ascorbate containing tablet which contains more elemental iron. It should be considered for at least three to four-month according to your hemoglobin level. So if you can provide your hemoglobin level or if you attach CBC (complete blood count) report than I can guide you further. I suggest you take the tablet mentioned above along with orange juice to increase the absorption of the iron tablet. I hope I have answered your question. Let me know if I can assist 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: I am getting a fever every day. But, every day the fever occurs and goes to a maximum of 100 degrees, and it gets back to the body temperature without any medications. It is repetitive. I have done a few blood tests and am attaching the reports. I have found out that my CRP and ESR is very high (I have a history of aortic valve replacement surgery). I am worried. I am taking Betaloc 12.5 mg, Ecospirin 75 mg, Warfarin 5 mg, Fibator 5 mg. Last week, I went out of the station, and I had a significant amount of traveling. ### Response: Hi. It is likely a viral fever only as it settles within four to five days. ESR (erythrocyte sedimentation rate) and CRP (C-reactive protein) are usually elevated due to viral fever or any other fever. As it gets recovered within four to five days without any antibiotics, then it is likely a viral fever, and the possibility of other infection goes down like infective endocarditis, typhoid, malaria. So there is no need to get worried. One may get repeated viral fever with travel, change in environment or change in food and the body clears it successfully. So there is nothing to worry about it. Since you have an aortic valve replacement, then we have to be vigilant regarding the possibility of infective endocarditis. So you should get your ESR and CRP done after two weeks, and if they are still elevated, then you should get an echocardiogram done to rule out infective endocarditis.-" "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 to know about my hymen's type and whether it requires surgery to have sex? Please help. ### Response: Hello. I have seen the attachment. (attachment removed to protect patient identity). You have an anterior lunar, the opening of the hymen is more posterior, but it does not mean you have to undergo a surgery for defloration. For further information perform an examination by a 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 want to know what the horizontal lines on my fingertips are. They appeared within a couple months, along with more lines on my hands than ever before. ### Response: I have seen images attached here (attachment rremoved to protect patient identity). It does not signify towards any health issue. It seems to be normal flexor creases. , as side effects. If you want to investigate than check your random blood sugar, serum cholesterol, serum LDL, serum Triglycerides, sgot, sgpt, blood urea and creatinine for routine check up. If any specific complaint present then let me know about that." "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 apologize for the long message, but I am a concerned mom. I have two sons (ages 3 and 5) and both of them and I have been experiencing chronic sinus or ear issues for the past several months. Their pediatrician has referred us to ENT since she does not know what it is. Both boys (and myself) have inflamed nasal swellings that block the nasal passages. We all have deviated septums. My 3-year-old has dog and cat allergy and is prescribed Nasocort and Zyrtec daily which are ineffective. The 5-year-old tested negative for all allergies. We use top line air purifiers throughout the house but are still experiencing severe symptoms. The boys had tonsillectomies, adenoidectomies tubes last year due to scale 4 with obstructive tonsils or adenoids.Nightly I have extracted sticky, firm clumps from behind the nasal swellings that only appear after massaging sinuses. They do not drain out on their own. Both boys ears are totally blocked. And my 5-year-old had dark brown fluid with strong foul odor leak out of one ear the other night. Both have recently been on Azithromycin (3 day doses of 5 ml per day) but symptoms have not improved. Not sure if any of the following are related, but all occured around the time symptoms began. My dad was at our house with a severe bronchial and sinus related illness and and also diagnosed with candida. We had also just been swimming in a lake. We live directly across from a large scale construction project that produces lots of dust that began around same time. My youngest had a recent staphylococcal infection on his arm treated topically with muciprocin. Any clues about what this could be and if it requires more immediate action vs. wait for ENT appointment? ### Response: Hi. Do not stop Zyrtec (Cetirizine) and nasal corticosteroid spray. I think that the black plug inside your son\s ear is a fungal infection. You need a topical antifungal" "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 big-time issue with itching on all parts of her body. She is 66 years old and has blood pressure and thyroid. Kindly suggest. ### Response: Please get comprehensive blood work done to rule out these causes. Please treat according to the cause. Symptomatic treatment includes using calamine lotion, Cala" "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 undergone pap smear test and PVS ultrasound yesterday due to some vaginal health issues. I have got the results of PVS ultrasound. I want to understand the results and to know whether I am in good health or whether I have any other abnormalities. I had unusual pinkish or pale brown discharge with an odor. It happened before and after my periods. It also happens when I do not have periods. I experienced pain last time when I had sexual contact with my partner. My gynecologist is waiting for my pap smear report. I am waiting for a gynecologist opinion regarding the results. Please suggest. ### Response: Hi. There are more chances for you to have a chronic infection of the cervix which ultimately leads to foul-smelling discharge. But a few possibilities of other things are also there. That\s why your gynecologist is waiting for pap smear report, and she will prescribe you medication according to the discharge type, amount and color. You may have to take medication up to 21 days, and you may require to test the discharge." "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 headaches. I had CT scan of the brain and the result was normal unenhanced intracranial appearances. What does this mean? I am currently on Omeprazole, Domperidone, Mebeverine, Fexofenadine, Avamys, Ventolin, Seretide, and Ranitidine. I have uploaded photos of my scan. ### Response: I reviewed carefully your uploaded scan report and images (attachment removed to protect patient identity) and would explain that they indicate a normal brain structure. The term ""nonenhanced"" means that there is no enhancement from the IV (intravenous) contrast, which is a normal finding. Contrast enhancement would be abnormal. The only finding in your CT (computed tomography) scan is a sinus inflammation indicative of chronic sinus infection or allergic reaction and some signs of your past nasal surgery. There is nothing to worry about. Coming to this point, your headaches could be related to a primary migraine headache or a tension-type etc. depending on the headache characteristics, but this too is nothing serious. Regards" "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 with my wife on the seventh day after her menses cycle. Can she become pregnant? Kindly advise. ### Response: Hello. There is no chance of her getting pregnant. Usually, a lady has an ovulation around the 12th to the 16th day of her periods with the first day of bleeding being the day one of her periods. Hope I have clarified your query. Regards." "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 24 years old and I have noticed that there is a piece of flesh that sticks out slightly from my vagina. I thought it was my clit but I do not know if it is right. It slightly comes out and I do not like the way it looks. Does anyone know what it may be? ### Response: It appears to be clitoral hypertrophied hood, which is often a natural development in women and can vary from women to women. However, this needs to be locally examined by your gynecologist to confirm and differentiate from labia minora hypertrophy. This can be surgically corrected for cosmetic purpose" "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: ### Response: Hi. You have asked an interesting question. Peanut allergy is one of the most severe food allergies. It may even result in anaphylactic death if not controlled at the right time. The routes of exposure of the allergen are mostly the accidental ingestion of peanuts or PB by the concerned person (who is hypersensitive to peanuts). Air-borne particles in a farm or factory or crushing environment may cause respiratory symptoms in allergic individuals. However, the odor of peanut butter or its mere proximity has not produced any allergic symptoms in various studies conducted. Hence answering your questions." "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 woke up a few days ago with a large bruise on the back of my left thigh. Unsure of how this happened, as I do not remember or have knowledge of hitting this area. I was drinking heavily the night before but do not believe this is a reason for the bruise. I have been working out a lot last week and possibly thought it could be a muscle bruise. I am more concerned with the shape and placement of the bruise and effective area of smaller bruises around the larger one. I have never got random bruises. I do suffer from anxiety and this is making it factor right about now. I am currently on Prozac. ### Response: I have seen the attachment. (attachment removed to protect patient identity). Your bruise is clearly due to hematoma. You should get a USG (ultrasound) of your thigh. Take some rest and bruise will disappear gradually. Also, if there is severe pain at that location, then x-ray should also be done to rule out any fracture. Muscle tear. USG of left thigh. X-ray of left femur AP (anteroposterior) and lateral. Muscle tear. Femur fracture. Take rest. Review after the USG report." "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 unprotected sex with my fiancee two days ago and I gave her Unwanted 72 and we had sex just after the departure of her period. What is the chances of medicine success rate as I gave her within half an hour? ### Response: Hello. The average success rate of an emergency contraceptive pill may range from 75 to 85 % after an unprotected intercourse if taken immediately. So, rest assured and wait till the expected period. But, however, I would suggest to use this pill only as an emergency back up, and go for a consistent contraceptive method like oral contraceptive pills which are more effective and cause fewer side effects. Because this emergency pill is high dose hormonal pill, side effects like delay in periods or irregular bleeding may occur." "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 31 year old male. My height is 6 feet and weight is 84 kg. My medical history includes psoriasis, hyperuricemia and essential primary hypertension. I am taking Cilacar 10 mg (Cilnidipine) one tablet daily after dinner at 9 PM for hypertension. For psoriasis I am applying Propygenta NF cream - combination of Clobetasol propionate and Neomycin sulfate cream. For scalp topical 3% lotion - Clobetasol propionate 0.05% and Salicylic acid 3% lotion. My uric acid is under control by drinking 3.5 to 4 liters of water regularly. My current blood pressure is 120/80 mmHg. For the last 14 months, there are flat hard lumps at the base of the penis just under the shaft. For this reason, I had visited a local urologist last year, but he suggested me to clean my penis under the shaft. This is to inform you that I have not cleaned my penis till the age 30. I am an uncircumcised male. As advised by the doctor I have cleaned my penis under the shaft with water. I do not masturbate regularly. But, since eight months the intensity of masturbation increased to four times a week till date. But for the last two weeks, I am feeling mild pain at the side of the lump. The size of the hard flat lump is more or less the same. Even if I press, there is no pain on the lump. My urinary flow is very good. No blood, discharge or foul smell under the shaft. The penile shaft is smooth. There is no burning sensation during urination and ejaculation. I am very much concerned. How to get rid of this occasional mild pain? What is this lump all about? Is this years of smegma deposition? Please help me out. ### Response: I think the lumps that you able to feel are nothing but smegmoliths. These are nothing but concretions of smegma, if not cleaned for a long time. Are you able to retract your foreskin completely? If you cannot, then you may be having phimosis, which can be managed by circumcision. This will also prevent further accumulation of smegma." "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 baby is 2 years old and has plagiocephaly. Can it be cured normally? ### Response: Hi. This usually occurs when the baby is small and it gets corrected by changing position of head frequently. In your case, the age of child is 2 years so most of the sutures in head are fused and skull bone has also formed. If plagiocephaly has persisted for so long then it is a bit unlikely that it will resolve now. However, for better judgement, I would like to see some pictures of head of child and an X-ray of head to look for sutures." "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 gets blurry, especially when I look at green lights at night. I wake up with a blurry vision every day. And at times, my eyes pain and itch. Please help me. ### Response: Hi. Blurring of vision at night and morning may be because of refractive error. This requires evaluation by an ophthalmologist. The itching in the eye can be due to allergic conjunctivitis." "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 I take Vitamin C because I am anemia patient and what is the name of Vitamin C supplement? My age is 19 years old and my height is 161 cm. ### Response: If you are anemic patient, then according to cause the treatment is given. For example, if iron deficiency anemia is present then the iron tablet can be prescribed. If vitamin B12 deficiency is present then B12 injection is needed. No need for Vitamin C intake for anemia case. The Orofer iron tablet contains Ferrous Ascorbate which is having a good absorptive capacity. So, I do not think extra Vitamin C syrup is needed. You can attach your reports 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: I am 14 years old. I have pain in my canine tooth due to a cavity. I have a sensitivity problem when I brush my teeth and when I eat ice cream. Is it normal? ### Response: If you have not filled the tooth and if there is sensitivity in the tooth, then it will not have a long term. It takes a month to have a formation of secondary dentine. So for one month, you must not eat too hot or too cold foods. Please mention about the treatment taken for the tooth. If you have filled the tooth, then there is no need to worry. It subsides with time. Kindly fill your teeth soon. If it is not filled, then you can have continuous pain in the tooth. You can also try using a desensitizing toothpaste." "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 34 years old male. I started having incontinence problems about 4 to 6 months ago (cause unknown). It began with issues only happening at night while sleeping. A month ago it had progressed to occasionally not even being able to make it to the bathroom before I began to pee. Then, about four weeks or so ago, while having sex with my girlfriend, I ended up with a fairly large cut or tear right underneath the head of the penis. It has happened before.About 2 to 3 weeks ago I somehow ended up with a UTI and yeast infection. For whatever reason, I have not taken it seriously (major depression) and two nights ago I started having pain (then ended up realizing these were little white ulcers that have since begun to spread rapidly). They are under the head of the penis, on my scrotum, and also on the shaft of my penis. Along with that, last night I realized the lymph node in my right groin was significantly swollen and painful as well. Today that became my lymph node in both my right and now my left groin as well.)Finally, when I woke up today I had a huge swollen ring of skin, underneath the head of my penis, along with everything else. I have had this same swollen ring one time before in my life. It is seriously swollen and more ulcers are on that skin as well. I did a bit of looking at pictures online and I found a condition that is very similar looking (as far as the swollen ring goes,) called paraphimosis. However, I have been circumcised since I was a baby. So I am not thinking that is it. Anyway, I am in fairly severe pain and I am worried about the lymph nodes in my groin (left and right) being swollen, that there is some bad infection spreading in my blood throughout my body. I guess I could be simply paranoid but I went from ignoring this to now freaking out. So I do not believe that this is the case. Please help. Any ideas or thoughts or suggestions? Currently, I am on Xanax, Adderall, Prozac, Abilify, Cymbalta, Suboxone, and Atenolol. ### Response: Hello. Relax and do not worry. I have some questions for you as follows: If possible send me more broad view images of ulcers and penis and of lymph nodes if are visible. I think you are suffering from STD (sexually transmitted disease) due to chancroid or lymphogranuloma venereum. You require STD screening test to properly diagnose the type of infection (STD) you are suffering from." "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 sister\s age is 28, normal, sensitive skin. She is having brown spots on her face. Can you please suggest the best Vitamin C serums for removing brown spots on her face without any side effects? Is there any other options (simple and safe) for removing such brown spots? ### Response: There are many causes for brown spots on face, it could be: 1. Freckles. 2. DPN- Dermatosis papulosa nigra. 3. Melasma. 4. Post-inflammatory hyperpigmentation. Treatment is different for each, it is very difficult to suggest any treatment for you without seeing your pictures, I will have to see the pictures to make the diagnosis so that I can suggest you the most appropriate treatment options. Please attach your clinical pictures of the face taken in good daylight." "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 found this spot on my tongue for the past seven months and for the most part, has not really changed. No symptoms, but can sometimes feel the bumps when I run my finger over it. Does this look like it is a frictional problem or something worse? I am guessing friction based on what I have been told before but want to confirm with another opinion. ### Response: I had gone through your question and understand your concern. As per your photographs (attachment removed to protect patient identity), it does not look like any severe problem. This could be the friction or irritational in nature due to a sharp tooth edge. This lesion only looks like hyperkeratotic and nothing else. So, there is no need to worry about it. Please let me know if there is any sharp tooth edge, also if there is any swelling under your mandible (chin). You can also take high Vitamin A diet like carrot or Vitamin A supplements for at least a month, it will be helpful and the lesion will disappear soon. Sharp tooth edge or faulty brushing technique. Traumatic ulcer. Frictional hyperkeratosis. Enameloplasty, if there is a sharp tooth edge. Brushing (modified Bass technique). Use ultrasoft toothbrush." "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 daughter is 16 years old. She has bumps on her forehead. They are flesh toned (flat top). They do not hurt or itch. They have been there about 2 years now (sometimes it seems they are more prominent than other times). She is at an age where they are starting to upset her from an appearance perspective. Two of the formations are actually linear. They almost appear to be a scar until you get close and realize it is a series of bumps in a line. She has never been on medication for them. She uses Proactiv for face washing purposes. Extensive research seems to indicate flat warts. Just trying to get any additional insight prior to our appointment. ### Response: They are flat warts, warts are an infection caused by human papillomavirus, it is contagious, better to get it treated soon. Linear pattern is called Koebners phenomenon, it is the formation of warts along the line of trauma or scratch. There is a major role of immunity in the resolution of warts, good sleep, eating nutritious food, vitamin supplements are helpful. Treatment options for warts are topical application of Retinoids that helps to exfoliate the skin, cryotherapy, topical application of Trichloroacetic acid, and radiofrequency." "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 week back, I slipped and injured my right thumb. There was a cut just below the top side nail with lots of bleeding. The doctor had bandaged it, and the wound seems to have healed. The X-ray report says \evidence of mildly displaced comminuted fracture is seen in the base of the distal phalanx of the right thumb. Rest of the visualized bone appears to be normal.\ The doctor has advised surgery which I do not want. Please advise if surgery can be avoided. ### Response: Hi. The need for surgery depends on the displacement and the width of the bone fragment. Kindly upload your X-rays so that I can give you an accurate advice. Regards. This professional advice provided by me stands subject to the actual examination of report/image and is based entirely on inputs provided to me. It should be correlated with clinical findings" "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 nose is always blocked. No matter, how many times I blow it, little comes out and I still have the feeling of blockage. What can I do? I am taking tablets for blood pressure. ### Response: From when do you have this problem? Are you taking any medicines for it at present? Do you have any headaches, heaviness or pain around the nose or face or there are any allergic symptoms? There is a possibility of having allergic rhinitis in 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: We are adopting a child through the foster care system and his mother and grandmother were both diagnosed with schizophrenia. We wanted to talk to someone about the risk factors, what it looks like if he does develop it? If there are things we can do to help prevent it? ### Response: Hello. If one parent has schizophrenia, there is about a 10 or 12 percent chance for the child to develop the same. (90 percent chance of normal child)." "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 16 weeks pregnant, will taking Sulfatrim DS (Sulfamethoxazole, Trimethoprim) harm my baby? ### Response: Hello. I do not recommend this Sulfatrim DS at your pregnancy age. If you have been prescribed for any infection, please tell the doctor you are pregnant and change therapy. Usually, penicillins are safe to use. Discuss this with the doctor who prescribed Sulfatrim to you. All the best to you and your baby." "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 on birth control pills called Yasmin for around four months. I take pills daily at night after sex that is anytime between 10 p.m. and 12.30 a.m. In the current cycle, I missed the pill twice but took it immediately the next morning and then took the normal pill of that particular day at night as well.I want to check can I have unprotected sex (without a condom) and still be safe from pregnancy? Can I have unprotected sex and take an emergency contraceptive pill? Should I stop the pills now so that I get periods immediately (even though my period is due this week) and when periods start, the same day I start my fresh pack of pills? Will this ensure safety if I plan to have unprotected sex this week? ### Response: As you have missed two pills from your schedule, you need to have a backup protection like condoms to prevent pregnancy and unprotected intercourse is not advisable" "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: How long should I take treatment to dissolve a tuberculosis lump? I have been detected this lump two years back. I showed it to the doctor where I was asked to take RHE-FD for two months which got extended to three months and stopped but the lump was not completely dissolved. Then again I got another lump near neck a year back and I again started the medication, which is still continuing. Within which I got the third lump and was operated and after culture test all the reports were normal. I was about to stop the medicines but the first lump now has become little big and now the doctor has asked me to have R-Cinex 450 for three months and stop RHE-FD. The lab tests performed were FNAC, histopathology, culture TB MGIT & identification.I just want to know that is this the symptom of a serious issue? Please suggest me a good suggestion as I am now fed up with it and want to get out of it. ### Response: Any anti-tuberculosis regimen has to be taken for a minimum of six months for pulmonary tuberculosis and nine months for extrapulmonary tuberculosis. Your tuberculosis appears to be extrapulmonary. There is no indication to stop treatment after three months even if tests are negative. Tb is completely curable if proper and complete treatment is taken. So, do not worry" "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 factor V Leiden showed a positive outcome before three months. I got Depo birth control shot before three months. I have heavy bleeding and blood clots now. Please suggest. ### Response: Hi. You have factor V Leiden showing a positive result. So you are at high risk for developing blood clots in various organs of the body especially in the lungs and leg as pulmonary embolism and deep vein thrombosis. If you have major clots occurring in the future, then blood thinner and anticoagulant like Rivaroxaban can be used. There is no treatment available for the eradication of factor V mutation. For heavy menstruation, you can consult a gynecologist soon for a pelvic examination and pelvic USG." "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 looking for advice and maybe a consultation from a neurologist.I have a benign cluster of cysts at the back of my brain that was about 1.2 cm in size when diagnosed after an MRI. I received this info from my family doctor who read the radiologists report that indicated no further action was needed. I was not given a cause and prognosis was all good given the small size and benign appearance. After some unusual headaches, I had a follow up MRI that showed no change and was told nothing further was needed. Before few months, I started having almost daily headaches, tingling in my head, dizzy spells, memory issues and brain fog, occasional nausea and pressure sensations in my head. An MRI was ordered, and my appointment for that takes months in my place. The symptoms seemed to come and go so I and were not interfering with life so I just waited for the appointment which was last week.I had a third MRI and was told the cysts have grown to over 2 cm and the report shows that rather than a cluster of cysts as diagnosed before, it could actually be a slow growing tumor. In addition, there is now and second unusual spot on the front of my brain. Since it is unclear what is going on, my family doctor has requested to have another MRI. As well my doctor is requesting an MRA because my father had a massive brain aneurysm at age 48, so she has suggested looking at the vessels as well. Then my doctor will refer me to a neurologist.However, this process takes time in Canada so I have a long wait time based on the fact that I am stable and the initial tumor is slow growing. I likely would not have the repeat MRI or MRA tests for four to eight weeks with neurology consult in three to four months.I am looking for advice on what to do next. I am an otherwise healthy 49-year-old woman. However, now I am feeling some anxiety over this which has resulted in sleeplessness. I really want to get to the bottom of what is going on sooner than later.I am currently taking Lithium 600 mg and Lamictal 100 mg for bipolar depression. ### Response: I have reviewed your case. It is very much a benign tumor which grew 1.2 cm to 2 cm. So it is not an emergency at all. First thing, I want to know which area of the brain having cystic lesion? So can you send me the radiologist reports of MRI and preferably photos of important MRI images so I can see how many cysts or tumors in which part of the brain is located. As treatment and prognosis of any brain tumor depend on size, number, and location. Second thing, please describe your symptoms in detail so I can correlate that is it related to this or not. Waiting for your response." "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 been suffering from this problem from last one week, as I retract my penis outer wall, it is paining and slightly swollen, also the tip of the penis has red small colour dots on it and it is scratchy and painful. So please recommend for necessary action. ### Response: It is looking like candidal balanitis. Please take the following medications and revert back to me in seven days. Tablet Intawin 200 mg daily for 10 days, Canestan lotion, apply twice daily, tablet Teczin M once 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 Mother underwent a cataract procedure. After the procedure, we were informed that there was some complication while doing the procedure and they have to do another retina surgery. The same happened next day. It has been more than three weeks but there has not been any remarkable improvement. She gets irritation. It feels as if there is some hair or dust particle in that eye. It pains sometimes but the pain has no specific trigger. She also complains of seeing multiple floaters blocking her vision. There is a remarkable improvement in her near sight. She is able to read without using glasses. But the far sight is not clear. As per her, it is worst than her earlier vision before the treatment. Kindly advise what should be our next steps. Also, is the treatment going in the right direction? ### Response: Sometimes, complications happen in cataract surgery also. It is mentioned in the medical literature that there is zonular dialysis this makes a little tricky surgery. This makes lens weak and there are chances of particles of lens going back towards the retina. But this is completely treatable and I did it in many patients and seen in many patients doing fine. Now, the irritation and pain are a superficial problem and is related to the surface and also could be because of sutures which were used during retina surgery. This will be fine for a period of time and I will be prescribing medicines. Little vision will be compromised but the good thing is that her near vision is fine. Distance vision will take time like four to six weeks and will not be normal as the other eye. The treatment is going right. So do not worry. I suggest you try Systane Ultra Eye" "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 Fluconazole 150 mg, and I am on my second dose. I just took it yesterday for a yeast infection. I was given Clotrimazole Betamethasone topicals cream to apply on the affected area twice a day. However, it seems to make it hurt in an hour after application.I first felt myself getting irritated in the vulva area about a week and a half ago and then started Monistat 3 with prefilled cream applicators and it seemed to improve however a few days later it seemed to reverse. Then, I received the Diflucan and it seemed the discharge has been less inside however, the external seems red and irritated and itchy still ### Response: Hi. I have gone through your history and understand your concern. It could be due to vaginitis caused by a fungal and bacterial infection. You have to take vaginal tablet as well as local application of cream. You can do one thing use plain candid cream and take antifungal and antibiotics for the same." "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 know if the ovarian stimulation for IVF can be started on the fifth day of the menstruation or is it too late? My doctor said I should start the medication for ovarian stimulation on the fifth day of the menstruation because of her schedule but normally I used to start it on day two or three. Do not you think day five is too late and the ovocytes can be compromised? Currently, I am on Rekovelle and in the past, I have been on Clomiphene. ### Response: Hello. You can definitely start the ovulation induction within the first five days of periods. The principle behind this is that the FSH (follicle-stimulating hormone) starts to rise from the second day of the period and by the fifth day, the follicles to be recruited this month have been selected. So any day from third to the fifth day of periods is fine to start the stimulation" "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 five days delayed now and feel light to moderate cramping for almost one week and sometimes nausea. I took the pregnancy test, the cheapest one and the result is weird because instead of a pink or red line, it shows a white line. And also I have a UTI. Is it possible that I am pregnant? And pregnancy test kit could not detect it? ### Response: You are right. Urine pregnancy test and transvaginal scan are unable to detect very early pregnancy. So, for that, we can use a blood pregnancy test (serum beta hCG). It is clearly detecting pregnancy status. For urine infection, you can have a urinalysis and urine culture, lots of water and cranberry juice. If infection positive then discuss here or with a local Gynecologist. In case of bleeding with abdominal pain and positive pregnancy test, you need to report to tertiary care hospital\s emergency. So do not delay. Do serum beta hCG (blood pregnancy test) now as urgent and then discuss it with your presenting symptoms." "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 58 year old female. I was seen at the weekend by the emergency doctor and was diagnosed with a bowel infection. I was rehydrated and given IV Paracetamol and sent home with oral antibiotics - Flagyl 400 mg thrice daily and Tavanic 500 mg twice daily. I followed a diet of fluids-only for the past three days. I am worried as I really do not feel that much better and the foul loose stools came back today. I think fever still comes and goes (do not have a thermometer, so not 100 % sure). I am on the last day of the Tavanic 500 mg today. Do you have any suggestions please? I take BP meds.- Metropolol 50 mg morning 50 mg evening, Telmisartan 80/25 one tablet in the morning, Nexium 20 to 40 mg daily (depending on how sliding hiatus hernia is playing up) and Allegron 30 to 45 mg evening (depending on how fibromyalgia is). ### Response: Hello. I hope I was able to help you. If you have any further questions please feel free to message." "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 on a 13-day cycle. My endometrium has shrunk to 7.7 which was 7.9 on 11th day. I am on Ecosprin 75 mg, Progynova 2 mg twice a day, Estrogen cutaneous cream. I was on Viagra vaginal insert for five days from day two. Now it has stopped. So, my question is why is my endometrium shrinking to 7.7 from 7.9? So my RE said will take a call after two days TVS. So, can you tell me what is going on? ### Response: A change of endometrial thickness from 7.9 to 7.7 mm is minimal and can be due to measuring bias. However, an ET of more than 7 and less than 8.5 mm by mid-cycle is an acceptable thickness for implantation. The medications that you are on are fine and should be continued. There is nothing wrong unless you develop irregular shedding or spots which can justify the loss of endometrial thickness otherwise the likely cause is USG measurement bias. Advise is to get a TVS repeated." "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 chest pain since 15 days. My ECG & TMT reports are negative. But still I am suffering with the pain.Please suggest me the appropriate treatment. ### Response: Hi Chest pain might be due to many reasons other than heart problem (primarily pleuritis - swelling of the lung membrane due to infection). Get your CBC (Complete Blood Count) and chest x-ray done to rule out this cause. Do massage on the affected area with a pain relieving cream/gel (Example : Bengay, Volini gel). Take tablet Zifi 200mg twice daily for 5 days. Consult a cardiologist online if the pain persists" "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 suffer from insomnia that had increased in the last year. I used a lot of medications that were prescribed to me by my local physicians such as (Diazepam, Lorazepam, Alprazolam, and Mirtazapine). Initially, it is useful at the beginning and then insomnia returned. I also follow a behavioral treatment (went to the bed at 12:00 AM and wake up at 7:00 AM on a regular schedule) but the problem is persisting. The main point is when I go to bed, I did not fall in sleep for at least three hours and in some cases stay awake till morning despite the medication that I took at night. My main concern is I want to sleep directly when I go to bed even if I sleep for few hours only. Looking forward to hearing from you and give me a suitable advice or medication. ### Response: It seems that you have been in trouble with sleep disturbances for a quite long time. Also, it appears that you have difficulty in the onset of sleep rather than difficulty in maintaining the sleep. Before proceeding to management, I would like to know few things first: Kindly provide me with this information, so that I can help you in a more effective way" "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 3-year-old son stuck a raisin up his nose. My wife and I are physician assistants. We went to the pediatric ED after attempting multiple positive pressure techniques without success. The pediatrician ED doctor was unable to visualize with a nasal speculum and was failed to pass an NG tube. The ENT who was consulted wants to go under general anesthesia to remove it tomorrow morning. My son is entirely asymptomatic, can we wait till we get back to our home after two days? ### Response: It is better to remove it as early as possible. It is an organic material trapped in a place full of bacteria so rhinosinusitis can occur quickly with the formation of pus. I do not advise you to wait to remove it as soon as possible. Also, you have to be afraid of his Inhalation while sleeping. Remove it under general anesthesia as the ENT specialist said." "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 problem with my skin for a long time where my acne is mild but It gets worse really often and makes things worse. I have a natural redness which does not seem to reduce. I have dry skin that can be sensitive to a lot of things. Currently, I am using Dr Organic Manuka Honey Cleanser, Olay moisturizer and to take my makeup off I use coconut oil.I recently came off a contraceptive pill about two months ago where my skin cleared up on one cheek but over the weekend my skin just went terribly bad. In the past to try and reduce my redness, I have used aloe vera, vitamin A, and some over-the-counter creams.For my acne, I have practically tried everything like over-the-counter creams, acne-clearing products, and organic stuff. Nothing has worked. This is taking a toll on my mental health and I want to sort everything out. ### Response: Hello. You are still in your teenage and acne is a common problem in this age group with frequent exacerbations due to any sort of mental or physical stress. Sometimes even periods exacerbate this and stress like exam or job tension. Moreover, you have been using various topical agents and you might have got contact dermatitis with all of these. You need to understand the nature of your problem first and try to relax first. My advice is to avoid cosmetics as much as you can. Use Brevoxyl (Benzoyl Peroxide Topical) Cream only at the time only on lesions in very little amount. Do not spread on the whole face." "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 44-year-old female. I get random chest pain either on the left side or on the right side that is painful to touch. There are some instances when it feels like my chest is going to collapse. This feeling lasts for a second or two. Almost like a lightning bolt has shocked me. There are other times where I feel like something is pinching or pressing on my left or right side of the chest.I have been diagnosed with costochondritis and GERD and prescribed anti-inflammatory pills plus Omeprazole. I also have high blood pressure and high cholesterol for which I take Losartan 25 mg, Hydrocholorithazide 25 mg, and Fenofibrate 145 mg once daily. I had an EKG done and that turned out normal.I went to the clinic two weeks ago as I had pain in the middle of my chest that lasted less than a minute. I had an EKG done again and it turned out abnormal. My blood pressure was elevated at 130/100 mmHg and I was having an anxiety attack. Although EKG was abnormal, blood tests came out normal and Troponin was negative. I am totally freaking out. Doctor says that I am fine but I should see a cardiologist to rule out heart problems. I am worried because several months ago my EKG was perfectly fine but now it is abnormal. Please help. ### Response: I understand your concern. Your troponin was normal, this is good because that was not heart attack. Regarding your ECG (electrocardiogram), I do not know what was the abnormality. I want to see your ECG to guide you accordingly. One thing I would stress that please reduce your weight as obesity is the most to many unwelcomed diseases. Obesity is a field in which cardiac diseases grow. Only reducing weight will solve many of your symptoms and worries. Regarding your chest pain, it is atypical and does not seem to be related to the heart. Take painkillers when you have pain." "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 getting wisdom teeth at the back of my mouth. Now I am 22. But I am teething and it feels uncomfortable. What to do to get relief from it? ### Response: Hi. Wisdom tooth eruption will occur periodically. You will feel pain and pressure in months. For relief, you may take tablet Brufen 400 mg twice a day for three days. Put oral gel Clinica (Chlorhexidine with Metronidazole) three to four times a day for a week in that particular area. And lastly that is most important, do saline water mouthrinses three times a day for two weeks. It will relieve the soreness of gum areas. Take a 1/4th teaspoon of salt in a cup of lukewarm water and do its rinses." "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 sick with a blocked nose and a sore throat from yesterday. It may be a viral infection due to cold, or it can be due to smoking for the first time. I am feeling tired and sick. I am taking vitamin C 1000 mg every day for the past three days. I have a feeling that I do not have immunity. Is it right to take vitamin C 1000 mg every day? Can I take them more to boost my immunity? Also, I took Panadol cold and flu. Please advice. ### Response: You are suffering from an upper respiratory viral infection. Vitamin C supplement is right and take them for one week. It is better to stop smoking for at least one week." "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 reviewing the patient care of a 4-year-old child diagnosed with the flu. He was having trouble breathing, so we called an ambulance. I was very apprehensive about him receiving any drugs from a doctor. His pulse was 149, 161, and 150. The medic then said his pulse was falling, which I did not see. He then requested an order to give Epinephrine, which does not make sense to me. His pulse rate then fell quickly. What is your opinion? ### Response: An ECG should have been done immediately to see if the child was having VT, SVT, or anything else that would require you to slow down the heart. Based on the ECG, the next step could have been planned. This is because you have only written to me about the heart rate. The other aspects, like breathing and circulation (blood pressure), also decide the modality of treatment. Does it make sense to give epinephrine to a child having tachycardia? However, if there was no pulse afterward, epinephrine should be given at that particular time." "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 took an i-pill eight days before my menstrual period was due and after five days of taking it, I started bleeding. The bleeding lasted for three to four days with light spotting towards the end. But, now I have again started to bleed much ahead of my menstrual period. This does not happen usually. It is slightly accompanied with pain in the stomach and back. What could be the reason? Is there anything wrong? I am a type 1 diabetic for the past 14 years and I am insulin dependent, but my blood glucose level remains in control. Please advise. ### Response: Hello. Get one gynecologic ultrasound and a routine urine exam done to rule out the cause. Most likely, the symptoms are because of hormonal imbalance because of the i-pill. I suggest you start a combination of the Tranexamic acid with Mefenamic acid 500 mg two to three times a day. I suggest you be on regular oral contraceptive pills rather than being on an emergency pill. Consult your specialist doctor, discuss with him or her and take the above medicines with their consent. Follow up with the ultrasound report." "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 76-year-old female\s CT scan showed the following.Clinical information: CT scan of the head, volume scan of the whole brain obtained without IV contrast administration.Findings: Large CSF density hypodense lesion is seen in the right cerebellar hemisphere. Left cerebellar hemisphere, brainstem, and fourth ventricle are normal. Large irregular hypodense lesion is seen in right fronto-temporoparietal lobe effacing the adjacent sulci and right lateral ventricle. An irregular hypodense lesion is seen in the left occipital lobe. Left lateral ventricle and third ventricle are normal. CSF cisterns are normal. No extra-axial fluid collection is seen. No midline shift noted. Densely calcified plaques seen in the cavernous segment of the bilateral internal carotid artery.Impression: Sub-acute infarct in the left occipital lobe, a subacute infarct in the right fronto-temporoparietal lobe, a chronic infarct in right cerebellar hemisphere, densely calcified plaques in cavernous segment of the bilateral internal carotid artery.She has had two strokes so far and is in a critical condition. I wanted to reach out to see if you can provide a second opinion or if it is possible to get some of her senses back so that we can say our goodbyes properly to her. ### Response: Hi. The CT report which you have uploaded suggests large brain infarcts (attachment removed to protect patient identity). I would appreciate if you can upload the CT film also to have a better view of the same. Besides, in such large infarcts, many patients may not recover and some may recover partially. It depends on the clinical condition and consciousness state of the patient. Please upload the medical case summary as prepared by the treating doctors if that is possible for you. Stroke." "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 25-year-old lady about 6 to 7 weeks pregnant. My HbA1c is 12. What should I do? ### Response: According to diabetes guidelines, the patient should have strict diabetic control pre-pregnancy. It is better to have a strict diabetic diet and sugar levels within the normal range and have HbA1c less than 6. Frankly speaking, I feel that during conception, less than 6 or 5 would be better but at 10, it is advised not to conceive but I think after conception it would have increased. As with high sugar levels, more chances of congenital anomalies in the fetus are there, most popular is heart defects. The baby could have diabetes and could grow fast due to sugar levels imbalance and can be large for the gestational age. It can have stillbirth, difficult delivery, intrauterine death, etc. Please contact maternal medicine consultant obstetrician and discuss your detailed history and treatment till now. In pregnancy, Insulin is preferred over oral medications. Have a strict diabetic diet, daily walk, yoga, or mild exercises. Try to have strict monitoring of fetus as well as your sugar levels. Things could be well only with strict diabetic treatment and precautions for the whole pregnancy." "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 32 years old. Last year, I had a cyst on my ovary and I had to undergo an operation to remove it. The doctors ended up removing both my ovaries. I was told to take Microgynon to balance my hormones. I have been very forgetful with my intake of the tablet for the whole year and have not been consistent. Now recently, as usual, I forgot to take tablets for a few days and started bleeding. I was worried it could be something more serious, but doctors told me that it was fine and it was because of the missed tablets. I have gained weight and my stomach appears bloated. At one point I was convinced that I was pregnant as I felt weird movements. The doctors did a scan and there was nothing wrong. I also went through a phase of fatigue. I sometimes get pain in my lower abdomen. I went to another doctor for advice as my cyst was never tested for cancer. He told me to go for thyroid, menopause and cholesterol test. I have not done them yet. They said that it may be the symptoms of menopause. I just wanted to enquire about my health, whether if this is really a menopause and the further steps to be taken. Please advise. ### Response: Hi. Yes, it is right. You can have these symptoms if you are going through a menopause. As both your ovaries are removed, you are going to end up in menopause. This is called surgical menopause. To decrease the symptoms of menopause your doctor prescribed you Microgynon (combination of Ethinylestradiol and Levonorgestrel). This is called hormone replacement therapy. Because of the absence of both the ovaries, the hormones are not produced in your body. Hence, it is replaced from outside in the form of tablets. Since you are not taking it on time, you are experiencing these symptoms. Thyroid problem and cholesterol levels are the other correlated problems that can be associated, so your doctor has asked you to do these tests. So remove your confusion. If both the ovaries are removed, then you cannot be pregnant." "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 weeks ago, a red or pink scar and extra skin showed up at my urethral or where the pee comes out. What has to be done? Currently, I am taking Monistat 7 and had a yeast infection previously. ### Response: I have gone through your query. I would like to know a few more details as follows: From the images (attachment removed to protect patient identity), it appears to be a slight prolapse of the urethral mucosa. However, a clinical examination is necessary to confirm. The reason is just inflamed, hypertrophic mucosa that is probably protruding out. If it is asymptomatic, then there is no cause for concern and should resolve once the yeast infection settles" "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: How far is the left ventricular diastolic dysfunction serious? I am 68 years old. I also suffer from diabetes, BP, heart issues. I have had an angioplasty done 10 years back and again an angiography five years back. Please advice. ### Response: You have LV dysfunction possibly due to a combination of hypertension and coronary artery disease. I would like to know whether the severity of LV dysfunction is critical or not, what type of LV dysfunction is there and what is the ejection fraction? I would be happy if you could send me 2D echo report for my perusal and prognostication." "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 commenced taking Femosten last month because I was not getting a period for the last six months. Prior to this, I got them intermittently for 12 to 18 months. For several months, I would just get my period for several consecutive months. My cycle has always been 28 days. My periods never differed, perhaps a little heavier than usual. I suffered constant hot flushing for six months. So the doctor prescribed Femoston which dealt with that issue. She did advise perhaps I would still have some bleeding. I have never had any breakthrough bleeding but last month I got a period, lasting for usual five days and yesterday, I have had another period. Just wondering about this. I am due to see my GP soon for a pap smear and review the Femosten. Should I make an earlier booking? ### Response: Hi. I can understand your concern. What about hot flushes? Do you have them? And when is your scheduled appointment with GP? Do you have foul smelling discharge? Do you have weight loss or low-grade fever? Do you have a family history of cervical cancer? Please reply to my answers of the above-asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health." "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 teeth are not in order. How to correct them? ### Response: Hi. Improperly aligned teeth are said to be in malocclusion. They cause problems like difficulty in breathing, speaking, eating and might cause dental cavities also. So, orthodontic intervention is necessary. Depending upon the severity of the malocclusion, removable or fixed type of orthodontic treatment (braces) might be needed. Removable type can be taken off by yourself while eating alone, whereas fixed one will be attached to the teeth for a minimum of 12 to 18 months." "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 suffered from ringworm (tinea corporis) long back. I used Itraconazole 100 mg for two weeks. Now the same has appeared on buttocks. For this, what medicine needs to be used? If I use these tablets, will it cause any other side effects? The problem is like round shaped and it is spreading. This is the problem. Please suggest me medication. ### Response: Hi. I have gone through your complaints and reviewed the attached photographs (attachment removed to protect patient identity). You are having tinea which is a superficial fungal infection of the skin. I would recommend you to take oral and topical antifungal medicines. I would recommend you to take capsule Itraconazole (capsule Onitraz) 100 mg twice daily and apply Luliconazole cream (Lulifin) cream on the affected areas once daily for four weeks. For itching, take tablet Levocetirizine 5 mg once or twice daily depending on the intensity of itching. These medicines will not cause any side effects. Also, keep the area" "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 30 year old mother of a 11 months old. Today, I found a red, inflammation on the surface of left breast on the lower side. It is a lump kind of stuff. I am doubtful whether it is cancer. I did not see any other symptoms of breast cancer as other things look normal. I am so worried. Please help. ### Response: An inflamed lump is unlikely to be a cancer. This is an often occurrence in women with babies being breastfed. It occurs due to an infection. However, any lump must be examined by a breast surgeon and if required a sample of the tissue taken in order to ascertain the cause and nature of the lesions. For safety sake, you need to visit a breast surgeon. However, the chance of cancer is relatively low given your age, etc. Please have it checked out. It is not something that anyone can diagnose without 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: My wife had NT scan and double marker test at 12 weeks and 3 days of pregnancy. The report is as follows, CRL is 59.2 mm, NT is 1.45 mm, free beta-hCG is 84.84 IU/L, equivalent to 2.217 MoM and PAPP-A 0.712 IU/L equivalent to 0.282 MoM. Trisomy 21 is 1: 450 1:47 and trisomy 18 is 1: 5315. I wanted to know about if the risk in the first-trimester screening window is positive. ### Response: Hi. I have read your question and understand the concerns. Hope you found the answer helpful. Regards" "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 schizophrenic but recovered. I would like to know what next after recovering symptomatically, functionally and cognitively over 2 years now. Do I get to gradually taper off my medications? Do I get back the level of energy I had during my pre-psychotic period before my first relapse? ### Response: Hello. Good to know that you have recovered from Schizophrenic episode. You can gradually improve your functioning by following a bio-psycho-social rehabilitation model. If this is first episode psychosis, many guidelines suggest continuing antipsychotics for 1-2 years after remission of symptoms. Discuss with your doctor about gradually reducing Olanzapine. It needs to be done very cautiously under supervision and monitoring to prevent any relapse of psychotic symptoms. If you had already had a relapse, it is advisable to continue on antipsychotic medication for a longer period at the lowest possible effective dose. So there is no straight answer to your question about tapering medication. Apart from medication, try to get some therapy/counselling to help you manage with sustained recovery. Also try to gradually get back into education /training or some job to improve your functioning. Take it easy during the remission period. Also ensure that you follow a healthy diet, sleep adequately and exercise regularly. 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 acne and very big and thin pimples. I am a male, 18 years old. ### Response: I just read your query. Acne at this age are mainly due to hormonal changes. They will settle on their own. But still if you want to take some precautionary measures, follow these: These all things will help you a lot" "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 daughter has been experiencing severe back pain, arm stiffness with grip loss, shooting pains down legs when the heel is put to floor and vision blurring when sitting in the car for long periods, for over two years following spinal anesthesia for C-section. MRI scans show nothing and she is taking a maximum dosage of Endone. She now has vascular issues with bilateral inflammation and swelling in lower legs. She has been to a pain specialist and neurologist who have no answers. She is losing hope and trying to care for four children. Can you please offer us some answers? ### Response: I understand your concern and would explain that her symptoms (especially the grip loss in her arms and blurring vision) are not related to a lumbar spine disorder. A brain disorder (intracranial hypotension) or a cervical myelopathy could explain some of her symptoms. Intracranial hypotension could be a complication of local anesthesia, but you should know that it usually leads to a headache and blurring vision or nausea when standing up or sitting and the symptoms usually improve with lying down. So, it seems that her symptoms are not typical of this disorder too. Coming to this point, it is necessary to perform a brain MRI study and a cervical spine MRI study. The bilateral inflammation and swelling in her legs do not seem to be related to any neurological disorder. For this reason, it is important to perform inflammation tests (complete blood count, PCR, sedimentation rate) and a Doppler ultrasound of the leg vessels to investigate for chronic venous insufficiency. A cardiac ultrasound is necessary to exclude possible heart failure as a possible cause of increased fluid retention. Hope you will find this answer helpful" "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 36-year-old male. I previously had a chlamydia infection and was successfully treated. Will such previous infection interfere or affect my fertility? I recently had a scrotal examination and the results were normal. ### Response: Hello. Chlamydia infection persistence or recurrence can definitely cause an apparent increase in the pus cell and WBC count in the seminal fluid which can easily decrease the total sperm count and its quality. If you have been treated it is good, but again it takes 90 days for new spermatids to form adults and become functionally mature for fertilization. It is always best to get a repeat semen analysis and culture done to be sure that there is no repeat or recurrence of chlamydia infection if you have been sexually active post your previous examination or if your partner was not treated along with 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 23-year-old girl. I underwent a rhinoplasty six days ago. Today my surgeon took the cast off, and I saw my nose with a lot of swelling, I have a concern that I will not get the shape as I want a thinner dorsum. I am uploading the pre-surgical and post-surgical pictures. Is it possible for my dorsum to get thinner after the resolution of the swelling? Or will it remain the same? ### Response: I have gone through the attachment (attachment removed to protect patient identity). Many of my patients will have trouble, so I do not assure them before surgery as the actual results take time to show due to swelling. I hope your surgeon must have convinced you and so you are looking for the second opinion. It takes up to three to six months for the swelling to subside completely. But you will be expecting a decrease in swelling after seven to ten days. Do not get worried and enjoy your holidays. Wait, and you will get an excellent result" "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 did my blood test. The hemoglobin is astonishingly low at 4.1. I did ferritin test and B12 test and the results are attached. Blood transfusion was done - one bottle. The hemoglobin increase to 5.5, but again reduced to 5.1. I have a fever on and off. What problem do I have? I am feeling very weak. How long will the treatment go on? ### Response: Hello. Your hemoglobin level is very low. In low hemoglobin state, the oxygen-carrying capacity of blood is affected and so weakness and other symptoms occur. You need to be given blood transfusion or iron injections. But, your ferritin level is high. So hemolytic anemia has to be ruled out first. For low B12 level, cyanocobalamin injections are to be given once a week for eight weeks. You need further investigations with peripheral smear examination report, serum LDH, serum bilirubin estimation, etc. Consult a nearby physician for physical examination and accordingly discuss your treatment plan. Hope this will help 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: What are some of the most significant health mistakes that people need to stop making, especially as they age? ### Response: 1. It can adversely affect liver and pancreas health. It may lead to problems like liver cirrhosis, diabetes, etc. in the future. 2. Smoking, it not only affects the lungs severely but also harms oral health, gut health, and also affects sexual health. 3. Eating excessive deep-fried food and processed food. It can lead to weight gain and other health issues. 4. Do not take proper sleep. Sleep deprivation may lead to many health issues in the future. 5. Not doing exercise. Exercise is the key healthy to the body. Skipping exercise can cause physical issues and also psychological issues. 6. Avoid mental health issues. Mental health should be given equal importance, like physical health issues. 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: My wisdom tooth is growing. It is very painful. What is the solution? ### Response: This eruption pain occurs in every 2 or 3 months. To suppress it you must do this antibiotic course: Tablet Augmentin 625 mg, two times a day, tablet Metronidazole 400 mg, two times a day, tablet Brufen (painkiller) 400 mg, two times a day but if the pain is severe take three times a day. Do this course for three days. And do saltwater mouthrinses 3 to 5 times a day for a week. Put a 1/4th teaspoon of salt in a cup of lukewarm water and do its rinses. Give me followup after two 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 have episodes of bad sinuses every year. Last year, I had hay fever with an extreme blocked nose. I went to my GP, and he gave me sinus injection. I got better after treating it. The doctor prescribed Allerway 5, and Spersallerg eye drops for me. This year, my condition seems to be poor. My sinus has become bad. I use endless nasal sprays and allergy tablets. But there is no relief. I went to GP again, and he gave me an injection. This time, injection has not helped me.I have ear pain, head pain, clogged nose, with itchy eyes and itchy throat. When I lie down to sleep, the pain gets worse, and I have throbbing pain in the head. I have nonstop sneezing for 30 minutes in the mornings. I have also taken two courses of antibiotics. But there is no relief. In the mornings, when I sneeze, the mucous seems to be yellow with some blood present in it. Later, the mucus becomes clear again. I cannot sleep at night because of the throbbing head pain. I will try to change directions, and I will add more pillows to sleep. But nothing has helped me. ### Response: Hi. You are suffering from an acute attack of bacterial infection along with allergic rhinitis. You can take the following medications. Use Avamyse nasal spray (Fluticasone furoate nasal spray) once daily for a month. Take Claritin (Loratadine) tablet once daily during the winter season. Take tablet Targo 750 (Levofloxacin) once daily for ten days. Try to do self-nasal saline or water wash. The last treatment for allergic rhinitis is immunotherapy. You can redo CT scan for the nose and sinus after finishing Avamsye." "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 nurse and I had the stomach flu about a week ago and decided to take a VD pelvis and abdomen radiograph of myself. Upon taking the radiograph, a number of small abnormalities in the pelvis were seen. At first glance, they appeared to be stones, but after taking repeat X-rays, one week later, the small circular spots have not moved at all. A urinalysis was ran and came back completely normal. I suffer from irregular periods but other than that, I am in good health. ### Response: Hi. I assume the radiographs were taken to evaluate any calculus, stone along the urinary tract. However, the small opacities seen in the pelvis are phleboliths within the veins of your pelvis and not stones. These phleboliths would not cause any discomfort to you and are asymptomatic. With irregular periods, I would recommend a pelvic ultrasound with KUB also to evaluate post void residue which can cause recurrent sub-clinical UTI." "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 IBS-D five years ago. This month tests have identified high levels of blastocystis hominis in my stool as well as yeast and imbalance in gut flora. I am traveling away and I am wondering what the best course of action for me is?I have done comprehensive stool analysis and recent full blood test. ### Response: Hi. Blastocystis hominis does not usually require treatment unless there is a co-pathogen (they were none found in your stool study) or if the individual is immunosuppressed. The other issue is your SCFA (short-chain fatty acid) and but the rate are a bit on the lower side." "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\s last period date was two months ago. After one month, we came to know through blood tests that she is pregnant. She had her first ultrasound 10 days ago and the baby is fine at five weeks and five days with a heartbeat of 114. But for the last three to four days, she saw some blood in her urine. Today, there was some flow like a period and we consulted the doctor.We did an ultrasound today. They could not find the baby\s heartbeat. So, we did blood tests. My wife is under a lot of stress because of bleeding and no heartbeat. Does this mean, she has got a miscarriage? Do we still have a hope to revive her pregnancy? ### Response: If a repeat ultrasound shows no heartbeat then she has experienced a missed abortion. This means that after the arrival of the heartbeat, the heart has stopped and the fetus is no more alive and not growing. The bleeding is nature\s way of aborting the non-developing fetus. This can happen because of possible congenital abnormalities or chromosomal abnormalities in the conceptual, which was deemed naturally unfit for further survival. The initial heartbeat of 114 BPM (beats per minute) was itself low. Ideally, it should have been more than 130 in a real fetus. The bleeding may continue for a week until she aborts completely. You may repeat the ultrasound again after a week to check for completion of miscarriage if the bleeding does not stop" "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 sperm count is low; it has dropped from 18 million to 3 million within a period of five months time. I have been diagnosed with bilateral varicocele. I have consulted three urologists. The first doctor advised me to go for ART (artificial reproductive technology) second one prescribed medicine to boost my sperm count and motility and the third one advised to get the varicocele corrected by surgery. According to him, surgical correction will certainly increase the sperm count. In case it does not work, then he asked me to go with ART. ### Response: Hi. After going through your report (attachment removed to protect patient identity), I am aware that you are suffering from severe oligozoospermia (oligospermia). After four days of abstinence, please repeat the semen analysis. Even after repeating the tests, if the sperm count does not change, then I would suggest you go with either of these options. In severe cases of oligospermia, medicine will not help. Some of the factors to be taken into consideration are the period of infertility, the sperm motility and the grade of varicocele." "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 39-year-old female. I am fatigued, sluggish, difficulty concentrating, migraines, and difficulty regulating temperature. I have periodic tightness in the chest and fluttering sensation. My EKG, CT chest, and chest x-ray are normal and the COVID test is negative.My Vitamin B12, folate, and vitamin D were low. I started supplements last month and levels are in normal range now, but I still have symptoms. Borderline low white count, ABS lymphocyte count, and slightly high platelets. I was diagnosed with lupus as a teenager but then in the early 20\s I was told that I do not have it. My father died at the age of 59 of a sudden catastrophic event, possibly a heart attack. Also my D-dimer was slightly elevated and so was my sedimentation rate.I have a history of cancer in the family, especially breast cancer. So, I am more concerned about cancer. I am currently on \x80\xa8Lamictal, Lexapro, and birth control pill. ### Response: Your reports are normal nothing seems worrisome (attachment removed to protect patient identity). Since you have a family history of breast cancer, you should get a mammogram done. Also get your BRCA gene (breast cancer gene) tests done. It is a blood test and if it is positive then it means high chances of getting cancer in the future. If it is negative, it is good. Also, you should take supplements and should stop birth control pills, they can also cause cancer sometimes. You should use a mechanical method of contraception like condoms, and should do regular exercises to reduce your weight too." "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 mom is a diabetic patient. She is given Glimser forte 1 and Glytrin met 1000 for her current blood sugar condition by a diabetologist. From last two days, she is feeling exhausted and very weak. Is it because of the tablets or any other reasons? ### Response: Hello. If she has started feeling so after the medicines have been started, it is as the dose might be high for her and her sugar levels are going too low. You can check it on your glucometer if you have one. Please meet your diabetologist for dose adjustment as soon as possible. Also, when she experiences such episodes, immediately give her some sugar or hard candy. Just as high sugar is not good for the body, very low sugars are also not good. So please do not delay and meet your doctor at the earliest" "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: For the past two months, I have had a pretty consistent elevated heart rate. Not by a lot but noticeable for me compared to what I was coming from.I cut out alcohol and caffeine and that helped but it always returns. My resting heart rate (I wear an Apple watch) is pretty consistent in the 53-58 range. But when I get up, go up or downstairs, it will jump to 100 pretty fast, then average out in the 80\s as I move about my day. When I am sitting at work it is 78-85 bpm. This is a good 8-10 bpm faster than when I am at peak health. I am not sure what is going on.I did a fair bit of cocaine and took some ED pills a few times (with the cocaine) before three months, so I wondered if maybe there is a connection. I have not done anything like that since then.I am a runner, but now when I run or jump it goes up to 150 bpm and higher pretty fast. If I push myself anywhere close to hard I am at 170-180 bpm pretty easily, so I slow down. And it seems my body does not recover quite as fast. So I have stopped running hard and just do light jogs, and play tennis. I recover pretty easily there. But it is annoying as I want to run and push myself.I will go two to three days with no caffeine, alcohol and then I notice my walking around rate is lower, like what it used to be mid 70\s. When it is like that I can feel it noticeably, I feel much more complete and whole. I feel great and no shortness of breath. So then I will have a few glasses of wine that night, and maybe a dessert (I like sugar at night) and I will lay down to sleep and my heart seems to jump up to 85-95 bpm for a while and it takes two to three hours before it rests at 53-58 bpm. And then the cycle starts again. I am so confused I do not know what the deal is. Is it the alcohol or sugar? I drink this one type of white wine a lot but I have noticed my heart rate does not react as much when I just drink beer. One night, I had white wine then tequila and my resting rate was like 68-78 bpm all night. I saw a doctor about three weeks ago and they did an ECG and listened to my heart and it showed no issues or irregularities. I do not have heart pain, though I did have a few sharp pains over the past two months maybe two to three times all lasting about one second and then it is gone all when I am lying down in bed trying to go to sleep. I do have shortness of breath due to the elevated heart rate when I am carrying stuff, going upstairs, etc. I do not have pain in my chest, jaw, left arm, etc.Sorry, this is so long but I really would love to discuss this with someone who maybe has heard of this before. To be clear what is annoying and confusing me is that my heart rate will steadily be 8-10 bpm higher at all times (aside from resting rate) for like a 7-10 days before it feels like it goes back to normal. But then there is always something that sets it off again. I never see it spike over 105 or so. ### Response: I understand your concern, but I assure you that there is nothing to worry about. It is normal for the human heart rate to fluctuate. For instance, during exercise the heart rate can go as high as 350 bpm in some people it does not mean there is a problem. It is normal. It is also normal for the heart rate to slow down when laying down. But it can increase while laying down in cases where you take alcohol just like in your case. You are having issues with anxiety probably because of the cocaine you used. I advise you to resume your exercise. Start jogging, it will help with your situation. You can only worry if you begin to experience shortness of breath, chest pain or fainting." "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 to four urologists and none of them know what is wrong with me. Hopefully, you will have some information I do not already possess.I have a lot of discomfort with the penile shaft. It feels like there as knots and stiffness in the shaft muscle. When running or any kind of exercise, it gets stiff and it is very uncomfortable. I am not sure if there is not enough circulation. The testicles are also red and the skin gets stiff as well. I have done blood tests, ultrasound, and the only diagnosis has been internal shaft bruising, from a urologist taking a guess. Years ago, I tried enhancement pills. That might have triggered the side effects. That is why he said nothing can be done. One urologist ruled out an infection. He said, however, these side effects are very strange and seem uncommon. One also laughed at me and said I do not know how to help you. I cannot wear gym clothes. This has made me very depressed over time. I need to find a solution to fix this issue. Please, please help me. If you are unsure please consult a colleague. ### Response: I agree that your symptoms are very vague. As per your history, I can conclude either This can be possible due to one of the side effects of enhancement pills. In some cases like in yours, enhancement pills are known to cause changes in the penis like skin stiffness. Anyhow, you also need to rule out Peyronie\s disease with an ultrasound penis. If not Peyronie\s then it is due to side effects of enhancement pills. But after confirmation of diagnosis, I will prefer a physical form of therapy like massage or traction" "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 dropped bladder that could be causing a lot of pain in my left leg but then I have sciatica as well. The lower parts of my legs have a stinging and pain feeling quite often. I have been to the gynecologist and was told that there is no connection to the two according to them. What exercise can I do immediately to relieve these feelings in the lower legs? I am 79 years old. Besides that, I am in excellent health. ### Response: I understand your concerns. I agree with your physician that your bladder issue has no relation to your pain in legs. Most likely it is due to sciatica. Management of sciatica includes weight reduction, local painkiller creams, vitamin b12, pregabalin tablets, and surgery if the pain is severe and there is motor function abnormality. Physiotherapy could be helpful" "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: mI believe that my 6 year old son has ringworm infection. It started out small and then within a few days has gotten larger. I have attached the photo for your reference. ### Response: Hello. I just read your query and saw your attachment (attachment removed to protect patient identity). Yes, you are right. It does appear to be a ringworm infection of the scalp called as tinea capitis." "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: One of my teeth started moving backward as soon as I started wearing my retainer just at night. It got painful to put the retainer back in, and so I stopped wearing it. I am terrified of orthodontists and dentists, and so did not let my orthodontist know. Now, two of my teeth has moved backwards and a couple are slightly crooked. Should I get braces again or is there another option for this? ### Response: To correct the relapse of orthodontic treatment, there are two options. It depends on how much tooth movement is required" "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 calcium score is 2000. For lowering it I am taking liposomal EDTA a chelating agent meant to reduce calcium deposits in arteries. But my vitamin C and magnesium levels are sharply reduced. How can I restore vitamin C and magnesium levels without stopping liposomal EDTA? ### Response: Hello. You are taking antioxidant EDTA (Ethylene diamine tetraacetic acid) for reducing calcium deposit in the artery and it is helpful in reducing blood pressure and cholesterol and preventing a heart attack. So you can be prescribed Vitamin C and Magnesium oxide supplements in pill form. Vitamin C 500 mg tablet is also available that also can be prescribed if needed. Your physical examination should be done and if symptoms like the heart beat faster, diarrhea, muscle weakness, and cramps, easy bruising and bleeding if present then intravenous therapy might be needed. So you can consult your physician doctor for examination and can get prescription for low vitamin C and magnesium level." "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: Please help! I am so upset. My daughter had a seizure. She had one 7 months ago too. We thought it was syncope, but now we think it is a seizure. She had CAT scan, blood work, and EKG and all the reports are fine. We saw a neurologist, and he said everything seemed all right. He gave her an overall examination, no other tests though. This time she bit her tongue and also urinated. She got sick when we got home from emergency room too.Do we have to take her back to the neurologist? Does she have epilepsy? ### Response: Hi. I have gone through your daughter\s comprehensive medical history written by you. Tongue bite and urination indicate that these episodes are seizures. The probable diagnosis would be epilepsy. Tongue bite is not seen in syncope, though urinary incontinence may be rarely observed. I suggest that she should be put on empirical antiepileptic therapy and observed for response. I wish her a good therapeutic response to medicines. Antiepileptic medicines." "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 eardrum perforation since childhood. I had tympanoplasty done last year but, that failed. Now, the ear keeps discharging all the time. I completed a course of Ciprofloxacin and Dexatops ear drops but after a week, the discharge is back. Please advise. ### Response: A recurrent ear discharge after a failed tympanoplasty needs to be evaluated completely" "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 suffering from breast cancer, and her treatment is going on. We have already done four chemotherapy with a gap of 21 days, but now instead the surgery doctor advised us to take 12 chemotherapy weekly. Please let me know the treatment that is going on is right or wrong? ### Response: It is called neoadjuvant chemotherapy. So with chemotherapy, the size of the tumor is reduced significantly to make breast tumor operable. After completion of the second phase, chemotherapy she will be restaged before surgery. It would be better if you would have attached CT scan, pathology (biopsy) reports also." "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 I have vaginal prolapse, will I be fitted with a pessary the day of discovery or will I be told to return another day? I am not really sure if you have a uterine prolapse but I seem to have several similar symptoms which includes, the feeling that you are sitting on a ball, increased discharge, constipation (what I believe to be the leading cause, since I have had chronic constipation as a child), a pulling or heavy feeling in the pelvis, the sense of something coming out of my vagina (when I checked with a mirror it looked like something was right at the entrance of my vagina). I have already made an appointment to consult my gynecologist. However, I just wanted to know how long it would take to treat this problem. ### Response: Yes, they may treat prolapse with pessary on the same day. As this is not a lengthy procedure, pessary insertion takes a few minutes to be done. But delays can be expected just in case a right size and shaped (according to your vagina size) pessary is not available right at the time of your presentation to the clinic. I hope it has helped you. If you require any further queries, please do not hesitate to contact 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: I am a healthy 50 year old man who worked out six days a week. About six weeks ago, I had chest pain and went to a hospital. I was admitted after having three blocked arteries, at 99, 93 and 88 percent, and successfully had three stents put in. Since released, I have turned to a vegan diet and eat fish, chicken, and greens. Would it be alright to have one cheat meal per week, aka steak, burger, Italian or would that do damage? Also, I have congestive heart failure with a fraction rate of 42. The doctor put me on Carvedilol and said with proper diet, exercise and meals, I can get that number back in the normal range in five to six months. ### Response: Hello. EF (ejection fraction) is not the only element indicative of heart failure. It may differ based on the clinical situation and other parameters. I agree with your current therapy. I agree with your doctor that a healthy lifestyle is necessary to improve your situation. We cannot make predictions on your heart function, but we can hope that everything will be fine. Unfortunately, this is a chronic and serious medical condition, which cannot be cured. The optimization of the therapy and a healthy lifestyle can help improve your survival and improve your life quality" "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 reoccuring pain in my anal for about 10 years. It stays for about 2 to 4 weeks and then it is good for 1 to 4 months. First, I thought it was hemorrhoids but then a specialist diagnozed it as an anal fissure. I am 29 years old, male, eat super-healthy and exercise. I have read about all possible natural treatments and have tried them (fiber, sitz baths, etc.) but the pain always comes back.What are my options? Would lateral internal sphincterotomy heal these reoccuring anal fissures? I also took pictures of my anal yesterday which I would like to have a specialist looking. One while a bowel movement (and bath and shower) and one the next morning. ### Response: We are here to help you. I have evaluated your reports and medical history (attachment removed to protect patient identity). As such there is no indication for surgery at this point of time until and unless your pain frequency increases a lot. If it is happening once in 2 to 3 months for a few days then it is bearable. I do not think surgery is required. At that time you can apply Lignocaine containing jelly for a few days and it will soothen your pain. As far your query is concerned, yes lateral sphincterectomy can help 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: From the last three months, I have a constant pain on the right side of my mouth. I believe the pain was similar to when someone has an erupting wisdom tooth, but I am not 100 % sure. When I looked in the mirror with a flashlight, I found a tiny white spot in the area between my right upper and lower wisdom teeth. I had this spot for at least 4 or 5 days, and then gradually it subsided within a week or so. After a week, when I took a look, that white spot was gone but the little surrounding area had become white. This white area got bigger with time. I visited a dental surgeon in a top hospital, who visually examined the area and asked me to get an OPG done. The OPG report suggested impacted wisdom tooth. The doctor said the white area was caused by trauma from the friction of the two wisdom teeth on that side with the skin.I was not very convinced and visited another dental surgeon, who also said more or less the same thing, after examining and going through the OPG. As per his advice, I got both wisdom teeth extracted. The white area has remained till this date, not the initial white dot which had disappeared within 5 to 6 days as mentioned above. I could not open my mouth properly for few days after the extraction, but when I finally did, everything appeared normal. Since then, I have not had any oral or dental issues. It is to be noted that neither doctor had seen the first tiny white dot or spot since I had met them after it was gone and when the surrounding area was white.I have attached some photos here, and the photos marked 1 and 2 show the first white dot. While the remaining show the condition after this spot disappeared. I request your thoughts and opinion about the issue detailed above. Could the original white spot be an ulcer or canker sore? If yes, what could have been the possible cause? Is a single canker sore cause of worry? Can it indicate some very serious underlying condition? I have read on the internet that mouth ulcers normally occur on the inside of cheeks, tongue, and lips. Can it occur in the area where the spot appeared? If it had been a mouth ulcer, is it possible that the ulcer affected the area in a way which caused a trauma resulting in the white area? I request a detailed response to the above at the earliest, please. ### Response: Hi. I have seen all the attached photos (attachment removed to protect patient identity)." "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 ago, I had a problem with one of my wisdom teeth. It caused pulpitis in the front teeth, so I got a root canal treatment on it, but I did not get the wisdom tooth out. The dentist cleaned the cavity on it as well but covered it with amalgam. Recently I started to feel bad breath when I clean with my tiny bristles toothbrush in this area. I think it mostly coming from the interdental space. Please let me know should I get it drilled again? ### Response: You have not attached X-ray with this query. Still, it might be an infection near the wisdom tooth. You may need extraction of the wisdom tooth. Send X-ray if possible and use warm salt water gargle twice a day for a week or two to remove the smell." "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: Recently, I have some acne under my chin and upper than my neck. What does this symptom show? I wonder can it have any relation with stopping of masturbation which I have done in about three weeks. Also, I had unprotected sex with someone 10 days ago and I am scared of HIV sign. ### Response: Hi. The erythematous papular eruptions which you have on your facial area seems to be acne or folliculitis (attachment removed to protect patient identity). This is a superficial skin infection, commonly bacterial and is extremely common irrespective of HIV status. It has no association with starting or stopping masturbation. For your unprotected sexual exposure get your HIV rapid combo test, if negative you will require a repeat testing at three months and preferably at six months of exposure also. I also advise you having safe sex using consistently and correctively condoms in the future." "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 prolonged spotting for one month followed by bleeding for 2 to 3 weeks. I took Meprate twice a day for three days, followed by one tablet each day. Bleeding stopped, but while I was taking Meprate on eighth day I did heavy workout and spotting started again. What shall I do? When should I take next Meprate dose. ### Response: Meprate is not the treatment for bleeding. Once you stop Meprate, you shall again get at the bleed in next 3 to 5 days and may be heavy, as it would be a 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 was taking Pregabalin for a long time. I got my blood test done and B12 has come 1993 pg/ml although the LFT and RFT are normal. Should I stop the intake of Pregabalin immediately and wait for fifteen days to get the B12 test once again? ### Response: Hello. Pregabalin medication is used for neuropathic pain. It does not lead to the elevation of B12. So, you can continue with this medication. For high B12 level, you have already ruled out liver and kidney disease by their subsequent reports. So, I suggest you investigate with CBC (complete blood count) and peripheral smear examination blood report for further work up. B12 is a water-soluble vitamin and it can readily be excreted through the kidneys. So, do not worry about that and investigate with CBC and peripheral smear examination report as suggested" "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 done proper dental care as followed by norms since childhood but was diagnosed with two root canals when I was 15, only one root canal had reached the surface. Now I am 18, and my recent visit to a dentist revealed that I have six cavities building up (one of my root canals has still not surfaced). I do not know where I am going wrong. Is it possible that my teeth are inherently weak and need more care? What should I do? ### Response: Teeth having multiple cavities suggests improper maintenance. It could either be due to improper brushing or too much of sticky food or a hereditary feature. You need to just visit your dentist and get to know the correct way of brushing and also have a meticulously good oral hygiene. Since the cavities have already started, get them filled and have the remaining teeth taken care of well" "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 indigestion problems last month and I was given a Pan 40 injection in a 24/7 hospital in my locality. The moment I was given the injection, my body developed rashes, redness, and itching. My doctor immediately gave Avil injection after which rashes and redness subsided. Two days back, I again had got indigestion problems after a week of having junk food outside. This time I had Pan D tablet, but this time after an hour I developed rashes, itching, and the whole body turned red. I again went to the 24/7 hospital and the doctor again injected Avil after which the redness and itching subsided. The doctor also told me never to take Pantoprazole tablets as I am allergic and reacting very badly. Now, I have been given Rantac and I have no problems now. So, here are my questions:As my doctor told PAN tablets will be regularly prescribed for other illness too to avoid acidity and other stomach ailments, do I have to tell that I have Pantoprazole allergy whenever I visit a doctor? Is Pantoprazole allergy something I need to be concerned about? Should I have to do anything? ### Response: I have gone through your question and I understand your concerns but yes Pantoprazole allergy is a permanent condition that you will need to report to any doctor you visit before prescribing medications. Also, this allergy is nothing to worry about as long as you avoid taking Pantoprazole but can get very serious and even fatal if you take it again. I hope you find this helpful" "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 E.coli bacterial infection. I am taking Ciplox TZ and Nitrofurantoin. But after taking Nitro, I get pain in the stomach and the right side in the groin area. Also if I go for a walk for around 1 km, I feel pain in the groin area and cannot walk for more than two kilometers. I also have kidney stones on bilateral sides. I have a grade II fatty liver. Please advise. ### Response: Hello. You have bilateral renal pelvic obstruction due to stones with diabetes with urinary tract infection. The pain in the groin is due to pelvic renal calculi, the pain of which radiates to the groin. The infection needs to be treated with tablet Levoflox 500 mg once a day for 14 days along with injection Amikacin 500 mg twice a day for 14 days (if serum creatinine is less than 1.6 mg/dl) followed by clearance of stones bilaterally. Otherwise, your infection does not get resolved as the pus is due to disease associated with stones. Your stomach upset and pain in the abdomen is due to Nitrofurantoin, which causes gastritis and acidity. Nitrofurantoin is not the right choice for treating such infection. It can be useful as maintenance therapy. Kindly get diabetes treated. Please check serum creatinine checked once you start injection Amikacin. The presence of stones prevents the total clearance of infection. Please get back to me if you have any more queries." "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 trying to put a condom on but I was doing it upside down then I flipped it and wore it. I am worried that while trying to put it in the wrong way, some semen might have got on to the condom. Is it possible to make her pregnant or the sperm dies in just a few seconds when they come in contact of the open air? I already had ejaculated once in my pants before. So it was not a precum that might have contacted the condom. ### Response: The sperm does not die as soon as they expose to open air. If the condom contains the sperm on the outer side, then it can cause pregnancy. As you mentioned that it was not just precum, but it was semen. So, if it was semen or sperm on the condom then they can cause pregnancy. If your partner was in her fertile period when you had sex, then there are chances of pregnancy. If she was not in the fertile period, then the pregnancy is unlikely. So, verify her fertile period. Also, the emergency contraceptive pill can be used within 72 hours of sex, to avoid pregnancy. Ask her to check it, and you can also check for pregnancy when her period is due or almost after two weeks, that she is pregnant or not. If her pregnancy test return to be positive even then there is an option to terminate it, after consulting with your doctor." "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 26-year-old male. My height is 160 cm and I weigh 55 kg. I have a severe one-sided headache. Please help. ### Response: You seem to have a headache which is located on one side only. According to me, you are having a cluster headache which can be due to many causes of stress, migraines etc. If you can tell me whether it is right or left sided and whether you have any associated symptoms like nausea, watering of eyes, sleep problems, dizziness I can help you better" "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 3-year-old son had diarrhea for a week. He has thrown up a couple of times throughout the week as well. He was eating and drinking normally and has appetite. There does not seem to be any blood in the stool. And his belly ache goes away after each diarrhea episode which he has many each day. He is usually drinking as well. His doctors seem to believe that it is a viral infection and will go away in time. We just started a bland diet for him. Should I be overly worried? He is active and wants to eat and drink. So is this something more serious than we think or am I too worried? ### Response: Hello. If there is no blood in stools, it is mostly viral. It usually gets settle in five 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: Recently, I have been having chest pain with burning around the heart area. I have had adrenal/chronic fatigue for one and a half years. Other symptoms since being fatigued include neck/head tremors, excited nervous system, elevated heart rate, pounding heart, exhaustion, low stress tolerance, increase in headaches, occasional arm aches, burning sensations in the arms. ### Response: Your symptoms are suggestive of anxiety/stress. I suggest you do upper GI endoscopy to exclude GERD which may cause chest pain and burning around the heart. Rest of the symptoms are due to anxiety. I suggest you consult your GP" "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 recently had an echocardiogram. The result was normal. The only finding was trivial regurgitation of my mitral valve. I was told this is normal. The question I have is, is this something that could get worse over time? If so, what lifestyle changes can I make now to prevent that from happening? I am 42 years old. ### Response: Hello. Trivial mitral regurgitation is physiological, which means normal. And in absence of structural heart abnormalities, this will not progress. So, there is nothing to worry about it and needs no specific precautions. You may continue with all your daily activities including physical exercises." "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 protected sex with a male prostitute. I did not receive it, I was giving and later I received it from the prostitute. This occurred before five months. I got tested at the health department for HIV and ECT and they came back negative. I looked at the symptoms and I am panicking. I have had a sore throat, runny and stuffy nose, lower back pain. I stand up at work all day (if that has something to do with it). My throat is red and I have had a bump on the back of the tonsils and it was white but it went away and today I now have bumps and kind of white-yellowish bumps. I have had diarrhea one day and I was feleing warm. All of those other symptoms that happened have gone. Just today, my throat is making me scared. It does not hurt or anything. It is just how it looks and the bumps. ### Response: Hello. I can understand your anxiety but anyways sore throat and tonsillitis can happen to a normal person also. You have tested for HIV and that test has come negative. You need not worry as that test came negative which has a good sensitivity. Pictures you have sent (attachment removed to protect patient identity) shows redness and swollen tonsils but that is not to worry about. You shall be alright within a couple of 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: My father who is 72 years old has a problem of uncontrolled shaking of his right hand for the past three years. The problem has increased over the years and now he finds it difficult to hold the toothbrush also. Some works he can do without much difficulty like riding a scooter, sweeping with his right hand etc. But this problem is only increasing. He has consulted a neurologist after my insistence to rule out Parkinson\s. The doctor assured that it is not that and gave some medication. This was about eight months back. But, there has been no improvement. My father does not have any other ailments. Of note, he only had a stent operation three years ago. Please let me know what is this problem called, how to treat this and is it curable? ### Response: Hello. Based on the symptoms you have described, your father likely has an ""essential tremor."" This is a very common neurological condition affecting 4% of the elderly population. Yes, it is not Parkinson\ s disease but it has to be differentiated from Parkinson\s disease by a neurologist especially who is trained in movement disorders. Movement disorder neurologist is additionally trained in conditions like essential tremor and Parkinson\s disease. Please do not hesitate to ask any further questions." "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: Kindly tell me the following:1. What is colic?2. What are the signs and symptoms?3. What are the causes?4. What are the remedies?With experience, kindly tell how parents can deal with colicky babies. ### Response: Colic is abdominal discomfort or pain mostly seen in the evening in bottle-fed babies. A consolable cry which improves with particular positioning of the infant. Most of the time, the cause is not known. Mostly associated with formula feed, improper burping practices. No exact treatment remedies are available." "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 done my eye test. During the test, I cannot read the fourth line of letters even with the lenses they provide. All the lenses I have tried. Is it serious? What is the problem? I am very tensed. ### Response: Hello. In order to answer you, I need little more details. But If you do not have any other problems like gritty eyes, red eye with blurred vision, an inflammation (like keratitis), is unlikely which is a kind of a swelling in your cornea. If you are a frequent computer user and mostly live in air-conditioned rooms," "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 my period a month back. And I had unprotected sex ten days back. I have a 26 days cycle. I took I-pill on the same day after five hours. My due date was six days back but still, I am not getting periods and brown spots are visible. Am I pregnant? ### Response: Hi. Kindly get blood hCG done. If it is negative, you need not worry. Most probably this delay and spotting are due to emergency contraceptive pills you have taken." "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 20 year old female. There is swelling, redness, and itching on my face. Please help me with a treatment. This problem lasts so long, sometimes more than six months. ### Response: I have gone through your complaint and you seem to be having dermatitis. I would recommend you to apply topical steroid like Mometasone cream on the affected area twice daily for two weeks and take antihistaminic like tablet Levocetirizine 5 mg twice daily. Consult a specialist doctor, discuss with him or her and start taking the medicines with their consent. Also, use a soap-free cleanser for washing face, avoid sunlight, hot humid weather and stay in a cool airy environment" "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 got double vision suddenly. Age 58 years. His BP was high. He has diabetes.His CT Scan report says:-Impression: Multiple calcified foci as described above. Diffuse cerebral atrophy.Content: Two calcified foci without perilesional oedema are seen in bilateral occipital region. Prominence of cerebral cortical sulci are suggestive of diffuse cerebral atrophy.What dose this mean? ### Response: Hello, It seems from the history that your father is having sudden onset of double vision. He is a known diabetic and hypertensive. The CT scan report you have mentioned here like diffuse cerebral atrophy is not of much significant and they indicate age related changes. The CT scan findings are not significant as a cause for double vision. First the symptom needs to be evaluated to find out whether it is uniocular or binocular. Uniocular double vision means double vision with one eye open. Binocular double vision means double vision which disappears on closing on eye and present only with two eyes being kept open. The most commonest in this age group is binocular double vision. The most common cause in your father for double vision is nerve palsies which affect the extraocular muscles like 3rd, 4th, and 6th cranial nerves. The cause is because of diabetes and hypertension. Most of them recover by 3-6 months. The treatment by vitamin B12 supplements and other vitamin B complex will help to hasten the recovery. Along with this strict control of diabetes and hypertension is required. Do inform me regarding whether it is uniocular or binocular and status of diabetes and hypertension, so that I can guide you regarding further treatment. Hope the information is helpful to you. Consult an 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 friend took a little more sleeping aid than usual (not suicidal) and I was wondering whether 350 mg of Unisom (Doxylamine succinate) is safe or lethal. He is showing signs of being super sleepy. He has a history of depression and drug addiction. ### Response: Hello. The usual dose of Doxylamine succinate as an antihistamine will not exceed greater than 60 mg 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 experiencing some pain in my left buttock that travels down my leg and cause a feeling of numbness and tingling in my left leg. I do not experience any pain in my lower back. It is only that after prolonged sitting, I start feeling pain in my left hip that travels down the left leg. I consulted a doctor, and he told that a disc in my lower spine is pinching a nerve that causes the pain to radiate from my hips towards my leg. I searched my symptoms and found that the pain resembled much of piriformis syndrome. What should I do? ### Response: As the doctor you consulted is right. These symptoms can be caused due to a slipped disc. To confirm this and we may need to take up an MRI of the lumbar spine. Having an MRI scan will be of the right decision. Post which if there is no disc disease is noticed than another differential diagnosis has to be made and treated accordingly. Please take an MRI scan and let us know the reports. I will help you further with the therapeutic plan." "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 daughter is coughing, sneezing, no fever, and wheezing when breathing. She was at the pool. Usually, she excessively sneezes after swimming. What can I do? ### Response: I have gone through your daughter's problem. Her complaints might be due to an allergic reaction to the chlorine in the swimming pools (particularly due to chloramines release) to which some people are more especially prone. This can also be due to the development of a chronic sinusitis" "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: Since the past week, I have had a twitch in my forearm area. I do not know if it was because I had to lift a three-gallon bottle for a long stance, or due to my anxiety issues. There is no weakness or atrophy as could be the case with ALS. Also, the movement of the twitch is very visible. It goes and comes. It will stop if I move it in a certain way. Is this serious? My arm feels strong, and I can spread my fingers wide. I am so worried about this intermittent twitch. It has not moved to twitch anywhere else, but has been confined to the small area on my forearm. Can you please tell me if this is something deadly? ### Response: I read your query and understand your concerns. I hope this answers you. Feel free to write back to me if you have more questions" "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 unable to look at the sunlight for six to seven seconds before three and a half weeks ago. The sun was behind a cloud and was not very bright. It looked like a white golf ball in the sky. I get mild headaches every day caused by bright lights and the lights at night such as street lights. Also, my nearsightedness got a little worse and sometimes takes a long time to focus on things. I do not have any white or black spots viewed on my vision. I went to an optometrist and an ophthalmologist. Both said that there are no signs of damage to my eyes and my eyes are stressed too much. They told me that everything would be fine in due time. What is wrong with me? I am tired of these little headaches every day. I also work outside all the day. ### Response: Seeing the sun and very bright lighting can cause damage resulting in phototoxicity and can cause macular (the focusing part of the retina) damage. So I would suggest you avoid such things again." "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 18 years old, and I am suffering from a carious tooth in premolar (upper left). Today it has got broken from the mid-portion. But the contaminated root is still present there. What can I do now? Is it better to do a root canal? ### Response: Hi. I have gone through the query. If you want to preserve your teeth, you can go for a root canal treatment. After that, you are given a post and core procedure, and finally, you will get a crown placement. This is the best management. If it is grossly decayed with root resorption, you can remove 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: I am a male, and from the past two days, I have pain and itching around the anus. The doctor checked and told that it is a thrombosed hemorrhoid. Regards. ### Response: It would be best if you can upload the pictures of the problem before I can comment and recommend anything definitive and specific to you. If I assume that your doctor rightly diagnosed the problem as a thrombosed hemorrhoid, then I suggest you try doing the following: Hope that information helps you to decide the best option for yourself. Revert with more information to a general 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: In my left kidney, there are multiple stones. The largest stone is 26 mm. And I have got my kidneys operated two times. First was an open surgery six years back and the second was endoscopy three years back. Can the 26 mm stone be removed by any medicine? ### Response: Hi. Cystone and Calcuri (Ayurvedic tablets) can be taken. Two tablets morning and two tablets evening 5 PM can be taken continuously for three months. Then you may repeat the scan. This size is difficult to dissolve within a short period, takes a long time. If you have pain, you may go for lithotripsy surgery and do the chemical analysis of the stone. This will give the type of stones. Based on this we can plan herbal therapy." "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 help. We have a zero tolerance for alcohol at work. I had some alcohol eight hours (3 to 4 ounces) before work started. I am a 190-pound good shape male 70 inches and 48 years old. Based on the 1 ounce per hour metabolism, I was sure I would be in the clear. I do not have a thyroid and realized I was cold and gaining weight. I had my TSH drawn and I was hypothyroid. Could the hypothyroid state slow my alcohol metabolism? Any defense I have may help. I would never have drunk otherwise. ### Response: Hello. No, hypothyroidism does not cause slower metabolism of alcohol" "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: From the past 12 months, my eyelids seem to droop when in a normal or relaxed state. It takes an effort to perform any kind of activity. I am doing eye exercises, but their effects are temporary. My eyelids close even more often after I use mobile or laptop. Could it be ptosis? If yes, how can it be treated naturally? What about surgery? I have attached few photos of my eyelids. ### Response: I have reviewed your photos very carefully (attachment removed to protect patient identity). I hope this will help you. Regards" "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 whose age is 48 years, got a back pain a month ago. So, we consulted a local doctor. He suggested an MRI test. We did that and his report says \degenerative changes affecting lumbar spine with left para-central disc bulges with posterior annual tear at L4-L5 and L5-S1 levels producing mild compromise of left lateral recesses with mild extradural compression over thecal sac\. I want to ask you if he will be alright in a few days after treatment or anything new he will have to do. ### Response: Regarding your concern, I would explain that these MRI findings are indicative of chronic degeneration of the vertebral column. There is no need for surgery. Nothing serious is going on. I would just recommend taking painkillers, avoiding prolonged sitting or standing up position, and weightlifting. A lumbar brace can help too, coupled with physiotherapy" "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 irregular bleeding for the past six weeks. I have been using Mirena for the past 10 years for birth control and PCOD. After Mirena my periods had stopped and I would get them once in six months for a day. In six weeks, I have got this bleeding for the third time. It lasts for a maximum for a couple of days. I am diabetic too, and it is under control. ### Response: Hi. As per your history, it appears that you are having abnormal uterine bleeding and the cause can be many. As you told that you are diabetic, I would advise you to get a transvaginal scan first and followed by endometrial sampling to rule out the cause. In your case of irregular bleeding my suspicion goes for hormonal disturbance. Please revert back after ultrasound for endometrial thickness. 1. Transvaginal scan and endometrial sampling.2. Fasting blood sugar. Revert back with the investigation report to 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 was tested during my last gynecologist appointment that I was positive for gonorrhea and have since got treated. Now I have realized that my previous sexual partner gave me gonorrhea. He had herpes 1 and did not test positive for gonorrhea. My sexual partner before that have tested negative for everything. I am wondering would his herpes 1 infection would be transferred to me as a gonorrhea infection? And can herpes 1 be detected through a vaginal swab STD test or would I have to get blood work done? ### Response: I have gone through your case. First, you need to understand that any infection is transmitted as it is. No infection can be transferred as another infection. So answer to your first question is no it is not possible for herpes 1 infection to be transferred as gonorrhea.And for your second question yes you can undergo blood test evaluation as well for herpes confirmation. Get the following test done. IgM and IgG (immunoglobulin M and G) for HSV1 and HSV2 (herpes simplex virus)." "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 is 37 weeks pregnant. She has itching on her belly, hands, and feet. I read on the internet that, it may be PUPPP or cholestasis or neither both of them. Is it something to worry? ### Response: If the itching is present with rashes, it can be PUPPP (Pruritic Urticarial Papules and Plaques of Pregnancy). But you need to see a gynecologist or a dermatologist before we can come to a conclusion. Itching alone without any skin rashes can be cholestasis in pregnancy. But few tests need to be done before we can reach the diagnosis. More important is to keep an eye on the baby\s movements. If it is PUPPP, then usually there is nothing to worry. If it is obstetric cholestasis, we will deliver the baby as soon as possible, as the benefits of continuing pregnancy after 37 weeks are less compared with the unpredictable risks to the baby due to cholestasis." "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 this ongoing pain in the toe of my right foot since some time now. If I wear shoes for a long duration, then invariably small blisters develop. Recently, pus had collected after a four-hour journey wearing shoes and as soon as I plucked the skin tip which I generally keep doing, it oozed out. I normally do not wear shoes, except for once in a month or two, but the toe is very sensitive to pain all the time. If I hit it against something even lightly, it pains quite a lot. It feels like the toenail is pushing against the skin at the end. Kindly suggest a remedy. ### Response: I read your query and went through your images (attachment removed to protect patient identity). Regards" "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 32 year old male. I have this skin condition right above my left ankle and its been there for almost 15 years. I have tried to get it treated a few times but, it just did not go away. Sometimes, it is itchy but at others it is fine. The last time I saw a dermatologist, she prescribed an ointment with Betamethasone and Salicylic acid, and also a moisturizing gel. But, it is still there. And, I think this is my last hope. Please check the image I uploaded. ### Response: I have gone through your query and viewed the images (attachment removed to protect patient identity). Regards" "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 an explanatory view for layman understanding in respect of the conclusion drawn in the report attached herewith. I would also need to know the effect on the health of baby and mother (including Down\s syndrome) and also other points mentioned in the report. ### Response: Basically report is normal (attachment removed to protect patient identity) and there is no evidence of any heart disease in the baby. However, since it is difficult to completely visualize the baby\s heart as it is small and deeply seated, some diseases may be missed especially minors. But at present, there is no evidence of any disease and usually, major diseases are not missed on fetal echo. So nothing to worry at present about the report." "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 20 year old female. I have had two sexual partners. The second one is my current boyfriend. I used to shave my pubic hair all the time but started getting razor bumps from it. I decided to stop and let the hair grow out fully before attempting to shave it again. I noticed the other day that I have a few bumps on my labia, some painful. I am not sure what they are and thought not shaving would stop bumps from forming. I have gotten painful bumps on my pubic area in the past when I shave and do not shave that seem to come out of nowhere. I have also noticed a smell from my vagina during the day and even after I take a shower the smell is still there. Is it because of me not shaving for months? Where do you think the bumps come from? My last question is do you think I have an STD? ### Response: With your description, I can list a few possibilities for the painful bumps over the pubic region: Do you have any discharge from the vagina?Do you have itching as well?Since when did you notice this? Please mention duration in days. I am afraid I cannot make any diagnosis or rule out STD here without seeing your clinical picture. Kindly attach your clinical picture along with your query so that it is convenient for me to comment on your condition and give you appropriate suggestions. 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: My fiancee usually gets her periods at the end of every month. We indulged in unprotected intercourse ten days back and within six hours, she consumed an I-pill. This was the date she lost her virginity. Yesterday, she noticed a white and red discharge on her private parts and today she was experiencing a burning sensation while urinating with a little pimple sort of bubble on her private parts. Is there anything to worry about? Will she get her periods soon? Also is this little pimple caused due to having sex for the first time? What is the cause of this white and red discharge? Please clear my doubts. ### Response: Since you have taken an emergency pill within 72 hours of intercourse, there is no chance of pregnancy. She will definitely get her periods. So relax and do not worry. The discharge could be because of hormonal changes due to the pill you have taken. The burning while passing urine could be because of urinary infection. There is nothing major to worry about. Avoid having sex till then. Wear cotton panties and loose lowers. Maintain personal hygiene and take plenty of fluids. Wash your private parts with normal tap water every time you use the washroom. Avoid using vaginal douches and creams" "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 not able to sleep from almost eight months now. I keep thinking, and questions keep running in my mind. I am also depressed. Please help. ### Response: Hi. The problem of sleep and excessive thinking might be due to depression itself. Go to bed after completing your work, get up in the morning on fixed time. In my opinion, you need to consult a psychiatrist either online or in person for a detailed assessment of your problem. After a full assessment only, I can advise appropriate treatment for your depression and sleep problem. It is unlikely that eight months long problem is going to disappear on its own." "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 received some routine blood work (annual physical) and my results came in today. I noticed something that made my heart sank. HSV 1/ 2(IGG) type-spec AB tested positive with a reading of 33.10 H. What does this mean? Am I extremely contagious? I have never had a cold sore, nor do I now, and I have no symptoms. ### Response: Hello. 1. In general population, around 50 to 75 % have HSV antibodies in the blood which they might have acquired at some time in the past life due to clinical or subclinical herpes infection. 2. If you do not have any active lesions you do not require any active treatment and neither are you extremely contagious, just as much as those 75 % others. Nothing to worry if only tests are raised and no ulcer or vesicles." "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 given injection in both sides of my butt. But my right butt is paining a lot. What could be the reason? ### Response: The buttock pain after injection can develop due to faulty procedure sometimes. If the injection is not given by an experienced person, then sometimes pain can persist for 1 to 2 days. Even with an experienced person sometimes pain can develop if a certain medication is given. So pain development depends on the medication also which is injected. You can wait for 1 to 2 days for relief from pain. You can apply hot compress once or twice a day for soothing." "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 problem of nose block and my ENT surgeon suggested me to go for a nose operation. As per doctor instruction, operation of my nose was carried out before three months. Now my nose is almost fine, but still I feel that something is there in my throat. I also feel itchy throat and every 10 minutes I need to make a sound to get relief of this itching. After nose operation, my ENT surgeon suggested Levocet M for my throat problem. He advised me to take daily one tablet at night for six months and slowly throat problem will be cured. I am taking Levocet M for the last three months, but still my throat problem remains the same. Please suggest me whether should I continue or stop this tablet. Is there any side effect if I am taking this medicine for a long time? Please suggest me what should I do. Will you recommend me to take any other medicine? ### Response: Hello. Your symptoms seem to suggest that you are suffering from allergy. Levocet M (Levocetirizine and Montelukast) is given for the same purpose. It is true that the medicine should be taken for a few months regularly." "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: Before five years, I was tested for thyroid. The result was TSH at 3.45. Five months later, my symptoms were getting worse, and my doctor rechecked me after five months TSH was 7.40, and free T4 was 0.9. I was diagnosed with hypothyroidism. Which would explain my weight gain, hair loss, fatigue, etc.Why was there a change in my TSH? She put me on 100 mcg of Levothyroxin and 500 mg of Metformin, and I had two ultrasounds of my ovaries (outside and inside), and they were fine. She also told me my Prolactin levels were at 31.4. What does that mean? She told me to come back in six weeks to get it all retested then promptly went on vacation. ### Response: Elevated Prolactin means the concentration of Prolactin hormones in your blood is high. Prolactin is a hormone secreted by the pituitary in the brain. It controls the action of sex hormones. It can be elevated due to problems either in your pituitary or in your ovaries. You require an evaluation for that. TSH (thyroid-stimulating hormone) values keep changing even in normal persons. It depends on physical activity, the rate of metabolism in the body. When tested initially, you might have been in the starting stage of hypothyroidism, and hence the TSH value came normal. After a few months, the hypothyroidism progressed, and hence your TSH got raised. I hope this answers your query. Any clarifications or questions feel free to ask. I am happy to help 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 got my wisdom tooth extracted. It has been 10 hours since the tooth had been take out. How long should I keep my gauze in? I have read articles on recovery, and it says a lot of reference to ""dry socket,"" which I am trying to avoid. ### Response: Hello. The gauze piece can be generally removed after one to two hours, provided everything is normal. Otherwise, you can change the gauze piece, along with the medication on it, and you can put fresh cotton. I do not know what your dentist had suggested to you. But I would suggest you can remove it, eat ice cream or cold beverages but do not sip. Sipping can apply force on your extraction site. Do warm water and salt rinse after 24 hours. Do not rinse too harshly just put little pressure. 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: My wife used Mefigest pills for the abortion of one-month pregnancy but she is still bleeding up to 12 days and I am not with her right now to take her to a doctor. Which medicine or precaution will help her? Please reply. ### Response: Hi. If she is bleeding moderately after 12 days, she needs to and see a Gynaecologist and get an ultrasound to see if there are any products of conception left behind inside the uterus. If there are, then she needs to undergo a dilatation and curettage which is a minor surgical procedure to empty the uterus. If the products are left behind, they can get infected too" "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 25 years old. I have a 7-year-old and a 2-year-old kid. After my son\s birth, I have gained quite a bit of weight just a little over the obese range. I say this because I do not know if it has anything to do with my problem.I am writing because I am having trouble finding online information about my lower back pain (behind the backbone). It does not hurt all the time. Mainly there is constant pain while walking, laying flat, or when leaning forward without support. Also, there is a real sharp pinch when my kids or spouse push on it either side. I am not sure if this matters, but once in a while when I stand from the couch there is a pinching pain in my lower front abdomen that goes away after a minute or two. Is there any idea you may have as to what is going on? I have been dealing with my back for a year now and my spouse is starting to tell me to get it checked out. I used to take only Ibubrufen when I get headaches. ### Response: I am sorry to hear about your pain, but I will try my best to help you. From history, the lower back pain may be related to mechanical or disc protrusion (PIVD) or some rare conditions like a kidney stone, or pelvic inflammatory disease. In PIVD" "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 unprotected sex on the seventh day of my periods, and I have five days bleeding. I took an I-pill on the 58th hour. I had bleeding on the seventh day after taking the pill. But, I am 10 days late for my periods, from the last month\s date. I am worried. Please help. Is there any chance of pregnancy? ### Response: Sexual contact on the seventh day of periods will not make you pregnant, as they are the safe period. You should not have taken I-pill. I-pills are meant for emergency contraception and not for routine use. These are hormonal medicines and can disturb and disrupt your cycles, and can cause abnormal bleeding. I think that is why your periods are late. But still, you can get beta hCG done to rule out pregnancy" "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 unprotected sex with my wife and got the infection on my penis two weeks back. The head of the penis became red. I used Quadriderm but it is not helping. ### Response: It may be due to fungal infection. Clean the area with warm water twice daily. Apply Candid cream instead. Check whether your wife is having a fungal infection or white discharge. You can get back with clear photos of lesions and details for clarification." "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 genital herpes, and I also get cold sores around my mouth. It is not happening often. But it tends to come when I do not expect it. It came before a week, and now it has gone. The only thing present is the red scarring that remains after the wound healing. Now, I have a boyfriend who is still afraid of it, mainly because of me and about this cold sore. ### Response: Hi. Herpes simplex virus type 1 causes cold sores. It recurs often, but the frequency of recurrence decrease with time. The infection is transmitted through direct contacts like deep kissing and oral sex. The virus can pass through silent phases as it can shed from time to time. But the chances of transmission are very less when compared to the possibilities of an outbreak. So it is better to avoid any physical contact during an outbreak. At other times, there is a very low risk of transmission." "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: Will Flucloxacillin help in tooth abscess? ### Response: 1. 2. Metronidazole is again an antibiotic on its own. 3. Yes, these medications will help to reduce the infection in tooth abscess along with active dental treatment. 4. Only with the antibiotics and pain killers, there is no dental infection which could be completely cured. 5. If you are going to self medicate yourself, please" "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 five days after finishing my antibiotic Norfloxacin. Is there a chance of getting pregnant? I am on the pill for more than a year and I take it religiously. ### Response: Hi. How are you doing? If you have been taking the contraceptive pills or birth control pills, then you are absolutely safe and no chance of pregnancy. When you have been taking the pills regularly, the hormone pills will completely suppress the hormones causing the follicles to grow and ovulation will not occur. So there would be no eggs released during the cycles. This change is not affected by the antibiotics. So rest assured, you will not get pregnant if your hormonal pills have not been missed." "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 acne is getting worse. The spots are on my face, back and chest. I have had the spots for about two years now. How can I remove the spots from my face? ### Response: Hi. I can understand your concern. Use a salicylic acid facewash twice daily and apply Benzoyl peroxide 2.5 percent gel on the pimples on the face twice daily and Benzoyl peroxide 10 percent gel on the pimples present on the chest and back twice daily. Along with this take a course of tablet Azithromycin 500 mg daily for three consecutive days in a week for six weeks. Continue this for six weeks and revert back. Seborrhea and hormonal imbalance. Acne vulgaris. After six weeks." "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 23-year-old man. I have anxiety and depression but no immunodeficiency disorders or chronic diseases. First, I wanna know if my immune system is weakened and how likely am I to die of Coronavirus.Second, I have itchiness in my throat and shortness of breath. I always have it because of anxiety but now it is more persistent than before. I also feel a very subtle feeling of pain, burning sensation and itchiness in my chest. I did not go out during the past ten days and have not been in contact with someone with positive Covid. And I quit smoking past week. Down to one or zero cigarettes from 20 a day. Why am I feeling itchiness and pain and burning sensation? How likely am I to have Covid-19? And how likely am I to die from it? ### Response: Anxiety can manifest itself in physical or psychological symptoms or both. The irritation sensation you are experiencing is a part of your anxiety. Also please do not believe the hype about covid. It has a low mortality rate, of 2-3 percent, that too mortality is very high in people above 60-70 years with other co-morbidities. You do not have any such disorders and you have not even been in contact with anyone, so do not worry. Please continue to take your medicines for anxiety if you are taking them, if not, please consider visiting a psychiatrist and get started on some low dose SSRI type of medicines. Also, if needed a low dose Benzodiazepines can be added temporarily. Also, please do some deep breathing exercises, or progressive muscle relaxation. You can also take some honey with water to reduce the itching in the throat and also try doing some gargles with lukewarm salt water." "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 seeing white stuff in my mouth. I see more in quantity in inner cheeks and gums when I wake up in the morning. It has been four weeks. It can be scraped off using the finger.I consulted a dentist nearby and she told me it might be leukoplakia and it goes away by itself in a few days but it did not. After a few days, I again visited the same dentist and she told me that it might be precancerous and suggested me to apply ghee on gums every night before bed.I tried everything but it does not go away. I see it every morning and evening. I brush my teeth twice a day. I saw a canker sore in my mouth when it started and I also sometimes feel burning sensation after brushing. Please diagnose and help me out. ### Response: As I can see you can scrape off your lesions, then it will not be leukoplakia because it is thickened, white patches that form on your gums, the insides of your cheeks, the bottom of your mouth and, sometimes, your tongue. These patches cannot be scraped off. So, I will go with the diagnosis of pseudomembranous candidiasis which will have buring sensation and the lesions are scrapable. Do not worry. It is treatable. If these antifungal creams are not available over the counter then you can suggest your dentist to prescribe them. Fungal infection. Secondary syphilis. Antifungal creams.-" "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 periods was two weeks late. Since I have irregular periods I was not shocked. I ended up taking an ovulation test that came back saying I was in my peak and hours later I got my period. However, I still went through with my insemination and the next day my period was gone. Is it possible that I could be pregnant? ### Response: Hello. The bleeding you have experienced may not be due to your period at all. As your ovulation kit suggested that you are at your peak, it means your ovulation was due at any moment. Many a time during the release of the egg there is bleeding. As the egg is released, the holding follicle ruptures. Sometimes the wall of the follicle is vascular enough to cause mild to moderate bleeding, which is picked up by the tubes and present as vaginal bleeding. It may last from two hours to two days. So, in my opinion, you were probably experiencing ovulation bleeding and the good thing that you went ahead with insemination." "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 oral sex, and my partner ejaculated his sperms inside my mouth, and I sipped the sperm that came out. After that he touched his penis, then he grabbed my pants near my vagina twice. After that, he used the same fingers inside my vagina. It was my first time with the oral sex and fingering. I do not know that there were sperms in his hand. We did not have sex. But, can I get pregnant in this situation? I missed my periods this month. What is the cause? ### Response: Hi. In your case, there is a chance that semen might have entered into the vagina. As you have not done any sexual intercourse, there is less chance of getting pregnant. You have to rule out pregnancy by urine hCG (human chorionic gonadotropin) test. You can do this test at home. If pregnancy is not present, then thyroid problem and diabetes should be ruled out. Excess stress, obesity, prolonged fasting can also lead to a delayed period. You can consult a gynecologist for examination if 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 am 29 years old and my wife is 26. I have been married for 2 years now. We are trying for baby since last 1 year but with no positive result. We used to intercourse as per ovulation calculator but my problem is that I can ejaculate only when she is on top.I fail to ejaculate when I am on top or in missionary position. In this position I suddenly lose my erection within 50 to 60 seconds.Is there any chance to get pregnant when woman on top? What should I do to increase my stamina? How to overcome sudden erection loss while intercourse in missionary position? I have attached my semen report here for your reference. ### Response: First, I would like to tell you that there is no problem in conception even if woman is on top. The possibility of pregnancy is not in the position. Women can get pregnant even when semen is outside the vulva or thighs and even with precum. So, do not lose hope. I went through your reports (attachment removed to protect patient identity). Except for some infection in your semen there is no problem. I would like to know the medication you have taken regarding this issue. How long has your wife being taking ovulation induction medicine? Hopefully I will be able to guide you better after that. Revert back with the answers for the above questions." "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 is HIV positive. My first baby is born. I am negative and my first child is negative. My partner is in ART treatment now. I am 38 days pregnant now. We checked with the normal HIV test, in that I was negative. But my friends told me, if the baby gets linked through the mother\s placenta, your baby will get affected by HIV. So, they told me to abort the baby. My question is whether transmission of HIV is possible through the mother\s placenta to the baby? Please advise me. ### Response: Hello. I have noted your concern. If the mother is HIV negative, then there is no risk of transmission of HIV to the baby" "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 tooth really hurts but I do not see a cavity and I am really scared to go to the dentist. ### Response: Hi. If you are in tooth pain, you definitely have to visit the dentist as soon as possible. Few tips for the first dental visit are as follows: Dental treatment is not meant to be always under a needle prick. There are so many methods for pain relief where you would not even realize that you got a needle prick at all. For pain relief at the moment, please take tablet Panadol (Paracetamol) thrice daily after food for three 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 34 year old male. My weight is 68 kg. I am married and have two kids. Because, of the disturbance made by my kids, I was not able to sleep well sometimes. So, I just started taking tablet Alprazolam 0.25 mg. Now I have been trying to gradually stop taking the medicine. So, I had 0.25 mg on the alternate days and in between 0.5 mg twice a day. I have a feeling that my body has got addicted to tablet Alprazolam. Because, from the day I stopped taking the tablet, I am not able to sleep even a little bit. Yesterday too, I tried without medicine. But, I could not sleep. Then at midnight, I had 0.5 mg and then slept for 4 hours. Please help. ### Response: I can understand your concerns. I would suggest you to take Zolpidem for disturbed sleep. Zolpidem is less addictive compared to Alprazolam. I will suggest you the following measures to get a sound sleep. Please try." "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: Dear Doctor,I am suffering from anxiety and panic attacks for the last 3 years.I went to a neurologist 2 years back and he advised me to take REXIPRA 10 for 3 months, SOLTUS 50 for 6 months, HEMIDAP PLUS for 9 months & ZEPAM .5 for 12 months. Upon following these medications, I was improving but was not absolutely fine. And after 1 year I visited the same doctor again and he advised me to take ZEPAM .5, REXIPRA 5 & AMIXIDE.Now I am absolutely feeling restless, sleep deprived and very anxious.When I leave these medicine, I feel addicted and I am in immediate need of it.Absolute anxiety and nervousness, high pulse rate and high BP.I am not able to understand whether I am suffering from a neurological or a psychological problem.Should I consult a neurologist or a psychiatrist?25 years/ male, height 6 feet, weight 70 kg.Please help. ### Response: Hi. I read your query and understood your concern. As per your diagnosis of anxiety and panic attacks, there should be no doubt whether you need neurologist or psychiatrist. Both these conditions come under the domain of psychiatrist and they are more able to treat these conditions. Other than anxiety and panic attacks you have got addiction problem because of the wrong use of medicines. In my view there is no role of SOLTUS in case of anxiety and panic attacks. If you feel fine with an online psychiatry consultation session (via phone or video chat), then I will be happy to help you. You con contact me by either putting a detailed query or booking an online consultation." "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 want to get rid of mouth smell. Please recommend a good remedy. ### Response: Hi. Do not worry. Do these things. Maintain good oral hygiene by brushing twice daily. Rinse mouth after eating food. Before sleep, rinse mouth always. Avoid onions, garlic, if these are the cause in your case. If you have constipation or stomach problem, use fibers and vegetables in the diet and reduce consumption of meat-based products. If you have a stomach problem, acidity, avoid citrus acid-causing foods. Use milk in the diet. For acidity, you need to consult a physician, if present in your case. Avoid or stop smoking. Try a mouthwash Chlorohexidine for 15 days. If you have stains, calculus, on teeth, get scaling done and do it every six months. If you have any problem in kidney, intestines, diabetes, then get it corrected." "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 contracted scabies from a hotel I stayed at over two months ago. Two nights later, I stayed with my partner at his place. I learned that symptoms can show as quickly as 1 to 3 days in cases of reinfestation and I immediately recognized the small red itchy dots that I began developing along with a burrow line due to having contracted scabies years ago after a holiday.I successfully treated myself and the symptoms eased. I visited my partner again only to have been reinfested by him. Although he showed no symptoms, he did the Permethrin treatment and I repeated treatment. Symptoms eased. This was eight weeks ago. Since staying at his room two days ago, symptoms have appeared again. Itching along with new red rash is appearing due to scratching. I have done the ink test and am convinced that the little line shown on my forearm is a burrow forming.What if I fail to understand that he has the disease and continues to experience no symptoms. It has been almost 11 weeks. How is this possible? Could scabies lay dormant for some time in darker, stronger skin? The anxiety this is giving me is crippling. Please advise. ### Response: I understand your concern. But it can mean that you do not have scabies and it is something else like papular urticaria or like that. Please send pictures of the affected area to help you better." "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 60 year old male weighing 70 kg. I have a swelling at the back of the neck. There is also a neck stiffness and giddiness as if the blood supply to the head reduced. I had sudden stretching at the same point 10 years back and had suffered the same problem for six months then. Volini, muffler and heating pads help reduce the swelling. Lifting or stretching the back of the arms, and turning the head sideways gives a creaking sound but, gives some relief. I have been using the computer for six to seven hours every day for the last 12 years. Please advise medication and a specialist, if any, to consult. ### Response: You had a sudden stretching of the neck, followed by severe pain 10 years back. Now, you are complaining of the same pain with swelling at the back of the neck with a feeling of giddiness" "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 your opinion regarding my future pregnancy. Five years ago, I gave birth to my son and had to have an emergency C-section. The doctor\s report read \upon entering the abdominal cavity, the patient was found to have a large uterine window consistent with a uterine rupture. However, there was a small thin area covered by serosa, with a blood clot underneath. The rupture extended along the upper right side into the right broad ligament and round ligament. The incision was closed in two layers, and most of the extension areas were closed and imbricated in two layers as well.\ My question to you is with all I went through with my son, would you recommend that I get a cerclage if I decide to have another baby or will I be alright without one? ### Response: How are you doing? Hope I have been of help to you. Do write back in case of more queries. All the best" "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 20 years old. I had a pretty bad cold three weeks ago. The cold seems to have subsided, but my lingual tonsils seem to be enlarged. I also have little bumps on the back of my throat. I have drainage in the bottom of my throat as well. Also, a few patches of white under my right tonsil. I do not seem to have any painful symptoms, except once in a while my thyroid or Adam\s apple presents discomfort. But, nothing painful though. I will include pictures if that is an option. I had an appointment with an ENT and he said everything looked normal. Just curious as to why this has not subsided or showed any real signs of recovering. It had been occurring for about three to four weeks. ### Response: Lingual tonsils may get enlarged during an episode of upper respiratory tract infection. Also with details you have provided it appears that you have some remnant inflammation in your upper respiratory tract. I suggest you take the following medications. Tablet of Trypsin-Chymotrypsin combination that acts as anti-inflammatory twice a day before meals, with Acetaminophen tablet as and when needed, with steam inhalation and Chlorhexidine mouth gargles. Continue this for five days. I also suggest you a tablet of Omeprazole once daily before breakfast for two weeks. If still your symptoms do not subside, then we need to do a throat swab and an endoscopy. Consult your doctor, discuss with him or her and take the medicine with 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 do masturbation in a week and my semen becomes thin and in liquid shape. Please tell me. ### Response: Do not worry. Masturbation is normal and there is no harm associated with it. You should reduce the frequency to thrice per week. The watery semen is due to frequent masturbation and that is common. There is nothing to be worried" "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 21-year-old male, and I was suffering from inflammatory bowel disease (IBD) before a year. After taking medications, my condition got better. So I stopped taking medicines, and I took Pantop-D (Pantoprazole) only for the gas relief. Before a month, I developed a fungal infection in my groin area, and the doctor prescribed me Itraconazole 200 mg. When I started taking medicine, my stools became hard, and I developed constipation. But I have not stopped taking it. Before five days, my problem got worse, and I stopped taking Itraconazole.Now, I have diarrhea with blood in the stool. There is bloating (gas) in the abdomen. Sometimes I have pain on the left side of the lower abdomen. I have a feeling of nausea. I am currently taking Pantop-D (Pantoprazole), Metrogyl (Metronidazole) 400 mg (started taking today only) and high fiber diet. I have a few questions. Does blood in the stool occur due to diverticulitis? Does taking Pantoprazole show any side effects on diverticulitis? Can I take ORS or electoral for rehydration? Please suggest your advice. ### Response: There are two causes for the blood in the stool. The reason can be due to infection and reactivation of inflammatory bowel disease. In such condition, we should treat the infection first. The common infection seen is bacterial, sometimes viral infection may also occur like CMV (cytomegalovirus). It is diagnosed by colonoscopy guided with biopsy examination. If there is no infection, then we have to take a biopsy for IBD activity, and we can increase the immune suppression. I think you are not taking immune suppression medications. Uncontrolled IBD has a poor prognosis, and the risk of complications is very high. I will suggest a course of IV antibiotics in the form of Ceftriaxone and Metronidazole." "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: Actually, we have a newly born baby boy of around one month and 15 days. Our baby has a problem that, he continuously cries. Yeah, we agree that generally, newly born babies cry normally, but we cannot accept our babies crying act. Why does he cry continuously? Please. Help we are really worried about him. By seeing him crying we cannot even sit. Please help us. ### Response: I understand your concern and your worry is genuine" "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 recently got a skin tag near the anus. It is painful to excrete. There is a pain the whole day and there were even blood stains once. I am really scared and embarrassed too. Excretion has become a scary thing for me now. Please tell me how to solve this problem. ### Response: Hello. From your description, it could either be an acrochordon (skin tag) or a filiform wart. It can be confirmed only after examining. For skin tags, no creams or tablet will help resolve the issue because a skin tag is an extension of the normal skin. The treatment option would be an excision by a dermatologist under local anesthesia. No down time is required to recover after the session. Ensure you do not pick it, as that can induce a secondary damage around the fragile skin of the anus. It is curable. So do not worry." "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 male pattern baldness along with dandruff. Because of dandruff, I keep on itching my scalp. I consulted a doctor, and she recommended me to use Betamethasone dipropionate and Zinc sulphate lotion along with Adgain capsule and a mild medicated shampoo. I used these products for a period of three months. Initially, I was very happy with its response. As my hair seemed perfect I quit the product for six months. Once I quit the product, again I had hair fall. Now, since one month I am using Minoxidil and have same feeling that once I stop this product again I will have same problem. Now, I would like to know, is it fine to use Betamethasone dipropionate and Zinc sulphate lotion for some time to regain the lost hair and then continue with Minoxidil? Can I start using Minoxidil continuously? Please suggest me, if any other alternative is present. ### Response: I have read your query in detail and understood your concern. It has no effect on an" "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: What is a concussion? What signs should I look for in a newborn to see if he has a concussion? ### Response: Hi. A concussion is an injury to the head and consequently brain, that is caused by a fall or a hit. The danger is baby might bleed inside the brain. Three danger signs to look for in a baby with a concussion are: The type of injury also matters. Sometimes even if no signs may be present, it is better that the baby is seen by a doctor. Usually, if the baby is fine for 48 hours after the injury, then it is unlikely that baby could have suffered a serious injury. CT scan of the brain is done to rule out any bleeds, in case of suspicion." "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 lump growing on my penis foreskin for the last seven to eight months and it is continuously growing in size. Since it was painless I ignored it till now thinking that it will go away, but it started paining and looking at its size I am worried now.A similar one started just near it a few months back, but that region used to get rubbed while masturbating. I think that is why that one did not grow and went away. Please help. ### Response: I have seen the pictures. (attachment removed to protect patient identity). This appears to be a sebaceous cyst of the penile skin. I would like to know if there is any pain or pressure sensation associated with this lesion. By the look, the lesion appears to be benign, and the best treatment would be surgical excision of this mass followed by a histopathological examination to confirm the nature. The surgery is simple and can be performed in local anesthesia. It will last for about 15 minutes. Sebaceous cyst, Fibroma. Sebaceous cyst, Fibroma. Sebaceous cyst." "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: What is the normal blood sugar level for open heart surgery patient in the morning test before fasting and after fasting? ### Response: Normal fasting glucose levels are the same for all types of patients, persons of different age group. The range of fasting glucose is 70 to 100 mg/100 ml (earlier upper margin was allowed up to 110 mg). The usual levels measured are fasting (10 plus hours after dinner) and after food or PP level ( two hours after food). Your terminology is not correct (before fasting and after fasting). Normal PP (postprandial) level is less than 140 mg/100 ml for all persons including one going for any surgery." "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 acute pain and inflammation behind the neck and shoulder. Tingling pain in the left-hand finger and pain in the middle back and sometimes lower back. I am male, 27 years old. ### Response: Hi. I think you must be suffering from cervical spondylitis with radiculopathy. This must have arose due to long time sitting posture or carrying a backpack. I suggest hot fomentation by hot water bag for 10 minutes with three sessions per day. Then, apply some local pain relief gel mildly. Approach a physiotherapist if the pain does not subside under three days. If needed, MRI." "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 spending sleepless nights. I am struggling to fall asleep and often get disturbed by dreams. I feel restless legs throughout the night. The next morning when I wake up I feel fatigue.I am addicted to Benadryl to get sleep. But, I am trying to avoid it now. Please guide me for a sound sleep. ### Response: And it is quite possible that due to this dependence you might be having these symptoms. Bena" "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 an I-pill nine months ago and I got my periods some two days later. Currently, three days before, while having an intercourse, my husband\s condom broke. Can I take an I-pill now to avoid pregnancy? Can I take this now? Are there any side effects? I want to know about a daily contraception pill. Is it harmful? Of note, I had a medical abortion 10 months ago. ### Response: Yes, you have to take it as you do not have any other option. It will harm your body if you take it so frequently. Your hormonal milieu is disturbed. Regarding side effects, you may experience bloating, heaviness, and stomach upset. For regular contraceptive pill, you need to tell me your last regular period" "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 age 46. Every day, for about 20 days now, I get up between 3 and 4 AM feeling giddy, uneasy with burning, and pain in the stomach and then pass gas in about 15 to 20 minutes which makes it little better and within another 15 to 30 minutes go to the potty which makes it much better and then stomachache subsides slowly in half an hour or so. Why is this happening? Any test to be done? Stomach pain is not severe. It is bearable. ### Response: Hello. I understand your concerns. From what you mentioned, most probably you have dyspepsia. I suggest taking a medication for one month. If the symptoms are still there we should do a test for Helicobacter pylori, if positive eradication treatment will be required." "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 24 years old. Height 5\10"", weight 55 kg. I have poor constipation, pain, and semi-solid stool for the past two years. All allergy test and reports are negative. But when I eat rice with pulses, I have no pain and stool is fine. So, what should I do? I have not had any allergy and igG and IgA level is 7.1 and 7.7, hemoglobin is 13.7. ### Response: You are suffering from constipation that can go away by eating healthy foods which are rich in fiber, such as leafy vegetables, raw fruits, and vegetables, nuts like almond and coconut also. If you are 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: My mother is 59 years old and she is having severe pain in the knee. After taking x-ray and blood tests we came to know that her vitamin D levels are low which shows 14ng /mL. Can you please suggest a cure for this? Can the pain in the legs be cured? Can you suggest a remedy to get the pain levels relaxed? I am more concerned as she is not even able to walk as before. ### Response: Hi. Vitamin D deficiency is the most common vitamin deficiency currently faced by the population at large. In about 80 percent of urban population vitamin D is either deficient or insufficient. Your mother\s problem is easily treatable by oral medications or injections. There is no cure, as the requirement is ongoing. Increasing the sun exposure to naked skin is necessary and if that is not enough, take regular supplements for life. Coming to the pain in the legs, this again can be multifactorial: What we need to do first is an assessment and physical examination followed by blood investigations and x-rays to pinpoint the cause. Please send the x-rays of the knee and lumbar spine and start her on the vitamin D supplements. The management for present situation would be: Revert back with the reports to an orthopaedician 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 wife has a normal regular menstrual cycle and her age is 35. I am attaching the estradiol (E2) hormone report of my wife. The blood serum sample was taken on the 23rd day of her menstrual cycle. The estradiol (E2) level is 179.48 pg/mL. We have been married since 3 years and have a 2 year old son. Actually, she has faced the problem of vaginal dryness lately. As it could be due to lower levels of estradiol or perimenopausal symptoms, so we got the estradiol level check done. Although, the report has a reference range, we do not know if this level of the corresponding day is optimal or not. Please advice on this. Kindly let us know regarding the estradiol levels in a healthy woman. ### Response: There are two major types of estrogen, the female sex hormone. They are estradiol and estrone. In younger woman, the first one is in abundant quantity and the second one is in less. And near menopause, the level just reverses. It means there is more production of estrone at menopause. The normal estradiol level in the second half in perimenopausal age varies between 39 to 300 pg/mL and it varies from different times of cycle. A level below 30 is definitely about menopause. Now, her level is within normal limit. I suggest you to measure the level of FSH (follicle stimulating hormone) to determine her menopausal status. However, at this estradiol level, she should not be advised for hormone replacement now. You may be benefited by the application of some gel or cream during intercourse." "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 started having a cold almost three weeks ago which developed from sneezing into a bad cough and now has subsequently cleared up. I also had a blocked ear for almost three weeks but it is now much improved. However, I often hear a ringing noise from it. I saw the doctor a couple of days ago who inspected my ear and said that everything appeared clear now and there was no longer any blockage. Why am I still receiving a ringing noise from my ear and how long does it take to clear up please? ### Response: Hello. Most likely there might be some fluid accumulation inside the said ear without showing any signs in an otoscopic examination which the ENT would have performed. Such minimal fluids can cause ringing sensation without any hearing loss." "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 working out at a gym for three months, the color of my skin has changed. It is darker now as compared to earlier. I want to know the reason behind this and the solution of this problem too. ### Response: I can understand your concern very well, but let me make it very clear to you that working out in the gym will not have any sort of effect on skin color. Going to the gym is a step closer to a healthy life. Skin color is determined by melanin, a color pigment which is synthesized within melanocytes. Melanocytes are color-producing cells. They are very sensitive to sunlight. Recent color change can be due to many reasons like It is very difficult to prescribe medications without seeing your clinical picture" "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 31-year-old male with a height of 180 cm and I weigh 83 kg. I am a father of three children. My problem is premature ejaculation. When I am having sexual intercourse, always the first round is very fast. It is just one to one and a half minutes and sometimes less than that. The second round of intercourse is slightly better than the first time may be two to five minutes. But, sometimes I feel there is an erectile dysfunction due to depression and I am not able to continue for the second round.I have tried Viagra for only three times just to experiment and the result for the first round of sex was the same as usual. But, the second round of intercourse was a bit longer say around 30 minutes. I had this problem since teenage. I thought it would go away but it has worsened. I have tried Lidocaine spray in the past to decrease the sensitivity but there was no big difference. Please advice. ### Response: Viagra (Sildenafil) is not the medicine to be used for premature ejaculation. You need to get a physical examination with a urologist to rule out any genital infection causing an early discharge. If not, practice following exercises on daily basis for three to six months for a permanent cure. You can visit the Internet and know how to do them. Until then, I suggest you take tablet Dapoxetine 30 mg 90 minutes before sex. Consult your specialist doctor, discuss with him or her and with their consent take the medicine. For better results, combine this with Lignocaine (Lidocaine) spray only to the frenulum of the penis" "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 on Mirtazapine for the past four months, treating episodical depression and panic attacks. Overall it was going good but yesterday I have experienced visual hallucinations for the first time. I will see my doctor in half a month only. Should I be worried? ### Response: Hi." "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 painful, swollen, reddish boil under my armpit two days ago. I went to a doctor yesterday and he put me on antibiotics. Yesterday night, when I took the antibiotics, after some time I got the feeling of stiffness in my right calf and thigh. My leg felt heavy and affected my walking a bit for some time too. I had thought it was due to a little bit of walking I had done yesterday. When I woke up in the morning, the stiffness was gone and my leg felt fine. In the morning again after taking the medicine, I felt stiffness in the right leg, and it is still there (it is late evening now) though less than before. Left leg appears to be fine. I also have a ringing sensation in my ears.I am wondering if this is due to antibiotics? Or is it just coincidence? I am not seeing any noticeable swelling in my right leg, but not very sure. Maybe there is a little bit. Please let me know your thoughts. Is it an emergency? I am in my office now and cannot go to the doctor before tomorrow morning unless it is an emergency. The boil has subsided quite a bit, and is much less swollen and painful. It is not reddish anymore. I am taking Pantozec 40 and Augmed 625. I am fine with stopping the medicine if needed. I am supposed to take it after dinner again tonight. ### Response: The antibiotic which you are taking does not have the side effect of myalgia and stiffness or joint pains. However, Pantoprazole may cause some times such symptoms. I think the boil itself can cause the myalgia and there is nothing serious. You need to complete at least three days of antibiotics because once you stop these medicines the symptoms will also resolve. I suggest you complete three days at least or if possible take for five 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 wanted to ask if it is possible to use an upper full denture to cover up my three missing teeth in the front? I only have one front tooth left and the other teeth in the back on both sides. Or should I try a different denture? Just wanted to know your opinion on this. ### Response: Hi. Full dentures are used to replace the whole lot of teeth when absent. In your case, as you have mentioned that you got only one front tooth left, it is much easier to replace only those lost teeth. So, the options here are removable partial dentures. Here you get regular or Valplast to choose. Valplast is much flexible than the regular ones. Fixed partial denture which is nothing but a set of crowns to replace your lost teeth with support in either side from your original back teeth. The options with the material and cost here are ceramic and zirconia where zirconia is much natural looking than ceramic. Dental implants replacing lost teeth with tiny metal screws followed by fixing the ceramic caps or crowns. Might be expensive for multiple teeth and takes time." "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 22-year-old male. Today I woke up and before taking a shower I felt a burning sensation when I touched the spot between my left leg and my scrotum, then I discovered some wounds, similar to cuts in the area, they were not there yesterday. I also have to mention that they had appeared before, in the same area (about three times in the last three years), and they usually disappear in about three or four days. I have a partner and I am really worried about this being herpes because if that is the case I would absolutely consider leaving her, just to avoid her my problems. I had sex with two strangers, with one of them about four months before getting this for the first time. I also removed my pubic hair with a machine about two weeks before this. ### Response: Hi. What is the complaint in it? Is it on one side or both sides? Have you ever noticed any blisters? What is your profession? Looking forward to your response in order to help 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 have right lower back pain from the past two years. I have enclosed my MRI reports. I take Nucoxia 60, whenever needed, 3 to 4 days when pain increases. I cannot tolerate anti-inflammatory medicine due to stomach upset. The pain always remains, but it reduces when I lie on my stomach. It increases on lying on the back, sitting, and standing. All blood tests including RA factor, HLA-B27, etc., are normal. Please see the MRI and advise diagnosis and treatment. ### Response: I would have preferred to see the MRI films myself rather than just the to report (attachment removed to protect patient identity). Number 1 and 2 are the most important. The exercises will help improve muscle strength and help with pain" "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 is two months pregnant. As she got pain and a little bleeding, we consulted a doctor. The doctor told that one is unhealthy, so she advised for abortion. We took one tablet and the next day she gave four pills. Two she inserted inside the vagina and two to take orally.After that, she got bleeding and severe stomach pain. Already 24 hours over but still the bleeding and pain have not stopped. When I informed this to our doctor, she advised us to get hospitalized for abortion. What can we do? ### Response: Stomach pain is a usual side effect of abortion pills. For that, your wife can take simple pain killers such as the tablet Buscopan or Spasfon. Secondly, bleeding happens just like periods or maybe heavier and may last for 8 to 10 days sometimes. If you feel that she is bleeding heavily, then you might seek medical help, and get her admitted. Otherwise, you must wait for 2 to 3 days, and bleeding will become lighter by itself. I hope it has helped you. If you have any further queries, please do not hesitate to contact 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: I have had the rash for about a week and taken antihistamines. I saw a pharmacist today who said she had never seen something like this before so I was sent to a minor injuries unit who told me to come back in two days if it had not gone. It leaks straw colored liquid and is very itchy and swollen with raised bumps almost like blisters. I do not really have fever symptoms. I am just very tired. ### Response: I have noted your concern and I have viewed the images (attachment removed to protect patient identity). It is infected eczematous dermatitis (IED). I suggest you take an oral antibiotic like either Amoxycillin 500 mg or Cephalexin 500 mg, thrice daily for a week. In addition, I suggest you take an oral antihistamine like tablet Cetirizine 10 mg once a day for a few days. I also suggest you apply a potent topical steroid like either Mometasone furoate 0.1 % cream or Clobetasol propionate 0.05 % cream, twice daily for a few 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: Four days ago, I had oral sex with a lady, who I already know. Though no intercourse happened, I am worried about STDs. Please suggest if I have to undergo any test. I am very tensed for this and I want to clear my mind. I do not have any problem except stress. Also, please explain where should I get the test done. ### Response: Hi. Oral sex does not cause HIV (human immunodeficiency virus) to the recipient. It may cause genital herpes, gonorrhea, chlamydia, syphilis and warts if these infections are present in the partner. Urine test for gonorrhea is done only if there is any burning or pain while micturition. These tests are usually free in government hospitals and private laboratory can also perform these tests." "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 5 years old. He was delayed in speech. Now, he started talking, but he is not clear. I consulted a doctor, and he suggested Sizodon 0.5 every day for tics. Yesterday, his preschool skills and LD were evaluated, and they said he has LD. Is there any problem with the above medicine? Does he suffer from any symptom of autism? ### Response: Hi. Your son is showing delayed milestone. He may have autism. It has its own side effects, but you can definitely use it if there are tics. It should be taken after consultation with a neurologist. Also, your child should be encouraged or stimulated to take an interest in learning and sports. Such chil" "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 18-year-old boy and cannot pull my foreskin back while erect. I am uncircumcised. One time I had a bath, and I opened my penis, left it for too long and could not get it back to its normal state. I had to go to the urologist to get it back to normal. ### Response: I have gone through your query. You most likely have a condition called phimosis, though it would be necessary for me to do a clinical examination to confirm. It is not serious, though it would be necessary for you to visit your local urologist for getting a circumcision done to help solve the problem." "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 19 years old, male, recently I have discovered that my crown hair is slightly thinning, however I think it is a cowlick, because the middle part of the crown where the swirl is thick but away from the swirl it is thinner. You can actually see my scalp lines or hairlines. You can see my top back hairline and side of the crown hairline. ### Response: Hi. I can see thinning of hair in the picture you have attached, but I cannot see the hair line (attachment removed to protect patient identity). An" "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 pain in my vagina about two nights ago, but I brushed it off. Today I had some spotting (very little light red blood), and I noticed I had two dark spots on my vulva. They are small and flat and dark brown. I also had sex last night (about 12 hours ago from now), but it was with a condom. I was wondering what this means. ### Response: Hello. It is difficult to make a comment over the possible petechiae (dark spots) over your vulval region. However, bleeding or spotting per vaginum post vaginal pain is likely to be your start of menses but as you had sex 12 hours back so due to rise in endorphins and progesterones post sexual activity the bleeding would have stopped. The cause of vulval spots could be frictional injury during intercourse or foreplay, now exhibiting as local small petechiae hemorrhage or hematoma. It would be best if you can send a picture of the lesion for an opinion and to rule out any STD (sexually transmitted disease) if you are suspecting one." "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 currently have pericoronitis and it has developed over these past two days. The main symptom I noticed was pain and discomfort in my lower right wisdom tooth. The tooth is half in and half out. I scheduled an appointment with my oral surgeon but would like some advice. I noticed yesterday that the lymph node almost behind my jaw on the side of the infected tooth was swollen and painful to touch. Then today, I noticed the lymph node under my chin was extremely large and painful to touch as well. It was not like that yesterday. Because of that, I went into an urgent care and he prescribed me Penicillin and painkillers. I have only taken one Penicillin pill over these past few hours. I started to do more research on the topic and came across multiple reputable websites stating that if you have swollen lymph nodes with pericoronitis to go to the hospital. I am wondering if I need to go this evening or if I can wait until the morning and discuss it with my oral surgeon. ### Response: Pericoronitis itself is usually painful mainly because of food entrapment between the gums and the half-erupted tooth along with inflammation there. The swollen and painful lymph nodes are nothing but indications of persistent infection. It does not mean that you have to rush to the hospital in this case. Once the infected tooth is pulled out and the gums heal normally, the lymph nodes get back to normal. The only case when you should be much concerned is that big swelling of the cheek which is visible on the face. You had mentioned that you had tablet Penicillin and painkillers. This is alright, it helps the infection go down a little bit while you wait for your appointment. But ideally, active dental treatment along with antibiotic coverage would be most helpful. You could as well continue Penicillin for at least five days three times daily and painkillers whenever you have pain. You can absolutely wait until your appointment for the scheduled extraction" "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 acne and oily skin with very bad acne scars and dark spots all over the face. Please help. ### Response: Hi. If possible provide me photographs of the affected areas which will help me for better understanding of your skin problem and proper treatment plan. Photographs are required for diagnosis purpose because the treatment given without proper diagnosis can be less helpful or can also harmful for 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 had unprotected sex with a sex worker 16 years ago. Two years after that I got sick with IBS and loss of appetite. I got tested for HIV by ELISA, combo test, tri-dot, RNA PCR all from different labs. My wife also got HIV tests done. I am very depressed. My question is HIV is not showing in my blood. What do I do? ### Response: Firstly, the tests which you had undergone for HIV diagnosis are highly sensitive and specific and gives accurate results. It is really good that your test result is negative, which had been done under varying time periods. The p24 combo is a highly sensitive and specific test and can detect both antigen and antibodies against HIV. If you have had no further exposure other than the one you mentioned, you do not require any more tests for HIV. You are HIV negative.The test will be negative, as you are not infected with HIV. No other test is required. Relax. Hope your query is answered, but if you have any questions please do not hesitate to ask or call anytime. You can also book an appointment with 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 cousin gave birth to a baby boy yesterday at 38 weeks and baby is 2.8 kg in weight. Yesterday evening the doctor told us that the baby has jaundice at 3.3 and now it is 5.3 What should we do for this? Is it dangerous? Hospital people said yesterday it was mild and does not need treatment, still, it increased? ### Response: Hello. Jaundice developing in a baby after 24 hours of life is physiological jaundice and does not require any treatment unless it crosses a limit assigned. Various factors are taken into account like: At present, I can assure you that no treatment is required. In your case treatment will generally be required once her bilirubin crosses 15." "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 getting drop by drop bleeding from the anus due to internal piles after passing motions in the morning. What should I do? ### Response: I would suggest the following at this point in time. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. This is going to help you a lot" "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 26 years old and I have missed my period this month. Last period was on 19th of last month. Few days ago, I vomited two times, so I have checked urine test a few days back. There was a faint line. Again I checked it in the evening on the same day, the result was faint line. But when ultrasound and T.V.S. test were done then result was negative. The doctor has suggested me to keep in touch and again check up after a week. Please suggest me what to do. ### Response: Hi. I can understand your concern. Urine pregnancy test may give faint line during early pregnancy. And also in ultrasound it may take around six weeks for visualization of gestational sac. So, you better go for blood test for pregnancy which will give accurate result compared to the urine pregnancy test. Beta hCG levels above 25 indicates positive result for pregnancy." "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: What does both kidney slightly hyperechoic in an ultrasound indicate? I am 19 weeks pregnant and very worried about my baby. ### Response: Hyperechogenicity in kidneys is seen in some congenital polycystic renal diseases leading to renal failure in late childhood or adulthood. But in fetuses, this marker has been studied sparsely. These studies have shown that if the amniotic fluid around the baby is adequate as per gestational age, outcomes are favorable like no kidney impairment. Please follow up with USG growth scan every three weeks to note the fluid level and liver echogenicity as well. If follow up reports remain within normal limits, it is just a normal variant. No need to worry in such conditions." "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 mom is a diabetic patient suffering from typhoid diagnosed an hour ago. She also had a blood clot in her brain. She is having headache badly. What to do now? ### Response: Hello. According to your query, your mother is suffering from a bad headache due to blood clots. Any headache with intracranial problems needs detailed assessment as there might be a headache of serious causes like raised intracranial pressures or venous thrombosis which needs immediate neurosurgery opinion. So do not worry. Just consult a neurosurgeon. Do not simply take medicines for relief from pain." "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 ADHD. My common symptoms are disturbance of selective attention of auditory and visual input, disorders of visual perception, impaired organization and categorization of verbal material, disturbance of language comprehension, impaired long-term memory, altered personality and affective behavior and handwriting problems. Already, I have tried medicines like, Focalin, Adderall, Strattera, Quillivant, Ritalin, Topiramate, Metadate, Concerta, Vyvanse, Dexedrine and antidepressants like Zoloft, Lamictal and Wellbutrin. They all give me the same effect and worst my symptoms. My brain SPECT indicates left caudate and right temporal hypoperfusion. These findings correlate with the reported symptoms of decreased attention and concentration when the temporal lobe is involved as in focal hypoperfusion. An interictal epileptogenic focus or learning disabilities may be present complicating the ADHD. I have no hope for this. Please help ### Response: I understand your symptoms and the clinical case scenario. Most of the medicines, which work for ADHD (attention deficit hyperactivity disorder), are not working well for you. Actually, they are worsening you. This is an observation which supports the possibility that we are not dealing with an ADHD alone, but also another co-existing disease, most likely medial temporal lobe subclinical seizures. So, you do not have any classical signs of temporal lobe epilepsy, but you do have T signs of temporal dysfunction. Revert back with the reports to 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 mother is a patient of epilepsy for 22 years. Earlier she was diagnosed as GTCS (generalized tonic-clonic seizures) and CPS (complex partial seizures) and given Eptoin 100mg BD at first, then Zeptol CR 400mg BD with Cloba 10mg for fits, convulsions, and senselessness. But still, it was going on. Now, for the last two years, we consulted another doctor, who diagnosed that her treatment was not in the right way. He said that the seizure was idiopathic generalized epilepsy with absence seizures and she was given Encorate Chrono 500mg BD with Cloba 10mg.After this, she was good for two years. Then she again developed fits, senselessness, and convulsions this year. So, we went to the doctor and this time the diagnosis is combination of multiple seizures with psychogenic non-epileptic seizure and was given Encorate Chrono 500mg BD, Levipil 500mg BD, Cloba 10mg HS, Nexito 10mg HS. But still fits and convulsion is going on after coming back from the hospital. Please advise what has to be done. Is the treatment going in the right way? Is there any need for medicines such as Topiramate or Lacosamide or Tiagabine medicines? ### Response: Hello. Your mother\s situation seems to be very complicated. I would like to explain that it is true that Carbamazepine (Zeptol) can have no good effect or even worsen idiopathic generalized seizures. The valproate plasma levels should also be performed, to know if she is being treated with the right doses of Encorate Chrono. I would recommend performing a brain MRI and a careful EEG to establish any possible cause of these seizures, which could be treated by a possible brain intervention. I would also reconsider the treatment with Escitalopram (Nexito), as it is an SSRI(Selective Serotonin Reuptake Inhibitor) and in rare cases has been shown to aggravate the seizures. Hope it was helpful." "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 and my fiancee had unprotected sex a month back. I had an orgasm before having but not during sex. She has PCOD so her periods are irregular. She went to the doctor and doctor suggested having Regestrone 5 mg three tablets for three days. She started taking it 13 days later and finished after three days. The day before yesterday, she got her periods. But she did not have blood clots and flow is very slow. Is there any chance of pregnancy? ### Response: Hi. How are you doing? As she has PCOD (polycystic ovarian disease), her ovulation date cannot be predicted. So there is always a chance of pregnancy. But as she had bleeding after having tablet Regestrone, pregnancy is not possible. Bleeding after having hormones will be thicker and lesser than normal, that is expected. Once the bleeding occurs, the inner lining of the uterus has fully been shed, so there is no chance of a possible pregnancy to get implanted on the post bleeding, thinned out uterine inner lining. So I do not see any chance of her being pregnant. But if you are still not satisfied or want a further confirmation, have her blood serum beta hCG tested. This can detect the smallest of pregnancy anywhere in the body." "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 root canal five months back and it has caused a lot of problems. The root canal left a gap between the molar and the tooth beside it. Food got stuck inside and it was causing pain. I came back and she said it was the tooth next to my root canal which was causing the gap. Now that tooth had a filling in it so she offered to redo it so the gap would disappear. After the new filling, the gap was still there so she put some kind of hardening fluid in between the gap and told me not to floss on that tooth. A few weeks later and the gap is back and now my tooth with redone filling is very sensitive. I am starting to feel like this is a lost cause and I do not know where to go from here. ### Response: Your case has become a bit complicated. It would have not gone this bad if the filling of the adjacent tooth would have been done before taking size for the cap, then the gap would have adjusted and you would not be having any food sticking complaint. But do not worry, there is an end to every pain and suffering. You might have to go for these stages of treatment now. First of all, an X-ray of the adjacent tooth that is feeling sensitive should be taken and assessed. The following could be the treatment options you could have. If there is some carious activity that has touched the pulp of tooth then you would be going for root canal treatment and capping as done before. Then cap will be placed and it will fix your gap. You can have an option of capping at sensitive tooth after deep filling if caries has not reached pulp. Cap size will be adjusted to fill the gap and you will be relieved. It would be great if you can provide me with some of your clinical pictures of teeth and X-ray of both RCT treated and sensitive tooth. Then I could suggest better which option will suit 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 30 years old. I have BRCA1 genetic mutation that is still undergoing more research as they are not sure of the exact risk yet. My mom had breast cancer at the age of 56 and her cousin had the same at the age of 46. They were both positive to hormonal therapy. Another cousin had ovarian cancer at the age of 49. They are all cancer-free now.I have a fibrocystic breast and one fibroadenoma confirmed with a biopsy three years ago. I had an ultrasound scan three months ago and found more cysts and nothing major to worry about. I had another ultrasound a week ago as I felt a new little lump. That lump turned out to be another cyst, but the doctor found another lump she had not seen three months before. It has regular borders and it is moveable but it has some vascularities. She says it cannot be a cyst and could be a fibroadenoma but it has to be confirmed by a biopsy which I will have next week.I know that sometimes triple-negative breast cancer lumps can be mistaken for fibroadenoma but how likely is that chance? I am feeling quite anxious and worried. With a fibrocystic breast is it possible to have a fibroadenoma appear this fast? Or is it possible that an ultrasound would have missed it last time? ### Response: Since you have BRCA1 (breast cancer type 1) positive with a strong family history of breast cancer, there is always a risk of developing cancer. You need to have a regular followup. Ultrasound sometime may miss early changes. Since you have a high tendency of developing cancer you can undergo a complete mastectomy. It is a tough decision for you, but it is worth." "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 acquired herpes simplex virus 2 infection two months ago from oral sex. Now, I have proctitis anal herpes. Is it possible to have it without engaging in anal sex? ### Response: Hello. Herpes infection normally involves either the mouth (manifesting as cold sores), or the genital region, and can include the scrotum, penis, and the anus. It is possible to have it without engaging in anal sex. It is a highly contagious disease, and in the active state it can manifest in the above-mentioned sites and also spread very easily. You should get yourself checked again for both HSV (herpes simplex virus) 1 and 2 to confirm if you have not done it. The good thing is it can be treated. You can do a course of Famciclovir two tablets daily for seven to ten days. Since it can spread through both vaginal and anal intercourse, it is better to get your partner tested too. The more you delay, there are more chances of it turning into a chronic infection." "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 all four of my wisdom teeth removed two days before and I have a bad taste in my mouth that tastes like sour dough but more like metallic. There is not really any pain there, my jaw is just sore from being held open for about an hour but the taste has been happening for about a day and a half. I am worried that it may be an infection even though I have been carefully brushing my teeth twice a day and using a lukewarm saltwater solution.Is there really anything for me to worry about when it comes to that and is there a way to get this horrid taste out of my mouth so I can stop losing my appetite? I am also on contraceptives so that is why I am a little worried that it may be a dry socket but I do not have the excruciating pain which is what confuses me. ### Response: Hello. It is very strange that you have all your wisdom teeth removed at the age of 14. These teeth normally start to erupt or come through at the age of 18 years or later when they start to cause trouble and we think of getting them out. If you, however, find the socket or the hole that was holding your tooth open, it is more likely a" "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 not getting full hardness. No morning erection. I got 70 to 80 % hard erection. This is happening for the past two years. Why is this happening and is there any serious problem in my penis? Please help me. ### Response: I have read and understood your problem. It can be due to stress or anxiety or due to a physical cause. For physical cause, you need to do some blood tests. Stop smoking if you smoke. Check BP. If you are taking any medicine or nutritional supplement on regular basis then it may be due to the side effect of that. So relax, do exercise, if no improvement then you will need blood tests. Usually, it is stress or any hormone, sugar problem, not due to any problem in the penis." "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: There is a white patch on either side of my cheek near upper wisdom tooth with a little pain. The wisdom tooth has erupted. I am a non-smoker. ### Response: This could be related to upper wisdom tooth due to its sharpness. Visit a dentist soon and get it checked properly and ask the dentist to treat it accordingly. Maintain oral hygiene properly and use mouthwash after brushing twice a day. Rinse mouth with salt water twice a day after every meal. Cheek cut. Proper clinical examination. Ulcer, candidiasis. Injury due to cheek cut. Medicines like anti-ulcerative gel. Maintain oral hygiene properly and use mouthwash after brushing twice a day. Rinse mouth with salt water and baking soda after every meal." "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 35 year old female. For four years, my right leg has swollen once in a year in the summer or when I go for agricultural works in mud fields. Initially it starts with fever, vomiting, body pain, chillness and then my leg will change to light red color and the swelling will start. Now, I am undergoing treatment. I am attaching the medical reports and the photo of my leg. My doctor told me that the swelling is due to mosquito bite. Please tell me the possible reasons for the swelling and the medical tests if any required. Please suggest the specialty doctor whom I should consult. ### Response: It looks like you had cellulitis. You might have scratched your leg and later on it has developed an infection. I think you are accumulating gas in your foot and in your leg. I think you should be seen by an orthopedic surgeon sooner rather than later. You need a complete examination of that foot with x-ray, CT scan and blood cultures. I am also afraid, if you are bone has been involved with the infection known as osteomyelitis. I do not think it is because of a mosquito bite.Please let me know if you need any further assistance. I will need to know the results of the x-ray and the blood cultures to suggest any antibiotics. 1. Gas gangrene.2. Osteomyelitis. CBC (complete blood count), kidney and liver function test, electrolytes, CRP (C-reactive protein), x-ray of the foot and lower leg. Consider CT scan of the leg as well. Revert back with the reports 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: My sister went through appendix surgery three days back. She vomited yesterday when we were taking her home and then we took her back to the hospital. The doctor gave an injection for vomiting and discharged her.Today, she vomited again at 7 pm. We need your expert advice if this is normal after appendix surgery. Should we get a scan again to ensure if the surgery went well? ### Response: If it is just vomiting without fever or pain in the abdomen and otherwise passing flatus and stools and able to eat well rest of the day, then it should be fine. Try to walk her around. If any of the above symptoms, any distress or discharge from the surgical wound is present, then contact the doctor. Ultrasound scan at day 3 following surgery is not of much consequence if no other symptoms are present. If symptoms are present, then get the patient admitted to a good hospital for monitoring and 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 got my teeth cleaned two weeks ago by a dentist and now a tooth is sensitive to heat. ### Response: Sensitivity is a common encounter after scaling and cleaning. I reckon you should try toothpastes which help reduce sensitivity. But even after using them if you feel sensitive to hot or cold then visit your dentist again to check for any hidden cavities. X-rays might be required to find them out." "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 15 years old and my friend has a throat infection. I was along with him while he had the infection and now the roof of my mouth and throat is kind of sore. It feels like there is mucus stuck there and I have a weird taste in my mouth.Could I have a throat infection? And if I do, is there anything I can do at home to get rid of this sore throat? ### Response: Hi. I understand your concern. There are chances of spread of throat infection through: Thus, there are fair chances that you might have acquired infection from your friend. You may now go for these investigations: If report shows any infection like staphylococcus then consult an ENT otolaryngologiist 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: For months I have struggled with low mood, debilitating anxiety, intrusive thoughts about the past, avoiding anything to do with the past, suicidal thoughts, self harm, and daily guilt and shame that has stopped me from hanging out with friends, or being successful in school. Everyday I just try to survive. My appetite sucks, I have trouble falling asleep and have frequent nightmares, I am exhausted all the time. I finally decided to get help. I saw a psychiatrist today, who concluded I do not fit any diagnosis, and with therapy I can learn to deal with the situation that causes these things. But there is no situation? How can someone be in so much pain for so long and the answer is basically that I am just too weak to handle life? I have never felt so awful ever and coming to that appointment was a big step for me. I feel like such a loser, I got nothing out of it except humiliation. Should I consider reaching out to a different doctor? Or am I overreacting and she is probably right? ### Response: I would beg to differ with the psychiatrist who you have consulted and all the symptoms you have mentioned are depressive symptoms which do need treatment with medicines. Therapy can only help increase the effect of medicines, it is not a replacement . I would prefer that a psychiatrist or a doctor should prescribe you a standard dose of an SSRI such as Sertraline 50 mg, and add low dose mood stabilizer such as Divalproex sodium 250 mg. Major depressive disorder secondary to a stress in past along with a probable personality disorder , will need further history to arrive at a diagnosis. Also consider doing some deep breathing, relaxation exercises." "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 diabetes patient. My sugar level in fasting is above 350 and I checked ketone in urine, it was found to be 4+. My height is 170 cm approximately and weight check found 62 kg. What can I do for ketone? ### Response: Ketones usually develop more often in T1 diabetes. Especially when there is no adequate insulin and glucose levels are higher than 300 to 350 mg. It is necessary to take adequate water to eliminate those through urine. Avoid exercise when ketones are present. Try and maintain closer to normal glucose levels. Check glucose levels at home more often (every 3 to 4 hours). You have to bring glucose in better control to prevent ketones developing. If proper care is not taken, there can be a further complication of developing diabetic ketoacidosis, a medical emergency. If you have any questions please do come back. Plus it is necessary to look at your current treatment (" "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 50-year-old female. My reports read \RBC are hypochromic and microcytic with few ovalocytes seen. WBC and platelets appear quantitatively adequate in the film. No early cells are seen.\ No cholesterol, normal blood pressure, not diabetic, a fibroid but gynecologist said there is no need to operate it since I will go into menopause. What does this mean? Any danger? Is it cancerous? ### Response: Hello. The presence of microcytic hypochromic red cells is indicative of iron deficiency anemia. Apart from this finding, the other findings are normal. There is no finding of leukemic cells. I have outlined the treatment plan for you. Iron and Folic acid tablets thrice daily after meals for eight weeks followed by a CBC (complete blood count) and serum ferritin level estimation. If serum ferritin levels are low, to continue with the iron and Folic acid tablets for another two months. Take adequate intake of iron-rich foods." "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 disordered tooth alignment. What can be done to correct them? ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). I had taken a look at your X-ray. You have got all the permanent teeth which are to be present at this age, and this is perfect. The haphazard alignment is something widespread and can be treated easily with braces. I advise you visit an orthodontist who is a specialist in treating such teeth and get an exact treatment plan for yourself." "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: For two weeks, I have been unbearably itchy. I had a rash to go along with it that looked more like little plaque rashes but those have faded now. I am left with super itchy skin that bumps up when I itch but fades away after a while. The itching is driving me insane. I have seen two doctors and they have no clue what is going on, just that it is not contagious because my husband and kids do not have it. ### Response: In my opinion, you are having urticaria as your rash came along with itching and then disappeared. I know it is hard to notice. Please avoid any perfumes, and contact with pets as much as you can. What is the pattern of itch? Does it occur at night only or get aggravated at night? Moreover, please send the picture of your lesions if possible. I suggest tablet Cetirizine 10 mg at night for 10 days. Apply Calamine lotion twice 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 lower right wisdom tooth is aching and am taking antibiotics but cannot open mouth all the way. It is too painful. ### Response: Hello. You should also start taking a muscle relaxant (Chlorzoxazone) with painkiller along with the antibiotic for a week. You will need a prescription for it. So, go back to your dentist. Do not delay for long else swelling might increase rapidly. Also, use warm salt water gargle twice a day. You will need to extract the wisdom tooth as soon as possible. Do slight exercises of the mouth after you start taking the required prescription, to loosen the jaw muscles to facilitate removal of the tooth. Did the dentist prescribe you Clindamycin?" "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 aged 62 years actually went to a dentist because she felt that there is rubbing in between upper jaw tooth enamel and lower jaw tooth enamel and something sour in taste gets secreted out of it. The doctor told that there is decayed tooth on both sides. The doctor filled the gap between tooth, did enamel treatment, put a cap on four of her lower jaw tooth. She did not have any problems for 10 days. But now, she is having tooth sensitivity problem in the lower tooth jaw where caps were put for four teeth. Whenever she drinks anything hot or a little cold. Please advise us on the treatment. ### Response: I had gone through your question. I can understand your concern about your mother. The history started after ten days that means there will be something wrong with the prosthesis (bridge). I think there must be chipping off of the sealant (the material that fixes the crown or bridge with tooth) or the gingival recession because of the altered occlusion. You need to get a desensitizing toothpaste like Sensodyne and use it for two weeks. In case you feel there is a gap between sensitive tooth and bridge you need to visit the dentist again and get it recemented" "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 25-year-old female. I found a quarter-sized hard nonmobile lump under my nipple a day ago. Is that an usual spot to get breast cancer? ### Response: It is usually uncommon to have breast cancer in this age group. It looks most likely a benign breast lesion or a localized infection. You have not given many details about this lump such as skin or nipple color change, any nipple discharge, whether you are married/unmarried or breastfeeding mother, any family history of breast or ovarian cancer which may be helpful in identifying high-risk breast lumps. Nothing to worry about, but it is recommended to visit a mammalogist or a General surgeon and let them examine this breast lesion. If needed they will put you on close follow up or investigate further with ultrasound breast or MRI breast. The significant risk factors for developing breast cancer are. 1. A family history of breast cancer.2. Obesity.3. 4. Any previous breast lump.5. Hormone replacement therapy, history of estrogen intake.6. Early menarche or late menopause. In case you have any family history of breast or ovarian cancer then you must go for genetic counseling also." "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 19 year old female. I have small cysts in my ovaries. Is this a serious problem? Can you tell me in detail about it? I have attached my sonography report for your consideration. ### Response: I read your query and went through your reports (attachment removed to protect patient identity). 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 32 years old. I delivered a baby two months ago. My issue is that due to hard motion, there is blood. I am taking Anuloma DS tablet. If I stop taking the tablet, again my motion will be hard and bleeding is there. Shall I take this medicine regularly as the baby is small? So help me. ### Response: Hello. Definitely, you should be careful about medications whatever you are taking during the lactation period. Because it may affect the baby\s health. During pregnancy and after delivery constipation is a common issue. You should try to manage it naturally. Anuloma DS is a good ayurvedic proprietary medicine which acts as a laxative. But it contains senna. Senna may causes motion to baby also. You can take Triphala Churna 3 g or two tablets with warm water after meals. Along with this you should change your lifestyle and food habits. Also, do regular Yoga and exercise. It helps to regulate your metabolism and bowel movement too." "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 27 year old male. I have been masturbating while watching porn for a year now. Now I am experiencing erectile dysfunction. Also, the stiffness of the penis is not the same as before (maybe because I am not getting aroused as easily as before) but after stroking, I feel the stiffness is fine. I have decided to quit porn and masturbation since yesterday. But still, I feel the same. I even tried to observe if the \morning erection\ is fine because of which I could not sleep properly. I was checking whenever I woke up in the middle of the night and I found that I was having no erection. I did have one while getting up and it was not the same as before (not as stiff as before). I am now scared. Do I have any disease? Will this thing get cured on its own? If yes, how long is it going to take? Please help.Edit: I am feeling a bit better now. The stiffness and the erection are back. The only problem I am facing now is a low sex drive. I think I am not getting aroused that easily. I am not having the mood. Is it because of the stress that I am going through or because of watching porn and masturbating all this while? Do I have erectile dysfunction or is it due to stress? I am scared.Please note, I have faced a similar issue before when I was taking anti-depressants. ### Response: I understand your concern and the confusion in your mind. My explanation to you is as follows: Watching porn and masturbation is done by more than 90 percent of the people of your age group and it is not an unhealthy behavior. So, do not worry or force yourself to quit masturbation as it is one way of letting out your inner sexual" "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 52-year-old male. My recent labs show elevated levels of BUN and creatinine. I have hypertension and it is controlled by medication. I am a weight trainer and boxer. I have followed a high protein diet over the years. My lab repot shows:eGFR - 71.BUN - 27.Creatinine - 1.32.My fluid intake has been down with my irregular schedule since the pandemic. I have increased my water intake now 64 plus oz of water a day and I have stopped taking any protein supplements. ### Response: I would like to know which medicines you take for hypertension? I would like to know, whether you have done any urine examination? Rest eGFR (glomerular filtration rate) of 71 is within normal range for you, if urine examination is normal. I would advise you to decrease the protein intake and avoid protein supplements. You take water as much so that urine daily passed is around 1.5 liters. If a urine examination was not done previously, I would advise you to undergo one routine urine examination and one ultrasound of kidneys." "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 12 year old girl has been on Celexa from the age of seven years for GAD. She has been on 20 mg for the past three years. It has worked well for the anxiety and mood regulation. She has been irritable and angry with some depression for the past six months. Would you think we should look at changing the medications? Should we go for an add-on medication or increase the dosage of the current one? She is also taking Synthroid, Singulair, and Benadryl. ### Response: Hi. Generalized anxiety disorder is a simple anxiety disorder which is very easy to treat with medicines if it is combined with psychotherapy and progressive counseling. Medicines alone cannot cure it. Celexa (Citalopram) used to help her in anxiety and mood swings is not working because she is 12 years now. There are many aspects to be looked into including the puberty onset and psychological changes that take place during the onset of adolescence. Attention deficit hyperactivity disorder , ADHD also should be suspected. I suggest not to worry much and consult your psychiatrist. The change of medicine is not needed for GAD but, should be assessed for ADHD or stress disorder. I also suggest regular cognitive behavior therapy and progressive counseling through online medium." "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 wake up with a heavy head, headache, and drowsiness. It seems tough to do anything in the morning. But, I feel more energetic in the evening. Why? ### Response: Hi. Many things can cause morning fatigue. If you snore at night, you may have a condition called sleep apnea or otherwise known as obstructive sleep apnea. However, this would not explain why you have more energy in the evening. The other things that can cause fatigue in the morning include depression and sadness. The type of sadness that gets more energy in the evening is called bipolar depression. Also, it is important to check thyroid when it comes to fatigue." "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 going to undertake a water only fast for 14 days. Which vitamins and electrolyte should I take and in what dose? Just heard of refeeding syndrome. Any other precautions? ### Response: Hi. It is not clear why you are undertaking water (only) fast for so long as 14 days. In case, you have decided to, I would advise you to do it under the expert supervision of an ayurveda or naturopathy physician who can monitor you closely. While fasting has obvious health benefits, prolonged fasting exceeding a week can have serious ramifications on one\s health unless carried out under expert supervision. It is always safer and advisable to have shorter fasts of two to three days maximum, in regular intervals, than resorting to a long duration fast in a single go. This can be fatal too. Precautions, that one must take in addition to the ones highlighted above, are as follows:" "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 muscle pain near the chest. I am having muscle pain near the chest from the last two to three months. I have done all the cardiac tests, and it is fine, then I consulted a rheumatologist, and she suggested some tests and medicine. It has been a month, and I am still having some pain. ### Response: Hello. You are right, and you have peripheral arthritis due to HLA-B27 positive. Your chest pain is due to enthesitis, and please feel free to query me in this regard. If your HLA-B27 positive by PCR (polymerization chain reaction), because that is a condition which can give rise to pain in the chest." "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: The patient is 11 years old, and right from birth, he is suffering from type 1 and 2 diabetics. Initially, he was on injection and now on tablets every day. As per the doctor, his pancreas is not working from his birth. Can you please let me know if there is any treatment available for this? Also, can the bone marrow blood infusion technique help in treating this issue permanently? ### Response: Yes, there is a procedure called pancreatic transplant. It must be taking place in your place as well. You can click on the individual hospital website and check if they have a pancreatic transplant facility, but it could be very expensive. But let me tell you one thing that even after any transplant, the patient has to take immunosuppressive medications all his life and compared to that the diabetes pills are still a better option." "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 received an electrical shock last night. The shock did not hurt, just felt it go up my arm and across my chest. I dropped the probe right when I felt it. No burn marks. Afterward, I was having sharp pains in my chest. I went to the ER, docs did EKG, took blood and urine, said everything was good. Yesterday, my left tricep started twitching like crazy. The twitching comes and goes. Could it be possible nerve damage or just something else? They did have an IV in that arm for like four hours. ### Response: Your symptoms could be related to an irritated nerve or muscle. For this reason, if the problems persist, I would recommend consulting with a neurologist and performing a nerve conduction study to examine your nerves. Meanwhile, I suggest having some rest and taking painkillers (Acetaminophen or Ibuprofen) and a muscle relaxant like Flexeril (Cyclobenzaprine) for the pain. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. I remain at your disposal for any further questions whenever you need. Kind regards" "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 erythema multiforme because of drug allergy and currently left with post inflammatory hyperpigmentation. How long will it last and how and what should I do or apply to let the pigments fade? I have my liver, biopsy test, and I need someone to explain the results. ### Response: I have gone through the pictures (attachment removed to protect patient identity). Your lesions are not only hyperpigmented (which shows the healing phase) but they are still erythematous (which shows the active phase). So, right now you should not worry about the pigment of these lesions. It will take some time like three months to recover. Even then some pigmentation may remain. But you should keep yourself relaxed as you had a serious condition and that is good you are in the safe phase now. I did not receive your liver biopsy report. Only CBC (complete blood count) was there" "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 done stress echo four months back and that was normal. I have also done ECG last week, it was also normal. I am facing some kind of pressure on the left side of the chest and feeling uncomfortable. Also having lots of burps the whole day. What to do now? ### Response: Hello. This is likely related to acidity and gastroesophageal reflux disease. Also, just see if this pressure feeling worsens on applying pressure over the area, if yes then it may indicate associated musculoskeletal cause. So, it does not appear a worrisome issue. You should have a healthy lifestyle like avoiding fatty oily spicy food. Avoid heavy meals, inspite have multiple small meals. Do not immediately sit or rest after meals, but have a walk for 10 to 15 minutes. Avoid smoking and alcohol if any. Also, the sleep pattern should be normal as much as possible. You should get prescribed antacid probiotics combination like Cyra D or Pan DSR before breakfast for seven 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 had a hip arthroscopy three weeks ago and today, my feet are very cold with no other symptoms. No symptoms prior to today. Could this be a result of the surgery or something else? ### Response: I understand your concern and would explain that your symptoms are not related to the arthroscopy. A possible deep vein thrombosis could cause these symptoms. Do you see any change in the color (pale or bluish) in your legs? Can you feel the pulse on the dorsal part of your foot whenever touching? I recommend trying to move your legs, and wear warm socks. If your situation worsens, and you experience pain, inability to walk, swelling or changes in the color of your legs skin, I recommend going to the ER for a physical exam and a Doppler ultrasound of the leg vessels. I remain at your disposal for any further questions." "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: Whenever I have sex, it feels like my vulva and vagina start out well lubed and with no issue but within 4 or 5 minutes they both become swollen and irritated enough that I cannot continue to have sex. ### Response: Hi. As per your history, swelling is temporary so do not worry. It may occur due to an allergy to condoms, vaginal douches, ragged intercourse, infections, and less lubrication but you said you do not have any problem with lubrication. Allergy to condoms , vaginal douches, ragged intercourse, infections, and less lubrication. Urine routine examination, pelvic examinations and check for STI's. If it is only temporary swelling means no need of treatment but if persists then let me know. Maintain good personal hygiene, allergy free barrier contraception, avoid allergic products and lubricants." "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 want to know how long do you have to wait to get tested for hepatitis B? I got checked for the first three months and it was negative. I am just nervous thinking was it too early? Six months later I did a liver test and blood test and everything came back fine. I just want to know should I get rechecked or am I good? Are liver tests good enough to check for hepatitis B and C? ### Response: It is very important to know, why are you willing to get hepatitis B and C tested? If you had exposure, please mention what exposure it was. Also, mention when did you get the exposure and when did you get the test 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 was taking Fluoxetine and Escitalopram before two years for around nine months and slowly tapered them, and I stopped taking them. Recently I visited a neurologist for nerve pain and burning feet. The neurologist gave me Trigabantin and Nexito forte. For restless leg syndrome and burning feet. I could not take them and stopped taking Trigabantin cold turkey in two days. After stopping Trigabantin, my legs are feeling slight tremors when I am trying to sleep, and also I experienced muscle spasms, and my muscles were not in control of me when I woke up sometimes.I felt like paralyzed when I woke up suddenly from sleep (this happened twice) after which I went to a psychiatrist, and he gave me Panzep ls. Now I am taking Panzep. Also, he prescribed me Nextril 50, Dicorate er 125 mg and Arifine 5 mg, these three I am not taking out of fear. My body is sometimes shaking on own from left to right when I am tensed or worried.I fear I have Parkinson\s disease. I fear that Trigabantin may have damaged my GABA receptors as well as dopamine receptors. Please advice me what should I do. Also, I am taking 100 mg Thyroxine for thyroid. Is my tremors due to anxiety or Parkinson\s please help as I am not able to go to work out of fear. Also, why am I not falling asleep usually and waking up gasping for air in between nights? Please advise. ### Response: Hello. You should meet your psychiatrist and have a second opinion, and please do mention the tremors and your concerns beforehand. About Parkinson\s disease, do you have any family history of Parkinson\s or any other neurological disorder in your family? Because your tremors have started after the medicine, it is highly likely that it is EPS. But you should meet the same doctor and get a second opinion." "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 my last period 1.5 months back which lasted for three days. I had unprotected sex two days after that. I took an I-pill on that day itself and started having bleeding in five days which again lasted for three days. It was more like a period only. I took a pregnancy test four days back and it came out negative but still, I have not got my periods. Please help. ### Response: Hi. You have already described that after unprotected sex you took a hormonal emergency contraceptive. After the I-pill, the menstrual cycle gets disturbed and can show some irregular cycles. For your satisfaction, you did a pregnancy test that was negative. If this test is done with urine, then it is better to have serum beta hCG (blood pregnancy test) that will clearly state your pregnancy status. Beta hCG can be positive after a miscarriage but it will show gradual reduction that can be checked by another beta hCG after 48 hours of the previous test. In case of bleeding, pain, dizziness, report to a tertiary care emergency department." "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 bumps on ankles, kneecaps and now inner-thigh. I took Allegra, Zinetac, Diprovate-G and-anti-histamines (self), and have limited or unpredictable success. ### Response: From your description of the problem it is very difficult to come to any diagnosis. It is best you send me photos with details or take an online consultation." "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 43 year old male. I have been taking Xarelto for about a year-and-a-half due to a pulmonary embolism that I had. They were very small. I have done every test including the factor 5 and the conclusion was my constant driving. My biggest fear is obviously getting another blood clot which I know you can get one while taking Xarelto. Obviously, every ache and pain I think that I have another one. Sometimes, I do get mild cramping in my legs but it comes and goes. My biggest question is if I was to get another blood clot. Is basically the only thing that can be done is just continuing to take Xarelto? ### Response: Hello. It blocks the activity of certain clotting factors in the blood. It is used to prevent or treat deep vein thrombosis in which blood clots form in the deep veins of the legs. This can lead to pulmonary embolism in certain cases as in yours and can be fatal. Your current medication comprising of Xarelto daily is a form of prophylaxis to prevent the occurrence of deep vein thrombosis. The dose is lower than that when you are being treated for deep vein thrombosis. There are other anticoagulants which can be used but Xarelto is preferred. If you were to get another episode of deep vein thrombosis, the treatment would differ. Deep vein thrombosis is associated with prolonged periods of inactivity, inherited clotting disorders, surgery, and certain cancers." "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 do not have any official diagnoses, but I am curious to know more about ADHD or ADD and OCD. Recently I was about to sit down to eat breakfast when I got sidetracked and started something else. One thing lead to another and next thing I know it is 45 minutes later, I have half of my room torn apart due to not finishing everything I had started, and I still had not touched my breakfast. I have had more of these types of situations recently, and it makes me frustrated and a little worried. I thought about going to see a doctor about it, but I was hoping for an opinion. Currently, I am not under any medications. ### Response: Start with one thing on another, and we may behave strangely. But it does not mean that you have some psychiatric diagnosis. The difference between abnormality and normality lies on a spectrum in psychiatry. Some criteria to define if a particular thing needs the attention of a psychiatrist. 1) Persistent in nature. 2) Disturb your day to day routine. 3) Functional impairment. 4) Disturbance of bio functions like sleep, appetite, etc. If all these things are not there, then I would not advise you to consult a doctor. If this last for some time, then contact a psychiatrist." "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: Elevated blood pressure first detected at age 18 (runs in family on maternal grandmother\s side). Never really treated until age 72 (anesthesiologist requirement prior to cataract surgery). Lisinopril 20 mg and Amlodipine 10 mg. Continued until age 76 with doctor altering dosage and frequency as that medication gradually seemed to lose effectiveness. At that point, intermittent racing heart beat and arrhythmia began to develop, accompanied by total loss of stamina (and sometimes near-fainting and nausea) after about five minutes of any sort of physical exertion.Based on his ECG tape, PCP diagnosed that as a-fib and did a cardiologist referral. Cardiologist looked at that same tape and said it is not a-fib. Might be any one or six or seven other things, but I cannot diagnose it when it is not happening. Next time it happens, go right over to your PCP and have them do an ECG, then come back here with the tape. That did not seem to make much sense. Thinking that might have been caused by the long-term use of Amlodipine, the PCP switched medications to Verapamil 180 mg and Carvedilol 6.2 mg. Those symptoms then seemed to go away for a while.Meanwhile, I experienced a ruptured Achilles tendon, and a minor Lacunar stroke (which permanently disrupted the pressure sensitivity of the skin on my left side from head to toe.) When the racing heartbeat and arrhythmia began to return intermittently about a year ago, I then discontinued all medication. The racing condition is now more or less constant, with the arrhythmia seeming to come and go (I can observe this using a mirror to view the right-side of my neck), the lack of stamina now seemingly permanent, a slight swelling of the lower legs and feet, shortness of breath upon reclining, and chronic insomnia. I am reluctant to get involved with the PCP again, expecting the same routine, rushing in for a quick examination (they give him 11-minutes), scheduling a bunch of laboratory tests at the local hospital and maybe another referral to the cardiologist, all with the same ultimate result, since these providers, well-intentioned as they might be, are not really allowed enough time to evaluate the problem and make a studied diagnosis.. ### Response: Hello. I understand your concern and would recommend checking thyroid hormone levels for possible thyroid gland dysfunction and continue taking antihypertensive medication. Regarding possible arrhythmia, I would recommend performing an ambulatory 24 to 48 hours ECG monitoring in order to investigate for possible arrhythmia. In the meantime, I would recommend continuing taking baby Aspirin and performing a lot of physiotherapies. Sertraline can help improve your situation too, as it helps increase serot onin levels." "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 28 years, married for two years now. My LMC was 17th to 22nd. My husband and I had unprotected sex on 10th. We do not wish to plan our family as of now. Can you please suggest if or not to take Unwanted 72 pill. I have heard it tends to delay periods. Please help. ### Response: Hello. You can use it only in an emergency and for occasional use. Take it within 72 hours of last intercourse" "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 protected sex with a woman. After a few days, I had an itch at the bottom of one of my ears. After 12 days, I done an HIV RNA PCR test and it was negative. After a few days, I had a wart-like bump in the shaft of my penis and body itching. Then after 60 days, I have done HIV duo combo test and it was negative. In these days, I had intense itching with rash similiar at the bottom of both of my ears. After 90 days, I have done the ELISA test, test for hepatitis A and B, herpes, syphilis, chlamydia, and they were negatives. After a few days, I had small itchy red bumps in the body. After 225 days, I done HIV tridot test and it was negative. But the itching in the body with bumps continues. Now I am 314th day after sex. What should I do? Should I go for another HIV test or other STD tests? ### Response: I have gone through the case. In my opinion, if you have no contact history for almost a year then there is no need to repeat all the tests. But first, you need detailed physical examination because there are different types of itchy red bumps and some of these are linked to sex and some are not. So do not go for all tests at once." "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 niece who is 4 years old is suffering from a brain infection. She also had a spinal tap test and diagnosed with a high infection. Suggest me the best specialist doctor for this. Is there any serious problem now or in the future? ### Response: Hello. The reports you sent me do not show normal values beside the observed values (attachment removed to protect patient identity). From what I can understand, this would have been a case of viral meningitis. If the child did not have any serious life-threatening episode during this infection, it is less likely that there would be any damage done. As regards the future, since there were no convulsions, I feel not much damage has been done, so things should be fine. Continue other medications as going on. Consult a neurologist for the same" "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 neurology related question. Actually, I have had two brain MRIs in the last two months and wanted to discuss those. I have anxiety disorder and depression. My first brain MRI said \non-specific increased T2 and flair\. In the second MRI, the above finding did not come but it said \mild age inappropriate focal cortical atrophy\. In both cases, the doctor said it is nothing to worry about. But, I want to take another opinion as well. ### Response: These brain MRI findings (attachment removed to protect patient identity) are not indicative of any serious medical disorder. The change in these two MRI results may be related to the MRI machine resolution (maybe you have performed MRI in different clinics) or may be explained by the radiologist qualification. Do you suffer from throbbing headaches? If yes, migraine is a probable cause. Chronic sinusitis seems to be the main finding in these MRI. Hope you will find this answer helpful" "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 CT scan of my heart to check for calcium buildup in my arteries. The score is 5.83 cubic mm and there is a break down in left anterior descending and no detectable calcification. An approximately 2 mm calcification is present within the proximal aspect of the left circumflex coronary artery about 2 to 3 cm distal to its origin. And 2.8 mm calcification is present within the proximal aspect of the right coronary artery just distal to its origin. Please tell me your opinion. Am I at a risk of heart attack? I do not have any previous history of heart issue, but heart disease runs in my family. Last month, my cholesterol and LDL were 280 and 235 and now 182 and 149 respectively. ### Response: Hi. We follow so many patients, but these are just a predictor of screening patient who are at risk. Even, a low score person also gets a heart attack. You need to show your report to your cardiologist rather than doing interpretation by yourself. Even we had seen so many patients with critical blockages in coronary CT and found the only minimal disease. So, it is not a gold standard test. Still risk factors like obesity, smoking, high cholesterol are better predictors. Revert back with detailed history to 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: I have a red itchy skin in my scrotum. It is dry, and the skin is peeling off. The rashes exist only in my scrotum. It also burns. I am taking Doxycycline for the past one month. Please help. ### Response: I have gone through the attachment (attachment removed to protect patient identity). It looks like scrotal dermatitis (eczema). Take one tablet Zyrtec (Cetirizine) daily for a month. Use a local antihistamine cream like Chlorphenoxamine twice daily. Use a soothing cream like Bepanthen (Panthenol with Lanolin) twice daily. Do not use soap or shampoo in this area. Take Vitamin A tablets once daily for a month. Eat a diet rich in vitamin A like carrots and tomatoes." "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 LMP was on the 29th of the last month. On 2nd and 3rd this month, I had a mild spotting and on 4th, I got my periods as usual. What can be the reason for the spotting and delay as I have not got this kind of spotting before? ### Response: Hello. Can you provide more information regarding the problem? If it is the first time, do not worry. It might be a hormonal adjustment. It will get normalized on its own. Get fasting TSH (thyroid-stimulating hormone) done if it is not the first time. You can calculate your BMI (body mass index) and work on it, as excessive weight can cause menstrual disturbances." "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 dad had gone through angioplasty a couple of weeks ago. He is not at all feeling hungry. At maximum, he is eating an apple a day. Due to this, he is feeling so low and worried. Hence I asked him to stop taking medicines for a day. Please guide what could be the reason. He is a diabetic and high BP patient. ### Response: It is normal after surgery, angioplasty and any other procedure to have lessened appetite for a few days to weeks. This is because of stress and anxiety. Just be relax and live a normal life. And never stop medicines even for a single day. The stent will get blocked and the other heart-attack will ensue." "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 believe I have chlamydia prostatitis. Six months ago, I started showing signs of prostatitis. I had a hard time urinating fully, I had pain and burning, fever, clear discharge. I was put on eight weeks Cipro. My body did not respond well to the Cipro. I stopped and had a chance to see another urologist. He did prostate check and urine and semen sample. Found nothing. No bacteria. He stuck a camera in my bladder and found no bacteria. I was given Flomax for two months and my symptoms went away. Recently, six weeks ago, I got chlamydia. I was given 1.5 grams Azithromycin taken over two days. Seven days after, I was re-tested and no more chlamydia. Then four weeks ago, I started to feel prostatitis symptoms show up again. Inflamed urethra and frequent urination with tenderness. I was given Pirinum by a doctor at my work to try to flush out any bacteria. The pain and inflammation went down but it is still constant. I believe after research I have chlamydia prostatitis and cannot go to a urologist at this time because of being in a remote country working. ### Response: I need to know a few more details to answer your query better: If your symptoms are similar to your previous attack of prostatitis then the treatment would be antibiotics for at least four weeks and Flomax. Ciplox would be the best choice but if you do not tolerate it, you can take Cephalosporin. Usually in prostatitis, we do not see bacteria in the urine, so that does not rule out prostatitis. Revert with more information to a urologist 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 22 years old and a mother of three kids. I am overweight. I currently weigh 180 lbs and I am 5\1"". I have decided that I want to change my life around and start eating healthy, stop smoking, start exercising, etc. I just want to be the best role model for my kids. My question is, what should I do to start this journey? Should I cleanse my body first before I start working out. If so, how to start? I just do not know where to start. Can you help me? ### Response: It is really nice to hear that you want to have a change in your life. This will be an example for other ladies also. Revert back after a month to a fitness expert 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: How to conceive faster? Is AF Kit advisable to use? ### Response: AF Kit is used for vaginal discharge and fungal infection. If taken by both partners, it will cure you of such symptoms and also treat PID (pelvic inflammatory disease). It is good to take this treatment as you are trying to conceive. To conceive faster, try having sexual intercourse during your ovulation days, which are roughly from 9th to 22nd day in a 30-day cycle." "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: Male, 55, 170 cm, 60 kg, non-smoker, non-alcoholic ,vegetarian. Day before yesterday nose and ear bleeding was there in the early morning. Done blood test and found platelets count 24000 only. The doctor suggested to take rest for 4 days. ### Response: Following is my opinion for your case. Your platelet count is low and suggestive of severe thrombocytopenia (attachment removed to protect patient identity). The bleeding could be due to that. The reactive large platelet also seen in smear. So platelet destruction might occurred in your body. Dengue and viral infection are common cause for that. Your platelet count need to be monitored at 48 hour interval. If platelet count still go down and bleeding does not stop than platelet transfusion might given. You can rule out dengue by Elisa or Rapid card test." "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 33 years old and I want to ask what and why we need to stop taking Ranitidine before endoscopy? Is it because it hides anything or make a false negative result? I have undergone endoscopy (first time) and still taking Ranitidine to control my acid. The doctor told me that my esophagus is not fine because I took Ranitidine. ### Response: According to me, it is not compulsory to stop Ranitidine before endoscopy. Sometimes, it may hide the findings of gastritis or an ulcer if taken for a longer time before endoscopy." "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, 50 years old, 5\5"", 155 lbs. About a month ago, I accidentally made a deep cut at the tip of a finger. The emergency room glued the finger closed. Seven days later, it split back open. It was no longer bleeding, despite being an open wound. I taped it back closed and was very cautious not to split it open again. The finger seemed to heal together. However, for the last 10 days, no additional healing or changes seem to have occurred. The finger appears mostly together, but the area that was sliced is inflamed and sensitive to the touch and does not seem to be improving any longer. Though the appearance is a bit inflamed (swollen/red), I am mainly concerned about the nerves which sting or hurt a little when the finger touches things on this spot. I would like to understand more about the nerve damage or issues that could be permanent with this injury. ### Response: Hi. I went through the files (attachment removed to protect patient identity). You seem to really have a bad wound. But you need not worry too much about the nerve damage in this part of your body as this area is naturally rich in blood and nerve supply. Though healing may take some time and area may remain sensitive to heat, cold, and touch but all will be fine within next two to three weeks as natural regeneration may take some time. The present condition of your wound looks satisfactory. And for the swelling, you need to do pressure bandage for few days or it will heal with time. Just apply Voltral gel (Diclofenac) and swelling will be better soon." "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 headache in my upper part of the head. I do not know if it is connected with my neck because I had stiff neck due to my sleeping position. Well I lay down to bed most of the time due to quarantine and after I had that stiff neck I had this. It is not actually a headache, I guess it is like irritation in my upper head. I do not know if it should be treated with a pain reliever. As it is not that severe I did not take it. ### Response: I understand your concern. I need to know more about your headache. How and when does it start? Is it unilateral or both sides? Is it intermittent or continuous or any diurnal variation? Any aggravating or relieving factors? Light or noise sensitivity? Does it associate with nausea, vomiting, or blurring of vision? Did you have a history of migraines or asthma? Any history of fever or sinusitis? You should always note the red flags of headache such as sudden onset of headache, the onset of headache after 50 years of age, increased frequency or severity of headache, new onset of headache with an underlying medical condition, headache with concomitant systemic illness (fever and weight loss), focal neurologic signs or symptoms, blurring of vision. In that case, you need urgent evaluation. If they are absent, you need not be worried. Some times neck muscle tension stiffness may lead to headaches, as in your case. Simple Paracetamol or muscle relaxant will be useful. Adjust your sleeping position, try not to use high pillows. Another most common cause of headache is migraine. Simple Paracetamol at the onset of the headache will be helpful. Also, avoid triggers that lead to a headache. You should have adequate sleep, avoid stress, and take meals on time. 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 believe I am suffering from a narcissistic personality disorder and pathological lying. From health conditions to plain misconceptions of me as a person. I want to live an honest and pure life, and I want to steer away from these lies I have succumbed to over the past couple aching years. I want to be able to do this without losing the people I care about.I have thought about just coming clean completely and telling them every false thing about me, but I will never have that type of courage. These are people I never want to betray. I need guidance, and I need advice, I feel as though my entire life is a lie, and it makes me genuinely suicidal at times. I am seventeen, please help. ### Response: I can understand your concern regarding your personality trait. We all are having specific personalities, and this is completely normal until it affects our social life. We all suppress our nature with our consciousness. If you think your daily life is changing because of your narcissism, it will be better if you will go for counseling. About your pathological lying, I will suggest you forget whatever you lied in the past. Now start with real life. Talk to your friends. Do not worry that you would lose any friend by confronting the truth. If you lose someone, then he is not your true friend. Never feel guilty about your past. Start a new life with full positive energy with enthusing and confidence. I hope my answer 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: My daughter is 3 years old. She is having a dry cough since four days. My doctor prescribed Asthalin and Levolin along with Montek LC. Will these help in settling the cough? ### Response: Hello. May I suggest: It Seems your doctor is treating her for an allergic lower respiratory tract infection. He is right. It should help in settling the cough. Take extra precaution for dust and stressors. If she does not respond within two days then she will need to be evaluated. Focus on a high protein diet and building immunity to prevent an attack. Avoid eating cold foods. Give warm saline gargles. You can try home remedies for cough." "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 lost my prescription for Lipitor and have been taking it for four days. I will get it tomorrow. I am on 10 mg a day. I am worried, will my cholesterol go up in that time since I am not taking it? ### Response: The main effect of Lipitor is to block the buildup and making of cholesterol in body. It does the job together with the help of other active ingredients and its effect on cholesterol synthesis is maintained in the body for about 20 to 30 hours. In this situation, it does not seem an issue if you just missed a dose or so. Do not worry about it. But start taking medication as soon as you get it back." "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 18 years old. I have a gap between my two front teeth, and I am very conscious about it. I hate to smile, and I have a feeling like as if my teeth are at the center of attention wherever I am. I suffer from anxiety and panic attacks. I am always worrying about it. ### Response: Hi. You must undergo orthodontic treatment for a better smile. This is the right age to get orthodontic treatment. Please visit your nearby dentist and ask for treatment options. Your oral look is essential for having better communication with the people you meet. Get it done soon for the betterment of your conscious behavior." "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 36 years old. I am a vegetarian. Before three years due to stomach disturbance, yellowish urine, pain and some popup and cracker sound in my legs and knee joints. I visited a doctor and he suggest me for liver function test and all reports in normal range except for sugar which was 138 mg/dL at that time, he gave some medicines and referred to an orthopedic for joint pain. I visited an ortho specialist and he took an x-ray of both leg knees and tell that it is an early stage of osteoarthritis of knee and suggest for MRI. I had done an MRI and in the report it is mentioned that the left knee has affected with osteoarthritis. After that he give some medicines for 10 days and refers to a physiotherapist for exercise and weight loss. I have visited as he told and I reduced my weight and now there is very little pain remain in my left knee.But now my other joints, hips joints, both hand knee has popup sound when movement including neck, jaws, all have some very mild cracking and popping sound, as there is no pain, but as it seems to be taken care of in the next few years, so I prefer to consult a specialist like ortho and gastro doctors. Still I did not found any reason behind my current health situation, still, I have yellowish urine. Kindly interpret all the reports. ### Response: Hello. Well I have gone through your history. I would like to ask you a few more questions to confirm the probable diagnosis. Do you experience a lot of fatigue? Is the sleep pattern normal or is it disturbed? Any feelings of tiredness in the mornings after sleep also? Any history of recent irritability, forgetfulness? When you say stomach complaints does it mean loose stools or increased frequency of stools or constipation? Any history of weight loss? I have gone through your reports (attachment removed to protect patient identity). Most of them seem to be normal except for mild ANA positive. You are right that it all looks connected and we need to reach the diagnosis, as management gets easier then." "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 31 years old. I can remember that since I was about 11, my left testicle has always been high up in my scrotum. When I look down at my genitals, I cannot see my right testicle. But, my left one is clearly visible and starts at the same position next to my penis. I understand that one testicle is normally higher than the other, but this is abnormal. It also feels stuck in position. Why? ### Response: Hello. I had gone through all the data you have posted (attachment removed to protect patient identity)" "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 used to play football a few years ago, however, I had to stop playing due to symptoms of immediate fatigue after a maximum of one sprint, wheezing, dizziness and palpitations. They were first attributed to asthma, however, upon having a cardiac MRI, I was told there are no issues with my lungs and the problem lies with my heart.They took an ECG and I was told I have two slightly impaired valves with some regurgitation and a slightly swollen right side. I might possibly have ARVC, however, I am still waiting to get a Holter strapped.What I would like to know is, will the Holter definitely let the doctors know if I have ARVC? If it is not the case can the performance of my valves be rectified or will my heart\s condition remain permanent? ### Response: Hi. ARVC (arrhythmogenic right ventricular cardiomyopathy) is diagnosed on echocardiography or MRI (magnetic resonance imaging). Then further risk stratified on past history, family history of ARVC or sudden death in the first degree relatives, or Holter monitoring to detect ventricular tachycardia. Furthermore, genetic testing can be done, especially if your first degree relatives also have the same disease. Competitive sports are a risk factor for the progression of this disease and also for sudden death. So exertion is contraindicated. It will be easy for me to guide you better if you share your echocardiography, and MRI reports with me and also send ECG." "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 third molar or a wisdom tooth removed which was impacted, a week back. I had three stitches after the procedure. I have swelling and pain when I open my mouth. The pain is reducing every day. Today I noticed pus formation and with slight pressure, it came out. It was orangish-yellowish color. Once this came out I felt better. My doctor has recommended only Ibuprofen 340 mg, Paracetamol, and Lysozyme HCl 30 mg. He also prescribed Clindamycin 300 mg but said not to eat it after my followup visit on the next day after tooth removal. Can you please suggest if I need to take any other medicine? I have started taking Clindamycin three times a day from today morning. Please suggest. ### Response: Hello. All you need to do is visit any nearby dentist if possible and get this cleaned or washed properly. Maybe after extraction, you spit something forcefully in 24 hours. This condition is normal." "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: The complete background of the history of the past 10 years is attached herewith. There is a severe migraine. Right now not on any medicine. Please advise the medication. ### Response: I have read your query and all your reports are very carefully (attachment removed to protect patient identity), before prescription I want to know about your diet and digestive system history. 1. Is your digestion normal? 2. Are menstrual periods regular or not? 3. Any surgery that you have undergone in the past? 4. History of hypertension and diabetes? Please provide me this history then I will prescribe you the best available treatment." "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 constant bleeding gums for the past two years. My dentist seems unable to help, as he advises me to continue brushing my teeth and the problem will come to an end. This problem seems to be creating new health problems for me. I really need help and I do not know who to turn to. ### Response: Hi. The cause for your bleeding gums can be local like calculus, for that you need to get a dental scaling done (oral prophylaxis). Brush your teeth twice daily using an ultrasoft toothbrush. You also need to get your blood pressure checked twice daily for three days. Most of the times the bleeding is because of blood pressure or diabetes which dentists miss some time. If it is intermittent and occurs every three to four months, it can be infection related. But most probably it is because of plaque and calculus related. You can upload a picture of your gums for proper diagnosis" "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 days ago I jumped off a gate that was about 10 feet tall. Upon landing, I landed flat on my feet, a surge of excruciating pain took over my feet. Since then, I have trouble walking and the pain has not yet subsided. Though it hurts a lot when I am walking and putting pressure on my feet when I am in a resting position they do not hurt much. I was unable to walk the next day but a day after I was able to start walking.I am having semester and having a lot of work to do. I may have pushed my feet further and both of my feet of purple bruises on them around the arches of my feet as well as the inner heel. I went to see a doctor yesterday and he said that if I had a broken bone that I would be screaming every time I tried to walk or touch my feet. He said that I likely have muscle contusions and the pain is due to the immediate shock in foot muscles while landing. I have been trying to walk on the outer sides of my feet when I need but I am trying to stay grounded as much as possible. Is there any chance the doctor may have missed something? What should I do? My classes are starting shortly and I am worried that getting around is going to be a major challenge for me. ### Response: Without examining you it is very difficult to be precise but I can say with confidence that you have a significant injury as bruising is a hallmark of either a fracture or a significant soft tissue trauma. Weight-bearing is the second thing we look at and if you cannot bear full weight with your foot flat and walk at least five to seven steps, then again you need to be cautious. Thirdly, if you have pain at a localized area rather than over a large area then again it is an indication for an x-ray. Looks like you need an x-ray. Not only will it rule out a fracture but also if you have no fracture but have the above symptoms then you need to look after yourself as some times the soft tissues take longer to heal than bony injuries. Also, sometimes you may need an MRI (magnetic resonance imaging) to be absolutely sure. 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 firmly believe that psychological disorders can come through genes. My mother had schizophrenia. I am so worried that I can also have it. I am depressed in the evenings daily, and I have lost a lot of joy in my life with feelings. I am thinking about the psychological disorders every day. Please suggest some medication or counseling. ### Response: Psychiatric disorders including schizophrenia do not follow a direct mendelian inheritance, and they have multifactorial etiologies. If your mother has schizophrenia, then you have an increased risk of having schizophrenia or other psychiatric disorders. But that risk is not very high. So stop remaining anxious. You are repeatedly thinking about psychiatric disorders, and it is due to anxiety. You do not have schizophrenia. Just stay relaxed and spend your time in constructive activities and you will be alright." "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 is having hypothyroidism. She is having the TSH level of 13 miu/l. We had consulted a doctor and after few tests, the doctor suggested to take Thyroxine 100 mcg everyday morning on empty stomach. How long she needs to take the medication? Is there a permanent cure for this? ### Response: Hello. I just read your query about your wife and her thyroid function test results. Well, she does seem to have hypothyroidism. But her dose seems to be a bit higher. Anyways, you must usually take it according to your body weight or the TSH values. Try to repeat the same TSH after six weeks and then we can decide what is an appropriate dose for her. Yes, she has to take this medicine for life. This is not a major disease but very important gland which is not functioning properly. So we need to replace the hormones which are formed by this gland all her life. This has no side effects, so relax and continue her treatment regularly. No, there is no permanent cure for hypothyroidism. Just replacement of the hormones which are deficient." "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 two questions. I have for years had mild sinus and allergy symptoms that I can manage but I did find this great idea about raw honey, where it includes bee pollen; which somehow has many benefits also for sinus and allergies. What I want to know is this; is a teaspoon of raw honey healthy to eat each day; and is it safe ? or is one teaspoon too much? Another thing is that my parents bought this small indoor infrared sauna; which also has many benefits for health. But I have always heard that infrared is dangerous for eyes. Does this mean I need protection glasses when I use this sauna? ### Response: Hope this helps. Please feel free to consult me back anytime for any kind of health issues. Regards" "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 got my nose injured around 9 years back while playing basketball. I got a deviated septum and sinus problem from that time. I got operated for both around 3.5 years back and I started feeling almost normal and cured. Recently 2 days back I had a moderate blow at the outer bone of the nose. Simultaneously I am also suffering from cold, nasal blockage, and sore throat. Now, this can be coincident as well. I wanted to know, can this be related to blow at the nose? ### Response: Post-trauma deviation in the nose is expected, but not always does this lead to a sinus infection and recurrent sinusitis. You already had previous surgery for deviation. So it also depends on your previous surgery that was 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 am a 26 year old male, unmarried. While playing cricket, I used to wear tight supporter. One day, while removing supporter, I noticed some vessel is obtained suddenly on my private part due to which it is looking like bending towards the right. That vessel is not painful. At the time of erection it disappears somewhat but at the normal condition, it is visible again. So, please help me. ### Response: Hello. A tight supporter on a relaxed flaccid penis does not cause any bending. Your bend is a developmental curvature. Please share a picture to see how severe it is and to plan what can be done. The picture should be of the erect penis from two angles and one image of the vein in a flaccid state. Revert with more information to a urologist 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 Barrett\s Esophagus, and sometimes she feels for something sweet, and I know she cannot be eating sweets. I searched and found out the foods she has to stay away from, but can she eat something small at least once a month? ### Response: Barrett\s esophagus is a serious complication of gastroesophageal reflux disease. It is advisable to avoid or restrict those foods which increase acid production in the stomach. But having sweets occasionally will not pose a problem. But one should limit the intake as much as possible." "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 daughter is 35 years old. She had a small scratch from a rusted wire on her right forearm, three hours back. There was no blood loss. And she did not wash it with running water or use Dettol or anything to wipe the area. Also, she had her last tetanus shot 5 years ago. Should we get her a tetanus shot? Please tell us what has to be done. ### Response: I understand your concern. You should clean the wounded area with betadine solution. She has to be given a tetanus shot. In case if the wound is painful, give her a painkiller. Revert with the following details:" "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 1 month old. His weight is 2.7 kg, and he has been suffering from allergy in his face especially on his cheeks and chin since last five to six days. Now it looks like a sunburn and an allergic reaction. But I could not understand the cause. He has trouble in breathing, and nausea and no medicines were used till now. Kindly suggest any anti-allergic syrup with dose. ### Response: Hello. This milk may be causing those allergic rashes on the cheeks and chin. Please observe, and if it is so, please wipe off the milk that is" "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 recently done a glucose tolerance test, where insulin levels were measured on 0 minutes, 60 minutes, and 120 minutes. The results are:0 Minute: Glucose 4.74 mmol/l, Insulin 11.2 uIU/ml.60 Minure: Glucose 8.71 mmol/l, Insulin 104.3 uIU/ml.120 Minute: Glucose 5.07 mmol/l, Insulin 13.16 uIU/ml.I can see that the glucose is within normal reference numbers, but on 60th minute the insulin seems too high. Is it? What are the reference numbers for insulin on the 60th minute? Is this a sign of insulin resistance? What would you recommend as a treatment? ### Response: I would like to see the image of your reports and would also like to know, have you undergone the HbA1c test. How long you have been diabetic, have you been on oral antidiabetics. Revert with more information to 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 am 32 years now and my wife is 31. Today in pregnancy test kit, result came as double red line (a red line for C and a red line for T). Is this positive for pregnancy? Actually yesterday is her date for periods, but this has also not occurred yet. What precautions should we take? We were planning to travel by car (nano) to native by tomorrow for about 8 hours journey ### Response: Hi. The (UPT Kit) urine pregnancy test kit with two red lines indicates a positive result and that she is at present pregnant. The confirmation for an intrauterine pregnancy can be further done with a transvaginal ultrasound scan. She should be placed on tablet Folic Acid hence and may be started on tablet Micronized Progesterone daily for pregnancy support. Travel by nano for eight hours in this early pregnancy is not advised at all. So, traveling by car is completely not advisable till at least 14-16 weeks of pregnancy." "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: How many times can I masturbate a day? I am a 14 year old boy going through puberty and hence such doubts. ### Response: It is one of its kind and the most interesting question that I have come across. It is good to see that how an adolescent can be so inquisitive about his sexual development. For any other sexual health related queries, feel free to 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 sure I have suspensory ligament tear or injury. I have slight pain and discomfort. My erection falls to one side when lying on my back and it also points downward when standing up. I do not have any past medical history. ### Response: Hi. As you have written that you have no past history of any significant condition, so I am sure there is no history of injury or pelvis bone fracture. It is highly unlikely for anyone to have suspensory ligament injury without a pelvic bone fracture. Penile normal anatomy is not that it stands straight at 90 degrees it always will deviate to one side. An injury which is common in the penis is penile fracture which happens during sexual intercourse but after that, there is no erection. Since you have an erection that is also not the possibility. As you have mentioned, you have a weak erection. To find the cause of it, further evaluation by means of blood test and sonography will be needed. But you should understand that erection strength and frequency decreases with age, erection which was present at the age of 20 will not be present at the age of 30. Still, if you are willing to undergo evaluation of the cause of erectile weakness you can let me know, I will tell you the required tests. If you are still sure that your condition is related to a suspensory ligament injury, an artificial erection test followed by a physical examination will be needed. This test is done by a urologist at his clinic where a small injection is given at the base of the penis to cause an erection, then penile anatomy is examined to see for any deformity. MRI pelvis is also an option to see for injury and its severity." "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 acne started two months ago, and I never had this issue before. It is getting worse. Please help. ### Response: Yes, you have acne bumps on your lower face, i.e. chin and jawline. I suggest you use either Nadifloxacin 1 % gel or Benzoyl peroxide 2.5 % gel, twice daily for a few 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 and my husband belong to A+ blood group. Is there any problem to get pregnant? And I may attain my periods one week before the date. Is this good for me? ### Response: Hello. The same blood group people can marry and produce a normal child. As far as same blood group people are concerned, do not worry about that. Rule out hemoglobinopathy before marriage by Hb electrophoresis by HPLC (high-performance liquid chromatography) method. If you both are relative in nature then genetic counseling is needed. If your period came early once, then no need to worry. If repeated irregular menstruation occurs in future then will think 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: The length of my penis is 5 and 1/2 inches and I am 38 years old. How can I increase my penis length? Is there any medicine, cream, lotion, oil or gel? ### Response: I would like to give you some information regarding our normal reproductive system: Male sexual organs: Female sex organs: So, the main crux of the above discussion is, ""To sexually satisfy a woman, size/length of the penis does not matter"". There are no exercises, pills or ointments that are safe to increase the penis size as they may create problems in your future sexual life. What matters is proper erection and proper ejaculation (at proper timings). Consult a sexologist online for further queries" "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 21-year-old male. I want to start amateur fighting, sparring, with headgear how likely is long term damage? Is it more with continuous high impact to the head, or one serious blow could ruin it? I am a physicist and value my reasoning a lot, I just wonder how dangerous is it. ### Response: I understand your concern and would explain that headgear or amateur fighting can lead to chronic damage to the brain (related to the repeated trauma). This can lead to small strokes and an increased risk of dementia in the future. It can also lead to increased risk of intracranial bleeding, due to the head trauma. As a Neurologist, I would not recommend this type of sport, as it can lead to irreversible changes in the brain." "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 braces on my teeth when I was 15 years old. Now I am 24 and I can see a lot of gaps developing between my teeth. Should I put on braces again or is there any alternative option that I should choose? ### Response: Hi. You must not go for conventional orthodontic braces treatment for such gaps, instead, you should go for clear or invisible aligners orthodontic treatment for it. In it you do not have to get bracketing done but only an invisible tray will be given to wear that will close these minor gaps. Once gaps are closed in 6 to 8 months then get fixed retainers at back of your teeth so your case may not get relapsed. I hope you will be clear about it 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 had genital warts last year, which has been treated. I got Pap smear, HIV, VDRL, and HSV tests, and all tests were non-reactive. I have white vaginal discharge, which is more than normal. The discharge is not smelly, and I do not have any itching. I have done an antibiotic course also, but this it is not improving. Please help. What is wrong with me? ### Response: I would suggest you get an ultrasound done to find out if there is any infection in the pelvis. Also, your partner needs to be treated; otherwise, he will keep passing the infection back to you. Please have him visit a urologist and seek treatment." "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 vulvar biopsy without any stitches. It seems to have been healing fine, until today. It looks as though there is pus in the area where the biopsy was performed. What should I do for this? Will Neosporin help? ### Response: Neosporin can help healing infections for small wounds over the vulva, but make sure that it is for external use only. Please ensure good hygiene of the wound. It may take one to two weeks to get healed. If the biopsy area becomes tender or you feel discharge coming out of it then do see your doctor. 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 a 57-year-old white male. My only medication is Metformin for a pre-diabetes watch. My blood sugar when I wake up is 100 to 121. I take it daily. I do not take metformin daily. My sex drive has dropped off to zero nine months ago. When I have sex, the quantity of semen is very less. Now when I go to the restroom, a lot of bubbles are created in the urine. It just started two weeks ago. My PSA is 3.1 and the urologist says I am fine. But, I know I am not fine. Please help. ### Response: Hello. I would like to know a few more details. It could be an early sign of proteinuria seen in diabetics. I suggest you get an ultrasound and uroflowmetry to check for your prostate size, flow rate and estimate residual urine. I suggest you also check your testosterone levels to look for the reason for your reduced sex" "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 27 year old male in good physical shape, doing workouts every day. My weight is 90 kg and my height is 170 cm. About four months ago, I started to feel a sharp pain on the left side of my face, above my left eye when I swallow liquids. The pain is not intense, but rather I feel like there is an irritated nerve. It lasts only a second, while I am swallowing the liquid and then there is no pain at all. After a while, I noticed that the pain activates when I kiss someone (creating a vacuum with my mouth). Last night, I triggered the nerve pain while I was cleaning my left ear with a cotton bud. The pain has neither gotten worse nor better in these four months. I consulted a neurologist and he did all the tests, like neuro test, 64-slice computer scan. There was nothing wrong with them. Then, I was at the otorhinolaryngologist and he checked my ears, nose, and throat. There was nothing wrong with them too. My neurologist wrote me Lyrica, but after three days, my head was spinning, and I felt bad. So, I cut it off. I am without any medications for two months now. The pain was still there while I was taking Lyrica. ### Response: I read your query and understand your concerns. I hope this answers your query. Feel free to contact me if you have more questions" "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 wart-like growth on my foreskin. I consulted a doctor, who asked me to get a circumcision done. So I got the circumcision done. The biopsy result showed that they were viral warts (condyloma acuminatum), and the doctor gave me tablet Valtoval for a month. After going through the internet, I found out that viral warts are caused by HPV, so I stopped taking Valtoval, as it is used for herpes and not HPV. But now, I got a small wart-like lesion on my penis. I feel bad and frustrated, and I do not know what I need to do. Please help me. What do I need to do? I am going to get married next month. I am waiting for your response. ### Response: Hello. I read your query and understand your concerns. You are right in saying that genital warts are caused by HPV (human papillomavirus), and even the biopsy of the excised skin confirmed the same. Although there are some reports that Valtoval (Valacyclovir) has some efficacy in HPV, it is largely inconclusive. Having said this, I think you need to opt for Imiquimod or Podophyllin as next mode of treatment. The former enhances your immune system, which helps in fighting from genital warts. In my own practice, I prefer this mode of treatment and find good results. I request you to discuss the use of Imiquimod with your doctor. At the same time, avoid unprotected sex with your potential partner now or in recent future, as it may transmit the disease to your partner. I must assure you that with Imiquimod, there is a good chance of remission of genital warts. I hope this helps you. Feel free to write back if you have more questions" "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 42 years male with controlled hypertension. I did my annual check-up, and I found ALT and AST are 192 and 142, which are elevated. I had an ultrasound, and I found fat from marked to moderate on my liver. Lipid profile results are in the optimal level, CBC and kidney results also fine. There is no sign for hepatitis as all result for A, B, and C are negative. What will be the reason for having this elevated result for ALT and AST, and what should I do? ### Response: Hello. In studies, we have seen that Candesartan (Atacand 8 mg) that you are taking, can cause deranged hepatic function and also inflammation of the liver (hepatitis) to some extent. That is why this" "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 brother was detected as HIV positive. Is this disease completely curable or not? Is there is any new medicine for 100 % cure for this disease? ### Response: Antiretroviral treatment (ART) needs to be taken regularly with 100 % adherence. With regular ART, HIV will be completely suppressed and this not only improves the quality of life but also prevents the risk of other infections and reduces the transmission. With this treatment, it is a well manageable infection. ART medication is freely available at all ART centers. Please revert if you require any further information. Best wishes" "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 PCOS and have done D and C recently. I have been prescribed Ovacet tablet for 30 days. Will the tablet regularize the periods and ovulation? Are there more chances for me to conceive because of D and C and the prescribed tablet? Please give your expert advice regarding the same. ### Response: If your periods are irregular, then tablet Ovacet (combination of L-Methylfolate, Myo-Inositol, and Vitamin D3) alone is less likely to induce ovulation. However, the tablet will help in normalizing metabolism and decrease the resistance to ovulation induction medicine." "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 baby is one year old, i dought that he is getting addicted to the smell of ""gutka"" intaken by one of my relatives and he takes my baby everyday. He is 70 year\s old, whenever my baby sees him my baby gets crazy and after going to him baby never wants to come back easily even to his mother. Plz help wheather it is addiction to intoxicating smell or its normsl over attraction to old person. Plz help me snd my baby. ### Response: Hi, The very first thing , confirm whether your relative is giving \Gutka\ to your baby also ? What kind of Gutka he is taking ? Baby may get addiction if he has got the taste of it and started taking it orally. Addiction with smell is difficult to comment on. Possibility of a normal preference and attraction with the person where your baby is feeling more confortable, more affection or some interesting action which your relative might be having and your baby is enjoying it. I suggest you just keep a close watch." "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 daughter is 19 months old and she passed a dark black putty stool today. She has been taking iron supplements for anemia for three and a half months now, and I have never seen a stool like this before. Should I get her checked over at emergency? ### Response: Dark color stool is probably due to iron supplement, you may be not noticed it previously or it may be that yesterday she has given more amount of iron supplement. Dark color stool due to blood is unlikely if there is no underlying liver disease or swallowed blood due to any cause. You need to worry if there is fresh blood in the stool. Advice: 1. Stop iron supplement for a few days, because you have never seen dark color stool previously. Persistent dark stool despite no iron supplement is abnormal and requires evaluation. 2. Keep a close watch for fresh blood, if you find it, it is necessary to investigate. 3. Post photo of stool if possible." "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 undergone a cesarean section for delivery of my baby two months ago. I need some guidance. Is it fine to continue my normal sex life from now onwards? What kind of precautions should be taken into consideration? Is it required to take any medicine to avoid pregnancy? Perhaps the chances of getting pregnant during this time are high. Any other suggestion or inputs from your side? Please help me with your valuable advice. ### Response: Hi. I would answer your question in the order you asked them. Normal sex life can be resumed six weeks after a cesarean section. However, it is better to consult your gynecologist before commencing sexual activity. Consult your gynecologist for a reliable birth control method. Choose whatever method suits you, right from condoms to birth control pills or the Depo shot (Progesterone). You would require reliable birth control, even if you are breastfeeding and not having your periods. Avoid lifting heavy weights, but you can resume exercise safely two months after cesarean section." "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 22 years old male. I am an athlete. One of my legs vein swells when I do sit-ups. Only for a short duration. I am tensed is there a problem. Kindly help me. ### Response: I read your concern. The swollen up vein could be varicose veins. And if you keep doing some activities that increase the pressure in the lower body or abdomen, it can give rise to immense pressure preventing backflow of the blood to the heart via veins. So, there is swelling in the veins. If you continue to do the same activity then you may lead to damage the valves in the vein. Now, at this stage, you may have a check up with some cardiologist to know the exact cause of the swelling. However, nothing to panic. Until then, I request you not to indulge in those activities that bring the swelling in the vein as a precautionary measure. You may continue with moderate activities that will anyway help you achieve the same result." "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 20-year-old male with a suspected fecal impaction or bowel obstruction. It feels like there is a poop or something in my rectum. I can barely pass gas, I have slight abdominal pain, and have liquid stools and diarrhea. I have had a dingleberry that has been stuck to the hairs for a while. The doctor said to take a bath, but it still has not come out yet. I do not know if I have to pass it through stools or not. I am straining to pass my feces and pass gas and my stomach feels different. I went to the doctor last week and he gave me Metamucil and align probiotic for constipation. I am worried. ### Response: Hello. I have reviewed your health query and can understand how worried you are regarding constipation issues. Hope this helps. Please feel free to ask more if you have queries. Regards." "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 knee is locked in hyperextension. I had an injury on my knee had lateral damage that was fixed by knee scope. This was successful, however, about two months ago, I twisted the wrong way and my knee got caught in hyperextension. I saw my Orthopedic surgeon and he told me I had a high rise patella and Chondromalacia. We did Synvisc and cortisone and physiotherapy. But my knee is still caught in hyperextension and cannot fix it. I am only 32 years old so I need my mobility but now I am in pain and can barely move any thoughts? Right now I am on Naproxen, and Tylenol. ### Response: From what I can read and understand by the brief history you have given is that there can be damage to ligaments and meniscus in your knee. Can you please elaborate on the range of motion of your knee? If it is barely movable it means that probably some tissue (either meniscus or soft tissue) is stuck causing block to the range of motion. Also are you having hyperlaxity? Generally people who have hypermobile joints tend to go for hyperextension. Also, kindly update the details of your surgery. Was there ACL reconstruction as well? As you pointed high rising patella, patella alta is more responsible for patellar dislocation/subluxation rather than knee hyperextension. Do attach a copy of the MRI you have." "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 is diabetic as well as a heart patient. Right now we performed a general checkup and in that, they mentioned creatine level is 1.4. How to reduce it? ### Response: Hello. It is impossible to reduce creatinine. As you see diabetes is a progressive disease and it affects the kidney. When we control our blood sugar strictly, we may postpone getting the kidney problem for many years. But if we do not control our blood sugar level strictly, we may get kidney problem soon. The point is, all diabetic people will get a kidney problem. It is only a matter of time. But there are some ways to prevent worsening of kidney problem. The blood sugar must be well below the normal levels. Each laboratory has their own normal range based on the reagents and types of tests they do. See what is the normal range given for creatinine. If the normal range is more than 1.4, then no need to be afraid. Since he is also having heart problems, I want to ask you a few questions: 1. Is he having swelling in both legs? 2. Is he having difficulty in breathing even doing his routine activities? 3. Is he passing less urine? 4. Is he already on tablets which increases urination like Lasix or Dytor? If he is not on Lasix or Dytor and he is having swelling, we can start tablet Lasix which reduces the load to heart and kidney. Please ask your father to start tablet Nefrosave twice a day after food which is good for kidneys. It can be taken with other tablets. Also, do a test called eGFR, which clearly says whether he has kidney problems or not." "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 suffering from OCD and took medication for around five months prescribed by a psychiatrist. Now I am somewhat managing the OCD, but at the same time, I have depression also. Now I lost interest in all things and feel like doing a job, earn money and living in a middle-class life who have to work all the life battling that anxious thought, never-ending though and always being cautious to not make act abnormal in a public place. I am totally tired and gave up hope of living life. Now, most of the time I have suicidal thoughts and find unworthy of life and social meetings. I am detached from my family and I hate them as they do not take my illness seriously.Consumed drugs: Flunil 20 mg to 80 mg and Zapiz 0.25. Please help. ### Response: Hello. Depression is comorbid most of the time with OCD (occlusive compulsive disorder) because it is a very frustrating condition when you do not have control over your thoughts. If you control your thoughts and control yourself to engage in it, then it is a very good indication. Now start to engage in other activities, physical exercise and a job as you wanted. Do not get hopeless, and remember one thing that God helps those, who help themselves. You can start with Clomipramine 25 mg and build up as guided. Psychotherapy will be more beneficial and will work as an adjuvant. When 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 am a 16-year-old female. I have mental health issues. Here in my country, there is no priority to this problem. Rather they just see it as an illness, and they think I am going crazy. I honestly think I might be. I have been trying hard to ignore my feeling and honestly, think that I am doing well. But could not control my feelings. Everyday seems to be harder, and I get so anxious. My insecurity feel is getting worse. I am not happy and tired of being sad. I do not know what to do more. I think I am losing hope. I need help but do not know where to find one. I feel like losing myself any time soon. I do not know if I can, but I think it is the only way. Please help. ### Response: Hello. I understood what you are going through. But you should appreciate yourself for finding the strength to be able to ask for help. That is half the battle. Depression can be handled in two ways: 1. Medicine, for that, you will have to consult a psychiatrist because these medicines cannot be prescribed online. 2. Psychotherapy, i.e., talk therapy, which is counseling in common terms. You should start it to understand your subconscious negative thought patterns, which are making to feel this way and keeping you anxious and sad. You should start cognitive behavioral therapy, which is highly effective in treating depression. Consult a therapist in your place or just start a session here. On your own, start with journaling and start writing down your thoughts. 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 went through a health checkup program last week. There were some findings. WBC count was 10900 (normal being 4000 to 10500), and HDL cholesterol was at 38. Can you please check them? Are the values alright? Are there any further tests to be done? ### Response: Hello. I went through your post and the investigations (attachment removed to protect patient identity). Regards." "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: For about 10 days, I have muscle twitching in my calf, thighs and also in my eyes. I am worried about it. I got my blood test done. It showed that I have a severe vitamin B12 and vitamin D deficiency. My vitamin B12 was around 50 ng/L. Can these deficiencies be the cause for having muscle twitching? Is it something more severe as ALS? I am suffering from stress. Please help. ### Response: The duration is too short for any serious ailment. It is generally related to stress, coffee intake, and vitamin B12 deficiency. There is nothing to worry. It will go off." "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 16 years old daughter is suffering from tonsillitis on a regular basis. She was prescribed antibiotics recently. After a few weeks, it became sore and swollen again. For the past few years, my daughter has ragged tonsils with continuous tonsil stones, bad breath, and sore throat. She is struggling each time, and I am worried about her future health as it is a chronic condition. She is taking Ibuprofen and Paracetamol currently. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). The tonsils are congested. The crypts are deep, and it is natural for her to get tonsil stones. If it is causing recurrent symptoms, you need to get the tonsils removed. They do not serve any purpose after 10 years, and it is safe to get removed." "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 facing skin problems for the past 12 to 13 years. Having an infection of tinea cruris and other tinea infection. It frequently occurs. On medication, it stopped but again it got reversed. Skin gets very dark on buttocks. What will be the permanent solution? ### Response: Tinea is caused by the fungus. There is no permanent solution as sweat or high humid will help the growth of fungus. So avoid sweat as much as you can. Use cotton clothes. Take bath twice daily. Do not use wrong creams or tablets." "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 this little bump on my stomach for a few years. I have attached a picture of the bump. I have shaved the area to give you a better picture. The bump is not growing or increasing in size. It has been the same size. What could this be? ### Response: Hi. I have seen the attached picture (attachment removed to protect patient identity). Since there are many causes of nodule and complete history with good clinical examination is necessary to diagnose the nodule, I would like to give a differential diagnosis of what could it be. Although it is looking more like a dermatofibroma, other possibilities are sebaceous cyst, pilomatrixoma, calcinosis cutis, folliculoma, and dermoid cyst. However, almost all these conditions are benign and simple surgical excision is the treatment of choice. I would suggest you visit a local dermatologist so that he could palpate the lesion and can reach the diagnosis." "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 reports read as follows:Total triiodothyronine (T3) CLIA 91 ng/dl. Reference range 60 to 200.Total thyroxine (T4) CLIA 7.8 \xb5g/dl. Reference range 4.5 to 12.Thyroid-stimulating hormone (TSH) CLIA 0.74 \xb5IU/ml. Reference range 0.3 to 5.5.What should I decipher from this? ### Response: Hello. I just read your query and saw all your reports which you have attached (attachment removed to protect patient identity). Hope you find my advice beneficial. Good luck." "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 5 years old and has developed rashes on face and few on his hands. He has no fever and is fresh playing around. He went out to farm with family and zoo last week, and since yesterday he started developing few rashes. He was having very low fever a couple days back but recovered without medication. My concern is these rashes could be due to any viral or the possibility of allergy? Please suggest any test or treatment. ### Response: Probably may be a viral infection like hand foot and mouth disease. Do not worry. Please give syrup Crocin (250 mg/5 ml), 3 ml SOS, if the temperature is above 100 F. As for the rash, please apply Calamine lotion. It should be better in a few days time." "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 twice in the last two weeks scratched the cornea of my eye. The first time was two weeks ago when I was wearing my contacts for an extended time (no more than normal) and started feeling severe pain, tearing, swelling of my right eye. It felt like the contact in my eye folded over (it was not). Slightly sensitive. It took a couple of days and I was back to normal but had not worn my contacts again until the day before, when I wore for a short time, no problem. Yesterday, I wore them all day and had the same reaction of dry eye, tearing, extreme pain, scratchy eyes, extremely light sensitive and very swollen eye. Do I need to go to a doctor for treatment or will it heal on its own? How long should I wait before I wear my contacts again? ### Response: Hello. It looks like you have a huge epithelial defect due to trauma caused by contact lenses. But the possibility of infection can only be ruled out by examining your eye. It would have been great if you would have attached a photograph but, let me suggest some medication that will cover both the defect and infection, if present. If no relief is obtained in a couple of days, then visit an ophthalmologist." "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 surgery on my knee. During coughing or yawning, I get a sharp pain on the knee. I am unable to stand for a long time. It hurts a lot. My MRI doctor suggests me to have a replacement on the knee. Please advise. ### Response: Your knee seems to be arthritic, and hence the doctor advises for replacement. I need to see the X-ray of your knee so that I can take a decision. It hurts because of the weakened muscles. Also, do core strengthening exercise for your back. Please send your X-rays. You need to take Calcium and Vitamin D medications. Wear a hanged knee brace while standing or walking. It will give a lot of support to your knee." "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 8-year-old daughter throws fits about everything, always speaks negative, says the meanest things possible, is unhappy 98 % of the time, never says anything positive, will be in a good mood then suddenly flip out, if she cannot find something she flips out. The list goes on and on. I am completely heartbroken for her, watching her and have tried nearly everything thinking it was nothing more than a child that had been given the world but I realize it is much deeper than that. ### Response: I can understand your situation in trying to deal with your daughter\s behaviour. Is her behaviour the same everywhere? What do the teachers say? Does she interact well with her friends? It will help to know whether her behavioral issues are limited to home or present at school as well? A detailed assessment including developmental history will be needed to formulate the reasons behind her behavior. It needs to be clarified whether this is a behavioral issue or whether there is an underlying emotional problem manifesting as oppositional behavior. Discuss with her school teacher first. Explore whether she can see a psychologist based at school, if available. If problems are significant and persistent, it is advisable to consult a child psychologist or child psychiatrist near your place for a comprehensive assessment and manage accordingly. Continue with clear and consistent boundaries. Parenting in this situation can be difficult and exhausting but consistency is the key. Get support from your partner, grandparents as applicable. Getting appropriate support will help to make the situation better." "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: Just two days back I suddenly experienced an upset stomach with just a semi-solid consistency of stool. However a day later, I found that I had the urge to pee more often than usual immediately after emptying my bladder. I am 40 years old and my last period was a month back. I am 5\3"" and weigh 70 kg. I have no pain at all while urinating. However, this sudden new symptom has caused me to be very anxious. I also have some PMS symptoms like muscle ache and so on. Could you please advise doctor? ### Response: Sometimes urine symptoms can happen whenever there is altered stool pattern. If there is any problem in stool passage, it may reflect as a burning sensation or frequency of urine as the nerve supply to both areas is same. In case there is no fever, and stomach is still upset, you can start with a probiotic like Econorm sachet twice a day for three days. If symptoms persist beyond 2 to 3 days, then get urine routine test and an ultrasound KUB and revert. A short course of antibiotic like Nitrofurantoin 100 mg twice a day for three days and Solifenacin 5 mg once a day for five days can be started after consultation with your GP." "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: Since yesterday, I have been so tired, and I have a swelling in my ankles. It looks like a mild swelling, but I am scared. I have attached pictures of the swelling. Is this starting edema because of heart failure? I had some cardiac enlargement on MRI, but I had normal ejection fractions a year ago. What do I do now? ### Response: Hello. I have seen and reviewed the images which you have attached (attachment removed to protect patient identity). It looks like you have mild edema around your ankle. In the absence of any respiratory symptoms such as difficulty in breathing, or other cardiac symptoms such as chest pain, it is not related to any cardiac issues. It could be due to other factors such as slight renal parameter derangement, or wearing very tight socks. I will advise you to get a CBC (Complete Blood Count), RFT (Renal Function Test) and LFT (Liver Function Test) done. If these tests are normal, you can go ahead and get an ECG done. But as of now, there is no need to worry about heart failure." "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 to get rid of the post acne hyperpigmentation that is a year old. I have had post-acne hyperpigmentation on my arm and back since I was 15 years old and have tried everything to fade and nothing works. ### Response: 1. Post acne hyperpigmentation lasting for so long is not very common. 2. There are two kinds of options for post inflammatory hyperpigmentation. Either using creams at home which I will prescribe you below or going for cosmetic procedures like microdermabrasion, or chemical peelings. You can start with the creams. Use for six weeks and see the results. Post inflammatory hyperpigmentation. 1. Glyco 6 cream (Glycolic acid) apply locally once at night for six weeks.2. Tablet Limcee 500 (Sodium Ascorbate and Vitamin C) once a day after breakfast for six weeks." "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: Currently trying to conceive and two months in a row my hCG levels rose to a 12 then dropped. My doctor said he has only seen this in one patient ever. I am scared I will not be able to have kids. Both months it happened. I also had positive home pregnancy tests. It is not normal for hCG to rise in non-pregnant women. My big concern is not ever being able to conceive. I have not found anyone who has been through this. ### Response: Hi. Do not worry. I do not see any reason for you to be concerned. For urine pregnancy test to be positive, Beta hCG has to be more than 25 mcg. From your short history I could only gather that your weight is slightly high. Weight has to be ideally: Height in cm - 100 = Weight in kg. Just 2 months is a very short period for you to decide your fertility potential. Just check if following tests have been done. Husband - blood sugar, semen count, motility and morphology at least twice 1 month apart. Semen culture and sensitivity is doubtful. Wife- blood sugar, pelvic scan, tubal patency, serum FSH , LH, AMH day 3 or 4 of period. I am sure you will be fine and will get positive results. All the best." "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: About two weeks before my most recent period, I began to get a fishy smell from my vagina. I wash it every day using Vagasil. So, I was confused. Once my period came, the smell went away and I thought it was gone for good. But, the day after my period ended, the smell was back, but it was a rotten smell, not a fishy one. I am currently on my third month of the birth control pills called Aubra. I am not sure if it has anything to do with the smell, but I figured it was necessary information. What I really want to know is what can be the cause of this and how can I get rid of it? ### Response: Hello. , or any disease you have been treated for. First of all, it is better to have a vaginal swab to check which pelvic infection this is. Notice any symptoms you have along with this vaginal discharge like fever, itching, abdominal pain, vomiting, etc. Follow up with the report of the vaginal swab. After sending the sample to the lab, I suggest starting: Consult a specialist doctor, discuss with him or her and start taking the medicines with their consent. Have treatment of disease completely if you have been treated for any" "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 an exposure with an HIV positive lady before four months and since then to a week back, all my fourth generation tests came negative as well as my VDRL was negative and also negative for HBsAg and hepatitis C. But I also did my RNA PCR test which came below detection range. The range was 20 to 100000 copies per ml but mine is below detection limit. Please guide me. I am freaking out right now. Is it possible to get negative after 75 days by fourth generation antigen-antibody test and have a below detection limit? I also took PEP after eight days of exposure but due to its side effect, I stopped it after 20 days. I tested 11 times in 75 days and all the test came negative except PCR test which came below the detection limit? ### Response: I went through your post. If a fourth generation test comes negative after three weeks of exposure, then the possibility of having an infection is less than 1 %. So I can assure you that you are HIV negative. You can repeat another test preferably CMIA (chemiluminescent immunoassay) HIV after three weeks again. So that we exclude HIV 100 %. So, relax and do not panic. You are HIV negative" "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 irregular periods. I am currently taking medication Levothyroxine 50. My T3 is 0.87 ng/mL, T4 is 8.30 ug/dL, TSH is 2.43 uIU/mL. I am 34 years old, weigh 75 kg, and 5 feet tall. Please advice. ### Response: Hi. From your query, I understand that you are suffering from hypothyroidism. I need to know when was it diagnosed, and what was the thyroid profile at that time. Irregular periods and weight gain is a part of hypothyroidism. I would like to modify your dose as well as advise you ways to reduce your weight. All will be well once we modify your dose." "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 baby is 22 months old. Yesterday, a cat scratched his toe. But my child does not have a wound or blood there. Do I have to give vaccination to my baby? ### Response: Hi. A cat has scratched your child, and it has not caused any barrier disruption or wound or bleeding. But still, it is advisable to clean the area with running water and soap. Apply some antiseptic in the area. Rabies is generally transmitted by animal saliva when it comes in contact with disrupted skin barrier and wound formed by the bite. In your case, you are safe from rabies, and rabies vaccine is not required. The scratch caused by a cat generally causes cat scratch disease. It causes scratching of the skin barrier and makes a wound. This causes infection with some bacteria like streptococci. You should wash the area properly and apply antiseptic. If there is a wound, you must give antibiotics. A tetanus vaccine is required when your child is not adequately immunized till date." "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 spots or granules on both sides of my cheeks and on lip corners for the past eight years. I was a smoker and occasional tobacco user. I quitted this four years back. I have no pain or irritation and I am in touch with a local dentist and taking vitamin D supplements. I need an advice for further treatment. ### Response: The long term habit of smoking and tobacco chewing has caused this on the inside of your cheek. Good to hear that you stopped the habit. The vitamin D supplement you mentioned is also nice. But it takes time to heal. For years together, the inside of your cheek has been exposed to heat and tobacco which are responsible for such a change. It will heal, no doubt, but it takes time. Be patient, have your dentist consultation regularly and avoid hot foods. Use a medicated mouthwash. The time taken to heal is generally more than the time taken for those spots to appear." "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 OCD for past seven years. My OCD is triggered only during my exams. Last year, I took Prodep 20 mg one month before exams and then stopped. I have my exams coming up next month. I have OCD attack, not able to concentrate on studies. Is it alright to use Prodep 20 mg for one month? I read online that it causes many side effects like loss of libido and erectile dysfunction. ### Response: Hello. Prodep (Fluoxetine) can be used in OCD and yes it has some side effects as you mentioned but not all the persons taking it suffer from these side effects. Secondly, it is advisable that you take these" "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 your advice, please. I am a 44-year-old working mother of three children and normally in great health. In the last 20 years, I have had about three visual migraines. There is no headache and I get back to normal 30 minutes later. This week, I had a visual migraine on Monday, felt a bit nauseous afterward for the rest of the day. I woke up on Tuesday and felt normal. Then about 8.30 AM started with another visual migraine. Then, I had a terrible headache and vomited. The right cheek and right arm went numb that lasted all day. I had another one on Wednesday and a fourth on Thursday. The thing that is worrying me is that I am still not back to normal. I could not remember people's names at work on Friday and felt totally spaced out and at times confused. I did not remember speaking to my mother on the phone this morning. In fact, I rang her and when she answered through the car speaker I had forgotten it was me that rang her. I saw my GP on Friday and she said no red flag symptoms but she has referred me to a neurologist as I have had multiple migraines and this is unusual. My appointment is on the 20th. The thing that I want to know is should I be going to the ER sooner for a scan? I know myself I am not behaving normally and my close family and friends have noticed. ### Response: Your symptoms could be related to status migrainosus, which causes a temporary dysfunction of some brain regions related to persistent migraine attacks. For this reason I would recommend performing a brain MRI (which would be better compared to the CT scan) and some blood laboratory tests to investigate for possible causes which have triggered these frequent migraine attacks as follows: If a brain MRI (magnetic resonance imaging) cannot be performed in a short period of time, a brain CT (computed tomography) scan would be an option in case of persistent migraine attacks." "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 done a root canal before few years. But it fell off, and nothing has been there for a few years. This morning, when I woke up, I saw a black pointy substance sticking out on my gum. What is it? ### Response: I have gone through the attachment (attachment removed to protect patient identity). On looking your tooth and after going through your complaint, there is a retained root piece. It is left behind there. There is nothing to worry. You need to extract it soon from your dentist. Root canal treatment generally fails when the tooth is not capped. Since it has fallen on its own, the top portion of the tooth has come off leaving the root stump. In some instances, you can see it after a long time due to gum recession." "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 attached an AP view of X-ray of my skull. On each side of my skull from the rear canals down are speckled cloudy areas. Do you know what can cause this? ### Response: I have seen your report (attachment removed to protect patient identity). The speckled cloudy areas on each side are your mastoid air cells that are filled with air and hence give such an appearance which is normal. However, I observe haziness involving your frontal sinuses and subtle involvement of sphenoid sinuses also which can cause a headache and cold on and off. Other features appear within normal limits. This professional advice provided by me stands subject to the actual examination of the report and image and is based entirely on inputs provided to me. It should be correlated with clinical findings" "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 21 years old. I have been suffering from frequent urination. I have never experienced bladder problems before. However, I do suffer from severe period pains. Is there any relation between the two? From the last few months, I have to pee very frequently. I was working a lot when this all started, so it was not too bad, as I was constantly busy and I had no time to think about it. I also feel as though it was not as bad as it is now. I am now unemployed, so I have a lot more spare time, so I do not know if this is a psychological thing, which is making me feel like it is worse.I constantly feel the pressure in my bladder to pee, and I feel it significantly when lying down. If I take a nap at any point or if I lay down, the pressure on my bladder is insane. Even if I go to the toilet, I feel the need to go again straight after. I have been to my doctor recently, and I explained my symptoms. He prescribed Trimethoprim, which I have been taking for three days now. I feel uneasy, as the doctor said this antibiotic normally works in two days. I am going to remain positive and do my full seven-day course. I have also given a sample of my urine to be tested, and I have also booked a blood test for tomorrow morning. I have been fasting recently, so the dizziness and dehydration are expected.I have been holding back on drinking water, as I fear this will make it worse. So, I drink two glasses of water maximum a day. I have read a few things online and realized that I have been doing the wrong things as drinking a lot of water will help wash the bacteria out. As of today, I am going to drink two liters of water a day and incorporate that into my lifestyle. What is it that I am suffering from? I have no pain whatsoever and no burning sensations. I do not have blood or cloudy or smelly pee. Will this ever go away? What can I do? I would really appreciate any help or professional advice. This is really starting to take its toll on my life, and I am beginning to feel really restless and unhappy. ### Response: Hi. This is definitely UTI (urinary tract infection). Sometimes, it becomes long-standing if you ignore it. You need to take antibiotics and plenty of fluids daily as a habit. Gradually, it will go. Do not worry. It is not the problem, which is not curable. To relieve your symptoms early, you can take some alkalizer" "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 is in the 25th week of pregnancy and she is not feeling the movements of the baby as she did before. The movements have come down to eight to 10 times in the last 24 hours. We are very tensed now. Please suggest us what to do. ### Response: I hope I have clarified your query. Do write to me if you have more queries. All the best" "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, 45 kg, 5 feet one inch. I have nausea, slight pain and burning sensation in upper left abdomen, and discomfort on the left side of the abdomen. I am currently on Dolgina, Librax, Calbo. ### Response: Hello. The burning pain and nausea with pain are suggestive of viral gastritis or small ulcer. Acidity or acid reflux from that can lead to nausea by irritation of posterior pharynx. I suggest taking Rabeprazole 20 mg OD for a week. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Avoid gastric irritants like: Cooked oatmeal helps in soothing the stomach. Probiotic tablet also can be prescribed if 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 recently had my blood tested and it turned out that I have WBC at 16000. I have no fever, a cold or a cough. Although I have rashes and I suspect this is pityriasis rosea. My doctor is not aware of my suspicion. Now he wanted me to undergo CBC and peripheral blood smear. If I really have pityriasis rosea what would probably be the result of my CBC and PBS? I am 22, female, 5\1"", 48 kg. ### Response: Pityriasis rosea is a form of viral skin infection. Your total WBC count can be high because of that and in your CBC, high lymphocytes can be a possibility but it is not the rule. If needed, topical steroid also can be prescribed. I suggest you consult a dermatologist for examination. Repeat your CBC with peripheral smear examination report after a week" "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 eating my food or anything like dairy products, etc., my stomach bloats and there is pain below the breast on both the side, but mostly on the left side. On touching the ribs, I get pain. I feel something is swollen. It is from a very long time. Please help me out. ### Response: I would like to know if you had any weight loss in recent time or used painkillers excessively or had black colored stool or blood with vomit? Do you have vomiting? Or a family history of any stomach cancer? If all these are negative then you are suffering from functional dyspepsia. That can be managed by lifestyle and dietary modification and 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 been diagnosed with oral lichen planus a year back and now I can feel a small cut like thing in mouth again. Can you help me up to diagnose if this is a normal cut or some other thing. I am 30 years old male. ### Response: Hello. The cut you are referring to seems to be due to cheek bite (attachment removed to protect patient identity). I need to know if there is any pain in the cut or pain on taking any specific food or liquid. I need to know when where you diagnosed with lichen planus. And have you been taking any medicine for that? The whiteness around the cut seems the keratinization that usually occurs due to the cell growth around the cut and that is normal. I would advise you to maintain good oral hygiene and if you have pain, apply some analgesic ointment on the cut. I would also advise you to have a visit to your nearest dentist in order to rule out any other disorder." "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: For the past few days, my vagina has been itchy and sorta red. Then it started to form bumps today and now it is all red swollen and itchy. And it burns when I scratch it. It is driving me crazy. Do you know what it could be? ### Response: Sounds like a fungal Infection. Have you recently had sex? If you have, you need to see a Gynecologist and get examined to come to a proper diagnosis and appropriate treatment. If you have not had sex, you could try Nystatin vaginal cream. Apply it twice daily with a clean finger inside and outside for 7 to 10 days. If you do not get relief from this, you need to see someone to get a vaginal swab to find out the type of infection you have" "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 bleeding gums for a year or so, and it usually happens after I brush my teeth. I find a slight change in the shape of my gums. I have been taking extra oral care. Is there anything I could do to stop my gums from bleeding? And if the bleeding stops permanently, will my gums take the original shape? I want to know this because I do not wish my gums to recede. ### Response: The most common cause of bleeding gums is plaque and calculus deposition on teeth and gums (due to improper maintenance of oral hygiene). Only brushing and mouthwashing at home may not work since it is a little advanced stage and demands professional help (teeth cleaning). Gums may recede due to loss of attachment with the teeth. That requires proper oral hygiene maintenance after cleaning. In some cases, gingival recontouring or reshaping is carried out. In short, see a dentist." "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 pigment dispersion syndrome for 10 years. Now I take Bimatoprost in both eyes at night. A few days back, I suffered a trauma to the eye area and as a result, I have a lot of swelling and a subconjunctival hemorrhage and the doctor carried out the funduscopic exam and it was clear. Today hemorrhage has gotten bigger and feel like my eye is discharging or weeping. Eyesight is normal. Should I get it checked? ### Response: I understand that you suffered a trauma to the eye. When examined, the doctor said that you have a subconjunctival hemorrhage with no damage to the retina. As of now your vision is clear but the hemorrhage has increased for two days and you are on treatment for pigment dispersion, psoriasis or ankylosing spondylitis. With this scenario, I feel that a visit to an ophthalmologist is necessary. An appearance of increasing redness of your eyes could be due to both the congestion of the eye or due to an increasing hemorrhage. The fact that you have discharge from your eyes suggests that an infection could have developed. This is quite a common occurrence after an injury. I advise you to avoid rubbing your eyes, wash the discharge away with cold clean water and review with your doctor." "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 experiencing headaches for the last three days. It is more of a burning or tingling feeling at the back of the head that seems to travel to the front sometimes. It is not a severe headache it is more of a dull ache and also my scalp feels sensitive when I scratch or touch in those areas. I have no eyesight problems besides blepharitis and no unsteadiness or vomiting.I have done an MRI of head and neck six months back and it was clear, and I was diagnosed with fibromyalgia four months back. ### Response: Regarding your concern, I would explain that your symptoms are suggestive of tension type headache, which is a benign type of headache related to psychological stress. A wrong posture can also cause such type of headache. So, in my opinion, there is no reason to panic. I would just recommend taking painkillers (Acetaminophen or Ibuprofen) and try to relax. A warm bath can help too. If the headaches persist, I would recommend taking Duloxetine (considering also the diagnosis of fibromyalgia) or Amitriptyline. There is no need for brain MRI, as I am sure that it will result in normal. 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 having issues with my tongue. I have pain on the back right side of my tongue which is making it very difficult to eat, swallow, and talk. Also, I have a slight fever (99.5) and my tongue appears to be white in color. The pain started three days ago. ### Response: You may have tonsillitis or so if you have an ulcer-like lesion on your tongue. Please attach a picture if possible. I suggest you take a painkiller for relief. Is the pain continuous or intermittent or comes only when you take food? Use warm salt water gargle twice a day for a week. You should see a dentist or an ENT surgeon as soon as possible. I can suggest better if I can see a picture of the area having pain. Touch the area and press there on the tongue. Is the area hard or swollen? Please describe. Revert with more information to 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 am a patient, age 30, with Crohn's disease. I take Humira and recently had a flare up, thus started a round of Prednisone to get through the flare-up. The combination of Humira and Prednisone has resulted in shingles. I saw a dermatologist who prescribed Acyclovir. I was six days into the shingles before realizing I needed to see a dermatologist. I have been on Acyclovir for two days and have not seen the shingles spread. Can I go for a trip? ### Response: I went through your post. Shingles involve a single dermatome. So, it is unlikely going to spread and will heal completely in two weeks. Prednisolone is a steroid and can cause reactivation of Shingles. So you need to take Acyclovir at least for one week and continue Prednisolone and Humira (Adalimumab) until your IBD (inflammatory bowel disease) goes in remission. Then you can slowly decrease the dose of Prednisolone and finally take it off. You can go on a trip." "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 acute sharp pain in my left chest under my nipple not in the middle at all. It feels like a tight constricting pain. I took Asprin three hours ago. The pain comes and goes occasionally and it goes to the left shoulder. It feels very localised. So, I am putting pressure on the spot where pain the is. It feels like it is between the ribs. Please help. ### Response: Hello. Does this increase in deep breathing? How long does it persist? Is it for a few seconds or minutes? Sharp pain and short-lived pain is less likely to be a cardiac pain. Cardiac pain is usually retrosternal, persistent, increases on exertion and relieves with rest, associated sweating, and uneasiness. Are there any risk factors for cardiac diseases like hypertension, family history or smoking? I think the possibilities in you are reflux disease, musculoskeletal pain, pleuritic chest pain which is the pain from linings of the lungs. Musculoskeletal pain increases if you press hard at the site of pain, while pleuritic pain increases on deep breathing or coughing" "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 daughter has an SGOT of 81 units per liter of serum. She is suffering from high-grade fever and cold. So we are giving Tylenol. What is the problem? ### Response: SGOT (aspartate aminotransferase) is a liver enzyme, which increases due to multiple causes. One of the reason can be a viral infection. These mild rise in titer are very nonspecific and do not to worry. When the disease gets controlled, it becomes normal. Your daughter is suffering from viral infection, so there is no need to take antibiotics. You can continue the rest medication as adviced by the doctor. Review after two 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 23 years old and on birth control pills for five years without missing a dose. Usually, I have a pretty regular cycle. Had sex using withdrawal method due to STD free and on the pill. Started a new job (career) as well as ended that relationship, missed a period. At about 10 days late, my home urine test was negative. The second test was negative about two weeks after this. Got some light spotting around next cycle but no period. How likely that I am pregnant? What else could be causing this? ### Response: Hello. I have gone through your history and understand your concern. As you had protected sex, there is almost no chance of pregnancy in your case. Delayed menses and spotting could be due to hormonal imbalance caused by sex. Get your blood beta hCG levels to rule out the possibility of pregnancy." "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 fever an immune response of the body to act as defense mechanism against infection, why is Paracetamol prescribed to reduce temperature?What will be happen, if not used? ### Response: Hi. Very much impressed by your query. Yes as you said, fever is an immune response of the body to act as defense mechanism against infection. Most of the time Paracetamol is not needed if body temperature is not crossing >102 degree F. But any temperature >102 degree F causes many biochemical and physiological damages to the body, such as: Because of all this Paracetamol is used. But definitely not required for a low grade fever." "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 is having a red eye. We are thinking that it is spreading to the other eye too. We visited an ophthalmologist and she said that it is viral conjunctivitis. She has prescribed Gatifloxacin eye drops four to five times a day and Moxicip ointment at night. This was three days back. How can we prevent the spread of this infection to my 4-year old daughter? My wife takes care of her at home. ### Response: Hello. Here are a few tips to avoid transmitting eye infections to those around you: I know some of the steps are hard, but one has to follow them." "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 keeps coughing at midnight and has breathing problem sometimes. So, doctor suggested an x-ray. I am attaching the report here for your reference. I tried searching information online and got some details, but want to know the exact cause, stage and treatment. So, please guide me. ### Response: Hello. It would be very helpful if you would share how long she has the symptoms of cough. Also, did she have any associated symptoms like fever, body ache? Did they bring up phlegm? Is there any history of weight loss or change in appetite? I assume that your symptoms were less than a week and this may well represent acute bronchitis. It can be viral or bacterial. Keeping in mind the current viral season (influenza), it is most likely viral in origin. But, I can be more certain if you would kindly answer the questions above. Revert back with the asked answers 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: I am 59 years old. I was diagnosed with hepatitis C alcoholic cirrhosis, acute pancreatitis and that was almost two years. I am currently taking Levothyroxine 50 mg once daily, Labetalol Hydrochloride 100 mg once daily, Lisinopril 20 mg once daily. I was in the hospital at first to stabilize my condition. My hepatitis C cleared but still of course I cannot change the damage to my liver.I was told I would only be given five to ten years if I would quit drinking. I kind of fell off the wagon about six months ago, about three liters a day. I weigh about 120 kg. I went to my family physician, he ordered a liver profile and complete blood work. I am going to get it done tomorrow, but the only concern I have is this day I have been having not much but had some black stools. Does this mean that my liver is failing? I tried calling my specialist but they had already left their office. Should I go to the ER or just wait till I call my specialists? I quit drinking about a week ago. Can you help me with some advice? ### Response: Black stools are indicative of acute gastrointestinal hemorrhage. Melena or black stools can also turn into a medical emergency if a lot of blood is lost and hence my sincere advice to you would be to go see a doctor as soon as possible. This does not signify liver failure. But melena does not mean that your liver is failing. I will advise you on the following until you get to the doctor. Take Omeprazole 20 mg one tablet immediately, followed by one tablet every morning in the empty stomach. Sucralfate syrup two teaspoons immediately, followed by two teaspoons after every meal. This will help in coating the ulcer lining and help in healing. 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 51 years old with a complaint of bloating, loose stools, burning sensation in the abdomen 15 years back. I managed two years without medicine. I was advised to use Rabeprazole to which my symptoms subsided a little bit. From then I cannot tolerate spicy foods, fruits, caffeinated drinks, and curd. If I take these foods my stomach starts bloating with loose stools, burning sensation in the abdomen. At times, I get pains in the hands and feet, burning sensation and pain in the back of the head and breathlessness. These symptoms subside by passing flatus and belching and on using medication.I was evaluated and diagnosed as a case of IBS. I am uploading my complete details. Please find attachment. ### Response: I reviewed all your medical reports (attachment removed to protect patient identity) and I can say as follows: First of all, you need to be examined with upper endoscopy and colonoscopy plus abdominal ultrasound. Your symptoms may be related with Gerd and hiatal hernia or gastritis, stomach ulcer. In the meantime, I would suggest using PPI\s (proton pump inhibitors) and antacid to improve your symptoms. After completing the exams mentioned above I will give you a more accurate opinion regarding your possible diagnosis." "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 got married 15 months back. From then I am trying to conceive. I am having irregular periods only after marriage. For the past two months, my period occurred in a gap of 45 days. When I consulted my doctor, I got to know it as PCOS. I am using B-long tablet in the morning, afternoon APCOD sachets and evening I am having Dronis-30 from second day of my cycle. I did thyroid and pelvis test. Both the reports were normal and Hb was 10.5. Can you please tell me for what purpose these tablets are used? And what is the problem with my body? I observe tender breasts after 10 days of period completion. Please help. ### Response: Hi. I understand your concern. For getting pregnant there are some treatment methods available, you have to take something for ovulation induction that is egg formation." "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 use contact lens instead of normal spectacles. Could you please tell me the types of contact lenses available? Which one should I use? Are there any drawbacks in using contact lenses? ### Response: Spectacles are the first option for refractive errors and contact lenses are only secondary. There are many types of contact lenses in various brands. Commonly used are soft contact lenses. There are daily disposable ones, monthly disposable ones and those which can be used for more than a month. These are available in different price ranges. Hope this helps. Consult an eye care ophthalmologist online for further clarifications" "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\s sister died of lung cancer at the age of 28 years. No one in their family had lung carcinoma. Now he is afraid of any familial risk and occurrence. He is 30 years old now. Is there any investigation to find whether he is at risk or not? ### Response: Lung cancer occurring at 28 years is unusual and he is right to be concerned regarding familial risk. But studies have shown that if a family member who had lung cancer and was a non-smoker, the risk of lung cancer in them is high. There are genetic tests available which can detect such mutation and their risk of causing lung cancer. But these tests should be done in a patient who had cancer so we can identify the particular mutation. So that the relatives could be tested for the specific mutation. Most widely known mutation in such cases is EGFR (epidermal growth factor receptor), which can cause familial lung cancer. If his sister was tested for this and was negative then there is no further need for testing. So even if we do the test in your friend and find some abnormalities, we will not be sure of their significance. It will only add to the anxiety of your friend. What I would recommend right now is to adopt a healthy lifestyle and avoid known risk factors for lung cancer. As some researchers have shown that family history makes you seven to eight times more prone than a normal person if you continue to smoke. Also, if possible, I would like to see the histopathology report of his sister regarding type" "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 period has been off for the past six months, meaning my cycle will go from 31 days which is normal, up to 51 days. I did not get a period for two months and then I got one next month. It was fine when it came again a month later and then it came very late the month after, no period last month and now this month I am five days late. Should I be worried? I have never been on birth control or any type of medication. ### Response: Hi. Irregular periods can occur due to many causes like anemia, hormonal imbalance like PCOD, thyroid disorders, etc. As you are having irregular periods for the past 6 to 7 months, better to consult your gynecologist once and get examined and go for investigations like hemoglobin levels, thyroid profile, ultrasound, etc. If she advises, you may need to undergo FSH and LH levels also. With this full workup, the possible cause of your problem can be identified and treatment can be taken accordingly." "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 short and curved penis. The curvature is towards left side. How can I make it straight? I want to increase its length by around 2 inches. How to boost my libido, stamina and erection time without any side effects? Are there any tablets or should I just follow a particular diet? ### Response: Advice: After all these measures, if you really feel that your penis size is very small, then you can increase the size of penis by surgical means." "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: Recently, I had unprotected sex. The first time, we both were drunk, but I know I did not ejaculate. Also, we did not use any form of contraception. She was ovulating during the second time and I used the withdrawal method. What are the chances that she can get pregnant? ### Response: Well, ovulation is the period wherein egg is released from the ovary and that needs a single sperm to head towards a pregnancy. There is about 30% chance of getting pregnant following unprotected sex during ovulation. She can have I-pill within 72 hours, preferably within 24 hours or as early as possible to avoid unwanted pregnancy. It is safe and does not affect her future fertility except for mild immediate nausea. I would also advise her to go for a urine pregnancy test about 14 days after intercourse if she does not get her periods." "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 is 28 years old. She is having a bad cold since last few days and having throat pain and discomfort. She has an ear pain because of continuously coughing and sneezing. Kindly let us know any further precautions and medications so that it can subside soon. She is currently having steam inhalation with Zandu Balm. ### Response: Hello. This sounds like a viral infection. I would suggest the following: I suggest testing a CBC (complete blood count)" "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: Dear Doctor,In the last 6 years, I am using Betnelan tablet for asthma. I want to know the side effects of it.Age 28 years, m, height: 170cm, weight 44kg. ### Response: Hi. The side-effects of betnelan tablet are as follows: I strongly suggest that, you can use inhaled steroids, which have much lesser side effects." "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 baby is 5 days old and is suffering from Pierre Robin syndrome. Kindly advice. ### Response: Hello. Based on that he needs to be managed . Revert back with the details to a paediatrician online for further follow up" "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 51 years old feeling frequent lower back pain and tiredness. BP, sugar and other tests are normal but my vitamin D3 is deficient. Please advise. ### Response: Hello. Vitamin D deficiency is one of the common cause of generalized body pain. It is more frequent in perimenopausal and postmenopausal women. Back pain can also be due to osteoporosis or degenerative (age-related) spine changes. It is better you start taking Calcium and Vitamin D rich diet which includes milk and milk products and meat. Back extension exercise and core muscle strengthening exercises can be done. Vitamin D sachet 60 k unit once a week. Tablet calcium 500 mg twice a day. It is better to get X-ray lumbosacral spine anteroposterior and lateral to rule out any other pathology" "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 a pressure in one of my front teeth. It is not painful and does not hurt to eat. Just feel pressure. I remember biting something the other day and it felt a little like I had bitten it too hard. No visible change to any of my teeth and it is not painful. The pressure is inconsistent. ### Response: Hi. I had gone through your question and I can understand your concern. As per your history, it looks because of biting on hard substance, periodontal ligament has been damaged transiently, it is a thin membrane between teeth and bone. There is nothing to worry, it will selfheal within three to four days. Remember that do not keep touching it, this may be enjoyable but it can lead to periodontal tissue damage. Also, take soft foods and do not bite on hard fruits like apple or even hard meat too." "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 29 years old and suddenly cannot get a full erection or keep one for very long. I am not on any medications. ### Response: Regarding your concern, I would explain that your symptoms could be related to an erectile dysfunction or psychological stress. Coming to this point, I would recommend consulting with a urologist for a physical exam and some tests like sex hormone levels, complete blood count, and blood electrolytes. If these tests result are normal, I would recommend consulting with a psychotherapist, who can help improve your situation" "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 pain in my right ear. The pain feels above and below my ear area. It subsides when I grind my teeth but in general, I keep having a light pain and the ear feels like it is closed. I do not have any infection or anything. The only thing at present is I have a slightly inflamed tonsil for which I am using antibiotics. The other thing is I am using antibiotics anxiety tablet Xet CR 12.5 ### Response: The pain could be referred pain from tonsils or TM (temporomandibular) joint pain or some proper earache. Since you are saying you do not have any infection, I am inclined to diagnose it as referred pain from tonsils. Tonsils and ear have the same nerves supplying them and the pain can get referred to ear from tonsil. If you can send a picture of your tonsils it will be very helpful. You just have to click few pics of good clarity of open mouth taking care to focus on the posterior pharyngeal wall. Additionally, please answer the following questions" "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 physician has always suggested Budecort 100 mcg for my kid for four years and Levolin inhaler along with Montair LC kids tablet daily and some cough syrup since he is allergic. He is having a dry cough and Altacef is given sometimes if worse.The doctor insists always at least for three months to continue the inhaler and the Montair LC. Is it safe for the kids? Is there any alternative medicine that my son does not have to take the inhaler or the nebulization. Kindly suggest an alternative medicine. ### Response: Hello. It seems your doctor is trying to control acute attacks of asthma which is right" "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 in real pain for past 9 months and my doctor is clueless after several visits. After a period of 38.6 weeks in latent labor, I had a vacuum assisted vaginal delivery (first baby). No ultrasound was done the very day of admission. With crowning left medio-lateral episiotomy was given. Extension of 1.5 cm up to anal sphincter was given and sutured. I gave birth to 3.6 kg baby girl. After 2-3 days in hospital I kept complaining about excessive pain and burning in that suture compared to others. I was told that it was normal. After a month I could barely sit and feed my baby. In follow up doctor told me it was normal and healing. After 2 months it worsened again and I could feel a hard lump in left side below my vagina and near anus. It has been 9 months now after my delivery and every 4th day or once in a week I get the lump tender, warm and hardness in between my vagina and anus, along with discharge of pus or light color blood which is immensely painful. It keeps coming back always. I am getting weaker day by day. Mild fever, stiffness in legs, body ache, inability to move and sit when the pus forms until it discharges from a hole that has been there always. The same hole closes each time after discharge. Which doctor should I visit? Please help me urgently. What can this be? ### Response: I have gone through your complaint. Episiotomy. Fistulogram. Abscess. Fistula. Fistulectomy with antibiotic coverage. Revert back after investigations 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: I am a 40 year old female. I did nuchal translucency (NT) scan at 12 weeks and 1 day. The result reads NT 1.1 mm. Free beta hCG 25.9 ng/ml. PAPP-A 0.53. My sugar levels and BP are normal. I am taking Aspirin and Enoxaparin every day. Kindly tell me about my risks. ### Response: Hello. How are you doing? I see nothing for you to worry about. Let me explain. Hope I have clarified your query. Do write back if any more queries. All the best." "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: For past six months, I have had an irritating aggressive dandruff on my right eyebrow. Granules develop that are painful to the touch. I have applied zinc oxide, tea tree oil, and Pramoxine hydrochloride 1 % (suggested by a pharmacist). They helped for a while but were not a permanent solution. Glycerine made it worse. Please give some suggestion. ### Response: Is this same episode or recurrent issue? How long did you use above mentioned topical agent? Do you have discharge from right eye? From your description one of the differential diagnosis is blepharitis. But to be sure of the diagnosis, kindly send image and revert back. Depending on the severity of inflammation topical agents can be advised" "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 discovered a tiny lump on the inside of my upper eyelid quite a long time ago. However, I had no pain or anything. Lately, I have been having bad headaches, today I got a shooting pain in the eye and since then, it has been a little blurred just at the top where the lump is. I have also noticed the lump has gone blue. ### Response: Hi. It seems a small marginal chalazion. A chalazion is a swelling formed due to blockage of lipid producing glands in eyelids. The good thing is mostly these are painless (except when it gets infected). In most cases, it resolves spontaneously. If it is painful, then you should visit your eye doctor and he might give you some antibiotics and NSAID. Warm compresses are also helpful. You are welcome for any queries. Have a nice 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: Please see my attached files and advised me that my radius bone is healing in alignment or not. My fracture is 20 days old, and plaster is opened swelling and pain in these areas. I doubt that my bone is not in alignment. ### Response: You are right, and the radius is out of alignment. The dorsal angulation appears to be 15 degrees. This is eyeballing, and I may be off by a few degrees, but the position is not acceptable in a young person, again I am assuming that you are less than 40 years of age and this is your right hand. Secondly, in the AP view the radial translation is acceptable, and so is the shortening. Clinically the wrist may look unshapely when compared with the opposite side if this is obvious and now 20 days down the line it can still be manipulated and put into a molded plaster as further delay will mean that the fracture will need a surgical procedure to improve alignment. I do not know why did they remove the plaster at 20 days as the plaster should be on for at least four to five weeks." "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: TSH is 5.59, T3 2.7, T4 1.3. Current Thyroid dosage 6.25 mg Monday to Saturday, 32.5 on Sunday. Is this a correct dosage? Patient is on dialysis as well for kidney failure. ### Response: Hello. I just read your query and from what you have mentioned it appears that you are having CKD and hypothyroidism and your thyroid test results show that it is still uncontrolled. You must take Nature Thyroid 32.5 mg two days a week Saturday and Sunday, and for the remaining five days weekly Monday to Friday take 16.25 mg. Repeat your thyroid function test after six weeks and then we will review again." "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 on antipsychotics - Amisulpride 100 mg and Abilify 20 mg. Can I have green tea extract along with these drugs? ### Response: Hi. I have read your concerns. Green tea extract has very good antioxidant properties. Its antioxidant properties equalthat of vitamins A and E. So, you can take it along with your antipsychotic medications. However, do not have more than three cups of green tea extract per day. Adverse effects may occur when taken in high doses. Consult a psychiatrist online for further queries" "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 my friend\s dog licked my hand and I ate food with that hand without washing it. The problem is that I also have a bleeding gum. Am I at a risk to contract any infections or diseases specifically rabies? Kindly advice as I am a little apprehensive. ### Response: Rabies virus is found in the saliva of the infected dogs (not all dogs). Infection can be transmitted through biting of infected dogs where saliva directly reaches our blood. So theoretically you can be infected but in reality, there are very few cases that infection is spread by licking. The crucial issues here are: Regarding other infection, you should not worry" "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 received a test back from my immunologist and I am trying to understand what it means. I am suffering from fatigue and chronic sinusitis. I have CVID and get infusions every three weeks. I have been having adverse reactions to the infusions. So, they ran several tests and this is one that came up. Before seven months, it was completely normal. Just want to understand what this mean. Thyroglobulin antibody measured by Beckman Coulter Methodology. The value is 12.9 IU/mL (0.0-0.9) completed high. I have attached the report for your reference. I have low IgG, IgA and IgM. ### Response: Hi. This is a test to detect whether your body is producing antibodies against your thyroid gland. A high value indicates that your body is producing antibodies against your thyroid gland. In simple words, it means your body is itself destroying its own thyroid gland." "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: Recently, I have noticed two little white pimple-like dots next to my molar tooth on the cheek and there is no pain. I was wondering what it could be and if it is serious? ### Response: Is your lower wisdom tooth removed? It seems to be a mild epithelial injury which occurs during chewing at the corner of jaws where last wisdom teeth meet. No need to worry about it, as it usually will go away on its own in a week or two. Use warm salt water gargle twice a day for a week or two and if need apply an antibiotic gel at the spot three or four times a day. If it does not go away, show to a dentist to check if the upper wisdom teeth are causing the problem and need to be removed." "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 sore at the middle of my penile shaft. I believe this was due to excessive masturbation and having sex when it was sore and hurting, to begin with. It seems like it is healing up, but I want to make sure. There has not been pus, discharge or pain from peeing. Just the irritated spot has been sore. The skin has turned dark there as it is healing I presume? I have been having sex with the same person for over two years so I do not think it is anything she gave to me as she is clean. I am just hoping this is not some sort of STI. ### Response: Usually, whenever soreness is present over the penis we have to rule out herpes or syphilis. But I have seen attached image (attachment removed to protect patient identity). It does not look like any sexually transmitted illness. For a few days, it is advisable to stop masturbation and you can apply topical antibiotic cream over that. If no improvement, then you have to consult a dermatologist for detailed 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 was just wondering. I like cereal and I try to go with a healthier option that still tastes good. So I found multigrain Cheerios and I thought they would be a healthier alternative to something like Froot Loops, Lucky Charms, and other sugary cereals. I know there are healthier options like steel-cut oats but I do not want to sacrifice all the taste. Just wondering what your thoughts on multigrain Cheerios are and if they are truly a healthier option. ### Response: Hello. When it comes to the content of sugar or high fructose corn syrup or chemicals, multigrain cheerios has it in the same amount as the normal one. Another good habit to follow is to eat one grain in a meal. For example, You should not be eating rice and wheat together in one meal. So multigrain is never the best option" "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 two periods in the same month. The first one was for five days and this one has lasted for six days, but I am still having some blood when I wipe. I do have PCOS and I understand that the period issue could be a result of this. I am feeling unwell and constantly have a headache. The first period was on the 5th and the next one was on the 26th. ### Response: Hi. You need some medication to control your cycle as well as your bleeding. Medications are different according to your need. If you do not want to conceive, a combined hormonal pill is ideal. But, if you are suffering from subfertility, an ovulation induction with a medicine called Clomifene is ideal. Consult your specialist doctor, discuss with him or her and start the treatment with consent. PCOS. Medication. Weight loss." "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 husband is 43 years old, and he refuses to visit a doctor. He used to suffer from joint tuberculosis five years ago, but after some hard levels of medications, he became healthy again. Now, almost every night, he has a mild fever, and he has become sensitive to light, and he has horrible headaches. He does not have enough energy, and he looks confused (he cannot concentrate on what he is doing). Once he passed out and it took some minutes untill he was conscious again. What is\x80\x8b going on with him? ### Response: With a past history of tuberculosis and now having mild night time fever with headache and getting episodes of passing out points toward some kind of infection in brain, may be tuberculosis of brain. It is a serious issue. I suggest you to take him hospital. He requires admission and detailed investigations. Tuberculosis of brain. MRI Brain with contrast.EEG.CSF Examination (only after admitting in hospital).other routine tests. |" "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 54 and passed by menopause. Recently, I had done my lower ultrasound due to heavy back pain, and ultrasound shows pelvic inflammatory disease. Suggest me what to do, pain is not bearable. I am already taking BP and cholesterol medicine on a regular basis. Kindly suggest. ### Response: Hi. You said severe lower abdominal pain and the ultrasound report came as pelvic infection disease. Are you having any white discharge per vagina or high color urine?" "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 taking Xarelto 20 mg daily for DVT from the past four weeks. My blood work shows increased AST, which is double than normal, and ALT, which is triple than normal. Should I take today\s dose? I take a lot of medicines for different health conditions. I have attached the photo of my prescription. ### Response: Hope this information will help you. Consult your treating doctor and discuss all these issues. Wish you good health" "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 mild localized effect of meralgia paresthetica on my left leg in the knee area with mild numbness around the localized knee area. I have mild pain on the left leg behind the knee disk from two years. The doctor gave me Etodolac 400 mg twice a day and Pantoprazole. My total cholesterol is 220 with triglycerides 310 from the last five years. Right now, I am taking Amitriptyline HCl 10 mg at night. Kindly advise about the safety of Etodolac. Internet sources threat about a stroke, heart attack, and stomach bleeding. So, I am worried. Kindly advise. ### Response: This professional advice provided by me stands subject to the actual examination of report/image and is based entirely on inputs provided to me. It should be correlated with clinical findings. Regards" "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 brother is a Thalassemia major patient. He goes through regular bi-weekly blood transfusions. He has been also taking one Desferal injection on daily basis. Recently T2 MRI scan was done for him which shows a severe amount of iron in heart and liver. I need your expert advice on chelating iron from heart and liver. Please suggest. ### Response: Hello. Sorry to hear about your brother condition. To treat chronic iron overload in the body due to thalassemia major, he can be given an intravenous injection or subcutaneous infusion of Desferal. Usually, in such case, 1 to 2 gm daily dose of Desferal might be needed. The only thing can be done for such iron overload due to thalassemia is Desferal injection or subcutaneous infusion. There is no other specific treatment for such iron overload apart from Desferal. You need to visit hematologist or trained pediatrician nearby for Desferal therapy. Unfortunately, no other treatment option apart from Iron chelators is available." "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 lower back pain in the morning and from recently, I cannot bend and I have weak legs and pain in the calves, hips, and hamstrings. I did some X-ray. Can you interpret it? ### Response: I have seen your reports (attachment removed to protect patient identity). Your X-rays indicate changes of spondylitis in the form of disc space reduction and osteophytes. For the symptoms you have, I would recommend an MRI of the lumbar spine with whole spine screening and back strengthening exercises" "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: Every time when I breathe, my left side hurts. It also hurts when I take a deep breath too. I do not smoke. What could be the problem? ### Response: Hi. I would like to know the following details before proceeding into diagnosis and management of your illness. Revert back with the answers to a family 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 had a brain scan, as I had a severe headache when flying recently. The CT scan revealed the following images that I have attached. My GP is not sure what it is and has referred me to a specialist. The waiting period is a few weeks, so I am obviously concerned and stressed. Please, can you let me know your thoughts? ### Response: The CT scan (attachment removed to protect patient identity) is suggestive of sinusitis. The images you have sent are not complete. Kindly send more images. With present images, you seem to have a frontal, maxillary, and sphenoid sinusitis, which is giving you headaches. During the flight, the pressure in our hollow bone (sinuses) changes, and since your sinuses are infected, you have pain. Kindly send more images to know the extent of the disease. Revert with more information to 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: My father had cataract surgery yesterday. His sugar levels were fine before surgery. Today he was given a Dexa injection 2 ml in his eye due to inflammation. After that the sugar levels have stayed between 280 -300 through out. Just before dinner, his sugar levels were 300 mg/dL. As advised by our doctor have gave him 16 units of Mixtard instead of 14 which he takes regularly along with regular sugar medicines.My questions are: Does Dexa injection increase the sugar so much and when will the effect go? In addition, he is also putting one drop of steroid eye drops Predmet every hour. From tomorrow, it will be once every three hours. Can this also increase the sugar level? From tomorrow how should we manage the sugar levels? Will the effect of steroids go away? Please see the attached prescription of all the eye drops after cataract surgery.He is taking Mixtard Insulin 30/70 - 50 units in the morning,14 units in the night, Glycomet GP2 1-0-1, Linagliptin 5 mg 1-0-0, Fibator 10 mg -0-0-1, Metolar 25 -1-0-0, Dynapres 0.4 - 0-0-1, Arreno 1-0-1, Ecosprin 75 1-0-0, Thyronorm 25 mg one tablet from Monday to Thursday and two tablets from Friday to Sunday, Cap Uprise once a month. ### Response: I just read your query and from what you have mentioned it appears that your father's blood sugar has increased because of steroids. As for your questions let me answer them one by one. Yes, Dexa injection increases the sugar so much and it will have decreased effect once your father is off steroids completely. Regarding managing the sugar levels, if his fasting is above 250 then increase his evening dose of Insulin by adding two more units. If his dinner blood sugar is 250 mg/dL above then add two more units to his morning dose of Insulin and continue monitoring accordingly. If" "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 erosive gastritis two years back and my latest endoscopy shows that it has been completely treated. But over the course of taking PPI, I noticed undigested stool and a feel of bloating even after taking medication. My doctor prescribed Sibofix, Darolac and Normaxin for a month as he said it might be a case of IBS. But, I do not have diarrhea, stomach pain or anything. It is just gas irrespective of empty stomach or after eating. I belch all the time. My endoscopy, stool culture, blood test, T3, T4, TSH, BP and sugar were normal. Can I take Normaxin for two more months as it helps a bit? Please advice regarding my situation. It would be a tremendous help. ### Response: Hi. I read your query and understood your problem. CBC (complete blood count) and LFT (liver function tests). Dyspepsia (indigestion). 1. Avoid spicy food, cabbage, cauliflower and salad.2. Avoid stress. Revert back after 15 days to 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: The gynecologist told me not to have an intercourse because I was having some brown spotting but it stopped and I had a little bit of intercourse but now I am scared something happened, should I be worried? ### Response: Brown spotting may be due to vaginal or cervical infection. And infection can be from your partner or you can transmit to your partner. So that is the reason doctor told not to have intercourse." "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: Serum GGT levels are elevated despite giving up alcohol. Even before, the frequency of drinking was maximum once in a week (90 ml). What does this imply? Please help. ### Response: There are a few questions regarding your health and lifestyle that would help in finding the answers to your query. 1. Have you had any jaundice recently or ever? 2. How long have you been taking alcohol? 3. Is there anyone in the family (siblings, parents) who has had liver problems? 4. Have you lost weight, how is your appetite? The reports are from last month, do you have any reports from before this (attachment removed to protect patient identity)? Have you done viral markers, like hepatitis C and B? The report shows raised GGT, but in your query, you had mentioned about gall bladder stones, but the report of ultrasound is KUB, which does not mention anything about liver, gall bladder or bile ducts. There are no reports of CBC (complete blood count) as well. Please do a repeat CBC, full ultrasound of abdomen (to look for gall stones and bile duct) and send." "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 neck has become very stiff that I cannot rotate my head easily in either direction. Even after two months of exercise (self-selected), there is no improvement. What could be possible causes and possible solutions? ### Response: Is it just a stiff neck or also do you have electric shooting pain in the arms and numbness or weakness? If it is only the former, then, oddly, the stiffness has not improved over a period is two months. I will advise you to have an X-ray cervical spine AP and lateral. Do you have any other symptoms like fever weight loss, night sweats, etc.? Please upload the X-rays. In the meantime, take Tolperisone 450 mg once a day to help with the stiffness. Also, try hot packs and take an anti-inflammatory tablet like Voveran SR (Diclofenac) 100 mg once a day after meals. If you do not have diabetes and kidney problems take Pan 40 (Pantoprazole) as an antacid before meals." "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 swelling on the gum by a back molar. It opened and discharged some pus and blood. Currently, I am taking Norvasc, Levothyroxine, Lisinopril, and Gabapentin. ### Response: Swelling of the gums with pus discharge is definitely a sign of an infected tooth. The tooth should be loosened in the socket by now because of the pus formation. Ideally, depending on the total number of remaining teeth you have and the strength of the tooth, the treatment plan can vary. If it is not strong enough to undergo a root therapy, then it is best to get it removed. For momentary pain relief, you shall take tablet Paracetamol 500 mg thrice daily for three days or until you visit the dentist" "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 weeks pregnant, and I am using 20 units of Corparin injection daily. On the first day, I was given 20 units, and on the next day, I was given 40 units. Will it cause any harm to my pregnancy? ### Response: Hi. Corparin (Enoxaparin) has low molecular weight. It blocks the formation of blood coagulation proteins, and it prevents the formation of blood clots. So the blood flow to the baby will be good. There will not be any rejection of the baby tissue by your body. Thus it reduces the chances of abortion." "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 patient of bipolar disorder. I am not experiencing bipolar disorder symptoms for more than two years. So, can I leave medication gradually? I have completed my education during my treatment. I was diagnosed with this disorder a few years back. I am constantly being treated for the past six years until now and unable to understand the timing of leaving the medication. I skipped the medicines all of a sudden two times before but not after that. My psychiatrist says that you are in a stable condition, but I cannot tell you when I shall end your minimal medicines. He even does not give any clues about this to my parents. And, all of us are confused and upset because of this condition. Please advise.I am currently taking Adablizer 10 mg 1/4th tablet only at night, Oxalepsy 300 mg one in the morning and one at night. ### Response: Hello. Normally, after the first episode of bipolar illness, medicines are advised to be taken for one year and stopped slowly. After a second relapse it is advised for two or three years and then stopped. For the third relapse, it is to be continued lifelong. If you have taken them regularly as you have said, you can try reducing them slowly over course of four to six weeks and if you feel that symptoms are recurring you might need to go back to the previous dose you felt comfortable on. Reduce Aripiprazole 10 mg to 5 mg for four to six weeks. Then reduce Oxcarbazepine 300 twice to 300 half in the morning and one at night for four weeks. Then make it just one tablet at night. Then Aripiprazole 5 mg half for four weeks. Then 300 mg half for four weeks. Finally, you can stop Oxcarbazepine and lastly after another four weeks stop Aripiprazole." "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 54-year-old father had been operated for gallbladder 14 years ago. Since then, his liver enzymes like SGPT and SGOT remain at 55 and recently his ALP was seen 140 and GGT at 79 which became normal after taking Udimarin Forte tablet. After stopping the medicine, the ALP again increased to 278. He takes Thyronorm 75 mcg for hypothyroidism and Cilacar 10 mg, a BP medicine.For triglycerides, he takes Rosumac F which got changed to E-Cod Plus. He also has a deficiency of vitamin D and takes Uprise-D3 once a week for that. He does not have any symptoms now but before sometimes he complained bitter taste in the mouth in the morning which went away after taking Liv.52 DS which he currently takes. He is a nondrinker and a nonsmoker. Is there anything to worry? Please help. ### Response: Hello. There is nothing to worry. Possibly, he has mild fatty liver because of which SGOT (serum glutamic oxaloacetic transaminase) and SGPT (serum glutamate-pyruvate transaminase) are mildly elevated. However, the ALP (alkaline phosphatase) is elevated in either obstruction of the bile duct or due to bone disease like vitamin D deficiency which he has. I would still suggest an ultrasonogram of the abdomen to look for fatty liver and CBD (common bile duct) anatomy" "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: This mole of mine has gotten darker. Can I send a photo and can you please tell me if I should be concerned? ### Response: I understand all your concerns. Please send some clear photos of the mole and measure the size of the mole" "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 13 years old and he has bleeding nose problem. Kindly advice. ### Response: Bleeding at this age should be evaluated thoroughly there may be a lot of possibilities like a JNA (juvenile nasopharyngeal angiofibromas), NPC ( nasopharyngeal carcinoma), nasal polyps hematological causes, etc. So an urgent diagnostic nasal endoscopy with a complete blood count should be done if there is persistent on and off bleeding (profuse) from the nostril. Also, take the history of any trauma to the nose." "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 it okay to get a tooth cavity filled without getting it cleaned post-five-day prescription of two tablets? Does this have consequences? ### Response: The cavity is always cleaned before filling it up. Five days medication is fine that is to subside any further infection. Caries, if present, are never left as it is. There may be another case if it is simply a hole or broken area and not carious but that is also irrigated for once atleast." "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 a headache two to three times also during the night once or twice. The pain is severe and only in my right temple. The pain lasts for 15 to 40 or so minutes. Pain pills do not work at all. It is not a throbbing pain. ### Response: Hi. The kind of headache you have could be either a cluster headache or a migraine from the description you provided. However, if it is accompanied by other symptoms, like vomiting or neck stiffness or feeling dizzy or visual disturbances then it needs to be further assessed for any underlying pathology. A cluster headache is usually very intense and lasts for weeks at a stretch and it can even be refractory to mild painkillers. It is also associated with eye-watering, photophobia, etc. This could be your first attack as it usually presents in the 30s. It would be helpful to know if you have other symptoms and more detailed description of the pain, its nature, whether or not it radiates, etc. Please provide me with details so that I can suggest an appropriate medication for 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 friend has a blood count of 32,000 cells/cu mm. He has been suffering from dengue for four days. He is admitted to a hospital for the same. The doctors are saying to conduct a blood transfusion. I am not sure what that is. Kindly reply. ### Response: Hello. Hope your friend recovers soon, without having to go through a platelet transfusion." "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 battling with back pain since a year. I associated this pain with a kidney stone which I had for a couple of years. I had a ureteroscopy, crushing and removal of the stone a month ago, but however the back pain still persists. An x-ray done today is attached. I had some back pain before two years due to herniated disc. I have undergone bariatric surgery for weight loss. My weight today is 113 kg. Five months before, during the gastric bypass surgery my weight was 145 kg. My worry is that I cannot exercise or walk long distances. As soon as I walk for 5-10 minutes the back pain is terrible and I need to either sit and rest the spine or press and stretch my back to get some temporary relief. The pain is quite unbearable. I current taking Ultracet and Myoril 8. Please do suggest the best remedy to enable me to become pain free at the earliest. ### Response: I have gone through the investigation reports (attachment removed to protect patient identity). 1. MRI of dorso-lumbar spine with extension to LS junction.2. X-ray LS spine (lateral flexion and extension views) to look for the amount of instability at L4 - L5 level. Revert back with the investigation reports to a spine 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 always have low WBC since childhood. I had a blow job, and inserted my finger in her vagina, and I am afraid because I might have rubbed my eyes after that. Am I at risk for HIV? ### Response: Hello. The chance of transmission of HIV by blow job is almost nil unless, there are bleeding wounds in both the partners, in the area of contact. It is very unlikely. So there is almost a nil chance. The transmission of HIV by finger insertion is also nil. Skin is an effective barrier. HIV does not survive in the environment or on hands for long. So the chances of transmission of HIV through eyes is very very minimal or nil. So the risk is almost nil. If she is negative there is no risk at all. You can get her tested. You can also get tested by antibodies test after three months of exposure. Else do an HIV RNA PCR test after 10 days of exposure." "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 currently have tonsil stones that do not occur every day but at a rate of three to four a week. Also, I notice it does not take much for me to get hoarse and my voice cracks for no reason when talking. I have also noticed that my sense of smell is off. ### Response: Tonsil stones are a sign of chronic tonsillitis. They occur due to the accumulation of food debris in the tonsil crevices. Follow up with the required information so that I can suggest you better. Regards" "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 herniated disk in the neck area. Later, my right hand started tingling and the numbness grew more pronounced. I also started having burning pain on the back of both thighs. I have had some muscle twitching down my right arm. I am having accuracy issues with typing now. I had another epidural and trigger point injects four weeks ago, but it does not seem to have done much this time. This week, I started having numbness in my toes and some burning there. My legs just do not feel quite right and maybe a little heavy. The thighs are still burning on and off. Do you think it is possible that my cervical issues at C4-C5 or C6-C7 could be responsible for both the hand and legs? Do you think I might have a lower back issue? ### Response: Hello. MRI cervical spine with images, neurological charting of extremities, vitamin D and B12 levels. Will advise once a provisional diagnosis is established. Revert back with the reports to an orthopaedician and traumatologist 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 23 year old male in good health.My knees feel stiff and weak when walking. It also happens on my finger joints. Also, I sweat a lot and my hands start shaking (fine tremor) with light activity. I do have a generalized anxiety disorder. Are my symptoms GAD-related? This started a month ago. ### Response: Hello doctor. Generalized anxiety disorder is one possibility, but also we have to exclude other organic causes like for example hyperthyroid disease (by testing TSH, T3, and T4). If you have performed any blood tests please send a copy of them. One thing that differentiates between anxiety and thyroid symptoms is night symptoms that are present in thyroid and not in GAD. Symptoms of hyperthyroid may include also: diarrhea, racing heartbeats, weight loss and/ or insomnia. So, if you experience any, do not hesitate to inform me in a follow-up query. Hope you find my answer useful. Your feedback will be appreciated" "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: Hi,A pimple popped out on my face yesterday. Now it has become bigger. Are there any chances of it getting infected? What do I do? ### Response: Hi. First thing is that you should never touch or squeeze a pimple. Wash your face three to four times a day with soap and cold water. Apply Clindamycin ointment three times a day for a week. This is a topical antibiotic and this helps in preventing the infection. If the pimple does not subside even after a week, consult a dermatologist online to know if you have to take oral antibiotics. -" "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 query is about my sister. She is a 31 year old female who is unmarried. Her height is 5 feet and she weighs 55 kg. She is suffering from huge uterine fibroid measuring 140 x 83 mm arising from the right fundus of the uterus. I would like to know what are the best treatment options available? Can natural treatments be tried upon? We have tried ayurveda, which helped only in shrinking bulky uterus but not fibroid. How serious is this condition? She is pale and underweight. Will surgery cause difficulties? Please guide. ### Response: As this is a subserosal fibroid, she is unmarried, the remaining uterus is bulky but endometrial lining is normal and there are no other intramural fibroid detected, the best form of removal for this large fibroid would be through a laparoscopic approach. A laparoscopic myomectomy can be performed through 3 hole technique and the fibroid can be removed with the help of a morcellator by slicing it into pieces before removal through the port entry puncture hole." "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 fiance\xc3\xa9 had her last period on the 6th. On the 25th, my fiance\xc3\xa9 and I had physical intimacy but no intercourse. But she did not have her periods until now. She did a urine pregnancy test. It shows negative. We are very fearful after reading that pregnancy can happen even without intercourse. So she met a doctor yesterday and told only about the delayed periods and the doctor prescribed Deviry 10 mg for five days (taking for the last two days). But still she is tensed and so could you help us on the following: What may be the reason for the delay? Could you please tell us how we can 100 % confirm pregnancy? ### Response: Hello. How are you doing? I do not think you need to worry about pregnancy, as the urine test is negative. It detects hormone levels of above 25 miu/ ml. But if you want to have a final confirmation the best method would be to have serum Beta HCG. This will detect the smallest of pregnancy anywhere in the body. Even those less than 25 miu/ ml can be detected. 100 % confirmation test. Pregnancy need not be the only reason for the delay in periods. Other possibilities are: Hope I have clarified your query, do write back if any more queries" "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 my periods today. Can you suggest a medicine to stop the bleeding for two days since I have to attend a holy ceremony tomorrow? ### Response: I have gone through your history and understand your concerns. 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: My father is in the hospital fighting pneumonia and has COPD. His latest X-ray has shown some improvement. The X-ray shows he has an extensive airspace and interstitial opacities in the left lung and patchy opacity in the right lower lung. The plan is to do a bronchoscopy and use a tube to assist in getting him oxygen. ### Response: Hello. I have gone through the history of your father\s illness you have provided (attachment removed to protect patient identity). The X-ray reports are suggestive of pneumonia. At this stage, on initial antibiotics and supportive treatment, if he has not improved, bronchoscopy may be essential to isolate the organism that has caused pneumonia. This will help to guide antibiotic therapy. By tube to assist oxygen, they are possibly implying putting him on a ventilator? That may be necessary if he is not able to breathe on his own adequately to maintain oxygen in his body" "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 major complaint is headache and dizziness. This has been ongoing for years, despite being to several doctors. I am currently on Levothyroxine for hypothyroidism along with Bisoprolol for IST. I have had an MRI and CT scan done on my head, both of which came back abnormal. My doctor has sent in a referral to a neurologist, but he has yet to look at any of my information. I just want an opinion to begin with. ### Response: Hello. Regarding your concern, I would explain that these CT scan and MRI findings are not related to the headache and dizziness. (attachment removed to protect patient identity). I would like to know more about headaches. Is it throbbing or like pressure? Do you feel nausea during the headaches? How long do they last? Do you tolerate the light during the headaches? In my opinion, considering the location of the headache in half of the head, it could indicate migraine. I would recommend starting therapy with Sertraline coupled with Verapamil. Regarding the MRI findings, in my opinion, they could indicate a normal variation of the brain structures. Anyway, a brain MRI after a year would 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 have an 18-month-old daughter. My daughter has had trouble with her bowels since she was 8 months old, she finds it impossible to do a normal stool. She strains and screams to the point, she falls asleep from exhaustion and still does not pass stool. She does have a regular bowel movement but she is in constant pain while doing it. Her stool has got to the point of having blood in it. I have taken her to numerous doctors and tried just about everything possible to help her. Her current specialist has given her the same medicine which I have stated does not work. It does not matter what the dosage is. I have contacted him to tell him it does not work and he has just said to change her to another type of laxative. Laxatives do not work for her. I feel it is something more serious. So I was just wondering if you could take the time out to give me some advice on what I could do or what might be wrong with my daughter. I cannot handle watching her be in pain anymore. ### Response: She has chronic constipation. As you have noticed blood she also may have fissure in anus due to which she has extreme pain. Give her lots of water and a high fiber diet. Give either one of them every day along with fruits and vegetables. You can try lactulose suppository for a few days which may prove more effective than syrup. Secondly, make her sit in a tub of lukewarm water with few" "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 condyle on my left side, causing my right side to do most of the work. I have a larger right cheek, and my face is off-center. Is there a safe procedure to replace the condyle that is missing? ### Response: Hello. I have read your history and complaint. The reason for the reduction in the size of the condyle could be as you said. The tumor infection could have entered the left joint capsule and gradually wearing it off. At this stage, our concern should be if this reduction (acquired condylar resorption) is going on or has stopped. This can be checked through a CT scan. On a positive note, there are treatment options available to solve your problem, which is by a procedure called distraction osteogenesis. But, the outcome of the procedure or even the treatment plan depends on various other factors. This is hard for me to search for which I would refer you to an oral and maxillofacial surgeon. An examination with the surgeon can give you elaborate details in the same, and if you would be a suitable candidate for such surgeries. I hope you got an idea of what I am trying to say." "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 48 years old. She is suffering from constipation with an anterior anal fissure for the past 10 years. Her TSH value is 7.01 mIU/L. She is taking two tablets of Bisacodyl BP 5 mg during night time every day. Now, I would like to know any suggestion from your side. ### Response: The anal fissure can be painful, and it can lead to constipation. The USG (ultrasonography) abdomen scan should be done to rule out any organic cause if present. As the fissure is present for a long time, she needs surgical management. For proctoscopy examination and operative management, you have to consult a surgeon" "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 red rash slightly above my lip line. It is dry and sometimes a little itchy. I did not use to have it, but it started around the time my partner got on acne medication and it does not go away, with the exception of when I traveled abroad for vacation. For some reason, it went away when I traveled. I have gone to two dermatologists, but I am looking for an actual solution other than it is stress. I have been stressed before and this did not happen. ### Response: Your concern is perioral dermatitis. It may be secondary to cheilitis as well. I also suggest using a 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 am a 72-year-old woman and having back pain for more than three days across the lower back and sides. It feels like inflammation. How can I tell if this is simple back pain or kidney problems? I take Lithium twice a day (bipolar) and Levothyroxine. Also Vitamins, Fiber gel tablet and occasionally Melatonin and Ativan for sleep. I have been on Lithium for over 30 years. I understand it can impact the kidneys. My liver and kidneys tested normal two months ago. I usually take Aleve for pain but yesterday, I accidentally took too much Vicodin for pain and had reactions (hot flash, nausea, and vomiting). Today I am off from all painkillers and using hot or cold compresses and rest. Kindly advice. ### Response: If your pain is aggravated by movements and improved by rest, then it is probably due to musculoskeletal rather than kidney problems. One of the tests to find out is to do a urine test to find out if there are signs of infection or blood. You mentioned that you have fatigue. And in this case, I would recommend that you visit your doctor to have blood tests and MRI (magnetic resonance imaging) scan of your back as soon as possible" "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 I had sex with sex-worker, I put my penis inside underwear before removing the condom. Her vaginal fluids would have spread in my underwear. After one minute, I removed the condom and put it back in the underwear. The penis could have touched vaginal fluids in the underwear. Is there any chance to transmit HIV by this? ### Response: Hi. The answer to your question is simple. How long do you live in water? The same is applicable to HIV virus too. How long HIV virus survive in outside environment? Here the answer is a minimum of eight seconds and a maximum of 30 seconds owing to environmental temperature. So, in your condition, even if she is infected, having a virus in vaginal fluid and then on your underwear, the virus is not able to survive in the outside environment and again virus has no capabilities to breach skin and pass into the body. So, the chance of acquiring HIV in the context you explained are not valid for transmission in any way. So, nothing to worry." "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 uneven skin tone with dark forehead and dry skin. I want to brighten my complexion. Also, I have small bumps and ingrown hair after waxing. I have attached pictures of the same. Please suggest a treatment. ### Response: Hello. I have read your query and examined your picture (attachment removed to protect patient identity). Consult your specialist doctor, discuss with him/her and take the medicines after 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 am 88 yrs old. I have a rectal or vaginal fissure I guess. The fecal matter comes out of my vagina. Sometimes, I have a regular movement but still have a liquid form from the vagina. I do not want surgery. What can I expect for the short term of life I probably have left, if I do not have surgery? The odor is my biggest problem. ### Response: Hello. It is very sad to know about your condition. I can understand that at the age of 88 years, how you feel and suffer. But foremost, you need to get examined by your gynecologist. If it is a rectovaginal fistula, the only way to provide relief is by a minor surgery called colostomy in which a small opening will be made on the abdomen from where your fecal matter will come out. You need to apply Vaseline and an Estriol cream mixed together on your thigh and vagina so that the fecal matter does not cause skin reactions. The only way to control the odor right now is to wear diapers followed by colostomy." "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 13 weeks pregnant. I got a double marker test:hCG free beta-62.50ng/mL.PAPP-A - 7.17mlU/mLTrisomy 21-1:250Trisomy 18/13 -1:100NT-1.00 mmNT MoM\s -0.63MoMCRL -61.8mmIs there any complication? ### Response: Hello. I have gone through your attached dual screen report and it shows low risk for all the chromosomal abnormality which is absolutely normal. In your case, all are at low risk. So, stay calm and enjoy your pregnancy" "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 this sudden sore at the tip of my lips. I am wondering what could it be. I used to have frequent fat sacks, but this seems very different. I am attaching a close-up photo of it. Please advice. ### Response: I have gone through your complaint and have seen the attached photograph (attachment removed to protect patient identity). You are having herpes infection which is a viral infection. You should try taking a course of antiviral like tablet Acyclovir 400 mg thrice in a day for 5 days and apply a topical antibiotic like Mupirocin on the affected area twice daily. This will resolve the lesion within 4-5 days. This disease has a tendency to recur as the virus lives in the nerves of the host. Stress, ultraviolet radiation, surgery and infections can cause recurrence of the infection. This viral infection is caused by herpes virus. Herpes labialis The recurrence of herpes infection can be prevented or reduced in intensity by the use of a sunscreen lotion on the lips. So once the lesion heals, start applying sunscreen on your lips." "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: Recently, I did a full blood workup, and my eosinophil count, WBC, and B12 levels are high. I am a chronic sufferer of pouchitis. My creatinine and Bun levels are normal, like all other levels. I often take many supplements daily. Can you please help me? I am scared. ### Response: I have gone through the attachment (attachment removed to protect patient identity). Your B12 level can be high due to an intake of many supplements that contains B12 within it. Your eosinophil count can be considered very high. Usually, it is elevated in the case of allergic inflammation or hives like a problem. Chronic skin lesion like eczema or parasitic infestation can lead to such presentation. So consult a nearby physician for detailed evaluation. You can take anti-allergic medication like Fexofenadine and Levocetirizine combination for seven days. Then, you have to repeat your full CBC (complete blood count) with peripheral smear 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: I cannot control my mind from using internet. Please share with me if any solutions are available. ### Response: I understand your problem. Social media kind of increase dopamine levels in the brain. Hence, they could be addictive just like cigarettes. Hence, hard to control. What you need to do is you have to make your schedule tight. Define a short-term goal, focus on achieving it. Reward yourself when you complete the task. This would definitely help 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: 10 days ago, my left eardrum ruptured by my mistake. The doctor said that it will heal on its own in two weeks time. He did not prescribe any medicine. Now, from two days, there is numbness and weakness on the left side of my face. There is mild pain around the ear, jawline, backside of the head. I have anxiety problem too. What should I do (any tests)? ### Response: Hello. You have said about numbness/weakness on the left side of your face. Is your mouth deviating towards the right side or your left eye not closing properly? If that is so, it may be a weakness of one of your nerves that supply the muscles of the face (the facial nerve). Do visit your ENT doctor so that he can have a look at the current state of your 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: Recently, I took out my bottom left wisdom tooth. I have got stitches over the extracted site. I have been taking Paracetamol and Ibuprofen 400 mg. Still, I have pain in the extracted region. There is no pus coming out from the gums. It looks swollen, and it is not red. Is the pain normal? Please guide me. ### Response: It is not normal, and it is a sign of infection. There can be a root tip or a bony spicule left in the extracted site. Consult your dentist soon. Kindly take a radiograph of the extracted site soon and correct the problem if there is a presence of root tip or bony spicule in the extracted region. You can take tablet Ofloxacin 200 mg and Ornidazole 500 mg two times a day for five 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 have a sickle cell trait. I was diagnosed with pcos and pmdd. I got a colonoscopy done for chronic constipation. But, the report was inconclusive. My main concern is that, my body is producing lot of male hormones. Due to which, I have a lot of facial hair and have a deep voice. On a regular basis, I have low blood sugar as well as low blood pressure, chronic fatigue, and chronic lower left abdominal pain. My periods are regular, but they are very heavy. I do have shortness of breath, muscle ache, headache, nausea and weight gain issues. Also, I am dealing with depression, mood swings, trouble to concentrate and at times insomnia. I am taking tablet Metformin. I am attaching all my reports for your reference. Please check them and guide me accordingly. ### Response: Hi. I have gone through your reports (attachment removed to protect patient identity). You have multiple issues with your hormonal levels. I will provide some guidelines which you can proceed with: Your TSH (thyroid-stimulating hormone) is very low. This means you are overproducing thyroid hormones and having hyperthyroidism. This causes anxiety, anger, palpitations, fatigue, muscle pain, intense bleeding during periods and depression and also leads to weight loss. The dose can only be calculated by proper examination and evaluation of the patient." "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 plica removal surgery six days ago. How do I ensure a good recovery, without scarring inside the knee? How much can I and how much should I exercise in this knee, and how? ### Response: Hello. Plica is a tissue that remains behind when the knee joint is formed (from multiple small pockets). In some, it may be a very tough structure and cause rubbing when the knee bends. Once excised it will not grow back and movements will not make this worse. You are allowed to do everything as soon as the pain and swelling subside." "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 issues with my left ear for the past two months. I normally clean my ears with peroxide. After I added drops of peroxide back last month, I noticed that when people spoke to me loudly I would hear wind sound in my ears. Also, my ears felt plugged and I heard thumping (heartbeat sound) in my ear.Two days ago, I attempted to clean my ear with a home irrigation system. I was able to dislodge a large piece of dried, white wax. My ear felt the best in a long time. I was hearing clearly and the sounds in my ear went away.Yesterday, my ear felt plugged again. So I irrigated my ear and nothing came out. But the plugged feeling and sound went away. This morning my ear felt plugged again, and I irrigated my ear and nothing came out. But my ear felt clear and the plugged feeling and sound went away. What is causing this issue? Why does it keep coming back? ### Response: Hi. It looks like your having a eustachian tube catarrh. This tube essentially ventilates both the ear and nose and in an event where this tube has got blocked, you might develop fullness and ringing sensation in the same ear. Self-cleaning your ear is the most dangerous thing you can ever do. Never introduce peroxide or any thing under doctor\s advice as it can be disastrous considering the ear and it is related structures to be one the most sensitive regions in the body. Another possibility is that there could be some remnant wax in your ear which can be the reason for you developing this ringing sensation on a regular basis. Other than this, take tablet Sinarest (Acetaminophen, Chlorpheniramine, and pseudoephe" "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 sagged skin in lower abs. Please help. ### Response: Definitely, the excess fat in the flanks and the sagging skin on the anterior tummy can be removed. We do call the procedure as a mini tummy tuck. That will help you in getting a good shape for the abdomen." "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 in a new relationship. I am wanting to impress my partner sexually but my problem is I am getting erection problems in front of her but in the home, when I am alone my erections are normal. Is this some sort of psychological issue? Is this common? How to overcome it? ### Response: Hi. Yes, what you are suffering from is psychological as you only face this problem in front of your partner and not when you are alone. This has to do with performance anxiety as you already feel the need to impress her so your anxiety is acting out in this way. This is quite common, particularly in young adults. You can overcome this by self-counseling and keeping your anxiety at bay while you are being intimate with your partner. If this does not help then you can get professional psychotherapy. Psychogenic erectile dysfunction Counseling Reduce anxiety, practice breathing exercises.-" "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 cough and frequent urination. My CT scan report suggests interstitial lung disease. Multiple lymph nodes are enlarged in the abdomen. Please advice. ### Response: The cough could be due to your interstitial lung disease problem. You can be prescribed steroid medication for that lung problem. Avoid smoking because it can worsen lung disease. The frequent urination could be due to urinary tract infection like problem. I suggest you investigate with urine routine microscopic examination for primary workup. Do not take excess spicy foods. The antibiotic course can be prescribed if urine shows pus cells and bacteria. You have to repeat ultrasonography scan or CT scan once the infection is resolved. If lymph node enlargement persists than you have to consult nearby physician for detailed evaluation. I hope I have answered your question. Let me know if I can assist 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: I am a female, and I am primigravida (17 weeks and 6 days). According to my LMP, I am 17 weeks and 6 day pregnant but according to my NT scan (done in 12-13 week )-gestation period showing pregnancy of 18 weeks and 3 days till date. Now I have to go for level two ultrasound, and my doctor gave me the date of next month. Will it be fine by this time to go for an ultrasound or late according to my gestation period? As I heard that it should be done between 18 to 20 weeks. ### Response: The number of weeks will be counted according to your scan date. So according to which your TIFFA (targeted imaging for fetal anomalies) scan will be dated. The TIFFA or anomaly scan, which you have mentioned can be done from 18-24 weeks and will give clear results. So relax and do not worry. You can go for the scan as per your gynecologist. However, if you have a doubt then get 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 first molar is paining. I am applying clove oil and had Aspirin. What is the treatment? ### Response: Hi. I have gone through the case and it seems you have an inflammation of the pulp tissue inside the tooth (the sensory area inside the molar). This condition is usually known as caries tooth, bacterial infection has broken the hard tissue of the outer layer of the molar and entered the middle area called dentin. It is the sensitivity area and so there is a constant pain. I suggest you to visit a dentist near to your place in order to clean your tooth from that bacterial infection and to seal it by permanent filling." "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 28 years and 6\1"" tall with weight 85 kg. I had frenuloplasty a few days back and feeling normal about it. Sometimes I get erections, and it hurts a lot as the stitches may be the reason. I want to admit that I had a premature ejaculation issue as well before the surgery. Was it because of this short frenulum, and will it be better now? Also, I was unable to penetrate the vagina easily. Will it be rectified? If no what else should I do?Please suggest. ### Response: I can understand your concern about your symptoms. Yes, for a few weeks you will be having pain. The premature ejaculation could be because of the short frenulum, now after the procedure we will know it for sure. If your premature ejaculation persists, we can think of the other causes. Yes, you will be better after surgery with proper foreplay and appropriate lubrication you can easily penetrate since you just had the procedure. We need to wait for the recovery to to think about other cause of your issue and work on it. I hope I have answered your query. If you have further doubts, I would be happy to help 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 just had my acromioclavicular joint separation (grade 2 or 3), AC ligament torn. I am ready to accept the recovery time. My question is can I do pull ups again in my life? Or any permanent disability may occur? ### Response: Sure the X-ray looks kind of AC joint separation due to the ligament injury. With the image, the injury looks between grade II or III. I will advise you to take the call for the MRI shoulder to focus on the AC joint. This will help us understand the extent of the ligament injury as from outside examining will be a little tough. Once we get the MRI, we will be able to see the internal soft tissues including the ligaments and muscles. Post which your query of doing pull-up can be answered. But for now, do not do any movements of the shoulder and let all the healing to occur. Meantime, please take the MRI so we can judge the trauma to the fibers of the ligament. Once we get hold of the MRI we can plan the exercise prescription if the ligament is not completely torn and in future can prepare you for the pull-ups. In case if found complete tear then can advise for the next course of action. I will wait for your response." "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 24 year old lady and married. I have thyroid and irregular period sometimes. For thyroid, I am taking Eltroxin 75 mcg and I am in control. It has been two months since, I last got my period. We used condom while having sex. For three days, I had light cramps on and off in lower abdomen. Since two days, I am having nauseous feeling. Took a home pregnancy test and got negative result. Kindly suggest. ### Response: Irregular periods are not only be associated with thyroid but few other conditions too. Check this time for your periods. Suppose, you are still not getting, but having nauseous feeling and vomiting sensation, then I would suggest you to get a beta-hCG test done to rule out pregnancy. Beta-hCG test is a blood test carried out that gives more confirmatory and accurate results even after home pregnancy test is found to be negative. No matter whether the results of beta-hCG is found to be positive or negative, I would recommend you to get an ultrasound of pelvis done. If the ultrasound scan turns out to be positive, we can know the pregnancy details. Medicine to get periods can be prescribed if pregnancy is ruled out. 1. Beta-hCG and 2. Ultrasound of pelvis. Follow up with reports to an obstetrician and gynaecologist 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 having kidney stones. Multiple calculi are seen in both kidneys. These kidney stones are there for the past two years, which were smaller in size and were two, and now the number has further increased. I am currently on himalya tablets, Neeri Syrup. I have attached the lab report for your reference. ### Response: Hello. I have seen your report. (attachment removed to protect patient identity). It is a case of bilateral kidney stones that are non-obstructive. Ultrasound is usually operator dependent, and the findings are not always accurate. Hence you have to undergo NCCT KUB (noncontrast computed tomography for kidney, ureter, and bladder) for definitive diagnosis. If that also gives similar findings, then you can either undergo medical management if the CT suggests stone of uric acid composition or surgical management if the composition of stone is non-uric acid.There are a few surgical options, which can be discussed following NCCT KUB. Please get back to me with NCCT KUB." "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 74-year-old male with a weight of 142 pounds and a height of 5 feet 10 inches. I take no medications except Ativan. I take vitamins. I am a non-smoker, worked in the auto body shop for two years painting cars, quit grain farming at the age of 44, minimal exposure to asbestos. I have been suffering from panic disorder for 56 years. Last winter I got a whiff of hot coals while cleaning my fireplace.Radiation exposure includes two thallium test, two barium enemas, one angiogram. Normal chest X-rays until last spring. Last spring X-ray showed scattered fibrosis. Normal pulmonary function test - FVC liters - Ref 4.11, Pre meas 4.18, Pre % Ref 102 ; FEV1 liters- Ref 2.70 , Pre meas 3.10, Pre % Ref 115; FEV1/FVC % Ref 68, Pre meas 74; FEF 25-75% L/sec Ref 2.40, Pre meas 2.35 , Pre % Ref 98 ; FEV3 Liters Pre meas 3.67; PEF L/sec Ref 7.87, Pre meas 10.63, Pre % Ref 135 . What could be causing the fibrosis? ### Response: Single chest X-ray cannot diagnose lung fibrosis and further tests are required to rule out other causes. As you said, the chest X-ray was normal before a few months and now showing scattered fibrosis. It is advised to repeat the X-ray after few days. Once the X-ray is reported as fibrosis, there is suspicion of a chronic irreversible disease known as IPF that is idiopathic pulmonary fibrosis. After this, I would like to clarify that having no significant past medical history of any risk factors, it is advisable to rule out common reversible infective causes like TB (tuberculosis) or pneumonia. Radiation exposure, you listed above, is not significant to cause fibrosis of lungs. But it can be a contributing factor. Chest X-ray is not much sensitive to rule out lung fibrosis and the next important investigation advised is HRCT (high-resolution computed tomography) scan to rule out IPF or other ILD (immature lung disease). In your case, the advancing age of the patient is the most important risk factor to be the cause of scattered lung fibrosis. Looking at the spirometry, it is absolutely normal which cannot rule out IPF and further tests like DLCO (diffusing capacity of the lung for carbon monoxide) with body plethysmography are advised. So in summary, as I said, single chest X-ray cannot diagnose lung fibrosis. Further investigations like HRCT scan, DLCO with body plethysmography and in some cases lung biopsy are must find out the exact cause of lung fibrosis" "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: Dear doctor,I want to test myself for HGH deficiency. Can you tell me a complete guide on how should I proceed? What tests should I do? After I have done them, can I post it here for a thorough examination from your doctors, so that they can tell me whether I am HGH deficient?I want to test that because I have hypothyroidism and I am taking Levothyroxine and my levels are now normal. They were not normal two years ago and I had severe symptoms of hypothyroidism (severe fatigue, severe muscle cramps, lethargy, brain focus problems, pretty much all of the symptoms of hypothyroidism).Moreover, I made tests back then and I saw that my somatoprin levels were a lot below the normal.My reasons for this testing is that I think that this hypothyroidism really has stunted my growth, and pretty much everything in my development. From 16 to 19 years, I have not treated my hypothyroidism and I just lagged behind in development compared to my peers.Now I just want to see if I can do anything. Maybe if I have HGH deficiency, I still could manage to grow a little with HGH replacement or something.My age is 21, I also have beta thalassemia minor. I do not have any other medical issues. ### Response: You need to check IGF1 level (insulin-like growth factor 1), liver function and kidney function tests and hemoglobin level. Also please take an x-ray of your left elbow and left knee joint AP view (anteroposterior view) to assess the bone age, and to check whether ends of the bones still have room enough to allow growth or they have fused. Kindly mention your height and your parents\ height. You may also send your latest thyroid reports." "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 husband is 36 years old. He is fit and healthy, rarely gets sick. But he is a Meth addict. He missed the vein when injecting in top part of his wrist. The injection site looks like a small ant bite. It formed a water blister that he popped and put Neosporin on. But his hand is red, swollen, throbbing and warm. He is in agony. He refuses to go to the ER. Is he in danger of dying? What should I do? How can I treat this? ### Response: This looks like a cellulitis (attachment removed to protect patient identity), it is an infection of subcutaneous tissue. He needs antibiotics and blood test. Convince him for visit. He will need a hemogram test, and blood culture to look for the extent of infection. In treatment, he will need antibiotics like Amoxicillin Clavulanate combination 625 mg three times a day along with some antacid like Pantoprazole 40 mg once a day. For pain and swelling, you can continue Ibuprofen, you can use Magsulf ointment for local application for swelling. He will need higher antibiotics as it appears severe cellulitis. So my advice is to visit ER soon." "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 experiencing flare-ups for weeks now. I do not know if this has something to do with the change of weather. I have been having trouble sleeping lately since I am very uncomfortable right now. I am using Cetaphil gentle wash and shampoo because my scalp gets itchy as well. I am using Elica ointment and somehow it helps me with some of the areas that are not really that worse, however, the uncomfortable feeling is still there. Sometimes I take antihistamines, however, I do not think that it helps me feel relieved with my atopic dermatitis.I am 28 years old and a project manager. My clients are in the US and I need to follow their timezone, my shift starts at 10 PM to 7 AM. I weigh around 190 lbs and I am 5\1"". I also have an irregular menstrual cycle, and I usually get my period every quarter. I have asthma and I am currently taking Seretide inhaler as prescribed by my doctor. Please help. ### Response: Hi. Atopic dermatitis is relatively more sort of relapsing with seasonal aggravation. It has a genetic and familial component as well. If you have severe symptoms which is hampering your daily activities you need to start with systemic immunosuppressants like Prednisolone and or Azathioprine. Elica ointment i.e. Mometasone is good enough for skin lesions. But I would rather add on Tacrolimus gel 0.1% over the inflamed lesions. But you need to use moisturizers very frequently than previous. You need to take antihistamine on a daily basis. Reduce your stress. Avoid wool and strong soaps. Practice wet wrap therapy. 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: Pain in lower right stomach and gas passes many times a day. And some time low burning in urine. No fever or any other problem. ### Response: Take the following medications for the stomach problem. 1. Capsule Esomeprazole 40 mg once daily before breakfast for four weeks. 2. Tablet Mebeverine 135 mg thrice a day before meals for two weeks. 3. Tablet Rifaxamin 550 mg twice a day before meals for two weeks. Avoid spicy food, bakery items, fast food, and caffeine." "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 a crown installed, and last night at dinner, the temporary crown came out.Is there some kind of substance that will hold the temporary crown in until I can reach my dentist? ### Response: You can leave it as such without placing the temporary crown. But make sure you do not bite onto anything until the crown is placed. Another option is that you can dip the temporary crown in water and then place it on your tooth and hold on for a few minutes. The temporary crown usually holds on and will remain intact for a few days. The last option is for you to visit your dentist and get it re-cemented right away" "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 rashes in baby since last week. I have applied Sudocream as advised by a doctor. I have also changed the nappy brand. But now there are small bumps on the back too. Here is the photo from one week and today. ### Response: Hello. I understand the situation you are facing with your child. Baby diaper rash is one of the most common problems encountered with the babies. Clean up soon after baby passes stool. Do not allow moisture to build up in diaper region." "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 20 years old boy. From the last 10 months I am suffering from physical symptoms like a tight band wrapped around my head every time, tightness and little pain in the neck, heavy head, head pressure a mild headache, ringing in the ears, dry mouth, dizziness, nausea, upset stomach, blurred vision, tense muscles, stress about having big diseases like a brain tumor, cancer, etc. I have also got MRI brain, CT scan. ### Response: . You seem to be suffering from chronic tension headache. I would recommend you to discuss with your doctor to start you on tablet Amitryptiline 10 mg once in the night and within three weeks, you would feel better. I would also recommend you to go for a morning walk, meditation and yoga." "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 Depo was eight months back. I started getting my period four months back. Last week, I started up Depo again (not on my period). 10 days back I had unprotected sex. I am not even sure if he came in me. I took a Plan B the next day. I was supposed to get my period two days later. Should I be worried about pregnancy? I feel like I just flooded my body with hormones. ### Response: Which day did you start Depo again? If we look into your query, you had sex and took I-pill in 24 hours. I hope you will get periods but as sex was not done in the most fertile period of the cycle, so least chances of pregnancy are there but the 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 51 year old male. I have diabetes. My fasting is 150 to 160 and PP is 250 to 300. I am taking Amaryl 2 mg morning and Janumet 50/1000 after lunch and dinner. Please suggest. ### Response: Hello. You are already taking Amaryl (Glimepiride) 2 mg and Janumet 50/1000 (Sitagliptin and Metformin) twice but still, your blood sugar is not under control. Are you following dietary restrictions properly? Your weight is on the higher side. I suggest the dose of Metformin can be increased to 1000 thrice daily but then you have to take Sitagliptin 50 twice separately. Amaryl 2 can be made twice daily. Consult a specialist doctor, discuss with him or her and start taking the medicines with their consent. If even after making this change, your blood sugar levels are not controlled within one month, you may have to take Insulin. With this, strict diet restrictions and weight reduction have to be followed. If you have any further questions, please feel free to write." "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 mild ear infection. I went to see a doctor as the ear started draining clear fluid. The doctor said the draining was only on the outside of the ear. She prescribed Ciprodex ear drops. I am on the second day of taking them and I just woke up in the middle of the night with severe pain probably worse than before starting treatment. Should I continue with the drops? I feel the pain is a side effect and I do not want the bacteria to become resistant to antibiotics. I honestly feel now that the pain would have gotten better on its own. ### Response: Hello. No, it is not so, as you have an infection in the outer part of the ear. It is called as otitis externa. In this condition, there will be a severe aching pain in the outer ear. The cause of otitis externa may be due to a humid environment, any micro-injuries, or any fungal infections. Now you are on Ciprofloxacin 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: My wife had her last periods 15 days back. The period lasted for about four days. We had a sexual contact a week later. She had her periods completed on Tuesday, and we had this on Thursday, and it was not intercourse. I was not able to penetrate her and was only sliding against the outer lining. Since it was unprotected, so as soon as I got the feeling of ejaculating, I withdrew. After that, I ejaculated outside. But I have a little doubt that maybe a drop or so might have come out when I felt like ejaculating and may have got on her outer vagina or slightly inner vagina. Are there any chances of getting pregnant? I doubt because of a drop that might have come out. She has a regular cycle of 28 to 30 days. ### Response: Hello. Pregnancy happens only on penetration intercourse with some volume of semen ejaculated inside into the vagina. Practically, I feel there is no chance of pregnancy. Also, the time period that you had intercourse is her safe period and not the fertile window which further reduces chance of conception. There is no need to worry regarding pregnancy or even take a contraception." "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 19-year-old male. A week ago my thumb became numb below the fingernail. It was numb for two days and this went away. Now my left middle finger and the ring finger are numb and my right thumb feels sore. I also have a burning sensation in the feet, sometimes it feels like there is water or ice on my feet. My right knee feels stiff and then I switch to my left knee. My doctor looked confused and said it was all anxiety. Really, I do not think so. Could this be an early sign of diabetes? ### Response: I have read through your question and I would like to tell you that peripheral neuropathy can happen in a patient with diabetes which does present in the form of burning sensation in the feet and neuropathic pain. At your age, type 1 diabetes that is insulin-dependent diabetes mellitus is more common. It can be diagnosed by a blood sugar profile. I would advise you to get an ESR (erythrocyte sedimentation rate), RF (rheumatoid factor), and CRP (C-reactive protein) done to diagnose the cause of the stiffness. If these tests come clear then most likely it a neuropathic pain caused due to a nerve compression for which we may need to get an MRI (magnetic resonance imaging). In the meanwhile, I suggest you can start taking tablet Neurobion Forte (multivitamin supplement) and let me know if you feel any improvement. Consult your specialist doctor, discuss with him or her and with their consent take the medicines" "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: Before 10 days, I had unprotected sex and that day at night I took a pill of unwanted 72. Till now I have not get periods. What are the chances of pregnancy? Please tell me. I am very worried about this. ### Response: Hello. It depends on when sexual intercourse happened (in relation to ovulation). The pill provides about 95 % protection against pregnancy. If the pill was taken when the period was due in next 2 to 3 days, it will delay your period. If it was taken more than a week before expected period, period should start on or before expected date. You can judge yourself accordingly. Sometimes, the period can start as late as 15 days after pill. You can wait till then and if period does not start, you can get a pregnancy test done to confirm or rule out the same." "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 22 year old female, suffering from ear pain. The doctor confirmed that it is due to some virus and there is a small hole in my ear. Some tablets and Otobiotic drops were given. Still, it did not cure my pain. Please help. ### Response: I understand your concern. You are probably suffering from CSOM (chronic suppurative otitis media) with otitis externa. For your ear pain due to secondary infection, I suggest the following." "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 29-year-old male homosexual. I had a sexual encounter 15 days back with a confirmed HIV positive guy. I gave him blow job with a condom and we smooched. He also blew me but I was not putting on a condom and when he spit out, there was a streak of blood in the spit. He says he has sinus problem so he has blood in the spit, not in the mouth. I checked his mouth there were no sores or bleeding gums. What are my chances of infection in this case? We did not ejaculate in each others mouth nor we had any kind of penetrative sex. I came to know two days back that he is positive. I am showing acute HIV symptoms burning eyes, nose, and lips. I am unable to sleep. Can I go for RNA PCR? After how many days will the RNA PCR be accurate? ### Response: Hello. There is certainly a sizeable risk of transmission. Since he spit the blood, whatever may be a source, meaning he has had viruses in his oral cavity. HIV RNA or p24 antigen test, both are equally good becomes positive in one to two weeks period after infection, so you may get tested now. However, it is better to get combined p24 or RNA and antibody testing done. Burning eyes, nose, not necessarily mean HIV. Repeat testing should be done after two weeks" "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 recently diagnosed with sciatica. I have some difficulty in walking. I am having Tramadol and Paracetamol for pain relief but they are not helping much. Could you tell me the underlying cause? Will I require a walking aid? ### Response: As you must be aware by now, sciatica is a term used when a person experiences radiating leg pain due to some pressure on the nerves. Assessment will include intensity of back pain, intensity of leg pain, the distance you walk without any requirement of analgesic and detailed neurological examination including assessment of motor power, sensory evaluation and evaluation of deep tendon reflexes. This will then be followed by dynamic x-ray and MRI scan of lumbar spine if required. Depending upon the correlation of clinical examination and investigation results, management can then be formulated. If you have localized back pain with some radiculopathy symptoms with no other neurological symptoms like numbness, weakness, paresthesias, etc., then you can start with following recommendations for initial period of two to three weeks. We will observe your response to this conservative management protocol for next two to three weeks. If you are not feeling better, then we might have to get some investigations like dynamic x-rays of lower back and few blood tests for evaluation. Enclose your previous investigation and doctor\s prescription. I can see them and advise you accordingly. Disc prolapse. X-ray LS (lumbosacral) spine - AP (anteroposterior) and lateral (flexion and extension) views. Avoid lifting heavyweight and acute forward bending in mornings. Revert back with the investigation reports to an orthopaedician and traumatologist 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: How do I help my 16-year-old teen brother who refuses to get help? I believe he needs help, but the last time we went to the doctor, they sent him to a counselor who did not do much. When talking to a counselor and other people, he does not show his true colors. At home, he has a very bad temper and tries to fight with everyone. The only one he gets along with is one of his brothers. He has threatened to kill himself because he does not have his laptop anymore, it broke. And he has also stated along the lines that he wants to kill our parents because it is their fault, he is like this. To be fair, our parents are very religious. I do not know how to help him because he does not want help. He says no one cares about him and we all want his life to be bad. What do I do to help? ### Response: It can be difficult to see your family going through challenging circumstances. From your report, it looks like your teenaged brother is struggling to regulate his behavior, blames others and is not able to take responsibility for his actions. As you may know already, there is no quick fix solution. Try to be supportive and available whenever your brother needs you. He is lucky to have an understanding sister like you. He needs to gently changed when he says no one cares about him. Why does he think so? Is he misinterpreting things? You said he gets on well with one of his brothers. Use it positively and involve this brother in getting help for your troubled sibling. Encourage him to enroll in some course, apprenticeship which will give some positive experience for him. Encourage him to join some sports clubs. Discuss with your parents about adopting a supportive, firm, boundaried relationship with your brother and avoid criticism and confrontational interactions. It may help to have a mentor to talk to him regularly and guide him to make the right choices. It can be any responsible adult whom your brother trusts and will talk to. Finally, encourage him to see a counselor or doctor again if problems persist." "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 baby is 6 days old and he is suffering from loose motion since today. ### Response: Hi. Basically, if it is watery loose motion, either it is viral induced or milk intolerance. In a 6-day-old baby, if mother\s milk is exclusively given, not to worry about it as it can simulate like a loose motion in breastmilk-fed infants." "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 31-year-old male, suffering from hair dandruff for the past one year heavily. I have a history of dandruff but I only used anti-dandruff shampoo before, only this last year it got so intense, that now it is not only in my scalp but it started to show on my face.It is showing a little bit above my upper mouth lip but a lot more intensive on my eyelids, and I always have a burning sensation above my eyes when I wake up and sometimes it is itchy and looking red but it is burning intensely these days. ### Response: These are typical symptoms of seborrheic dermatitis. It is a chronic condition due to overactivity and inflammation of the sebaceous gland sometimes aggravated by fungus Malessezia a normal inhabitant of the body. You need to stop all oil application. 1. Use anti-dan" "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 premature rupture of membrane. I lost total amniotic fluid like a gushing flow, that time actually I was in the toilet for elimination. I have multiple fibroids, and HBsAg positive, but I do not know what is the reason for the fluid leak. The doctor said it is because of HBsAg. Please tell me what is the reason behind this. Termination has been done. Prescribed for myomectomy surgery. Can you tell my possibilities of pregnancy and precautions for next time? And one thing, my body temperature in both palm and the sole is high compared to others. I do not have any fever. ### Response: Hello. The leak can be due to many reasons. The most common is due to some contraction of the uterus and may be due to a weak membrane and or more baby movement, sudden irritation, and strong contraction, due to some infection and many more. If you have one pregnancy with fibroid then there can be a pregnancy with fibroid and you can also go for myomectomy and then pregnancy. The only thing you should do is to take more care and more rest next time. and take medicines regularly with a regular check-up. Only these things are in our hands. The temperature of the palm and sole, is mostly because of your body nature and not related to any other thing (individual variations)." "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 noticed that in my face near to mouth, I have something like eczema, but colorless. I checked on the net and it is like ringworm. I am very much worried. What should I do? I am currently on beta blockers. Last week when I had a blood test, my doctor advised me to take Iron supplements. ### Response: Please put up some clear pictures of the affected area for proper evaluation and guidance. Revert back with photographs 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 am trying to conceive for the past six months. So, I keep tracking my period on my phone. My usual cycles were around 30 days. Before two months, my cycle lasted for 43 days and I thought I was pregnant. But, I was not and had a period that was heavy and passed several clots. After it was over about two weeks went by and then I started spotting brown. It lasted for almost three weeks straight now and it has not stopped at all. It has remained very light the whole time.Yesterday, it got really heavy and red again, so I thought it was my period coming around but today it has stopped. It is just light spotting. This cycle now has been 46 days long. I am not sure what is going on. I am really worried because before now my cycle was always normal for around 30 days.I had been to a gynecologist for painful periods before and he told me that I had cysts on my ovaries and may possibly be getting endometriosis. Before that I had been somewhere else and he told me that I had hormonal imbalance. Did you get any clue what is going on? Should I be afraid that I am not fertile?The longer cycles and constant spotting really worries me. Please let me know your opinion. ### Response: You seem to be experiencing periods irregularity since last two months where I believe your stress levels have been high, which could have delayed your menses. The presence of continued spotting from the mid cycle to till date in this cycle is possibly due to serum progesterone deficiency or luteal phase defect (phase after ovulation and before menses). The presence of ovarian pain was probably indicative of ovulation called mittelschmerz, which was normal guess." "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 22-year-old male. I played soccer throughout my teens competitively. Five years ago, I injured the muscle in my thigh, what I presume was a tear of which I sat out from sports for a week or two, however, was rushed back into playing by my mother who thought I was faking the injury. I injured the muscle again, and these proceeded to happen again once more, leading me to quit sports and focus on going to studies the following year.Currently now, whenever I stretch my thigh muscle by pulling my leg up behind me, I get a slight uncomfortable feel in my thigh muscle which I know is not normal, however, it is not painful enough to tell me to stop doing it. Furthermore, I have been in the gym and jogging where my muscle seems to be fine, but when I decide to sprint there is a 50 percent chance that I will get into discomfort again. However, it does not feel like a tear, but it will become numb for a few days and finally, if I go to kick a ball it is almost certain that the same result from sprinting will happen.I have recently started to stretch the muscle to try and see if I can regain its strength to allow me to do these few things again without worrying about hurting my muscles again. I am not sure what other things I can do to help this, such as different types of stretches, etc? ### Response: I read your concern. So there is a possibility that a scar formed on the tear area of the muscle leading to stiffness and numbness is due to any neural stiffness around the scar area. Possibly there will be nerve entrapment. Do not worry. All you have to do is: 1. Get a deep friction massage to relieve the tension in the muscle. 2. Slowly release the scar by massaging the scar frequently. 3. Gently stretch the muscle and hold it. 4. Keep icing that area frequently. Before attempting any running or any strenuous activity, I advise you to properly activate and then strengthen that muscle. Progressively increase the load on the muscle. 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 know about breast cancer stage cT2N1M0 doctor is done mm, after this treatment, what is the next step to be followed? ### Response: I think you are talking regarding your self according to history. The TNM staging is showing lymph node involvement also. So after modified radical mastectomy breast removal, you need to investigate with IHC of your breast mass. The immunohistochemistry is to be done for at least ER, PR, and her neu. According to these histopathology and IHC reports, your further chemotherapy treatment will be planned. You can discuss all these with your treating doctor/oncologist. I hope I have answered your question. Let me know if I can assist 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: My father is 63 years old. He suffered from a mild stroke yesterday and we would like to seek the second opinion on the proper treatment for his case. He was given Catapres to lower his blood pressure and was asked to continue taking his maintenance medicines for hypertension (Losartan). His latest BP taken just a while ago is 140/80 mmHg. We would also like to ask for guidance whether this warrants a trip to the ER. Since the hospitals are now full of confirmed and suspected COVID patients, we are concerned that going to the hospital may be more detrimental to his health. Please help. ### Response: Regarding your concern, I would like to explain that his blood pressure values are normal. I would like to know his symptoms. Did he perform a brain CT scan? As he suffers from diabetes, the most probable cause would be an ischemic stroke (blood clot)." "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 clear bubble in the sclera of my eye in the corner close to the nose. This has not gotten any bigger and sometimes it appears smaller. It does not hurt. I have had it for years. My eyes dry a lot and I have an issue with dry eyes and allergies. Could this be serious? Sometimes my eye in the corner is sticky as well. Please help. ### Response: Hello. This appears to be a conjunctival cyst. It is not harmful. This can be caused by a mild foreign body sensation. You need to then stop this eye" "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 always had floaters, and almost like a visual snow which is more prevalent at night. I had anxiety as a teenager and I noticed the floaters after I developed high anxiety. I have a 20/20 vision otherwise. Recently, I developed astigmatism, a very slight case. I spend a lot of time on the computer. One doctor said that my eye pressure was 5 in both the eyes. But then, I went for two other opinions and the eye pressure was between 10 to 12. So, it looks like the first optometrist had not calibrated her machine properly. Tears revealed healthy central vision and no retinal tear. While I am in the grocery stores and driving at night that is when I really notice it, and everything seems surreal and too bright. Could this be a case of computer vision syndrome or something else? I also have dry eyes. ### Response: It is good to know that you are so aware. I will try to answer your queries one by one" "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 I marry a woman without a thyroid gland? She has a nodule in her left lobe of thyroid gland but after total thyroidectomy, there was no cancer. I am tensed because she has no thyroid gland. The surgeon said it is not a matter but some doctors say there will be a complication in future. I am tensed with her life-span. Can she live a normal and healthy life without a thyroid gland? Some doctors say that every medicine has side effects.So I want to know that the side effects of synthetic Thyroxine taken for whole life? Can she concieve? Can I marry her? Please answer my every answer clearly. It is my future. ### Response: Hi. According to your history, the queries you have are usual and answers are yes, she can live quite a normal life provided she takes the supplement Eltroxin (Levothyroxine) timely and according to the prescription. Yes, she can conceive but for further information, you should consult a Gynaecologist. There are quite common side effects of Eltroxin but they do not hinder in normal sex life neither would be a reason to not marry her but you might like to consult an endocrinologist for further information." "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 migraine for seven days. It is so severe that I cannot stand light or noise. I have been unable to sleep. I have been nauseated and vomiting. I cannot handle anything. I am a female. I am 35 years old, 5\4"" in and weigh 260 lbs. ### Response: Medication right now you are using is more than effective. But medication like Tryptons (Sumatriptan) is most effective. Metoprolol, Propranolol, Gabapentin, Pregabalin are more effective medication to prevent recurrence. You have to reduce weight which may useful to reduce the attacks. Regular exercise and yoga may be useful. If symptoms are not improved, please consult your physician. He will examine and treat you accordingly." "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 dad recently had an echo done which showed valve issues. The cardiologist wants to do a Lexiscan. I thought there are less invasive tests like calcium scoring that would give the same information. Why would the Lexiscan be recommended over other tests? ### Response: Hello. Calcium score is not as informative as Lexiscan. It is a screening test and not a diagnostic. CT coronary angiography may yield a better information, but has false positive and negative rates. However, CT coronary angiography may be used as an alternative rather than calcium score. Also, treadmill test is an alternative to Lexiscan if he is able to perform exercises. Anyway, Lexiscan is much sensitive than calcium score for detection of blockages. Hope this helps you and get back if you have any doubts" "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 my penis foreskin tip tight and rigid and is not moving back for past one month. ### Response: Hi. I have gone through your query. From your description and photo (attachment removed to protect patient identity), it looks like you have a condition described as phimosis. It is a fairly common condition and can be easily treated by a simple surgical procedure called circumcision. I would suggest you visit your local urologist who can perform the surgery" "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 and my fiance had sex for the first time two days back. We both were virgins till now. We used condoms while intercourse and also checked them for breakage but found them to be non-broken as per our knowledge about condom breakage. But my fiance is experiencing headache, feeling like urine not in control, abnormal feelings, etc. We are worried if these are signs of pregnancy or just due to first time intercourse. Please also tell about detecting condom breakage or leakage, as we could not find any visible hole in the condoms after intercourse. If anything serious, please suggest about taking I-pills as 72 hours are not yet completed. ### Response: It is not possible to say so early if one could be pregnant from your history. If you have doubts about condom breakage, I would advise considering an emergency contraceptive pill that is I-pill. The symptoms she has could be due to urinary tract infection. So she can get a urine analysis and culture to look for infection." "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 27-year-old male, height is 1.75 and weight is 83. The doctor has diagnosed premature ejaculation problem. When I was engaged in self-masturbation, sperm came out within one minute. Sometimes feel it was over and it should be ejaculated. But nowadays I cannot stop self masturbation. The family is discussing marriage, so I was thinking about my sexual problem. I need solutions for premature ejaculation problem, and strengthen my penis. ### Response: Hi. Masturbation per se does not cause any sexual problem in the future life, so do not worry excessively about it. However, to manage premature ejaculation you can learn about the start-stop technique or squeeze technique. There are medications available for this purpose like Dapoxetine 30 mg one hour prior to sexual activity. Also, get yourself investigated to rule out medical conditions such as thyroid dysfunction or diabetes hypertension, etc. Also, try Keigal exercise to strengthen your pelvic floor muscles." "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 vitamin D level is good and all my blood reports are fine. But, why am I getting body pain? Even I sleep for seven to eight hours and still I do not feel fresh. I always get the feel to sleep more. I took Ibuprofen, but it does not work. It disturbs me in sleeping. Most of the time, pain in lower legs, hands and shoulder does not go away. Do I have cancer in my body and it spread to my bone marrow and result in body pain? Do I have any cancer in my stomach or pancreas? Do I have any blood disorder or autoimmune disease or any cancer like leukemia, lymphoma or non-Hodgkin\s lymphoma in my body? Also, I do not have a fever or cough. I do not experience any weight loss; I feel tired all the time and feel vomiting after eating. Please explain my problem and the treatment. ### Response: Based on your query, my opinion is as follows: Thyroid function tests and serum calcium. If they are normal, then lifestyle modifications. Lifestyle modifications." "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: The problem started out with a dry cough. The next day, I had achy bones and headache. It seemed like it was going away and came back the day after when I woke up feeling like throwing up. My eyes, chest and upper back aches with a feeling of nausea. Please help me. I am scared. ### Response: I have gone through your query, and I can understand your concerns. The symptoms you have described suggest that you have a viral fever along with inflammation of throat (pharyngitis). There is no need to worry as it can be cured completely with treatment. Please consult a physician, discuss with him or her and get the following things done with consent. If symptoms persist despite, then blood investigations and throat swab may be needed. Do warm saline gargling or gargling with a numbing mouthwash. Use expectorant cough syrups." "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 59-year-old male. I have dark spots on my cheeks close to eyes on both sides identical. I would like to have medical advice on this problem which I am having for more than three years.I am currently taking Obimet SR 500, Glimisave M1, Pivasta 2 mg, Pinom 40 mg, and Clopilet 75 mg. ### Response: Please send two to three clear pictures of the affected area for better evaluation and guidance. Do you have any symptoms (itching / burning) over this area?" "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 39 years old. My weight is 73 kg. I have been taking L-Pride (Levosulpiride), Nuanxit (Flupenthixol), Rabefit (Rabeprazole) and Rabifast-DSR (Rabeprazole sodium and Domperidone) since last 15 days. After taking these medicines, I am experiencing low sex drive and problem in erection. Do these medicines have something to do with these symptoms? If no, then what may be the possible causes of that? Can I use Sildenafil citrate? If yes, what amount and with what name it is available? ### Response: Hi. I have read and understood your problem. Levosulpiride and Flupenthixol can cause problem with erection. This is the cause of erectile dysfunction in your case. Sildenafil citrate (Viagra) is usually prescribed at a dose of 50 mg three hours before sex. But, should be taken after clinical checkup including blood pressure." "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: What does it mean if one has unprotected first-time sex but is not sure whether he discharged inside or not? But his partner starts bleeding day after that. Is it normal? ### Response: Unprotected first time sex means that both the partner are doing for the first time without using any contraceptive method, i.e., condom during the first time of sexual intercourse, the hymen of the female is intact or may be ruptured prior because of any physical strained. In the first time, sexual intercourse intact hymen may break and that causes the bleeding suddenly or afterward it. So it is normal. First sexual intercourse. Take rest nothing else. If bleeding persists and whether the female partner misses her menses, do follow-up immediately." "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 28 year old male. For the past four years, I have been experiencing hair loss. About two and a half years ago, I started using Finasteride once a week along with a Ketoconazole shampoo 1 % and Lipogaine, which is similar to Rogaine. I would use this only at night usually using about 2 to 2.5 ml total around my temples and at the vertex. The ingredients in Lipogaine are water, propylene glycol, ethanol, minoxidil 5%, azetinol, saw palmetto, beta-sitosterol, oleic acid, gamma & alpha linolenic acid, apple polyphenol, biotin, niacin, biotinoyl-tripeptide, phosphatidylcholine vitamin B6 and B12. The treatment was working well, and I grew back some hair, but about four months ago, I started experiencing a drastic increase in hair loss. I would wake up in the morning after applying the Lipogaine, and my hair would be extremely dry, brittle and stiff which would cause it to fall out very quickly. Around the same time, I developed a circular rash on my forehead which I received while doing cardio at an unhygienic gym. I went to the gym with no rash and left the gym with a 2 inch rash on my forehead. I went to see a dermatologist who told me it was seborrheic dermatitis but he thought it was weird that it took a circular shape on my forehead.Around the same time, my overall activity level dropped as well. I was much less active although I still go to the gym every day. I would go to bed late around 4 AM and wake up at about 12 to 1 PM. I recently switched to regular Rogaine which has shown an improvement as far as my waking up hair quality is concerned, but now I am experiencing scalp dandruff possibly because I am using it twice a day. I also increased my Finasteride usage to two to three times a week. I am still losing hair, but I do believe it has slowed. My hairline has receded since the start, and I feel that I have been losing hair somewhat evenly everywhere on my head except for my sides. Before I believed it to be a hormonal imbalance like a thyroid issue, but lately I am leaning more towards an immune response brought on by the rash on my forehead and my high quantity of Lipogaine usage, which would cause some scalp irritation, along with my lack of daily activity. Also, even though the doctor did not see it, I have noticed occasional small red bumps on my scalp. After using Rogaine for about three weeks, I decided to try the Lipogaine just for a night and got the same dry and brittle hair response as before. Please help. I would love to keep my hair as long as I can, but it is a losing battle right now. ### Response: If you are comfortable using Rogaine solution, you can continue with it or consider Minoqilib 5% (Minoxidil) solution 1 ml at bed time over the scalp. If you have seborrheic dermatitis or dan" "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 five years old. Recently, he lost his front bottom teeth and now the other front bottom tooth is also loose. Is it good or bad? Before four months, all his molar teeth were removed due to decay. ### Response: Exfoliation of primary teeth is not bad at five years of age. Mostly, the primary teeth fall due to the clear eruption of the permanent teeth. There will be a formation of roots of the permanent teeth to erupt. The roots of the primary teeth get resorbed by the crown of erupting one and the teeth become loose or fall. It is normal. In case, if you are not using a space maintainer on the posterior teeth (molars), you need to use 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: I am 36 years old male. My weight is approximately 80 kg. My nose has been blocked and I am feeling tired. My throat is becoming sore. My chest is restless. What to do? ### Response: Hi. It seems that you are suffering from viral infection that could be the cause of your symptoms. I would suggest you to take I would also suggest you to take salt water gargling three to four times a 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 had a sexual encounter before 11 days. She gave me only a hand release and used her finger on my prostate with a glove on. After a day, I started urinating extremely and frequently. No burning with urination but after urinating, there is a slight burning sensation in my penis, and outside of my anus. This burning occurs mainly while sitting down. I do not frequently urinate anymore, but I still have the slight burning sensation after urinating and while sitting. I got tested for STD, and it was negative. My doctor prescribed me Doxycycline before three days. There is no noticeable difference yet. ### Response: You have acute prostatitis. This could be due to various reasons including retrograde ejaculation, delayed hypersensitivity to the gloves used or bacterial infection. Was your semen or urine tested for a culture?" "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 had pacemaker operation six months back. From past five days, her heart rate is hitting 130 very frequently (when she is not idle) every 20 minutes or so. She is feeling a discomfort because of this. When we met the doctor with the pacemaker test, he told everything is normal. My question here is if everything is normal why heart rate is hitting 130 frequently? It is on every activity she does like walk, bath, etc. Please kindly advise me on this. ### Response: Although it is difficult to answer without knowing the exact diagnosis, if pacemaker/ AICD is working well per interrogation, she is safe in terms of fatal arrhythmia or dangerously low heart rate, as her device will kick in if it detects any abnormalities. My advice would be to 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: My son is 4 years old. At one and a half years, he was able to talk and copy words fluently but after 2 plus, he stopped talking logical words. He can copy words if he wants though. He has fear of darkness and instant high volume sound. Night watching is also a habit (10 to 12 nights/month). The pediatrician told us that he has no normal physical problems. Speech therapy is continuing but after four months, the success rate is about zero. Please help. ### Response: As per your history, the child might have autism spectrum disorders. It will be worthwhile to see a developmental pediatrician or a pediatric neurodevelopmental consultant. You need to carry or record his preschool behavior chart when visiting the consultant. If treatment is started after a proper diagnosis, the results are excellent" "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 20-year-old healthy young man. I do not drink or smoke but I do work a lot. I work for 60 hours actually and just moved out of my house with my family. I got my own new place as well as trying to maintain a relationship with my current girlfriend. I do not really have any health issues besides occasional high blood pressure. I have been having palpitations for the last month. I get a few palpitations every single day and some are scary and uncomfortable while others really do not bother me. I have had an EKG in the past. I have attached the reports of the same. I saw a cardiologist and they did a few different tests and said my heart looks normal but I am still getting the palpitations even though my doctor put me on Metoprolol which is a beta blocker. What do you suggest? ### Response: Hello. I have gone through your reports (attachment removed to protect patient identity). All the tests are fine. The cardiologist said your heart is normal. So, you do not have to worry. Tablet Metoprolol has been given for symptomatic relief for your palpitation. Probably, you are having stress. Manage your stress and you will be fine" "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 iron deficiency for three months and have been using Iron supplements. My ferritin is still low though, so I am using Iron supplements still. My question is, my RBC has been increased to 4.52, hemoglobin is also gradually increasing to its normal levels (11.2). Now it is on its normal levels but hematocrit was increased too yet it is still low (35.0 %) at this point, am I anemic? The more I use Iron supplements, will my results become better gradually? I really need to know. ### Response: Hello. Serum ferritin reflects the iron store. Whenever an Iron supplement is started, the iron store is replenished in last. So gradually your ferritin and iron level will come back to normal. Your RBC and PCV (packed cell volume) are not much altered. So do not worry about that. So you are having mild anemia. You can investigate with stool routine micro examination and occult blood test to exclude any parasitic infestation which can lead to a small amount of bleeding from the intestine and so anemia can worsen" "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: Yesterday, I had an ultrasound of my abdomen. They gave me the report online and I am not sure how to read it. The things I am looking up are extremely worrisome. It is all saying cancer. I am going for a CT scan within a week. It is without contrast because I have myasthenia gravis and the contrast really affects my breathing. Will contrast make a huge difference? Below I have pasted the results and it says:Normal liver and gallbladder.Left renal calculus.Complex heterogeneously hypoechoic cyst in the upper pole of the left kidney for which further imaging is recommended. Also, I have been urinating almost every hour and it feels like my bladder is never empty. I have had a kidney stone four years ago. But the part about the complex cyst on my kidneys is troubling me. ### Response: I understand your concern. So, you have a cystic lesion in the upper part of your kidney. First of all, you are only 28 years old and at your age, I would favor many benign lesions over malignant ones. If they are not talking about solid components of the lesions, it again favors benign lesion. Let them do CT (computed tomography) with i.v. (intravenous) contrast, if possible share both ultrasound images and CT images with me. One more thing, if you do not have any sign of night sweating, weight loss or redness in your urine, again malignancy risk is too low. 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: Hi,I was supposed to get my period on the 19th of this month. Generally, my period lasts 25 days, but it did not arrive this month.After taking a urine test using a pregnancy detection kit, I received a positive result. So, I think I am pregnant. I have not taken a scan or contacted a doctor. I do not want to carry my pregnancy.Is it necessary to have a scan performed before taking abortion pills or can I take the pills directly? If so, can you please make suggestions as to the pills I should take and how to use them? Also, what is the last date for me to terminate my pregnancy using pills? If there are any side effects, please mention them as well. ### Response: Since a urine pregnancy test result was positive, you are pregnant. However, it is very important to confirm the same by scan and to locate the pregnancy to make sure it is in the uterus and not outside, which is called an ectopic pregnancy. Ectopic pregnancies cannot be aborted by pills and they present a dangerous situation, which requires immediate medical attention. You can terminate an intra-uterine pregnancy with pills up to 63 days after the first day of your last period. Following that, failure rates are high. The earlier the termination, the less risk of complications. Pills for termination cannot be prescribed over the phone or online, as it is illegal and dangerous. I would also advise you to consult an obstetrician and gynaecologist online about receiving counseling on ending your pregnancy" "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 18 years old. My period is always regular and exactly on time (every 34 days x 7 days of bleeding each time) but this time it is two weeks late. I am getting hot flushes, fever, I am cold all the time, dizzy, lightheaded, very weak. My abdomen is cramping and hurting, been so for a few days, the discharge has not changed since ovulation. I am very emotional, crying all the time.I cannot be pregnant, I am single and a virgin. I have a healthy weight, do not have any eating disorders, have not been under lots of stress or anything similar lately. I am just so scared. Feels like period cramps but less intense. Been going on for days. I really do not know what to do. I do not want to go to a gynecologist. I am afraid and really not ready for that. I just want all this to go away and to get my period back. Please help. ### Response: According to your history and symptoms, it seems that nothing is wrong with your body system. Sometimes, periods get disturbed. Your symptoms are pointing towards signs of PMS and I feel that you are panicked by the situation which is making the condition worse. I would suggest that you have not to worry about it and just wait for a few more days. Hopefully, your cycle would resume by itself because unrecognized stress results in delaying of the cycle." "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 itching and scratching for the past three months. She is 85 years old with a controlled diabetic. For now, she is applying Polysporin ointment and Benadryl 25 mg. She gets better for a while, and she gets it again. I am attaching the picture. Please suggest. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). It looks like prurigo simplex. Apply Mometasone cream. Mix it with coconut oil in equal ratio and apply over the affected area twice daily for two weeks. Take tablet Levocetirizine 5 mg twice daily. Please say whether your mother had any skin lesion in the fingers, abdomen, thighs, and private parts. Please mention whether the itching got increased at night. Please say whether any family member had similar complaints. If these are present, then the treatment varies or else go ahead with the above treatment for two weeks." "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 an aorta aneurysm removed four weeks ago. While in the hospital and rehabilitation, I complained of my ear hurting. I often collect ear wax, so I thought that was the problem. Now that I am home and have a CNA and therapist helping me get stronger, the ear pain is the only pain I have. She put Debrox and Hyland's earache drops in my ear. She flushed the ear with warm water for two days. The pain is so bad that I can hardly eat because chewing hurts. It hurts in my mouth too. I have been putting saltwater in, but it does not seem to help. Might I have an ear infection? I am not well enough to go to an ENT's office, and I am not sure if they are open. Any advice you can give would be greatly appreciated. ### Response: Hello. It is likely that you have developed otitis externa following wax removal. Syringing often leaves some moisture in the ear and this provides an ideal medium for fungi to grow in. Do you have pain while touching your tragus or moving your pinna? If you have severe pain then you may need analgesics. It would be better to use Paracetamol 500 tablet as and when required." "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 29-year-old male. I have a low sperm count problem and also found tiny calcifications in both testes, bilateral minimal hydrocele. I am married two and a half years before and trying to conceive from the last seven months found I have low sperm count issue of 16 million per ml. I am taking Kalyanamka Ghrutam. I require your advice and treatment as we are trying for a baby. I have attached my reports. ### Response: I have seen your reports. (attachment removed to protect patient identity). Usually, both arise as a result of local trauma or local infection. I do not know how long the swelling in scrotum (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 a small swollen lump on the left side of my neck. I do not feel sick. But I feel like I have a fever and headache. My teeth look fine, and I do not have sensitivity. Can I have an infection in my teeth? ### Response: Hi. I had gone through your question. I can understand your concern. Yes, as per your history, you may have a dental infection or an ear problem on the same side. You need to upload a picture of your teeth so that I can conclude it. There can also be a dangerous lesion associated which may present as lymphadenopathy of the neck. You feel feverish due to the infection you have." "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 reports are as follows. My blood phosphorous level is 4.58 mg, and it was always 3.2 mg. Rest kidney test is fine. Seeing my report, can you please tell me if my kidney is failing? I am too much worried. I am having Metformin 1000 mg as I am prediabetic and Voveron painkiller last week? ### Response: Hi. As such increase in phosphorus is not a marker of kidney disease. I do not find any reason to worry." "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 got my ears pierced last week. I have small bumps on that site. In my left ear, the skin is peeling. What could it be? ### Response: The bumps signify there is some local inflammation. If there is associated pain, discharge, pus or fever then you need to take appropriate antibiotics as these are signs of infection. I suggest you to visit your doctor who performed the surgery for physical evaluation. The peeling in the ear could be due to an allergy to the earring or whatever you are wearing in the ear.bIt could also be an allergic response to any cream or ointment you had applied. I suggest you to take tablet Paracetamol 500 mg twice a day and observe. If it worsens or develops any additional symptom it needs physical evaluation. Otherwise, it will subside. Please send me the photograph of the ears for further support. It will help me to understand the local condition better, so that I can give you decisive instructions." "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 diastasis recti. Do I need surgery to repair it? I have three children of ages 4 and a half years, 2 years and 7 months. ### Response: Diastasis recti is a medical condition in which the abdominal muscle is separated into right and left halves. This occurs in pregnant women due to the stretching of the abdominal muscle during growth of uterus at the time of pregnancy. The most common cause for this is repeated pregnancies at short intervals. Make sure you do not have constipation. Eat healthy, nutritional homemade food. Have a lot of green vegetables, fruits, fresh juices, etc." "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 doubt regarding vitiligo condition. My father-in-law has vitiligo and he is 60 years old now. He has 2 sons and 1 daughter. Daughter is married and having two kids. None of the above have this condition. Is there any chance of getting vitiligo to his sons or to his grandchildren in future? To say simply, is vitiligo hereditary? ### Response: I understand that you are concerned. There is a definitive genetic component in vitiligo and if someone is affected by it, he is more likely to transmit it to his kids than a person who does not have it. There are 4 to 5 times more chances of getting vitiligo than general population without it, if one of the parent or sibling has one. So, if both parents and siblings do not have, then chances are less. I mean if only grandfather is involved and not the father, then chances reduce." "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 age is 40. Currently, I am having less erection when trying to have sex. Sometimes, not able to get an erection at all. It is a very embarrassing situation. I am married for the last 11 years. We were having great sex before our marriage. After marriage and with our kid, sex has become boring. Now when I am trying to have sex, I am not getting enough erection. Sometimes, it is zero. In between, I tried Manforce 50 and after that DT Manforce 100. Sometimes, it works and sometimes not. I do not have diabetes or hypertension. I do not have any bad habits. I do not smoke and I drink once in six months. My doctor has advised me to take Nano Leo capsules twice daily after food and tablet Duroplus twice a week 30 minutes before sex and go for sex after two hours. I am taking these pills for last 25 days. Duroplus I had only taken twice. My problem is previously my erection was less but when erected, it used to last long. Now I am getting erection immediately and it is hard erection but not able to maintain it. Now I am able to get my morning eraction sometimes. I have checked my testosterone level. It is 501. Please suggest medication and let me know whether I need to stop Nano Leo tabelt or not which I am taking right now. I am doing some regular workout 45 minutes to 1 hour per day. Eating healthy diets, avidoing junk food, spicy food. Taking almonds, wall nuts, lemon, honey, banana, resins, cummins, ginger, onion, garlic, pomegranate, apple, carrort, spinach in more quantity in my food. What else life style modifaication and diet I can follow? Please advise accordingly. ### Response: Hello. I can understand your concern. Nano Leo consists of L-arginine and is a good supplement. This could be due to a short duration of action 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: I seem to get lesions or blisters maybe on my arms. They are usually round with one pus-filled bump and at times it could be many small ones. They rarely itch, burn or anything. They crust over and peel and leave dark acne-like marks on my arms it is so annoying because I am embarrassed by the marks on my arms. I always get at least one of them per month. ### Response: I saw the photo you sent. (attachment removed to protect patient identity). As you say there is pus formation and you are getting it recurrently almost every month. I like to know a few things before finalizing my diagnosis and treatment. Is there any pain? If pus discharge how much? Do you get them at the same site always or different or in any particular fashion like linear? Are you a diabetic? Since when are you having them any fever associated?" "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 30-year-old female with a height of 5 feet 3 inches and a weight of 65 pounds. This is my first pregnancy. All test reports are normal until now but my BP is 140/90. Is it very high? I am too much tensed. Please help me. ### Response: Hello. Fourteen weeks pregnancy and blood pressure is 140/90. You need to monitor your blood pressure every six hours with your gynaecologist who will judge whether it is really raised or just a chance of finding. Accordingly, he will prescribe you medicines. You may start with tablet Aspirin 75 mg to maintain your blood pressure and fetal growth parameters. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. You need to have diet changes such as low salt diet, no pickles and spicy food" "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 dog scratch. Stray dog accidently tripped over my legs and his foot bruised over mine. No cut, no blood. Do I need rabies vaccine? ### Response: I have read your query carefully, I just want to confirm that is there any blood from the scratches over your skin? Wash the scratches with soap and plenty of water. If possible provide a image of scratches to me so that I can conclude and if possible watch over the dog for 10 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 had sex with a sex worker a day before yesterday. But I told her not to remove her dress because I did not have a condom. Then I had a hug and allowed her to suck my penis for five minutes. While doing, she told me that my liquid is coming in her mouth, and so I stopped. After that, I sucked her breast some time. I do not know either milk is coming or not. Then finally I told her to do hands blow job after which I ejaculated.My question is the next day I got a red pimple in my inner thigh on both sides and is getting irritated. Why is it coming suddenly? I feel it may be an indication of HIV. It happened only after the incident. I was thinking in two ways. Could it be due to my liquid which went inside her mouth, if she has an infection? Or maybe due to that, I have sucked her breast I felt I might have drunk her milk. Is this an initial infection of HIV? Kindly look at my attachment. Please advice. ### Response: As per your exposure, you seem to be safe from HIV. The thigh lesions are not due to HIV (attachment removed to protect patient identity). It could be due to other causes. Do you have any symptoms like pain, itching, etc.?" "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: Initially, I had bumps on my scrotum and now I got few bumps on my penis head. I have attached the pictures for better idea. First It was told that these maybe cysts. And later it was told as Fordyce spots. Please give me correct diagnosis. ### Response: Hi. They are neither cyst nor Fordyce spots. Sexually transmitted disease can be a probability. But, for proper diagnosis I need to know the complete history that is the onset, progression and duration of lesion. Please send me the photos of lesion on the scrotum too. Only then I would be in a position to make any valid comment. Revert back with the answers for the above questions 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 am a 38 year old male. When I was 19 years old, I had a circumcision due to a tight foreskin. This has never been a problem until of late. There are two issues that I am suffering with. The first is on the under side of my penis when I get an erection to have sex or masturbate, where my \banjo string\ uses to be, I have a scar or skin tear (only in this area), which is then taking a couple of weeks to heal. The other issue is now when I pee, it feels like my pee hole has closed slightly causing a back pressure. I have also noticed the difference when ejaculating, as I use to be able to ejaculate quite far, but now with the restrictions; I cannot do this. I have looked at articles saying the closing of the hole does happen with circumcised men. But it is strange that it has only happened in the last six months, while I have been circumcised for 19 years. Regards. ### Response: Hi. I read your query and understand your concerns. I hope this helps you to some extent. Feel free to write back to me if you have more questions." "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 64-year-old male. I am a healthy person. Currently, I do not have any symptoms or problems. Recently, I have done a PSA, sugar, CBC, and urine culture. Please check my reports. It shows that there is a presence of blood in the urine. Please suggest. ### Response: Hi. I have gone through your query and reports (attachment removed to protect patient identity). On seeing your reports and abnormalities, you can have a mild infection. As you are asymptomatic and the presence of blood in urine is observed only by a microscope, and the PSA increase is also minimal, I would suggest you repeat the urine analysis after three weeks. If still, if you have blood in the urine, then you will have to do a CT (computed tomography) scan to make sure that the kidneys and the urinary bladder are normal." "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 21-year-old female. I had unprotected intercourse with my partner the day after my periods end and consumed an i-pill on the same day. I had a blood discharge after 10 days and it was there for three days. I expected my period dates to be between 19th to 24th of this month but my periods were delayed. So I did a home pregnancy test and it is negative, and till now I have not got my periods, are they delayed? What may be the cause? When can I expect my periods? Are there chances of pregnancy? ### Response: Taking i-pill during the first half of the period cycle results in early periods. The three days of bloody discharge you had was actually a light period which came earlier due to the i-pill. So, now expect your next period around a month after that bleed. No need to worry it is very unlikely that you are pregnant." "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 33 year old male. I am having regular water retention problem, specially on the abdomen region. It fluctuates quite a bit and so does my weight on the scale. Sometimes there is a lot of discomfort to even wear normal trousers on certain days. This however is most prominent on the days after consuming alcohol the previous night. This has been there for the past 3-4 years, but recently I have observed that this swollen abdomen region remains for couple of days. I have had a thyroid test last month which was normal and general health checkup every year including ECG has always been normal. I am not under any medication and no known ailments. I should also add that my LFT test was done about a year back and that was normal as well. It is just too uncomfortable on certain days to wear the usual clothes (trousers) and I would like seek a permanent solution to this problem. Kindly advise. ### Response: Hello. First of all we have to find the cause for this. If no cause is found then we would call it idiopathic. I would recommend you following investigations: You should avoid alcohol, take low salt diet and do regular exercises." "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 this black spot (bar shaped) that has been on my toe for a while. It may be nothing but I just wanted to get it checked. ### Response: Hi. I saw the photos (attachment removed to protect patient identity). It is just an old hematoma (blood clot), may be due to some blunt injury to toe like falling of hammer on your toe. Try to remember whether you had any injury there a few months ago. If it was due to injury, it will slowly fade away. If you cannot remember or it is not due to injury, it is better to see a dermatologist. I want to tell one other thing. In that photo, the left corner of nail, the skin is eroded. Do you have itching there and scratching it? Apply some olive oil there everyday at night." "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 got my wisdom tooth extracted a few weeks ago, and I am concerned about a piece of red tissue growth in my socket. I am not sure if it is just a new forming tissue. Please clarify. ### Response: Hello. 1. It looks like a piece of surrounding gum or gingival tissue remaining after extraction. 2. I wanted to know when did you notice this for the first time? Was it not there right after extraction, or did you not notice? 3. From photograph/your attachment, it does not look like anything major. (attachment removed to protect patients identity). 4. If you feel pain or sensitivity in it, I would suggest you consult your dentist. He will remove it from the site, and it will not interfere any more. 5. Just keep a notice of whether it is increasing or decreasing in size or any color changes. 6. Avoid very hot and spicy food at least from that side for some time. 7. Report me if you notice any changes. Follow up after a week." "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 the rabies virus survive outside the host animal under sunlight? ### Response: Rabies virus is not very robust under external environmental conditions. Direct sunlight and lack of humidity are very deleterious to its survival. It might survive for a couple hours or so, but there is no definitive proof. Rather what is important are the precautions that one should take if contracts virus. For example, washing contacts with soap and water are extremely essential. If the directly contacted skin is broken or cut then one may consider vaccination too. Let me know if you have any further queries." "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 query regarding a possible miscarriage. I am five weeks pregnant and I woke up with abdominal pain and found a discharge in my urine that looks like small pieces of solids (beige color with a fluid inside) and with small pieces of what looks like tissue. There was no blood and just orange discharge. However, I am on Progesterone. So, the orange discharge may be from that. I am concerned about the solid pieces. I went to a doctor and they did an ultrasound and said my cervix is still closed and both gestational sacs (I am pregnant with twins) are still there. I also did a blood test and my beta has been doubling as it should (currently at 1734 at 5 weeks). Could this discharge be something else? Does this sound like a miscarriage if there is no bleeding and the cervix is still closed? I cannot stop worrying. ### Response: No, this is the effect of the medicine. The discharge normally increases during pregnancy. And, if you are using vaginal suppositories, it may be because of staining. If the ultrasound shows everything is normal, then do not worry as your beta hCG (human chorionic gonadotropin) is good with doubling values. Do take rest. Do not exert yourself. Avoid intercourse" "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 13 year old said this tooth was hurting him when he bit down in class. So, he just painfully pulled it out. He is really concerned because the tooth has a root on it. It is the second one from the back on the top right side. ### Response: I have read through the complaint and the relevant details. Considering the age of your son, I am pretty sure it is the milk tooth that he has forcefully pulled out. Ask him if the tooth was loose and that he was not able to chew food properly on that side. Do not worry because it is a milk tooth which will otherwise shed on its own around this age if he had not pulled out himself. That empty space will be occupied by a permanent molar tooth eventually. You must have noticed that the pulled out tooth has uneven roots. It is a normal thing to be. Now my advice is that, please visit a nearby dentist to ensure there are no tooth remnants left behind in the socket which if present might hinder the eruption of the subsequent permanent tooth. Also, make sure there is no bleeding in that region and ask your son not to play and touch that region with his tongue. These are the ways one could help the socket heal properly" "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 32 year old female. I took Breeky for abortion two months back which completed successfully. Now, I have not yet started menses. Please advice. ### Response: Hello. Normally, the periods take around two to three months to resume after taking Breeky (Misoprostol). I see you have a high BMI (body mass index). That may be one reason for irregular periods. Also, hypothyroidism needs to be ruled out. Just check your TSH (thyroid stimulating hormone) and if it is more than the upper limit of normal, do consult a doctor nearby for starting treatment. In the meanwhile, try to cut down your extra calories and do workout. Hope this helps. Get back if you have any queries" "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 an abdominal CT done for pain in my lower abdomen, groin, and testicle that resulted after a sudden twisting movement. The report did not really address a cause for any of the pain, though when I was looking at the images, I noticed what appeared to be two stones of some sort on my right side. These were not mentioned at all in the report. I was wondering what they were. I am attaching the link to view the images. ### Response: I have seen the images (attachment removed to protect patient identity). I understand your concern. Regards" "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 intense itching on my scrotum and penis and along the sides of thighs and also some hard pimples are there on my scrotum. Please help. ### Response: Hi. As per your history, there are two possibilities either you have scabies or fungal infection, and treatment of both are different. Before deciding the treatment I advise you to send me a photograph of the affected area." "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 recently that my left arm seems to be raised automatically. This is also about my waist height. I saw a neurologist three years ago, and everything was fine. I also had a brain MRI in 2018 because I was having problems with gait, sometimes need to put my hand on the wall when brushing hair or teeth. My orthopedic doctor found that have a bit of cervical stenosis in my neck C3 and C4.I also hold my cell phone in this hand for many hours while typing. Sometimes when I try to keep three things in my left side, it is a kind of clamps up, and I forget what I am holding (about five yearslike this). Intake blood pressure medicines, and I take a large amount of sleeping pill called Zolpidem 20 mg per day. I am finding it a bit difficult to work sometimes and also suffer from a sore neck sometimes. ### Response: The clumsy hand and gait difficulties could be related to the cervical spine stenosis. Anyway, I would recommend performing a brain MRI and a physical, neurological exam by your neurologist, before coming to this conclusion. I would also recommend stop taking Zolpidem gradually. Instead, I would recommend switching to Mirtazapine, which can help regulate your sleep without the adverse effects of Zolpidem. I hope you will find this answer helpful. I remain at your disposal for any further questions whenever you need." "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 58-year-old male. I am healthy, and I do not have erection issues. My partner is 55 years old, and she is healthy. She visited an obstetrician and gynecologist last month. She is celibate for about six years. But now, we are living together for seven months, and we are trying to have a more physical relationship. On my first attempt, she had pain during initial penetration. During my second attempt, she allowed for penetration up to four inches, and she was very comfortable to have further penetration. During the next attempt, she started to have pain even beyond one inch of penetration. Can I know whether inserting finger during lubrication make intercourse uncomfortable during initial penetration? ### Response: Hi. At 55 years of age, it is vital to know whether she has reached menopause or still she gets her menses. Even perimenopausal status itself can cause atrophic vaginitis. The second reason can be PID (pelvic inflammatory disease). It can also initiate a deep pain during penetration. Due to prolonged abstinence, the vagina muscles can be tight, and it can also cause vaginismus. All these features are needed to be evaluated and ruled out before proceeding 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 prostate is enlarged, and it used to irritation while urinating. But after the treatment for enlarged prostate, the irritation has come down. I have enclosed my entire medical records for your opinion. Is surgery required now? Will eating fish aggravate my condition? ### Response: Hello, I have seen all your reports (attachment removed to protect patient identity). You had episodes of Urinary tract infection (UTI), which was fairly severe with WBC (white blood cell) count of 28,000. The ultrasound shows prostate to be 57 g. Prostate surgery does not depend on the size of the prostate only. It depends on how much obstruction it causes. So, I need the following information: Depending on all above, I can advise about surgery. You can eat fish, as there is no problem. Revert with more information to a urologist 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 33 year old male, who has schizophrenia and depression from the last 12 years. My current problem is low libido and erection-related issues. I do not wish to take any medicine like Viagra or other similar medicines. Please suggest a medicine which can cure my problem. I also need help in doing physical exercises, as I feel low in energy. My current medicines are Qutipin 200 mg, Oxetol 600 mg, Bupron 300 mg, Arip 30 mg, and tablet Qtencare. My testosterone levels are 150, and my current weight is 135 kg. I am also on medications for diabetes and high blood pressure. ### Response: I read your query and understand your concerns. I hope this helps you. Feel free to contact me if you have more questions" "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 checking on for my dad\s health condition. He has been urinating every once in a while. If I can give you a ratio of how many time he urinates in an hour, is usually twice which is not normal. On consulting a nephrologist, we were advised for an ultrasound scan. I have the report and I need to know more on this current condition. ### Response: Hi. I have gone through your query and reports (attachment removed to protect patient identity). The reason for this is not apparent on USG and needs further 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 40 years old. I have major adult acne breakouts mainly on my cheeks, neck, and under my ear. I am dark complexioned, so when it does clear, it leaves scarring and dark spots. The last dermatologist I consulted suggested birth control. Could please give some suggestions? ### Response: I saw your pictures (attachment removed to protect patient identity). I can see pus-filled acne along with post acne pigmentation. Start using Azithromycin 500mg of any brand for six consecutive days after breakfast. Apply Epiduo gel once daily bedtime for a short contact period of 30 minutes then rinses off with cool water. Start biluma cream once daily in the morning on the spots. Avoid all sorts of dairy products bedtime and prefer carrots and spinach along with few soaked almonds. Have reviews about salicylic acid peeling and plan for three sessions accordingly. I hope this will help 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 suffering from fever and loose motion for the past one day. I have taken Paracetamol and the fever has gone, but today again there is fever. I checked the temperature was 101.5 yesterday evening. Please suggest what to do. Today only two times I have gone but in the evening fever started with approx 100 temperature. ### Response: Fever associated with loose motion could be due to bowel infection. You need a complete physical examination as the fever has been persisting. So, should see your family doctor" "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: Due to an accident, I had unsafe sex. I went to the pharmacy to get a EPC or morning-after pill. However they said they were not being sold. They prescribed Althea cypriterone acetate ethinyl estradiol (2 mg / 35mcg tablet) from Trust and said to take 1 per day for the next 21 days. However if I understand correctly: Is this a normal contraceptive? I read some things about the yuzpe method, how would this work with the contraception described? And I already took one pill an hour ago. What should I do? I do not want to get pregnant. Especially since this is the 13th day since my menstruation, I am getting worried. ### Response: You should get emergency pills if they are selling normal contraceptive pills. Anyway in emergency pills the dose of hormones are more. So you can take 4 tablets two times a day for 2 dose. Can also works same as emergency pills. But at the same time you should understand that emergency pills are not 100 % safe and there is up to 30% chance of failure. But have only option after unprotected sex. And your cycle can be irregular for 1 or 2 periods if you are not pregnant. Best way to confirm whether pills worked or not is to wait for 15 days atleast and do urine pregnancy test on kit and see. If turns to be positive than you are pregnant and if negative than pills worked well. Do" "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 had a wisdom tooth coming out and my gums are swollen and I am suffering from the pain. When I brush and floss, it bleeds. What is this? ### Response: You need to go to your dentist and get an X-ray done to find out whether the tooth needs to be removed. Wisdom tooth always causes such problems due to lack of space causing infection due to food debris accumulating at the pockets of the gums there. Use warm salt water gargle twice a day for a week or two. You may need antibiotics too. If it started recently, then you can wait for two weeks or so to see if it erupts normally and comes to the correct position. If it is more than that, go to your dentist as soon as possible." "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 period was on 11th of last month. Now, the pregnancy report is positive and blood test for hCG was done in which report showed 1176. 14 hCG level and 48 hours later showed 1342. 41. Is it normal pregnancy? My age is 36 years. ### Response: I can understand your concern. According to your description, the possibilities are: You are pregnant which is indicated by urine and blood tests. Now, we have to confirm whether the pregnancy is in uterus or not. Usually blood levels of beta hCG should double in 48 hours. But that did not happen in your case. Now, we have to rule out the possibilities like abortion or ectopic pregnancy. For this, please undergo ultrasound once which will help in ruling out ectopic pregnancy. Take Progesterone supplements to prevent abortion. And repeat beta hCG levels again after 48 hours, this will help in confirming the site and nature of pregnancy. Ultrasound, repeat beta hCG levels after 48 hours. Ectopic or abortion. Progesterone supplements." "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 8-year-old son has nystagmus like eye movement only when he is in the car looking out the window and as soon as he looks at me, it stops. ### Response: Hello. The eye uses several mechanisms which help to keep it steady and focused in on a target. Such mechanisms are inoperative when the person is just looking in a particular direction and not trying to see anything specific or while 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 had done antibody for HIV1 &2 Rapid Screening Test at 63 days which was negative and then I did HIV RNA Realtime PCR Quantitative test at 69 days which was also negative \x80\x9cTarget Not Detected\x80\x9d. I heard PCR is very sensitive and conclusive. Is that true at 70 days as well? Should I be concerned or am I risk free? Although I am having diarrea from a few days ### Response: As the test are negative at 69 days , so you are free from HIV infection and need not to repeat the test. PCR test is usually not used routinely . Antigen antibody test can detect almost all cases after 4 weeks. If you can tell me about thest rapid test for HIV 1and 2 you have done then I can give more detail ? which generation test you have tested, was it 4th generation test ? 4th generation test can pick up more than 95 percent case at 4 weeks , and you have tested after 69 days and the results are negative. So just relax." "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 got a fever with a chill. So, got my CBC done in which hemoglobin is 14.5. TIC is 6800,neutrophil is 65, lymphocyte is 29, monocyte is 0, RBC count is 4.67, hematocrit is 46.8, MCV is 100.2, MCH is 31.0, MCHC is 31.9, and platelets count are 113.0. Malaria test is negative. Two years before, I already had a dengue and my platelets are usually 140,000 in number. What to do? Fever is 99.5. No vomiting and loose motions. Earlier i used to drink and also smoke five years back. Now, I have minimized a lot. I am a little worried. Kindly guide. ### Response: CBC seems to be good except for a mild decrease in platelet count. You need to do a dengue serology again but as of now there is nothing to worry about. Please let me know since when you are having the fever." "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 MRI scan report shows:Right central disc protrusion causing minimal thecal sac indentation which is seen just abutting the spinal cord at C5-C6 level.Disc protrusion causing subtle thecal sac indentation at C6-C7 level.Disc protrusion causing subtle thecal sac indentation at C4-C5 level.Disc protrusion causing subtle thecal sac indentation at L3-L4 level. ### Response: Hello. I read your query and went through your reports (attachment removed to protect patient identity). It shows there may be a minimal indentation of the thecal sac at cervical 5 and 6 vertebrae, and mild indentation at few other cervical levels due to a disc prolapse, which might cause a headache, a neck pain or a tingling sensation of the upper limbs. And, if the indentation is too severe, it causes vertigo and a reeling sensation" "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 recently developed acne on my cheeks. I use Cetaphil face wash twice daily and follow it with Biotique honey water toner, and Nivea moisturizer. ### Response: Hi. It seems to be mild to moderate acne, use acne soap bars containing Benzoyl peroxide. Wash face one time daily, not more than that. Avoid using antiseptic medicated soaps as they disturb natural face flora. Use Clindamycin 5 % cream, apply in the morning after face wash, and apply Adapalene cream 1 % at night time. You will see the effect in two weeks. I do not think at this stage you need any oral tablets. Let me know if you have more questions. Also, do not get pregnant while using these medications as these are teratogenic, and may harm the baby. Discontinue two to three months before if you plan for pregnancy." "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: About a year ago, I had a long break from doing any type of fitness. About five months ago, I started doing more things again, mainly little things like going out to hang out with my horses, and going to a therapist for a bit. Then around two or three months ago, I decided to go to a fitness trainer to get myself even more fit for my horse riding. I have been held back quite a bit by an issue, what tends to happen is normally when I do something strenuous (but it also happens when temperature switches or the air just becomes more humid) I will start feeling my heart rate become quite rapid and heavy feeling, then I feel dizzy (my head feels really weird) and I will quite quickly feel sick and have to throw up or at least dry-retch. The doctor thought it might be something to do with my thyroid glands so took a full blood test, everything looked normal, my trainer thought it might be anxiety but it has happened at times where I am at my calmest, and my parents thought it might be because I am unfit, but after doing training and my fitness is pretty much back up to where it was before my break, it is still happening and has not improved at all. I have always done sports for most of my life before the break, the main two being athletics and horse ridings (though I only do horse riding now as well as fitness training). ### Response: As per your symptoms, you feel dizzy when you do strenuous work or when the temperature changes (I guess when it becomes hotter) and when it is humid. As you feel nauseated. And you said that all blood reports with thyroid reports are also normal. The chances are this is due to vasodilation, that is the blood vessels dilate so the adequate amount is not reaching heart which in turn reduces blood supply to organs. Vasodilation. 1.Vasovagal syncope.2.Hypovolemia.3. Postural orthostatic tachycardia syn" "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 right shoulder is excruciatingly painful. I play quarterback in football and I am 16 years old. Since I participate in a throwing sport, dead arm syndrome is something that I suspect may be the cause of my pain. I have also noticed that my upper right trapezius if lower than my left one. Please help. ### Response: Hello. At present I would suggest you to follow price protocol, that is protection, rest, ice, compression, and elevation. I would suggest you to stop doing any sports activities which aggravate your pain. Once pain subsides you need to strengthen the shoulder muscles as this condition develops due to weak shoulder muscles. I would suggest consulting any physiotherapist to learn how to strengthen your muscles. It is very important before you proceed to play otherwise you might get reinjury. If your condition does not improves within a week consult any physiotherapist. 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: My son is a bipolar patient, he is not taking drinks, and smoking mean while for the last four months. He is under treatment for bipolar disorder. Now, after four months of treatment, we put him to college after the gap of two years, but he just went for a week and not going now. He was on Quitiapine 300, but he got angry so the doctor increased his medication to Quitiapine SR 500 and Oxetol 300 twice. I am too worried after the change in the medication my son has an urge for smoking. ### Response: From your description, I understand that your son has developed bipolar disorder or psychosis in the background of substance misuse. He is on medications (Qutiapine and Oxetal), which are mood stabilizers and antipsychotic medicines, which will be helpful to treat your son\s condition. Therapy and motivational interviewing will help to treat urge to have cigarettes and other" "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 50 years with PAF. My first A-Fib was five years ago. I converted on my own. It went away for five years and in the year end, I started a keto diet and went into A-Fib twice and converted on my own. Started keto again and went into A-fib twice again and converted on my own. My cardiologist has me on 50 mg Flecainide twice a day. I am also on Prozac 20 mg and Trazadone 400 mg. I am concerned about developing Prolonged QT, and I am not sure if Flecainide is really necessary? I am worried about what Flecainide will do to my heart. I have a healthy heart otherwise. 60 resting heart rate and 95/70 BP. ### Response: I passed carefully through your medical history and would like to explain that you are right when you worry about your current medications. Both Prozac and Flecainide increase QTc interval and may predispose for arrhythmia. I would recommend stop continuing their concomitant use. But if it is not possible for the moment, you should discuss with your attending doctor to keep the most indispensable" "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 chronic kidney disease and am on dialysis and scheduled for transplant next month. Today I tested positive for genital herpes. Will this cause me to not be able to receive a transplant? I know you have to take immunosuppressants and I do not know how this will affect my situation. ### Response: Hi. The immunosuppressive agents taken post-transplant will increase the risk of having an outbreak of genital herpes. So you have to report to your doctor to put you in a prophylactic antiviral therapy." "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 unprotected sex before two days. The next day, I took one Yaz pill. Do I need to take more pills? Will it be effective? ### Response: I have gone through your history, and I can understand your concern. Delayed menses can occur due to hormonal imbalance caused by sex. Do a home urine test if you miss your period by seven 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 22 weeks pregnant. Due date is after three months. I smoked marijuana for the first few months to help with severe morning sickness. I stopped smoking probably last month. I went to a gynecologist this month, and they took a urine sample in which they tested for drugs and marijuana was the only one I tested positive for.After two weeks of my appointment, I smoked once to help with a bout of morning sickness and have not since then. And I have planned not to do ever again during my pregnancy. My next appointment is after one week. Will I be threatened with CPS because of my positive urine from last time? And will they test my urine at my next visit? I am only 18, and I am very nervous. I am concerned because before I got pregnant, I smoked marijuana every day since I was 15. How long will it stay in my system? How can I safely detox it from my body? ### Response: Hello. My advice to you that please stop taking marijuana, if you love your baby, then please stop it right now, because it affects your baby growth. And why you want your baby to suffer because of you, so please stop it and the other thing there is no safe antidote of marijuana. So better is to stop it, and yes, marijuana remains in your body system for up to three weeks. Please take medicine regularly and do USG (ultrasound) regularly and please for your child please stop to take marijuana." "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 pain in the left lower jaw. I do not have any tooth pain, but the skin surrounding the last tooth is troubling me. Please help. ### Response: I think it can be due to pericoronitis. This is a condition where the tissue over the erupting wisdom tooth will get inflamed. Apply anesthetic gel in that area. Do lukewarm saline mouth rinse three to four times a day. If possible attach a picture for better diagnosis." "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 surfers eye or something similar, my doctor claims it is a freckle at the surface of the eye but my insurance does not cover the removal since it is harmless. So, is there any other way I could get it removed? ### Response: Hi. Surfer\s eye also called pterygium is a fleshy growth over the cornea. It is formed due to UV light. Small pterygium does not affect but large pterygium may cause astigmatism and blurring and may need surgical removal. I am not sure about your insurance policy but usually, cosmetic surgeries are not covered. So, if it is causing blurring or astigmatism, then you might claim that it is affecting your vision. You should discuss with your doctor and he might make a way out for you within legal limits of your insurance policy. Second is you get it done privately but that may cost you. So, discuss with your doctor and I hope he will suggest you the best." "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 age is 27 years and I am a female. I have anemia with a very low ferritin level 2.1 and HB is 6.5. Can it be cleared by taking diet and iron supplements? Which is a good time to take Zincofer syrup, how much ml? Please advice. ### Response: Your symptoms are suggestive of iron deficiency anemia. I want to check your full CBC report. The investigations that are suggested in your case is peripheral smear examination, transferrin saturation, and serum TIBC (total iron binding capacity) also. You need to be given iron sucrose injections to replenish lost iron store and to improve hemoglobin level. Then maintenance with oral ferrous ascorbate tablet or iron syrup can be prescribed for three months. Provide your reports 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: The patient is 62 years old, weight 41 kg. All test reports are normal. There is a boil problem in the upper half of the right leg above the knee. She is having a burning sensation due to the same. It is spreading. Is it due to insect bite? ### Response: Hi. It is not boil (attachment removed to protect patient identity), it is a case of herpes zoster. How long she has been suffering from this? Is this her first episode? Diabetes? Burning and pain are there?" "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 18 years old and my grandfather said I might be teething because one of my molars are swollen. He said once I lose this molar, a new one comes in. Is that true? ### Response: Hello. He is not wrong nor right. If your molar in the age of 8 was not replaced with a permanent one and if there is any chance of having a molar in eruption stage then it may be true. Generally swelling around teeth comes due to gum inflammation or due to some infection in teeth. In both cases, you need to visit a dental clinic. Just get this swelling checked before it becomes some severe infection and know the status of your teeth whether they are temporary or permanent 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: My husband and I had intercourse on the 25th night and the tip of his penis started bleeding during this. It was the first time he inserted his penis inside. The bleeding stopped the next day but the pain persisted. Today, there is a slight pain but he is afraid if he pulls the foreskin back, the bleeding will start again. He is also afraid that in the future the same thing might happen. Is circumcision necessary now? Is there any ointment or cream to stop the bleeding if he inserts again? Please advise. ### Response: Hello. From what you say, it is likely that your husband is suffering from coitus related frenular tear. No ointment can cure or prevent recurrence of the same. A minor procedure like frenuloplasty is still associated with recurrence. Ideally, circumcision and 6 to 8 weeks abstinence are the best treatment options. Kindly visit a Urologist for further management." "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 31 year old male working as a software professional. I have been facing a problem with anal pain during bowel movement and also feel the pain after the bowel movement for some time. I have been facing this problem since 10 days. Motion is normal. I have overcleaned the anal area and had itching of the anus for sometime before the actual problem started, but not now. Please suggest medication to heal the problem. ### Response: I went through your post. The treatment is almost the same except for a severe anal fissure that is bleeding. Regards" "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 C-section delivery last month. Although stitches are healed and I am not having any trouble in the incision area. Since the last one month I am noticing that the area around my navel region has sunken in. I am having a rounded depression starting from the belly button to downwards. I am not having any pain in the area. Can you please have a look at the pictures and let me know what it could be. ### Response: Hi. I have seen your images (attachment removed to protect patient identity). This is not abnormal. Your tummy fat is dissolving which was accumulated during pregnancy. Your uterus is also sinking that is why your tummy appearance is like this. It might take a couple of months to get it normal. As you had C-section recently so I will not suggest any exercise. You can use an abdominal belt if required for support. After six months, you can start exercise to get it in normal shape." "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: Please tell about worm infection. I am 20 years old and had worm infection twice in the year and had also completed Vermox Mebendazole course of three days twice. Please suggest taking it again is dangerous to health or not? ### Response: Usually, you develop worm infestation when you consume food which is uncooked, not washed properly, or if you eat food out frequently (from the infected food handlers). Alternatively, you can take tablet Albendazole 400 mg single dose. Once in six months or once a year should be fine if you eat out frequently. Consult your specialist doctor, discuss with him or her and start taking the medicines 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: My husband went to the hospital before four days because he felt dizziness and chest pain. They found no troponin and told us his EKG was fine. His bp was 105/70 mmHg in the hospital. The next day we went to a cardiologist and found partial right bundle block and he ordered more tests. Today we heard that his grandmother had IHSS. We were not aware of this during our appointment with the cardiologist. Today he went to the grocery store and he felt the same dizziness symptoms, though it was not the same degree as before. My concern is whether if this is something to go to ER? His BP 15 minutes after today\s syncope event was 123/70 mmHg. ### Response: I understand your worries, but there is nothing much to worry about. It is common to have an event of fainting and dizziness, I see often amongst my patients with RBBB (right bundle branch block). RBBB is due to a slow heart rate that is why he is having dizziness often. You should not worry about going to the ER (emergency room) as his blood pressure and heart rate is normal for now. You should keep monitor of the rates at least every two to three hours. Hope he gets better soon." "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 two small anal skin tags developed from healed fissures. Physically they do not bother me much but mentally I do not like to have them. I consulted a doctor, he said he can only remove 90 % of skin tags as removing completely will affect the sphincter muscles. He also said skin tags might grow back in future as skin looses as you age. Is there any side effects of the surgery or should I go ahead with surgery? Do the skin tags reappear after surgery? ### Response: Hello. I will definitely help you regarding your query. Skin tags are formed in long standing anal fissure. These are nothing but accumulated skin due to fissure. Usually nothing to do that but if you do not like them, you can opt for surgery. It is a very minor surgery. No side effects or any problem after removing them by experienced hands. A raw area will form that will heal by its own. It can reappear if you have another formation of anal fissure. So avoid the conditions that will cause it again. So do not worry just go through the surgery if you do not want them." "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 daughter has a fever for the last two days. She has tonsils. The doctor has given half Dolowin Plus twice a day and Ziprax 100 DT twice a day. Yesterday she had 103 fever. Fever does not come down by Dolowin Plus. So I gave Meftal P 100 mg. But in the night and the day she did not have fever. But now again she has 102.4 fever. Can I give PCM with Dolowin Plus? ### Response: Hi. I can understand your concerns. Dolowin plus has already got Paracetamol in it so there is no need to give Paracetamol with Dolowin plus. You can give Dolowin plus every four hourly if fever persists. If there is a fever in spite of giving it, then cold sponging of the child should be done. If fever persists then Widal test and malaria antigen test and complete blood count should be 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: There is pain near the lower back portion above the tailbone in the right side, little swelling too. There is no problem in walking but sometimes it pains too much on some jerk or stretch. ### Response: Hi. This seems like coccydynia, pain of coccyx bone or near to it. Did you have a fall on your tailbone a week back? Also, if you had lifted something heavy, this kind of pain may come to lower back and may get radiated to buttocks or lower. Do hot pack for 3 to 4 minutes and ice pack 1 to 2 minutes, at least two sessions in a day. If you have any local pain relief cream, please apply it locally. Those painkillers will not work for this pain. Let me know in five 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 an 18 year old girl, I am having left abdominal pain and burning sensation on urinating. I did an ultrasound, but it was normal, and no renal stones were found. After few days, I started having pain from the back till the bladder, vomiting, and weakness. So, I got admitted, and they gave me painkiller injections, IV fluids, tablet Levofloxacin 500, tablet Flavoxate, tablet Pantop, and tablet Voveran. I am not discharged still, and I have pain. The doctor diagnosed it as urinary tract infection. Is it really UTI? ### Response: I saw your reports (attachment removed to protect patient identity), and from what you say, it may be a urinary tract infection. To rule out urinary tract infection, I would suggest urine culture. Left sided pain can occur if the left kidney and ureter is infected, with obstruction. From your ultrasound report, there seems to be no obstruction to urine flow from left kidney. But, ultrasonogram is prone to errors. I would suggest CT KUB (computed tomography of kidneys, ureter, and bladder) for better decision making" "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 repeated thoughts of past bitter situations all the day for the past six months. I get easily upset and I start crying for unnecessary reasons. This is making my life hell and I have no peace at all. I am having a very poor concentration, not able to study. These thoughts are killing me literally in all ways. Kindly help me out in this situation. ### Response: Hello. You seem to be suffering from obsessive thought disorder with depression. You may have compulsion but you have not mentioned in your symptoms so it seems to be only an obsession. For example, having an obsession with contamination and compulsion of washing unnecessarily with frequent hand washing. In obsessive thought disorder, it is difficult to control your thoughts though you know it is unnecessary. You must start taking antidepressants medication which can help you with both obsession and depression. Your obsession will increase with stressful situations. Capsule Fluoxetine 20 mg daily in morning after breakfast can be started. You need to monitor for a long time and increase medication doses to control your obsession. Consult your specialist doctor, discuss with him or her and with their consent take the medicine. It is a very minimal dose. You may need higher doses. You can learn to do relaxation to decrease your anxiety from thoughts" "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 18 years old and I took five I-pills within two months and I am not getting periods. The last I-pill I took was before two days. Will it affect me in future while having a baby? Does it affect my fertility? Please answer me as soon as possible. ### Response: Hi. While I-pill is a good emergency contraceptive, it is an emergency contraceptive. Taking five in two months is way too much. Please stick to routine contraceptives like pills and condoms and use I-pill sparingly. Now having five I-pills in two months will not have any long-term effect. It will not make you infertile. But it will lead to menstrual irregularities which might last for 3 to 4 months" "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 aged 27 years is going through her 5th month of motherhood. Before delivery she was looking good and also her skin was fair as well as good. But now her skin got darker, there are some spotting on her face and also dark circles around both the eyes. Kindly help to improve her appearance. ### Response: These changes are all due to hormonal changes which occur during pregnancy. So, it is very difficult to treat. It is better to avoid any treatment during this period. Moreover, these changes many times subside after pregnancy or lactation period. So, counseling her is the best choice. Use a safe soap or cleanser like Cetaphil to wash face. She can use sunscreens like Shade lotion 2-3 times a day. It helps to prevent darkening of skin. Ask her to take nutritious diet as recommended during pregnancy. Do not strain or rub the eyes and give rest to the eyes. Check if there are any refractive errors of eye." "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 smoking habit for the past eight years. How can I stop smoking? I have used Nicotex to relieve this issue. Please explain. ### Response: Hi. I have gone through your post and understand your concern, Let me assure you that quitting smoking is not that difficult as people believe if you have a strong will, there are many treatment options. I would suggest some of them. You can start Bupropion sustained release tablet once a day before stopping smoking for a few days and then once you start to feel disliking smoking, stop cigarettes and take it twice a day. You can chew Nicotine gum if you feel an urge at any point in time. However, as I said strong will for quitting is important." "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 suppose I am suffering from anxiety. Also, I get scared of certain people or situations where I feel that I will be judged. Always, I think that people are judging me on whatever I do. So, I get anxious. This is a pattern since long. I understand that I can overcome it, as I find that there are few reference points in my memory where I have handled those situations well. I think I need help now as it interferes in my day to day life. Although I am able to manage it till now and am leading a good life, I think that I can do much better at work and relationships and will be able to enjoy life. ### Response: I can understand your problem. Feelings that people are judging you, becoming conscious when people are around you could be occurring due to anxiety, most likely social anxiety. This should be evaluated properly. Social anxiety can be treated easily with medicines and behavior therapy. This will help improve your productivity. Please provide me more details in follow up" "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 beta thalassemia trait a serious case? ### Response: Hi. Let me explain you about beta thalassemia trait. It is good that you are aware of using online health portal. Beta thalassemia trait is the heterozygous condition and the patient can live a normal life. If nutrition is not maintained properly and if any unusual excess bleeding occurs because of some reason then sometimes Hb can be decreased and the patient feels weakness because of that. But as such thalassemia minor patient have no any problem which hampers usual lifestyle. You have to take precaution while doing marriage. Before marriage, your fiance thalassemia report should be done. If she is also having thalassemia minor then the chance of the baby having thalassemia major is 25 %. And thalassemia major is danger condition. Hence just keep in mind that before marriage your fiance should also be checked for thalassemia minor. If you are not having thalassemia minor then no need for further testing of your fiance." "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: Dear Doctor,Is it safe for a 9 month baby to travel to the Dominican Republic? Also, is it safe for a 8-9 month old to take vaccines for malaria and typhoid? ### Response: It is safe to travel to Dominican Republic, but you need to care abut many issues. While traveling there are many issues related to health of your baby, example: he can get infection like malaria, typhoid, hepatitis A & E and varicella. For food related infections (typhoid and hepatitis), you need to maintain hygiene and use trusted and clean water source and food. Avoid contact to persons having fever/rash/jaundice/loose stool/abdominal pain/vomiting. Regarding your query about vaccination for malaria and typhoid. So conclusion is that you can safely visit there by taking some prophylaxis. Hope this will help you. You can ask any further query regarding health issues of your baby before and during the journey or there after to a paediatrician 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 on 200 mg Quetiapine IR for some time. Finding it after years of medication tweaking to truly keep my bipolar II symptoms in check, with no significant side effects. I ran out while traveling abroad. Though I have no means of obtaining a new prescription, I do have plenty of Seroquel XR (in 50, 150, and 200 mg dosages) with me. For two nights, I have tried taking a 200 mg XR pill in the evening. Unfortunately, I have gotten little to no sleep and am very concerned about sleep cycle disruptions, as they have always led to more severe symptoms in the past. Moreover, I feel the sedative effects throughout the following day, an impairment I simply cannot afford to deal with right now, as well as a more persistent general sense of anxiety and agitation.If I were to simply crush these pills into a powder, would I be able to take them as though they were immediate-release of the same dose? Or would doing so alter the medication\s properties? I am aware of the medication guide\s instruction against chewing or cutting the sustained-release pills in any way, but I wish to know what the actual effects of doing so would be. Any suggestions on minimizing related risks, like food or water consumption tips, titration from a lower dose, etc. ### Response: Hello. Let me enlighten you with the concept of IR and XR medication." "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: Four months ago, I had an encounter with a CSW. During that time, I kissed her mouth, boobs, and the outer lips of the vagina (not vagina). I had taken tests for HIV, HBsAg, HSV, after three months and all those came negative. During that time, I had taken a normal urine test for UTI. In that report, the pus cell values are 3 to 6.My questions are:I had not taken any separate test for gonorrhea, chlamydia, or trichomonas. May I take that normal urine test report (whose pus cell values were 3 to 6) as conclusive because in a forum, I have read that pus cell values of more than 10 is only considered as STD. Or, do I have to take a separate test for those?Is there any chance of oral HPV transmission by kissing the lips (mouth), and the outer covering of vagina. If so, is any blood test available for testing oral HPV? ### Response: You said you did your HIV test three months after sexual exposure. So, it is very unlikely that you got infected. Secondly, the likelihood of getting gonorrhea and other infections which you mentioned are very unlikely after three months. If you had developed gonorrhea, there would be discharge or bumps over the penis within one month. About oral HPV, if your sexual partner had this infection, then there is a possibility of transmission, but that too is very unlikely. If you had developed, you would have symptoms by now. There would be at least minute warts that would have appeared over the oral cavity or genitalia. So, do not get tensed. Be cool" "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 lean body. I tried many times to gain weight but failed. Should I take protein shakes or diet only? I am very upset about my body. Please help me. ### Response: Hello. Very few people ask us how to gain weight. It depends on bodies basal metabolic rate. Many people who eat too much but still will not gain weight because they have a high basal metabolic rate, which we call it as BMR in medical terminology. Some people eat very little but are fat or obese. The BMR of an individual depends on his or her genetic makeup. You can try having a high protein diet or protein supplements. I suggest you visit a nutritionist or a dietitian who can help you with proper food requirements based on your body requirements as every individual has different BMR. I hope this information 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: For the past three months, I was having a dry cough. I consulted a doctor who advised me Augmentin 625 mg, Grilinctus, Betadine gargle, and steam for five days. That gave me a lot but not full relief. I continued gargle and steam for some more time. Since then, the cough is reducing. But, some amount of mucus remains in my throat. Nothing comes out but keeps giving me a feeling of something there. ### Response: The problem you are suffering is a viral illness that is temporary. You also need to check for any triggers that cause the mucus to increase. The feeling in your throat may possibly be due to" "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 mom has a severe abnormality in the lower abdominal part. On doctor\s consultation, we have done USG. In the report, the impression shows that mild hepatomegaly with grade II fatty changes, right-sided mild hydronephrosis, bulky heterogeneous uterus with multiple SOLs. What does it mean? Is there anything serious? Which type of specialist we should consult in this case? ### Response: Hi. There is nothing to worry about. For hepatomegaly, you will have to lose weight and avoid oily foods. There is mild SOL (space occupying lesion) in the uterus which could be because of hormonal changes. Please get yourself checked by a gynecologist with the reports. However, if you have a doubt then get 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: I have attached two ECGs, one from recently and the other from last year.Please discuss at length with no holding back on technospeak as to whether the latest test shows any improvement. Any information is appreciated like the severity of infarction, estimated time ago it happened, etc. It would interest me greatly to know whether the infarction occurred 55 years ago with a diagnosed rheumatic fever. Is it possible it was not rheumatic fever? I suffered a fall a few hours before the symptoms. No streptococcus involved condition. I was 11 and am now 66 years old. ### Response: ECG does not show any sign of infarction, rheumatic heart disease. It only has right bundle branch block that is a normal finding. Rheumatic heart disease is best diagnosed on echocardiography. ECG fails in that purpose." "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 pain in my left side of the chest and under armpit from the last one week. My EKG report is clear but my resting heart rate is always 50 to 60 bpm. During running, my heart rate is 100 to 130 and during walking, it is 70 to 90 bpm. My blood pressure is 100/70 mm/Hg. My age is 27 years. I am single, non-smoker, and do not consume alcohol. What reason can cause my left-sided chest pain and low heart rate? ### Response: I passed carefully through your question and would explain that your symptoms do not seem to be related to any cardiac issues. Considering your age and the fact that you have no cardiovascular risk factors there is nothing to worry about your heart. Your heart rate and blood pressure fluctuations are quite normal during physical activity and do not indicate any serious cardiac condition. Anxiety may also trigger this clinical situation. I would recommend using painkillers. If the pain persists, I recommend performing a chest X-ray study, a cervical spine X-ray study, complete blood count, PCR (polymerase chain reaction), ESR (erythrocyte sedimentation rate) for inflammation" "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 30-year-old married woman. I have got my last period before two months. I am having nausea for a few days. I have tested through pregnancy kit, and it is negative thrice during these two months. What should I do? Is there any blood test or other way I can check what is wrong? ### Response: I can understand your concern. Irregular periods can occur due to many causes like stress and strain, dietary changes, etc., leading to hormonal imbalance. General conditions like anemia, thyroid abnormalities, etc., can also cause irregular periods. To find out the exact cause of the problem, please go for a blood test to check pregnancy which is more accurate than a urine test. If that gives negative result, pregnancy is almost ruled out. The other option is ultrasound, which helps in ruling out the pregnancy and also to find out other possible causes of irregular periods like PCOD, etc. Hope I have answered your 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: I have a burning sensation on the feet for three days. I am currently under Clonazepam. ### Response: Causes of burning feet include peripheral neuropathy and plantar fasciitis. I suggest you use footwear even at home and take over-the-counter pain medications to alleviate pain. You may also use Diclofenac gel for local application. If the symptoms do not subside over one month, please get electroneuromyography of the lower limbs to look for nerve involvement." "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 had an echo test. The report says \Mildly dilated LA. Normal LV size, with moderately reduced function. Mild MR. LVDD II\. What does it mean? ### Response: Did he have any chest pain or heart attack in the past, or is he diabetic? To summarize the report, it says there is a decreased functioning of the heart, which most commonly occurs due to coronary artery disease or sometimes due to the weakening of the heart muscle. So, he should get his evaluation done, ECG (electrocardiogram), lipid profile, sugars both fasting and post lunch, and angiography. He should be on medicine to prevent further decline in the heart functions which includes Aspirin, Clopidogrel, statins like Atorvastatin, beta blockers like Metoprolol, ACE (angiotensin converting enzyme) inhibitor like Ramipril, and diuretics like Spironolactone, etc. Hope this helps you and get back if you have any doubts" "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 cold, cough and I am ill for the past two days. Please suggest any medication because I am having my exams. ### Response: lt is the body\s mechanism to fight off the infection thats why we get cough and sneeze to expel the infection and it is not the medicine that could help you for the exam. Purchase a steamer or dehumidifier, pour in camphor oil or karvol vapocap cut it, and pour its oily content in the water and take its steam. I assure you nothing will help you better and quicker than this. After that try studying, taking the help of a spectacle (zero power). Take karvol steam thrice daily and continue Montair-LC once daily for three days. It will be alright soon." "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 trying to conceive for one year. I am 30 years old. I have children already. Tracking BBT and LH to determine ovulation days (which I have found my peak). I had lots of irregular periods with 20-day cycles. Last cycle was 26 days. I want to try Clomid because I believe I may be having problems with the release of eggs. Please help. ### Response: Hello. Before opting for ovulation induction in your case, it would be important to learn if your partner\s semen analysis is normal on the first hand. Your cycle seems to be regularly irregular, which is often seen in cases of women with estrogen deficiency and the ones with progesterone deficiency. As you have mentioned that your thyroid is normal, but my primary concern with regards to ovulation remains the estradiol levels, FSH, LH, AMH, serum testosterone on day 3 of your cycle and serum progesterone on day 21 of your cycle. Without having these reports handy, it would not be recommended to opt for Clomiphene citrate to induction ovulation. Please share your latest ultrasound pelvis as well to check for your endometrial thickness in proliferative or mid-cycle. Also, app tracker for LH is futile, rather it is suggested if you can opt for LH ovulation kits to actually determine your LH surge during cycle as that would be more objective." "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 had a kidney transplant for three years. His health condition was good until last year, but for the past seven months, he started getting a fever for every 15 days. They have taken his full body tests twice in these six months, and everything seems to be fine, but the fever is continuing for every 15 to 20 days. Please help us how to know the reason and rectify it? ### Response: Kidney transplant patients are one medication that weakens the immune system of the body. This increased the risk of catching any infection. Plus there is a chance of reduction in white cell count due to the same medication. That is why I suggest you do the following. 1) Blood complete picture, this will show if you have low or high white cell count and might also give an idea to the type of infection like bacterial or viral. 2) Blood or urine culture to identify quickly any possible infections. 3) Chest X-ray to see if there is any chance of infection. If it is more, they may require a reduction in dose. 5) Doctors checkup will help identify any places where infection could have started like chest abdomen throat etc. I hope this answers the question. In case you have any further questions then feel free to contact in writing." "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 is suffering from high BP from two days. We met a cardiologist and I have the reports. Can you look at them? Our business is not going well. So, he is a lot tensed lately. He had something similar two years ago. ### Response: Hello. I have seen the echo report you provided (attachment removed to protect patient identity). It is a normal echocardiography report. (You have not provided" "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 taking my second-day pill of my Krimson 35 for PCOS. I had unprotected sex with my husband, and we are not planning for a baby now. Should I take I-pill also along with Krimson 35 to avoid pregnancy? ### Response: Krimson 35 (Cyproterone, Ethinyl Estradiol) is used as an oral contraceptive pill as well. It should be started from day one of the periods. So if you are having periods and started Krimson as well from day one and had unprotected sex, then there are fewer chances of pregnancy or conception. There are fertile periods in each cycle and first five days of periods in which there is menstrual bleed are included in the infertile period of sequence, so fewer chances of pregnancy if you have started Krimson in periods. You can further clarify if Krimson not taken on the second day, then kindly mention which day you have started Krimson. Have a balanced diet, weight, and BMI. Send scan and detailed sex hormonal markers reports as well. As above. With detailed history and reports." "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 severe infection on my penis head which I suspect (also confirmed by a doctor) to be Zoons balanitis. The infection has been for a year now. I am circumcised and this infection has been recurring for the past six years in the same area. The infection has eaten off whole skin on my penis head and also blocked my urinary opeing. It is so painful and burns when I pee.I have been applying a Fucibet cream for seven days now and also taking antibiotics prescribed by a Dermatologist but no improvement. I do not know what to do. I have been to various doctors including Urologists. They have done biopsy and results came back negative on cancer cells. I have tested positive for herpes and MRSA. Please help. ### Response: Hello. Can you send a picture of your lesion for proper diagnosis and treatment? Please avoid application of steroids over the area. It is good that you are circumcised." "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 31 years old. I am married for the last two years, but still, I am not successful in doing intercourse with my wife and I am really frustrated. Also, my foreskin on the penis does not draw back when tried. I want your help in doing successful intercourse with my wife. When I consulted a sexologist, he says that I need to do circumcision, as the foreskin does not draw back. When I try to insert the penis, it is not getting inside her vagina, but shrinks and stays at the head of the vagina only. Please help. ### Response: I understand your concern. You are having phimosis. In phimosis, the foreskin does not role back and it is difficult to do intercourse. The other thing which can cause foreskin not to roll back are genital candidiasis but as per your description, you are having phimosis. You should do circumcision, it is the best treatment available and it is very effective. You should consult a general surgeon or urologist, they will do the procedure in your penis. Do not worry circumcision is a minor procedure done under local anesthesia and it is an out patient procedure. It will take only two weeks to recover completely and it will solve your problem permanently and also it will help you to enjoy sex also. 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: My partner missed her period. We have done home pregnancy tests which showed negative. She does not have any pregnancy symptoms either. What may be the reason of her missed period? ### Response: Hello. Kindly note that we cannot rule out pregnancy still so wait for another 4 days and do urine pregnancy test again. Were her periods regular before? Does she have any medical illness like fever in last week? Any stress? Any thyroid problem? Any mild bleeding per vaginum? So kindly answer above questions so that I can help you more." "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 25 year old female. I noticed a yellowish-brown coating on my pubic hair and underarms. The affected area is smelly too. Is this something to be worried about? What medicine should I take? I have uploaded an image that is very similar to my condition. ### Response: Hello. I have seen the image (attachment removed to protect patient identity) and understand your concern" "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 lowering (variable) neutrophil for past two years. The count is like 2.6, 2.3, 2.0, 2.43, 1.91 being recent, which is lower than usual. The other counts like lymphocytes, platelets, and hemoglobin, RBC are all within range. My only problem is I am getting recurring cold. In the last result, my MPV came a little higher 13.10, whereas normal being 12. I am fearful of leukemia.I did peripheral smear test as well. No abnormal cell was seen in peripheral smear. Only mild neutropenia was seen. I need help to know precisely why only my neutrophil is getting down? Is it leukemia? ### Response: Your absolute neutrophil count is borderline low in the recent report. In the value of the previous description was within the range that is more than two. So it cannot be called persistent neutropenia because the normal range is more than two. Anyway, your peripheral smear examination report does not show any abnormal cells. So the chance of leukemia is very less according to the mentioned report and peripheral smear examination report. The repeated cold can be responsible for an increase in lymphocytes and so relative neutropenia can be seen. I hope I have answered your question. Let me know if I can assist 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: My problem is severe itching beneath the belly and between thighs. There are also marks. When I first consulted, the doctor prescribed Onabet cream. It did not go. The second time, another doctor prescribed Permethrin cream. It did not go. Later I consulted a doctor directly and he gave me Ebernet cream. Still, I have the issue. I also used Clotrimazole cream. It did not go. I maintain good hygene. It is almost like dermatophytes as one of the doctors said. Please prescribe me a strong ointment. ### Response: I have gone through your case. Sometimes fungal infection may require six weeks of treatment. And problem arises when the patient leaves treatment halfway considering it is not effective and then it becomes resistant, and require even prolong treatment. Similarly, itching due to" "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 been put on Prednisone steroids for 21 days because of an allergic reaction to poison ivy. I have been off them for almost three weeks and I still feel withdrawal symptoms. The latest side effect, tonight, was red finger tips with white palms. The soles of my feet are also very red. Should I go to the hospital or wait it out? I do not want to lose my hands and feet due to a medication I have been given. ### Response: Hello. I read your query and understand your concern. You received Prednisone for 21 days and have stopped them three weeks ago. Let me explain about steroids. Steroids are tapered slowly if taken for a duration longer than a week." "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: For the past three weeks, I have had my normal right eye floaters seem strange. I noticed peripheral flashes when blinking and walking and quick black narrow lines. I saw an ophthalmologist. He found the retina to be fine. I now have some flashes around peripheral in the right eye and a new large annoying floater, no curtain or loss of vision. Talked to an ophthalmologist last night. Said not to move eyes much. Should I go to ER? No vision loss. Just flashes and fast moving stringy floaters and flashes when moving eyes and walking. ### Response: Hi. The hollow of the eye is filled with vitreous jelly. With aging, the jelly starts to liquify and separates from its attachments to the retina. This results in a little tug on the retina, resulting in flashes. This phenomenon is known as posterior vitreous detachment or PVD in short. The large floater appears when the PVD is complete, that is, it detaches from its final strong attachment on the optic nerve head in the retina. What you are experiencing is normal aging of the vitreous jelly. Now in this process, sometimes breaks may form in the retina leading to floaters. Floaters may be due to the cells from the back of the retina gaining access to the vitreous cavity through the breaks in the retina. Sometimes floaters may result when the break involves a retinal blood vessel. It is extremely important to get a dilated fundus examination done on an urgent basis to rule out any of the breaks. If found, they can be lasered to prevent further progression to complete retinal detachment. So kindly do see a retina specialist. Let me know how it went." "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: Dear Doctor,I have not get periods since 45 days. Normally I have a problem of delayed periods. Pregnancy test came negative.Can you please advise? ### Response: Hi. If you are having delayed period, there could be lots of reasons for it. So I would suggest you to check your thyroid and prolactin staus and also get a TVS done to see the condition of your ovaries. However, it will not cure your primary cause. You must find out the primary cause to get permanent relief. 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 a wheatish complexion. Can you please suggest if I can use Kojivit cream for skin lightening? ### Response: Yes, you can use Kojivit gel (Kojic acid) safely daily. But, it only removes extra tan from your skin. You can try using a Glycolic acid based face wash for better results of skin lightening. Make sure that you apply sunscreen every 5-6 hours. You can also get chemical peeling, microdermabrasion, and laser done from a dermatologist." "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 dry, scaly patches on the scalp for the last six to eight months. Since childhood, I have severe dandruff, mild itching and hair fall. I consulted two doctors. First one said that it may by scalp psoriasis and the other told that it looks like some fungal infection. I am using Salisia KT shampoo. I do not have scales on any other parts of my body. I am worried by thinking it may be scalp psoriasis. I can easily remove the scales present on the hairline. Please suggest ### Response: Yes, the symptoms can be of both seborrheic dermatitis and scalp psoriasis. Please follow up with the photos as it will help me to arrive a final diagnosis. Revert back with the answers to the above questions 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: My penis is very small (3 to 5 cm). It is the size of a child. My age is 23. Please help. ### Response: Hi. Penis length is usually measured in an erect state and is between 2 to 6 inches normally. What we see in porn videos is not normal. For females, only outer two inches of the vagina has sensation. So for successful intercourse, any penis length more than 2 inches is adequate. Often duration of intercourse or masturbation can be short. If done frequently, and with time, this duration will increase. Right now you do not need medicines. If you have persistent issues, you may contact again." "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 root canal done for a tooth, a couple of months ago. My crown came out 8 days back. I did not go back to the dentist, but now a screw came out my tooth. What does this mean? When should I visit a dentist? ### Response: First of all, I would like to explain the treatment that has been done to your tooth according to the details provided by you: You have to get the screw and crown fixed back in that tooth else it might breakdown more and more. The screw was put in place after root canal treatment as your tooth was badly damaged and needed support to place the crown. Since it has broken, it needs to be done again to prevent further damage of the tooth. So, visit your dentist immediately to save your tooth. Revert back to a dentist online for further follow up" "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 it possible for me to have a successful pregnancy with a 7.3 cm intramural posterior fibroid? I would rather not have it removed. ### Response: Probably it is possible as many women conceive and have successful pregnancies. But on the other hand, it is also a risk factor for the miscarriages, and it may or may not interfere with implantation though miscarriages are higher with submucosal ones. But it is not like that you cannot conceive or have successful pregnancies. You have the chances to get pregnant. Most of the intramural fibroids are notorious for making labor process complicated, but as far as implantation is concerned, they do not interfere much with it. I hope it has helped you. Should you have any further queries, please do not hesitate to contact 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: I have done TESE last year. During my normal movements like rising from a chair, it seems to cause pain in my testicle (just like when you touch a wound). This pain is shooting to the hip like a nagging pain. Is this normal? what can I do for this? ### Response: This pain and discomfort are common after TESE (testicular sperm extraction). Any straining like rising from the chair will cause pain. I suggest you wear tight underwear so that testes does not hang loose. It will support and reduce pain. Your body will heal on its own" "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 21 years old female. I want to use Glutathione for skin whitening. So I want to know whether 1000 mg Glutathione is safe for the body or not? Will taking 1000 mg Glutathione daily show any side effects? If yes, then what type of side effects it will be? Will it affect my menstruation? Well, my health is good. Sometimes, my heart feels uneasy and my knee aches a bit but apart from that I am fit. ### Response: Glutathione is a natural product and for maximum efficacy, it is given intravenously. However, it is impractical to get intravenous every day hence oral Glutathione is given widely. Ideally, it is given 500 mg twice daily but 1000 mg per day can also be given along with Vitamin C. The side-effects are minimal when taken orally. Though FDA has not approved this product, it is widely consumed in some parts of the world. But remember one thing before you start the treatment, this effect will be present until the pills are consumed. Once you stop, you will return to your normal color." "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 30-year-old male. I had cheek biting on the left side, and I removed my left upper wisdom tooth before three months. I have a white line and patch adjacent to the lower left wisdom tooth. I also have some white dots over the cheek. I had some sensitivity issue in the left lower wisdom tooth, and I consulted an endodontist.The sharpness of the cusp was reduced, and GIC filling was done for the mild decay. Now, I am eating only on the right side of the tooth. I have a fear of damaging the filling, and so I am eating food on the right side. Now, I do not have pain, but, occasional sensitivity issues. I am advised to have braces after two months. I have an impacted lower left first premolar to erupt. Should I need to conserve the left lower wisdom tooth or can I extract it? I am attaching the images and X-rays. Please give your advice. ### Response: Hi. If you have sensitivity on your wisdom tooth, you should re-evaluate the filling. However, if it is not severe and increasing in nature, please wait for sometime, and it can subside on its own. The presence of wisdom tooth will not interfere with the braces treatment. Usually, when the upper wisdom tooth of the same side is removed, it is advisable to remove the lower also, because without any opposing upper tooth, it is impossible to bite and it can cause supra eruption causing other problems. But it can be removed at the time if it causes trouble. It is not a mandatory procedure at this time." "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: Approximately 15 years ago I underwent a catheter ablation procedure to fix an irregular heartbeat. It was cured. My question is that can a cardiologist, who did not do the ablation, see exactly what was done without seeing a report of the procedure? I am currently taking Symbicort 200. ### Response: I understand your concern and would explain that a cardiac MRI can reveal the site of fibrosis, which correlates with the ablated region, in the myocardial tissues. This way a cardiologist who examines the cardiac MRI even years after the procedure can localize exactly the region of ablation, without the ablation procedure report." "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 this hard crusty stuff around the perimeter of my ear canal. It itches and if I scratch it will come off but it sometimes causes clear fluid to drain out of my ear. It also dissolves if I get water in my ear. I am currently on Amoxicillin for a tooth infection. ### Response: Probably you have a subclinical otitis externa. In this condition there will be a very subtle infection in the ear canal which leads to an intense amount of itching. With the use of earbuds the raw area gets exposed and flares up the irritation even more. Impacted wax can also be a source of the irritation in the ear. This is often associated with fullness and pain. You can follow the advice mentioned below. 1. Please stop using earbuds henceforth. 2. Tablet Levocetirizine 10 mg one tablet at night for the next 10 days. 3." "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: Since two years, I am having pelvic pain, scrotal pain (scrotal veins) and the penis has become visibly smaller. There is erectile dysfunction, loose skin above the penis and between scrotum and anus, diarrhea, mood swings, muscle spasm, joints issues, GERD, hormonal changes (level of free testosterone is of a man aged 70, while I am 33), headaches and ringing in the ears.What is the reason here for scrotal pain, pelvic tissues deformation, enlarged veins and gastric issues? Do I have rectal cancer? ### Response: Hi. All your symptoms fit into changes concerned with the liver parenchymal disease with associated varices and enzyme deficiencies rather than rectal cancer. However, on observing your MRI (attachment removed to protect patient identity), I could deduce- I would request you to get your liver function tests enzymes panel done and a routine abdomen ultrasound to evaluate liver echotexture. The preventive measure that you can take is prohibiting alcohol and other alcoholic beverages" "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 25 year old female. Two years back I had noticed a very thin black straight line on my nail in the right hand finger. This line is growing along as my nail grows. Though the line was thin initially, now it has increased in its width and thickness. When I searched in the net about the straight black line on my right hand forefinger, it is showing up as something related to skin cancer or melanoma. I am worried. Should I be concerned about this? I am not very dark, nor very fair. I have wheatish skin. Please advice me. I am attaching a snap of my finger with dark line for your reference.Also, I used to have three moles on my left hand which had been there since my childhood, but to my surprise two years back they went off easily. I got another very small new mole at a different place on the same hand and that too went away when I scratched it off. Is this something normal? ### Response: I can understand your concern. I have gone through the attached picture (attachment removed to protect patient identity). Presence of linear pigmented lines on the nails can be due to multiple causes. In white people they are considered abnormal and require thorough assessment including biopsy. In dark skinned people it is a common variant. The most common cause of these lines is racial factors. You do not have to worry too much, but do keep a watch on the pigmentation. If you notice any variation within the pigmented line or pigmentation on the adjacent nail fold or finger pulp, then consult a dermatologist in person and get yourself evaluated. Regarding moles at other sites, it is sometimes possible that they can disappear. So you do not have to worry about that." "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 is suffering from back pain from couple of years and now this has got extended to legs. She kind of gets regular pains like muscle pulling in legs. We got the MRI done and it says well defined altered cystic signal intensity noted along the lumbo sacral nerves on right side measuring 1.8 x 1.4 cm. Based on the MRI results what do you suggest? ### Response: Hello. Regarding your question, I would explain that this cyst is not related to her clinical situation. These cysts are since birth and are usually asymptomatic. In my opinion her symptoms could be related to the bulging disc in L5S1 level, which may need surgery. For this reason I would recommend consulting with a spinal surgeon. Another treatment option would be steroid intrathekal injection. You should discuss with her doctor on the above treatment option." "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 few lesions on my penis and suspecting as HPV. I remember first I noticed these before five months after a lady in massage center rubbed my penis with her buttock for her tips. I did not have any intercourse at that time. Last month, I gave HPV swab and biopsy tests, but nothing got diagnosed. I do not think there is an FDA approved screening test for males.Last month doctor removed those lesions using laser, now my doubt is these lesions can lead to cancer? If yes, only penile cancer or this virus can transfer to throat and head and can cause head/neck cancers? Now if I have HPV vaccination, that will be helpful? Any immunity supplements can help to cure HPV? For the safer side, I have given HIV antigen and antibody test twice after 14, and 28 days of my last sexual encounter (had oral sex with a condom) results are negative.1 st test value is 0.18 and the second test value is 0.36 and as per the lab report it of the index. Increase in antibodies value in the later test is fine or abnormal? ### Response: Hello. The HPV infection is caused by a group of viruses called Human papillomaviruses. Majority of them are self-limiting and do not produce any symptoms. Most common viruses that cause warts are type 6 and 11, and they are harmless, whereas types 16 and 18 cause cancer. Now in your case, I need to know the type of virus found in the lesion. If that is negative for HPV, you need not worry. HPV spreads sexually and can spread to genitals, rectum, mouth or throat, and condom can offer protection though not complete.The HPV vaccine does offer protection, and you can go for it. There are no provided supplements that can enhance immunity. Your HIV antigen as well antibody titers are within normal limits, and you need not worry about it. My only suggestion is to avoid high-risk sexual behavior, which reduces sexually transmitted altogether. Please get back to me if you need any more clarification." "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 25. I have gone through ACL reconstruction and meniscus repair surgery on left leg almost three months before. Now, on post-op rehabilitation. The doctor has suggested me to walk slowly. Currently, doing squats and weight exercises. I just wanted to know still how much time it will take for me to walk and run normally. Will I be able to be normal in future like others from past 10 days? I am getting pain near knee cap region. Even after three months post operatively. ### Response: Hello. I read your concern. In my opinion, it will take another 6 to 8 weeks for you to start running. I hope you got your movement range completely in your joint. Now, do your rehabilitation and weight training properly as advised. You can start walking normally. The pain what you are referring could be due to muscle stiffness or soreness. Get a gentle massage done for your thigh and leg muscles. Do not strain your joint. This should help you to get rid of the pain and the discomfort." "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 cracked temporary crown in the tooth. I had some decay in the same tooth. I do not have pain in the tooth. But I had a sensitivity. My dentist examined the tooth and told that the decay has extended to the nerve area. My dentist did a root canal in the tooth. Now, I am fine with a temporary crown placed. Can I get a permanent crown now? Please advice. ### Response: Crown failures often indicate a caries progression below the tooth. The supporting tooth substance which is infected by caries can no longer resist the forces of mastication, and they tend to crack, break and fail. The tooth decay must be removed entirely to protect the tooth. You had tooth sensitivity due to the affected nerve present in the infected tooth. In the root canal treatment, the infected nerve is removed, and it is placed with gutta-percha. After that, a filling is placed to protect the tooth. Now you can go for a permanent crown. As long as the root canal treatment is fine and the tooth substance is adequate, you can proceed with a permanent crown. Please send the X-ray of the root canal treated tooth to guide you further. I would like to see whether the root canal treated tooth is fine and to see whether the remaining tooth substance is sufficient to support a permanent crown. Brush your teeth twice daily and take good care of your crowns and bridges by using interdental brushes." "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: Hi Dr. I have mild lower back abdominal pain, lower back pain , and pressure on the bladder area. My local dr. diagnosed me with IBS after doing CT Scan (ethnography oral and IV contrast) , urine, stool and blood test. The CT scan showed everything was normal and urine, stool and blood tests also normal.He said take these 2 medicines. 1 - duSPATALIN 200mg twice daily, and 2 - DOGMATIL 50mg twice daily. When I read the side affects of DOGMATIL 50mg, it has a lot of side affects for which I am a bit scared of. My question is should I be taking DOGMATIL 50mg? ### Response: IBS is more a problem with small and large bowel, not stomach otherwise. So, since you do not have any symptoms suggestive of stomach involvement, I suggest you to refrain from use of Dogmatil. Duspatalin however can be used and very well tolerated among IBS patients. It is basically an anti spasmodic agent, it reduces pain, but can cause constipation. You should remember this while its use. I hope this serve the purpose" "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 rash for the past two weeks. It is getting progressively worse. It does not itch or hurt, but it is spreading. It started on my stomach. Now, it is on both arms, neck, back, and upper legs. The red dots that have been there for two weeks are larger now than they were originally. After a week from the initial onset, I got more red bumps. I also woke up feeling really ill the other morning. I had gotten adequate sleep but, had a headache in the morning, felt groggy, eyes were irritated, and my nose was running. Can you please help me identify what is wrong and what to do. I am attaching the pictures. ### Response: I have read your query and seen the pictures (attachment removed to protect patient identity). Regards" "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 53 year old lady with controlled DM for four years and mild hypertensive for two years, I have received Influenza vaccine and Meningococcal vaccine on the same day in both upper arm sides before one week. Today, I developed painful swelling with redness in my left upper arm at the injection site. What is the home treatment for my case? ### Response: Hi. High blood sugar or poor control. Blood sugar profile and HbA1C. Cellulitis. Injection site infection in people with diabetes. Antiseptic cleaning, reduce blood sugar and dose adjustment of Glucophage." "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 am asleep in bed and it is cold outside, I wake up out of breath and unable to breathe. I gasp for breath. This happens few times a week, only in the fall and winter. I eventually fall back asleep. I just got an inhaler, Ventolin. Hope this helps me. I do not know what is causing this. Medications I am on are Lisinopril, Clozaril, fish oil, and Klonopin (as needed). ### Response: With your history, it seems you have airway obstruction probably due to seasonal change. Continue Ventolin (Salbutamol). Once your symptoms are settled, do a spirometry test, to assess the level of obstruction" "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 4 year old son has a broken ulna and radius. They are broken in the middle of his arm. The x-ray shows that the broken bones are displaced. The doctor did not perform a reduction and ordered a full arm cast. He stated that the bones will set themselves as my son grows. Is this true? It does not make sense that reductions are performed on some children being that ""the bones will set themselves as a child grows"". I would like to know if my son has received proper treatment. ### Response: Hello.I have seen the x-rays of your child (attachment removed to protect patient identity).To be very honest, I am not happy if this is the position which has been accepted after the cast has been put. But in your child\s case, I am unhappy because : It is also known that serial x-rays have to be done because the position in a cast can change and lead to unacceptable malalignment. In any case, I will advise you not to panic. It would be better to go for closed reduction and above elbow cast under sedation." "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 daughter whose age is 15 years. She has not started menstruation. I want to know the reasons, please. ### Response: Hello. Usually, girls start menstruating by the age of 15. If there are still no signs of menstruation then it is possible that she might be suffering from congenital gynecological malformation. There could be many reasons for that. It could be due to a thick membrane covering the vagina preventing blood to come out. It could be any other malformation in the outflow tract of the female organs. It could be due to faulty hormones or decreased hormone production or genetic issues. I suggest you visit a gynecologistfor an examination and detailed evaluation to look for the 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 am a lazy one, and all the time\s something is running in my mind. I am not accurately able to focus on my studies, and I am getting afraid and tensed by every little issue. So kindly help me. ### Response: Hello, Welcome to ilciniq.com. Continuous something running in mind if it is unwanted is called brooding or rumination. The more you continue it, the more problems it may create. Problems like making you more lethargic. Better start behavioral modifications like exercise, distraction techniques, keeping yourself engaged, etc., with a proper timetable. Watch yourself for anxiety, and depression symptoms if any, then seek help accordingly." "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: This is on behalf of my partner. She is 51 and has been through the menopause. She has not had a period in 3 years. Last week, she bled quite heavy for a few days. A duty doctor told her to get a blood test done. She had the blood test done today. My partner did not tell the family history of cervical cancer in her mother to the duty doctor on the phone or to the person taking her bloods today. My question is, is the blood testing enough to rule out anything serious? Or should she see a doctor for an internal examination? ### Response: Postmenopausal bleeding is the vaginal bleeding, which occurs 1 year after attaining menopause. It should be evaluated, particularly in whom with a family history of carcinoma. PMP bleeding patients are at high risk of endometrial cancer. The causes of PMP bleeding include vaginal atrophy (the most common), hormonal replacement therapy for menopause Like Tamoxifen, endometritis or endometrial infection, endometrial hyperplasia, endometrial carcinoma, cervical polyps, cervical carcinoma and any other gynecological carcinoma. Better to go for TVUS (transvaginal ultrasound scan), Pap smear and then endometrial biopsy based on the wall thickness." "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 ate I-pill tablet because, after sexual relation, I touched and wiped off sperm and touched inside the cervix. So, we have doubt that she might get pregnant after touching inside. Please tell what will happen to her after taking the pill. ### Response: Hi. If her periods are regular and expecting it in a few days, she will not get pregnant as ovulation is over. But her periods should be regular. I-pill will also protect but it should not be taken frequently." "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 boy and my height is 5.1 feet, my father\s height is 5.0 feet and mother\s height is under 5 feet. So, can I grow 5.6 feet? Because my head is bigger than my body so I look awkward. Kindly help me, please. ### Response: Hello. Being a teenager, your body is actively growing in length and you will probably grow more until your bone\s growth plates fuse. Taking both your mother\s and father\s height as 5 feet, the expected height is roughly 5\4\\ with a little room for changes either way. Vitamin and Mineral supplements could supplement your growth and you may consider that." "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 relatively healthy 68-year-old female who has been having episodes of tachycardia while at rest. This started three months ago. I also have dizziness while reclining mostly at night. I do have medicated high blood pressure, osteoporosis, and GERD. I do seem to tire easier also. I play tennis three days a week and walk over 10,000 steps every day. My watch indicated 12 times I have had tachycardia. Should I go to a cardiologist about this? ### Response: You have dizziness problem while lying down if you have frequent episodes of dizziness in lying down position than positional vertigo can be possible. For which physiotherapy can be beneficial. You need to check your blood sugar and hemoglobin level as well. You have mentioned that you have a high blood pressure problem. So persistent hypertension can cause a light headache and dizziness. If blood pressure not controlled by exercise, then medicine needs to be given for that.For tachycardia, you need to investigate with 12 lead standard ECG testing. You can consult nearby internal medicine specialist for your detailed evaluation as discussed above. I hope I have answered your question. Let me know if I can assist 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: I am on Novelon for the last four months. I started my new pack on the 29th, had intercourse on the 30th. Generally, I take my pill while going to bed. I forgot to take the pill on 31st night and took it on 1st morning. Basically, I took my pill late by 10 to 11 hours. And then, I continued taking rest of the pills on time. Is there any possibility of getting pregnant here? Please advice. ### Response: I have gone through your history and understand your concern. As you are taking the medicine regularly and if you took the missed pill within 24 hours, you should continue your pill and you will not get pregnant" "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 toothache. I have an unfinished root canal for about eight months, temporary filling has also fallen out. Now I am with severe pain. Unable to drink, eat, etc. What should I do to relieve the pain? OTC is not working. ### Response: Hi. I have read through your complaint and the relevant details. You said it is an eight months old treated tooth and also with incomplete root canal treatment. With this, I suspect that the tooth is severely infected and you might need to take a course of antibiotics along with pain killers as an emergency till you seek a dentist as soon as possible. Also do not worry that the temporary filling has fallen out. That is okay because if it was there, you would have got a swelling due to the severe infection pressurized within the boundaries of the tooth. Re-root canal treatment is highly questionable at this stage. Meanwhile, take the tablets as per the prescription. Note: Please do not repeat the course unless prescribed again. All medicines are to be taken after food only. If you get any skin rashes or allergies immediately stop taking the medicine. If you having any gastric irritation during the course of the medicines, please take tablet Omeprazole 10 mg 12 hourly 30 minutes before food along with the other prescribed medicines. However, I advice you to visit a dentist as soon as possible to get it virtually treated because antibiotics are mere ad-ons to the actual treatment." "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 not sure why I never bothered to ask these questions before now, but I suppose it is better late than never. I have what appears to be a single genital wart just below the head. I have had it since I was 16 years old. I went through five years in the military with this without any problems. I passed all the medical screenings and received all the vaccinations that were standard at the time. I have been out of the military for two years and still in relatively good condition. I do not have high blood pressure or any genetic propensity for any large health risks. I also can confirm that I do not have diabetes. Partner wise, I did not have sex for the first five to six years of having one, nor did I have any sexual contact to include oral. I did not notice any change once I started having sexual partners after. I was always careful to wear a condom though. I only am bringing it up now because I was asked today by my doctor (during a routine yearly visit) when the last time I had an HPV vaccine was and if I had one in the military. When I could not tell him he made me another appointment to see him to get a sample and a few other things.This single wart has never grown in size, become sensitive, multiplied, or shown any sign of life for lack of another way to put it. It is small enough that if I did not look for it at the underside of the head, I would not see it at all. Surely, a wart cannot just exist for a decade? ### Response: A single wart cannot exist for such a long time. There has to be an increase in the number. Are you sure it is a genital wart? Were you diagnosed by a dermatologist? Clinical photographs would have helped" "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 lack of interest in sex, erectile dysfunction, premature ejaculation, depression, and low BP. ### Response: Please provide me more details. What kind of symptoms do you have? Have you taken any treatment so far? Any history of hypertension or diabetes? Any history of smoking or an excess alcohol intake?" "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 age is 27 years old. I am unmarried. Three years ago, I have undergone a myomectomy and a large fibroid was removed. Since then, I am fine. For the past one month, I am bleeding again with pain. Now, the scan showed more than three intramural fibroids. One largest fibroid measuring 40 mm x 35 mm. Except this, the uterus is normal in all aspects. Thyroid test also shows normal. Please describe ayurvedic medicine to reduce my fibroids. ### Response: Hello. I just read your query. In ayurveda, there is panchakarma therapy. Under which there is a procedure named as virechana therapy which is purgation therapy. It is helpful to your problem. Along with it, your treating physician will prescribe you oral ayurvedic treatment. So you should visit a nearby ayurveda physician or panchakarma center and ask for the procedure. Hormonal imbalance or idiopathic causes. Ultrasonography." "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 ear problems now for a long time. The problems occur when I am outside in the fresh air, even for a short period. As soon as I am outside in fresh air, I get red spotted rash in the ear canal that eventually secrete some fluid. After a while, it gets filled with so much fluid that the doctor has to suck out all of the secretions, as the ear canal gets plugged. My ENT doctors do not have any suggestion on this matter. ### Response: Your problem does appear rare. Can you help me with more details on it? If you provide me answers for these, it will help me make a definitive diagnosis. I will help find a solution to your problem. Revert with more information to 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 am a 35-year-old male. I feel pressure and a sort of burning sensation in my food pipe. My very first symptom occurred in the form of trapped burp in the chest last month. I had a bit of bulgum alongside which I keep throwing out. I took Pan 40 for two weeks and stopped thereafter as it was not doing much wonder. I consulted one doctor online he suggested me a five-day course of medicines Rifagut 550, Librax, and Rabium DSR. I started feeling better in the due course. Now it has been two days there have been mild symptoms like burning and pressure feeling in the food pipe post taking meals. Kindly suggest what to do? ### Response: Hello. Your symptoms sound more of a problem known as gastroesophageal reflux disorder which is due to reflux of contents into your esophagus from your stomach. Have short frequent meals. Do not overload yourself. Have a walk after meals and do not directly lie down. Cut down your intake of coffee, and alcohol. I would suggest you to continue a couple of medicines that will make you feel better." "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 1 year old baby is having a white thin line surrounding the black area in the eyeball in the left eye and the white part is little red. ### Response: Hello. From the pictures you have sent (attachment removed to protect patient identity), there are two possible diagnoses. Although I feel this is more a picture of keratitis." "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 operation of the disc necessary or can it be done by exercise? ### Response: Hi. Surgery on disc problem is not must unless they are compressing the nerve and causing weakness in both legs and you lose control over urine and passing stools. If it is a mild compression, you can manage with exercise and meditation. In some cases, you can try the lumbar epidural injection" "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 chickenpox for the past five days. Now, the blisters have become blackish. What shall I do for a fast recovery? ### Response: Hi. Chickenpox is a self-resolvable condition. Make sure to decontaminate the bedding and clothing as falling of blisters results in virus dissemination." "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 23-year-old male. I have been feeling a lump in my throat for quite some time now. Upon inspection, I found it is located on the palatoglossal arch on the base of the tongue. It is painless and does not cause any problem while swallowing food or liquid but there is a feeling of irritation sometimes. I quit smoking for four years now and consume alcohol moderately. I have attached the pictures of the lump, I am afraid it is cancerous. ### Response: I have seen the pictures. (attachment removed to protect patient identity). The growth is just a small salivary gland papilla. Your symptoms seem to be due to reflux laryngitis and not due to the growth. Treatment for reflux: 1) Avoid spicy and very hot food items and dairy products. 2)" "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 diabetes at age 22. When I was first diagnosed, I was taking pills which never worked. So, after a while, I started taking Insulin and have been since. I am taking five shots a day including rapid and long-acting Insulin. I was wondering if I would be type 1 or type 2 diabetic. ### Response: You can be either type 1 diabetic or LADA (latent autoimmune diabetes of the adult) which behaves exactly like type 1. That is why pills worked for you first and then you ended up on Insulin. Either way, you will surely need Insulin to survive. I can recommend some tests to confirm your type and I can help plan your treatment according to your weight and some nutrition counseling that will help control your blood sugar nicely." "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 get really bad sun-induced headaches (chronic migraine). I cannot go anywhere without sunglasses. Unfortunately when I am driving it is worst. I wanted to get tinted windows but that is illegal in my area without a doctors note. Is there anyway to get one online through a doctor or would I have to find a local doctor to go in and see? ### Response: Hello. I understand that you are suffering from chronic migraine and your headaches are triggered by light. Unfortunately, I will not be able to give you a valid prescription. You will have to visit a local doctor for that. But using tinted glass can only offer so much protection, there is no way it can block all the light coming through. Another important issue is that it can never stop sunlight coming through the windshields, or stop light from oncoming traffic and other bright lights. I feel that you will do much better with migraine medication than the tinted glasses." "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 facing extreme gas problem almost continuously from the last few months. I feel constant uneasiness, bloated feeling, and slight pain sometimes. I have taken a few symptomatic medicine and a few ayurvedic tablets like Liv-52 and Triphala, but no relief at all. Please advice. ### Response: I can understand your concern for your symptoms. 1. Severe acidity.2. Abnormal intestinal movements.3. Constipation. Basic blood test, stool routine test, and upper GI endoscopy. You can take intestinal digestive enzymes supplements, medications for acidity and medications for constipation (if present) with the consent of your specialist doctor. Avoid oily, spicy, uncooked, partially cooked or unhygienic food, gluten-rich diet and high-fat content in the diet." "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 25 years female. My HB level is reduced to 9 grams percent from 10 grams percent. I have a habit of eating raw rice and cardamom. I feel giddiness and headache and blackout of vision and my periods are delayed by one month and 20 days. And I am not pregnant. ### Response: Hello. You are anemic which can cause headache and blackouts in your vision. The consumption of those food products could be a sign of pica which is common in people with iron deficiency. It can take many weeks to build your iron levels back up with oral iron. If you are not pregnant, the delay in your menses is likely due to not ovulating with your previous cycle. I would advise further evaluation with laboratory work and to follow up your primary physician for the other symptoms you are having." "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 16 years old. I am hypermobile, especially in my knees, and almost every day. Especially nowadays I get horrible pains in my whole knee, deeper than the surface. My knees are bent inward, so like the opposite of being bow-legged and I was just wondering if these were just growing pains? or anything more? ### Response: If there is no history of any injury, and no inflammation or infection like swelling, skin redness or local warmth on touching, then I will like to advise you for conservative management initially in form of: 1. Intensive physical therapy with a focus on strengthening of qua" "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 injured my hip after a fall from a trailer, where my leg and hip got twisted. I had an MRI of my right hip after the fall. The report said, diminutive or obliterated anterior labrum, with degenerative posterior labrum. The fluid adjacent to right greater trochanter is suggestive of trochanteric bursitis. ### Response: Hello. I have seen your MRI report (attachment removed to protect patient identity)" "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 four weeks pregnant and I have BV (vaginosis) and some candida hyphae. My gynecologist prescribed me to apply internally Zidoval gel for five nights and then take two days break and apply Canesten soft gel pessary the following night. I already asked her if it is safe to take during early pregnancy and she said yes. I am now doing some online research and found many contradictions. Do you think that these are safe to apply? I am so much worried. ### Response: As such local application is somewhat safe and if you have diagnosed infection then it is always a query whether to take or not. If the infection is not much severe then you can wait for 12 weeks of pregnancy and then take the medicines. In early pregnancy there are many contradictions whether to give or not to give tablets. But if the infection is severe then infection itself can cause harm to the pregnancy which is less than the medication hopefully because there is no certain study available to count actual risk while treating this type of infection in early pregnancy." "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 smegma since 1.5 years which resulted into balanitis (that is what I think as per symptoms like difficulties in pulling foreskin, cuts, pain, rash swelling, etc.) and recently I applied Candid cream (non steroidal) twice a day for 10 days and smegma seems to be gone and also balanitis seems to be fine. But my foreskin and glans still becomes red and I can see small red spots after rubbing penis to clean. Also just saw a blister at the opening of urethra (it is little inside and need to spread the opening to see it). What could be the reason? ### Response: Hi. Can you tell me if there is any burning, pain, discharge, itching or difficulty in passing urine? Are you able to retract your foreskin up completely? Is there history of sexual exposure? Are you married? When we rub on penis head or foreskin, it can become red as the skin is very thin and sensitive. The skin lining the urethral opening is usually pink or red. Sometimes what we think is a blister may be normal mucosal skin. If there is a blister or ulcer, see your doctor or a urologist. Let me know answers to the above questions." "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: How do you know when you are depressed and should see a doctor? ### Response: Hi. The cardinal symptoms of depression are following, and these should be present for at least for two weeks: If you have any of the above symptoms, then it indicates that you have some mood disorder. This is also important to remember that these symptoms may be present in other medical and psychiatric disorders as well. If your symptoms impair your functioning in any domain and causing distress to you or your family members, then it is time to see a doctor. In my view never to wait for more than two weeks for impairment in functioning to see a psychiatrist." "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 semen analysis done two months ago and they found enterococcus faecalis. What causes this? Urologist put me on Amoxicillin and a month later a 2nd analysis showed the bacteria had gone. Just recently they did a fertility test since I am family planning and everything looked good except the round cells. Seems you should not have more than 1 million and I had 11 million. What does this mean towards family planning? Also, does this mean I have an infection again? If so, why did it come back or be there in the first place? What can I do to fix as it stressed on the family planning aspect? ### Response: Hello. Relax and do not worry. First of all, why did you have a semen analysis done? For what complaints? Enterococcus fecalis is very rare and may suggest contamination. If other parameters like count, motility, etc., are fine then it is nothing to worry. About round cells (sometimes sperms may also look like round cells). If possible, send me printed report of your semen analysis." "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 developed some sort of an infection on the outside of my penis. It has been a little over a week and there are white, flaky spots now. Can you please advice? ### Response: I request you to kindly upload a few images of the affected area so that I can have a look and guide you better" "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 recently treated for a sinus infection with Augmentin which I am still taking now, I feel dizzy, and my ears feel clogged now. Should I go to a doctor, or is this normal in the endings of the illness? ### Response: Hello. I completely understand your problem. I am sure that you are aware ear and nose are connected by a tube called Eustachian tube. Whenever we suffer from common cold or sinusitis, this tube gets congested as well. This leads to symptoms that you are suffering from. I would suggest the following, 1) Continue Augmentin 625 mg for seven 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 currently 12 weeks pregnant. I had my first ultrasound at 9 weeks. Everything went fine. The past few days I have been experiencing sharp pains in my lower abdomen and sometimes in my sides. This pain is just uncomfortable, I would not say it is severe. I have not had any bleeding but I have had white milky discharge. All I have been taking is a parentral Vitamin once a day. ### Response: How are you doing? Hope this is your first pregnancy. From your history, I feel this is just the pain due to streching of uterus. Uterus is just a 7 cm muscular organ, till you reach 40 weeks, baby weight is gradually increasing, thereby streching the uterine muscles which will be painful. This also stretches the muscular and ligaments support to uterus, attached to the bones around. Vaginal white thin discharge is normal due to the progesterone hormones. As long as you have no bleeding, no other obstetric and medical problems, this is fine. To relax uterus, you can have tablet Duphastone twice daily for a month. This is Progesterone which supports the pregnancy." "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, who is 57 years old, was suggested to go for AVR (valve replacement). His weight is 74 kg. What are the procedures followed for valve replacement? Is there any consequence after the surgery? Can he lead a normal life after surgery? Which valve do we need to choose irrespective of cost? How many days does he need bed rest? My father has high BP, and always it ranges around 170/80. ### Response: I have read through your query in detail. Please find my observations below. The valve replacement surgery is usually done using open heart surgery technique, and the surgeon connects the blood vessels to a heart-lung machine and then stops the heart. After this step, an incision is made into the aorta and using careful precision the aortic valve will get replaced. This operation is 98 percent successful. For people less than 65 years, the valve implanted is a mechanical valve, and this is because a mechanical valve will work for many years. In patients older than 65 years, a biological valve is used. He can lead a near normal healthy life. He has to follow up with his doctor regularly and be on medications for a long time. He will be in the hospital for a week and should not be on bed rest. Only thing is he must avoid physical exertion after surgery and take strict precautions for three months after surgery. The blood pressure will get controlled with medicines and doctors make it a point that operation is not risky due to that. Regular medication has to be taken and should get echocardiography as instructed by the surgeon and cardiologist." "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 diagnosis of scarring of tympanum before 30 years. Recently, I was diagnosed with bilateral hearing loss and tinnitus. Could the residuals of this scarring have any influence on my hearing now? ### Response: Hi. Scarring of the tympanic membrane (myringosclerosis) rarely causes symptoms. Tympanosclerosis can extend to the middle ear and produce hearing loss. With your clinical history, it suggests presbycusis (an age-related degenerative disorder of inner ear). You need to visit an ENT specialist for proper examination and audiometry." "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 always a weakness in the head to foot along with pain. A few days I have pain in the chest when I am traveling, then the second day always fall ill. ### Response: I understand your concern. Feeling weakness and falling ill when traveling is due to any internal problem like anemia. A complete blood count is recommended to rule out anemia, and a full biochemistry panel to evaluate the status of your liver and kidney function together with urine analysis. Blood electrolytes to measure to rule out related deficiencies. Have your meals regularly. Do not skip them. Wish fast recovery. Let me know if you have any other concern. When you get your laboratory results, pass them to me to analyze and further advise." "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 urinary external sphincter void dysfunctioning. The doctor had suggested Botox injection 200. Is this permanent cure or you suggest other medicine or tablets? ### Response: Hope you are fully evaluated with the urodynamic study. Botox injection for urinary external sphincter void dysfunction is not a permanent cure. It has a 70 to 90 % success rate with 5 to 12 months duration with a mean of nine months duration of action by various studies. In case of significant residual urine, self-catheterization may be the alternative." "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 18 years old boy. I am having very uneven skin tone on my cheeks somewhere it is dark and somewhere it is white. It started about one year ago. What can I do now any remedies or diet or treatment? ### Response: Hello. Yes, you have pigmentation problem along with mild acne. I will suggest you to start with topical Clindamycin lotion over the pimple area morning and evening and a topical retinoid at night time by mixing it in cold cream. Wash your face with Dove soap. Retinoid at night will improve your skin problems. Apply Acsolve lotion over the lesions BD, apply Arynoin gel plus cold cream at night in small quantity on the whole face. Use skin aqua moisturizing serum 2 to 3 times a day, use Solaris sunblock SPF 60, avoid using Dettol and other irritants." "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 dry red small area on my face for years now. I went to my dermatologist and he told me to buy a cream (I do not remember the name). It worked for a while, but after it stopped working. The redness gets redder, when it is hot I sweat on my face or if I scratch it. It does not itch at all nor have any other redness anywhere. I had dandruff but I am using dandruff shampoos for years now and do not have anymore. I have another thing to say. I have a small lump on my thumb, it has been there for one year but these days I smashed it a little and it got bigger. When I press on it, it hurts, and it does not look like a wart. What can I do for these issues? I will upload the photos. Please help. ### Response: I have seen the photos. (attahment removed to protect patient identity). It is not clear. I want to know about your age, exact morphology site of rash, any disease present or treatment taken, and diagnosis made for either of the lesions? Please send clear photos of both the lesions and all details and any other lesions if present. I will try to help you. It may be allergy or infection or else." "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 ringworm on my arm. I used Daktarin and that did not work. Then I used cider vinegar and it has turned black. Should I be worried? ### Response: Hi. I have read your query in detail and do understand your concern. Also I have viewed the attached pictures (attachment removed to protect patient identity). This is irritant dermatitis which has developed due to the use of vinegar. It is very less probable that the fungal infection has been cured. Proper oral and topical medicine for one or two months is needed to cure your disease. Remember to wear loose cotton clothing especially when at home. If any other family members are affected, they must also be adequately treated to prevent recurrence. Also get your blood sugar levels tested. Meanwhile, you may apply antifungal cream such as Clotrimazole twice daily over the lesions of ringworm." "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 19 and in good health. For about a year, I have had some strange heart palpitations. They tend to happen at night when I lie down. They are very strong beats and irregular. It lasts only a couple of minutes but is quite scary as it feels like my heart is beating out of control and out of rhythm. During this, my chest also feels quite tight and uncomfortable. At the University recently, I had a physical examination, and the nurse noted that my pulse was a bit irregular. No one in my family has any heart problems. I do have anxiety, and I am taking anti-depressants. ### Response: Hello. One of the most common causes of palpitations is anxiety, but it can also be due to heart rhythm problems. So, these must be excluded first. I advise you to get an electrocardiogram (ECG) done at the time of palpitations. If that is not possible, then get a baseline ECG at any time of day or night, and another test called 24 to 48 hours ambulatory ECG. It will record your ECG continuously for 24 to 48 hours, and any palpitation episodes will be recorded. No need to worry, palpitations are not life threatening. I suggest the following: Follow-up is advised within seven days with these reports. Regards" "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 pain, little but noticeable in my gum. It is not inflamed or red. What should I do? Is it infected? I need advice. Please help. ### Response: I have gone through your question. I can understand your concern. If the lesion is white and painful, it can be the aphthous ulcer or canker sore. If there is no visible lesion as you said, the pain may be because of any dental infection. If the pain will be tooth related, your tooth may be tender if you press on it. As your question is not clear about the area, whether it is swollen or not, how many days you feel it, I am unable to guide you in detail. Please reframe your query so that I may provide you better opinion. If you think the pain has infectious symptoms like swelling, interference with sleep cycle, fever, you need to take antibiotics like Augmentin 625 (Amoxicillin and Clavulanic acid) twice daily for five days. Also, do saline gargles." "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: Please tell me if this statement is true or not. I have been told that if you brush your teeth within a half hour after drinking or eating anything acidy, such as coffee, beer, or tea, it could actually brush the acid into your teeth, causing more damage than brushing. The problem is that after each meal, I usually have the time to brush my teeth. A half-hour later, I am involved with something else and my teeth are the last thing that I am thinking about. Neither my dentist nor anyone else has directly answered my question. ### Response: There is no problem in brushing immediately after a meal. Such acidic foods damage teeth only if they remain in the mouth more than half an hour which cause some surface calcium loss due to the formation of calcium carbonate after salivary acids and other acidic foods react with tooth calcium" "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 42-year-old female, in good health aside from anxiety (currently taking 5 mg Citalopram). A month ago, I suddenly experienced muscle twitching all over both legs and this went on for two weeks. I took magnesium and it subsided and has not really returned except for an occasional twitch here or there. I am extremely concerned because over the course of the month, I have had three episodes where I forgot how to swallow for a second. It was scary and now I am afraid I have the onset of ALS. I do also have a long time habit of throat clearing. Although I have not experienced any muscle weakness, are those symptoms indicative of ALS? ### Response: Twitching of muscles can be due to anxiety as well as Citalopram. What is important is that you mention having them before initiating Citalopram. If it is occasional then you should rather not bother yourself because twitching intermittently is there even in an otherwise healthy individuals. What is important is your sensation of forgetting to swallow. This is" "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 15 years. He got his DTaP vaccine two weeks ago and had CBC 20 days later. All came well except neutrophil count, which came back as 800 and total WBC 2500. We are going to repeat the test tomorrow. Can the vaccine be the cause for the neutropenia? And if so, how long will it take to recover? ### Response: Hi. Based on your query, my opinion is as follows: If the count continues to be low compared to previous report before vaccination then bone marrow aspiration or biopsy needs to be done. Revert back after the investigations to 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 5 year old son has a lump on his neck. He had a similar lump about two years back, but it disappeared. The size of the lump is a little bigger this time. What to do? ### Response: Hi. Lump in the neck is due to an enlarged lymph node caused by an infection. If the node is enlarged, then a course of antibiotic has to be given after consulting a pediatrician. If it responds to the antibiotics, then nothing more is required. But if the lump is increasing in spite of antibiotics, then the following tests need to be done to know the type of pathology:" "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 58-year-old female with a history of hysterectomy twenty years before. Now, I have osteoporosis and I do not want to take a medicine after viewing all the side effects. I am having difficulty in losing weight despite many diets. After searching on the web, I decided to do hormone test and now I want to have an opinion from a doctor about the results I have obtained and what step should I take? My thyroid results are T3 at 4.6 pmol/L, T4 at 14.25 pmol, and TSH at 1.48 mcU. E2 66.4 pg/mL, progesterone at 0.81 ng/mL, testosterone at 0.25 ng/mL. I want to know if this is in order and I need your advice. I am currently on multivitamins, calcium, and vitamins. ### Response: Hello. Your thyroid profile is absolutely normal. Your other hormones show postmenopausal status which is normal at your age. For osteoporosis, you should take calcium and vitamin D which you are already taking. You should also start with hormone therapy for the shortest duration and lowest dose as it is not harmful This will help to strengthen your bones which is very important for osteoporosis." "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 32 years old. I have been drinking for the last five years. LFT before six months showed normal and CT scan whole abdomen did 10 months back showed the liver is normal. Pancreas normal no gallstones but I have been drinking heavily these six months due to stress. Now I have stopped. For protection prevention, can I take Ursodeoxycholic acid 300 and Evion 400 and Metadoxine 500 for a month or two? Will it be of help to regenerate or eliminate toxins from the liver? UDCA, vitamin E, Metadoxine, will it help? Please suggest the dose and before after meal. ### Response: The body will naturally heal itself since your LFT and CT was normal. Regarding medicines, they have a limited role in such situations. Although there is no harm in the above medication for a couple of months under medical supervision. Please consult a nearby doctor who can examine you also." "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 on my birth control Yaz for 10 to 11 months. Last month, I went on a holiday which collapsed with my placebo pill days with period days. So I started the second pack skipping the placebo pills from the previous pack to skip the period. However, ever since I started the second pack, I have been having spotting and later with breakthrough bleeding.So I decided to stop my second pack at the 11th pill to have my period (so together with the previous pill pack, I took 34 active pills before I stopped taking for a period). I took a four-day break as instructed from the pill pack instruction and started a new pack afterward as usual. It has been seven days from now in this new pack, and I had sex with my partner without extra contraception (condom), is it safe? ### Response: As you were on pill regularly so that ovulation did not occur possibly. This means you are safe most probably, but 100 % accuracy is not there. But for practical purposes, it is almost safe. Take a urine pregnancy test after two to three weeks, and that will confirm 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: On March 1st I flew to Utah from Texas and developed cold symptoms after three days. It was a normal cold, but as it was almost gone (no more congestion, did not feel sick anymore), I lost the sense of taste and smell overnight. I have not had a sense of taste or smell for 11 days now. I do have a history of losing my sense of taste and smell for a few days during cold with congestion and for four weeks when I had mono.I did speak with a general doctor and he seems to think my loss of taste and smell is cold or allergy-related so he does not think I have Coronavirus. However, this loss of sense of smell is different than all the rest. I have never been without smell for this long after a normal cold and I have had a fairly clear nose for the entire duration of it so it cannot be due to congestion. I just wanted to get a second opinion on if you think it could be Coronavirus as news has just come out that this is a possible symptom of asymptomatic Coronavirus carriers.I am currently on Amoxicillin for sinus infection. ### Response: Hello. I appreciate your timely picking up of the signs and reaching out to us. We have two scenarios. First, is that you have Coronavirus infection and the cold, allergy, and loss of smell are due to it unless you develop more severe symptoms like fever, temperature, breathing difficulty, respiratory distress, you do not go anywhere out of home. You are gonna remain quarantined till 15 days from now. Take plenty of fluids and water. Eat good and normal diet. Exercise indoors if you can. Second, it is allergy-related. In this case, it should subside in some time. You can try some nasal steroids and other measures told above. In the first scenario also nasal steroids can be tried. You can revert back to us if you need any further support." "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 I have something along the lines of a bipolar hypertension situation. I wake up in the morning, my blood pressure is prehypertension to around hypertension stage 1. Not that bad. But In the evening, to later in the night my BP is through the roof. In the midnight, my BP is measured to be 176/126 on standing. When I lay down on my left side and it is down to 110/60 after a few minutes. I could use some help in figuring this out. I am 20 old. ### Response: I understand your concern, do not be bothered you will be fine. I advise you to get a pen and paper, write down your blood pressure measurement for three days. Make sure to measure immediately you wake up from sleep in the morning before any activity. Get back to me with the readings, it will help understand what is happening." "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 18 years old. I swim five days a week for at least one to two hours per day and noticed my penis had a dry spot. This has been going on for at least a month and it slightly itches. Sometimes, it hurts and is slightly swollen. ### Response: I have noted your concern and I have viewed the images. It is dermatitis/ eczematous condition of the skin of the glans. I suggest you apply a topical steroid such as Cortisone cream, twice daily for a few days. In addition, I suggest taking tablet Cetirizine 10 mg once daily for symptomatic relief from itching. Regards" "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 chicken last night at an outside restaurant. Since then I am having too much of gas and little constipation. Also, my head is heavy and I feel like there is a stomach infection. But, until now I did not get loose stools. What should I do now? ### Response: Hello. You seem to have developed acidity following chicken consumption. At this time I would recommend you take a combination of Pantoprazole and Domperidone once daily for three days. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. You need to take a soft and bland diet." "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 STD question and hope to have an STD specialist doctor to assist me. I had a sexual contact three years ago and only last month I went for (VDRL nontreponemal test) and is negative. I have read online that after several years or after sometime usually, the result can be negative even if a person had syphilis before. I am afraid it might be a false negative since it was a few years ago. May I know should I test for Treponemal test such as TPPA or FTA-ABS to rule out the false negative by VDRL after three years test, I worry it might false negative by VDRL? The negative VDRL test was one month ago and possible exposure was three years ago. Does this mean the person does not have active syphilis infection? Does this also mean it would not proceed to latent or tertiary syphilis that will damage the body such as paralysis, numbness, gradual blindness and dementia? ### Response: TPHA (Treponema pallidum hemagglutination) or FTA ABS (fluorescent treponemal antibody absorption test) would be confirmatory in that case. You may take this test. Syphilis may slowly progress to the tertiary stage with neurological involvement. CSF V" "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 heavy feeling over the chest frequently. Sometimes, I also have pain near my left ribs when I move my hands. Whenever I stand up, little pain or crushing pain happens and disappears suddenly. I have done endoscopy for the stomach. I have hyperacidity and H.pylori infection. Also, my endoscopic reports showed me red spots over the food pipe. I have grade A acid reflux. Why is it happening in me? Is it related to the heart? Please suggest. ### Response: Hi. I have seen your reports (attachment removed to protect patient identity). You have reflux esophagitis with antral gastritis. Proper treatment is required for eradicating the H.pylori infection." "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: One year ago, the patient had seizure and fits. I have attached the preliminary observation report, which was done by a neurologist. Then, we started the medication as per the prescription. During the course, the patient reported intermittent light headache. A week before, the patient had a severe headache with vomiting. The CT scan has been done and the latest observation is also attached. Tomorrow, we are going to have an MRI. May I know your opinion? ### Response: I have gone through your query with diligence and would like you to know that I am here to help you. Revert back with an MRI report to 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 am a 50-year-old male, slim, and quite health conscious. Today I had a package blood test done. Other things are fine but in LFT total bilirubin is 1.47, direct bilirubin is .22, and indirect bilirubin is 1.25. SGPT and SGOT are normal. All other parameters are normal. I do not have any problem right now.Two months back I had some food on a train which led to vomiting and diarrhea for one day. After ten days, I had abdominal pain for two-three days. Then acidity in the stomach here and there for some days. It all lasted for about two months, during which I lost two to three kg of weight also. But now my appetite is perfect, and I have resumed my regular exercise. Stamina is also fine. I had a cough and cold for a few days, which is ok now. Please guide me on what could be the cause for these elevated levels of bilirubin. I suffered from viral hepatitis when I was about 25 years old. ### Response: Hello. You do not have any complaints. 1. Total bilirubin 1.4 2. Direct bilirubin 0.22. 3. Indirect bilirubin 1.25. Only total bilirubin is slightly elevated. For some people, if no complaints, this mild increase common need not worry." "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 hepatitis B and have attached my test results. But I am not sure how severe my case is. Do I need medication, or do I just have to monitor my condition? ### Response: I have seen your reports. (attachment removed to protect patient identity). As I can see from the reports, you are positive for Hepatitis B. The indication for the treatment as per American guidelines is dependent on liver function test and the presence or absence of cirrhosis. So you will need further testing in the form of a liver function test, a thorough clinical examination and an ultrasound of the liver to ascertain whether you will need a treatment or just follow up. 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: We had an unprotected sex on 13th day of her period. She took Ipill 19 to 20 hours after sex. Now on period due date she got light bleeding for two days. According to her, she always gets her bleeding only for two days. 28 days cycle. Before sex she got periods on 21st and after sex she got it on 19th of next month. Any chance of pregnancy? ### Response: Since you have taken emergency pill within 72 hours of intercourse, there is no chance of pregnancy. So relax and do not worry. However, if you have a doubt then get 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: I am a 54-year-male. I am a sugar patient. I have sudden pain at the back side of the head, and I had the same problem at five years back. Yesterday he went to the hospital, and the doctor suggested a tablet Amitone (Calcium carbonate) 10 mg at 8 pm for one month. After taking this tablet from early morning to evening, I feel lazy, with body pains. Can I continue this tablet? ### Response: It is essential to rule out the cause of the headache first and foremost and to see whether these physical symptoms he has now are related to the headache or medication. Since it is at the back of the headache, I would strongly suggest getting a CT scan done to rule out anything serious. Secondly, does he have any weakness in the limbs, or is it just feeling lazy? If there is any weakness in any part of the body, the ct scan is again essential. If there is body ache, then I suggest give it a few days. It should subside. 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 had protected sex with a sex worker. First, she started off with a protected blowjob followed by protected sex which lasted no more than 30 seconds.My concern is that three to four hours prior to sex, I shaved my penis and got a tiny cut on the shaft. Although during the entire activity I made sure that the cut was covered with the condom, but still wanted to check if this was a risk situation. I am worrying a lot. Please help. ### Response: Hello. I have noted your concern. Protected sex is safe as far as risk of HIV is concerned. However, there is still a risk of genital herpes, HPV infection or warts as a condom does not cover the entire penis and there is some uncovered skin at the base of the penis for a skin to skin contact. If the cut was covered, it obviously does not increase the risk. Even if it was exposed, then HIV is still not a risk as it has to be a fresh actively bleeding cut for the virus to pass through. A paper thin cut that is a few hours old is self-sealing. Regards." "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 suffering from anxiety for the last 10 years. I was able to live a normal life and working happily. I was on Nexitoplus (do not know if I had depression). Two months back because of family problems (father health issue), financial stress, work pressure, and continuous thoughts. The panic attack was on Nexito 20 and Etizola but with no greater relief. After that, our family doctor changed to Nexito forte. Now I am feeling physically well. Looking for motivation to get on with life and go to the job. Prior to use of Nexito forte, I was not able to concentrate. I was feeling less interested. Can you suggest how long should these medications be used? Also, how can I be mentally strong? ### Response: It is quite common for anxiety to get elevated when faced with stressful situations in life. The good thing is with appropriate support your anxiety will come down eventually and you can function normally. Nexito (Escitalopram) is a good medication for your condition. It is positive that you are feeling better now. I see that you are prescribed Nexito Forte (which contains Clonazepam in addition to Escitalopram). I will recommend discussing with your family doctor and switch from Nexito Forte to Nexito (Clonazepam is not recommended for long-term use). Nexito 10 mg once daily can be continued at least for a year after your anxiety comes down and you are feeling better. Then it can be gradually cut down. I will recommend having some psychological therapy or counseling to deal with factors contributing to your anxiety and help manage family problems and stress at work. Exercise regularly, try yoga or meditation whichever you find comfortable." "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: Hello, I'm a 25 year old woman who recently discovered they are pregnant. My period was due on 1st of this month, that same day I took a test that came back positive. I've tested several times sense and all have been positive. However on the 6th, I noticed some bleeding. The first time it was on the napkin and a bit made it into the toilet. Then it went away for several hours and then came back but only on my napkin. It's now almost 3am and I noticed I'm still spotting but very lightly. I do have an appointment today to confirm if I'm really pregnant but I am concerned. ### Response: I would like to let you know that any spotting or bleeding in early pregnancy is a sign of threatened miscarriage. You need to visit your doctor so that she can perform a scan to check if the pregnancy is still viable or not. Also if your previous cycles were totally regular, then you would be mostly around 5 weeks gestation. So please visit your Gynaecologist as soon as possible. Wishing you good luck and a great health. - Ultrasound for viability and also. - after the ultrasound, to consider progesterone support as advised by your Gynaecologist. avoid sexual intercourse till 1st 3months of pregnancy." "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 daughter just had a tooth surgery and bleeding is not stopping. Is it normal? Three hours before only she had it. ### Response: Hi. I had gone through your question and I can understand your concern about your daughter. No, the bleeding should have been stopped with a half hour or two, but maybe the clot has been dislodged from its position and it has bled now again. You need to role cotton, sterilized or a new one purchased from market three to four times equal to the socket, not too big or small, put it on the socket and close the mouth tight. Keep the teeth closed for half an hour, do not talk for this half an hour, even do not spit the blood out too. Make sure that mouth must not open for this half an hour. In case there is saliva in the mouth, she can swallow it but mouth must be closed at the time of swallow. You can also visit the dentist in case the blood does not stop in the next half an hour after the above procedure is done. Post-operative bleeding. If the bleeding does not stop, get an injection of tranexamic acid, keep the cotton on the wound and do as said above. Do not spit or talk for the time the cotton is in the mouth." "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 21 years old. I want to know about Manforce 100 mg tablet because my friends are saying this is an excellent tablet for better intercourse. Can I use this tablet? ### Response: Hello doctor. Everyone goes through this phase in their sexual life when they doubt their performance naturally and start using tablets or supplements for a better sexual life. If you are a strong, healthy male, without any medical problem, then you will be able to enjoy intercourse naturally, and there is no need for any tablets. Tablets such as Manforce 100 (Sildenafil Citrate) or Viagra can cause a lot of side effects, like headache, delay in ejaculation, priapism, etc. Kindly refrain from using such tablets and also advise your friends not to use it. These tablets are meant for people who can not achieve an erection naturally, secondary to some medical disorder. 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: Hi,I think my wife has BPD. She always blames her sister for everything. Please guide me how to handle this? ### Response: Hi. Your one liner problem description is very difficult to answer; though I will give a shot at it. Kindly give a detailed account of her personality, temperament and your problems. Only on providing detailed complaints, will I come to know about the exact situation and offer you best advise. Alternatively you can book for an online therapy for your wife to further diagnose." "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 days ago, I had what I thought was a standard case of food poisoning, mild diarrhea, and vomiting for around eight hours. By the next day, I was feeling fine and was able to keep all liquids and food down. Now, over 24 hours later, the vomiting has reoccurred. Should I be concerned about my vomiting pattern? Is it a virus or food poisoning? I am a female, 29 years old and no other medications. ### Response: You have developed transient gastritis due to food poisoning and it may take few days to settle. You need to take PPI (proton pump inhibitor) Pantoprozole 40 mg for few days and an antiemitic (Ondansetron) for a day or two. It is not virus, you need not worry about it. It is temporary, I can assure you that" "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 baby\s birth vaccine has been delayed by one week due to health issues (my baby was born on 15th but the birth vaccine was given on 22nd). So, the next vaccine which was supposed to be given in six weeks has been given on 7th of this month (after two months) but if I see according to his birth it should be near 1st or 2nd and the next vaccine which is in 10 weeks comes on 7th or 8th of next month but according to his birth the 10 weeks completes by 1st of next month. So my question is are the vaccination being given as per the day of birth or as per the time from when the birth vaccine was received? Please solve my problem and tell me whether my baby is on the right track of recieving vaccination. ### Response: Hi. I understand your concern. Vaccines are given as the birth age for a full-term normal weight baby. If the baby was premature and hospitalized, then it can be delayed. If it is delayed then one month gap is usually kept between two vaccines for better vaccine uptake. You are right, your baby\s next dose schedule is around 1 or 2 of this month. There must be a reason for the delay, as I mentioned earlier. In the long run, it usually does not make a lot of difference. Make sure all the necessary vaccines are received." "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 33. Sometimes, out of nowhere, I start feeling dizzy, pressure in the chest with heavy breathing and weak legs and hands. Sometimes, I have headaches. No arm or chest pain. It was happening to me when I lay down and now it happens when I am standing too. I took medicine for acid reflux for two weeks. I have no heartburn. But still, have symptoms. Blood pressure is normal and heart rate changes frequently from 59 to 78. No stress and no anxiety. It happens when I am very relaxed. Mostly at night, but lately during the day too. I did ECG but they said my heart is good. But maybe I have something it does not detect. I had a reading of 152/99 two weeks ago, but after a diet, it went down to 120/81. ### Response: This can be cardiac arrhythmia like PSVT (paroxysmal supraventricular tachycardia) or atrial fibrillation, in which heart rate suddenly goes up and also suddenly decreases. Blood pressure falls during these episodes and one has dizziness, fainting, chest pain or discomfort, blackouts, sometimes syncope. Usually, ECG is normal as it is usually done in between the episodes. ECG done during episodes will show abnormality. You will need 24-hour Holter monitoring. So, visit a nearby cardiologist for these investigations. Is there any stress or anxiety associated? Until your evaluation is complete, you can ask your local doctor for tablet Ciplar LA (Propranolol) 20 mg once a day. Also, thyroid test should be done. ln order to abort such episodes, you should try to cough hard. Hope this helps you and get back if you have any doubts" "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 had partial penectomy two weeks ago, and our doctor has suggested for another surgery. I am sending his postsurgical reports. Can you please let us know if surgery is required, and he still have cancer? ### Response: All tumor has been removed, and resection margins are free. But tumor involvement is deep inside, and so the surgeon wants further surgery so that the tumor should not come back after some time. Also, ultrasound reflects a reactive lymph node, and so your doctor might be planning for the removal of lymph nodes. Further surgery is needed to prevent the come back of cancer." "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 high BP from last night 160/110 but I am not feeling anything wrong. I am 60 years. I have taken Amlodipine 5 mg one tablet last night but I have a sleepless night. Should l take the same medicine 10 mg now? ### Response: Hello. Your blood pressure is high considering your age. Although you are asymptomatic you need to control blood pressure to avoid complications related to high blood pressure. If Amlodipine 5 mg cannot able to control blood pressure than combination antihypertensive medication or high dose of Amlodipine can be prescribed. For getting prescription, you need to consult a nearby physician." "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 lost sexual interest in my spouse and I do not get an erection at the thought of making love to her. Otherwise, I have no issues with erection. I masturbate daily and do online sex chat. Please advise how to bring back the lost sexual interest in spouse. ### Response: As you are addicted to online sex chat and masturbation, thus lost interest in your wife. Your sexual needs are fulfilled by that. So, first stop sex chat and masturbation for a week and spend time with your wife, and take her to romantic date or dinner. Try to remember the quality time you spend with her in past. Talk to her as you talk on online sex chat that will stimulate you. Also try to find the reason that why you lost interest in your wife. Spending enough time with your wife and taking her to short weekend romantic trip will help you to find interest in her. Try to do these as much as possible. Go for evening walk with your wife." "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 bad cold sore 8 weeks ago on my top lip and a bit of the skin above it. I used Zovirax externally 2 weeks course and Acyclovir 2 weeks course to treat it. The actual sore improved, the blister stopped weeping, the scab formed and flaked off within 3 weeks but the redness is still lingering. I rung the doctors that put me through a pharmacist who told me to use Hydrocortisone 1 % cream. I used it for a week as he recommended but it still did not go away. That was two weeks ago. I also had a new flare up three days ago. Also on the top of my lip symmetrical on both sides. It looks different to a cold sore in that it was some redness and skin flaking. Home remedies I have tried so far: Aloe vera (not much help), Tea tree oil (irritated it), Manuka oil (helps healing where the sore is but seem to irritate the new flare up), Coconut oil (irritated it), Almond oil (seems to soothening it at the moment). I am worried if this is still unresolved herpes/cold sore and can be transmitted to my partner who does not have herpes. Is it contagious and am I able to kiss my partner? ### Response: Hello. As per the current picture sent by you, it does not look like a cold sore as of now (attachment removed to protect patient identity). Apply Dologel only. It contains Cholinesalicylate along with certain other ingredients that help to heal. No application of any lipstick or any other ointments or creams to the region. I would not advise kissing for 2 more weeks atleast till things resolve to prevent spread. Also, limit alcohol intake if you are currently consuming alcohol. Avoid spicy foods too to promote healing." "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 36 years old, male. I am traveling and had sex two weeks ago without condom. After two days, I felt itching and pain while peeing. Now, two weeks later, I have white painful wound on my penis. I visited a doctor yesterday and received an injection and two pills antibiotics. He said gonorreah. I am scared that he could be wrong. Please help me. ### Response: You have developed ulcers after two weeks. Usually, in gonorrhea you will have painful white discharge from penis. In syphilis, ulcer will develop after 10 to 14 days, painless single, button like ulcer. Painful genital ulcers in this case are may be herpes simplex, chancroid, and syphilis (from your picture) (attachment removed to protect patient identity)." "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 had unprotected sex yesterday and scared about pregnancy. She took I-pill after one hour. Please suggest what else we need to do to avoid pregnancy. Her last period was 12 days back and her next period is after 20 days. So, will her periods be regular or not? If there is any possibility to occur some unwanted change then please convey us with treatment or checkup. ### Response: Your partner has taken the I-pill after one hour of sex. This rules out the chance of pregnancy in all respect. So, please relax. You have nothing to worry for now. But, you should ask her to start regular pills like Femilon (Ethinyl estradiol and Desogestrel) or Novelon from first day of her next cycle. This should be continued for 21 days and new pack to be restarted after a gap of seven days. This is an excellent form of contraception. Now, she may have some form of bleeding within two to three days. Do not panic. This is normal as a reaction of the I-pill. Her next cycle will be delayed also. This is also normal. Just ask her to start the pill from then. Meanwhile, you use condom for protection as you cannot repeat I-pill so often. Contraceptive guidelines." "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 74-year-old male, weighing 142 lbs, height 5\10"" and a non-smoker. I worked in an auto body shop for two years and painting cars for 18 to 19 years. Had minimal exposure to asbestos and quit grain farming at the age of 44 years. When I was 56 years old, I had a severe panic disorder and MVP. Around three months ago, I had a very small amount of blood in my phlegm when clearing my throat about six times. The doctor said that it was due to a blood vessel breakage, but ordered a pulmonary function test and chest CT to be sure. Pulmonary function test done two months back was normal. Chest CT findings showed no bronchiectasis or interstitial lung disease, no pneumothorax or pleural effusion. There is very minimal atelectasis in the left and right lower lobes. There is a 2 mm pleural based RT, lower lobe pulmonary nodule and no additional nodule or mass. My pulmonary doctor talked like nothing is seriously wrong.What is your opinion? Should I have follow-ups on the 2 mm nodule? What did minimal atelectasis mean and what caused it? I take no medicines except Ativan PRN. ### Response: Hi. See, solitary pulmonary nodule which is asymptomatic does not require any further investigations. However, any persisting fever, cough and cold warrants bronchoscopy and biopsy of the lesion to rule out any possible causes. Atelectasis is the collapse of alveoli of the lung. So, that needs an evaluation from my side. I would suggest bronchoscopy for you based on your current scenario" "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 suffering with breast cancer as primary and now there is brain metastasis. The disease has spread to all the parts of the body including the bones. I have attached her PET scan for your reference. We are taking the treatment for the disease and her physical condition was very good till last week. Our doctor got changed suddenly as he moved to another hospital and the new doctor is taking care of her now. Every month we used to have Ibandronic acid for bone, but we did not receive this medicine last month as this doctor did not include it. Now, my mother is getting severe leg pains and not able to sit or get up. She is unable to stand for even 2 minutes. Can you see the PET scan report and suggest good medicine for the bone improvement? Can you suggest a good medicine for bone metastasis? Some doctor said that Zoledronic acid is better than Ibandronic acid. Please suggest. ### Response: Hi. I understand your concern about the patient. As per the scan report you sent (attachment removed to protect patient identity), though the metastasis is widespread, she has relatively improved as far as bone are considered (sclerotic). In case of cancers, bone quality is largely affected. Bisphosphonates are used to improve the quality of bone, which is a slow process." "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 55 year old female. I am suffering from stomach pain. My ultrasound scan was reported as normal. The CT scan report is normal with an impression as minimal free fluid in the pelvis. Our physician told that I have some infection in the intestine and was advised to take antibiotic and pain killer. I got my uterus and ovaries removed 10 years ago. Actually, I have pain in the right side of the abdomen and around the navel. General surgeons feel that it might be a muscle spasm or some gynecological symptom. Please give your valuable suggestion. ### Response: Hi. Inflammatory. Contrast-enhanced CT scan and urinary culture. 1. Inflammatory.2. Infective.3. Neoplastic. I suggest an antimuscarinic agent such as Buscopan (Hyoscine butylbromide) or Mebeverine for symptomatic relief of pain along with your current painkillers. Consult your doctor, discuss with him or her and take the medicine with consent. Revert back with the answers to the above questions to a general 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 tingling left arm. Thumb and index finger are somewhat numb. Skin lesions infect arm. I was told that they are not shingles. Bone at base where skull and spine meet is stiff and sore. On no medication. Taking Ibuprofen for pain. ### Response: Tingling sensation in the left arm can be due to nerve compression in the neck or in the arm. You will need a thorough physical exam followed by electroneuromyography study of the arms and legs and if possible, MRI of the cervical spine. Meanwhile, do not lift heavy weight and bend forward." "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 got a teeth cleaning done, but the inflammation is still there. The dentist said that I need to get treated for a receding gum line through surgery. She said it was due to brushing hard and asked me to switch to a soft bristle toothbrush and sensodyne toothpaste. I am also awaiting some fillings. I already have a temporary filling which as fallen out and the hole seems to be too big. Please advice. ### Response: Hello. Use warm saline gargling daily at least 2 or 3 times, for two weeks. This will help in reducing the inflammation and help in preventing further recession of gum line. Also if you can get Betadine gargle for rinsing then it would be much better, this would be of great help in case of severe periodontitis (gum inflammation and receding gums). Use sensodyne toothbrush (as suggested by your treating dentist) which have very soft bristles in an upward and downward motion only. Do not scrub the toothbrush over gingiva (gums) as it may cause further recession of the gum line. If the recession is severe then it may require flap surgery, still, the receded gingiva can never be brought back but a further recession can be avoided. You need to get that filling done as early as possible or it may result in infection of the tooth root. The receding gums might be due to:1. Faulty brushing habit.2. Calculus deposition.3. Poor oral hygiene. Intraoral x-ray of the affected area. Use of saline gargle, betadine gargle, flap surgery and antibiotics if required. Follow proper brushing technique with soft toothbrush." "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 working at a steel industry. So, due to excess heat in the workplace I always have a lot of sweat in private areas. I consult a doctor for the infection. He prescribed me Betadine powder to use and Fourderm cream. Is it helpful? ### Response: My opinion is not to use Fourderm cream (combination of Chlorhexidine gluconate, Clobetasol, Miconazole and Neomycin). It has strong steroids and has a lot of side effects. I suggest Onabet cream (Sertaconazole) or Candid cream - Clotrimazole instead. I also suggest Abzorb powder (Clotrimazole). Consult your specialist doctor, discuss my opinion with him or her and take the medicine with consent. Please put up two or three clear pictures of the affected area so that oral medications may be added if 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 have soreness on arm and scabs but when the scab falls off, it does not heal. An original sore was small rounded with a crust. Sore is over a year old. I am using aloe vera cream and steroid cream for a month. ### Response: I have noted your concern and I have viewed the images (attachment removed to protect patient identity). I can see a crusted plaque. This could be either in situ carcinoma (Bowen\s disease) or a squamous cell carcinoma. I can see signs of photodamage in the background, lots of sunspots. I suggest a skin biopsy" "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 25 year old male. I am suffering from hair loss for the past three to four years. I can see my hairline slowly receding from the forehead. I have been suggested Hair4U 10 % lotion and Biotin tablets. Do these drugs have any side effects on the body? Can I take Finasteride for hair loss? ### Response: Hi. The treatment started by your doctor is fine. The only thing is that the treatment for hair loss has to be followed for a long time and you need to be regular with your follow up visits. Regarding side effects, both these medications (Hair4U and Biotin tablets) are pretty safe. So, you need not worry. It contains 10 % Minoxidil or Aminexil (Kopexil). Biotin (Multivitamin) tablets promote hair growth as well." "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 Saturday I was feeling some discomfort with one of my teeth. It is a tooth that has a crown on it. I was chewing on a piece of steak, and it felt sore. It felt a little sore on Saturday, Sunday, Monday, and Tuesday. I saw my dentist on Tuesday and they did not see any thing wrong on the X-ray, but when she tapped the tooth with one of her instruments, it felt a little sore. So, she made me an appointment with an endodontist for a root canal on Friday. Well, now my tooth no longer feels sore or hurt. If there was a problem with the roots on my tooth would it not show up on an X-ray? I am not sure what to do now. ### Response: Sometimes, it takes time for an abscess to show on the X-ray, but pain starts as soon as it starts producing pus. When the quantity of pus increases and causes bone loss at the root apex, then it starts showing on the X-ray. If tapping causes pain, then the tooth do need root canal treatment" "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 and I had some intimacy a month ago and we had a hunch that she might get pregnant although we did not have sex. We were close but I do not think that anything should happen because we both were wearing clothes (undergarments). Because of this hunch, she took Unwanted 72 under 12 hours. She had her last period from 31st to 4th last month. She took the pill on 6th. Now, its been more than a week and she did not have her periods. Also, she is a virgin. Are there chances of pregnancy? For how much longer will the periods be delayed? ### Response: Hello. I have gone through your history and understand your concerns. As she had Unwanted 72, the chances of pregnancy are not there in your case. Delayed menses could be due to hormonal imbalance caused by the pill. Just wait and watch for your menses. If missed by seven days get your home urine pregnancy test 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 have a black type of a crack on the inside of my cheek and lips, no pain, a bit of irritation, and kind of like a small bump. I am a daily smoker and drink occasionally. I noticed it only a week ago. I have been smoking for five years and drinking ocassionally these years. ### Response: That is an ulcer caused due to biting (attachment removed to protect patient identity). Apply Orafast gel on that and it will heal in 3 to 4 days. That is not an issue but please do not smoke. You know the complications of smoking. It is hard to stop a habit but if we try nothing is impossible." "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 help. I think I might have herpes. I had sex couple of days ago and now it hurts to pee. ### Response: Hi. I am sorry to hear about your condition. But your lesions do not look like herpes (attachment removed to protect patient identity). They look more like folliculitis. That is bacterial infection of the hair follicles. It can occur due to improper hygiene, aggressive intercourse, and non-sterile shaving equipment. Usually, application of antibiotic ointments or creams help. Meanwhile also increase your water intake to prevent UTI (urinary tract infection) which can also occur along with this" "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 got struck with a metal brooch in his left eye corner and the eye became red. There is a kind of brown spot at the corner. At the very end of his eye, a bubble is formed. Now, what should I do? I am worried, and it is hurting him a lot. Please help. ### Response: Hello. I think the injury to the eye by the metal brooch has caused a collection of blood there. It is known as a hematoma. This is the reason for the brown spot and bubble formation. You should consult an ophthalmologist for an eye checkup to confirm that there are not any pieces of metal lodged in the eye or skin around it. If that is normal, then you need not worry. The doctor will prescribe some pain killers to reduce pain and redness. Everything will be back to normal within a few weeks. But be cautious, and get it checked by an ophthalmologist at the earliest, so as to avoid any potential complications." "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 will first summarize my case, and then I will put my query. I had been diagnosed to have GAD and social phobia before 10 years, and I was taking Paxil 20 mg daily in the evening along with CBT. The result was excellent. The anxiety and depression went away, but with a very high level of weight gain, significant fatigue and some sexual dysfunction (low libido). Due to the side effects of the drug, I tried to withdraw it all together around two years back, and there was a relapse. Therefore, I have come back to the medication with some changes. Initially, my doctor replaced Paxil with Prozac and Wellbutrin XL, and then replaced Prozac with Zoloft. Wellbutrin had many side effects on me. Hence, I avoided it altogether. He also avoided Effexor. I am currently on Zoloft 50 mg in the evening along with Buspar 10 mg four times daily.The query now is, which of the following strategies will have few side effects like fatigue, weight gain, impotence, decreased libido, and to delay the ejaculation?A combination of 20 mg Prozac during the evening time along with Buspar 10 mg every six hours daily.A combination of 10 mg Lexapro in the evening along with Buspar 10 mg every six hours a day.A combination of 50 mg Zoloft every evening along with Buspar 10 mg every six hours daily.How would you arrange the side effects? I would like you to mention the side effects regarding impotence, libido, weight gain, fatigue, drowsiness, negative impact on the system and liver in long-term usage, control GAD, SAD and social shyness, delayed ejaculation as a positive side effect, interfere with food, other medicines and supplements etc., in a descending order. Please discuss every question in detail according to your practical experience. Best regards. ### Response: I read your query. Out of the three options, the third option would be the best possible concerning the balance between the effectiveness and side effects. Zoloft (Sertraline) and Lexapro (Escitalopram), both are almost equal regarding the side effects and efficacy. With my practical experience, impotence and loss of libido are known side effects of all the three" "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 4-year-old daughter got poked in the eye with an umbrella, and now that seems to have a scratch around her lacrimal caruncle. She is not complaining about pain, and her eye is not watering anymore. ### Response: The red areas on the photo look like subconjunctival hemorrhage. These are benign lesions in which a little blood has collected in the empty space just under the conjunctiva. To get rid of this condition you need to ice the affected eye (ask your daughter to close her eye and apply ice in a plastic bag or clean cloth over the closed eye for about 10 to 20 minutes). It goes away on its own in a week or so. You need to take your daughter to an ophthalmologist in case, 1. 2. The redness is persistent or increasing. 3. She has pain in her eye or pain on looking from side to side (moving her eyes). 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 recently had my annual exam done and have some odd results. Vitamin B12 was over 2000 ng/ml ref range was 200 to 1100. I do not take any b12 or multivitamins. Globulin was 1.8 g/dl ref range 1.9 to 3.7. Albumin/globulin ratio 2.7 range was 1.0 to 2.5. AST 41 u/l ref range was 10 to 40. ALT 83 u/l ref range 9 to 46. Hemoglobin 17.4 g/dl ref range from 13.2 to 17.1. Is this a serious sign of something wrong? I have noticed. I do not feel that great these days. My doctor has put me into getting an ultrasound on my abdomen. ### Response: Your B12 level is very high. Liver disease, kidney disease, myeloproliferative blood neoplasm, etc., are some of the causes for elevated B12. Your ALT (alanine transaminase) is high, so for liver disease do further work up in form of USG abdomen and viral marker study. Your hemoglobin is mildly high, the proper workup should be done for that in form of full CBC and peripheral smear examination. Also check serum urea, creatinine for checking kidney profile. Investigate with these reports for primary work up. We can discuss further if needed then" "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: Dear doctor,I have noticed a lump the size of a grape on the outer left side of my clitoral hood; that was not there during the last two or three days. It is painless, hard, no irritation or color change, no strange or closed discharge. But it is huge and getting bigger every day. Any general idea of what it could be? ### Response: Hi. Depending on your description, there could be few possibilities: Since it has been around for only a few days and not sore, I think it is just a retention cyst. Any gland around that place whose duct gets blocked may lead to an increase in the size of that gland resulting in cystic swelling. Sometimes, it resolves on its own. And at times, when it does become infected, it will turn sore and become very painful. I suggest you visit a doctor as an absolute diagnosis is necessary. Your doctor may suggest removal of the lump depending on the symptoms." "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 treated some HPV genital warts using cryogenic therapy, followed by applying a liberal amount of Podophyllin, which I left on overnight. Sometimes during sleep, I became very ill and agitated, had the chills and could not get warm, and when I got up I was very weak and lethargic, no appetite, nausea and diarrhea, swollen throat. I thought it was influenza since the virus is currently being transmitted locally. But upon further reading, the symptoms I am experiencing the textbook overdose of Podophyllin. It has been about 8+ hours and the symptoms have not gotten better, or worse. I washed off the affected area with soap and water with the morning shower. Is there anything else I should do to treat the symptoms, and how much longer are they expected to continue? ### Response: Hi. Your concern is acute systemic toxicity due to Ligans in Podophyllin most probably. Have a single dose (2 ml) of intravenous or intramuscular Pheniramine (Avil) along with a single (2 ml) dose of Dexamethasone intravenous or intramuscular by consulting a general physician nearby you. This will help in stabilizing the symptoms." "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 pain in my buttocks. I am unable to walk, and it has been there for a week. I am unable to move my body during sleeping. Please help. ### Response: The pain can be a musculoskeletal pain. A hot compress can be applied over it. If there is no improvement, you can consult an orthopedic surgeon for a detailed physical examination. If the pain is sharp, then it should be ruled out for nerve compression." "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 24 years old, and my heart is having episodes of rapid, uncontrollable pounding which is giving me shortness of breath and faintness. This has only started recently with my first episode giving me tunnel vision. What should I do? ### 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. Blood pressure falls during these episodes, and one has dizziness, fainting, blackouts, sometimes syncope. ECG (electrocardiography) done during episodes will show abnormality. You may need 24 hour Holter monitoring if ECG is not informative. So, visit a nearby cardiologist for these investigations. Till the time your evaluation is complete, you can ask your local doctor for tablet Metoprolol XL 25 mg once a 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: There are swellings near anus and vagina with pain. I guess the wall was ruptured during the process of cleaning as the pressure from the pump was too high. ### Response: Hi. I need to know more details regarding the swelling. A picture of the swelling gives better information regarding its nature. When was it noticed? Any pus? Please revert with details so that I can give specific comments." "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: 1. What causes acne scarring? 2. What ingredients should people be looking for to diminish them (In the products they use)? 3. Is scarring more difficult to get rid of on darker skin tones? If so, please explain why. 4. Is it possible to achieve complete removal of this without getting something like a chemical peel? 5. How effective are peels and other cosmetic procedures for this issue? Which procedures would you say are the most effective? 6. For people who do not want to undergo a cosmetic procedure, what are some things they can do on their own to help? Sunscreen? 7. Is there any way to prevent scarring from occurring? If so, please explain. ### Response: Hello. 1. During severe active acne, inflammatory process leads to scarring if it is not properly treated or treated late during course of acne. So treatment of acne is very important both early and according to recommendations. Because inflammation leads to destruction of collagen fires in skin, resulting in scar formation. 2. People should use products that contain collagen, hyaluronic acid, elastin (the natural ingredients present in our skin and maintain its contour and give it even surface). 3. Scarring can be more difficult to treat in darker skin type because of heavy melanin pigmentation present naturally in their skin which also take part in inflammatory process occurring during acne. 4. Once scarring occur, it is not possible that it get improved on its own or without any treatment. Different options available for scars are topical gels and chemical peeling. Apart from that Co2 fractional laser is also available to get rid of it. 5. Chemical peeling is a method by which skin is stimulated to produce more collagen and making the skin scar free and improving its texture. The more effective treatment is fractional laser that helps in stimulating fibroblasts, increasing collagen production and improving acne scars. 6. People can use topical gels containing collagen if they do not want to undergo procedures. Sunscreen do not have much role to play. 7. For prevention of scarring, early and proper treatment of acne is needed. Oral Retinoids are recommended to prevent scarring." "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 know the cost of veneers and if it is possible to only cover a few teeth or the whole top or bottom would have to be done. What are the effects of veneers and what are the advantages and disadvantages? ### Response: Hello. Veneers can be given on all front upper and lower teeth to get uniform whiteness on all teeth. Else it can also be used for a specific tooth if it is discolored. Veneers offer excellent aesthetic appearances as they cover the visible part of the teeth. They can sometimes get dislodged if improper biting force is applied to them. The other option is to give full crowns over the teeth which over white teeth, not just the labial surface. The cost may vary according to material quality and different clinics." "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 something which affects me a lot. Basically, I desire to have a mental illness, I have been even faking certain symptoms. To be exact, I do actually have mental health problems, I am diagnosed with Asperger's, bipolar disorder and OCD. However, I have a feeling I am not ill enough and I want to be much sicker than I am right now. I know that is not normal and I am incredibly ashamed of it. Right now I am in remission of BAP and I should be glad for that, but instead of it, I am desperate and unhappy. The only thing I want is a relapse and it is not just a wish, I am doing something for it. I go to sleep at different times every day to destroy my sleeping rhythm and I do not take my meds (Valproate for BPD) regularly. I always skip them on purpose in such a way that nobody can notice, I am afraid to stop taking them at all because of the potential reaction of my parents. Then there are things which I just pretend to look sick, for example, I tell people that I have bad dreams and sleep paralyzes frequently, while I almost do not.When I was hospitalized with mixed mania and then with depression this year, I felt a strong need to be the sickest person in the psych ward or at least look like that. I made certain symptoms like hallucinations up. I also exaggerated everything. I had severe insomnia but I always purposely slept even less, I had meltdowns but some of them I triggered purposely or I just made them up. I self-harmed to look ill, not because of an inner need. I do not even know how sick I really was and what I just faked. I have heard about the factitious disorder and I wonder if I have it or not. I am not sure because I have a feeling it does not fit perfectly with me. Is a strong desire of having an illness a part of that disorder? Please, if you have an idea what is wrong with me, tell me. I am disgusted by myself, I want to stop this desire, faking and lying but it is just impossible. I am afraid to tell my real-life psychiatrist because he would not ever believe me on any real symptom then. I am also too ashamed to tell anyone I know. I am sorry this message is too long. ### Response: Hello. It is good that you are aware and trying to take the help of a psychiatrist. You are suffering from borderline personality disorder. You like to take attention from people. You want to be pampered by your family and that is why you are looking for such an illness or faking illnesses. It is your personality which makes you fake risky diseases out of anger or an emotionally unstable situation. So, no one can help you until you want to take help for yourself. There is no medication that can change your nature or personality. Dialectic behavior therapy from a clinical psychologist can help 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 57-year-old male with polycystic kidney disease. My BMI is 27, and I am a non-smoker. My creatine ~1.25, eGFR ~63. I am currently on 30 mg Lisinopril, 12.5 mg Hydrochlorothiazide daily.Most recently I changed to (6 months ago), taking 40 mg Lisinopril only and noticed bp increasing so added the HCT. Since starting HCT, hypernatremic @ NA=130.My query is I get a rapid spike in blood pressure over the course of two to three days from well-controlled 130/80 mmHg to 165/105 mmHg which has maintained for the last seven days and continues. What are the possible causes of such a rapid sustained spike? ### Response: The causes of this accelerated phase could be multiple. My advice will be to continue with Lisinopril as advised. As HCTZ (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: My blood work is showing high WBC and RBC. WBC is 11.3 (normal should be 11), and RBC is 5.14 (normal should be 5.0). Neutrophils are 7.6 (normal should be 7.5). Erythrocytes are at 2 not showing the normal number it should be at. However, it is flagged as high. My alkaline phosphatase is at 121 (normal should be 120), and alanine aminotransferase is showing at 75 (normal should be at 36). I also had an ultrasound done and showing 3.5 cm of bile sludge. Would these results indicate to you that I require gall bladder surgery? I do have pain under my right side rib cage into my right side upper back- tolerant pain. So my surgeon said to think about gall bladder surgery. Do my blood results and sludge showing in ultrasound reflect that I should have this surgery? ### Response: Hello. The concept of when to get the surgery depends upon how much pain you have, how bad is the underlying disease and how long you have the inflammation. Given the history of pain, a slightly elevated white count, abnormal liver function test and biliary sludge. It would be a good idea to consider laparoscopic gallbladder surgery. The timing of the surgery whether to do it during an acute attack of pain or as an elective procedure depends upon the surgeon you are seeing." "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 drink alcohol, I get frequent urination that happens on bed without my knowledge. It is the worst situation for me. Is there any remedy? ### Response: This is commonly seen with many people. The best way out is to either avoid alcohol or do not consume more than 60 ml at one time. Actually by consuming alcohol, you lose your brain command and hence, it happens. You can also avoid consuming alcohol after 8 PM and go to the toilet before you go to bed. Medicines are not indicated because they may interact with alcohol" "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 28 years old and weigh 90 kg. My problem is anxiety. I feel anxious whenever I have to deal with my boss, attend a meeting, speak in front of a crowd. I feel breathlessness and discomfort. My voice starts to break. I am doing well at my job and recently got a promotion. However, this has made me anxious as my job now requires to constantly deal and talk with people and be more answerable to the management. ### Response: Hi. Your history reflects social anxiety disorder but that needs detailed assessment. You need medication as well as psychotherapy session, medications are required to control the symptoms but medications has some limitations like it would not change your personality, thinking style and behavior, for that you need to have sessions to understand the situations, and to learn to deal with anxiety and stressful situations. It is called systemic desensitization for social anxiety. Do you take any other medications right now? TFT (thyroid function test). Tablet Zoloft 50 mg half at night for three days then one tablet at night, tablet Propranolol 10 mg as per need during social anxiety." "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 67 years old. She has the following health issues:Type 2 diabetes mellitus without complications, high blood pressure disorder, aneurysm, fluid in the lungs, (HFpEF) heart failure with preserved ejection fraction, atrial fibrillation (irregular heartbeat), collection of fluid in sac covering heart, chest pain, chronic left-sided low back pain with left-sided sciatica, temporary loss of blood supply to brain, low blood pressure from this year, bladder infection.Currently, her most upsetting symptoms are as follows:Doctors think that she might have TB and so she is on TB medicine as an empirical treatment. Severe shortness of breath (even when lying on the bed), temporary loss of vision. Currently, she sees but not like before. Low blood pressure (she is currently on Sodium chloride serum), very moody and frustrated and angry most of the time. She used to be a very calm person before. Hallucinations, not able to sleep.Her medications are shown in the attached picture along with the number of tablets per day and the total dosage. Could you please advise us about the medicines she is being given since she is very upset about it and we think she might not be able to complete the TB treatment. Are there any medicines that have bad interactions or unnecessary? ### Response: First of all, stay calm and support her fully. I understand it is tough to stay calm and there are too many medicines to take but she can do this." "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 26 year old female. I had got positive pregnancy by the urine test. I scanned by ultrasound but no detection of the fetus. My last period was two months ago. And my missed period was last month. My doctor gave me FOL-XT and Miprogen 200 mg. I am confused about tablets. If I have to take them or not. ### Response: Your urine test is weakly positive. It means your pregnancy may have occurred late, hence not detected on ultrasound. Sometimes, in these cases, there is a risk of miscarriage. So, the doctor has given the medicines to protect from such occurrence. You can take it and repeat the pregnancy test every week and ultrasound after two weeks" "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 abdominal pain in my left side, it is not acute and continuous, but when I sit or stand for a long the pain arises. My doctor prescribed Banocide and Ultracet tablets. ### Response: Hi. There could be many reasons for the problems you are stating. So to know exactly what is the cause of pain many more questions need to be asked. I would like to know exactly where on the left side does the pain occurs? Is it below the ribs or lower than that? Do you have any change in taste or acidity? Does the pain also go to the back? What is the color of your urine? Any other problems like loose motion or vomit? Do you have a fever? These questions will help me come near to the diagnosis and then with relevant tests, we could come to a confirmed diagnosis. As far as the medication that are prescribed to you I would like to say that both of them are strong pain killer which are given for problems like kidney stones, but they will not cure the problem." "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 blood chemistry result. ### Response: I had gone through all your reports (attachment removed to protect patient identity). Revert back with the report 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: I have an eye power of -4 in both the eyes since school days. We are expecting our first child. Are there chances of similar eye problem in our child? ### Response: Hello. You are having myopia of -4 dioptres in both the eyes since school days. The treatment for this condition includes: Refractive errors of more than -6 dioptres is called pathological myopia and are hereditary in nature. In your case, the refractive error is less than -6 dioptres. So, there are less chances of your child getting myopia. But it cannot be ruled out completely. Regular eye examination for the child is necessary after birth to rule out myopia." "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 husband is addicted to alcohol and smoking. What treatment is recommended? ### Response: Hi. First of all, treatment for alcohol addiction and smoking is a self-decision and self will. If he is willing to stop, then you can take help from de-addiction centers for medicines. For smoking cessation, Buspirone can be helpful. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Again the only concern is that the person should be willing" "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 hyperpermeable intestine treatable and or curable? Kindly suggest. ### Response: I hope the following information will help you understand the condition first, and thereafter the possibility of cure and treatment. Together it should help you get your answer. To start with, I am sorry, but your question does not have a simple yes or no answer. Normally, the gastrointestinal epithelium provides a semi-permeable barrier that allows nutrients to be absorbed while preventing larger, potentially toxic, antigenic, or pathogenic molecules or organisms from crossing into the bloodstream. Abnormally increased intestinal permeability allows the individual to absorb the bad food molecules and absorption of bacteria and/or yeast from the gut to extra-intestinal sites, such as mesenteric lymph nodes, liver, spleen, and systemic circulation. Increased intestinal permeability occurs commonly with diseases including inflammatory bowel disease, rheumatoid arthritis, ankylosing spondylitis, asthma, eczema, food allergies, alcoholism, trauma, and surgery. Glutamine, phosphatidylcholine, flavonoids, soluble fiber, and fish oil, as well as probiotic organisms, including Lactobacilli and Saccharomyces boulardii, can assist in correcting this abnormal permeability. It would be necessary to avoid triggers like alcohol. And of course, other conditions like rheumatoid arthritis should be looked for. The treatment of cause will help remove the cause. So the treatment and cure would depend on how well one is evaluated." "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 suffered a stroke seven years ago, that got the right side of his body numb and non-functioning. But, after all these years, he constantly refers to a pain in his left leg. Can you tell me what would give him relief from this pain? I am attaching his latest reports here. ### Response: Hello. I have gone through your query and attached reports (attachment removed to protect patient identity). I hope this answers you. If you have more questions feel free to write 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: I am a 30 year old male working in a national insurance company. My height is 5 feet 11 inches and weight is 85 kg. I do not drink and I do not have any other habits. I eat mixed diet.I am married and have one baby girl (two years of age). I am leading a stressless life both at home and office. I am a very calm and smooth going person.My only concern is my health.I feel some pricking pain in the upper back side of the shoulder and left side of the chest. I feel very uncomfortable.I feel drowsy and unsteady throughout the day.When I am walking or sitting or sleeping I feel that I am pulling down to the ground and I feel extreme tiredness and pain in legs. At the same time, I feel air hunger and not able to breath comfortably.With all these pains and drowsiness I am doing my routine work.Also I feel pain in left side of head next to eye and I feel dull.Two years back I underwent MRI cervical spine, CT chest and one year back I underwent CT coronary angiogram. I was diagnosed with sliding hiatus hernia last month. I underwent appendicitis operation one year back. I am attaching my recent reports for your reference.As I am young, I am much worried about my present health condition. As I do not have the habit of regular exercise I keep gaining weight. I am not sure whether my diet is healthy and balanced. Please advice. ### Response: I have reviewed all your reports (attachment removed to protect patient identity). You seem to be having GERD (Gastroesophageal Reflux Disease) due to hiatus hernia. The GERD might cause the chest and back pain. Get an ECG done to rule out any cardiac event. Stay healthy." "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 29-year-old male. I have a dark brown complexion. I am taking Maxiliv injection IV twice in a week for four months to lighten my skin. But till now there is no change. Why I am not getting any result. I do not expose myself in sunlight and use sunscreen also. I want to know about glutathione effect only. Do I need to increase the dose? ### Response: Hello. It is not necessary that every individual responds to glutathione injections. Effects vary from one individual to the other. If there is no response even after 10 doses, then you should stop treatment. It would not be of any use. Glutathione is not permanent lightening agent. An alternative procedure like peels can be considered for face and if necessary for arms. Or Q switched Nd YAG laser for the face it reduced pigmentation. Rest all measures you are already aware of I suppose." "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 frequently doing masturbation daily. Due to that, I am suffering from back pain and also a pain in my penis. Is there any effect in sex life? How to overcome this and what ayurvedic supplements are used to gain and improved sex life? Please help out this situation. ### Response: I just read your query. See you can overcome the problem of excessive masturbation only with your strong willpower. So be determined that you will not do it excessively. Try to distract your mind with the help of other positive things. Back pain can be due to many causes so visit a nearby physician and ask for the examination and take treatment accordingly rather than taking random treatment. You do not require any supplements right now to increase your stamina. Do not take anything without any indication because it can affect you in the future" "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 in week five ultrasound for IVF pregnancy. hCG has been doubling appropriately. ### Response: Hello. The scan (attachment removed to protect patient identity) shows a single intrauterine gestational sac of about four to five weeks. However, the sac is a bit irregular. It could indicate early failure. A follow up with transvaginal ultrasound is recommended in one week\s interval. Yolk sac and fetal pole would be visualized in the follow-up scans" "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 doctor prescribe Zpack for me yesterday. I have shortness of breath and chest tightness, I was also wheezing, but when he listened to me breathing he didn't hear it. I'm really worried about taking this antibiotic because even though I'm not allergic to any medicines that I know of, he didn't really ask me many other medical questions to see if this was a safe option for me. I read this medication can increase heart rate and people have went into cardiac arrest? I already have a resting rate of about 105, and pretty bad anxiety. I just would like some reassurance that this is safe drug and I don't have to worry about deadly side effects..I'm also a smoker/34 year old female. ### Response: " "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 experienced semi-runny diarrhea that has an orange or brown pigmentation. It is not bloody, nor contains mucus. I passed this when I woke up at three in the morning because of something, and before going to sleep I had experienced some stomach aches but ignored them and slept through. During breakfast, I had eaten a yellowish curry type of food. I had a couple of snacks midday which contains an extremely red pigmentation and also a bag of puffs which contain an orange pigmentation. I then had brown rice for dinner before the stomach aches began. I also drank a drink made from a mixture of water and a red syrup a few times during the day, though not many amounts.The only medication I am taking now is Amoxicillin (bad sore throat, recommended by a doctor), and I also have slight acid reflux so the intensity of the snacks may have not done well. What is the cause of my extremely orange diarrhea? It is like a copper-orange and brown color. I am 18, female, 5'3"" in height, no records of this before. ### Response: You may need not to worry about orange colored stool. It could be due to food intake that contains carotene. I suggest you take Rabeprazole 20 mg OD antacid for week. The associated gastritis can be responsible for stomach pain. If after 3 to 4 days stomach pain and loose stool continues, then investigate with stool routine micro-examination and occult blood test for further work up." "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 21 year old female student with great interest in human growth. More specifically, growth in height, as in getting taller. As learned from textbooks, teenagers stop growing around 18 to 21 years old. Well, I have always been optimistic about everything, and I refuse to believe that our growth is limited to a certain age. There are some recent articles that highlighted growth after 21 or 22 years, and this really gives hope to people with height issue, including me. I know that genetic plays more than 80 % of our growth. I am 5 feet tall, and I had my period when I was 10 years old. I gained only 1 to 1.5 cm a year since 12 years old. Based on health record, I gained only about 5 cm. My dad is 5.5 feet and my mom is 5.4 feet tall.Can I still gain some height? I assumed yes because we now know there are other bigger suns outside of our galaxy and the astronaut did not stop searching when they landed on te moon decades ago. How can I maximize my growth? What are the causes of my lack of growth? What are the factors that stop human growth? Can you give me any other information? I am about to conduct a personal experiment (with precautions) on myself to see if I can gain 2 inches in three years. I am hoping that with proper rest, nutrition, and physical activities will maximize my growth. There will be no height enhancement pills involved so, I really need to study from you guys. I know there is an attitude in my writing, so please do not mind me, I am born bold. ### Response: Hello. I just read your detailed information and would like to answer your query one by one. Hope you find my advice of some benefit. Good luck" "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: Does this look like an early nail clubbing? I came across something on the internet and started looking at my nails. I did a Schamroth test and I have a very small window. I am a bit concerned. ### Response: Hello. Nail clubbing is present if oxygen saturation is low or if there is an increase in reduced hemoglobin for a long time. So do not rely on Schamroth. Clubbing can occur without any disease. You need to get one arterial blood gas test. Kindly send the photos of your fingers and toes" "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 20-year-old female. Since two years, I am getting tiny white balls coming out from my head in comb with dandruff flakes and a lot of hair fall. I took homeopathy medicine and after some time, it came again. ### Response: Hello. I am not very sure what you are referring to by saying white balls. To be more precise, I would like to see the picture. For any query, please make it a point to add the clinical picture, which would make diagnosis and treatment easier in the field of dermatology." "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 on Lipitor 40 mg and Trilipix 135 mg for nine months, and now my LDL is 42 dropped from 140 together with weight loss. Four months ago my hemoglobin decreased to 9.5 but had some recovery recently to 10.5. My weight at present seems to be stable at around 58 kg (height 1.62 m). I still feel energetic but sometimes worried and anxious. Are these the result of very low LDL? or Is there any relationship? ### Response: I can understand your concern. Your LDL is reduced because of medication. Your anxiety is not due to medication. Similarly, this medication also does not affect hemoglobin. I hope I have solved your query. I will be happy to help 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: I had a fall before four days and hit my eye. I have a lump on my eyebrow, and that is not going down or getting better. It is hard and painful. ### Response: Hello. I have gone through your query and I can understand your concerns. As of now, you can do the following things: Blunt trauma. Hematoma following a blunt injury. Conservative. Revert after two weeks to a general practitioner 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 father usually jogged every morning and does regular exercise. His bowels are not clear and the right side of his body has a burning sensation. As per the ayurvedic doctor, his cholesterol is increasing. So, please can you help me with some probable reasons for the above problem and their cures? ### Response: Burning sensation in the body can be due to Pitta dosha increase. Moreover, your doctor\s advice regarding an increased cholesterol level and prescribed treatment are also right. You can follow the same prescription you are following. He has to take treatment regularly for two or more months under supervision. These changes can be due to age or may be due to diet. So, avoid excessively spicy, oily, deep fried food and junk food. You can also perform a blood test related to cholesterol called as lipid profile test after discussing with your doctor" "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 sometimes get, jittery and flutters. Uncontrollable fear of bad things. I feel cold in my head, running stomach and need to urinate. My left side feels numb. What can I do? ### Response: The symptoms which you have mentioned are suggestive of anxiety disorder. However, the common medical causes of your symptoms like diabetes, hypertension, and cardiac diseases, thyroid disorder, and vitamin B12 deficiency must be ruled out. An MRI of the brain will help to rule out brain pathology, which can cause numbness. Assuming it to be an anxiety disorder, relaxation exercises like deep breathing and meditation will be beneficial for 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 44 years old male. I am attaching pictures of my seven year CBC history. Here is what happened this year. On my annual physical 11 months back, my WBC was low. Three months back, my GP checked it again. WBC came back in range but platelets were low. Over seven years, platelets have been between 134 and 165. GP sent my CBC history to two oncologists for review of low platelets. One said do test for H.pylori, hepatitis c, and HIV. Did the tests, all came negative. Both the oncologists asked to follow CBC. My father died of multiple myeloma at age of 64. The other day, I noticed a small bruise on my hip. Probably no big deal but have a heightened awareness now. My question is due to my father dying of MM and/or my CBC history, am I at a higher risk of blood cancer? What or when should I be concerned, what to look for? I certainly do not want to go to an oncologist with a single bruise. ### Response: Your CBC does not suggest multiple myeloma (attachment removed to protect patient identity). In the case of multiple myeloma, anemia can be there and clinical symptoms like a constant headache, kidney system related symptoms, etc., can be present. But as your father was having a history of multiple myeloma, you are also at risk. But it does not necessarily mean that you will develop cancer in the future, the risk can be there but exact percentage cannot be predicted. So if you suffer from any unusual symptoms related to multiple myeloma like a headache, affected vision, weight loss, bone fractures, fever, etc., then you have to consult a nearby doctor for detailed evaluation. Your CBC is not showing any dangerous finding but still, I suggest you investigate with peripheral smear examination report and serum immunofixation electrophoresis for further work up. Peripheral smear examination will show any abnormal cells if present and electrophoresis will help in identifying monoclonal M band if present. You can revert back with that report." "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 left upper eyelid is bigger than the right. ### Response: Hello. I have seen the image uploaded by you (attachment removed to protect patient identity). Kindly give me a detailed history. Revert with more information to 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: I am suffering from disc bulge at the level of L5-S1. It causes pressure at nerve root for past two months. I am under treatment but no satisfactory improvement in these two months. Please help. ### Response: You have mentioned from MRI findings as L5/S1 disc bulge, instability at L5/S1 level and pars defect of L5 with likely compression of both exiting L5 nerve roots. I would like to know few more details such as, Revert back with your MRI and x-ray films 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: My date of the period was 10th of this month but I got it on 6th. Next month on 2nd, we have a religious function in the temple, so I want to delay my periods. Which medicine is better to use? Some say Primolut N or Ovral G or Ovral l. ### Response: Hi. Generally, to delay periods, Progesterone hormones have better performance. So take the following medications in given dosage, two days prior to expected next date of your periods, till the date you wish to delay. Delaying periods in once a blue moon is fine, but doing it frequently might cause irregularity in periods, or transient cysts in ovaries. Tablet Primolut N 5 mg twice a day after food. Start from two days prior to expected next date and take till the date your purpose is served." "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 diagnosed with the degenerative changes in the cervical and many more things. I am attaching the MRI report also. Symptoms include pain in neck, shoulder, hand, weakness, dizziness. I cannot sleep properly, cannot sit for a long time. I have also consulted with some doctor but no result. I have got relief when I am taking medicine, otherwise, it goes worse. Please see what the problem is and please clear it. ### Response: Hi. I have read your concern and seen the MRI report. It seems that the spine shows degeneration in the bones and disk but does not show any impingement of the spinal cord and the nerves. However, the cervical vertebrae are abnormally straightened as opposed to normal curve (this signifies muscle strain). The pain you are experiencing can be discoligamentous in nature, meaning this is coming from the disc and bones and joint attachments. It is a good thing that you do not have any motor weakness (signifies intact nerves). This usually resolves in pain medications and rehabilitative medicine in six weeks. This should help you. Age-related changes. Repeat MRI after rehabilitation in six weeks, serum, calcium, sodium. Cervical arthropathy due to RA or TB. Degenerative cervical spine disease. Pain medications, NSAID and Gabapentin. Exercises and rehabilitative medicine, physical therapy." "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 neck, shoulder, and arm pain. It swells in my triceps and my biceps hurts like it is torned. I can make simple moves. x-ray confirmed cervical lordosis. Please help. ### Response: I have gone through your complaints and understand your concern. I generally see many cases like this at my clinic. I give them rest, analgesics, anti-inflammatory tablets, and ice packs till the symptoms reduce to some extent. Then I get an x-ray and if necessary an MRI (magnetic resonance imaging) done to find out the exact reason. In your case, there are three possibilities: 1. Soft tissue inflammation, there may be no bony involvement only the soft tissues around the region might be inflamed that may be causing the pain. 2. Neuropathy, there may be a partial or complete inflammation of the nerves in that region that may be the root cause of such kind of pain. 3. Disc prolapse, there may be a compressed nerve in the spine somewhere that might be causing radiating pain in those regions. The possibility of a disc prolapse should be kept in mind. I suggest you get an x-ray as well as an MRI done to find out the exact cause. Do get back to me after your reports are ready. But I assure one thing, even if it is either of the above three possibilities, all have a good prognosis and you should eventually get back to normal in a few days.Nothing to worry about. 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 had three pilomatricomas removed surgically since I was 12. I still have five left in my body. My father also had them too. Is this something that eventually stops occuring? ### Response: Hi. Pilomatricoma is a small benign tumor arising from the base of the hair follicle. Usually, they are not hereditary but very rarely 1 out of 100,000 cases, it can be genetic. Once cured after surgery they do not occur at the same place but in your case, one cannot guarantee you that it will not occur again." "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 yeast infection weeks ago and I am starting to get the symptoms all over again but now I have a blister and soreness along the labia minora. I have a burning itching sensation and my vagina is sore. It burns a little when I pee and it hurts to wipe. My vagina looks red like it is irritated. I am afraid that it could be herpes. ### Response: Herpes may present like small vesicles with clear fluid. If they rupture and have a red base. Also, the other possibilities like chlamydia or trichomonas infection, etc. Get these done: Vaginal secretions culture and microscopy. Use Candid B PV gel local application. Please consult your doctor he will examine and treat you accordingly." "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 I use Crest whitening strips if I have a permanent retainer? ### Response: Hello. The strips will whiten only the portion of the tooth that it comes in contact with. If it is a fixed retainer, then you can use it on the front surface, but do not let the chemical touch your inner surfaces of teeth. I will prefer not using it in such a case, as there will be a difference of color in your outer (front) and back (inner) surfaces of teeth. If it is removable, you can. Make sure you remove all the excess material from the mouth and teeth before putting the retainer back on. If your teeth are sensitive, then it might ache a little while placing back the retainers. I would recommend you not to whiten teeth regularly as it can weaken your teeth and cause sensitivity in the long run. You can also ask your dentist regarding tray and gel method, for at-home whitening methods" "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 met an accident and I was wearing a helmet and it was ripped off in two meters and then for around five meters, I was without a helmet. Then after that moment I fell down and saw some lines and web like things. I consulted three doctors and every one is saying that there is no problem in my eyes. So, I even took a brain scan and the result is nothing and this is the third day. Even now I have not got any change. I am still seeing the lines and all. Can you please suggest anything for this? I am highly worried. ### Response: This condition is called eye floaters, this might be a benign condition but in your case, as it popped up just suddenly after eye trauma, I would be going to an eye specialist, as this might be a sign of vitreous or retinal detachment or inflammation in the posterior part of the eye. CT scan will not show anything but they need to do retinoscopy. Let me know if you have any other questions." "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 27 year old unmarried male and my penis size is too small and thin. In the normal position, it is 3 inches, when it gets strong it is 4 inches. Are there any medicines or surgeries for the growth of penis? Also, my penis is not getting strong even when I am in sex mood. When I shake it with my hand, it slowly gets strong. Due to this problem, I am feeling tensed about how I am going to move with my wife after marriage. My marriage date is getting close. ### Response: Hello. Kindly investigate your serum testosterone and serum luteinizing hormone level, length and girth can only be increased if these levels are low. But, in those individuals in whom the testosterone level is normal, let me tell you one thing that, there is no medically proven treatment for increasing the length and girth the of penis. On erection, the normal size varies from 3.5 inches to 5.5 inches, and normal vaginal size is also between 3 to 4 inches. So, any erected penis of size more than 2.5 inches is able to satisfy both the partners. Orgasm in both the partners is independent of size, girth, and length of the penis. So, my advice is to decrease your weight, do regular exercise," "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 neck problem for a few months with tingling, numbness, and pain on my arms and fingers, especially in early morning and evening. Kindly help. ### Response: Your cervical spine MRI shows spondylitis in the form of posterior disc bulges at C5/6, C6/7 and C7/T1 levels indenting the thecal sac (attachment removed to protect patient identity). There is narrowing of neural foramina at these levels with indentation of right exiting nerve root. This may cause tingling numbness in hands. Rest of the spinal cord shows normal signal." "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 recommended by my cardiologist for a heart valve replacement surgery as my latest echocardiogram results, both transthoracic (TTE) and transesophageal (TEE), revealed that my mitral valve prolapse had worsened. The diagnosis was severe eccentric MR. However, during the latest TTE scan, the radiographer who did the scan said that my regurgitation was only moderate. I find this very confusing and was wondering if MVP is a reversible condition. No current medications. ### Response: Hello. First of all, the severity of MR (mitral regurgitation) will be correctly deciphered by your cardiologist. An eccentric type of MR is actually a grade higher than what it looks. Like your radiologist may think it is moderate but it is severe, but because of its eccentric nature, it looks lesser than what it is. The second thing is, why are you not on any medicine yet? You should be on ACE (angiotensin-converting enzyme) inhibitors and diuretics. If you have symptoms like breathlessness, these medicines will relieve that and prevent heart events too. If you have symptoms and your heart chamber size increases, then you should go for MVR (mitral valve replacement). If a prolapse is worsening, then it will not reverse." "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 developed feet neuropathy, primarily the right foot from the past one year. The symptoms went away six months back but returned a month back (burning, tingling, etc). I suffer from high blood pressure and anxiety. The neurologists could not find the cause after all tests. I tested negative for HIV but tested positive for herpes 1 and 2. Can herpes cause this? It has been so long since I had these symptoms. ### Response: Hello. It is less likely that your symptoms are related to herpes. Herpes infection does not usually lead to such a clinical situation. Besides, a positive test does not always indicate an active infection. The fact that your tests resulted in positive means that you have gone through this infection in the past. In fact, herpes 1 is a very common infection (almost everyone has gone through it). So, I do not think that your symptoms are related to these types of infections. In many cases, no cause of peripheral neuropathy is found (idiopathic peripheral neuropathy). Regarding the pain and burning sensation, I would recommend starting treatment with Pregabalin or Gabapentin. Another possible treatment option would be Duloxetine. I would also advise you to be active. Physical therapy can help improve your clinical situation. You should discuss with your doctor about the above treatment options." "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 obsessive compulsive disorder. When I was taking Uvox for four years, it was all fine. Now it relapsed, and I am taking Uvox before I used to take Stalopam.Can I get back to my healthy life and go office rgularly where I have to do brain work for nine hours? Please let me know. When I will get my healthy life back? ### Response: Hello. OCD responds well to medication (SSRIs - selective serotonin reuptake inhibitors) and psychological therapy (CBT - cognitive behavioral therapy). I presume you are on Fluvoxamine which is useful in OCD. You need to be monitored by your doctor to optimize the dose and monitor for any side effects. If there is no adequate response, alternative SSRI like Sertraline can be tried. Once your symptoms are under control, you can continue to work and function normally. There are lots of people with OCD who are on medication and continue to work well. Also, try to have CBT for OCD which will help to prevent relapse in the future." "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 cannot sleep early at night and cannot wake up early in the morning. I normally sleep at around 2 AM and wake up at 10 AM in the morning. I am also very tensed when I try to sleep, lots of thoughts come to my mind regarding my life, my past, and my future. I think unnecessary things. I also watch TV and use my mobile before sleeping sometimes, but even if I do not use them, I cannot sleep early. Please suggest any exercise or some other method to solve this problem. I do not want to take any medicines. ### Response: Hello. I completely understand that you are concerned about your sleep timing and have difficulty in initiating sleep due to excessive thoughts. I hope this information is helpful. Do follow-up if you feel the need. Best regards." "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 molar extracted 10 days ago, and I am now having severe pain. It was a simple extraction that did not even require stitches. I was prescribed Penicillin VK q.i.d for a week and a few tabs of TYL3, which did next to nothing. I had all four wisdom teeth out about 20 years ago with no complications, but I am now older, unemployed and have dealt unsuccessfully with a severe dental phobia that I have had since I was a small child. Please help. ### Response: Hello doctor, I read your history, almost everything you have attempted. Still, I would recommend the following things. 1. Take Ibuprofen 600 mg three times, (8 hourly) a day, or if having severe pain, you can take it six hourly for three days. 2. Do salt gargles, i.e. take a cup of lukewarm water to add 1/4th teaspoon of salt in it and do rinses six to eight times a day for next 10 days. It is mandatory. The best way for healing of the socket. 3. Find out if you can get this zinc oxide eugenol material over the counter then you can put a pinch of it at socket your self at home. This is not cement it is another material. If it is not possible then go ask your dentist to give these" "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 age is 19 years. I am on antidepressant tablets like Paroxetine prolonged-release, Clonazepam, Mirtazapine, and Dosulepin. I have a problem with erection and do not have a sex drive. Will these medicines have any adverse effects on my sex life? What should I do? ### Response: Hello. You are on three different types of antidepressants - Paroxetine, Mirtazapine, and Dosulepin. Clonazepam is meant for short term use. Is your depression better after having these medicines? What is the duration of your medication? Do you experience any other side effects apart from sexual side effects? Mirtazapine is the antidepressant that is least likely to cause any sexual side effects. So it can be continued until your depression is better. Consult with your doctor about gradually weaning off Paroxetine and Dosulepin while monitoring your health. Also, Clonazepam should be gradually weaned off, if using for more than a month. Added to that, seek counseling. Take healthy foods and do regular exercise; it will be helpful." "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 trying to have a baby but nothing is working out. When is the right time to conceive, either during fertile days or ovulation? I tried during fertile days, but nothing happened. Please explain. My cycle is 31 to 34 days. ### Response: If your cycle is 31 to 34 days long, then 13th to 24th day of your cycle is fertile period. You should have sex in the above period for at least on alternate days and this will increase the chance of having a pregnancy. Even if everything is normal then also, you do not need treatment for at least a year. There is naturally a minimum of one chance in 12 cycles in a year of having a pregnancy. You have only one chance of pregnancy if ovulation is normal in one cycle. So, there is one chance in 30 days and 12 chances in one year and this is when you have a normal cycle and ovulation. So it is a time-consuming process. Do not get frustrated. Just say that in one cycle, if you did not ovulate at all, then that chance is gone and you have to wait for the next. This is what you should first understand." "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: Emergency contraception is 95% effective means is there some chance of getting pregnant? What more precautions could be taken during sex so that there will be full surety about it? After taking it, will the periods be painful? In what way will it alter periods? Will it change the number of days of period? And what is withdrawal bleeding? Will it be there immediately after taking it? Or after a day or two? When it will be 100% effective? Is there any other way to avoid pregnancy completely in unprotected sex? ### Response: Hi. I have read and understood your problem. Yes, there is some chance of pregnancy. You can use condom, but there is no contraception 100% effective even after contraception-operation very small chance of pregnancy remains. You can bleed any day after taking I-pill. There is no fixed rule it may take even 10 days and bleeding usually will be normal not painful. 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: Hi docor,Can I take Arjunarishta? I have high cholesterol and am using Rozavel 5 mg. ### Response: Hello sir, I just read your query. Arjunarishta is advised in conditions like high cholesterol level. As you have this problem, you can take it along with your current medicine. But keep some gap between your allopathic medicine and Arjunarishta. Arjunarishta is not advised in diabetic patients. So, if your sugar levels are controlled you can take it in the following dose. Take 10 ml of Arjunarishta with an equal amount of water two times a day after food for one month. Consult me or a nearby Ayurveda physician after one month regarding improvement and for further management. Hopefully, you will feel better results within a month. Poor eating habits and improper lifestyle. Lipid profile test after one month." "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 like something is wrong with me. From last week a lot of back pain (not muscular), tummy and waist pains almost like contractions when it gets bad. I get blackouts and feel dizzy when I stand up. And I am not pregnant. What do you think can be wrong? ### Response: While menstruating, do you have any history of vaginal discharge or lifting heavyweight? These problems look like to origin from uterus. Various possibilities are an infection, fibroid in the uterus, changes in the position of the uterus. If any discharge needs to be treated for an infection, you would need one ultrasound if no discharge or menstruation was present at that time. You can try tab Dicyclomine 20 mg whenever required. Regarding, you blackouts this occurs due to postural hypotension, you need to increase fluid and salt intake and avoid a rapid change of posture. Also, get your blood pressure tested once, because low bp can also cause these symptoms." "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 done an OPG. My dentist is saying to remove the wisdom tooth on the lower side of the jaws on both the sides. I do not have pain in the wisdom tooth. But I feel pain in the left side molar. My doctor has advised for RCT for that molar tooth after removing the wisdom tooth present on both the sides. What can I do now? ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). Your OPG (orthopantomogram) shows that your lower wisdom tooth is impacted or tilted. They are putting pressure on the other molars. So it is advisable to remove them as soon as possible to prevent further damage to other 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: My 2.5 years old is having a wet cough and running nose (no fever). It starts with a dry cough and in a day or two, converts to wet. The same process has been going on for a month. He stays healthy for 2 to 3 days and then falls sick. Advise medicine for current situation and supplements for immunity improvement. ### Response: What you are describing seems to be something like hyperreactive airway disease. In such cases, we initially give a trial of Montelukast for a few weeks to a month and look at the response. Based on the response, we may add steroids followed by inhalers (different combinations) (again based on response). This requires multiple follow ups and evaluation in the initial few stages till stability. Hence I would recommend you to go to your pediatrician and ask him about the above thought process that I have described." "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 chronic dry cough originating primarily in bronchial area. I feel fatigue, vertigo, lack of appetite and periodic nausea. Please help. ### Response: Hello. Chronic cough since long time suggests some allergic condition like asthma. For proper diagnosis you should do a chest x-ray and spirometry test. Other symptoms can be suggestive of some infective cause like tuberculosis. So, ultimately after an x-ray and spirometry test we can make a definite diagnosis. Vertigo can be because of chronic cough. But, clinically it is very difficult to say. Some blood test may also be required for making a diagnosis. Usually, the asthmatic patients have some other allergies also. You have not specified any other symptoms in detail. Please do not hesitate to contact me after doing the above mentioned tests. Treatment mainly depends on the reports. Allergy. Chest x-ray and spirometry test. Asthma. Inhaler medicines. Avoid known allergen." "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 got married before seven years and living happily with my wife. A week ago, I had a very enthusiastic sex session in the shower. During which I slipped out and missed going back in and had a substantial impact. At that time I believe I had a frenulum tear and the skin was split. After initial redness and swelling, now it has a small scab. How long will it take to heal? And is going to a doctor worth my time? ### Response: It is quite common to get a frenulum tear while having coitus. It will heal within four to five days and pain will subside in a day or two. However, if you still continue to have pain, you can seek an opinion. Avoid coitus for few days for a quick recovery." "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 pimple that was huge and it busted with puss and left a dark spot on my face. What should I do to heal and get rid of the dark spots? ### Response: Your history is suggestive of post-inflammatory hyperpigmentation. To prevent further darkening, make sure you use good non-comedogenic sunscreen with SPF 50. To improve the dark spot, you can use topical Kojic acid cream, apply to the dark spot at night" "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: Today is CD6. Yesterday, I started taking Clomid for CD5 to 9. CD10 is scheduled for cervical polypectomy. The night before instructed to take Misoprostol. Can I try to conceive this month right after a cervical polyp removal? The polyp is very small in the cervix. ### Response: If a cervical polyp is removed anytime, there will be some fresh blood. So it is not advisable to have any medication for pregnancy, in the same cycle as the removal. As blood is not a good medium for sperms, sperm motility is reduced or stopped by blood components. You can try for pregnancy, but when there is blood with a raw area in the cervical canal, sperm health may be reduced. You can have sexual contact after bleeding stops, usually which stops within 2 to 3 days. Next periods your chances will be better. Better use Clomid from the next cycle." "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 anxiety and social phobia. I consulted my psychiatrist to use either Citalopram or Mirtazapine. I doubt to take Citalopram because I know this causes sexual side effects more often than Mirtazapine does. However, regarding Mirtazapine, I read various things online that, because it is a norephedrine activator (SNRI) instead of SSRI, it can cause anxiety to become worse. I want a second opinion, if I were to use Mirtazapine, what is the recommended dose for anxiety and social phobia? ### Response: 1. Both Citalopram and Mirtazapine are good choices for managing anxiety and social phobia. 2. If you are worried about sexual side effects, Mirtazapine will be a better choice. 3. Both Citalopram and Mirtazapine can take up to four weeks for the therapeutic benefits to become apparent. Some people can experience agitation and anxiety during the first week or so, but usually, it settles down. Mirtazapine has a sedative effect as well, so it should be beneficial. 4. The usual starting dose for Mirtazapine will be 15 mg once daily at bedtime. If needed depending on your response and tolerability, the dose can be titrated up to 30 mg or 45 mg per day. Medication can only be started after your doctor has ruled out any contraindications and should be able to monitor your response. 5. Finally, in addition to medication, you can also try psychological therapy and CBT (cognitive behavioral therapy) for anxiety. They are highly effective and help to prevent relapse after the medication is discontinued when you have improved. Usually, antidepressant medication needs to be continued at least for six months after you feel better. 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 got my tooth pulled six days ago and it still hurts really bad. There was something in my gums that is no longer there and now it is a big hole. What to do? Do I need to worry or it is just the process of healing? ### Response: Due to this, there is a pain. You should consult your dentist and get evaluated. He can clean the extraction socket with antiseptic solution and place medicated" "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 question is whether or not it is safe for me to use anesthesia to fall asleep while having all four of my wisdom teeth removed. I am a quiet person and did not ask many questions during my consultation. I cannot breathe very easily through my nose because I have some sort of sinus issues and it is worse when I am laying down flat on my back. I wrote down that I had sinus issues on the papers I filled out but half the time they do not look at them. I know i should have brought it up at the consultation but I was shy and nervous about the whole thing. They said they cannot even do the surgery if I have a cold. Can they do anesthesia if I have sinus issues? I would prefer to be knocked out when they take my teeth out but I am even more worried about not being able to breathe through my nose.As of right now, I am scheduled to have my wisdom teeth taken out at a hospital with many assistants who will monitor everything while the surgeon works. They also said they would be putting a tube down my throat in case I need help breathing. That makes me even more worried because I will not be able to breathe through my nose and my throat unless the people monitoring me are breathing for me the entire time during the operation. That worries me. My question is: Should I be taking anesthesia to go to sleep if I have difficulty breathing through my nose? I am not worried about the surgery itself but being given anesthesia and not being able to breathe once they give it to me freaks me out because of my sinus issues. If I did not have sinus issues I would not be worried so much. ### Response: Hello. You do not have to worry at all. There will be people concerned by you. Having a sinus issue is not a contraindication for anesthesia. You can have sedation supplemented with local anesthetics. In case you need endotracheal intubation, that will be safer for you because your nasal passage will be bypassed and you can be totally knocked off which is called general anesthesia. This will be done by a trained anesthesiologist. So, do not worry at all and leave your worries on your anesthesiologist. You will do absolutely fine. Wish you all the luck." "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 hypothyroidism five years ago and currently taking 100 mg of Synthroid. My most recent lab work showed that I am now at hyperthyroid levels. In the past, I tried reduced levels of Synthroid but felt terrible.I was diagnosed with peripheral neuropathy about 15 years ago with tingling and burning in the face and limbs. My Neurologist looked for MS due to my sister having the disease. The Neurologist said only to contact him if it got worse. I used to get two or three episodes per year, mostly during stress or period of fatigue.In the last six months or so, I have almost constant tingling in my face, feet, and arms, and numbness on the sole of my foot. Burning is off and on, some days worse than others. I mentioned it to my GP at an appointment about one month ago, but he said it was nothing to worry about. Researched that thyroid problems can cause tingling, burning, and numbness. Could this be from thyroid? Usually, I would push my GP, but my husband was recently diagnosed with late-onset MS (five months ago), and I feel doctors will think I am a hypochondriac. I am planning to visit my doctor after the holidays but my husband had his attack recently, and I am focused on his issues. I am just curious if I should be worried. Please help. ### Response: There are two issues involved, thyroid problem and the other one is if you \x80\x8bhave MS. About thyroid, you are taking 100 mcg (not 100mg) Synthroid since long. My suggestion is to look for thyroid levels and consider tapering slowly over six months. You can discuss with your doctor for the same. Next are your tingling and numbness. It could be because of diabetes. I am not sure if you have diabetes. If yes, reasonable control of sugar is required. If you are not tested for diabetes, then get tested for the same. As you have hypothyroidism, there is a good chance that you may also have diabetes. Tingling and numbness can also be because of vitamin B12 deficiency. Check for levels of the same as it can be easily corrected with supplements. Multiple sclerosis can be diagnosed clinically and by specific laboratory tests. If your doctor has already done it, and assured that you do not have it, then no need to worry. You have fear and anxiety about getting the same as you have a family history, and your husband is also diagnosed with it recently. If you have any weakness in legs or hands, blurring of vision, and paresthesia in extremities, then consult your doctor." "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 55 year old female. Can a breathing treatment given before a chest x-ray, hide lung cancer? ### Response: Hi. I have read through your query. Please find my observations below. Breathing treatments like nebulizers will not hide any suspected lung cancer when given before taking a chest x-ray. Chest x-ray is a basic investigation used to screen the lungs field and heart and usually done as a routine investigation. A routine chest x-ray usually picks up any nodules or mass in the lung fields that might represent lung cancer and is not affected by the patient taking nebulization therapy. If there are strong reasons to suspect a lung cancer, then a CT scan chest is the best investigation and gives a complete detailed overview of the lungs. In conclusion, breathing treatment will not hide lung cancer when given before taking a chest x-ray." "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 read that drinking alcohol affects the HIV test results. Does increased alcohol intake delay seroconversion time? If so, then how long one should wait? Three or six months? For such cases, can we take HIV DNA PCR as a screening test? Whether this test is also affected by much more alcohol intake or not. How reliable is this test? I had oral sex around three years back, and I consume 150 ml alcohol regularly. For such a person, what HIV screening is recommended? For late seroconversion, which test is taken to find out HIV infection? Please explain in detail, as I am obsessed with HIV. ### Response: Hi. Hope your queries are answered, but please feel free to ask or call anytime for any further information. Best wishes" "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 penis top is red with a white pimple. I used Mupirocin ointment four months back. Then again the doctor gave Betnovate RD a month back and I used it three times. Now, my skin looks very dry and ugly. The redness has reduced but the skin looks abnormal. ### Response: I have gone through your complaints and it could be yeast infection. I would recommend you to upload the pictures of the affected areas so that I can have a clear picture of the condition and can guide you accordingly" "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 issue regarding my gums. For the past few days, I have been feeling that my gums are becoming weak and thin as they are leaving my teeth and going down from my teeth. I want to say that a part of the teeth which is hidden under gum is showing. I am a smoker and I am already trying to leave it. Please suggest me some treatment. I usually brush once daily. ### Response: Hello. I have been through your query and I can understand your concern. Receding gums can be a problem associated with many factors. It is known as the recession of gums. I would like to know if you have a habit of brushing your teeth hard. Smoking causes stains on teeth and there could be the urge to remove these stains by brushing hard on the tooth surface leading to the recession of gums. I would like you to have an appointment with your nearest dentist in order to get the teeth cleaned (scaling) properly and also to assess the severity of the recession so that the treatment can be done accordingly. Meanwhile, I would also advise you to brush with a soft or ultra soft-bristled toothbrush twice daily and also floss daily. Also do not scrub the brush onto the teeth hard, be gentle while brushing. I would love to hear from you regarding the follow-ups." "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 actual period date was over a month ago. I missed my period. A small dark spotting was seen. The pregnancy test is positive. Please suggest an abortion kit. ### Response: As you have missed your menses and the urine pregnancy test is positive and as I believe this is an unplanned pregnancy, firstly before considering an abortion pill, you must rule out an ectopic pregnancy as an abortion pill would then be ineffective. So, please get a transvaginal ultrasound done to confirm intrauterine pregnancy and follow up. Regards" "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 age is 26 and I had unprotected oral sex. I licked a sex worker\s vagina with a lotion. I had protected vaginal sex. Performed HIV tests on 25th, 42nd, and 70th days. I also did HIV1 PCR RNA qualitative on 76th day. CMIA antibodies on 70th day. Now, we will get the result of p24 on 86th day. All my reports are negative. But, I have rashes and recently got a cold. Are my tests results conclusive? I feel each and every symptom to be related to HIV. ### Response: Hi. HIV can never be diagnosed based on clinical symptoms. Moreover, symptoms of HIV include a generalized lymphadenopathy, weight loss of more than 10 % in short duration, long term diarrhea more than one month, etc. You have done CMIA test after 70 days that detect both antigen and antibody. It gives conclusive result after six weeks. So you may need not worry. However, the guideline says that you should repeat your HIV test after three months of exposure and that too after 85 to 90 days of exposure." "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: Currently, I am on Telvas AM and BP is well controlled. My question is:1. I want to shift to Cilnidipine instead of Amlodipine.Heard from many patients and clinical trials that Cilnidipine is useful in sympathetic nervous system hyperactivity as it is dual type CCB. I have that. Will it be a good alternative to Amlodipine? Will Cilnidipine be equally efficacious in terms of BP control when compared with Amlodipine?2. Is there any difference in efficiency if I go for seperate tablets of Telmisartan 40 and Cilnidipine 10 mg or single pill consisting of both is preferred? Can I take separately? ### Response: Hello. Regarding your concern, I would explain that Cilnidipine is a good alternative for treating hypertension, especially in patients with uncontrolled hypertension or after a stroke. It may be more effective that Amlodipine and with fewer adverse effects (less edema). You may use them (Telmisartan and Cilnidipine) separately or even in the same pill depending on how it is more convenient to you. Anyway, you need to discuss with your attending physician on the maintenance scheme and periodic follow ups." "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 unprotected sex with fiancee a month back. She took i-pill within 12 hours. After two days, she had withdrawal bleed for three days. She was supposed to get her periods on 24th. But, till date, she did not get it. She has thick white secretions and pimple from past three days.Is she pregnant? Or how many days can she wait? ### Response: I have gone through your question and I understand the concern. I-pill (emergency contraceptive pill) causes the next expected periods to be delayed by 2 to 3 weeks. I will suggest her to get a urine pregnancy test done. If negative, then she can safely wait for the periods for another two weeks" "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 attaching a picture of my wife\s left eye. I believe there is a stye or something else inside the left side of the eye. It has been around 8 to 10 days now. Earlier there was a pain in the eyes for the first 2 to 3 days. Later on, the pain was not there but I saw a lump or stye like structure in her left eye. I can also see a small lump from outside which appears like it is filled from inside. This is probably the first time happened with here. Also is it fatal? Kindly suggest what it is and the medications. ### Response: Hello. I have gone through your wife\s problems and seen the photo attached (attachment removed to protect patient identity). This condition is called a chalazion, it is a sequel of style and it happens when long-standing infection is set up in the eyelid glands. They are usually treated surgically unless resolving with a course of antibiotics. So my advice is that you please do the following. Avoid eye rubbing. Hot fomentation to the affected eye and massage the lid after giving heat. Tobramycin eye ointment two times a day for a week in the affected eye. It is necessary to meet an ophthalmologist in the following scenarios. If eyes become red, start having sticky discharge from eyes, vision becomes blurred, not responding to treatment even after a week." "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 on Sulpitac 50 mg, Xet CR 25 mg, Pregabid NT at night and Waklert 50, Beta cap 20 in the morning. I have a long history of paranoia and depression. Currently, the only symptom is excessive hair scratching. My hand is always on my eyebrows. The problem is particularly bad at night. There is some twitching or tingling in fingers. Please suggest any adjustment of medicine. Could this be due to any of the medications I am taking? ### Response: No, I do not think any medicine is causing this. The compulsive scratching or pulling of hair could be due to unconscious anxiety. You are on Paroxetine 25, and if the anxiety is still persistent, then we can think of increasing the dose to 37.5 mg. Increase in dose would help in controlling the unwanted impulses. You can talk to your doctor about that. Apart from this please start taking good vitamin B12 supplement which will also help in early recovery." "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 received unprotected oral sex 13 days ago. No symptoms of genital herpes except for today, I have an itchy anus. No visible bumps, blisters or pain. Is it possible this is the beginning of an outbreak? Or perhaps caused by severe anxiety and prolonged sitting? ### Response: Hello. Itching over the anal region can be due to many causes: In genital herpes, there will be burning/tingling sensation before the blisters appear. Another possibility is gonorrhea if there is any history of unprotected anal sex. Please watch out for rashes, blisters, or discharge. Sitz bath will be of help for itch relief." "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 sinus operation last week but have developed a pain in a tooth that needs a root canal treatment. It is extremely painful. Is there anything that can be done? ### Response: Get an appointment as soon as possible. And take painkiller tablet Brufen 400 mg six hourly if you are having really severe pain, otherwise eight hourly like three times a day for three days. Do not lay down straight at bed at night. It aggravates the pain. Put some cushions and high pillows, raise your back while sleeping. If pain still gets aggravated then you need to go in an emergency room and get chamber of root canal tooth opened in the emergency so that pressure of infection gets released and then you continue with root canal at regular visits later. Stay happy and blessed." "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 went to an optometrist and diagnosed with something like below.Retinal exam showed OD temporal area of pigmentation (old chrpe vs atropical hole) with area of retinal elevation.I have attached the optomaps. Can you please tell me how serious is this? Does it need surgery? ### Response: Hello. I have gone through your optomap. (attachment removed to protect patient identity). The first (left eye) one seems fine. The second one (right eye) on your left-hand side has a few changes. It is a bit tricky to make assumptions based on images, but are you referring to the retinal elevation and hole and chrpe on to the left-hand side? There are a multitude of options to treat such a disease. Some doctors, with such a finding, might say that it is a small hole and localized elevation and especially if you yourself have no symptoms like flashing light or floating objects, might ask you to simply follow up with them and recommend observation. Others may recommend that you get laser or surgery done more so in case you have symptoms as mentioned above and if you have had any such incidents in your other eye, or have risk factors like a high power. So in summary, I can say that it mainly depends on the progress, your symptoms and the risk factors. I can assure you that observation for a retinal problem like yours can be done because it is not involving the center part (macula). But the doctor may opt to treat with a laser depending on the progress of the condition. Once again it depends on your progress, risk factors and symptoms." "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 35 year old male. The problem is that for the last 6 months or so I feel a little flesh near the anus area. There is no pain or itch and I do not experience any bleeding or discomfort. Sometimes, it is virtually suppressed and sometimes I can feel it. I am afraid that it is something related to piles. Regarding my diet, I am a non-vegetarian. Before two years, I used to have alcohol daily. I left it completely for a year. And for the last one year, I used to have beer occasionally. For high blood pressure, I am taking Metzok 50 mg and Lonapam 0.25. ### Response: I have gone through your complaint. I would suggest you the following which will definitely help: I would suggest you to consult a surgeon for further assessment." "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: In my groin area, there are some pimples, but there is no pain in that area. I feel uneasy. I am using Zincoderm ointment. I have attached the photos. Kindly help. ### Response: Hello. I have seen the pictures. (attachment removed to protect patient identity). I have gone through your query and understood your concerns. In my opinion, the picture you have sent may be either warts or molluscum. As both mentioned diseases are contagious you must be careful from now onwards. If you have a weak immune system then it will take time to go away. I would like to suggest you go to a dermatologist once so that they can scrap the area and see that in a microscope. For now, I will prescribe one ointment that is Imiquimod cream. Use this cream three days a week (Monday, Wednesday, and Friday). To use the cream, follow these steps: Wash your hands. Apply a thin layer of cream to the area to be treated, just before going to sleep. Rub the cream into the skin until it disappears. Wash your hands. Leave the cream on the area for six to ten hours. Do not bathe, shower, or swim during this time and no sexual contact at this time. After the treatment time is over, wash the area with mild soap and water to remove any cream. If there are any side effects with that cream contact your dermatologist." "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 my legs are restless and lack energy. I am feeling tired with frequent yawning and sleepiness in daytime. Sometimes, I feel nervous and vertigo while walking. Please suggest a medicine. I had Escitalopram 10 mg bd, but it did not work well. My other medication list is attached for your reference. ### Response: Hi. The symptoms described by you are symptoms of depression which are due to low dopamine levels. Escitalopram increases serotonin levels and there is a dopamine deficit remaining in most patients. You can make it 300 mg after a week if necessary. Do not stop Escitalopram. This should make you feel fresh and energetic. If your leg restlessness remains, ask your physician if you can take a beta blocker along with current medicine. Specify probable causes if any. Major depression, dopamine deficit. Tablet Bupron XL 150 mg in the morning along with previous medicine." "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 dad underwent echocardiography. The LVEF % which used to be in the range of 45 % earlier has dropped to 30 % to 35 % range. He had an episode of VT before two years and had ICD embedded. I am attaching his earlier and latest report. Please explain. ### Response: Hi. I have gone through his reports (attachment removed to protect patient identity). Wall motion abnormality is seen in the echo report of your father. The heart is supplied by three arteries LAD, RCA, and LCX that is, left anterior descending artery, right coronary artery and left circumflex artery respectively. Any obstruction in blood supply in these vessels will cause decreased blood supply to a particular area of heart (which is supplied by that artery). As blood supply is compromised the muscles in that part of heart will not get proper nutrition and will start degenerating, which is medically termed as regional wall motion abnormality (RWMA). A coronary angiogram should be done to rule out coronary artery disease (blockage in the coronary artery), which is the main reason for RWMA and decreased ejection fraction. My advice is to get a coronary angiogram to rule out the blockage in the coronary artery." "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 26 years old and have pain in left side of left chest just below the tit. When I touch that place, I feel nothing and it is numb there. When I sleep by keeping the face up I feel someone is pressing my heart and feel pain. When I hold that place and pull out, I feel relax. For four months, I am feeling too much pain when I eat any cold thing. The doctor examined me and said there is no heart problem and gave me Vaserol 20 mg but I did not feel any improvement. Then again I saw the doctor and after X-ray, he said the heart is okay but there is a problem in your chest muscles. He gave me a painkiller. I felt good but when I pulled heavy thing, I again felt pain in my chest and now it has been four months, I have not seen the doctor and have severe pain in chest moving from left to right, up to down. Also, before sleep at night, I am sweating too much. ### Response: Your symptoms do not seem to be related to any cardiac disorders. A lung disorder or acid reflux could be the cause of your complaints. For this reason, I recommend consulting with your attending physician and performing some tests. A chest X-ray study and pulmonary function tests, complete blood count, PCR, ESR for inflammation, a fibrogastroscopy. If all these tests result are normal, you should consider anxiety as the main cause of your complaints." "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 18 year old healthy female. All day today, I have had sharp pain in one tiny spot on my left hand. There is a tiny red mark that looks like a scratch, but it is not. It is not warm, but the pain is also spreading to my arm. I have also had the same type of pain in both my legs and my foot for a couple weeks now, but no veins or redness are there. I have anxiety which makes me always think the worst. I am scared that I have DVT and that any minute now I am going to drop dead. Please give some suggestions as to what this might be. Could it be something with muscles or nerves? Should I go to a hospital? Any information would help. ### Response: Hello. 1. Vitamin B12 deficiency, hyperthyroidism, thiamine level and CBC (complete blood count).2. If the above are negative, then nerve conduction study or electromyography (EMG) of the affected hand. It would depend upon the blood work. It does not appear to be a DVT from the information provided. Revert back with the report 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: Hi, a pleasant day..i have a problem with my liver,i just have an ultrasound last month, to found out i have a moderate fatty lever grade 2,,my problems is sometimes i feel some soreness in my stomach. if i to rate the pain 1-10,10 being the highest ,around 3-4..may i ask for sum advice..or medication for it ### Response: Hi, I went through your USG report and I see that you are worried about your Fatty Liver.. Need not worry about it.. Fatty Liver is something very common in most of the population in the current era all because of our present food habits and less physical work due to digitalization in every industry.. Fatty liver is nothing but excess cholesterol deposition in the Liver.. . Engage yourself in regular exercise.. That will do.. And do check your Serum cholesterol levels and revert back to me.. We may start medicines if levels are very high.. See you... Fasting Lipid ProfileFBS, PPBS Fatty Liver Diet modification as 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 already put my query to a neurologist. Still, I would like to get opinion from you as well. My son is 3.5 years old. He has been diagnosed with benign childhood epilepsy. His MRI and CT were normal. There are epileptic form of discharge 8 Hz spikes from right occipital lobe. Usually, he will be conscious and feel involuntary movements in left leg. In severe case, he will lose balance and fall down. This will happen once in a week. We consulted a neurologist and epileptologist here in my place. They prescribed him Topamac 50 mg twice a day and Lobazam 10 mg for three months. I am concerned about the long-term usage of Lobazam. Will it cause any serious side effect? Now with medication he is fine and attends kindergarten school. Please do reply about my concern. ### Response: I went through your query. I can understand your concern about long-term effects of antiepileptic medications. So, in reply to your query, I would like to make suggestions for your son as follows: Treatment of many types of childhood epilepsy requires long-term antiepileptic medications, sometimes for years together." "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: What can I do for knee pain and lose joints and repetitive sprained ankles and hip tightness? I am a 15-year-old girl, and I have major knee pain that comes and goes. It is always swollen. ### Response: Hello. I would advise you to start strengthening your muscles by doing simple stability exercises and slowly progress to weight training. Have an adequately supervised session for a while to avoid any compensation of movements. Once muscles get stronger, you will get good support for the joints and may prevent pain and inflammation. Kindly get checked if you have any other parameter that causes joint issues like raised uric acid levels calcium levels. You may take medications if there is anything of that sort, by consulting a general physician. I hope this is helpful to 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 31 weeks pregnant. I have been having contractions for six days straight now. They started at 20 minutes apart, then got closer. They have been two minutes apart lasting an average of 54 seconds for three days. They have not let up or have stopped. I went to the hospital and they said there has not been enough change in my cervix and sent me home and said not to come back unless I start bleeding. During the last checkup, I was 100% effaced, 2 cm, and 0 stations. I have been leaking clear fluid like crazy, but when I called they said it was probably a discharge. My legs and feet are very swollen. I know something is not right, but they refuse to run any tests because they believe it is false labor. What do I do? ### Response: Braxton Hicks contractions do occur about six weeks prior to labor but are generally not associated with effacement. If they were real labor pains you should have started fetal descent from 0 stations by now as well. Now, if the intensity of the pains are increasing between contractions then they are true labor pains and if not they are false labor pains. Ladies tend to gain weight because of hemodilution and edema in pregnancy i.e. swelling of the feet, it is a normal part of pregnancy. Leaking per vaginum is again significant. If it looks like water and starts suddenly, I would request you to reach the nearest hospital as soon as possible. I would finally suggest you meet your gynecologist and request NST (nonstress test) for the fetus and examination of the cervix. 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 itching and infection in my private area for the past one month. Please help. ### Response: Any other area affected? Any history of diabetes mellitus? Hypertension? Thyroid disorder? Any family history of disease? Is itching occurs predominantly at night? Looking forward to your response in order to help 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 was wondering whether you think it would be worth it for me getting a second x-ray to confirm if my growth plates have fused? The first one shows no visible plate. ### Response: Hello. I have gone through your query and understood your concerns. To tell you the exact answer we need your age and from your question, I suggest you take an x-ray but not now, wait for some time and then have an x-ray 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: For some days I was burping a lot with burning sensation around the stomach. I went to the doctor and he advised some medicines Vibact DS 1 at night for three days and Torfix 400 three tablets each day for three days. I am better now. Just for a normal checkup without any issues I went for a urine and stool routine check and found that occult blood is present. I have done stool OBT test before as well just two to three months before and everything was normal. When I see internet I am worried about all occurrences. Please help. Am I going to die? Currently, I am taking Telday 40 for blood pressure and discontinued Telekast L10. ### Response: Hi. Nothing to worry. Stool occult blood positive implies that there is microscopic evidence of blood in your stools. It can happen due to multiple reasons. You might be having some amount of inflammation in the gut which caused your symptoms. These can result in positive OBT (occult blood test). Please take tablet Pantocid (Pantoprazole) 40 mg tablets once daily for one week 30 minutes before food. Get few tests done after two weeks like complete blood counts, liver function tests, and stool occult blood." "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 believe that I have symptoms of MPD. Some are from my past and some are present. For examples, I see things in black and white, low self-esteem, feeling evil, substance abuse (weed and alcohol), feeling empty, not sure how to react to emotional or social situations and unhealthy relationships. I have never tried to harm or kill myself, but I put myself in risk or high endurance situations, depression, anxiety. I was binged and purged between ages 13 and 20. I have controlling impulses such as pulling out hair, over picking skin and masturbation. All that started back between the ages of 5 and 11. I also believe it could have something to do with genetics or upbringing because my mother and grandmother show these signs as well.I visited a psychologist for the first time last year and he diagnosed me with depression and severe social anxiety. I did not get In detail about my past or present problems other than hair pulling and anxiety. He asked me about my history with drugs. At first, I did not mind, but then I started to get embarrassed and had a panic attack. Then, he made his diagnosis. I stopped treatment after a couple of months. I find it is often hard for me to follow through with plans, but I would like to try moving forward again. ### Response: Hi. I can understand your concern. Some of the symptoms you have mentioned suggest depression and anxiety. Low self-esteem, feeling low, etc., are classical depression symptoms. Hair pulling is one of the anxiety symptoms. Under unconscious anxiety, individuals develop a habit of pulling hair. You have never developed an idea of self-harm, but there is a practice of putting into a risky situation. This could be a feature of bipolar but should be evaluated. History of abuse of weed also increases such risk-taking behavior. If your day-to-day functioning is impaired, then I would advise you to please get yourself evaluated by a psychiatrist. A proper evaluation will help in making a diagnosis. Mood stabilisers can be used for treatment and will treat the symptoms. Avoid using weed because this might cause the development of acute psychotic symptoms." "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 loose gum flap between my top Incisor teeth. It has been there for a few months now. I thought it would go away in time, but it is still there. When I accidentally bite on it while eating it hurts. The only medication I have taken so far is vitamin C chewable tablets, but I do not think that will fix it. What can I do about this problem? ### Response: I have read through your complaint and the relevant details. The loose gummy flap should be caused by any trauma and in my opinion, it is getting injured every time you bite by the lower front teeth. That could be the reason for not healing. Instead of plain Vitamin C, I advise you to take multivitamin tablets available in the store as it helps in better healing. Also, I advise you to apply ointment Dentogel 20 mg thrice daily on the sore area. Do not rinse it off with water immediately, but leave it in place for 15 minutes at least. Since you said it has been there for four months, I reckon you visit the dentist straight to check if there is any particular sharp tooth that hurts that part of your gums. If that is the case, the sharp portion of the tooth causing injury could be easily smoothened and polished in two minutes. If it is possible, you could also send me a picture attached with the complaint for better diagnosis." "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 5 months old. He can hold his head during tummy time and turn his head in both directions. But when we make him sit, he usually looks in one direction. He has a flat head on one side. Does this mean he has torticollis? ### Response: A child with torticollis will not be able to make much neck movements at all, in any direction or position. The very fact that the child can look in both directions during tummy time is suggestive of the child not having torticollis. As regards to the flat head, some kids have it but do not worry. Also, with regards to the child looking in one direction only while sitting means that the child requires a little bit more strength to turn his neck (which should develop with time)." "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 (female, 38 years) had my first outbreak of corneal herpes five months back. It was treated incorrectly by a GP first with Cortisone and antibiotics. The eye doctor put me on Acyclovir cream and later added Cortisone drops to prevent scars. After a month, while on vacation (lots of sun and salt water) it came back. I did not recognize the signs at first and thought the redness was only due to irritation. It lingered, so after coming back home, I was put on Acyclovir orally. Two months back, the dye did not show any active ulcers, so I could lower the oral dose to 400 mg and use Cortisone drops again. Last week for a check up the dye showed two active ulcers again.I am really shocked and scared now. My doctor did not say if it was stromal keratitis or not. Is there a way to tell? I have always had 100 % vision since the lesions are not in front of the pupil. But I do not know why I had a recurrence even while on Acyclovir. Could the Cortisone drops be detrimental? My doctor said to increase the dose back to 800 mg and stop Cortisone. Is there a way to clear this for now? I do not know if I had two relapses or if this never really healed in the first place. Is there a way to prevent such frequent outbreaks at all? It is difficult not to stress when I fear I will go blind. ### Response: Hello. Please do not panic. You will not go blind. I assume this is herpes simplex and you have herpes epithelial keratitis. The steroid has no role in epithelial keratitis. Steroid increases the risk of recurrence. That is why steroid is instilled undercover of antiviral. If there are more than two attacks in a single year, then we may need to continue prophylactic oral Acyclovir for a very long period (maybe years). With recurrent attacks, there may be scars which may blur your vision." "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 want to ask for my baby. She is 1 year old. Four months back, we met (me with my family) with a road accident. My baby\s left brain got damaged and a little blood clot is there. The doctor has done one surgery. After the surgery, she lost her vision. Now she cannot see. The doctors said maybe she will get vision within one or two years. But not sure. What can we do? Any specialty hospital or medicine available? ### Response: Your baby is suffering from damage to optic nerve resulting from trauma to head. The remaining potential in the optic nerve can be determined by a test called VER, visual evoked response, in which light stimulus is provided and corresponding electrical response in the brain is measured. You can get back to us with the test results for further discussion." "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 right eye appears blurry but only in sunlight and I see my eyelashes blurring my vision. I can read clearly with both my eyes and can also watch TV and normal activity while indoors. But during day time in bright light, I cannot see clearly with my right eye. I am 43, male. My eyesight has been myopic with both eyes at -1.5. ### Response: Hello. The symptom that you are suffering from is referred to as hemeralopia, this symptom can be caused due to a number of different conditions. The most common mechanism of such a blurring involves a central corneal opacity or cataract obstructing central light rays when the pupils are constricted in bright light. I can tell you that most of such causes are treatable and can be picked up quite easily on a simple eye exam. So, I suggest that you visit an ophthalmologist. In case you need any further information, please send me a scanned copy of your doctors reports. I will do my best to help." "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 unprotected sex on the second day of my period. My partner did not discharge. Can I get pregnant? ### Response: I have gone through your query. It is highly impossible to get pregnant due to unprotected intercourse during your period. Endometrium of the uterus is not habitable for a conception during this condition and hence pregnancy is not possible at this time" "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 17-year-old female. I was diagnosed with Carpal Tunnel syndrome last year but the pain started before that. At that time my hand only hurt when it was bent to a certain position, and it hurts when I am on my fours or when push-up position. It did not hurt when my hand was squeezed or doing hand exercises.The doctor prescribed me with Etoricoxib (Arcoxia) 60 m which I took twice a day for a week and told me not to move my right hand. I tried not to use it as much as possible but since it was school time, it required me to use my hand. After the medication was over, I was not able to come back to the hospital (even though I was told to if the pain did not go away) and talk to my doctor about the condition of my hand.Now, my hand, specifically the palm of the thumb, started to hurt even if it was not bent or I am in a push-up position. It is more painful when it is squeezed. Our place is quarantined and I am sure getting appointments will be hard during this time, so I am trying to relieve the pain at home. But still, I want to have some instructions from the professional. I have 10 Arcoxia pills here at home, should I take it to relieve the pain? Should I follow the initial instructions of my doctor and take it twice every day or just take it whenever I feel pain? What should I do? ### Response: Hello. Please take the pain killer Etoricoxib only if you feel pain. Try to apply a wrist support belt. It will help your wrist to keep in position. MRI (magnetic resonance imaging) of the wrist. Nerve compression. Carpel tunnel syn" "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 chest pain and palpitations when I take tablet Cyclopam? Is tablet Cyclopam dangerous for me? ### Response: At the same time, it also blocks muscarinic receptors that are presented in the heart, brain, salivary gland, etc., that are considered as side effects. So, a person may get heart palpitations, anxiety, etc., and using the" "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 like somebody else is there within me. I am feeling like this because some words are coming in mind like somebody is saying within me. These words are horrible and hurt me a lot. And things are being done which I do not want to do in mind without my control. Time after time, problems are increasing.During the starting stage, I heard vulgar words. But after some days other problem which is more horrible. Due to this, I cannot concentrate on my studies. Please tell me what the problem is? Give me a clear idea of the issue. And how to diagnose it? Please help. ### Response: You might be having hallucinations (auditory) which happen due to imbalance in your brain neurotransmitters. It is a good thing that you can understand at an early stage that this is not normal, first treatment gives better results. I would suggest meeting a psychiatrist as soon as possible who will start you on some medicine. Please do not worry, and it is manageable with medicines. Do you have any family history of psychiatric disorders? I would suggest mentioning it to the doctor as well. I hope this helps. Let me know if you need anything else." "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 mild sore throat last Friday and started to take Strepsils then the pain gone last Sunday. But early morning today at around 2 AM I had chills until the morning. I took Paracetamol right away. My body temperature is 37.2 currently. Should I go to the hospital? Are my symptoms same as the Covid-19? ### Response: Hello. Viral infections produce similar symptoms. Common cold or seasonal flu produces similar symptoms as does Coronavirus. However, it is the severity of symptoms that are worrying in Coronavirus and the body\s response to contain the virus. There is no need to panic right now. Just take precautionary measures like proper hand hygiene and proper respiratory etiquette and maintain a sort of isolation. Take plenty of fluids and other supportive measures as required. If symptoms do not improve or worsen over a couple of days you can visit a health facility. However, if there is any history of contact or presumed contact with someone with suspicious symptoms or a travel history then it is better to report." "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 this problem for 8 years with no proper solutions. Please help. Strange sensations, tiredness, feeling of heaviness in the arms and legs. Hands and feet become warm. I have an electrical shock like feeling in face. I have extreme fatigue, unsteadiness and muscle twitching in the arms and legs and my eye often twitches. Now my feet and hands itch like crazy. Feet are worse than the hands. I take Cymbalta, Lyrica and Levothyroxin. I have had MRIs of the spine and brain, nerve conductivity test, and many blood tests including heavy metals, HIV, syphilis, drug test, vitamin levels test, Lyme disease test, ANA and so many others.The doctors are not able to figure out what is wrong. I had about 25 hours of sleep only this whole week, because I have so much pain. When I do sleep I thrash all over the bed. Going this long without getting much sleep is not normal for me. I usually do get more sleep than this. When all this first started I got very sick, lost weight (about 40 lbs in two months) and laid on the couch for a year missing out on life because I was too exhausted and sick.I do not know if all these symptoms are related to one issue or more. The doctors thought I had MS, but no lesions. Please help me ### Response: I read your query and understand your concerns. If your age and other description does not match with the above narration or if you have more questions feel free to write back to us. Consult a neurologist online for further help" "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 24 years old male. For the past five years, my body weight is 45 kg and no changes in weight. I look very skinny and sometimes, get heat abscess too (in six months I have got at least 15 to 20 abscess). Kindly help me why I am unable to gain weight. I have no other health issues. I am normal. The only thing which bothers me is weight and abscess. Guide me if I have to do any checkup. ### Response: First of all, check your blood sugar level as diabetes can be the reason for repeated infection and abscess. So if diabetes present sugar level should be controlled. Investigate with serum TSH (thyroid stimulating hormone) to rule out the thyroid issue. If no any organic cause present than nutritionist help taken to modify diet. Consult a physician for 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: I have an inquiry regarding my upper teeth. I recently have noticed then when I am talking or smiling, my upper teeth barely show at all, so it looks odd when I talk because you can only see my bottom teeth. I was wondering what caused this? Because they were not like that when I was younger. ### Response: 1. I have read through your complaint and the relevant details. 2. The possibilities for your upper teeth not visible during talking or smiling are a short upper lip, short upper teeth, and most rearward upper teeth. 3. The imbalance between any of the above is the reason for this esthetics problem. 4. And these are the permanent teeth now where the changes are very much possible. Because when you were younger, you had only the milk teeth. 5. Now, considering your age, the treatment plan would be either, orthodontic treatment (braces), or lip lift surgery (esthetician treatment), or combination of both." "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 facing certain problems which include balancing problems, blurred vision and sometimes, headaches, concentration issues. It has been 2 to 3 months that I am facing all these. ### Response: I have gone through your case and can well understand your genuine health concerns. The cause of your symptoms can be related to brain disorder or vitamin B12 deficiency or eye problem. In my opinion, you should consult a physician first because you need a thorough neurological examination. These symptoms can be related to cerebellar disease which is a part of the brain. Vitamin B12 can also cause balancing problems, headache, concentration issues, etc. Sometimes, a refractive error in the eyes can also cause balancing problems, blurred vision, headache. I suggest you consult an ophthalmologist also. Get your serum vitamin B12 done. If you have low levels then you may need B12 supplementation. Cerebellar disease or vitamin B12 deficiency, eye problem." "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 is seven weeks pregnant (about three weeks from fertilization, we think, because she has long cycles) and came down with shingles almost 2 weeks ago (and a cold about a week ago). She has been taking Acyclovir and the pain has reduced but is still present. We are worried about the effect on the baby, particularly because we have read viral infections in early pregnancy can lead to Autism. Do you have any advice about how serious the risks are? ### Response: Shingles is herpes zoster, which is the reactivation of the chicken-pox virus in the body due to an immunocompromised status like pregnancy. But thankfully, the effects are not disastrous for the unborn baby as your wife already has antibodies against the virus in her body to combat transmission. If she had disseminated widespread shingles, there could be theoretical chances of viremia and fetus being affected. She is already taking Acyclovir, so viremia is not possible anymore. Do not worry, be happy." "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 got my blood tested, and the TSH is slightly elevated. Should I consult an endocrinologist?I have been suffering from a sleeping disorder for the last three years but never diagnosed with thyroid or any other disease except vitamin D deficiency.I am tackling my insomnia with exercise and also taking the prescribed dose of vitamin D for my deficiency.Yesterday, I received my recent blood test and found a slight increase in the TSH. Does it mean I have a hypothyroid or hyperthyroid disease?If it is in the initial stage, how could I prevent it? The blood report is attached with this query.Total triiodothyronine (T3) CLIA 90 ng/dl, total thyroxine (T4) CLIA 7.6 \xce\xbcg/dl and thyroid stimulating hormone (TSH) CLIA 5.59 \xce\xbciu/ml. ### Response: I just read your query and read each one of your reports that you have provided (attachment removed to protect patient identity). Hope you find my advice of some benefit. Good luck" "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 underwent hysteroscopy and D and C, and laparoscopic surgery due to postmenopausal vaginal bleeding and a transvaginal ultrasound that showed 1 cm of thickness, a uterine polyp, and an endometrioma on the right ovary. The path report had a gross-section and a diagnosis section, no microscopic section. The diagnosis on the polyp was an endometrial polyp. There is no mention of the endometrium. My doctor\s office is saying there is no mention because the pathologist was not concerned about anything. This report seems incomplete to me. There was slightly more said about the ovary. Is this a complete report? Should I expect more of a description of the endometrium to be sure cancer is not present? ### Response: The full pathology report of any tissue includes a gross description, microscopic examination findings, and diagnosis. So, In this way, your report might be written. If cancer is present, then atypical malignant cells in microscopy are seen along with gross growth also. Your diagnosis is a polyp, which is a benign condition. Provide your report as an attachment for giving more comment on that" "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 to ask about my risk of pregnancy from precum. My husband just let his penis inside me three to four times without a condom and he did not have an orgasm. Could I be pregnant? This happened around two months back. I got my periods five days after the event which was my regular date. I also got periods after a month but periods lasted only two days and a little bleeding happened on the third and fourth day. Can I be pregnant? ### Response: Hello. Pre-ejaculate or precum usually does not contain sperms so the chances of pregnancy are very low. Moreover, you seem to have got your periods twice after the unprotected intercourse. So, it is unlikely that you may be pregnant. But still, for your confirmation, you can check your urine for pregnancy with an early morning urine sample. This is because the bleeding pattern had been different from prior cycles. If it is negative you can stay assured that you are not pregnant" "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, age 59, had an ischemic attack recently (Trop T test positive, CPK-MB elevated). She has had a BMV for her mitral stenosis two years back. She is currently in the ICU, on medicinal therapy (anti-thrombotics). She underwent an angiogram yesterday (report and video attached). Her RCA is 100 percent chronically occluded. LDA and LCX have 70 percent and 90 percent occlusion respectively.I have the following questions: 1. What\s the chance that angioplasty can help the total occlusion in her LCX? 2. Will a newer technology like Rotablator/IVUS increase chances of clearing the totally occluded artery? 3. We are in a center that does not have surgical facilities so a bypass surgery will require shifting her to a another hospital. How safe is it to do angioplasty in this situation? And would you consider it risky to shift her to a bigger city? That will involve 2.5 hours of road travel (after which we can wait ) followed by a 1.5 hour long flight? ### Response: I am sorry to hear about your mother\s poor health condition. 1. There is a very good chance that angioplasty can help with the 100 % blockage alongside a stent. She is still young. If she can adhere to lifestyle modifications and medications it will help. 2. Rotablator or IVUS can definitely help with clearing the clogged arteries. Although they also will require stenting because the site of the clogged arteries have become weak and will require stenting as support. 3. In situations like this I advise angiography for my patient. The recovery period is shorter and patients are able to live a quality life with modification of lifestyle and medication. It is not safe for her to undergo the stress of traveling at this time." "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 not getting the stool from three days and because of this, I am not able to eat food from three days. What is the reason behind this? Which disease symptom is that? What is the possible medical treatment for it? ### Response: Hello. You seem to be suffering from absolute constipation. If you are not even able to pass flatus, then you need evaluation for intestinal obstruction. I would advise you following: 1. To get a thyroid function test done as hypothyroidism might be the cause behind constipation that you are having. 2. To take Laxative like Lactulose in the night. 3. To increase fiber in the diet and to take fruits like Papaya which are bulk-forming. 4. You may alternatively take Cremalax in the night as you have been taking. 5. Another thing that you can take is Isabgulla Husk. You can take three teaspoons full in night time and as it is bulk-forming. It may help you with your constipation. In case you have already taken Creamalx and still not passing the stools, then Macrogol (Polyethylene Glycol) sachets help a lot." "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 two kids and recently diagnosed with PCOS. My last ultrasound showed I had 30 follicles in my left ovary and 25 in my right, with only one mature follicle, we have been trying medicated times intercourse with a trigger shot and it is not working. I am not getting pregnant. Why does PCOS affect with fertility so bad? Took Letrozole 2.5 mg three tablets once a day from day 3 to 7 and then did a trigger shot a week back- Ovidrel. ### Response: It is one of the most common reasons for irregular menses, especially oligomenorrhoea and primary or secondary female infertility. The increased an" "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 grind my teeth at night even though it has not been confirmed. I have the white lines on my cheeks. Yesterday and today I have this pain from my left molar to my TMJ and ear ache. And I do not know if it is from where the grinding is getting worse, a tooth infection, or ear infection. I have an ulcer at the back of my mouth where the white line is where I grind my teeth. A bit sore and tender at one spot under my mandible. ### Response: Hi. The grinding teeth at night usually come from stress or psychological problems so you should visit a dentist near to you in order to get a night guard to protect grinding teeth at night. At the same time, you should consult with your psychiatric physician to know the cause and the origin of the grinding that why it comes at night. The night guard is a plastic impression that covers the crown of your all teeth. You should wear at night when you are sleeping and you will remove when you wake up in the morning. It would be good to attach the photo of your 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: I have my one vagina hole, but it has two different sections inside. Like there is a skin inside, and a penis or finger can either go left or right, and I do not know if this is normal or not. ### Response: I will feel sorry that you have the congenital disability of your reproductive tract, the vagina, and it is called a septate vagina. Only surgery can cure it. You need to see your gynecologist as soon as possible. If the defect is only in the vagina, you need not have to worry much, and it can be cured easily by a simple surgery. Whereas if the internal organs are also duplicated, you need to do a series of surgeries and treatments." "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 7 months pregnant and my first pregnancy was a missed abortion. During this pregnancy, I underwent tests like thrombophilia profile and protein S antigen test in which my protein S levels were found low: 58% according to protein S antigen and 32.90% as per protein S functional test. The doctor has told me to take Heparin (Enoxaprin) injection daily of 40 mg throughout my pregnancy and six weeks after delivery. Kindly suggest. ### Response: Based on your query, my opinion is as follows: 1. Protein S antigen levels are borderline, however the functional activity level is a bit low. 2. This increases the risk of clotting, which is always increased in pregnancy. 3. To reduce anticoagulants like Heparin is necessary. Ecosprin will reduce activity of platelet and hence both will be helpful. Do continue as prescribed. Watch out for any purpura or bleeding spots in skin. You can get a prothrombin and activated partial thromboplastin time done to check the efficacy of heparin, if necessary." "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 month I had periods on 10th. We had sex on the 23rd night and 24th and I had unwanted 72 on the 24th night. Now I was expecting to get my periods on 7th or maximum by 10th of this month but I have not got my periods yet. What can be the problem? Is it a sign of pregnancy? ### Response: Hello. As per the dates you have provided, you had sex on the 23rd of last month, that is 13 days from your period date, that is the most fertile period of the cycle. But you took emergency contraception, so chances of pregnancy are very less. Also, please can you tell that if your partner was using condoms or you were on any contraception apart for that emergency pill? When you take an emergency pill it also affects your period schedule. It can be 7 to 10 days before or after scheduled date, so the best course will be getting a pregnancy test done using home pregnancy kit. Kindly specify other details too so that I can guide you further. And do not panic, we are here to help." "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 mixed emotions. Sometimes I am overwhelmed with emotions. But sometimes I am entirely emotionless. I am unable to concentrate on my studies as I am extremely drained mentally. Nothing is making me feel better. If I feel better for some time, at the end of the day, I feel completely numb. I am sleeping a lot nowadays. I am unable to do my work. Please help me. ### Response: I have gone through your problem, and I can understand your concern. It can be due to mood disorder and depression. You need to consult a psychiatrist soon as depression can present with a sleep problem, a decrease in energy, numbness, unable to concentrate on work, and low mood. In such situations, taking SSRI (selective serotonin reuptake inhibitor) can help 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 have sunburns and my legs are swollen. What am I supposed to do now? ### Response: Hi. Sunburns or solar burns can be treated as follows: Do a complete hemogram, blood pressure examination, blood sugar, uric acid level tests, and thyroid profile. Revert back for follow up with the test reports 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 am a 32-year-old female. And I have got throat pain on 22nd and met a doctor on 26th for the same. He gave me Azee 250 mg and one multivitamin for five days and I have taken it till 30th. From that day I am doing basic gargling and taking milk with pepper and haldi in the night. But yesterday I got the message that whoever visited one mall from the date 10th -17th and having any symptoms of Covid-19 should seek medical support. I visited that mall on 12th and after that, I got throat pain but it is already 22 days since I visited that mall and almost 10 days I have this throat pain. Should I consider this throat pain as a symptom? I do not have any temperature or any other problem. I called the helpline and told them that I visited the mall on 12th March but not that particular shop and told me about my current situation and the person told me to take the Azee tablet for two more days if I still have mild throat pain. I want to know since it is already 22 days I visited the mall and also my throat pain is already there for almost 10 days, do I need to worry about anything? I am very scared and panicked after seeing that news. Please help me with your suggestion. ### Response: Hi. Is there any cough or breathing difficulty or wheezing? Does anyone else in your family have similar symptoms? Is there any nasal congestion or discharge or block? Can you please take a picture of the back of the throat with open mouth showing details of the affected area and send it 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 mother\s ultrasound has been done. As the report says gall bladder is normally distended with normal wall thickness. Multiple tiny calculi are seen. CBD is of normal caliber. No intraluminal calculi noted. Impression: > Cholelithiasis > Hepatomegaly with moderate fatty changes in the liver. Can this problem be recovered with medicine? Or an operation has to be done? Please suggest me. ### Response: Cholelithiasis or gallstones are very common. It is something you should not lose sleep over. However, I would like to know why did your mother undergo an ultrasound? Did she have pain or post-meal dyspepsia? Whilst this condition cannot be treated with medicines, there is no reason to get it surgically removed immediately unless she is suffering from regular pain, is a known case of diabetes, or the stones have migrated to the CBD. That being said, it is always best to get it removed after discussing the risk Vs benefit of the surgery with your doctor. Kindly update about any other medical conditions your mother is suffering from and I will be happy to guide you further. Liver function test. Nonspicy, nongreasy meals." "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: The patient underwent angioplasty two months ago. The medication provided makes the patient unwell and there is a loss of appetite. We need proper medicine advise. ### Response: I have reviewed the detailed query and the attached picture. I have reviewed the medications patient is taking (attachment removed to protect patient identity). There is no medicine that seems to be unnecessary. All are needed for the patient. That is why the physician has prescribed these medicines. Feeling unwell and loss of appetite have a lot of reasons and can be due to any one of them. The patient\s heart is also one of them. Certain medications also have a side effect of loss of appetite and feeling sick. The age of the patient and recent angioplasty adds up to the symptoms. To me, there seems no need for medication change (and this is based on the limited information provided about the patient. I do not have knowledge about patient\s past medical history, recent health issues other than the heart, status of kidneys, liver, and lungs. To start or stop any medication we need to know the health status of all the body organs). I would recommend to regularly check the patient\s blood pressure, blood sugar levels and other routine blood work. Consult back to his cardiologist in a couple of weeks. This visit is recommended post-angioplasty to see if everything is alright. He would do an echocardiography, EKG (electrocardiogram) and other heart tests to see all is as it should be. Hope it helps. Please feel free to ask more if you need further assistance" "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 1 year old and has constant cold. I have consulted my pediatrician also. He has been suffering from cold, and wheezing for the past one month. If I use Augmentin Duo, he is getting fever, wheezing and severe cough. So I use Azithral 200, Levolin, and the condition is somewhat fine. But he is not getting complete cure. Please help. ### Response: Hello. Your child may be suffering from what is known as hyper-reactive airway disease. Please get the child evaluated physically with chest X-ray and basic blood tests like CBC (complete blood count) and CRP (C-reactive protein) at least. Based on the reports, if it does not show any infection, you can start the child on a long term course of Montelukast 4 mg one dose at night along with syrup Levolin (Levosalbutamol) based on the degree of coughing. The child may also need intermittent nebulization with Duolin (Ipratropium, Levosalbutamol) and Budecort (Budesonide) as and when the need arises." "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 know the results of my brain MRI. I do not know what this bright spot near the vestibular nerve is? Can it be vestibular schwannoma? Or something else in some cranial nerves or near the brain stem. In the second picture that is highlighted what can this white cluster shaped thing be?I have got a few symptoms. For the past three months, I have had tingling and needle sensation starting from the right eyebrow then radiating towards the left side and the entire forehead and right eyelid and sometimes even towards the tip of the nose. The sensation never stops no matter what I do. I feel dizzy all the time like if I am on a boat. When I tilt my head and move it gets even worse and starts spinning. I have a hard time looking at an object and cannot focus. My left eye is getting blood red whenever I look at a screen. My doctor prescribed Cortisone tablets that did not help. My left ear feels clogged and my hearing on that ear is reduced too.I also have tinnitus lately on the same ear. Doctors at first thought it was due to B12 or Iron deficiency but both are at normal range. My blood pressure is normal too. Lately, I have this numbness and tingling sensations om my feet and fingers too and whenever I visit the toilet when I check the stool is yellowish color and floats on the water and no solid shape. The full blood tests show absolutely normal for liver, pancreas and bile. Blood sugar levels are also normal. ### Response: I have seen the reports. (attachment removed to protect patient identity). The white area in the circle is likely minimal fluid and mastoid effusion in the left mastoid temporal bone, in the inferior air cells area. It can be due to a mild left middle ear infection. Your symptoms of feeling dizzy and spinning and left ear problems can be explained by the finding. There are less changes of vestibular schwannoma in the area. There are no other lesions in the brain." "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 16 weeks pregnant and hypothyroid. I am currently taking 75 mg per day of Eutirox (Synthroid) during weekdays and 100 mg per day on the weekends. About a month ago, I got my TSH and FT4 levels tested and the results are:TSH 1.65 mU/LFT4 16.6 pmol/LReference values: 1st trimester 12.1-19.6, 2nd trimester 9.6-17.0, 3rd trimester 8.4-15.6.Today I got my TSH and FT4 levels tested again, these are my results:TSH 2.91 mU/LFT4 15.9 pmol/LReference values: 1st trimester 12.1-19.6, 2nd trimester 9.6-17.0, 3rd trimester 8.4-15.6.Antibodies: HTG. ### Response: Hello. I just read your query and from what you have mentioned it appears that your requirement is increased during pregnancy. You have not mentioned what was the dose that you were taking before getting pregnant. However, you can increase the dose from the current twice per week 100 mcg that you are taking to thrice per week 100 mcg and 75 mcg for the rest of the four remaining days of the week. Repeat your thyroid function test after six weeks and then we will review again. You need to repeat your thyroid function test throughout the pregnancy every six weeks. 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 a female, 18 years old, suffering from weakness, headache, body pains, back pain, stomach pain, and leg pains. Sometimes, not able to bear pain. I am suffering since last two months. ### Response: You have severe anemia (attachment removed to protect patient identity) which needs to be corrected urgently. Some of your symptoms can be attributed to the anemia itself. However, it is very important to identify the cause of such severe anemia. Please give me more details about your symptoms and get the following investigations done. 1. Peripheral blood film.2. Hb electrophoresis.3. USG of the whole abdomen.4. Serum electrolytes. 5. Liver enzymes. As soon as possible get the tests done so that we can correct the anemia and identify the cause. You may need blood transfusion if symptoms are severe or if there is breathing difficulty." "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 tested positive for an autoimmune disease. My titers were 1280. I then had more blood work done by a rheumatologist and just now received some back online. I noticed my alpha 2 globulin was high (1.12) and my gamma globulin was pretty high as well. The rest were normal on the protein electrophoresis. What does this mean? ### Response: Hello. You have not mentioned which autoimmune disease test has come positive. High levels of alpha 2 globulin are seen when there is a loss of albumin via urine because alpha 2 is a large molecule. It does not pass kidney filtration. So, it is retained because it is a component of globulin. That is the reason for high levels of globulin in blood. You need to test your 24-hour urinary protein that will tell whether you are losing protein in urine or not. Regards" "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 aged 85 years is taking drugs for Alzheimer\s for over six months. She suffered sudden jerks of hands and legs. She was admitted to the ICU and is now shifted to a room. She was treated with antibiotics and given sedation drugs. Will the jerks come back? She is taking medicines for diabetes and thyroid as well. ### Response: Hello. I read your query and understand your concerns. I hope this helps you. Feel free to write back to me if you have more questions" "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 15 years old and I have these small bumps on my penile shaft. I know they are not STDs or anything like that but I have read that it might be hair follicles. Any recommendations or products that I could use? Also, there will occasionally be red pearly rashes that will appear every once in a while. Please help. ### Response: I request you to kindly upload a few images of the affected area so that I am able to have a look and guide you better" "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 weighing 65 kg and my height is 5\6"". A 20 mm follicle found on day five of menstruation, what does it mean? I had cramp since day four till day six. Last month 5.7 mm hemorrhagic cyst was found on left ovary during day three but this month it got disappeared and now 20 mm follicle found on right ovary. Please help me to understand what exactly is this. Is this normal to find such a large follicle on day five? Actually I would like to get pregnant. Please help. ### Response: Hello. I have read and understood your problem. Are your periods regular? Thyroid stimulating hormone (TSH) , prolactin, hemoglobin (Hb), total count (TC), differential count (DC) levels and cancer antigen (CA125) are all normal. Ultrasound of pelvis suggests follicular cyst which is an unruptured follicle from the previous cycle and will disappear. It means there is a problem with ovulation, follicle is maturing but not rupturing." "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 problem of acidity. It feels like a condition when a woman is going through morning sickness. I am 21 and single, but every morning I feel nausea and cannot eat anything until I throw up. Any slight stress, excitement, or sadness increases acidity that I am not able to eat anything unless I puke. I have a history of H.pylori but it has been treated with the triple line therapy, but since then I have this problem of acid reflux, and especially then when do not get sufficient sleep. Because of that, I have lost 9 pounds. I try my best to get sufficient sleep but eight hours seems not enough for me. This whole thing started since I had H.pylori. Although it was treated, these kinds of symptoms have developed since then and are very irritating. Please help. ### Response: The root cause for your acidity is stress and please concentrate on the causative factor of stress. If you come to know what is the causative factor, then try to plan how to face or avoid in a non-stressful way. If you are facing problems please consult your neuropsychiatrist. He will guide you how to face it. You also need cognitive behavioral therapy also. Avoid high spicy non-vegetarian food. Eat more fruits and green leafy vegetables. Eat" "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 is five weeks pregnant and it is the second time. Our first kid is now 6-1/2 years old. He is totally refusing to have a sibling. He makes statements like ""I do not want a brother or a sister. We are a good family like this."" He says it is not a good idea to have a baby. He does not want his mother to be fat and have a big tummy. We did not tell him yet that my wife is pregnant. How can we deal with this and would this affect him psychologically? ### Response: Hello. What you are describing your child is normal insecurity of the first born child. They feel that their parents will be snatched away from him. Also when the second child is born, the elder one craves for more attention from the parents. This is also called as sibling rivalry. You need to ensure your elder child that he will be loved and taken care of as earlier. When you make your child responsible with affection, this fear will slowly go away" "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 is around 18 weeks pregnant and, she started to spray pesticides inside our home. I am concerned that this might harm our developing baby. Please advise. ### Response: Hello. I understand your concern. Definitely pesticides of any category are harmful. If it can damage the pests, then that will be harmful to the baby. But we humans are bigger in size and damage is not significant, unless sprayed daily for many days, for a long time and directly onto the face. By 18 weeks, the baby is fully formed, so there cannot be any significant damage or long term effects on the baby. To be on a safer side better to avoid your exposure to pesticides. Do not worry, and your baby will be ok now. I hope I have clarified your query, do write back if any more questions and for your feedback." "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: Hi I am writing this because lately I have been having some issues lately related to my health and I was hoping to get some answers, advice and help because I want to stop the problem from getting worse and start getting better and i am a male and I'm 22 years old. Now one of the symptoms I've been having are headaches like they would happen imma say every couple days like it comes and goes like now I don\t have a headache at the moment. Second symptom I had was nausea and I had it yesterday for a short period of time but I managed to eat something and I don't have it right now currently. Other symptoms I've been experiencing to like eye pain to that comes and goes but mainly in my left eye like twitching and tingling to,Little loss of balance when I get up out the bed I guess from resting for a certain period of time like now my balance is fine now but I have this Cold feeling in forehead and lips now which is new to me I never had it before so it\s happening right now but yea and Little tingling feeling in throat And Tingling in private area that comes and goes. I was wondering if a neurologist can help me out here because I'm wondering if this is a nerve problem and how serious this is. Please ### Response: You are suffering from Episodes of headache with nausea , which are not present every day. also having left eye pain and twisting with tingling, imbalance while getting up, tingling in throat and over genitals, coldness over forehead ... I would like to suggest to do some routine blood investigation tests and this symptoms seems like vitamin B12 deficiency or hypothyroidism. Vitamin B12 level Thyroid profile" "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 sending a colonoscopy and USG abdomen report. After studying, kindly give your opinion whether piles operation is required, give the interpretation of findings of colonoscopy and USG report in simple language which disease I am suffering from the report. ### Response: No piles operation is required. USG abdomen shows nothing serious (attachment removed to protect patient identity). There is mild fat in the liver, mild increase in the size of prostate and spleen. Small gallbladder polyp that needs follow up USG for an increase in size. Colonoscopy is suggestive of some infection. Tuberculosis but biopsy does not suggest about it. Further plan CECT abdomen to make the diagnosis." "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 experiencing discomfort and pain in the upper right side of my back leading to my neck for about a week. Ice, heat, cream, and Ibuprofen do not seem to work. Now, the discomfort and the pain has circulated off and on from my back to my abdominal area and my torso. Could this be related to stress, or could this be related to having gas in your body or is it ulcer related? ### Response: Your symptoms are suggestive of GERD (gastroesophageal reflux disease). I advise you do an upper GI (gastrointestinal) endoscopy to know the cause. I suggest you take tablet Pantop (Pantoprazole) 40 mg once daily for 14 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 have rashes all over the body from sauna visits I guess. I first noticed it three days ago. It started as bumps on ears and now they are all over my back, chest, neck, top of feet, knees and upper legs. Currently, I am taking Benadryl pills and topical cream. ### Response: Hi. I have gone through your case. It is an allergic reaction to the temperature and lights used in the sauna (attachment removed to protect patient identity). Please use Calamine lotion. Apply twice daily for seven days. Only take a small amount." "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 neck and shoulder pain after a car accident. I had an MRI scan done and would like to know what the white lines on the C4 and T1 of the vertebra are and if I have any damages in my neck? ### Response: I have gone through the images (attachment removed to protect patient identity). The scan seems to be normal to me except for mild kyphosis of the cervical spine. This could be due to ligament injury or due to muscular spasm. I suggest we do dynamic flexion and extension X-rays of the cervical spine after a month of the damage. The pain is most likely related to muscular spam and should subside in two to four weeks." "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 52 year old female, who weighs 75 kg and I am 152 cm tall. I want to know whether we should opt for hysterectomy or not. I do not want to do a hysterectomy, as it may interfere with hormonal balance later. I have postmenopausal vaginal discharge, with a fair amount of red spots. What could be the cause?I went through menopause 1.5 years back. I have type 2 diabetes, for which I take Glimepiride 1 mg, once daily. And I have hypothyroidism, for which I take Eltroxin, once daily. I was diagnosed with asymptomatic cholelithiasis, 15 years back. I have attached my ultrasound of the lower abdomen, transvaginal ultrasound, pap smear, and MRI pelvis reports. ### Response: Hi. I have reviewed the reports (attachment removed to protect patient identity). According to the reports, there is an increased thickening of the endometrium, which is the inner lining of the uterus. A thickness of more than 5 mm is considered abnormal and often considered as a predictor of cancer. Those women who are diabetic, are more prone to spotting. Your doctor had rightly directed for a hysterectomy. I assure you, at 52 years, there is no chance of hormonal imbalance following hysterectomy" "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 29 year old unmarried male. I have phimosis from the age of 13. After constant stretching for three months, it cured. Now, I can easily pull back my foreskin in both flaccid and erect condition, but my tip of the foreskin is pinkish white in color. If I pull back my foreskin, that pinkish white color comes to the middle of the shaft. It will not irritate or itch. Please suggest a cream for getting the original color of my penis in that area. ### Response: I have seen the images sent by you (attachment removed to protect patient identity). The thing you are talking about is actually fibrosis ring, which was causing your phimosis. It is like scar tissue. It will not cause any problem as skin is getting retracted completely. The ointment will not make it like normal skin as it is scar tissue. As it is harmless, there is no need to worry. If you want to remove it for cosmetic purpose, then you need to undergo circumcision, but it is not advisable." "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 unprotected sex with my girlfriend. Her regular period was on 17th of every month. We had an affair on the 16th day. She is 18 years old. After 19 hours of sex, she took an i-pill. Now she is having some white discharge and bleeding with clots. Please help us. ### Response: Hi. You have had sex with her in her fertile period, and chances of pregnancy were practically high in that period. She has rightly taken I-pill within 72 hours which shall prevent pregnancy. It is expected to occur shedding the endometrium completely thereby preventing pregnancy. If she is changing 3 to 5 pads daily, then it is normal and expected to occur. So, just wait and allow the bleeding to complete and then reduce over the next few 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 29 years old. My last period was about two months back, and I had the bleeding for three days. I found out that I was pregnant about four weeks back. I had an ultrasound scan vaginally two days back, and the doctor did not find a fetus. She just found that I was five weeks and one day pregnant and not six weeks as we had thought. She has ordered an HCG test, and I have to go back to her next week. I am very much worried. I cannot even sleep. How normal is that the doctor does not see the embryo in the first five or six weeks? I love my baby already, and I cannot think of a miscarriage or ectopic pregnancy. Currently, I am taking prenatal vitamins. ### Response: If she found that you are five plus one weeks pregnant, then that means she has found the gestational sac with some fetal tissue but no cardiac activity. I have to see the sonography report to comment on it. Usually, around four to five weeks, the fetal poles can be viewed. And around six weeks cardiac activity can be appreciated in the sonography. If not, then it can be a delayed pregnancy or there may be a decreased growth of the baby. There is nothing to worry about a delayed pregnancy. But, if there is a decrease in the growth of the baby, then it is a matter of concern. But you have to wait for a few weeks for confirmation. If the baby increases in size around six plus one weeks, then the baby is growing well, and there is no decreased growth. You do not have any choice other than to take medicines and wait for the next scan." "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 23 year old male. I have started to workout recently. Today, after workout and cardio when I was taking a shower I saw blood coming out of my right nostril. The blood stopped immediately but there was bleeding from my right nostril for a few seconds. I have experienced this for the first time in my life. Should I get it checked? Please help. ### Response: Hello. Bleeding from nostrils is one of the common conditions encountered in our daily practice." "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 writing hoping you can give me a sigh of relief or a little clarity. First, let me start by saying I do have an HIV phobia. However, below will give you a better idea of my story.Two months back, I had unprotected oral sex with a guy that lasted for about two minutes. He then penetrated me unprotected for about a minute in which I made him put on a condom.After we were done, he cleaned himself up and penetrated me again for about three minutes. Ten days later, I noticed I had a sore throat and dry cough with a very low temperature and immediately scheduled a visit with my doctor as I was really nervous.I had a slight fever and asked my doctor to perform an STD test. When I got my results back I tested HSV 2 positive. I thought I was fine as far as those results were concerned.However, I read that there was a window period that I needed to test. As time went on I started to have a very upset stomach, gassy, bloated and diarrhea. I am also lactose intolerant. So, I suspected that it was from that.It went away but today I have it again, however, I am taking Penicillin and I heard that this was one of the symptoms. I have a dry mouth which I also heard could be from the Penicillin as well. My period for this month is noticeably lighter than normal which I am freaking out about.I never got a rash or anything or that I noticed. About a week ago, my husband started having diarrhea with an upset stomach and I noticed a rash on his knee which looks more like a bruise than a rash.It was red and purple with no bumps and very small but had no other symptoms. I also noticed that I had a small lymph node in the neck (which is the reason I am on the Clindamycin).I got nervous and decided to go back to the doctor so that she could test me for HIV again and the results were still negative. The lymph node has gotten smaller and stopped hurting, however, I do not see a stone or anything in my mouth that looks like a stone. Now my mouth is really dry not producing any saliva. This is my biggest concern. I also developed thrush. I have stopped taking any medicines so that I can see which medicine it is. Can you please give me some insight? ### Response: A fourth generation HIV duo test is considered reliable and conclusive if it is still negative after six weeks. Most STD (sexually transmitted diseases) specialists consider this six weeks gap as the upper limit of the window period for an HIV duo test result to be considered final. Since your exposure was two months back and your last HIV duo test was almost eight weeks after exposure, your test result is reliable and conclusive. You do not need to worry about HIV from that particular episode" "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 36 years old cousin has a problem lately that whenever he masturbates his right hand becomes numb and suddenly he cannot move it for few seconds and after some time it gets fine. Is it a serious problem? ### Response: It does not appear to be a serious illness. Does he get any other symptoms like neck pain or arm pain? This may occur due to compression of the nerves supplying the right arm leading to the symptoms. You should get cervical spine AP (anteroposterior) or lateral view. Till that time he can have tablet Neurobion Forte (vitamin B1, B6 and B12) once a day which is a nerve vitamin. If this is not helpful then you need to take tablet Pregabalin 75 mg bedtime, which is a nerve stabilizer. Consult your specialist doctor, discuss with him or her and take medications with their consent. So overall, it does not appear to be serious and worrisome but should be evaluated" "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 confirmation about spotting during fertility window, high and medium. Is it normal for 20 years old lady? ### Response: If you have been sexually active during your fertile window, then this could be an implantation bleed, get a serum beta hCG test to confirm pregnancy. If you are not, then the most common cause of mid-cycle spotting is ovulation bleed which is physiological in most women." "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: Whenever I am outside of home my face is looking red and many people asks me that why your face looks red. Please suggest me what should I do for it? Even in the evening, I mean without in sun rays it also looks red. I am a 20-year-old male. ### Response: Hello. I just read your query. There might be many reasons for turning your skin red while going outside. Most common reasons may include that your skin is very sensitive and whenever you go outside your skin is not able to tolerate the external heat and produces heat stress to your skin and skin turns red." "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 head has been spinning for several days and I used to hear some claps in my ears. The day before yesterday, some pimples appeared in my body and my stomach was very hot and I was vomiting yellow. Is it related to vertigo or to something I ate? I took Cotrim for pimples. ### Response: The spinning sensation is due to vertigo which could be due to either vestibular neuritis or Meniere\s disease in both conditions cause vertigo. In order to identify the cause, please provide me with more details: There is no relation between vertigo and the skin lesions. Vomiting could be associated with vertigo. I recommend Meclizine 25 mg tablets once daily before bedtime. Metoclopramide tablets one tablet before meals" "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 tooth started hurting about a month and a half ago, just one night of hurting badly. Then went away. About weeks later started hurting again but nothing too bad. I just dealt with it. Now, again I have severe pain. I went to ER, said it was abscessed tooth and gave me Amoxicillin. The pain was still very bad so went back to the doctor. Three days later they prescribed me Clindamycin. Started taking them this morning. The pain is very bad and now my face is starting to get swollen. My whole face hurts, hurts to talk or really do anything. Should I go back to the ER or wait and see if this new antibiotic works? Please help me. ### Response: I have gone through your question and I can understand your concern. I think you are having an acute periapical infection with involvement of buccal and mandibular space infection. If the swelling is increasing and there is burning pain you may need another antibiotic with Clindamycin. For that upload a picture so that I can provide you with the best possible treatment plan. Make sure you do not have any airway obstruction, that can be dangerous. Periapical infection due to the cavity. IOPAR X-ray. Acute apical periodontitis. Buccal space infection." "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 16 year old male. I have had a lot going on right now and usually I would just smoke to chill out. However, to overcome my depression, anxiety, stress etc., I started masturbating. I never did it much. After I started about a few weeks ago, I did it twice a day, then stopped for a while. Now I am worried. I am not too addicted, but it is urging. I am scared to do it because I am experiencing slight pain in the testes, rare fatigue, weak/no morning erections, and slight shaft aches. I know I should stop and I will. ### Response: Hi. Apart from this, as you said ""proper diet and lifestyle changes"" are to be followed: Just follow these for a month and let me know how do you feel. Get back to a sexologist online for further follow up" "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 my pictures and ultrasound results but can you help me to read it and say if I am pregnant or not? ### Response: I have gone through your history and understand your concern (attachment removed to protect patient identity). As your pelvic ultrasound showed some changes which are suggesting pregnancy, get your blood beta hCG levels to rule out the possibility of pregnancy." "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 unprotected sex with my partner. After a month, I had a delay in my periods. I want to know about pregnancy. ### Response: Hi. As you had unprotected sex, there is a chance of pregnancy in your case. It depends upon the day of your menstrual cycle it happened. Delayed menses is due to hormonal imbalance caused by sex. Get your home urine test if you miss your periods by seven 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 have been diagnosed with bipolar disorder two years back. Another doctor changed the diagnosis to light bipolar. The last one told me it is just depression and anxiety. I had mood stabilizers, antidepressants, and Modafinil tablets. Due to an overdose, I gained a lot of weight. So, I gave up on the medications cold turkey and started work outs and medications. I consulted a homeopathic doctor and started medications for depression and anxiety. I plan to go a nutritious diet for managing the depression, which lasts for three to four days when I am not stressed and longer when I am. Can a person be hypomanic for more than three weeks if he is bipolar-2? I used my willpower to accomplish more as I was moving to another country. I prayed more and started doing all the things systematically with planning.As my faith got increased, I started to become compassionate with people, and very confident about things. I was very optimistic about getting a new job and believed that God would give me everything I needed. I felt most of the favorable things happening in my life as God\s actions. I felt very happy and present at the moment. I was not euphoric. I was not talking excessively, not irritable, or low on sleep. I slept for seven hours at night. I was not jumping from one idea to another or jumping from one activity to another but I was finishing tasks systematically in a calm way. Suddenly, I felt bored and depressed one day as I was not able to follow up on my exercise, diet, sleep, and prayers. Then, within two days all the systems in my life crashed. I felt depressed and anxious. But, I did not cry. I feel angry and lost in thoughts about my past. I just sit with my phone the whole day and eat a lot for many days. Then my efforts come back to get back into the system. I connect the feeling of happiness that was there a few days ago as euphoric and being productive as hypomanic. Is this bipolar 2 or just depression due to unsystematic living? If the praying and systematic part were hypomania, then if I maintain a good nutritious diet plan, do yoga and exercise twice a day and sleep for six to seven hours a day to fight the depression part, will the hypomania be controlled? ### Response: Hence to be clear, if these fluctuations in mood are causing you distress or dysfunction in your daily life and are not remitting on its own, only then you can consider pharmacotherapy. Otherwise, you can continue with non-pharmacological measures as you are doing already" "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 anemic. How to increase hemoglobin levels in my body? Which fruits should I take? ### Response: If your hemoglobin is below 10g/dL, then iron supplements have to be taken once daily. Syrup Ferritin is a good choice. A healthy diet will definitely help in elevating your hemoglobin level very soon. Have three meals a day with adequate fruits and soups in between. You can have more corn, pomegranate, watermelon, sprouts, green leafy vegetables such as spinach, broccoli, etc. If you are a nonvegetarian, you can take more of lean meat (grilled chicken) and boiled eggs. Revert back with your hemoglobin reports after four weeks." "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 took an I-pill after I had sexual intercourse, a month back. My period came seven days before the expected date. The bleeding was brown in color, and it lasted for two and a half days. After that, I did not get my period next month. I am experiencing tenderness in the breast, frequent urination, and nausea from few days. But now, I feel no tenderness. I took a urine test on the day of my missed period, but it was negative. Am I pregnant? ### Response: Hi. It is unlikely that you are pregnant. This often happens after taking I-pill. Nonetheless, I would suggest you confirm the presence or absence of pregnancy by doing a blood test namely the serum beta hCG and share the reports. If it is negative, then repeat the test after a week, if it is still negative, then no need to do anything. Use protection during sexual intercourse in the meantime, your periods will start eventually, and then your menstrual cycle will become regular. Once your cycle is regularized, I would suggest you think of getting regular oral contraceptives pills, as I-pill is not meant to be used except in an emergency If you have any doubts, please let me know." "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 18-year-old male and suffering from acne since I was 14. I have tried a retinoid, Doxycycline, countless topical creams and scrubs, a six-month course of Accutane, and nothing seemed to work permanently. Accutane was the most effective drug at preventing my acne but, two months after I stopped it, my acne came back, not as severe, though. I believe that signifies the acne I suffer from is hormonal, so I just have to wait until the testosterone I produce stops affecting my sebaceous glands drastically. But I wanted to know if there is anything else I have not tried because my face looks horrible, and I have severe hyperpigmentation from the past pimples. I was looking into a chemical peel because I was told it would make your face produce less sebum in addition to inducing collagen production. More information about my skin is that I am white, light-skinned, and about 150 lbs. ### Response: It seems like you have had really bad acne and have been trying hard to improve it. I would suggest you not to stop the treatment abruptly as it usually leads to a flare. Instead, once the acne is controlled, you should reduce the frequency to a maintenance dose, such as weekly once or twice, for a longer-term. Salicylic acid peels do work well for acne and oily skin when applied correctly. You may need four to six sessions, with monthly one session frequency. Chemical peels even help to lighten your post-acne pigmentation. Do not prick your acne as it leads to infection, scarring, and pigmentation." "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 24 year old female. I am taking medicines for migraine (Sumatriptan). My tablets have expired. Can I take them? Would they still be effective? ### Response: Hello. Its effectiveness will not be as desired." "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 ENT doctor told me that I am having granulation with pharyngitis. He applied silver nitrate. Will I be fine? ### Response: Hi. The condition you specified might be granular pharyngitis. If it is a recurrent condition you can be treated with Silver Nitrate to remove those granulations. There is no problem in the above-mentioned treatment. Apart from antacids, I suggest you take antibiotics and mouth gargles. If possible, provide me a picture of your throat by taking a picture in the mirror (if possible)." "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 little white spot in the area where my back wisdom tooth used to be. It covers where the socket was when I got it removed 4 years ago. I currently take Suboxone and chew Nicorette gum. Is this normal? ### Response: Hello. As you have mentioned it can be a canker sore. And if it is painful and irritating then visit the dentist once to show it properly. If there is nothing like this then I would suggest you apply any anti ulcerative gel, like Dologel or Dentogel (Choline salicylate) whichever is available at your place. Or get Metrohex gel (Chlorhexidine gluconate and Metronidazole) for better results. Maintain oral hygiene properly and use mouthwash after brushing twice a day. Apply baking soda, lemon juice and salt mix in a paste form for 1 to 2 times a week for better results" "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 25 years old, have a job and study besides. I cannot sleep well when I come home. I wake up every one hour. I also have terrible pain in my ankle at night and in the morning but disappears during the day. Moreover, I have a high temper and worry a lot about everything. ### Response: From the given symptoms, it is not possible to zero in on the exact cause of your present condition. But because you have mentioned you work as well as study and have a tight schedule, the sleeplessness could be due to the stress you are experiencing. We cannot yet say it is stress disorder. But it has to be stress-related. Regarding the ankle pain, when the muscles relax, it pains and when it is stretched there is no pain. It has to be arthritic kind of pain. For that, I suggest you consult an orthopedic. For stress, you should try to reduce the stress you are taking now. Learn relaxation techniques. Start physical exercises and be calm. I suggest you consult a psychologist online or in person. There is no need to worry" "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 having ice pick headaches. Hence, I went for an MRI scan and regular blood tests. Now, I am wondering whether my report is normal. ### Response: The attached MRI images (attachment removed to protect patient identity) showed normal findings. Revert back with the complete pictures to a radiologist 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 one larger tonsil and there are no symptoms. It does not bother me unless I look at it. ### Response: One-sided enlarged tonsil is not a good thing to have. Usually, when both sides are enlarged, it would mean an infection or chronic infections over tonsils and pharynx. Unilateral enlargement needs to be investigated to rule out a tumor or abnormal growth. If you were to show to me, I would go for a tonsillectomy surgery where I remove both side tonsils and send them separately for biopsy (histopathological examination). That will give us a final report on what exactly it is." "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 daughter is 6 years old having trouble in speech. While taking she cannot clearly pronounce word R and L. She always speaks L instead of R. ### Response: This means her neurological development is normal, memory and intelligence intact. This kind of giggling or word pronunciation is common up to 8 to 10 years, with age it will improve. Then no need to worry, just she needs speech therapy. I will tell you tomorrow what you have to do and whom you have to meet for speech therapy." "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: As per advise of doctor I have taken Dapoxetine (Duralast) 30 mg before 1 hour intercourse, it did not work? So can I take any other medicine or take higher composition of same medicine or two tablets before 1 hour? ### Response: Taking two tablets of Dapoxetine might cause dizziness, flushing of face, nausea, vomiting, etc., side effects. But you can take two tablets that is 60 mg prior to sex. But if problem persists then better to consult your doctor again. Regular use of SSRIs like Paroxetine daily will help to delay the ejaculation time. Continue to take Dapoxetine 30 on SOS basis. This will help in delaying the time." "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 29 year old married female. I delivered my baby a year ago. I had post-spinal headache for three days in the hospital. Again, for the last eight months, I have been suffering with severe upper shoulder pain, neck pain and one-sided headache. It started with severe giddiness and nausea. I have consulted many neuro physicians and they prescribed me medicines for migraine along with antidepressants. But, I did not get any relief.A neurosurgeon told me to take Dolo for three weeks and Stalopam 10 mg. That too, did not help me. I got my MRI scan done and was diagnosed to have a small cyst (subependymoma) in my head, which doctors said as non-cancerous and not related to these headaches. I lifted heavy weights in my fourth month after my delivery and I had upper shoulder pain.Later, my neck and head pain started. I guess, pain in my upper shoulder muscle leads to neck pain and headache. Doctors say it as a migraine, but I am not sensitive to light. I started taking Vasograin since five days and feeling good for about 80%. Please help to come out of this terrible headache and muscle pain. ### Response: Hi. We are here to help you. You seem to be suffering from fibromyalgia (muscle pain and fatigue) Fibromyalgia can be associated with migraine headache that presents with one-sided headache. Also, following delivery, females do get these kind of pains and headache due to breastfeeding has led to vitamin D and calcium deficiency causing such pains. Now, I would recommend in such case a test for vitamin D and iron profile. Treatment recommendations would be Amitriptyline and Duloxetine for pain. Vitamin D and iron can be added later based on the reports." "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 my routine medical check-up. And I got my CBC report. My platelet count is 210000 and in range but my MPV (mean platelet volume) is 12.8. Is it anything to really worry about? ### Response: Hello. You need not to worry about your platelet count and MPV. In your attached report, total WBC (white blood cells) count is borderline low and lymphocyte count is borderline high. So it could be a temporary viral infection. You can repeat your CBC (complete blood count) after a few days to check the count again. Do not worry and repeat CBC after a few days. You can revert back once you repeat CBC." "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 34 years old and diabetic. My penis foreskin is not pulled back. It is swelled and tears on the tip of foreskin are not healing and are very painful. Penile glans has white discharge. ### Response: The diagnosis seems to be something called candidal balanitis or fungal infection of a part of the penis. Are you married? And if so does your spouse experience any discomfort or white discharge? This information will be helpful to plan the treatment for both of you simultaneously so that we can eliminate the chances of ping pong infection and recurrence." "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 57 years old. She is having skin infection around his face, neck, and ear area and she is a cardiac patient.For the past two days she is taking Surfaz-SN ointment (Clotrimazole, Beclomethasone Dipropionate, and Neomycin sulfate cream), Zenflox- OZ (Ofloxacin and Ornidazole), and Allegra 120 mg. Please help. ### Response: Hello. Your mother has herpes zoster. It is caused by varicella zoster virus which causes chickenpox earlier in life and gets reactivated later in life to cause herpes zoster. She has to take tablet Valacyclovir 1 gm thrice a day for seven days. For the pain, tablet Diclofenac 50 mg at night ( if severe, twice a day). Apply Fusidic acid cream twice a day over it to avoid secondary bacterial infection. Varicella zoster virus. Herpes zoster. Tablet Valacyclovir 1 gm thrice a day for one week, Diclofenac 50 mg at night for one week (twice a day if severe pain) along with tablet Rabeprazole 20 mg in the morning empty stomach. Follow up after one week." "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 use a combined contraception pill. In this cycle, I forgot to take the 8th and the 13th. I further forgot the 15th but consumed it in the morning and on the same day on time consumed the 16th. On the 14th I had unprotected intercourse. Should I now take the pill after, or wait? And in the case of pregnancy do I have to consume the abortion pill? ### Response: Since you have missed pills in between, it is better to take an emergency contraceptive pill within 72 hours of intercourse. There is no chance of pregnancy. However, if you have a doubt then get 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: I am a 42 year old male. In my right testicle, I think spermatic cord is enlarged. I do not have any pain. The right testicle feels firm and spermatic cord feels hard. ### Response: Hi. You seem to have developed funiculitis which is inflammation of the spermatic cord. You will need a course of antibiotics. Please revert back with more details for further guidance." "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 get frequently sick with joint and muscle pain and burning legs sometimes feel difficulty walking and climbing stairs. I consulted a physical, he tested ANA and it came back positive but since ESR and CRP are normal he said no need to test further and I am perfectly healthy. But my pain never subsided, I cannot go to the office due to AC and joint pain. It is affecting my work and quality of life due to frequent sickness and unable to do normal activities. After consulting a rheumatologist he further tested ANA profile and anti ds DNA. That also came perfectly alright. I am confused with my body why my joints are paining so much without any disease? ### Response: I would like to ask you a few more queries." "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 erectile dysfunction due to atherosclerosis causing less blood flow to the penis, this may be due to family history of high cholesterol. The allopathy medicine suggested for this is Tadalafil 5 mg every day (vasodilator).Is it manageable through Siddha medicines? I am 33 years old. My height is 176 cm, and I weigh 76 kg. I have borderline high cholesterol, and I do not have high blood pressure or diabetes. I do not have the habit of smoking or drinking. Please go through my blood reports. ### Response: I have gone through your reports (attachment removed to protect patient identity). As per your blood report, your cholesterol profile is above the upper limit. This might be the cause for the penile artery blockage (atherosclerosis plaque). But, I think the other possible reasons for erectile dysfunction may be: For cholesterol, you consult a general physician and they would prescribe Simvastatin. This will reduce your cholesterol and reduce the plaque. If you wish to have sexual intercourse, on that day, take one tablet of Tadalafil before sexual activity. Otherwise, do not consume it regularly. It has many side effects." "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 experiencing acid problems. I keep burping after eating. I started to take 20 mg Omeprazole. I have been taking it for three days, once daily but I experience side effects such as muscle weakness, headache, and shortness of breath. How long should I take the medicine? And can I switch to Esomeprazole? ### Response: Hello. I will definitely help you with your problem. Burping after eating is a very common problem. It is known as gastroesophageal reflux disease. I will suggest you some precautions to prevent it. Eat less quantity of food every time than before. You may eat five to six times a day but with lesser quantity. There should be a gap of two hours in the night after eating and go to bed. Walking for sometimes is a must after every eating. Avoid spicy and fatty foods as much as possible. You may switch to Esomeprazole it is more effective. You should take syrup Sucralfate two tablespoons three times a day. It will help to heal ulcers and for fast recovery. 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 just got my braces removed today and have been getting some heavy bleeding when brushing my teeth, should I continue to brush my teeth while it bleeds or just stop? ### Response: I can understand your concern regarding the dental health. Bleeding gums after removal of braces is a very common problem among all. So first of all, consult your dentist for scaling to remove local inflammatory factors. Till the time do gargles with mouthwash after every meal to maintain oral hygiene and avoid brushing to not allow bleeding." "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 tingling sensation without pain in the inner aspect of the arm on and off. Also, I have a tingling in the gluteal and lower back sometimes going to the feet. I have no other issues. I am awaiting a neurologist appointment. It is only on the left side. Is it serious? ### Response: I went through your post. It is nothing major. So, there is no need to be anxious about it. Regards" "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 had a total knee replacement two months ago. Doctor suggested to put knee splint for nearly a month, and after that, she went to physiotherapy and her knee is very stiff now. She could not able to bend her knee, and having excess pain. Almost her BP is raising during physiotherapy and the pain stays for a day. Is this normal? ### Response: Hello. You have mentioned that your mother had her knee replaced two months ago. I am assuming it is a primary rather than a revision. I will be concerned as much as you are as by six weeks we expect at least a 0 to 90 degree knee bend. By this, we mean that the patient can bend her knee sitting on the edge of the chair and have her foot planted on the ground comfortably. If this is not the case then we need to look at her progress with physiotherapy. If this is slow but steady and the patient is making satisfactory progress weekly and is able to actively participate in the physiotherapy without much post-therapy pain, then I will recommend continuing with physiotherapy but keep a strict eye on the developments and progress. If it is neither i.e. range of motion is less than 0-60 and the patient is struggling with physiotherapy then you seriously need to go and see your surgeon. And I will recommend a MUA (manipulation under anesthesia) which will improve her ROM (range of motion) and make her life with physiotherapy much easier. Also, if you wish you could upload her x-rays post-operatively and a picture showing her ROM and may be I can help ou further and will be able to guide you towards the next steps that you need to take. In the mean time ice the knee after each physiotherapy session." "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 23 year old female. Few weeks earlier, I had tooth pain after eating. Yesterday, I had acute pain in the tooth. I have attached the OPG scan for your reference. I would like to know, from the OPG, what is your opinion about the extent of decay? And also I would like to know about the possible diagnosis. ### Response: Hi. Before I answer, I would like to point out a few issues here. You have not mentioned the location of your tooth pain, whether it is on the right or left side. The right and left indicator on the orthopantomograph (OPG) are not visible on the scanned image. So, I am going to describe the findings as I see it. To my right and left, I can see there is decay in two upper molar teeth. Upper third tooth from my right and the upper third tooth from my left.The decay in the upper right first molar appears to be deep. Depending on the symptoms, if you have acute pain that is unchanged, persistent and disturbs your sleep, then the tooth will require root canal treatment (RCT). This is because the nerve of the tooth (pulp) has been involved by the decay. If the RCT is started right away, the tooth can be saved. The decay in the upper left molar tooth is moderately deep and can be filled, if you get it done right away. If delayed, then the decay is likely to progress and involve the nerve of the tooth (pulp), then root canal treatment would be the only option to save the tooth." "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 11 years old. I am on my period. My vagina hurts and itches during the period. Why? ### Response: At the young age of 11, itching around the time of periods may be just minor infection. Usual infections are respiratory infection or urinary infection. If you have any respiratory infection, suppose you cough into hands later if you wash your genitals with same hands after using the wash room. This will transmit the infection to vaginal area, and you get itching around area. Same is with urinary infection. When you have periods, the vascularity of the vagina and surrounding area is increased. When the vascularity increases the infection flares up, and you get itching." "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 mind flip problem. My emotions get changed every hour. I am studying and living in a hostel. I have the feeling of loneliness. I do not want to be alone. I do not know how to deal with it. ### Response: Mood swings with frequent low mood episodes can occur due to lots of causes. If you have a predominantly low mood, it can be dysthymia which is a low grade chronic long-term depression. As you are living in a hostel, it is very obvious to lack proper family support. You should have adequate talk to your parents. I know it is tough to visit your home frequently as you are studying. Try to share your thoughts with your friends. Make such friends who listen to you and take proper care of you. If still, you face the similar problem, I would suggest you visit a psychiatrist for appropriate assessment. Do not worry. I am sure that you will be fine with a proper friend and family support. You do not require antidepressants or mood stabilizer" "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 breast MRI two months ago, a routine screening due to BRCA1 status. There was a non-mass lesion seen on the left breast which the radiologist said was stable for three years. On the right breast, there were three foci seen, two measuring 5 mm and one 3 mm. The 5 mm foci have been stable in size for one year. But, the 3 mm one is new.The doctor did not recommend a biopsy because of the small size and after mammogram and ultrasound were performed, he gave it BI-RADS III and told me to go back in six months for another MRI and a mammogram. Should I be concerned about these and ask for a biopsy? ### Response: A BI-RADS III (Breast Imaging-Reporting and Data System) means the lesion has a high probability of being benign and something which is not of a serious concern. The MRI (magnetic resonance imaging) is a detailed test and has good accuracy. However, a suspected BI-RADS III lesion needs to be followed up on the MRI and mammogram as recommended by your doctors. In reply to your questions, you surely need a follow-up testing after six months. A biopsy for the 3 mm lesion which is showing benign features on MRI is not usually recommended and there is no serious concern right now. You can possibly get an ultrasound mammogram after three months if waiting six months for the next MRI is causing anxiety" "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 abnormal pap tests for the past four years. Now I am having really thick light brown mucus discharge almost daily. The last one this morning was bigger than a quarter. What could this be? ### Response: Hi. I understand your concern. At the age of 29 years, I would want to know what the abnormality in PAP smear was? I hope it is LSIL (low-grade squamous intra epithelial lesion) or ASCUS (atypical squamous cells of undetermined significance) or only mild dysplasia. Any of these findings are suggestive of only some infection in the cervix creating some changes in the lining of the cervical canal. This only warrants follow up and repeated PAP smear evaluation. These infections on the cervix can cause small ulcerations, which would appear like a raw wound. Once the raw surface if formed, the secretions from the underlying cervix increases. Just like in common cold secretion from the nostrils increase, cervical secretions also increase. The sudden appearance of excessive brown discharge can follow any local insult like recent sex, or recent periods or local trauma by a tampon or even urinary infection. But it is not to be worried about. If it is been a year since last PAP smear or at least six months have a repeated smear. You may need local antibiotic treatment. If the cervical erosion is significant and the abnormality you are experiencing in PAP is more than what I mentioned, then you may need excision of the ulcer with cryotherapy or electrotherapy or chemical. But at this young age of 29 years and as the doctor has put you follow up for four years, I bet you belong to low-risk stage. Nothing to worry about. Just simple treatment of local medication will do." "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 mom aged 45 years, is having a fever for almost two months. The temperature used to vary from 99-100 degrees Celcius in the night times and gradually it comes down. She was weighing 105 kg and now she is 88 kg. Now, she is having bone pain and light fever in the night when there is a pain in the bone. She has been advised with calcium and iron tablets. She is also getting her regular periods. Menopause has not reached yet. Kindly advise. ### Response: The fact that she has been having fever off and on for the last two months and is a low-grade fever especially in evenings with accompanied weight loss and bone pains indicates a possibility of tuberculosis infection. It is better to get her Mantoux test and ADA (adenosine deaminase) levels done to rule out the same. As she has been in a colder country the possibility is unlikely, if she has been staying with you for more than six months or if she has recently visited you two months back then there is all possibility of her having contracted the infection from India and she carried it with her. Please follow up with the reports." "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 28 years. I have a history of three miscarriages all at 6, 5, and 5 weeks. My torch test came positive for Rubella IgG. Others were nonreactive. Other investigations were normal. I am asking if this could be the cause because I am confused. ### Response: Hello. I understand your concerns. Rubella IgG antibodies indicate either previous old infection or vaccinated status. It is not the cause of the repeated miscarriages. I suggest: Wish you all wellbeing" "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 saw a red color wound inside the anus of my 3 month old baby. He is fussy while passing stool. Is it anal fissure? Do we need to consult our pediatrician immediately? I am expecting your valuable advice. ### Response: Hello. Yes, it can be anal fissures. Also, you can look for a skin tag around perianal area, which occurs in anal fissure. Does the child have constipation or tight stools? Because, if it is an anal fissure, then we will have to see the cause of hard stools as the difficulty to pass stool can cause fissures. He should also be checked for hypothyroidism. Is there any blood in stools? Most likely, it is anal fissure. The rest all can be said on examination for which you should see a pediatrician." "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 generalized anxiety disorder and panic disorder. It is mostly under control, but I get very nervous at the doctor. I have had a BP reading as high as 167/105. My doctor says its just because I was nervous. Is this true? I am not overweight, I exercise regularly, I am not hypertensive, I eat healthily, I am only 18 and neither of my parents has high BP. So, was it that high because of anxiety? Could a heart problem cause it to be that high? ### Response: You may have high BP just for once. It may be due to anxiety. Persons with anxiety and depression may have high BP. You should do BP monitoring for one week. Check your BP twice a day for one week and note it down. Or at least once a month for four to six months. If you still have persistent high BP then go for hypertension management. And if you have an anxiety disorder, then treat it as early as you can. It will surely help lower your BP. You are too young to have high BP. You must monitor your BP. The long-term high BP can lead to various organ damage" "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 taking Lorazepam for 25 years. The last four years I am taking 4 mg daily. 2 mg at night for sleep and the other two split in the day. I only had two today and do not have any for tonight. I will pick up my prescription in the morning. I am concerned if me going from 4 to 2 will cause any serious symptoms. ### Response: It will cause some symptoms like tremors, anxiety, lack of sleep tonight, but serious side effects will probably not occur especially if the dose is taken in the late afternoon or evening. You can have some antihistaminics like Cetrizine or Levocetirizine 10 mg tonight if available and help in tackling the symptoms to some extent. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. If you noticed excessive symptoms then you should call the ambulance and keep someone informed about your Lorazepam status or keep a chit in your wallet. Overall, I do not think, there will be any serious side effects within such a short period as some amount of Lorazepam will stay in your body 24 to 48 hours. Hope this helps you and get back if you have any doubts" "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 35 years old, 5 feet 11 inches tall and weight 79 kg. Vegetarian diet. Before two years, due to stomach disturbance and pain and some popup and cracker sound occurred in my knee joints. I visited the doctor and he suggested me for a laboratory test of liver function test and all reports were in normal range except sugar which was 138 at that time and gave me some medicines and referred to orthopedic for joint pain. I have visited an orthopedic specialist. He took an X-ray of both leg, knee, and told that it is an early stage of osteoarthritis of the knee and he suggested for MRI and I got my MRI done. In the MRI report, it is mentioned that left knee has been affected with osteoarthritis. After that, he gave some medicine for 10 days and referred to a physiotherapist for exercise and weight loss. I have visited as he told and now I have reduced my weight and now there is very little pain remaining in my left knee but now my other joints like the left hand thumb, finger, and both hand and knee have popup sound during movement. Kindly diagnose my problem and suggest the treatment for the same. ### Response: Hi. I went through all the history details and reports. It shows mild osteoarthritis which is not reversible. But if you maintain your weight and exercise, it will halt. Take a lot of fruits and vegetables. The cracking noise is normal and you need not worry. I hope I have answered your questions. Please feel free to ask me if there is any doubt in this regard." "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 got a temporary filling in my tooth today. But there was swelling and pain after five hours. ### Response: I can understand you are worried about pain and discomfort in your tooth. After dental procedures like filling a root canal, infection and pain are not so uncommon. Many dentists give pain medications and antibiotics before discharging the patient (after the procedure). I would recommend you to consult back your dentist for these medications as he knows your case better. Also, you need a prescription for taking these medications from a pharmacy. For pain though, you may take over the counter painkillers like Ibuprofen or Tylenol after the meals. But this is not a permanent solution as we do not know at this point if there is an infection in the tooth root. Hope it helps. You may add follow up query here if you have more questions. I would be happy to assist" "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 working in a decontamination area in a hospital and I had a small cut on the hand. The water came inside my gloves while washing dirty instruments of operation theatre. Will I get HIV? ### Response: Hi. First, HIV can survive only for 8 to 12 seconds in the outside world. The HIV contaminated instruments and waste material from instruments cannot cause HIV infection as there will be more than 30 minutes before contacting you. Second, never work with open wounds. Taking HIV out of the equation, you have the highest chances of HBV (hepatitis B virus) transmission as it can survive upto 30 days in a harsh environment. Thirdly, as there is open injury, there are chances of bacterial infection. Finally, you are not at risk of getting HIV but at risk of getting HBV. You can take the HBsAg vaccine as a preventive measure." "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 3-year-old son has been complaining of headaches and back pain. He also has epilepsy and had two spinal taps. He has been diagnosed with epilepsy since he was two weeks old. In the past, he has been on Phenobarbital. Please help. ### Response: Hello. Lumbar puncture or spinal tap causes a headache and back pain in almost all kids. If the spinal tap was done due to a headache then it is to rule out meningitis. You can just give any painkiller for relief until the investigations are done. If it is persisting, the ENT (ear, nose, and throat) and ophthalmology opinions should also be taken regarding a headache. MRI of the brain would be recommended" "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 severe pain in my sacroiliac joints (eight years). The doctors focused only on my lumbar sacral spine, and it has got fused before two years. However, the pain persisted. I found after a surgery that bilateral sacroiliitis showed up on MRI before two years. I saw a rheumatologist for the first time who diagnosed me with ankylosing spondylitis and started treatment. For the past 12 months, we have tried different things to treat it. I also feel so sick on myself. I also have a low-grade temperature, nausea, dizziness, fatigue. Currently, I am taking Gabapentin, Palexia, Midon, Xarelto, Zofran. ### Response: Hi. You have spondyloarthritis. You may benefit from TNF (tumor necrosis factor) blockers. They will help in controlling your disease." "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 injecting Botox into my forehead for three years now and never had a reaction. Two days ago I visited a different dermatologist and right after the session, I developed hard lumps on every injection site. I returned to the same dermatologist and she told me this is nothing to be concerned with and should reside in two days. She also gave me Arnica oral tablets to use to speed up the recovery. This is my second day after the injection and there are no signs of healing. I am unable to go to work because my forehead looks like it has been attacked by a beehive. What can I do to speed the process? ### Response: Kindly send image and revert back. Without clinical photographs, it is difficult to comment" "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: Since my childhood I was complaining short sightedness that the doctors call high myopia. 19 years back, I was having lasik operation for both eyes then my vision improved, 6 years later, eyes vision begun decreasing. After that I was having light sensitivity. I am feeling headache by the time I am watching the television and computer screen and after. Also I feel the headache at the sunny day time. Sometimes I feel dry and wet eyes. Six years later I was diagnosed with retinal macular degeneration. For further medication say that is a treatment with adult stem cells but I do not know a lot of this operation. So I want to know if this procedure is certified and proved. And other advice you can give me.This is my medical repport: Patient came with complaints of diminished vision since childhood. On examination: Right eye: Dvr: 6/9 with corrections, Anterior segment: Lasik flap, Fundus: chorioretinal degeneration. Left eye : Dvl: 6/9 with corrections, Anterior segment: Lasik flap, Fundus: chorioretinal degeneration.Intraocular pressure : 14mmHg, Intraocular pressure : 16.5mmHg, Diagnosis: Lasik with Myopic chorioretinal degeneration. ### Response: It seems from the history that you have undergone LASIK surgery for correction of myopia. No need to worry the treatment is also simple and you can use artificial tears eye" "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 non-alcoholic fatty liver grade 2, bilirubin 1.7, and creatinine is 1.2. How to reduce cholesterol and bring back to normal liver function? ### Response: Hello. Your fasting glucose is high so that you might also have diabetes. Should treat it adequately, apart from diet and lifestyle changes. Cholesterol is fine, and if you follow the changes in diet and lifestyle regimen, cholesterol will get normalized too. Excessive sleeping and always feeling tired is due to alcoholic fatty liver damages. Stinging nettle supplement will help detox your liver. Keep following up with gastroenterologist regularly." "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 dad is suffering from throat infection from the past four months. He is telling that there is no pain. But, there is a sensation which makes him feel uncomfortable. He went to many doctors but everyone said it is due to gastric. But, last week he had done a GI endoscopy and the RUT results are positive. So, I just want to know if it is a serious matter. ### Response: Acid reflux can lead to chronic cough and throat pain. So, acid reflux should be treated with an antacid like Rabeprazole. Avoid excess spicy foods. The head can be elevated while sleeping. Provide your report to comment further regarding endoscopy results" "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 aged 29 years 3 months, height is 5 feet 8 inches, weight 77 kg. My doctor checked my HbA1c a year back and found it 4.2. Recently, I was facing little dryness in my mouth and that is why drinking more water too. Also facing some little burn in my feet. Other things are fine till now. Is there any probability that I got diabetes by this time? Should I go for another test? ### Response: Hello. I understand your concern. Your HbA1c report is in the normal range, you do not have diabetes. If your test was done in a reliable laboratory, there is absolutely no need to repeat this." "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 eager to get my reports examined and get your opinion. Reports attached for your reference. I would be more glad to seek your advice on my LFT/KFT and diabetes reports. What is required to bring all parameters to normal? I work for an IT company and mostly sedentary lifestyle. Hardly I walk for 3 to 4 km in the morning. No smoking, moderate alcohol, vegetarian. I feel tired most of the time, disturbed sleep, unknown reasons for weight increase from 82 kg to 87 kg in the last couple of months. Currently, on Ecosprin 150 mg and Fibbitor 20 (daily once in the morning) for eight years due to MI and was administered check angio. Please advice. ### Response: You have diabetes mellitus (type 2). This occurs due to deficiency of insulin which is secreted by the pancreas. You will require reduction of your weight, regular walk at a brisk pace for about 45 minutes to one hour daily for most days of the week. You already have had an MI as per your history so you have to be extra careful with your weight and diabetes. You can continue the" "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 used to have a long-term groin injury from playing badminton which caused jarring pain which ended up me having to stop for a while. I have not played badminton for four years so the groin injury subsided by whenever my groin is stretched it is always tender and has a lot less range of motion compared to the other side. I took up squash a year ago and have been playing at quite a good or intense level five times a week. In the last week, I have had quite a bad hip pain on the same side as my old groin injury. The groin injury has not come back (i.e. jarring, pain, etc.) since starting squash but it has still remained a bit tender when stretched with less range of motion than the other side. The hip pain has started getting bad at night three days ago and affecting my sleep so I have therefore stopped playing. I have been doing resistance band exercises I found online for adductors, abductors, etc., with stretching groin, hamstrings, etc., but has not got better (although it has only been three days). It is a dull ache for most of the day which only goes if I take Ibuprofen and does seem worse at night. The hip pain is fairly central but more on the outside. ### Response: I have understood your concern about groin pain. See you need to give sufficiently enough time for healing of adductor muscles tendons, which is getting worsened by repeatedly stretching. No doubt that you need more range of motion, but the first choice is to promote healing and decrease the pain, so for that, you need to take physiotherapy treatment, like ultrasound with ice and laser therapy, which helps in healing. then gradually after 20 days, you may start with exercises" "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 did a root canal on the upper first molar tooth before three weeks. I had sensitivity towards cold and sweets for years. The tooth was slightly loose. So I did a root canal on it. The second sitting was done before a week. I started to have pressure on the tooth after two days. I consulted the dentist, and he told me that the seal has got broken. The doctor said to me that the tooth should be pain-free for a weekend to have a fixing over it. But, I had more pain than before doing a root canal. The pain was terrible. Now, I have pain, pressure and it hurts even for a light pressure on the tooth. I do not have sensitivity. Now, it has been two days, and still, I have pain over the tooth. Please help. ### Response: Hi. You have an infection still lingering in your tooth undergoing root canal treatment. It causes pain." "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 during sex. I had bleeding for the first time when I tried, so I thought it is easy to take it, but it hurt me. So I stopped him now, I cannot have sex. ### Response: Pain during such a pleasurable thing like sex is a spoiler. There are a few common causes of severe pain during sex. 1. Any unhealed injury or abrasion in the vagina. 2. Any infection in the genital tract. 3. 4. Uncomfortable or unrealistic sex position. First, you need to assure you are not having any injury or painful spot in the vagina. If that is not the issue, you should look for any foul-smelling discharge from the vagina, which is indicative of infection. Thirdly do lots of foreplay before sex to naturally lubricate the vaginal canal and use lubricants like K-Y Jelly while doing sex. Always try a sex position which is comfortable and pleasurable for you. Do not just follow the lorn clips." "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 an extraction of two tumors of epithelial-myoepithelial carcinoma with a prominent dedifferentiated (high-grade transformation) myoepithelial component extracted from my nasal cavity before three years. MRI scans were performed to look for recurrences. In my previous MRI, I had a perfusion curve showing ascending plateau.I have significant weight loss for the past seven months. I have occasional nosebleeds with pain. I also have fever, sensitivity, and bleeding in the mouth palate occasionally. Currently, I am taking Iscador P series II injections three times a week, painkillers, and supplements. Please advice. ### Response: Hi. Please give your queries and concerns on pointwise. So that, I can answer them for you. I will point out the abnormalities present in the scan soon." "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 tiny red dot on the bottom of my pinky toe. It seems to be some blood blister. If it pops, it will bleed forever. It will not go away. What is it and how do I get it to go away? ### Response: I saw your picture (attachment removed to protect patient identity). It is called pyogenic granuloma which is a lobular capillary hemangioma. It is a collection of capillaries and is not contagious or infectious. Usually seen on hands, feet, and face. It bleeds on trauma. The treatment is the removal of the lesion. You will have to meet dermatologist to get it removed. After numbing the area with Lidocaine, the dermatologist will remove it using electrocautery or radiofrequency or surgical Co2 laser" "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 implanted with a pacemaker. I am aged 71, potassium 5.1, fasting glucose 273, postprandial 353. What diet should I follow? ### Response: Hello. It needs to be monitored very strictly with diet so that it will help to manage the present condition and avoid kidney problems. Avoid excess potassium-rich foods like greens, citrus, tender coconut water, ragi in diet till potassium is under control. You can include fruits like apple, pineapple, and guava in diet approximately 100 g 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 noticed a little red bump on the top of my labia minora (right underneath the clitoris). It looks a bit swollen and it is sensitive to touch. I did notice a small bump on the outer side of that labia minora too but I cannot be certain that was not there before.I have had Bartholin\s cysts in the past, so I know it is not that and I do have genital herpes and it does not seem like it is an outbreak either. I really do not know what it could be? Please help. If need be I will even attach a picture. ### Response: Hi. Your text mentions the lump to be below the clitoris, so is it just above the opening where you pass urine (urethra)? In that case, it could be a urethral caruncle? You can search for the images of the urethral caruncle and see if it matches your problem. If not send me the pictures, so we can make a diagnosis." "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 19 years old, and I am not sexually active. I have pain in the breast on both sides. It got started before few days, and my left breast has got changed in texture close to my nipple. It is too sore. The breast pain is not constant. It happens when I wake up, when I run or when I press them. I have not got my periods this month. It is not abnormal. I got a heavy period last month, and I have pain in my lower abdomen for a few months. It is always sudden and sharp. It is not constant. I do not know the reason for having this problem. I had vitamin D deficiency before few years. Please suggest. ### Response: There are many possible causes for having breast pain. Hormonal fluctuations related to menstruation or pregnancy are often responsible for breast tenderness. Having some degree of swelling and tenderness just before a period is reasonable. The common causes of breast pain are menstruation and pregnancy. Breast pain is common during the first trimester. Breast pain also occurs when having a pregnancy at a young age, and when having puberty in both girls and boys. The other reasons can be breastfeeding, fibrocystic breast changes, and mastitis in which a blocked and infected milk duct have some redness. Please say whether you had any discharge from your nipples, like blood or pus. Please tell if you had any breast infection with localized redness, pus or fever. Please say whether you had any new lump associated with pain. You have to wear a well-fitting brassiere for support, especially if your breasts are large. You can have lower abdominal pain due to some reasons ranging from caliculi to appendicitis. Vitamin D deficiency does not cause these symptoms. You can apply ointment over the breast if you have any superficial infection." "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 feeling of a lump in my throat for over a month with a feeling of trouble swallowing. There is no pain and I can get food down but it feels like it takes more time to get the food down. I went to a hospital and they did a CAT scan of my throat and said there are no tumors. It feels like I have to throw up but when I try to, it feels like I am going to throw up a ball and cannot. I got this pressure in my nose and throat/chest when I tried to throw up the other day. Also, I saw small blood streaks in the saliva while I was trying to throw up. I have not seen blood any other time besides then. ### Response: Swallowing is a process which starts at the mouth and ends at the stomach. CT scan for your throat just investigates the pharynx and the upper esophagus. You have to investigate the whole track. A barium swallow is so helpful as it can detect strictures and masses along the swallowing tract. Barium swallow scan is cheap, safe and fast. The second step is pharyngoscopy and it may be needed or not according to the barium swallowing scan" "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 premature ejaculation and also my partner complains that I have a small penis. Is this related to premature ejaculation? Also, I have a small pimple on the tip of the penis. Kindly request you to advise me on the same. ### Response: Hello. Small penis is not at all related to PME (premature ejaculation). What is the timing, as you mentioned that you are suffering from PME? Then only, I will be able to suggest a treatment. Small pimples over the tip of penis is normal. Also, send details like color, consistency of these pimples, are they painful or causing itching. Kindly answer all these questions, so I will be able to help you better. Revert with more information to a general practitioner 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 24-year-old woman suffering from hemorrhoids. I have a feeling that my anus is reducing in size. My doctor has advised me to do a surgery for removing it. But my hemoglobin levels are low. So my doctor recommended me to increase the hemoglobin levels. I am taking iron supplements to improve my hemoglobin levels. I am very depressed. I have a fear that a delay in surgery can worsen my condition. Please suggest some remedies to prevent the shrinkage of the anus. ### Response: Hi. You have to remove piles through surgery as it is increasing in size. Anal shrinkage is not a complication of piles. Because of the enlargement seen in piles, the anal area looks shrank. Avoid taking excess spicy foods." "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 observed a white round swelling at the right rear of my mouth cavity behind the last tooth. Also a white straight line behind my uvula. Sometimes I feel that something is stuck there in my throat. No other symptoms. ### Response: Hello. Your symptoms can be related to many diagnoses. A picture if possible would help. It can be a yeast infection, a viral or a bacterial infection. I suggest you do some examinations such as a throat culture and a blood test. Meanwhile, some tips: Hope my answer was helpful" "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 22 years old. I have problems with my beard. My beard grows in patches, only in certain parts of my face. The remaining areas are clear without any facial hair. It makes me look awkward. Does any supplement encourage hair growth and solve my problem. Is that possible doctor? ### Response: Hello. Beard and mustache are said to be secondary sexual characters. Some people may not get the full area of beard distribution at a young age. The area and thickness of facial hair increases as you grow. Repeated shaving also increases the possibility of hair growth and thickness. But you should also know that there are chances of some treatable causes like fungal infections or a condition called alopecia areata which commonly affect the facial hair growth. Have a balanced diet with high proteins, vitamins, and minerals. You can also take Biotin supplements. Get back to a dermatologist online with clear facial photos, to rule out the causes for incomplete facial hair growth" "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 37 years old. My random blood sugar level is 227 today, but I had a sweet tea 15 to 20 minutes before getting the test. Should I test it again? Can I still control my diabetes or does it have no treatment? ### Response: Hello. I went through your post. You have not mentioned whether you are on any treatment for your diabetes. However, I would suggest a few things. Regards." "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 two marks on my labia. They neither cause me pain or discomfort. I have labeled them in the photo. I believe one of them is an ingrown hair. I am not sure what the second is? I did not have sex for a few weeks and while doing sex I used a condom with the same partner. I am wondering if this looks like herpes or HPV? Does this look like an std? Is this a concerning presentation of my labia? ### Response: Hi. I have gone through your history and picture and understand your concern. (attachment removed to protect patient identity). These spots could be due to inflammation or a simple fungal or bacterial infection. Apply some ointment on it and keep watch on it (size, color, and pain). 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 a history of back pain and pain during intercourse as well as bleeding after. My pap smear came back CIN3. What can I expect? ### Response: It depends on practices prevalent in your country and the prevalence of cervical cancer in your locality. Normally we would do colposcopic directed cervical biopsies to rule out cervical cancer and act according to the report of biopsy. Some doctors may prefer removing uterus after cancer is ruled out, especially if your age is more than or equal to 45 to 50 and if childbearing is complete. If there is a chance of cancer, extended surgery (for removal of the uterus) may be required. Kindly do not get frightened by the answer, as I have just mentioned possible treatment options we consider in our setup. All options may not be applicable in your case." "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: One week ago the back of my son\s legs became spotty most of the spots became blisters, looked a lot like chicken pox, but some stayed as little spots. He also has a few spots on the outer side in his elbows, but these have not blistered. He is not ill, and not on any medication. ### Response: Hello. I will not be able to diagnose and grade your disease without a photograph, so would you mind in sending the good quality photographs taken in a natural light so that I could prescribe you the best according to the grade." "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: For the past few weeks, my mother aged 65 is experiencing chest pain or slight discomfort only when she walked for a while. We consulted the medicine doctor and he recommended the stress echo test which we got done. The test comes out to be positive but not strongly positive. We need another opinion on the report that comes out. ### Response: Hello. If she is having consistent chest pain or heaviness or discomfort on exertion, then it suggests the possibility of blockages. And stress echo additionally supports this possibility. It shows hypokinesia with stress which is suggestive of blockages in heart vessels. So, she should be on medicines like Aspirin, statins like Atorvastatin and nitrates, and these medicines are the most important part of her management. And she should also undergo angiography for confirmation of blockages and further treatment. So she should at least have medicines regularly till angiography is 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 have a very sore penis from excessive masturbation and vigorous sex. The shaft of the penis seems to be less firm that it was in the skin and appears to be stretched out near the head of the penis. There is no pain but mild soreness. There is some soreness if I try to play with it. There are no signs of bleeding or bruising that I can see. The penis seems to be numb and unresponsive to touch and also very hard to achieve and maintain the erection. I am currently on Seroquel Restoril and Nortriptyline. Is it permanent damage to the penis? This issue has been quite worried, and I am not able to sleep well. ### Response: Hello. The penile soreness is probably due to infection as penis appears to be reddish, due to this it feels soreness. It is not permanent damage and will be normalized once treatment is taken, which includes antibiotics. Antibiotics are to be chosen after culture and sensitivity test. Hope this helps you to decide further course of action." "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 went in for a regular eye exam and told I have an epiretinal membrane. Last year I had floaters and flashing and went to a specialist who said all is fine. I went for new glasses and they told me I had an epiretinal membrane. I have an appointment next week with the specialist, but so worried I may need surgery. My husband passed away recently and a few weeks later my mother also passed away. I did the eye graph exam (from internet search and there is no distortion). Is this something I can live with or shall I have the surgery next year? I have no one to help me and may have help next year. ### Response: The epiretinal membrane will decrease you. There is a jelly-like substance in the eye and as age progresses it starts to liquify and you start seeing floaters. You should go to an ophthalmologist immediately in case if there is an increase in the number of these floaters or if you are seeing flashes of light. Because these are the signs of retinal detachment. Get your retina checked at least once a year. Right now you have to ignore the floaters and you will get used to it. The surgery is only necessary if you have difficulty in seeing or retinal detachment or cataract. You can talk to your doctor about it and tell you are not comfortable going for surgery until next year. Next time you attach the reports given by your doctor it will be helpful for 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: I am suffering from nightfall for past three months. Please give solution to stop nightfall. ### Response: Hello. This is normal for young individual who thinks more about sexual things. Practice the following to control the nightfall. 1) Take Fenugreek (methi) with honey daily. 2) Take curd daily as it helps to sleep better without interference. 3) Gourd juice also induces better sleep." "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 got blood in my cough two weeks back only once and there are red pimples on my neck. I am feeling weak. I used to take tobacco one year back which I left after rehabilitation. I have read that these are symptoms of cancer. ### Response: Hi. Do not panic. At this young stage lung cancer is unlikely, blood in sputum has multiple reasons like bronchitis, bronchiectasis, which can be treated. The red rash can be a local vasculitis or allergic cause too. Kindly do a routine blood test and chest X-ray and contact us through profile for further follow-up." "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: Just over a week ago, I developed severe swelling and soreness on the left side of my throat, particularly at the base of my tongue. My left ear is also in a lot of pain. Swallowing is extremely difficult and I went to see local urgent care where they prescribed me with Amoxicillin 500 mg and said it was most likely pharyngitis even though I have not had tonsils for many years.My main concern, even though it is a worse case scenario, is esophageal cancer through HPV can occur, as my girlfriend was recently diagnosed with HPV. Again, I know this is the worst case scenario, but since she was diagnosed I really been concerned about HPV-related cancers. From what I read and what I\ve been told, there are no real tests to check in men for HPV and even though there is the vaccine it is not recommended for men ages 26 to 45 years.I have already been taking Amoxicillin for about four days now and nothing improves. I have also tried taking regular over the counter cough drops and gargling with salt water. This has not helped at all either I have also been told that throat cancer from HPV can usually be spotted unless you have lesions in your oral area. Right now I am at a loss of what I really need to do? Any help or advice would seriously be appreciated. I am also under Amlodipine 5 mg. ### Response: Hello. Your problem can be due to pharyngitis. It is possible that Amoxicillin is not effective enough in your case. You may need some other antibiotics. I want to see your throat myself. Can you send me a picture of your throat? (I should be able to see posterior pharyngeal wall and tonsils). We can think of HPV-related problems only after ruling out other infections. Did you lose your weight? Are you having any swelling in the neck (lymph node enlargement)? The only way of ruling out HPV-related oral cancers is by taking an oral biopsy. Before concluding anything please send me a picture of your throat. I will be able to guide you in a better way." "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 attached my two ECG reports here. Are they normal? They were taken consecutively, 1 minute apart, the one with 106 heart rate was taken first and the second one with 93 heart rate was taken later). I see some broad peak in the second one. I am not sure if it is an error or something else. My questions are as follows: Do both ECG charts represent healthy heart? The reason why I went to the hospital is that I felt chest pain and I checked my heart rate by a phone application. It gave a normal reading except for one time it gave 39, but immediately after that it gave 79. Do you think the 39 heart rate is an error? Should I feel relaxed and be assured that my heart is fine? What is that broad peak? I have very mild mitral valve regurgitation that was diagnosed to not have any treatments. Also, before I did the ECG, I just ate and I was very concerned about the chest pain. Please explain. ### Response: You may rest assured as I have carefully reviewed your health query, including both the attachments with different heart rates (attachment removed to protect patient identity)." "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 eyes are red and warm since the last four days. I wear spectacles. What could this be? ### Response: Hello. You may be suffering from conjunctivitis or some other eye infection or it might be some allergy which is common. You should wash your eyes with warm water mixed with a pinch of salt (similar to one prepared for gargling, but with lesser salt). Do this every two to three hours for three to four times in 12 hours. If redness is reduced, then most probably you have conjunctivitis. In any case, you should consult an ophthalmologist personally for a checkup, as redness and warmth may mean a lot of things and can be diagnosed better with a thorough 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: I had unprotected sex a few days before my expected date of periods. The period is now late by a week. I have been having cramps. I also had a brown spotting, but there was nothing after that. ### Response: How are you doing? Hope I have clarified your queries. Do write back. All the best" "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 married for eight years, it was a love marriage, and things were fine initially. Three years back, my husband left his job to pursue his passion for becoming an entrepreneur, and I supported him in whichever way I could, both mentally and financially. But, things did not go as per the plan. He has always been a very confident person, who has always thought high of himself. So, because of all this, his weekly drinking habit got converted to daily drinking. It has been three years since we had any sexual relationship. When I try to confront him, it only ends up in an argument, and he tries to pull me down mentally. Things took an uglier turn when he verbally abused me, and I had to leave the room to protect me and my kid. He keeps abusing me mentally in front of our 5 year old son. It is very disturbing to see our kid being raised up like this. It has become a routine for my husband, although lately, he has become very sensitive about me. I told my father about this, and he asked me to come back home. My mother is suffering from blood cancer, and she will live only for 2 to 3 years more. She does not know about all this, if I leave everything today, I may loose my mother way too early. She will not be able to bear it. I am so mentally sick and irritated, and I do not know wat to do. My husband says that things will change. Is it advisable to forget everything and start fresh? My mind is saying no, but I cannot disturb my parents anymore. Please help. ### Response: Hi. I have read your query and understand your concerns. I hope this helps you. If you have more questions, feel free to write 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: I am suffering from anxiety and depression from past few years. I took various antidepressants. Now I am taking Vilazodone, one tablet in the morning and Lonazep 0.25 mg from last ten days. But I am having breathlessness and palpitations when I do any small physical activity and irritability. My hands get numb, and itching occurs on my hands and legs. I guess it is because of diabetes. I feel my chest is heavy, and my legs and back pains a lot. My sugar level is 130 fasting and 235 postprandial. I am taking Glimisave M. My sugar levels fluctuate badly, and my HbA1c is more than 7, a few months back. I think due to sugar intake it is out of control; otherwise, it is normal. I have very low energy due to depression medicines, and I am very drowsy, and irritability does not reduce. I have negative thoughts, and my hands get numb. I have a habit of chewing tobacco. Please, advice some treatment. ### Response: I am sorry to know that despite the best efforts you are not responding with current antidepressants and there are active symptoms. In case you have more questions, feel free to write 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: I have an X-ray. I like an ENT to give me their opinion. My dentist thinks that my upper molar area that is close to the sinus may have an issue based on how the x-ray looks. ### Response: Hello. There does appear to be a radiolucent shadow in that upper molar area. But we need to correlate the findings with your symptoms." "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: Lately, I have been feeling lightheaded and unbalanced. I have been diagnosed with panic attacks once in the past. I am not sure if I am getting the same panic attacks again. Please advice. ### Response: Hi. The symptoms of panic attacks are episodically occurring attacks for a duration of 10 to 20 minutes. The symptoms include: Also, panic attacks are followed with constant apprehension regarding a future episode and change in lifestyle due to such episodes. If you have at least 4 to 5 of the above symptoms, then you have a panic attack, or else you could have any other illness. If you have only lightheadedness and imbalance, then it could be due to any cause related to brain or inner part of the ear. Kindly book for an online counseling session to discuss more details regarding your problems so that we may help you in a better way." "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 Spirulina 500 mg tablet be taken twice to replace the intake of 2.5 mg folic acid and vitamin B? ### Response: The amount of folic acid or vitamin B available in a capsule of Spirulina is not sufficient to meet the daily requirements of these vitamins. So, it is essential to substitute it by other vitamin supplements." "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: Ten days back I had green chilies and sprout. While coming back from office I felt discomfort around belly button then coming back from office I had buttermilk and after that fried rice and basa fish. After that loose motion started for five to six times at night and there was mild pain around the belly button. Took Norflox TZ then flow came down after day after I visited doctor yesterday seeing no improvement and after examining he did not suggest any test. I insisted him but still, he said nothing needed. Medicine advised by him are as follows:Pantocid DSR one in empty stomach for seven days.Brakke one after breakfast and one after dinner for five days.Telday 40 at 6 PM (this is ongoing medicine from last three years for blood pressure).Cyraflora one after dinner for 10 days.Lots of drinking water and one liter ORS every day.Today morning the loose motion was somewhat solid but again after lunch, I had pomegranate and two chocolates and again had loose motions. I have no abdominal pain, quite active, no fever, only feeling that I will pass stools if I try to fart. Stool color as mentioned to doctor and you as well is oily foam (which is causing me tension). I know I should not have had the milk chocolates and mixture today. All I need to know is:If the medicine prescribed is okay or not?I just quit smoking as well from last day so I think recovery should be early already three days past?Can this stomach upset be any other underlying health issues (like cancer and all)? I am very tensed.Any tests needed?What all to have in the daily diet for a healthy gut and what exercise is needed?Can tension worsen this situation? ### Response: From what you mentioned, you have gastroenteritis. The medications prescribed are suitable. It is less likely to be due to cancer. At the moment there are no tests needed. Have a healthy diet with enough vegetables and fruits, avoid spicy and rich foods. Stress can cause diarrhea and bloat" "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 22. I had an intercourse two months back. I got my period on 13th of last month and I did not get in this month. What should I do? Need your help. ### Response: Hi. Please do not worry. Get a urine pregnancy test done. If it is positive we will opt for medical termination of pregnancy. Please note that medicines to induce periods is different in case of pregnancy test being positive and negative. Kindly review with a pregnancy test. UPT." "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 distal phalanx of the left-hand middle finger is broken (complete and open fracture) along with nail bed injury five months ago. As of now, I was feeling some abnormal activities at the fracture site. So I went for an X-ray, and it shows half of the bone is healed from the lower side, and the upper side of the bone is still unhealed. ### Response: Well, we have to treat the patient and not X-ray. Kindly describe the abnormal activity you are feeling. Secondly, anything which you are not able to do with this hand?" "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 29 years old with a Paragard IUD, and it has been dropped beyond the normal place. I was told to get my IUD out. I have an abnormal discharge, and I am 10 days late on my period. I got a pregnancy test done, and it was an error. I had an ultrasound, and I saw what looks like an ectopic pregnancy. I am concerned that I saw a heartbeat and a living thing in the scan. My IUD seemed like it was just about to come out and did not appear to swell my fallopian tube. I was told by the technician if the IUD is taken out, then I will be fine. I have unprotected sex every night, but my pregnancy test is an error. If the ultrasound is not negative or positive and looks like a heartbeat and not a flat line, then what does it mean? If it is red and blue scan, what does it mean? They kept asking me about my period for more than five times. The technician had her supervisor suggestion that the IUD needs to come out. I am having weird discharge, bloated, painful stomach and diarrhea. I had a miscarriage last year and the symptoms were the same that time. What shall I do now? ### Response: Hello. You are missing the most important thing that is the pregnancy test is an error, which means it is not positive. Of course, if IUD (intrauterine device) is displaced from the normal position, there is a chance of pregnancy and also of tubal ectopic pregnancy. But, it is not that all cases have a tubal pregnancy." "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 daughter, by chance, poked her finger in my eye and I got a redness on my left eye, in the white portion. I had little pain for ten minutes and now it is better. I put refresh tears in my eyes as they are otherwise always red due to dry eyes. Can I use the same or do you suggest any other? ### Response: Having said that, kindly share photos so that I may guide you better. Regards. Revert with more information to 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: I always stutter or stammer while speaking. Please guide me. ### Response: Stammering or stuttering is either because of structural or functional aspects. A structural defect is most commonly tongue-tie if you had at birth during your speech development. Functional aspects are almost always due to stress and decreased self-confidence levels. (unless you got any neurological problem, which is usually not). To check for tongue-tie, try to touch your chin with tongue. If you can reach the beginning of chin, then there is no structural problem." "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 72-year-old female and I have a severe prolapse. I was told four years ago that I had a problem in my cervix. So was unable to have a ring fitted around the prolapse. I have been told that it is unlikely cancer. Now after having it all this time, I have been told there are alternatives to having a hysterectomy like having a mesh implant or having the prolapse stitched back. But, I am wondering if I could have either of these procedures due to whatever is on my cervix. I am on medications for diabetes and high blood pressure. Please help. ### Response: Hello. Cervical prolapse has four stages according to severity. In severe cases, surgery is the best solution to relieve the pressure symptoms and to prevent complications such as urinary incontinence. The best solution is hysterectomy but in your case you refused it. I think you should discuss with your gynecologist about other surgical solutions such as laparoscopic fixation or Le Fort surgery" "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 it possible to get some sort of sinus infection from accidentally aspirating soup when you are eating? I always make the mistake of choking on ramen and it has been happening a lot lately. I noticed in the last two months that every time I have ramen and choke on the soup, I get a sinus infection or something that feels like uncomfortable post nasal drip. Could it be because of choking on the ramen? ### Response: It is very unlikely that you develop a sinus infection following consumption of any food. Post nasal" "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 getting some sound in both the ears. It continues as a mild sound of high frequency and another sound like humming, vibrating and pulsating sound. This becomes noticeable in the quiet zone and less prominent in working or outside areas. It is mild tinnitus, but bothersome in the night and silent area. However, I do not face many problems to get sleep. I get to sleep at 10 PM. Doctors say that there is no cure. There is a possible relief from Caroverine, but no doctor recommends that. There is sound therapy (experimental), which can cancel out tinnitus sound and after a long time neural network stops generating such noises. There are two activities one at auditory cortex and second at cochlear hair cells of the ear. How to make out the location of fault? Please guide me and advise me what to do with this tinnitus sound. Which is the safe way to ease it? What are the recommended herbs or medicines other than vitamins? ### Response: Hi. Yes, you have tinnitus and many medicines are available to cure it. First, get an audiometry done to see if there is any associated hearing loss. I suggest tablet Cinnarizine twice daily for at least three weeks and tablet Vitamin B12 1500 mcg daily. Consult your doctor, discuss with him or her and take medicine with consent. Do not use earphones and even limit your mobile usage. Follow up with your audiometry report." "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 undergone bladder surgery for poor flow. Now, I have done some blood test. I am in confusion. I have got rheumatic fever before 20 years. I am taking many antibiotics for the past two months. Please suggest. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). Your ASO (antistreptolysin O) titer is raised suggesting antibodies against streptococcal metabolites. Your ESR (erythrocyte sedimentation rate) and neutrophil counts are mildly elevated suggesting a mild inflammation in the body. It can be due to urinary tract infection. Kindly continue the medicines recommended by your physician for UTI and consult your urologist for a deeper insight as it may be related to your recent bladder operation." "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 29 year old female, and I have started taking Femilon from last month, from the fourth day of my period. I forgot to take the 18th-day pill at night, but I took it the next day early morning as soon as I remembered. At that time, I did not have sex with my husband. After this on the first pill-free day, I had unprotected sex. Except for that one pill, I took all the pills on the correct time without any mistake. I am worried about pregnancy. Today is my fifth pill-free day, but I have not got my period and yesterday I checked pregnancy test, which was negative. Please help. Can I be pregnant? ### Response: Hello. You are unduly worried. A single pill miss is so common, and you have managed it effectively. Wait for your periods for next two days and if not, do not bother, start a new pack" "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 sister is 32 years. After her second birth, she got the problem of diffuse toxic goiter what is called Graves\ disease. She is on medication for the last six years. She is on Carbimazole. But, it is not effective as when she stopped taking the medicine she suffers again from the symptoms (heart rate and sweating). The doctor advised her to get treatment by radioactive iodide. But she is worried this can lead to infertility. So, the other choice was to do a surgery to remove the thyroid gland. But, she will be on Thyroxine for the whole life. I wonder if this is the only choice she has. And, if this is the case, what is the best for her as she wants to get pregnant and she is breastfeeding now.Note:The thyroid gland is diffusely enlarged with increased tracer uptake and homogeneous distribution.No definite focal lesion seen.20 minute Tc uptake = 5.2 %. ### Response: Graves\ disease treatment options are the following. Therefore, radioiodine ablation is the best and easiest treatment" "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 and took a pill after two days. Again in a gap of three days had sex and took an I-pill. 10 days later, I had periods, and after that, I have not bled since then. I took three home pregnancy tests which showed negative. What could be the reason? I am on regular Thyronorm 62.5 for hypothyroidism. I had ovarian cyst four years back, which was treated with medicines. ### Response: One thing is clear that the pregnancy test is negative. We will have to investigate the reason for not getting periods. Get an ultrasound pelvis done. There can be ovarian cyst again as they tend to recur. Also, I suggest you take progesterone tablet like 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: I am 64 years old. I am nondiabetic. I did a complete health checkup and found my Hb1Ac at 6.5 %. I have a CRP of 35 mg/L. I have PSA at 4.4 ng/mL. My urine culture report shows a negative result. Is there anything abnormal? Please suggest. ### Response: Hi. I have gone through the reports (attachment removed to protect patient identity). The most concerning result is about your blood sugar levels. It seems that you can have diabetes. Please consult an endocrinologist for a proper evaluation. Your HbA1c is high, and blood sugar levels are also high. Avoid taking sugars in the diet and do physical activity regularly. PSA (prostate specific antigen) is very commonly high at this age group. It alarms you to have a regular follow-up visit with your urologist. It is good to check your prostate soon. Your C-reactive protein levels are also high. It can happen due to any specific inflammation." "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 facing severe pain near the tail bone, I use a computer daily, and I play badminton. I even applied gels but no use. ### Response: Hello. I have studied your case. Due to microtrauma, there may be fibrosis formation. Do hot fomentation over the sacrum. It will take weeks to months to subside. Use ring cushion and take sitz bath [sitting in lukewarm water for 10 minutes]. Take analgesic like Nucoxia 90 (Etoricoxib) once daily along with tablet Methylcobalamine 1500 mcg once daily consulting your doctor. If not relieved with all these methods, then local injection may be required. You can take this consulting your doctor. Clinically spinal origin of pain needs to be ruled out if required MRI spine can be done. I hope this answers your query. If you have additional questions or follow up queries, then please do not hesitate in writing to us. I will be happy to answer your queries." "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 a candida albicans. I used emergency contraceptives as and then but I treated it with Ciprofloxacin antibiotic. I also started using cotton pants, took care of my vagina too. Then last month, I went to the clinic and retook the test hoping it would come out clean. Then they said I have a staphylococcus infection. It was moderate and I took the same antibiotics they prescribed. I did not have any symptoms but I treated it anyway. Then, earlier this month, I had catarrh which I also treated with an antibiotic. Now, I am four days late from seeing my period. I am very scared, I do not think I am pregnant because I check with a strip two days ago and it tested negative. I am just very scared because I feel it was the infection that is delaying my period and it is messing with my system inside. How dangerous are staphylococcus infections, and why have I not seen my period? ### Response: Hi, Welcom to ciliiq.com. You do not need to be scared. Vaginal infection should be taken care of, but these infections are not uncommon in sexually active females. So do not worry. If there are no symptoms, taking antibiotics every time may not be the right thing to do. Just maintain hygiene. Staphylococcus infection is also not an uncommon vaginal infection, sometimes even contamination from the surrounding areas while taking swab may show such a picture. Period delay due to this seems unlikely. Wait another week and recheck in the urine. If still negative, see a gynecologist who can examine you and find out the reason for it. It could be hormonal imbalance or a uterine or ovarian pathology. 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 a 54-year-old woman. Around four to five months, I have been experiencing heavy hair fall in the frontal and lateral region. Since the past one year, I am also experiencing thyroid conditions (hypothyroid 6.40) along with stress and menopause (menopause onset was seven months before). I can notice new hair follicles but very less in number compared to hair fall (more than 100 at times).I have taken multivitamin tablets for a month. Now, I am taking menopause tablets. I have been applying onion, aloe vera, and ginger oil for the past two to three months. Also, I am consuming yogurt, milk, dry fruits. Kindly suggest some measures to arrest the hair fall and initiate hair growth. Also, suggest dietary restrictions and additions if any. I am a housewife and mainly do household chores, though nothing significant. ### Response: I understand your concern. Thyroid issues and stress causes hair to fall. Please send me images of your scalp to assess your hair loss better and help you accordingly. Meanwhile, you can start using this. Kindly consult your doctor to discuss and take the treatment with consent. 1. Anaboom anti-hair fall serum on the scalp once a day. 2. Tablet Keraglo Eva once a day. 3. Keraglo-AD shampoo thrice a week apply on the hair for 10 mins and wash off. Also, get the following tests done 1. Hemoglobin. 2. Serum ferritin. 3. Vitamin D levels." "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 met with a girl a few months back. She had been rubbing her vagina and then put her finger in my backside. She said she was clean but hard to know. After about three months, I got tested for STD panel and came up negative with everything including HSV 2 except for HSV 1, which came up positive. However, the test used was herpeSelect Elisa IgG, which I read is known to have false positives. My score was 3.3. I read if the score is less than 3.5 then it could be a false positive.A week later, I retested using herpeSelect immunoblot, which is supposed to be more accurate and tested negative for HSV 1 and 2. However, for the past three months, I am having itching in my backside, which could be due to sweat and anxiety. Do I have anything to worry about or trust the latest results that I have no herpes and put this to rest? ### Response: Hello. 1. The manifestation which you are saying are not of herpes, they normally present as grouped vesicles on an erythematous base. 2. Herpes has an incubation period of five days, it means symptoms would have to develop within five days of infection. 3. Your test are absolutely normal and you do not have to worry about it. 4. If you would have any vesicular eruption which is extremely painful, then you would have chances of herpes, so go for Tzanck smear and DFA (direct fluorescent antibody) test for it. 5. Always indulge yourself in safe sex practice because herpes genitalis caused by HSV 2 (herpes simplex virus) is an incurable condition." "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 an abdominal ultrasound scan done today and report shows that my liver is mildly enlarged and shows diffuse coarse structure. No focal lesions noted and span is about 15.5 cm in the mid-clavicular plane. I am a known diabetic for the past 6.5 years, and even has some blood pressure around 130/80. I am using Betaloc-50 for that. I am having acidity problem regularly. 13 years back, I had a mild fatty change. ### Response: Hi. Such findings in ultrasound represent fatty liver disease. The causes can be alcohol, non-alcoholic fatty liver disease, chronic hepatitis B, and C. In such case, I would advise you to get liver function test, anti-HCV antibody, HBsAg, In case these reports are normal, and you do not consume alcohol, it means you have a non-alcoholic fatty liver disease. Get the tests done and revert back with reports." "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 guy penetrates my vagina without protection and I do not know his status. It was for approximately for 10 seconds. What are the chances of contracting HIV and should I get a PEP? ### Response: You had a low risk for HIV acquisition. Studies have shown that risk of HIV acquisition through receptive vaginal sex (receiving the penis in vagina) to be 0.08 % (one per 1250 exposures). Post-exposure prophylaxis needs to be started as early as possible within 72 hours of the exposure." "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 relative aged 82 years is suffering from prostate cancer. It was discovered one year ago. Surgery was done eight months ago, and it is still spreading. He is not diabetic. Will chemo might be fatal? ### Response: Hi. I have read through your query in detail. Please find my observations below. It is important to know when the cancer spread was first detected. If it has spread to involve other areas then it is likely to be stage 4 cancer. I have served in a cancer institute for years and have seen many patients like him getting chemotherapy to prolong life. Liver and kidney functions and general condition should be maintained during treatment. Radiation also helps many patients. Usually, the survival of a patient with advanced stage cancer is not more than two years with good care and treatment. This is an average and rarely patients might survive to three to five years. Chemotherapy and radiation therapy might help to extend the life of the patient and slow the disease progression but cannot cure cancer. At the age of 82 years, it is important to give him good nutrition and diet with proteins and vitamins. Pain relief is important for him and this is to be discussed with his doctor. Please see that he is comfortable. Hope this answers your question." "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 recent accident happened to my father which makes him unable to walk. A week ago, he suddenly fell on the ground while walking and his right leg was injured. He was transferred to hospital and X-ray indicted his leg is not broken but severely ricked, as a result, it is not moving and will need time to recover. However, the problem is not the injured right leg but the left leg. His left leg is fully functional (i.e., he can move his knee and toes without any pain and numbness) in laying down and sitting position but once he stands up, he can not even rise up his left leg from the ground. Therefore, he is now completely paralyzed and unable to walk. What could be the reason?Here are some details about his medical background. He is about 70 years old. He has been suffering from type 2 diabetes for over 20 years and three years ago was prescribed to use Insulin. Recently, his doctor told him that his blood sugar is under control. He experienced previous imbalance feeling and fell several times while walking in past. Basically, whenever he stood up, he would need an effort to gain his balance. His hands also have been shaking a bit. He had an open heart surgery 10 years ago. He had a back pain (even in laying down position) which went worse after the accident. He has lost a majority of his vision over the years due to glaucoma. His X-ray indicates no broken bone. ### Response: I read carefully your question and would explain that this clinical situation could be caused by a stroke, which is probably the cause of falling. Another possible cause would be a nerve damage related to the trauma. For this reason, it is important performing a brain CT (computed tomography) scan or MRI (magnetic resonance imaging) to investigate for a possible stroke. If this test result is normal, I would recommend performing a nerve conduction study to examine his nerves" "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 an issue with my foreskin, it does not retract and it hurts whenever I have sex. I do not have pleasure during sex, and it is also difficult to keep personal hygiene in those areas. I am a bit afraid that it can be phimosis. It is not from when I was born but happened suddenly and unexpectedly just a few months ago. What should I do in this situation? Where shall I go? Do you think I will need to have a surgery? Please help. ### Response: Hello. Relax and do not worry. Please send me images if it is possible. Yes, it is phimosis. And from what you are describing, it sounds like severe phimosis. You will have to get a circumcision done. So, please consult a nearby urologist." "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 18 years old. I want to ask about having sex after periods because I am so worried my mom and dad will find out I am pregnant. I had sex today after my period and it was from the past two days. ### Response: Hello. Pregnancy usually occurs when sexual activity is practiced without protection, during the fertile period. You can estimate your fertile period using the calendar method. If your menstrual cycle is regular, then ovulation occurs 14 days before the next anticipated period. So, around that ovulation period, one week on either side is fertile period. As you had sex just after your period, it is unlikely to cause pregnancy" "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 has got high BP. Her BP is 160/100 mm/Hg. What we have to do to decrease it? Please suggest. ### Response: She has stage 1 hypertension. For that lifestyle modification is needed. Take low salt diet. Use potassium salt for cooking. Fruits and green leafy vegetables can be taken more. Avoid a sedentary lifestyle and do active exercise daily for half an hour to one hour. If the blood pressure is not controlled by lifestyle modification, then medication like Telmisartan or Amlodipine can be started with a low dose. The secondary cause of hypertension can be ruled out by renal doppler arteriogram, urine VMA (vanillylmandelic acid) estimation, serum sodium, potassium, and aldosterone estimation" "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 experiencing pain in my urethra while urinating for weeks now. Also, have mild pain in my left testicle. Today morning when I woke up at 6 AM, I observed a milk-like liquid drop at the tip of my penis. Is it a sign of any kind of STD? ### Response: Hi. I can understand your concern for your symptoms. Yes, infection should be ruled out. If you had unprotected sex with someone, then we can think of STD. If yes, give more details for investigation. If not, it can be other bacterial infection. Retrograde ejaculation can also cause this kind of discharge. Do a urine complete investigation for better understanding and treatment regime." "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: What are some foods or liquids that you can eat when you have or are recovering from the stomach flu? Kindly tell the foods that are easy to digest and give a nice boost of energy or nutrients. ### Response: Hi. Whenever one suffers from gastroenteritis or stomach flu, there is fluid and electrolyte deficit because of frequent loose motions and vomitings. So main aim of treatment is to restore the lost fluid and electrolyte plus to treat the infecting germs causing the disease." "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: Since last week, I have been entirely unable to sneeze. While I have gotten the urge to sneeze many times, I cannot complete the act. In other words, I experience the \ah\ but not the \choo.\ I am very concerned, as I have never had this before. I have read on the internet that it could involve the brain stem. I do not have any other symptom that stands out. ### Response: I read your query and understand your concerns. I hope this answers you. Feel free to contact me if you have more questions" "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 in testicles when I touch them. Can you please help me with this issue? ### Response: Hi. You can have two things, epididymo-orchitis or testicular torsion. Treatment for both are totally different." "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 26 weeks pregnant. This weekend I had my glucose tolerance test (3 hours) and on which I failed badly.My fasting numbers were 172, 325 and 318. I know they are bad, but my doctor never told me to follow a strict diet of three to five days prior to the test.In my pregnancy, I have been craving for a lot of sweet things, so kept having them. Iced tea, cold drinks, juice, ice cream; anything sweet you can think of.This is the reason that caused such a high levels of sugar in my blood.To confirm that I have gestation diabetes I am going to repeat my test and I have been following the required diet before the test.What do you recommend me? Should I repeat the test? Can the numbers be lower next time?Should I take high carb diet and avoid all the sugary stuff for test? Please suggest. I am extremely worried. ### Response: You are suffering from gestational diabetes mellitus without any doubt. As per IADPSG criteria (International Association of Diabetes and Pregnancy Study Group) and DIPSI criteria (The Diabetes and Pregnancy Study Group India) both makes you overt diabetic. These levels demand for a strict diet control. If the repeat OGTT (oral glucose tolerance test) also shows similar values, then you would have to be started on human Insulin for controlling your sugar levels. Revert back with the reports to 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: My daughter is 2 years and seven months old. From five days, she has little bumps on her finger and she is having an itching sensation especially during nights. This happened after she played with clay in the garden. I am assuming it to be some insect bite. I am not sure though. Please advise. ### Response: Yes, there is a strong probability of some sort of insect bite. Keep watch, she might feel sleepy after Atarax. Apply calamine lotion locally. If the swelling does not disappear in two days, she may require antibiotics to prevent infection. As of now no need. It may be painful, give her syrup Ibugesic 2.5 ml twice a day morning and evening post meal. All medicines to be taken after doctor\s 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 am female, have good health, fit, and 45 years old. For the past two days, I have had a small amount of tingling in the upper lip. No weakness, no face or body numbness, no headache. Please help me. I have severe myopia and wear glasses. ### Response: Hello. Your symptoms are so localized that it is really exceptional for any neurological disorders like MS (multiple sclerosis), Guillan Barre or any brain tumor (other symptoms should be present and the beginning is a little slow and progressive)." "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 Hb is 15.8 but HCT is 49.2 and total RBC count is 5.63. What is the reason? I fear about polycythemia. Is it possible to reduce HCT? ### Response: Hello. If you are a smoker, then stop smoking. At this stage, secondary polycythemia is more common than primary and smoking is the most common reason for secondary." "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 twin nephews who are 45 days old. I feed them with NAN of 90 ml for every two hours. Is there any established time interval and quantity to feed infants? Please suggest. ### Response: Baby\s are fed on demand, and it is not given with a fixed time interval. Usually, it takes two to three hours to have gastric emptying in babies. When the baby is fed before two hours, it results in overfeeding. As babies are on formula feed, they may take time to get digested. Do not delay the feed for more than three hours. You can increase the feed after third or fourth feed. It depends on the ability of the baby to digest. Demand feed is safe if babies are in full-term weight." "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 get a second opinion on my dentist\s plan to fix my missing teeth. I am missing my upper lateral incisors since birth and have had a temporary resign bonded bridge since I was 17. I am now ready to take the step to a more permanent solution. My two options are a bridge or implants. After my X-rays and MRI scan, it became apparent that I do not have enough bone for implants and I would need a bone graft. Since I would need at least 3 mm for each side, my dentist told me that there was a chance it might not take and I would need another surgery. The position of the roots of the adjacent teeth are not a problem, there is enough space to place the implants, just not enough bone.Initially, he did say he would prefer to do the implants, since it is a better solution for long-term. When my dentist asked the opinion of another dentist in the office, he said that the bridge would be a better solution so I would not have to go through multiple surgeries and it would be done sooner. The bridge is indeed a quicker solution, but I am not very keen on having parts of my teeth removed for the bridge. It will also need replacing at some point, and if the underlying teeth have a problem, the whole bridge needs to be replaced. Both my sister and mother have a bridge (they are also missing their upper lateral incisors) and I am not impressed with either results (these were placed by different dentists).I am fine with the process taking a little longer (and being more expensive) if it means it will give me a more natural smile, but I am also afraid that I will be going through surgery for something that might not even take. My dentist now does not want to express his opinion anymore, and just keeps giving me the pros and cons. Any insights would be greatly appreciated. ### Response: In my view, even though I do not have any pictures or X-ray, I believe it is better for you to get bridges. You can get costly Zirconium bridges which are highly aesthetic and looks exactly like natural teeth. Get those side teeth root canal treated to prevent future sensitivity or pain. This will give you a highly satisfactory result in my view. Implants need much bone support and as your lateral incisors are congenitally missing, the bone at the region will be very thin and any bone graft is bound to fail in > 50 % cases. For more details, send pictures if possible." "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 49-year-old female, weighing 79 kg with a height of 165 cm. I have gum disease and I am attending the dentist every three months for a clean in the hope of stabilizing my gums. My gums can appear red and I have noticed redness adjacent to my missing back tooth. I have redness along my gums which has been a long-term issue. I am just not sure about the redness near the missing tooth. Perhaps it has been there for some time. Would it be gum disease? I had an infected abscess in that spot two years ago. I have attached photos. ### Response: I feel the gum disease has caused a periodontal abscess. It is an infection with a collection of pus around gum tissues. You need to show to a dentist and get it treated. I feel along with periodontal therapy, the dentist may also prescribe some antibiotics to you. Your pictures (attachment removed to protect patient identity) are not really clear. You may also try to send me better snaps for clarity in diagnosis. Scaling and root planning need to be done with antibiotics" "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 dental scan the week I conceived my baby or possibly the day I conceived. Should I be worried? ### Response: Hi. The dose of radiation in a dental X-ray is very less and approximately 0.01 mSv. This will not cause any significant harm if you got X-ray done on the day you might have conceived. Please avoid X-rays during the pregnancy." "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 about to have an open inguinal hernia operation after 15 days. I have been having terrible anxiety leading up to it. I went to my PCP today and informed him of this. He prescribed 25 mg of Zoloft for me. I have read that it takes a month for Zoloft to work. Also, I have read that Zoloft can cause bleeding and complicated risk after surgery. I will be under general anesthesia. Is it safer for me to wait and begin taking the Zoloft after the surgery if I need it? ### Response: I would like to know that whether your hernia is the cause of anxiety. If anxiety is the case let me assure you that you have nothing to worry from surgical aspect as hernia repair is not a complicated or major surgery. So, the blood loss should not be worrying if you were only on Zoloft. But would like to know if you are having any other medication. Also, since your BMI indicates you are obese, which might be one of the causes for a hernia. Would like to know some other parameters like your blood pressure and sugars, your cardiac status as indicated by ECG and 2D echo. How is your exercise tolerance? Your coagulation profile, other basic blood reports like CBC. How about laparoscopic hernia repair? Or why not under regional anesthesia? Would also suggest yoga and meditation to relieve your anxiety and stress" "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 two upper premolars removed during my ortho treatment and the front two teeth bent inward. The new doctor corrected it, but now the same thing is happening again. Why? ### Response: Hello. Removing upper premolars is a part of orthodontic treatment if space requirements make it mandatory. This is done to take back your forwardly placed front teeth. The doctor should maintain the inclinations of the front teeth while taking them back. Failure of which leads to the appearance of teeth being tilted inwards since it is corrected now nothing to worry. I hope the space closure went well for you. I hope that answers the 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: I am a 47-year-old male. I am a known case of bronchiectasis since childhood. Is there any new treatment? Or new interventions for the best quality of life? ### Response: I can understand your concern. Yes, a new pulmonary antioxidant is available. May I know his current medications? Is PFT (pulmonary function test) report done or not?" "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 how many days of periods, sex should not happen to avoid pregnancy? ### Response: Hello. Your question actually pertains to a natural birth control method called rhythm method calendar method (you can search it on net). Let me tell you the safe days are the days you can actually have sex in order not to get pregnant but, this method is not full proof and there are failure rates too. Consider first day of your cycle (menstrual cycle) as the day from which you began to bleed. You keep a track of your cycles and determine your shortest and longest cycle but before that know it that your cycles must be regular. Substract 20 from your shortest cycle and 10 from your longest cycle and you get your safe days. Eg. Shortest is 26 Longest is 30. 26-20= 6 30-10= 20. Days 6 to 20 is unsafe for you. Rest all will be safe to have sex to avoid pregnancy. There are many other calculations for calendar which you yourself can search but my recommendations will be five days after the last day of your first cycle that is when the bleeding stops will be the safest (though not 100 percent)." "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 oxygen level is 93, my pulse is 95, and my heart feels different like maybe it is skipping beats or something. Should I go to the ER? This has been going on for about four to five days. ### Response: It is better to go to the emergency room and to get an ECG (electrocardiogram) to confirm the diagnosis. Do you have any history of diabetes or hypertension? These risk factors for atrial fibrillation are quite common for people your age" "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 going through depression. I have been having suicidal thoughts. I have been thinking about death quite often. Last time when I felt depressed, I tried to cut my veins, but got caught. For example the other day at school, I imagined a way of killing a girl. I do not know what to think. I just hope I am not crazy. Please help. ### Response: Hi. Firstly, I reckon that you are going through a very difficult time right now. However, you are dealing with it courageously, and I commend your effort to reach out for help here. 1. Depression.2. Anxiety." "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: From the last one week, I am suffering from nose blockage, fever, sneezing, and coughing. And from yesterday, I got my periods also. So my body is feeling totally weak. I am unable to stand properly also and also have a reddish color in the throat. What to do doctor? ### Response: The symptoms you are having are suggesting of possible viral flu infection. If you have a reddish color in the throat, then it is possible bacterial tonsillitis. Should get further checked by your physician as might need prescription medications. Use nasal saline spray to keep your nose unblocked. Apply cold balm on your chest and upper back to relieve congestion at night. Aerosol therapy can help together with taking anti-histaminic orally. Let me know if you have further queries. Wish fast recovery" "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 I use expired condoms? Is it dangerous? Will it affect my health? ### Response: Hi Use of expired condom will not cause any serious health issue. The following can happen: Even if the condom is expired, it is better to use it rather than not using one. Consult a sexologist online to know other modes of contraception" "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: Thought to have likely acute AIH for the past eight months. Currently, being treated with Prednisolone 8 mg to go to 5 mg and Azathioprine 50 much. My ALT/AST are within normal range last two months coming down from almost 2000. ESR has been steadily rising since past five months, commenced Azathioprine later, ESR was normal. Can you tell me your thoughts? I did not see the consultant for two months. I have been told all other blood reports are fine, ESR now is 52. ### Response: Hi. In general, ESR is a very non-specific marker. It has no significance in isolation. So you can ask your doctor for a chest X-ray. It is however not essential if you do not have any symptoms in general. So go ahead with your treatment. If you have any symptoms like cough, weight loss, then we need to do work-up for tuberculosis." "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: MTP in 4 weeks, LMP a few months back, checked now, it was negative. What is my problem? When can I expect my period? ### Response: Hi. MTP pills are hormone based so they can change hormonal balance in body leading to irregular menstruation. Also carry out pregnancy test. I would suggest you to wait for 1 week more and if menstruation does not occur till then,then consult a gynecologist and have yourself examined. But do not worry too much about it since it is a very common problem after taking pills and can be treated easily." "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 went to a doctor for a pain in the abdomen. After a few days, pimple-like blisters appeared on the center left stomach and center lower back. I went to the doctor again on day-2 of blisters and it was already fluid-filled. The doctor prescribed Acyclovir 800 mg five per day for seven days. I stopped Acyclovir on day-4 because of severe dizziness, but the blisters are already pus-filled, and bruise-colored. I am on day-5 of shingles now. Is it alright to stop the medication? Also, what are the chances of having shingles again as I get older? ### Response: Hello. Completing the prescribed course of medication during an active infection will reduce the chances and increases the gap between the episodes. As the age goes on, and when there is low immunity, there are chances of reactivation of shingles again. It entirely depends on your immunity. Shingles can occur anywhere in the body. There is nothing to worry regarding the site of occurrence" "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 took Lamotrigine for six years at around 300 to 600 mg I think. I have been off it and unmedicated for depression and anxiety for the last 5 to 6 years roughly besides some Xanax that I used three years ago. I am a 25-year-old male and have been having small memory lapses lately but they are very inexplicable ones and I wanted to know if there is any evidence that Lamictal use for the length of time I did could cause long term issues with memory or dementia. ### Response: Hi. As you mentioned that you are suffering from depression and was always undermedicated, in depression, it is common to have a disturbance of memory and attention which lead to forgetfulness. These memory issues are most probably due to depression itself and not due to Lamotrigine use. For depression, I would suggest you have an SSRI which are the best treatment strategies for depression and discuss your memory lapses to your psychiatrist." "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 applying MMC in LASEK surgery safe enough? Concerning risk with corneal opacity from LASEK vs corneal 370 \xb5m left after LASIK, which is greater? ### Response: Hello. Applying MMC (Mitomycin-C) in LASEK is safer and in many studies, it has not caused any problems. So, you need not worry. Coming to your second question, LASIK with 370 \xb5m left, is very safe as we take the safety level as 250 \xb5m. Hence I feel LASIK risk is lower." "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 37 years old. I have gained a lot of weight of late and my weight is 101 kg at 5 feet and 7 inches. I got all the tests done and I have a fatty liver and am pre-diabetic. Can I take Metformin for weight loss and diabetes? Can it help me in reducing the fatty liver? Please help. ### Response: I understand you are worried about your weight gain and being prediabetic. Hope it helps. If you need further assistance, feel free to ask. I would be glad to answer" "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 26 years old unmarried male. Please tell me what is the best medicine for penis enlargement in size and strength? ### Response: Hello. I read your query and understand your concerns. First of all, I like to inform you that there are no medications available for penis enlargement. This is only the marketing of bogus products and till date, there is no product discovered which can increase the penis size. The only approved option for enlargement of the penis is a surgical procedure. The surgical procedure is indicated when there is a condition called micropenis (less than 2 inches). With surgical correction, the size of the penis can be increased to the required size with little complications. I also take this opportunity to inform you that size of the penis have little relevance when it comes to sexual pleasure. As per the anatomical details of female, any penis which is larger than 3 inches can give required sexual pleasure. This is because only outer three inches of female have sensation and remaining part of the female vagina is insensitive. I hope this helps you. Feel free to write back to me if you have more questions" "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 doing a root canal on one tooth, it has been taking three sittings, and I still feel the pain during the procedure, and I cannot bear it. What shall I do? I am now terrified of going, and I want to deal with the painful tooth? What is your suggestion? ### Response: I understand your concern. Root canal treatment usually takes three to five visits. However, pain virtually vanishes from the second visit onwards. Underlying infection may make it difficult to obtain proper anesthesia, because of which it hurts during treatment. You should go through a complete course of antibiotics, as prescribed by your doctor, and in the same course, your treatment should also ideally get completed. Treatment may even take more visits, but pain automatically subsides with the elimination of infection. The procedure is almost pain-free." "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 taking Welbutrin for the first time and I have questions about the physical and mental side effects. Also, I have depression coupled with suicide and self-harming thoughts. In the past, I have been on Lexapro.I want to inquire if I am improperly diagnosed? ### Response: You are suffering from depressive features and hence the low self-esteem and self-harming thoughts. I suggest you take Zosert (Sertraline) 50 mg twice daily along with tablet Lonazep (Clonazepam) 0.5 mg at night for a period of two weeks. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. You need to focus on a new hobby. Give time for physical fitness.You can review with me for further followup" "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 60 years old and need a hip replacement. I am healthy, no diabetes, no heart problems. My sister had a horrible anesthesia awareness incident a few years ago, and now I am terrified to have my surgery because of any risk of being paralyzed but awake. What can I do to make sure I am asleep during operation? ### Response: I suggest you opt for regional anesthesia by a spinal and epidural anesthetic. They will give an injection between your spine, and this will make your legs numb and any sensation below the navel you will not be feeling. After the surgery numbness will go and all the sensations will be recovered. If you want to sleep, the anesthetist can give mild sedative, and you will be able to hear everything but no paralysis." "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 and I had unprotected sex four days from her period and she had taken the Unwanted 72 two days later. Her periods started four days before the due date and also stopped the same day. The flow was not normal and she was also having severe pain in the stomach. Kindly let me know if she is pregnant and the precautions need to be taken. Also, suggest the reason for stopping the bleeding on the same day. ### Response: Hello. Few basic facts about fertility. The ovulation occurs around the 12th to 16th day of periods. Life of the egg is 24 hours and that of the sperm is 72 hours. So I do not see any reason for you to worry as there is no chance of egg meeting sperms. But as she had an emergency pill, the hormone progesterone pill, the balance would have got disturbed. Usually, she will have the bleeding with thick dark blood seven to 10 days of the pill. Having a bleed after the pill means the inner lining of the uterus has gone. So, there is no chance of pregnancy. Maybe some more bleeding is expected. So, there is a pain in the lower abdominal area. Next period will be one month after this bleeding" "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 32-year-old male with somewhat oily and a very pale skin. I have an acne prone in the T-Zone. In the morning, I wash my face with lotion soap (non-antibacterial) followed by SPF 30 Face Lotion. At night, I use a 2% salicylic acid face scrub followed by 2% salicylic acid toner, and finally the face lotion. I have been doing this for about four years and it has eliminated my acne. Is it fine to continue this routine as I am in my 30s? Am I doing any harm? Is there anything else I should add to my routine to keep my skin healthy? ### Response: Hello. If you had acne then the application of 2% salicylic acid face wash does help. But, using the same for four years is not advisable as it leads to constant peeling of the skin and makes the skin photosensitive. Continue using sunscreen in morning. Kindly send images and revert back so that medications can be advised." "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 a dry cough for the last nine months. I am not taking any medicine for a dry cough. Suggest some test for a dry cough. What could be the reasons for a dry cough? ### Response: I understand your concern. I highly recommend to consult with a gastroenterologist and run upper endoscopy in order to determine the right diagnosis. For the moment, I advise you to avoid spicy or oily or high-calorie foods," "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 going to get married after six months. My fiance is my dad\s sister\s son. Our blood groups are the same B+. Will there be any problem to the baby? If yes, then what is the solution? ### Response: Hi. The blood group will not be a problem but, there are chances of high consanguinity. Consanguineous marriages are associated with an increased risk for congenital malformations and autosomal recessive diseases, with some resultant increased postnatal mortality in the offspring of first cousin couples." "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: Other than the Snellen chart method, how doctors will check the vision of a person? I am a lazy eye person with low vision. How will the doctor identify my vision percentage? ### Response: Hello. There are many methods to check vision, according to the age of the patient. For lazy eye, usually crowded charts are preferred with more letters in one row like ET" "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 T hormone is 157 dl and prolactin is 22. My sperm is 28 million and normal morphology. The scan showed normal testis size but grade l varicocele both sides but I have erection dysfunction and no sensation in my penis. ### Response: Your serum testosterone levels are on the lower side. But the semen analysis is good. So do not take hormone replacement now. If you take testosterone supplementation, chances of decreased sperm count are there. Grade one varicocele does not require treatment unless it causes changes in semen analysis or scrotal pain. You need a workup for your erectile dysfunction. See your urologist." "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 coughing, throat infection from last week. At that time fever did not persist and also did not felt any chest pain. Two days later, I consulted with a doctor. He prescribed Cavidur 625, Montek LC, Ambrolite syrup and Betaline gargle solution. Since then throat infection improved and frequent cough also coming out. Coughing also improved remarkably though not completely. From yesterday onwards fever is occuring (maximum 100-degree Celcius). I have not come in touch with any foreign returned person nor went outside. In our state, there is no incidence of Covid-19. Please suggest what to do? ### Response: Hi. I can understand your concern. In my opinion, you should get done a chest x-ray and CBC (complete blood count). If both these are normal then no need to worry much. 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 been suffering from groin fungal infection for a long time. It had healed six months ago by Onabet and some anti-fungal pills, but now it is back. This time it is scrotum itching. Also, on the penis. There are small dots on the penis and the top is red and a bit swelled up, maybe because I itched it. ### Response: I can understand your concern. From your description and clinical pictures (attachment removed to protect patient identity), it seems that your symptoms are due to a condition called the scrotal dermatitis. The cause is multifactorial. It may be due to irritation from clothing or some products you are using to wash the area. The main stay of management is remove precipitating factors. Loose clothing should be advised to remove the occlusive element. Use some absorbing powder after bath. Use Cortisol cream once daily for seven days. Take Cetirizine 10 mg tablets at night time. Review after one or two weeks" "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 unprotected sex with my boy friend two days before my actual period, at around 5pm. I took an i-pill within one hour after sex i.e, before 6 pm. It is three days more than my actual period date and I still have not got my periods. What are my chances of getting pregnant? Are there high risks involved in getting pregnant since I had unprotected sex 2 days before my period date? Should I do a pregnancy test? If yes then what tests should I do and when is the right time to do? What should I do? Please advise as I am worried. How many days should I wait, since today is the 3rd day and I still have not got my periods? Please help. ### Response: Please do not be worried. You have done a right thing by taking i-pill within 72 hours of last sexual intercourse. You were not likely to menstruate on your actual due date simply because it takes about 5-7 days for bleeding to occur after taking i-pill. It is also a known side effect of i-pill that the following menses may be delayed or may be heavy. In case periods do not resume in the next 10 days, then you must do a urine pregnancy test to rule out pregnancy. If the test comes as negative, then please do not take any medication. Just wait for your periods to return, till then practise barrier contraception. If the test is positive which is unlikely though, keeping in mind that i-pill does not cause any congenital abnormalities in fetus, you would need to make an informed decision as to continue or terminate the pregnancy (which can be done by medical methods in early first trimester after ultrasound scan confirmation). Consult a gynaecologist online for further follow up" "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 kissed someone who had chronic hepatitis B. So, I put my first hepatitis vaccination immediately, a second vaccination a week later and the third one, two weeks later after the second. Am I protected against hepatitis B? ### Response: Hello. Yes, you are protected. Although the booster is not taken, some amount of immunity is provided by vaccination, it is enough to protect. So, it will protect you. Now, the best way to confirm this is by getting immunoglobin titers done and if the titers are adequate, that indicates the complete protection. So, visit the nearby laboratory and ask for hepatitis B immunoglobin titers. Hope this helps you and get back if you have any doubts" "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 16-year-old female. I have been sick lately (sore throat, coughing up yellow, green stuff, etc) but this morning I woke up with my cough worse and my ear aching and ringing and throbbing. Anything I can do to make it stop? ### Response: This appears to be an upper respiratory tract infection leading to throat congestion and blocked eustachian tube leading to symptoms. You should have Augmentin 625 mg (Amoxicillin and Clavulanic acid) three times a day along with some antacid like tablet Pantoprazole 40 mg before breakfast once a day for five days. Also, have Betadine gargles four times a day. For cough, you have syrup Ascoril two teaspoon whenever needed up to three times a day and also have anti-allergic tablet Allegra 120 mg once a day for three to four 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: Is it necessary to check oxygen saturation if the patient is on oxygen for shortness of breath? ### Response: Hello. As you said that patient needs oxygen for shortness of breath, it is absolutely not required to measure the oxygen saturation all the time. But, if dyspnea (shortness of breath) is due to COPD (Chronic Obstructive Pulmonary Disease) that is due to excessive smoking, then controlled oxygen should be delivered by monitoring oxygen saturation through pulse oximetry. The reason behind it is that carbon dioxide is the only source of stimulation for respiration. Also, uncontrolled oxygen delivery has its own complications. To monitor response to oxygen given, the only method is to check saturation non-invasively. So, for this type of use, it is not advised to check saturation regularly. But if you require oxygen continuously, then it should be monitored through pulse oximetry." "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 taking Prevacid (Lansoprazole) 30 mg once daily in the morning since the early 90\s for what at that time was diagnosed as acid reflux. Recently, I have been experiencing some reflux after eating supper at night. Why would this start up again after being free of it after all these years taking Prevacid. The only change in my diet is I am reducing my daily coffee intake in an effort to stop drinking it all together. ### Response: 1. 2. The other possibility would be that you are developing tolerance. So, the medication may need to be switched to another medication in the same group giving you the benefit. The other possibility would be that you will have to stop Donovan and may need to switch to another medication in the same group giving you the benefits of cross-tolerance. 3. I would also suggest a good duster for H and R infection and try to avoid late night dinner. The last meal of the day should be two hours before going to bed." "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 29 year old married male. I have premature ejaculation problem. What are the ways for me to overcome it? Will exercises or workout help in overcoming it? Can you suggest me ways to overcome it? ### Response: Hello. Premature ejaculation in most individuals occurs because of associated anxiety, psychological reasons, and hyperexcitation. Relaxation and treatment of anxiety result in improvement in most individuals. The first thing you have to understand that it is normal to ejaculation earlier when even an individual start engaging in sexual intercourse. This occurs because of a poor experience, anxiety, and restlessness. Lack of confidence is also a reason for early discharge. So accept that even if you are ejaculating earlier even then there is no weakness in you. This is a normal thing, and you should not lose confidence for that.Distraction during sex is one method to delay the time. This will help in delaying the time. Use of Lignocaine jelly over the tip of penis reduces the sensitivity of the penis, and this helps to delay the time. This can be tried. If that does not help, then you can think of using medicines. Dapoxetine is commonly used to improve the time." "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 24-year-old female. I was engaged in some foreplay with someone last weekend. And they fingered me hard. Last night, I noticed a tiny bump on the inside of my vagina. It is a pea-sized right against the wall. It is completely painless, and I would not have even noticed it was there had I not put one of my fingers inside myself.Is it possible that this is just a cyst from the rough foreplay? It feels a bit smaller than it did last night, but I cannot tell. It almost feels like a pimple, But it is on the inside of my vagina, and I can only feel it by pressing my finger against it. What could this be? ### Response: Yes, probably it is due to injury caused by fingering. And if it is not painful and not causing any discomfort, then you only have to wait until it resolves spontaneously. And the other option is that after a few days say three to four days you can get yourself examined by your local doctor to make sure that there is nothing more than that and this swelling has been resolved entirely. I hope it has helped you should you require any further queries. Please do not hesitate to contact 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: I am a 29 year old male unmarried. For more than one year, I feel pain in the anus like throbbing (pain like beating in the anus) and feeling huge pain four hours after masturbation. The pain continues for five minutes or 10 minutes and gradually reduce and stops. Pain rarely comes. Sometimes, without masturbation also but if I masturbate pain definitely comes. It starts at midnight or sometimes in the day. I always drink plenty of water. I never feel any pain or any problem in passing stools. I am having type-1 diabetic and taking insulin injection for the last 13 years. I am taking insulin three times and I have my diabetics in good control. I do not know what type of problem I have. Which type of treatment is required? I am afraid of what might happen if I enter into a marriage with this problem. Please help me. ### Response: Hello. Your symptoms could be related to a local infection or coccydynia. Coming to this point, I would recommend consulting with a surgeon for a physical exam and an ultrasound of the soft tissues in this region. A dynamic radiography is necessary to investigate for coccydynia, which can be treated by surgery." "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: Should I always eat before workout? Why is it good to eat before you work out? What should I have? ### Response: Usually, food is recommended to consume 2 to 3 hours before a workout. If it will start in less than an hour, then Greek yogurt, piece of fruit such as banana, apple, orange." "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 lipoma in my arm. Is there any cure? ### Response: HelIo. I have gone through your query and understood your concerns. Lipomas are painless swellings. For lipoma, the best treatment is surgical excision and as it is not a big surgery you can go for it. Consult a general surgeon online regarding the surgical removal of the swelling" "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 uncle had got schizophrenia when he was 20 years old. Now he is 45 years old. He gets aggressive after taking pills, and he is alright without them. He has stopped talking. He is not sleeping and talking to anyone. He isolates himself. He does not even take a shower. My dad bathes him. ### Response: Hi. Your uncle has schizophrenia. It is a chronic disorder. It is a less likely cause for getting aggressive after taking pills. If he is on any antipsychotic medication, then it will get better for him after taking it. You have to teach to improve his care. He needs Amisulpride medication. Your uncle is suffering from negative symptoms because of schizophrenia. You have to take him outside to the sunlight exposure for 20 minutes. Give him some brain stimulating work like training him to separate vegetables, wheat from the rice mixture of 100 grams. I am sorry to say that he may have a lifelong illness. But it can be controlled with medication and behavior therapy." "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 dengue from the last three days. The platelets have dropped from 197 to 129 today. I have the following questions: My fever fluctuates between 101 to 104 despite having Paracetamol. Is that normal? Also, when should I get admitted to the hospital? When does the body start producing or rising its platelets? I feel the very reason we do fluids therapy is for the body to do it on its own. Correct me if I am wrong. Any help will be much appreciated. ### Response: Hello. Hope this helps. Please feel free to ask more if you need further assistance" "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: This mole has been there forever and my dermatologist noted as one to watch along with a few others. She said it was raised on one side and that luckily most melanomas are flat. Now I stare at this mole constantly wondering if it is growing. I have been reading about nodular melanoma, as it is slightly raised. It is brown, symmetrical and 2 to 2.5 mm maximum. I have such health anxiety. Could you please help? I have had two wide excisions of dysplastic moles, which has led to my worry over melanoma. Currently, I am taking Sertraline 50 mg. ### Response: I have gone through your case in detail. Well basically it is not the matter whether the mole is raised or flat. Basically, it is the change noticed by the doctor or the patient himself. By change, I mean change in size, shape, symmetry, color, and other symptoms such as itching and bleeding. All these symptoms raise the suspicion of developing melanoma. Your lesion has been static then you need not worry. Moreover, it does not look malignant to me as well. Just relax about your present condition. But however, keep on reviewing your lesion after every three months. Just relax" "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 mother of two children. My daughter at the age of 21 started showing signs of depression. She had to drop from university. After six years of struggle and treatment, she is on her way to recovery. But even now she gets panic attacks and feels depressed and is unable to handle stress.My son at exactly the same age (21 years) started showing signs of depression. My kids had a very normal childhood without any issues. We are a normal healthy family.My husband\s family has a history of mental health issues. I have heard that at least one member from all our extended family branches had mental health problems. My father-in-law was a patient of chronic depression all his life. Please let me know if depression is genetic and is it possible that my children\s problem is because of the genetic predisposition. ### Response: Hello. You have asked a very pertinent question. Depression is usually caused by a combination of genetic and environmental factors. If there is a positive family history, a person is more vulnerable to develop depression, especially when faced with environmental stressors (epigenetics). So to answer your question, yes, genetic predisposition could have played a part in your chil" "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 dull pain in my testicle for the past three weeks. It is not very severe. I can ignore it. I have performed a TESE. I noticed no lump and no swelling. The testicles are normal to see. I am worried that it could be something serious. Can it be blue balls? ### Response: Hi. Pain in testicles can occur due to multiple reasons. Since it is mild, it could be due to prostate swelling, a urinary stone or dilated testicular veins. These can be ruled out by examination and ultrasound. Since no lump is palpable and there is no change in testicular size, a testicular tumor is unlikely to occur. You can wear tight underwear and take some analgesics. If it persists or worsens or there is any swelling, please consult your doctor." "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: Why are some people still tired after taking a nap? Does the length of the nap matter? Is there a cutoff time where it reaches a diminishing return? Are some people\s bodies just not suitable for naps? How do you plan the perfect nap? ### Response: The short nap is not hazardous at all. It cannot lead to tiredness. Even a short nap can help in relieving tiredness. So do not worry regarding taking a nap. In the afternoon, 30 minutes to one hour nap is best one to relieve your fatigue. If you feel tired more easily then it cannot be due to nap but it can be due to some other cause like thyroid, electrolyte disturbance, low calcium, stress, etc." "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 triglyceride is 600 plus. Please advise any medicine. I do running for 45 minutes. ### Response: Hello. Triglyceride levels are very high. I think you might have any metabolic or hormonal problem. I advise starting immediate healthy changes in your diet and lifestyle regimen. Take supplements containing plant sterols, red yeast rice, omega-3, co-enzyme Q10, etc. Fibrates to start but need a prescription from your caring doctor." "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 abdominal pain for the past two months. I have done tests like CT scan, stool test, and blood test. Now I am feeling feverish, headache, stomach burn, and severe pain. ### Response: It would have been great if you could have shared the report of CT scan and blood tests to tell you about your problem. For now, I suggest you to take capsule Esomeprazole 40 mg once daily before breakfast since you have pain, which seem to be secondary to peptic ulcer disease or acidity." "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: What is wrong with a junior school child who has diarrhea and either stopped drinking or is unable to. He has eyesight weakness and now wears glasses. He worries a lot and despite a good appetite does not put on weight. Has difficulty in reading and writing. He has no power, strength or stamina. Thyroid tests are all normal. Has he some other congenital disorder? Because there is definitely something wrong and we are guilty of not observing him fully and properly. ### Response: Hi. Causes of diarrhea and poor nutrition at this age might be due to celiac disease (an autoimmune disorder), worm infestation, IBD (Inflammatory Bowel Disease)." "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: Dear Doctor,Will harmoni-f pill prevent pregnancy if taken continuously before and after having an unprotected sex? ### Response: Hi. Harmoni-F is a contraceptive or birth control pill that needs to be taken daily to give the desired contraceptive effect. It is not an emergency pill as you have been thinking. Please use additional protection to avoid unplanned pregnancies. If you have any further questions, feel free to ask 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: Me and my wife had sex on 12th January and she took ipill on 13th January.She had her periods on 21st January.We again had sex on 25th January and 10th February with protection (condoms).On the 10th evening some spotting started and it stopped on 17th February.The spotting was dark brownish color when it started and ended with bright red color.There are no signs of pregnancy till now.Can this be the side effect of ipill or is there a chance of pregnancy? ### Response: Hello. The bleeding due to menses on 21st January after ipill confirmatively rules out pregnancy which could have occurred due to sex on 13th January. The repeat sexual intercourse held on 25th January (she was in her safe period and hence pregnancy is unlikely) and then 10th February (this time she was in her fertile period) might result in pregnancy. But you have had protected sexual intercourse. Chances of pregnancy are minimal and the spotting is unlikely to be an implantation bleed. The spotting is more likely to be a breakthrough bleeding which is possibly due to the side effects of ipill which is known to cause irregularity in menses for the next 2 cycles. However, the best way to confirm or negate pregnancy would be to opt for a serum beta hCG test. This test if positive shall confirm pregnancy and if the levels are less than 1, then pregnancy is ruled out completely. This shall allay your anxiety." "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 history of melanoma and now I have a mole. I am not aware how long this mole has been here on my arm. But it just really stands out and makes me nervous. Does this mole look concerning? It has a small hair that is growing in it. Previously, melanoma was removed from my left hand three months back. ### Response: I saw your pictures (attachment removed to protect patient identity). Your concern may be acquired compound nevus or melanocytic nevi with dysplastic changes since there is no clear margin. It is advisable to have a histopathological examination of the mole for confirmation" "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 eight weeks and three days pregnant. I have been spotting every day for almost two weeks. I have not been bleeding heavy or had any blood clots or tissues. I went for my USG three days back and they were unable to find any heartbeat. Kindly advise if we should still stay positive. I am worried. ### Response: Hi. I have read your concern. I know you are anxious but to be honest, the likelihood that this will be a miscarriage is very high. By at least six weeks, there should already be a heartbeat on the ultrasound. We usually give at least two more weeks to repeat the scan especially if it is from a spontaneous conception (not an IVF pregnancy) since the exact date of conception is not determined. If you have not had an ultrasound before this then I suggest you have another USG after two weeks. But if the age of gestation was already determined prior to this USG, then it is highly likely that this will result in what we call missed abortion." "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 test is positive for infectious mononucleosis. But my EBV IgM is negative. How accurate Monospot test is? One week abdominal pain and severe throat pain were there. ### Response: Monospot test has high sensitivity but it is not so accurate. It can come positive in other infections like rubella, CMV (cytomegalovirus), HIV, toxoplasmosis, and other diseases like SLE. So, if EBV IgM is negative then chances of it being infectious mononucleosis is low. EBV infection causing mononucleosis is usually self-limited and last for 3 to 4 weeks." "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 severe localized pain when I lift my left arm over my head and it is in muscles for more than four months. The rheumatologist did an x-ray and blood test which are all normal. He prescribed tablet Arcoxia-285 (90 mg) and Panadol (665 mg) + injection Depo Medrol 40 mg for 14 days. Seven days have been passed but a bit of pain is reduced but muscle is slightly locked and I cannot freely move my upper arm (pain is near triceps and biceps). Any advice will be greatly appreciated. ### Response: Hi. I read in detail your symptoms. It is suggesting periarthritis shoulder. The profile does not suggest inflammatory arthritis as the signs of inflammation are lacking and the tests are normal. Periarthritis shoulder or frozen shoulder. MRI shoulder. Adhesive capsulitis. Periarthritis shoulder. Continue medication. Local fomentation. Range of motion exercise. Avoid lifting weights. Avoid gymnasium and weight training. Avoid heavy bag lifting." "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 took a Festone kit 1+4 after 40 days from LMP. Bleeding started within an hour, but it lasted for just few hours. How to confirm my abortion? ### Response: Hello. If your bleeding has stopped in just few hours, one cannot be sure if the abortion process has completed or not, unless an ultrasound confirmation is made. I hope you took the kit under a gynecologist advice after confirmation of an intrauterine pregnancy or after confirming pregnancy with a urine pregnancy test. Usually the bleeding will last for five to seven days. If pregnant, then a gestational sac will be passed with pain and bleeding will stop. So, you are requested to get an ultrasound done to check whether the abortion process has completed." "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 28 year old male. I have had severe acid reflux and stomach bloating three times in the past 12 months. It started suddenly each time. There is no prior symptom. This is the third time and it has been going on for a month. During the first time, I treated myself with antacids (Calcium carbonate) and a two week cycle of Nexium with probiotics. When it came back for the second time, I had Pepsin and Betaine hydrochloride, probiotics for a month. It worked very well. Five months later, it came back for the third time now. I have had no acid reflux, but just bloating. I am taking Betaine HCl and Pepsin, but it is not going away. I will start to bloat right after my first bite of food. Even drinking water too fast will make it. The bloating is bad. I have severe bloating and pressure for hours after I eat. I think my stomach is not producing any acid. Could it be like that? ### Response: You described two different entities here. CT scan of abdomen and upper gastrointestinal (GI) endoscopy. 1. Indigestion.2. Hiatus hernia.3. Esophagitis. GERD with gastritis. Continue treatment for gastritis." "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 witnessing a discharge of white substance. It discharges during pee and also normally it is happening from the last two days. Please tell me what is the problem and solution for it. ### Response: Hi. Females normally have some white discharge during the cycle. If you do not have burning sensation, pain or itching. And the discharge is not foul smelling, then no need to do anything. It is normal. If it is abnormal, then you will have to take medicines accordingly. For tablets ease consult nearby physician, let the doctor see what type of discharge you have and take antibiotics accordingly." "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 ringing in my ears for two or three months. My doctor said it was an ear infection in both ears. I had two courses of Augmentin, but it did not improve. I had to change my doctor for some reason. The new doctor gave me Soframycin ear drops but when I went back to her for followup, she had changed her location. So, I went to a third doctor who said there were white balls in my ears. She thought it was a fungal infection and prescribed Bactrim DS and Candibiotic ear drops. When I returned, one ear had cleared up. She took a swab and then rinsed out my other ear finding a large amount of white matter like balls. I have just received the results of the swab which says it is not fungal and there were no known bacteria, but there was blood in the sample. So, they now think it is bacterial and want me to go back on antibiotics. The noise is sometimes loud and sometimes quiet, but it is always there. My hearing is not impaired at all but rather more sensitive than normal. My ears burn and throb at times but there is no great pain. Drops of vinegar and water help. I am not sure what to do. Please help. ### Response: You seem to be suffering from tinnitus which is nothing but a ringing sensation in the ears. There are various causes for tinnitus and the most common among them are a sensorineural hearing loss, Eustachian tube dysfunction, otosclerosis, ossicular discontinuity where ear bones become dislodged from their joints, chronic middle ear infection etc. But, the most common cause for ringing sound in the ear is a sensorineural hearing loss, probably age-related. Even unrecognizable minimal sensorineural hearing loss can cause disturbing tinnitus. Usually, fungal or bacterial infection of the external ear will not cause tinnitus. It is unlikely that it is bacterial or fungal. Infection of the ear canal is causing the ringing sound in the ear. There can also be ear blockage. In that case, your symptoms should resolve with antibiotics within a few weeks. You should undergo pure tone audiogram to assess your hearing threshold. If there is a significant change in higher frequency hearing then that is the cause for your tinnitus. If your symptoms persist then hearing aids or tinnitus maskers will help you to overcome your problems. There are other treatment modalities such as a tinnitus retraining therapy which can be helpful in some patients You should consider visiting an audiologist also after consultation with your doctor" "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 problem in breathing sometimes and the body gets warm. Kindly help me with it. ### Response: Hello. I have gone through your reports. Do you have any history of chest pain or heaviness on exertion? I have noted a few abnormalities (attachment removed to protect patient identity): Other parameters are fine, and figures in bold are not necessarily abnormal. Slight derangement in liver enzymes is there, that is likely to be due to fatty liver. Get your BP checked once" "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 8-year-old nephew is suffering from an unknown disease. We did two tests as suggested by the doctors. The names of the tests are CK and ALP. I am attaching the reports herewith. The doctors suggest that there is no treatment for these diseases. He walks with the help of his toes by lifting his heels and putting his weight on his toes. Kindly suggest me some medicine or natural diet by which he can be cured. ### Response: Hello. I have gone through the attachments (attachment removed to protect patient identity)." "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: Hello,I am currently 25 weeks pregnant and will be staying in a smoking hotel room for three nights. Is this dangerous in any way for the baby? ### Response: Hello, How are you doing? So, even though the damage to the baby will not be substantial, for the sake of the baby, try to avoid smoking or exposing yourself to the smoke. Hope I have clarified your query. Do write back. All the best." "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 70 years old and diabetic. The doctor advised me to take Gorochanadi Gulika one tablet each in the morning and evening. I started taking the same. In between for one and half months I stopped taking it. Now I want to start taking it. Before that, I wish to have your advice. I take insulin and other tablets as prescribed by my allopathic doctor. ### Response: I can understand your concern. You can continue Gorochanadi Gutika as they advised. You can also take some home remedies along with your previous medications. After 4 to 5 days, monitor your blood sugar levels. It will be in normal range. Do these things and provide your valuable feedback. 1.Avoid spicy and fried junk foods. 2.Avoid smoking and" "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 always had weird symptoms and I think I have celiac disease. I also think that the combination of all my symptoms may mean something. I was tested once for thyroid problems and once for Lyme disease because I had a big, dangerous tick-bite rash. I am 19 years old and according to my growth curve (height of father and mother) my height should be 1.80 meters. I started puberty later than everyone else my age. I have always been too short, I am 1.68 meters now and I do not think that I will grow any longer. I am also feeling tired and sleepy all day long. I thought it was because of school and other stuffs and I just need some rest. But now during my holidays, though I have slept around 8-10 hours every day, I feel tired and sleepy. My black circles also did not disappear.My symptoms are as follows. I have signs of anemia, such as rapid heartbeat, headache, dizziness, pale skin through which veins can be seen and had little cracks at the corners of the mouth some years ago. I use to get sudden muscle spasms once per day or so. Since birth, I have been suffering from asthma and acid reflux. I have small individual red spots on torso, joint, bone and muscle pain for a few times a day and it does not hurt too badly. I have pop elbows for a year or so. I am getting pale sores in the mouth and bad teeth. I brush twice a day with an electric brush, but still many problems when I go to the dentist. I feel bloated and constipation. My stools are of bad smell and oily. I am also getting diarrhea a few times per week. I got hereditary hair loss and bald temples. I have a history of migraine including temporary blind spots in sight. Occasionally, I get strange things in eyesight, not only normal floaters, but sometimes also hundreds of very fast moving transparent balls. Sometimes, I suddenly see a very flashy thing in my eyesight for a few seconds. It takes long for me to fall in sleep after going to bed. I had intestinal problems all my life, but I just thought that they were normal. When I was very young, I did not really have so many issues like I have now. When I was around 14 years old, many of the problems started. I actually ended up in the hospital, because I had an unbearable pain under my ribs (right lower quadrant). They thought that I had a perforated cecum, but luckily that was not the case. They did not really know what it was, but I had high fever and I threw up 20 times or so. Around 17 years old, I started balding. Strangely the migraine has gone, but instead I have more signs of anemia. I eat a decent and good amount of vegetables and fruits. What do you guys think? Is it celiac disease or something else? ### Response: 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: I had unprotected intercourse three times with an unknown woman. After 20 days, my symptoms started with stomach cramps and diarrhea. My endoscopy report shows acute superficial gastritis. But my CBC test was fine. Doctor prescribed medicine, but it did not help. Day by day, I became tired all the time, I am having a rash, oral yeast infection, and diarrhea. After two months, a gastroenterologist checked my CBC, stool, urine, HIV(combo), Hepatitis B and C, and serological test. All were negative. But the doctor did not understand what my problem is. But I always thought that I may be affected by HIV. After three months again, my HIV Elisa combo antigen and antibody test came out negative. But I am very much tired, and diarrhea persists with stomach upset. After five months, I consult an HIV specialist doctor in the ART center; that time my rapid antibody test again was negative. But this time, my CBC report shows an infection. HIV specialist told, my CBC shows an infection, but it is not specific for HIV. May be I have another infection. After seven months again, my HIV ELISA (antibody) test came out negative. After nine months, I was tested for STD pannel such as Hepatitis B and C, CMV, H. Pylori, VDRL, Herpes virus 1, and 2. But all the results were Negative. Now, after one and half years, my HIV and antibody test is negative. But I always think I am infected with HIV because I have symptoms, and medicine is not helping me. So I am planning for the HIV PCR test now. My question is :1) What is the suspicious cause of this problem(gastritis with diarrhea)? I guess my problem is sexual infection. Before this, I never faced these problems, and it has not happened due to my lifestyle and food habits.2)Is my HIV test conclusive for HIV?3)I do not have IBS. Only HIV, HBV, HCV, TB cause these symptoms or another virus can also lead this sickness?4)Advice me for more tests to rule out the reason for sickness.What can I do now? Please help. ### Response: Hello. I read your query and understand your concerns. First of all, I feel there is neither HIV nor any sexually transmitted infections. This is because repeated tests without any evidence of infection are enough to tell that there is nothing concrete in this regard. Now coming to your questions. 1. The most likely cause of your problem is stress. You might be aware that stress affects your gastrointestinal system severely and can cause a variety of symptoms, including stomach ache and loose motions. 2. Yes, it is conclusive 99 % although PCR will make it 100%. 3. The chronological association between the stress after unprotected sexual encounter and development of gastrointestinal symptoms indicates the virus are not the cause including HIV. 4. There is no test to diagnose hypochon" "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: For the past couple of days, I have been having left side pelvic tenderness. It does not hurt very much When I lay down or stand up, but hurts when touched, especially if pushed down or put any pressure on that area. The pain is right in the area next to my left hip bone. I do not know why this pain is happening and I have never experienced anything like it before. My period was due and I am a few days late this time. I have not tested for pregnancy yet. Today I started spotting some pink discharge and a very small amount red blood. It was not in the underwear and I found it only when I wipe. I am getting concerned and do not know what is going on. Could this just be early pregnancy? Or is it something worse? ### Response: Hi. Well, firstly I would like you to get a blood test done to rule out pregnancy. It is serum beta hCG. You must also get a vaginal ultrasound done urgently. The reason I am asking for these tests is either you could be having these symptoms because of an ectopic pregnancy or an ovarian cyst. The pain may be an indication of the process of either expelling out from one side of the tube or rupturing and thinning of the tube. The more serious of the two situations is the possibility of ectopic pregnancy, which can be ruled out by the tests. If it is a cyst, then it can usually be made out by an ultrasound. I urge you to take these steps and let me know. Revert back with the reports to 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: Can one pump and breastfeed simultaneously? Why or why not? Please provide the explanation or suggestion on how this can be done. ### Response: In case you have nipple problem in one or both the breast, there is no harm in using the breast pump. Even if the mother has an excess of breast milk which is causing discomfort, then breast pump plays an important role. If the mother feels like storing the milk because of unavoidable circumstances, then using the breast pump milk can be stored for not more than 2 to 4 hours. Nowadays, there is electric pump available. It is less painful and does not require manual efforts. So, it is safe, and there are no side effects in using a breast pump and feeding simultaneously." "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 4-month-old baby girl is coughing from the last five to six days. It enhances at night. Please suggest medicines. She is taking Visyneral-Z. ### Response: Hello. I understand your concern. The baby\s age is 4 months. At this early age, cough medicine is not advisable. Usually, at this age, babies are breastfed and have nasal block which can lead to breathing difficulty including cough sensation. During feeding times, ensure the baby is held in the upright position and given proper burp." "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: ### Response: Hello. Sleep is a very complicated process and it is a way of healing and relaxing the body. Four steps are there for the sleep process to complete. Every person has their own patterns but largely we can say good sleeping habits change life patterns. A normal individual should sleep 8 to 9 hours with different posture change. Obese should prefer right and the left lateral position as oxygenation improve which is compromised in supine sleep. BIPAP and CPAP are the machines which are the treatment if sleep apnea and also snoring patient, the patient only has to out nasal mask and they can sleep well with improved oxygenation and also enhance quality and standards of life. During sleep, there is a good temperature for body but this is according to age. Music and light also affect but it differs person to person." "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 pain in lower abdomen, penis, and testicles. Please advice. ### Response: Pain in lower abdomen and testes can be due to multiple causes ranging from urinary tract infection, infection of testes, varicocele, or some stone problem in ureter and kidney. You will need a few investigations to see for the cause then only treatment can be advised. You will require sonography of abdomen and testes, microscopic urine test, and renal function test. Depending on the report of this test, we can determine the cause and advice further. If pain is too severe, you can visit a urologist for physical examination. Sonography of abdomen, pelvis and scrotum,with colour Doppler testes, urine microscopic test, and renal function test. Epididymo Orchitis, urinary tract infection, varicocele,and intermittent torsion. Follow-up with reports." "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 scratched by a nail of the dog a week back. Do I need to do anything for that? The dog died today, probably due to some other reason, and the dog was not vaccinated. ### Response: Hello. Are you sure the dog scratched by nail or teeth? Is any open wound or bleeding present at the time? Did the dog die due to rabies or any other cause? So many questions there. Better get ARV vaccination (anti-rabies vaccine). Since dog died, the reason not known take human rabies immune globulin (HRIG) administered only once first, if you are previously unvaccinated. Then take ARV prophylaxis." "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 got this eye problem three days ago. I do not know what happens but when it is evening, I notice that there is a frequent watery eye dirt in my eyes, sometimes it is a little bit only and sometimes a lot. But, it is very frequent like every minute like that. So that the veins in my eyes turn red. So, my eyes turn red also. It is not noticeable, but when I look at it clearly and I lift up the lids, I really can see the root. I do not know what to do. It is not hurt. I am just bothered about the eye dirt that comes out every minute and the red veins or roots in my eyes. Hope you can help me. ### Response: I do not know whether the dirt is white or yellow. However, it seems to be allergic. Wash your eyes with water (not warm) as well. If no result, the problem may be an infection. Most probable viral one, other probability bacterial but very little. I advise you to try the allergic treatment and if no development for one to two days you have to go to an ophthalmologist to define the problem" "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 6 years old. He got lung allergy so the doctor gave Levolin 100 and Budecort inhalers and some syrup like Montair LC kid. So my son is getting free from the fever, coughs, and cold by using these medicines. After completion of these medicines course, he is repeating with the same cough, cold and fever. Where as he will not eat any foods like chocolates and other flavored items, but he eats very rarely.On using these medicines is there any side effect in his growing future? I want to know is there any permanent solution for him without using these medicines and being healthy? And he is getting this problem when there are changes in weather and if he eats any chocolate and other foods. My son gets a fever with a high temperature of 101 and goes to 103 degree celcius. Sometimes we used to give him Meftal 8 ml and P-250 or Calpol for every four hours when the temperature was 100. After giving these medicines he was being sweated a lot specially on his head. Why there is sweating from head? Is this sweating from head cause any problem? How long should he use these mediciens? What are the foods that are good for him and can we give him dry fruits and fruits? Which are best for him? ### Response: The doctor has given the right treatment and please follow his instructions. The inhalers are safe and do not have any side effects as the dose of medicine is in micrograms which is very small. The allergic problem will resolve by itself as he grows. Sweating when fever reduces is very common and not a matter of concern. After the course of calcium and vitamin D3 sweating problem will also reduce. About the food discuss with your pediatrician as it depends on the individual child." "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 unprotected sex last month but I took I-pills within 72 hours and also I had periods in last 15 days back but now I have some thick discharge coming out of my vagina. Please tell me are there chances of pregnancy? If not, then why this thick thing getting discharged? Please help me. ### Response: Hello. It is unlikely for you to be pregnant now. Because I-pills are highly effective in avoiding pregnancy. Also, you had bleeding, ruling out the possibility of pregnancy. Still, there is no harm in getting urine pregnancy test done, just to confirm. Did you not have similar discharge anytime in the past? Some individuals may get such discharge cyclically due to hormonal changes. Also, there is a possibility of candidiasis in you. Do you also get itching near or inside vagina, is this foul smelling discharge? If yes it further suggests candidiasis. You should have Clotrimazole pessary to be kept in vagina bedtime for seven 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 40 year old man. I have a foot pain which was diagnosed a few years ago as plantar fasciitis. I use shoes with special support, insoles, and cushion on the socks. I also have a pain in my right knee, especially on the inner side. I want to know if there are any exercises or stretches I can do to improve the condition. Also, can you suggest any other home treatment options for the knee and the feet? I am giving you some more details about the presenting complaint. Regarding the foot pain, I feel it early in the morning after walking or after sitting for a long period of time. And the knee pain is usually while walking. However, the condition gets worse if I walk after sitting for long periods of time as well. I have been going to the Chiropractor for a few months. The knee pain has gotten better. They have recommended hamstring stretches, quadriceps stretches, wall stretches for the calf, foot stretches and bridge exercises. For the knee pain, they have diagnosed sore muscles in the inner thigh, right above the knee and it is responding well to such treatment. Also, based on the tests they suggest my gluteal muscles are not activating fully due to prolonged sitting. ### Response: The protocol followed by you is good. You should follow that regularly for the next one month. For the plantar fasciitis, I suggest the following: For the knee pain, I suggest the following: This will help ease your pain. Happy recovery" "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 on the fourth day of my period. Intercourse (just for a few minutes) but ejaculate outside. During sex, I was still bleeding. My cycle is usually around 27 to 30 days. The latest cycles were 30, 30, 28, and 27. Is there any chance that I will get impregnated? Also, I did not take Plan B. ### Response: Hi. Periods is the safest time to have unprotected intercourse whereas pregnancy is concerned. It is highly unlikely to conceive during periods. There is no need of taking Plan B in such case. So do not worry" "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 lips have got swollen. It happened around last year too. From night, my lips got huge, even after I took OTC allergy medications. I woke up in the morning. I felt nauseous, but my lips got little smaller. I continued to use OTC medications. ### Response: According to the history, (attachment removed to protect patient identity) you have an allergy disorder, and so the lips can be swollen. Now, your allergy is being subsided as there is an improvement seen with an antiallergic medication. So you can continue with antiallergic medicines if there is improvement present. For allergy Levocetirizine and Fexofenadine can be taken and if the allergy is severe, then a short-term steroid course is given. In such an allergy problem, it is advisable to investigate with CBC (complete blood count) and AEC (abnormal eosinophil count) investigation to check if there is eosinophilia present" "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: Every morning while I brush, I notice bleeding from my gums. I do not have any pain. What is the possible cause and solution? ### Response: Hello. I understand your concern. The most common cause of bleeding from gums is inflammation of the gums, otherwise called as gingivitis which leads to periodontitis if left untreated. The reason to develop gingivitis is mostly associated with oral hygiene and oral hygiene habits. You may consult your local dental doctor and get a dental cleaning done and follow up after a week to check if your symptoms have subsided. It is most likely to resolve if associated with oral hygiene. Other factors affecting gum health may be menopause, diabetes, etc. Visiting a dentist every six months for a regular check-up is recommended." "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 and I had protected sex on the 15th of this month, but I cummed in the condom but kept going. Not taking any chances she took a pill on the 18th. From the next day after taking the pill she had light bleeding in the form of blood clots and also experienced abdominal pain. The pain has persisted till now but the severity has decreased. Could you please tell me whether she is pregnant or not? ### Response: If you had protected sex then she should not be pregnant. Do one urine pregnancy test for confirmation. Abdominal pain can also be due to stomach infection or kidney stones. Eat healthy and less oily food. If not decreasing then she will require an ultrasound scan for further diagnosis." "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 18 years old and I just started taking online college classes. I attempted to go to in-person classes but I had panic attacks and I dropped out. For the last two years, I only leave my apartment to go to the movie theater and grocery store. I also go to the doctors and therapists, but recently my mom and I made the decision to stop trying to find the right fit for therapist and just focus on school. I also am having problems going to my psychiatrist now. I live with my mom right now, but I would love to change that in the future. I do not know how to work towards that goal though. I was wondering if going to a two month in patient treatment facility for young adults would help? My official diagnoses are ADHD, social phobia, and depression. I also do not have any friends and sometimes have trouble feeling safe outside my room. (I am not actually in any danger, I just feel like I am). ### Response: Hello. As per details provided by you regarding your diagnosis, such patients tend to have difficulty in attention and concentration along with difficulty in facing social situations and anhedonia. The best course of treatment as per prevailing clinical guidelines is psychotropic medication along with psychotherapy. Because of your comorbid diagnoses, the medication and therapy may take more time than usual. But in 90 % of cases, it proves effective. Regarding in-patient treatment, you can go for that in case you feel that you have difficulty in compliance with outpatient medication and therapy" "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 25-year-old male. Recently, I went for a trip and ended up in engaging in sexual activity with a female sex worker. I first did a vaginal intercourse with a condom and then oral sex using the same condom (with the vaginal fluids). After 15 minutes, I got an unprotected oral sex from the worker. Could this lead to HIV transmission because the initial vaginal fluids may be present in her mouth? Before the act, both had a shower and mouthwash. Should I start the PEP medication? ### Response: Hi. First, protected sexual activity carries negligible risk. Protected or unprotected oral sex carries no risk as HIV transmission through oral sex is none considering she has no oral bleeding or ulcers and you have no ulcer on the penis. Shower bath will not protect from HIV and vaginal fluids in the mouth during oral sex carries no risk as these fluids will be neutralized by lipases in saliva. PEP (post-exposure prophylaxis) is indicated only within 72 hours of the act and not effective after that period. You have a very negligible risk (0.01 %) of transmission considering she might be reactive." "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 35 year old male. I had testicle and lower abdominal pain from couple of weeks, but I did not have burning sensation on urinating. So, I started taking antibiotic (Azithromycin) and analgesics (Ibuprofen). Now my pain has almost subsided, but I have developed a lump on the posterior side of the testis. The size of the lump reduced in the last couple of days, but I still have a slight stinging pain sometimes. Please help me treat this. ### Response: Hi. I read your query and understand your concerns. I hope this helps you. If you have more questions, feel free to write back." "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 25 years old. I have been diagnosed with essential thrombocythemia. The reasons are elevated platelet count (about 700,000 to 900,000 platelets per microliter of blood), positive JAK2 V617F mutation analysis, etc. There are different opinions coming from doctors in my country. Avoiding details, some advice me to take Hydroxyurea, some say that Hydroxyurea is unacceptable for guys of my age because of hard side effects and advise me to take Interferon alpha. Some say that I should not take any medicines and exclude disaggregates and I should just monitor platelets count to be lower than 1,000,000 and some other indicators. Kindly advise. ### Response: I can understand your situation through which you are going. I have reviewed your query and below is my advice for your case. It is myeloproliferative neoplasm and the chance of acute myeloid leukemia is less in such case. In young age group people usually there is no need for starting 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 got chronic sinusitis diagnosed by ENT doctor. I am suffering from difficulties of swelling for months, feel like something is stuck in my neck like sputum or something else that is moving up and down, especially while eating or having flu. Do you think it is related to ENT or I have to do a gastric endoscopy? Otherwise, I am healthy. I used a nasal spray (Cortisone) for the same. ### Response: Hello. In such a patient what we would do is a laryngoscopy. Just to rule out any growth or inflammation. Secondly, we need to check your hemoglobin status to rule out Plummer Vinson syn" "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 diabetic patient (type 1) for the past 12 years. I have never suffered from floating stool for such a prolonged time. I am suffering from this problem for the past six months. I am suffering from excessive gas and frequently get stomach aches. Can you please let me know the problem? How can I help myself to get better? I am just trying natural remedies at home like garlic, ginger, honey, apple cider vinegar, etc. ### Response: I can understand your concern for your symptoms. Autoimmune pancreatitis. CT scan abdomen with contrast, lipase, amylase and upper GI endoscopy (to rule out gastritis). Severe gastritis. Autoimmune pancreatitis. Continue treatment for diabetes, pancreatic digestive enzyme supplementation, and treatment for acidity. Avoid oily and spicy food. Take fat-free and high protein diet." "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: On having sex I start to lose my erection, when I wear condoms also I do not feel anything after wearing condom. It was my first time and I did not feel any pleasure while entering a vagina. Is this a major issue? Should I get it checked? ### Response: Hi. First of all, you should understand erectile dysfunction. You are just 23. Other than these two reasons, ED can also happen due to performance anxiety. Anyone can feel anxiety and apprehension when they go for first time sex. That is natural. Not knowing what to do and how to do, not having sexual experience, worry about getting pregnant, worry about failure, worry about satisfying that partner, worry about what will happen if others come to know, etc., there are so many stressful anxious questions inside your mind. All these combines to create performance anxiety and ED happens. So do not worry about that one incident. Regarding condom, while wearing condom, men naturally have lesser pleasure because of the sheet between penis wall and the vaginal hole. Do not worry too much about it because the more you worry, more the problem will trouble 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 unable to lose weight even though I exercise a lot. Also, my penis size is small. Could this be a hormonal problem? ### Response: Fat is stubborn and it takes a lot of effort to get rid of it. If you are doing regular exercises, please consult a physical trainer to know whether the workout is scientifically efficient for weight reduction or not. If you are working out under the supervision of a professional and still unable to shed flab, I suggest you get your thyroid profile done along with lipid profile. The penis appears small when there is abdominal fat. I suggest you focus on the reduction of belly fat. Your organ size may be just right" "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 hit my shoulder a while back. Since then, my shoulder slightly turns to the side like a dislocation or something whenever I do anything strenuous like work out or swimming or hanging on to something. I can just tilt my hand and it would come back to the original position, so it is not a complete dislocation. I consulted a doctor and he took an MRI scan and it read Hill-Sachs lesion. He asked me to maintain the shoulder in rest for six months and do nothing which is hard for me to accept as I lead a very active life. How would I know whether it is healing or it has healed in the future as he did not make any future appointment? ### Response: Hi. Shoulder subluxation with Hill-Sachs lesion. Always wear the arm pouch and avoid movements of the shoulder outside the arm pouch. Revert back with the MRI report to an orthopaedician and traumatologist 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 15-month-old son was vaccinated with measles vaccine at nine months. Now, he will be vaccinated with MMR and varicella on the same day. I am afraid of the adverse side effects of the MMR vaccine. My son is not premature nor underweight. But after birth, the doctor treated my son with Gardinal because the nurse told the doctor that the baby was trembling when crying and sometimes when not crying.With regards the family history, my wife\s 75-year-old grandmother is now under treatment for a neurological disorder or madness for four years. Sometimes, she has to be admitted to the mental hospital. My 62-year-old mother is suffering from a hearing problem since three years.So, keeping in mind the above things and the data available from the internet about the MMR vaccine, I want to know the chances of being affected adversely by MMR vaccines like autism and hearing problem? ### Response: As per current recommendations, MMR (measles, mumps, and rubella) and Varicella vaccines can be given to your child at 15 months of age at different sites. There is no association of MMR vaccine with autism. The benefits far outweigh any risks" "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 has nausea, vomting episodes that are not related to conditions, for example she can eat and feel nauseated or vomit after an hour or two or not feel anything. Then a few days later it can happen again. It comes and goes and is not stable, or triggered by certain conditions. It is totally random mostly. She gave birth to twins with a CS and was on Prontogest supplement for 7.5 months. ### Response: Hi. She may have repeated biliary colics or recurrent attacks of gastritis or may have urinary tract infections. So, she needs urine routine test, liver function test for further comments." "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 started having tooth pain and it has not gone away. I do have a white lump on my upper gum but I have had it for a while. Sometimes, it goes away and then comes back. My tooth pain almost feels like a cavity but I am not sure. ### Response: It seems your tooth is having a chronic abscess due to infection reaching the pulp and beyond the roots of the tooth and the white swelling is an abscess. I suggest you consult your dentist who will take an X-ray of the tooth and will confirm the diagnosis and explain the treatment and prescribe the medication. Mostly, if the case is of abscess and if there is enough tooth structure, you will have to go for a root canal treatment followed by a crown. So, do not worry. Another possibility can be a gingival abscess, but in this, pain on chewing is rare" "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 spinal fusion surgery down my entire back about two years ago when I was 17. I never had terrible back pain but as of recent, it is been somewhat bad. I feel like a 97-year-old woman. I have difficulty in sleeping because some positions just make the pain worse. Will this last forever? ### Response: I read your concern. In my opinion, post-surgery you should start work on a little bit of rehabilitation to strengthen the spinal muscles. That would have prevented these kinds of issues. Do not worry. I would like you to have a good recovery session frequently inside a pool and stretch your body to work on whole body flexibility within the limits it allows and progressively extend more. Do not try to push too hard as it will increase tightness. I would like to know if you have any sort of pain and spasm or pins and needle sensation or tingling sensation anywhere in the upper and lower body. If so get yourself properly checked up with your surgeon. I would also recommend you to be active. Have good food and support yourself in every position properly especially those positions you are required to maintain for a longer period. Kindly try these things and then let me know how you feel after three days. 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 having mild pain while coughing, sneezing, or doing some full stretch work below the lower rib in the right side of the abdomen. Kindly suggest treatment. ### Response: Hello. Kindly get an ECG, chest x-ray done. Also, mention what medication are you taking for your sickness. Pain while coughing could be due to inflammation in the intercostal muscles due to excessive coughing. Other reason could be due to pleural effusion. That why at lest chest x-ray and ECG is needed to make the right diagnosis. You can try muscle relaxant for pain relief like Mobizox one tablet two times a day for two days (Chlorzoxazone is a centrally acting muscle relaxant used to treat muscle spasm). Antihistamine for cough and sneezing.like tablet Montair-Lc one tablet daily once a day for five 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 having a piles problem. I had blood in my stool for about one month, and now a lump is felt outside of my anus. I need some medication. Please suggest. ### Response: Hello. I have gone through your issue. It does not confirm that you have piles but, it could be most probably piles. I would suggest you some laxative for some time if you do not have loose stools. It could help to heal. Syrup Looz (Lactulose solution) 30 ml at night before bedtime for two weeks and Anovate cream (anti-haemorrhoidal cream with Beclomethasone Dipropionate) for local application twice a day for ten days. I would advise you to consult a gastroenterologist at the earliest to have it assessed properly." "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 a polyp in my sinus and have been suffering from frequent cold for a long time. Now, I am facing a fluttering sound in my ear. What should be done? ### Response: Generally, polyp in sinus needs to be removed. If ethmoidal polyp, then it can be treated with steroid spray. Ear problem can or cannot be due to a polyp. You need to tell your complaint in detail. Sometimes, polyp can block the eustachian tube and ears and it can cause ringing or fluttering in the ear. Kindly tell me in detail so that I can guide the treatment. If you have got a CT scan done, then you can send me or else you must get a CT scan PNS (paranasal sinus) done. Revert back with detailed history to 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 have done four ultrasound scan of my 37 weeks baby showing the impression of the fetal left lateral cerebral ventricle is significantly dilated (approximately 27 mm) with the irregularity of the wall. Left choroid plexus is enlarged and filled with a hypoechoic central part. Corpus callosum is thin and irregular, the pericallosal artery is normal. These features are strongly suggestive of late second or early third-trimester vascular insult or hemorrhage. The doctor advised for a postnatal MRI brain evaluation and pediatric neurological consultation. ### Response: Hi. All these suggest that there is a problem on the left side of the baby\s brain. To ascertain the cause and extent of the problem, MRI (magnetic resonance imaging) brain is definitely required. Based on the MRI, further investigations can be planned. At this point, it is difficult to predict the outcomes of this problem" "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 started taking Flonase at night for hay fever and when I wake up in the morning I am having wheezing and my chest is tight. I do not want to stop taking it because it is so helpful for my allergy symptoms but I am really worried about this side-effect. Current medications are Cymbalta 120 mg/day and Suboxone 5 mg/day and Sprintec. I am a 29-year-old female with height 5'1"" and weight 108 lbs. ### Response: Flonase (Fluticasone) is an intranasal steroid spray that has very less systemic absorption. It will help relieve allergy symptoms and will not cause wheezing. In fact, for wheezing, you may need another steroid, like an inhalant steroid using inhaler or Rotavap (rotary evaporator). Budesonide or Seroflo and Salbutamol are such inhalers. Do you experience any other symptom? Since when are you taking the two" "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 met with an accident before a few days where I happened to have a deep cut and I got in touch with the blood of another guy. Recently, I had a pimple on my penis shaft and when I approached a dermatologist he advised that I get tested for HIV. I had a third generation test using vitros eci post five to six weeks past exposure and tested negative. My doctor advised me to get a test at least after 10 weeks post-exposure for confirmation. I am pretty nervous regarding the same. Can you please advise me what are the chances of contracting HIV and do the symptoms definitely occur in every individual post-HIV contraction? ### Response: Firstly, risk depends upon whether that guy has HIV or not. If not then nothing to worry, but considering the second possibility, then some risk remains of transmission, but not cent percent. Now, if the test is negative after five to six weeks then it is unlikely for you to have HIV as majority of those who are exposed becomes positive within this period. Only a minority of patients develop delayed seroconversion. So considering overall status, I think, there is no need to worry about it and you are unlikely to have HIV. However, get tested after a few weeks to clear out doubt and be sure. So you should not worry now and get back to routine, and get tested at later date. 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: Can a torn cartilage in the throat trap food and cause bad breath? ### Response: Hello. There is no cartilage in the oral cavity and oropharynx. A cartilage is present in the larynx (lower throat) and below the larynx. Any injury can cause a tear in the cartilage. But, it will not cause bad breath. Generally, food particles get trapped in the tonsillar crypts in the oral cavity, ferments, and cause bad breath. If you have symptoms suggestive of acidity, then acid reflux causes regurgitation of food and causes bad breath." "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: The molar on the left side of my mouth was filled last year and right now it hurts really bad. I took Tylenol and Motrin, but none of them help. I cannot remember if I pulled out that molar a while ago or if it still needs to be pulled. It is not really loose, but I can move it around. If I try to pull it out I am afraid that it will be my permanent tooth. The pain started last week. I do not know what to do. I talked to my dentist and he said that he did not see anything wrong with it but, for some reason, the pain is still going. I cannot sleep at night and it gives me ear pain. ### Response: Hi. I have read through your complaint and the relevant details. Firstly, I would like to tell you that ear pain, pain during night, and the looseness you feel in the tooth are all the signs of a deeply infected tooth. Secondly, it is not necessary to be for the same filled molar to give you trouble. The pain might be from the same molar or could be due to a different tooth on the same side. I would not be able to arrive at a correct diagnosis until at least I see a picture of your teeth in that row. It seems you take pain killers for the same and there is nothing more I could prescribe (considering your age). The only way to immediate pain relief would be an active dental treatment for the affected tooth as soon as possible. It cannot be cured just with pain killers or any other medications. I advise you to see the dentist with an emergency appointment and look upon the issue." "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 24.5 years old female. I am seven weeks pregnant and have a history of ectopic pregnancy and two miscarriages. My doctor has prescribed Folic acid, Duxil, Susten 200 mg, Duphaston, and Ecosprin. All tablets once a day. Should I take both Susten and Duphaston or just Susten is enough? Also till what time am I supposed to have these? ### Response: Hello. As you had previous miscarriages and ectopic pregnancy, your doctor might have prescribed all these tablets for the maintenance of pregnancy and to prevent abortion." "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 this strange feeling behind my jaw on the left side just under my earlobe. When I fill my mouth with air to increase the pressure, the area that is irritated fills with air and makes a strange separation noise. It sounds like pulling apart wax and hair and I can feel the air in the area. Then it just makes a squishy noise. I have no idea why this happened but it started approximately 1 to 2 days ago. What could this be? ### Response: The problem you are stating can be wax filled in the ear which is in a liquid state due to the entry of water and can cause this squishy noise in the ear. I suggest you prevent entry of water while taking bath for a few days by applying cotton to your ear during the bath time." "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 know why do women become fat during or after pregnancy? ### Response: Hello. Women become fat because of lack of physical activity, exercise, fluid redistribution during and post pregnancy. All these factors cause weight gain" "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 50 years old. I have decreased libido, lack of proper erection, and early ejaculation. Please advice. ### Response: You are 50 years old, and you should get yourself checked by a physician to rule out hypertension and diabetes. These are important causes of erectile dysfunction. Reduced libido could be age-related. The" "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 heavy gas problem with heaviness on head and neck. I am a diabetic with 72 age, weight 60 kg, and height 160 cm. ### Response: Hello. You can have a functional indigestion problem and so gas problem. Kindly mention any other clinical complaint if present to guide you further. You can be prescribed Gelusil or Alcid MPS like syrup to solve your gas problem. Meanwhile try to avoid intake of gas-forming foods like turnip, onion, cauliflower, cabbage, etc. Aristozyme like fiber supplement can be given for relief from indigestion. Eat slowly and avoid intake of excess fatty foods. If no improvement, then USG scan done for further work up." "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 recently diagnosed with type 2 diabetes. My fasting glucose was 108, and my A1C was 6.6 %. I was not put on medication yet but instead will work on my weight, exercise, and diet over the next three months before my next visit to see if I can prevent getting worse. I am 6\1,"" and 285 lbs. I am mostly sedentary but will be introducing an elliptical workout every other day for about 20 to 30 minutes a time.I purchased an diabetes monitoring system, but need to know how often and when I should check my blood sugar and what should my target ranges be? I need to know what my daily gram and carbohydrate intake should be. Or, even better, what should my percentages be based on my 1,790 caloric daily intake of carbohydrates, protein, and fat. Currently, they are based on the ADA recommendations.Carbohydrates 40 % / 179 g, protein 35 % / 157 g and fat 25 % / 50 g. I also have high blood pressure. I am on 100 mg Losartan, and my reading today was 117/84/77 bpm. Kindly help. ### Response: You have provided good necessary information to start. My strategy as a diabetes specialist, I like to do very detail analysis to make a customized approach for each patient. 1. Based on the information, you provided, you should be on medication from my experience, like low dose Metformin 500 mg twice daily with meals, or Metformin 500 mg. Extended-release once daily. While you work on diet and exercise, this is help also prevent complication from diabetes. Metformin will help you lose weight too. Metformin also improves your insulin work better for you for better and quick control of blood sugar. 2. You can check blood sugar three times weekly, at different times. E.g., one-day fasting (before breakfast, second-day post-lunch, and third day at bedtime. (2 hours post-dinner). Keep diary readings. However, you prefer to see the trend of your blood sugar. Normal range fasting in the morning 90 to 120. Post-meal 120-140 average is good. You are in more top weight category so surely gradually need to lose weight, do not attempt instant aggressive weight loss you will end up injuring yourself and will regain weight too. I would keep carbohy" "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 22 year old female. My height is 163 cm and weight is 60 kg. I intend to take on paleo. Please give me your suggestions. I am a vegetarian. If I am eligible for taking paleo, then please give me a diet plan. I have attached my reports for your kind reference. ### Response: Hi. I have gone through your query and reports (attachment removed to protect patient identity) with diligence and would like you to know that I am here to help 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: Dear doctor,My mother is 84 years old and when she walks or stands, she feels severe burning pain in her vagina. Can you please suggest a medicine? ### Response: She may be suffering from atrophic vaginitis along with a possible uterine descent which can exert pressure over the perineum while standing or walking and combined together can cause discomfort. Please take her to a gynecologist for a local examination and a high vaginal swab culture to rule out any infection" "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 age is 30 and unmarried. I suffer from a migraine for the past 16 years. At least one time per week, duration of more than 10 hours. ### Response: Hello. Noted you are having migraine problem many times. So, if you are having repeated migraine headache problem then prophylactic treatment for a migraine can be started. For prophylaxis Amitryptiline, Beta blocker, Topiramate, etc. Try to avoid loud noise and more sunlight exposure. Peppermint or flaxseed oil topical application can be beneficial. During an acute attack of a migraine, Rizatriptan 5 mg tablet can be taken." "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 that for the past 4 day so or so I have had some congestion in my chest that comes and goes... a few times (a total of about 3 hours in 4 days) very mild chest pain.So I have been staying in bed and on Tamiflu for a few days and 2500 MG of Amoxicillin since yesterday with mild improvement. My other symptom includes that I get a bit tired if I walk more than 5 minutes,,Not had a fever, chills, cough or a sore throat...and have not lost my taste or smell..I am just paranoid about covid...ALSO I have had one incident of yellow drainage that came from my lungs as flem but more instance of clear drainage (but only 3 small ones)I am also not fatigued and actually insomniac as I usual am (sleep a few hours at night) ### Response: Hi. Fever has to be there in COVID. Since you have had no fever , cough is productive, Covid is virtually out. You might be having Allergic cough or some Lower Respiratory Tract Infection. You are on Amoxicillin which is a very good" "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 29 years old and I have smoked three and a half pack years in total. I quit smoking three years ago and I smoked half pack a day from 19 to 26. My great grandmother on my grandfather\s side died from lung cancer at 49. She was a very very heavy smoker and so was her husband so she was always around it. Does her dying early increase my risk of getting lung cancer or does it not matter because she smoked very heavily but that is several generations ago. Her daughter who is my grandfather\s sister is in her 70s and has COPD. She was also a lifelong smoker. Should I be worried even though I just have 3.5 pack years? I do not know if genetics were still a factor here. Please help. ### Response: Yes, lung cancer does have a genetic predisposition. However, it is not that anyone who has a family history of lung cancer will get it. Various other factors like heavy smoking, pollution, body immunity also play a role. I do not find any reason to worry if you do not have any symptoms now and if you have quit smoking. However, there is no harm in getting a single chest X-ray done to be sure of the current status. However, if you have any particular symptoms, please let me 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: My husband\s eye got hurt with my finger accidentally. Now his eye hurts and can barely open. There is a red spot on the white area of his eye. What do we do? Please help. ### Response: Hi. Your finger might have hit the eyeball blood vessels. These vessels can bleed due to trauma and can cause a subconjunctival hemorrhage (bleeding behind the conjunctiva thereby causing a red eye). This does not cause any major problems and resolves on its own in a week. Other possibilities for not opening the eye can be an injury to the cornea, which can have an epithelial defect. This causes a lot of pain and watering, and he may not be able to open his eyes due to pain." "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 28 year old unmarried woman. Last month my period was irregular. I got my periods on the 30th of last month and it was already 20 days later from the actual due. Initially, I had spotting for five days, then I bled for seven days and again, had spotting for three days. Now, I am bleeding again from today on the 27th of this month. Please help me out. My height is 155 cm and weight is 63 kg. I have this complaint once since last month. Normally, my periods will occur in an interval on 40 to 45 days. This is the first time I am experiencing spotting, bleeding and delay. Is this a serious problem? ### Response: Please do not worry. Irregular periods are not an alarming thing to worry about. Irregular periods are due to Please get your complete blood count and thyroid profile done. Also, get a pelvic scan done to rule out the exact cause. Just get your urine pregnancy test done with early morning urine sample, if you are sexually active. If not, then just ignore. Do get back to me with reports so that I can guide you further. Take plenty of fluids, vegetables, fruits, iron-rich diet and exercise. Revert back with the reports to 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 just found that I was pregnant three days ago, I got a faint positive and went to the hospital. The doctors said it was too early but they did a blood test and my hCG was at 150. I had sex yesterday morning and started light bleeding after. I had two small dots but the rest was light pink. I went back to the doctor and they did a vaginal ultrasound and I had the same problem. My cramping is nothing major. I am 21 years old, 5 feet 4 inches, and 161 pounds. Can you tell me if this is a miscarriage? ### Response: Hello. It could be a miscarriage and could be spotting in early pregnancy as miscarriages are usually confirmed on ultrasound scan and bleeding is heavy with abdominal pain and it usually takes a few days before getting stopped. I would suggest you to repeat a pregnancy test and see if it is positive or not because if pregnancy is miscarrying then there is a possibility for that to become negative due to falling levels of hCG." "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 are a serodiscordant couple and we want our child. Please suggest to us what has to be done. I am an HIV positive man and my wife is HIV negative. I take my ART medicine regularly. We want a healthy child without infecting my wife and my child. Is it possible with natural process otherwise sperm washing process? Please give me information about that if you can help me please respond to me. ### Response: Hi. You have three options. IVF, sperm washing, using pre-exposure prophylaxis. First two are safe but very costly considering technique and your status. Last option is cheap but is a little bit risky and need compliance from your wife. Your wife needs to use medicine regularly and you should be on treatment to reduce viral load. If your viral load is undetectable, and your wife on PrEP, then there is a very good chance of pregnancy without being infected." "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 baby 9 months ago. Since I was 18 weeks pregnant, I had heart palpitations and high blood pressure. I do not have high blood pressure now, but I am still having palpitations, but not as frequent. It seems to be a hormone imbalance. I got them this month on the first day of my period and a couple other random times. Two weeks ago, I started getting swelling in my right hand only when I lie down or sleep. Also, I have had random itchy spots like hives just in random places. ### Response: The palpitations you are experiencing are mostly a normal phenomenon during pregnancy. It is known as sinus tachycardia. Nevertheless, it is better to get an ECG done to reaffirm my suspicion. The hives and skin issues are also could be due to the hormonal changes in pregnancy. ECG if sinus tachycardia and then no need of any active intervention." "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 work in night shift. What can I take to be alive and energetic at night during work? I feel sleepy, and I am slow during my work. Please suggest. ### Response: Hi. Since you are working in the night, you might be losing out the necessary sleep. So you are unable to focus entirely during work. It is essential for an adult human being to get seven to eight hours of quality sleep every day. Once you finish your job in the morning, try to have a hearty breakfast and then close the windows of your room with a dark curtain that blocks the entry of light. Request your family to keep the house quiet and try to sleep at a stretch for at least six to seven hours. It will help you unwind and relax. During the weekends, try to avoid staying out for long periods. Try to catch up the lost sleep. Some foods that help in inducing sleep are dairy products, bananas, and almonds. To keep you awake and energetic during work, avoid eating heavy meals before and during work. Eat small meals at frequent intervals. Please remember that the best time to sleep is the night time. Keep looking for better work opportunities, and sometime in future, you can move on to a job that lets you sleep well at night." "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 51 years old. Over 9 years she is unable to sleep properly either in the day as well as night. She started to feel irritated and we consulted one of our family doctor and he suggested to start Stalopam plus. But now a days even after taking the same medicine she is not getting proper and sound sleep. Currently, she is on Stalopam plus one capsule a day. I have attached the prescription. Please suggest us what to do? ### Response: Hello. I have gone through the prescription attached (attachment removed to protect patient identity). Diagnosis was anxiety with insomnia for which Stalopam plus (Escitalopram) was prescribed." "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 daughter is nine years old. She had body odor in the armpit. I was alarmed because it smelled like an adult body odor. She had sweating. A few days ago, she told about her nipple that one nipple looks normal and the other one looks hard. I want to know whether she has reached the puberty stage. I have another daughter. She is 13 years old. She does not have these problems when compared to my younger one. Please help. ### Response: It is normal to have these findings now because a few kids have it. Normal growth cycle follows these ways. The first one is thelarche. In this, there is a development of the breast. The second one is pubarche. In this, there is a development of pubic hair. Then the next one is menarche. In this one, there is an onset of menses. In between thelarche and pubarche, there is a growth spurt. So all these occur gradually. It is normal for your child to have this development. You can consult a doctor when there are secondary sexual characters like breast development and growth of pubic hair before eight years of age in a female child." "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 3 years old and has retractile testicles. Is surgery generally required for this condition? ### Response: For retractile testis, we can wait up to the age of 8 years. Usually, the testis descends by that age. If there are no complications and it is a proper retractile testis and not an undescended testis, then you can wait till the above age. However, continuous monitoring with USG (ultrasonography) is required every six-monthly. However, if the testis is completely undescended, then it is advisable to do orchidopexy surgery before the age of 2 years." "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 I have a problem with my cornea. I had itchy eyes (due to hay fever) last week. During that time, I had a gritty feeling in my right eye which made me rub my eyes. It got really sore and small thread-like materials are coming out of my eye. I am scared if it is part of my cornea shedding off. My vision is blurring out since three days. What do you think it is and what should I do? ### Response: Evaluation of your history indicates that you are having allergic conjunctivitis with probable involvement of cornea resulting in keratoconjunctivitis. The thread-like material coming out of the eyes indicate ropy discharge which is typically seen in allergic conjunctivitis. No need to worry, as it is not part of the cornea. Since the cornea is involved, you need to use artificial tears eye" "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: Few years ago, I had spasmodic dysphonia. My voice was husky and high pitched. I took medicines and speech therapy. There was slight improvement in my voice but after that my voice is high pitched. I want deeper voice that is manly voice. What should I do? Is there any way to get deeper voice, except surgery? Please suggest. ### Response: Hi. Spasmodic dysphonia is one of the difficult conditions to treat and patient motivation is most important. Speech therapy is tried always and some benefit is there. Botox injection in spastic muscle will give best results, but speech therapy has to be followed. Botox has certain duration of action, so the results may last around 6-12 months. In that time, if the cause of spasms is known, that should be tried to be eliminated permanently." "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 wheezing problem. It is like asthma. Can I have a quick remedy as I am in office? ### Response: The presence of wheezing suggestive of bronchoconstriction induced by asthma or bronchitis. For immediate relief, you can take Salbutamol inhaler two puffs readily. If nebulizer is available then Levosalbutamol and Budesonide Respule can be taken through nebulization. You can consult a pulmonologist for chest examination and accordingly your further management plan." "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 26 years of age married for two years with no kids. I have a cystic structure on my left ovary 7.5 cm x 5.5 cm. Before I had a tubular cystic structure on my right ovary 6.5 cm x 5.5 cm which is gone by itself. I just wanted to know what kind of operation is done for this cystic structure and after removal will I be able to get pregnant and the doctors told me that my baby bag is twisted (facing the other side) and the chance of getting pregnant is 15 % lower than the normal ladies. Is it correct? And how it can be corrected? ### Response: Hello. As the CA 125 (coelomic epithelial antigen) levels are normal, the cyst is likely to be a simple ovarian cyst. A cyst of size more than 4 cm if symptomatic can be removed with laparoscopy. But if asymptomatic then a trial of low dose oc (oral contraceptive) pills can be given for two cycles to allow natural resolution of the cyst. Secondly, retroverted uterus as in your case has reduced chances of conception, but with the change of position during intercourse that can be overcome. For infertility management, it is important to learn your hormonal status and regularity of your menstrual cycle. Please follow up with details. Regards" "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 getting pain in the middle of my chest when I put pressure on it such as while sleeping when I suddenly wake up or turn around. Why? ### Response: It occurs when the cartilage between the sternum and ribs becomes inflamed and irritated. Try the following methods. 1. Ice pack to your chest. 2. You can take non-steroidal anti-inflammatory" "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 suffering from what I think are mental problems since last year. To give you some context, I went abroad for studies, and I felt extremely lonely and miserable there. After a year, I was suffering from sleep problems. However, one day, I had confusing thoughts, just before I went to sleep. For some reason, I became convinced that I had a mental illness, and I began researching my symptoms. My condition also declined. I began to feel detached from everyone and everything around me, and I felt like I was losing touch with reality. This went on for some months. However, during this time, I felt fine when I was in the company of others, and therefore longed to be with people and talk to them.I gave my exams, even rejoined a job, which I had left to do my masters. There are periods when I feel completely fine. But, there are periods when I feel terrible. I am having the following symptoms. Whatever dreams I have, I tend to remember and notice them more. I could be dreaming about my old house or someone. So when I wake up, these dreams cause me to feel uncomfortable, like maybe I will lose my grip on reality. Whenever I see or meet a person I have dreamt about, I get an uncomfortable, unpleasant feeling and a memory of the dream. This makes me afraid that maybe I will be unable to distinguish between dreams and reality.I get mental images and thoughts of memories or things I dreamt about. This gives a very unpleasant feeling. For the past few days, I am getting strong mental images of faces of people whenever I talk to them or think about them or see them. For instance, I would be thinking of someone, and I will have a strong mental image of their face. I would be talking to someone, and a different mental image of their face would pop up. I am really scared about this. Why am I getting mental images of everything like this? I feel depressed and sad that I will lose control, and that I will go crazy. At times, I am confused and not able to process things properly. I have also started feeling scared and petrified for no reason. I get a sinking and nervous feeling in my chest. My hands shake at times, and I feel like I will lose control. This has been happening for the past 10 months. Are my worst fears true? Do I have a mental illness? ### Response: This can be done only with in-person consultation with a psychiatrist. So, I advise you to go to a psychiatrist in-person and start the treatment" "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: Please find attached the blood test report. Highlighted in bold are the tests which are out of range. Can you please advice on the reasons and corrective measures to get the exceeded test values in control? Do I need to perform any follow-up tests? I have got the blood test profile checked just as a general checkup and not specific to any illness (I get it checked once every two years). ### Response: Hello. I have gone through all your reports (attachment removed to protect patient identity) and I am impressed with your overall health. However, there are a few things that need to be sorted out. Your total red blood cells and hemoglobin levels are slightly increased than normal but not significant in the absence of symptoms like headache, hypertension, itching in the body after a warm bath, etc. If you are a long-term smoker, this could be a cause of the slight increase. Do you have any chronic lung disease or kidney disease that is known to you? Also, I see that your serum lipase is a little off, it usually indicates pancreatitis. Are your suffering from any symptoms like abdominal pain, fever, nausea, or vomiting? I suggest you repeat serum lipase." "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 baby is 2 years old. For the past four months, she gets constipated. She has to move her bowels daily because if she does not have it more than 24 hours, she will get constipated. We tried changing her milk, but it only made her stools harder. She is currently on similac go and grow. We add water on her milk because she hates drinking water and she is a very picky eater. I use pedia lax to help move her bowels. What should I do? ### Response: Instead of using 30 ml water with each scoop, please add 45 ml water to each scoop for making the formula. Also, reduce the consumption of milk and simultaneously increase the consumption of fruits, vegetables, chicken, etc., whatever the child likes. As of now, you can use laxatives as and when required. However, as soon as a week or two after the above diet changes are made, the need for a laxative should be much lesser than what it is 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 am scheduled for a joint block injection in my right foot due to arthritis pain. Will I be able to drive home myself from my appointment or do I need to take someone with me? ### Response: Hi. The injection given for the joint block for arthritis contains some local anesthetic. So, you may not feel pain at least for half an hour to one hour. But as soon as you reach home, keep your leg elevated and apply some ice packs as it may bother you that evening. 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: Dear doctor,Can you tell me which exercises are the best to do when one is having ankylosing spondylitis with an Andersson lesion apart from any outdoor exercises? ### Response: Hi. You have to inform us of your age, duration of symptoms, whether you are on any medical management, the extent of your body joints and spine involvement, etc. Considering all these have been done, I would suggest you concentrate on deep breathing exercises and pranayama. Also, we advise you to avoid the use of high pillows or a soft bed. Now as you know, the chest expansion is limited when one is having ankylosing spondylitis, swimming is a good exercise that helps most joints in addition to the back. You may also need to check your vitamin D status and the calcium, phosphorous and alkaline phosphatase levels. Yoga can be tried but will have to be individually tailored. All the best for a sporty day. Consult a physiotherapist 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 son has been asked to take manasamitra vatakam for anxiety by a friend who is a Sanskrit scholar. He is now 17 years old. What is the right dosage? Any food restrictions? ### Response: Hi, If your son needs to take manasamitra vatakam, you can buy only a good brand. Hope this helps. If you would like to have a detailed analysis of the problem of your son, please either book a phone consulttaion with an Ayurveda Specialist or consult a psychiatrist 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: For two years, I wake up in the night with dry throat and mouth and blocked sinuses. Back of mouth or throat is also coated with unpleasant, pale yellow scum on waking (during the day, I am fine). I saw ENT doctor a month ago, diagnosed inflamed sinuses and prescribed four months of steroid drops. These are not working and now I have blood flecks in mucus when I blow nose first thing on waking. This morning, blood streaks are also in the scum from throat which feels raw. ### Response: Hi. I think that you need to perform a CT scan for your nose and sinuses. There may be a surgical cause for your naso-sinal problems as polyps, deviated septum or hypertrophied turbinates. Perform the scan then show it to me. Do you have excessive sneezing or rhinorrhea? Do you have any allergies for any odors?" "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\s BP is always fluctuating. She has high heart rate and was taking tablet Concor cor 2.5 mg. Later the doctor changed it to tablet Telma 40 mg and Ivabrad 5mg. My mother is not feeling well after taking tablet Ivabrad. ### Response: Hi I would suggest her to have low salt diet and start doing few mild exercises. Revert back with the information to a general 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 have a question about hearing. Firstly, I am aware that hearing loss takes place when the tiny hair cells within the inner ear are damaged. My question is, once a particular hair has been damaged, will the same sound level that previously damaged it, hurt it again? For example, if you listened to a sound at 90 dB for nine hours and your hearing was damaged, would doing the same thing another day further damage your hearing? Or would it not change anything, as your ears would not be registering the same level of sound as the previous time? ### Response: There is something called a temporary threshold shift and permanent hearing loss. Temporary loss is the loss which if a sudden burst of sound and you get hearing loss as hair cells are fatigued however hearing regains soon in some time. If it is a permanent loss that too at a severe level for all frequencies chances are the person will not notice the same loudness of the sound afterward however there are some pathologies where the sound amplifies itself, and it is called recruitment. So in that condition, the person may not even respond to a loud sound of 80 dB however they might complain abnormal loudness at 90 and feel the same discomfort as a person with normal hearing has. It all depends on the pathology and condition of the hearing loss." "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, my wife got a red rash on the right cheek. It was small and weak at first, but grew in size as a large patch and spread underneath the nose and mouth in two days. It causes a strong stinging and burning sensation. Please help. ### Response: Hi. Were there any blisters or pain before the occurrence of rash? Please send a few photographs of all affected areas. Revert back with the photos 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: For the last five months, I have had problems with my throat, left side. I have a hair-in-throat feeling that will not go away. I have been to two ENT already. The first one did not do any tests and just prescribed Penicillin, assuming strep. Later on I did develop an infection, which cleared out with Ceftriaxone.The second ENT prescribed Azithromycin, Deflazacort and cleaning with baking soda. Felt a bit better, but feeling is still there. ENT said tissue was swollen, and true enough, I see a part unusually swollen, no pain though, just the annoying feeling. I am horribly terrified of the possibility of this being throat cancer, even if both ENT have ruled it out. Can you please check the pics and give me your opinion? ### Response: Hello. I do not know whether this satisfies you but there is nothing to suggest that you have any growth. It is either LPR, GERD, chronic pharyngitis due to other causes that may be causing these symptoms. At times it can just be globus pharyngeus." "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 candida balanoposthitis. I consulted a doctor, and he gave me Glospor DS 200 mg for a week with Livafin ointment. But still, I am having red spots on the penis. My penis is uncircumcised. Please provide your suggestion. ### Response: Hi. Please say whether you have diabetes. Please tell whether you are sexually active, with a regular partner and whether you use a condom. Please upload the appropriate images of the present condition, so that, I can 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: I am a 21 year old female. I have been suffering from hirsutism (due to PCOS) for about six years. I have undergone treatments like LASER (for about a year) and even consumed antiandrogens and contraceptive pills. But, nothing really worked out. It is horrible now. The growth of the hair is very thick and grows very soon. I wax once a week. I even used few creams, but again nothing gave out the results. The doctors I consulted told me to lose some weight, and trust me I am doing that. Please help me out. I want to know if there is any surgery to eradicate hirsutism. I heard laparoscopy might help. Please do write back to me. Your reply is awaited sincerely. ### Response: Before I can answer, I would like to see some lab reports. If you have them, please send those reports. Revert with more information to a family 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 have increased ringing in both ears. I have been diagnosed with post nasal drip. The left ear feels blocked and the left side of the throat feels clogged as well. I had taken antibiotics on the prescription but that is not working. My ear testing results were normal. ### Response: Your problem seems to be due to sinusitis. Sinusitis itself can cause clogged feelings in the throat or sinusitis can cause secondary pharyngitis which can cause throat problems. Do you have a headache or nose block or excessive sneezing? I will want you to send me a clear picture of your throat where I can see your tonsils and posterior pharyngeal wall. Also, please let me know the name of the medicines you have been taking and also the duration. I am enabling free follow up. Please revert back." "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 an abortion seven months back. I have been having black colored periods bleeding from the last three months. The bleeding is black on all the days of the periods. ### Response: Hi. How are you doing? That is quite a short history. Having black or altered blood in the first few months after abortion is common. We have to rule out the following possibilities. Get a pelvic scan to rule out any endometrial polyps or any uterine masses or any endometrial pathology. This polyp may be from the cervix projecting into the vagina causing such symptoms. Rule out a possibility of a second pregnancy, so get a home urine pregnancy test done. It may be early pregnancy bleeding. Hope you are not using any other hormonal pills. If you have a lot of vaginal discharge, itching, foul smell, then it might be a vaginal infection. In such a case, I suggest a course of antibiotics. Vaginal infection can cause a lot of spotting or altered blood loss. If your periods are associated with severe abdominal pain, then it could be endometriosis, which will be corrected only with hormone pills or by getting pregnant. It can be diagnosed with physical examination and using pelvic scans. During the examination, the cervix can be evaluated, and Pap smear can also be taken. Hope I have clarified your query, do write back. All the best" "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 41-year-old male. I have been elected for an EKG because I am a pilot and need a medical certificate. I have hypertension that is controlled easily with 10 mg Propranolol a day and 10 mg Lisinopril a day. My BP is 117/70 with 66 BPM. There are no symptoms of chest pain or shortness of breath ever. Yesterday during a routine visit I asked physicians assistant for a 12 lead EKG as I have heard it is a good thing to do. Never had any symptoms, slightly overweight, BP great with 10 mg of Propanolol and 10 mg of Lisinopril. I had an abnormal EKG and asked if I have ever experienced the symptoms of a heart attack? I have a copy of my EKG which is machine printed that reads ""abnormal old anterior infarct."" I have an appointment with a cardiologist but I am going crazy until next week. Should I be worried? ### Response: Hello. Your ECG (electrocardiogram) is absolutely fine. However, get an ECG for a final confirmation" "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 eyes twitch a lot. I started experiencing it last year. It lasted for a good three months and then subsided on its own. This year it has started again. It is very annoying and hampers work. I wear spectacles and got my vision tested a while back. So my power is correct. Can you please help me on this? What medication should I use to make it go away? ### Response: Do you feel any kind of fatigue also along with the twitchings? Did it start last year after any kind of systemic illness like viral fever or any trauma? Any kind of treatment you take for any disease? Your symptoms may purely be due to weakness without any associated pathology but may be associated with some local or systemic disease like blepharitis, or myasthenia gravis. You can try using multivitamin specifically rich in vitamin B12 and Folic acid" "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 did not use left side for eating prior to RCT. Little pain was there but not sensitivity. After one corner broke then I went to the doctor and they suggested me for RCT as it happened because of cavity. One of my tooth second last from the end of lower jaw. One day it broke down and I went to doctor then they said you should go for RCT and I took RCT treatment. Prior to this I did not use that side for chewing as sometimes it hurts suddenly. So before RCT one of the corner was broken down already.After RCT, again one corner broke down again and now when I close my jaws it hurts. Also when I rub my finger slightly it hurts sometimes a little pain. No sensitivity is there with cold water but hurts little when I close my jaws or I rub my fingers on it. ### Response: I have gone through your query and understood your concern. When a tooth decays and when the nerve layer of the tooth is affected, it starts to give out pain and it loses its vitality becoming more brittle. Hence it could have fractured. Also, to save such tooth, root canal treatment will be performed. Mild pain/discomfort after RCT is quite normal for the next 3 to 5 days for which you would have been put under pain killers. This period is for tooth healing and it is essential that you do not disturb or bite food on that tooth. Once it completely heals, crown procedure is generally performed. Placing a crown over the root canal treated tooth is mandatory to protect the tooth and to prevent further fracture of the tooth. Do visit your dentist for the crown procedure and till that do not eat hard, chewy foods and avoid chewing food on the involved side." "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 52 year old female. Two weeks back, I had severe abdomen pain and got a sonography done. I have been diagnosed with amebic liver abscess. It was identified 13 days back and I was admitted in hospital for three days and was given saline and Metronidazole dosages, but still not recovered. Doctor told it will take 15-20 days to recover, but even after 10 days there has been no change. My main symptoms are pain near abdomen, frequent fever, loss of appetite, feeling weak and dizzy. I am attaching the sonography details and prescription details. Kindly check and let me know your view on this. ### Response: Contrast enhances CT scan of liver triphasic. If abscess is present then aspirate the abscess. Follow up after CT scan to a general 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 am waiting to be booked for what my doctor calls a core-biopsy and it is taking too long. As I wait I would like to research and gain more information. I would like an interpretation of this report please. These are the results of a fine needle aspiration on left breast:The smears are highly cellular. Cohesive branching monolayers of mildly pleomorphic ductal epithelial cells are present in a background containing frequent bare bipolar nuclei, occasional macrophages and some myxoid stroma. Within the epithelial cell aggregates, nuclear streaming and an admixed myoepithelial cell population is revealed. No dissociated malignant cell population or true papillary epithelial cell aggregates with fibrovascular cores are identified. ### Response: This is a picture suggestive of a fibroadenoma. It is not a malignant bump. But, FNAC identifies only the part that has been included in that needle. So to confirm, we do a trucut biopsy which tests the entire lump and is conclusive. 99 % this is a non-cancerous lump." "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: One week before three kidney stones came out, and I have a burning sensation while urinating after that. I went to the doctor he took some test and told that my creatinine level was 1.6. Is it dangerous? I have hypertension and my value is 150/100. ### Response: Based on your history you might be having a urinary tract infection. Urine infection is a known complication in patients with urine stones. Do you have other complaints in addition to burning sensation like fever with or without chills, abdomen pain, vomitings, and blood in urine? The rise in creatinine in your case can be due to a pre-existing renal disease due to hypertension, or the current urinary tract infection may also cause this. I advise you to get, 1) Complete urine examination for any urinary tract infection. 2) Urine culture and sensitivity to identify the specific organism causing infection and antibiotic sensitivity. 3) Ultrasound abdomen to look for any urine stones still present. 4) Complete renal function test. 5) Complete blood count. You are welcome back to me with any further queries." "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, 25 years old, not married. Recently, I had a circumcision (seven weeks back) surgery because of phimosis. The foreskin was removed till above the ring of my penis head. During sleep or when it is erected, skin is automatically moving below the ring and automatically coming back to normal position. Here are my questions.Even after circumcision, does moving or retraction of the skin below and above the ring matter?I am having a little bit difficulty to move the skin to below the ring with my hand, during masturbation. Even sometimes it is moving on its own when erected. Is it okay?Will this affect my sex life in future?I am doubtful that I might be having less natural lubricant under the skin of my penis. Because of that, I see some pain if I hardly rub my penis during masturbation. Can we hardly rub the penis during masturbation? If yes, is this pain common? Do I have natural lubricant issue under the skin of penis? Please clarify my questions in detail, as I am shy to ask these questions to a doctor directly. ### Response: Relax and do not worry. After circumcision, you will not have any skin on your penis head. If you pull also, it will go back to the ring of the penis head. So, that is normal. So, nothing to worry. If you are feeling too much" "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 28-years-old male with 250lb. I have little pain in the chest when taking a deep breath, especially in the morning. I do not have a cough at all when I try to cough hard sometimes there is little tiny blood in my saliva, and my mouth tastes bloody. I keep smoking these two weeks a lot which I can see when I smoke a lot my chest hurts, but this blood thing is scaring me that I may have lung cancer. What should I do? ### Response: I can understand your concern. First of all, do not think directly about lung cancer because the possibility of it is very less. Possibility of other smoking-induced lung diseases like pleurisy, lung infection, bronchitis, etc. is more likely. So please let me know, 1. Since how long do you smoke? 2. How many cigarettes per day? 3. Do you have breathlessness? Please reply to me answers of above-asked questions, so that I can guide you better. I will be happy to help 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: I am a 30-year-old female with weight 95 kg. I have a sore in the right foot in which the skin is coming off and is irritating. Also I have a slim like substance that builds up. The smell is really bad. ### Response: Hello. I understand your concern. This condition is known as pitted keratolysis (attachment removed to protect patient identity). It is a superficial skin infection, caused by Corynebacterium species. Take the following treatment. Kindly consult your doctor, to discuss the suggestions and take the treatment with consent. 1. Cream Mupirocin apply once at night. 2. Benzoyl peroxide 5 % gel apply once in the morning." "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 grandmother is 65 years old. She has a problem with eye flashes for four years. She complaints of getting lights in her eyes in various shapes like stars, sparks, and pictures of various colors. She is left with only 5% eyesight. Please recommend the best medicine and eye drops for this problem of eye flashes.She is currently using ayurvedic eye drops. She underwent laser treatment. ### Response: Flashes are usually due to retinal problems like retinal tears, or detachment. Floaters in diabetics can be due to blood in the vitreous. These have to be treated with lasers, retinal surgeries and/or intravitreal Avastin injections. As she is left with only 5% of vision these are the only options. Strict control of diabetes is a must. Please give the history of any eye surgeries, past eye treatments, present vision in both eyes. Kindly send pictures of old records for more details." "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: Before a month, someone who has labial herpes kissed me on my cheek. After that, my lips were burning, but I did not apply any lotion on the lips till now. I am a little bit hypochondriac. Before two days I met my boyfriend and I kissed him on the cheeks. The next day, I feel pain on my chin and after that I had something like acne there and then I had two aphthous ulcers at an interval of two to three days. One under my tongue and another inside the cheek or lip. Now, my boyfriend has headache and throat pain. He thinks it is the beginning of an upper respiratory tract infection. Could it be his primary infection? Did I pass herpes to him? Can we do a viral culture of his throat to know whether HSV-1 is present or not? Is am I HSV positive? Please help. ### Response: Hi. As I understand you are conscious about you and your friend\s health. But, no need to worry. First, I would like to tell you that herpes infection are transmitted by direct contact like kissing and manifest with multiple painful vesicle, which may develop to ulceration associated with pharyngitis or ulcer over oral mucosa. So, if you had a kiss by a confirm case of Herpes labialis, you may get such infection. But, it is not always an infection to convert into a disease as body\s immune system protects us from such kind of pathogen. I do not think to go for viral culture as it will not help in deciding treatment plan. Viral infection usually gets cured itself within 10 to 14 days. You may be having a herpes infection, but do not worry." "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 period date was 21st last month. I had unprotected sex on 20th last month and had taken an I-pill within two hours. Since the 6th of this month, I am having irregular bleeding which has been increasing. Is it a side effect of the pill? Is it implantation bleeding? I also have a history of ectopic pregnancy which had happened two and a half years back. ### Response: Hello. Emergency contraceptive pills are hormonal pills that can disturb cycles. For your satisfaction, I suggest having serum beta hCG (blood pregnancy test) and then to regulate cycles, you can have combined oral contraceptive pills cyclically for three months. In case of irregular periods for many months with abnormal hairs growth and sudden weight gain, it is better to have a transvaginal scan and blood sex hormonal tests on day-2 of periods" "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 26 year old female. I am trying to get pregnant. My doctor recommended me to take Susten 200 after the ovulation period. Now, I am on the 29th day of my cycle. I have some pregnancy symptoms. But, I am not sure. Please give me some clarity. I am scared too. ### Response: Please note the following physical signs of pregnancy, which you may experience in a few days if pregnant: I suggest you consult your gynecologist for other blood tests and confirmation. Have a nice 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: A rash appeared on the crown of my penis before three weeks. A reddish mark appeared on the head of my penis. It does not hurt during urination. I had done an HIV test, and the result came as nonreactive. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). There is a rash, but it is minor. It usually happens after sexual intercourse. I recommend you apply Mupirocin ointment twice daily for two weeks. It will get cleared soon. Do not use soap over it and avoid having sex for some 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 have a small question about exhaling breath sounds. I always listen to my body and make sure everything is as it should. I have mild ETD, which makes my nose a little stuffy when in dry environments or the humidity is low. Two weeks ago, I was to hiatal hernia surgery. They did check my lungs and did not say anything. But, I notice that if I listen to my breathing when I forcefully exhale there is a little sound. I am not sure if it is squeezing or whistling. I cannot hear it if I breathe normally in and out. It also depends on my head elevation, either up or down. Should exhale air sound like air coming out? Will it change on the head position? ### Response: We are here to help you. When you listen silently, you can hear the exhalation sound, and that is absolutely normal. A few people have that sound in excess, and that can happen due to nasal polyps, obesity, and breathing disorders. So, if you have any of the above, then it is a concern. Otherwise, generally while in silence everyone hears their own breathing sound." "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 24 year old male. From the last 15 days, I have pain at the time of passing urine. So, I went for a urine test of complete urine examination and urine culture. There was nothing wrong with the complete urine examination. But, in the urine culture, at the bottom of the report, they mentioned one comment: \occasional inflammatory cells seen\. Kindly correlate clinically. I am attaching the files. Please go through the files and suggest medications, please. ### Response: Hello. I have seen the reports sent by you (attachment removed to protect patient identity). It shows urine infection with E.coli type of organism. Inflammatory cells are seen due to the infection. I suggest: Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Repeat the urine culture tests after eight days to check if the infection is gone" "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 daughter is 4 years 6 months old and had vomiting and fever from yesterday morning. Vomit and leg and hand are paining. If she has some food, she vomits. What is the reason? Please advice. No loose stools, not eating for past two days. ### Response: Hi. According to the complaints you gave, it may be viral fever with gastritis or urinary tract infection. Viral fever with gastritis, urine infection. Urine routine, and microscopy. Viral fever, urinary tract infection." "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: There is about a quarter inch long strand of skin going away from the anus and I think it is a hemorrhoid. Also, that is dark purple in color. I am in need of your help. ### Response: Hi. I want to assure you that do not worry as everything is going to be fine soon. I have thoroughly gone through your case and can well understand your genuine concerns. I have seen the attached picture and it looks as hemorrhoid (attachment removed to protect patient identity). I am unsure about the position of the lesion that is, whether 6, 9 or 11 o\clock. It usually is due to portal hypertension. Proctoscopy or colonoscopy by a general surgeon. Hemorrhoids. Avoid constipation. I suggest Lactulose syrup if you have constipation. Consult your doctor, discuss with him or her and take the medicine with consent. Take plenty of water and high fiber diet. Ask your primary care physician to refer you to a general surgeon for proper evaluation and treatment plan. Do not let it go untreated as it may complicate and will have serious consequences." "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 appreciate if you can help me out. I am taking Propranolol 120 mg. I restarted after a short period of stopping it without the doctor\s advice which was wrong of me could be just the side effects cause I feel low-high, low-high, basically, my mood keeps changing. What causes mood swings, feeling too high with full of confidence, etc. to feelings of low depression? ### Response: Hello. In ischemic heart disease also it can be prescribed. But it is not related to mood swings. You are having mood elevations as well as depression. So, suggestive of some form of psychiatric disorder. Bipolar mood disorder also has to be ruled out. Your blood lithium level has to be checked. Behavioral counseling and medication will help you. You can consult a psychiatrist for examination and counselling. Do not stop Metoprolol without doctor advise." "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 vagina is producing yellowish green mucus. That sometimes has blood in it. It also smells horrible. It had been going on for about two weeks, but recently started to have blood in it. I am on regular Zoloft and Melatonin. ### Response: Yellowish green discharge may be because of vaginal infection. You said that you have blood in between. If blood comes during menstruation (monthly), then it is normal. And if it is not a menstrual bleeding, then you have to be checked by nearby gynecologist to rule out cervical bleeding or other." "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 got my front (upper 12 probably) tooth RCT done six months ago. The RCT was short because I experienced acute pain beyond that point. RCT is about 1.8 mm short. He then suggested getting apicoectomy because RCT was incomplete. From a second opinion, the other doctor recommended a re-RCT. What should I do? Do I need to get the surgical procedure done? I have no symptoms of pain in the tooth. My teeth are generally weak and hence a little pressure is felt. The tooth area is mildly sensitive, but I suspect it to be from other nearby infected tooth. ### Response: Hello. I have been through your query, and I can understand your concern. Endodontic treatment for any tooth when it is not completely done like in your case it is short. It might be that you cannot feel pain or have any other discomfort. But it is highly susceptible to the secondary infection in the root. I would highly recommend going for the re-RCT treatment as it will not require any major surgical procedure and the tooth will be saved as a whole (in retreatment only minimal tooth material is lost). However, sometimes if space is some mm short, then if the root canal is properly sealed, it might not lead to further secondary infection. But that is just one such case. So if you wanna wait for the symptoms, you can but I would suggest you go for re-RCT. Apicoectomy is more invasive and will remove a small unfilled lower portion of the tooth and then accordingly seal the apex of the root. This also is a way to seal off the apex for underfilled root canals in RCT. But re-RCT is more desirable for me if you would have been my patient. Also, maintain good oral hygiene and brush your teeth twice daily and floss regularly." "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 two inner ear conditions. Both are somewhat rare: Right-semicircular canal dehiscence and Left- patulous eustachian tube dysfunction. What I want to know is whether I can fly- take an airplane without getting ill and sustain further inner damage? ### Response: 1. Super semicircular canal dehiscence is a rare inner ear condition. In this condition there will be giddiness and imbalance when exposed to loud noise and imbalance, echoing of once own voice, etc. This condition usually does not get worsened by change in environmental pressure. So air travel will not be an issue in this condition. In any case keep anti-vertigo medications such as Stemetil handy when you fly. 2. Patulous eustachian tube is a condition involving middle ear and nose. My guess is because of similarity in symptoms you have been given both the diagnosis. I can say that if there is vertigo then it is superior canal dehiscence if there is no vertigo chances of Patulous eustachian tube are high. In any case people with Patulous eustachian tube will have certain degree of pressure symptoms in ear when they fly but most of the times it will not be very severe. You can use simple saline nasal spray before boarding the flight and every two hours in air to reduce symptoms." "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 take coffee and tea during the day 6 to 8 cups. Is coffee good for health? What are the cons of coffee over cardiac patient or heart? Does it create heart disease? Currently, I am taking Ascard 75 mg. ### Response: Coffee in mild consumption is good for health in general. Excess consumption of caffeine increases BP and HR. I do not have any information on your BP. However, the echo shows some changes could be secondary to mild to moderate degree of uncontrolled high blood pressure, the left ventricle wall thickness is 11 mm which is slightly increased. The rest of the echo as reported is good (attachment removed to protect patient identity)." "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 47-year-old male. Now, I have pain in my knee. I have taken a lot of painkillers to get relief from it. But it comes back again. I am unable to run fast. I cannot walk fast. I have numbness in my right leg. Please help. ### Response: For knee pain, you can investigate with an X-ray or MRI (magnetic resonance imaging) scan of the knee joint. If there is any ligament injury in the knee joint, then it will be seen in the X-ray or MRI scan. You can consult an orthopedic surgeon for an examination. For numbness, you can investigate with serum B12 estimation, serum TSH estimation, random blood sugar estimation, SGOT (aspartate transaminase), SGPT (alanine transaminase), urea, and creatinine. If there is a need, NCV (nerve conduction velocity) study can be 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: My baby has a fever for five days with between 101 to 103. She is 10 month old. Doctor prescribe Paracetamol, Azithral, and Meftal P. But there is no impact now. She has a fever with a cold. Please suggest. ### Response: Antipyretics like Paracetamol and Meftal P (Mefenamic acid) are to be given in adequate doses to act effectively. Generally, a viral fever can last for 4 to 5 days and it can present with high-grade fever. Please let me know the weight of the child so that I can advise you exact dose. Do cold sponging of the whole body to decrease the temperature. 1.CBC.2.CRP (C-reactive protein).3.Malaria antigen test.-" "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 strange sensation in my leg for around two years. It usually only affects the lower half of the left leg and foot but has recently encompassed the upper sections. This is accentuated when walking and more so when the pace gets quicker. The feelings feel as if my lower leg and foot are quite light on the lift and not entirely under my control.The foot can feel as if it wants to turn in when I am running but never does, almost like a buzzy electric wave feeling. There is no weakness of the leg itself. I have suffered from cold feet over the years, and these can be pronounced, making the foot very stiff so that wiggling the foot and toes can be quite difficult.It can occasionally feel as if there is a block in the leg. The same sensation with a feeling there is a block can be felt in the forearm also. There are icy hands as well, which can affect ability with the thumb numbness now and then. When sitting, the feet feel as if they are stretching out with light relief available when I do. I am worried about MND. ### Response: I read your query. As per your symptoms, there can be chances of MND. In MND, there are also other symptoms, and there are chances of underlying sclerosis. But you can not rule it out on your own. You need a clinical examination by a trained physician. So I advise you to visit a nearby reputed physician and ask for the complete examination. Once a proper diagnosis is made, only then start taking treatment rather than taking random treatment. I hope you understand my point." "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: In the attached image, there can be seen as a reflection of light or white forelock. He looks to me to be between 18 and 21. His eyes are bright blue, and it cannot be seen in the picture. I am wondering if he can be diagnosed with Waardenburg syndrome 2. ### Response: Hello. But with the forelock of hair, he may have Waardenburg. But we must see if there is any hearing loss or defect in arms and other limbs. Can you provide more details? Any history of hearing loss? Congenital hearing loss is present in most cases. The syn" "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\s age is 49 years. He feels burning in the chest after waking up at midnight. Waking up is normal as routine. ### Response: Hi. Your father can have a duodenal ulcer with acid reflux. I suggest Rabeprazole 20 mg OD for one to two weeks for that. Meanwhile, avoid gastric irritants like excess spicy foods, excess tea, coffee, stress, smoking, etc. Cooked oatmeal help in the soothing of the stomach. Include curd in your diet. If no improvement, then USG abdomen or endoscopy like investigation can be planned." "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 her periods last to last month. Sixteen days later, we had a sexual intercourse. But, there was neither penetration nor ejaculation. Being unsure about the seminal fluid discharge or coming in contact with her genitals, I gave her Unwanted 72 the next day which was within 48 hours. Later, she went through its general side effects but without withdrawal bleeding.Further, she got her periods last month which as per her was her usual bleeding except for the first day as it was little heavier than normal and it continued for four to five days.After a few days of her periods, she told me about feeling nausea, headache, dizziness and a discharge which continued for two to three days.Now, in this month she got her periods two days later which again was normal as per her and yesterday she again felt nauseated. Please help me. Is there anything to be worried about? Are there any pregnancy chances? She had a normal cycle of 28 days and she got vomiting two days before. Please help me with your advice. ### Response: Hello. As long as she is having regular periods of normal flow and quantity there is no need to worry. There is a complete absence of periods in pregnancy, sometimes early pregnancy bleeding known as implantation bleeding does occur but it is very light and lasts only a couple of days. Nausea and vomiting that she is experiencing are most likely due to hormonal imbalance due to the emergency contraceptive pill. Do not worry. However, if you are still very anxious you can do a pregnancy test with a sample of early morning urine and check the results. That should ease any remaining doubts" "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 question. My girlfriend is already on krimson 35 due to PCOD. After we made love, she missed her periods. Now, she is also complaining of morning sickness and pain in lower back. All symptoms are same as she reported five months back when she was pregnant and doctor advised pills for three days for chemical abortion. We feel that she is pregnant again. What we shall do as we are not ready to have child right now? Shall we take that same abortion pill again? Will there be any health complication? Please guide. ### Response: So, if your girlfriend is regularly having these pills, you need not be concerned about pregnancy. But, there exists risk regarding pregnancy only if she is an irregular user. PCOS. 1. Urine pregnancy test.2. Serum LH (luteinizing hormone), FSH (follicle stimulating hormone), TSH (thyroid stimulating hormone) and prolactin estimation. Revert back after the tests to 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: My tampon will not go in no matter how hard I try and it hurts so bad. I cannot get my finger in either sides. I have planned to have sex soon but my vagina is too tight. What can I do? Is this normal? I really want to get a tampon in, because I am tired of pads and I feel like my vagina is blocked. Currently I am on Fluoxetine. ### Response: Yes, some girls may have a tight vagina. I would suggest it is better to get yourself examined by a doctor under good light as the actual diagnosis of tightness can only be found out then. Different causes may include vaginal septum or vaginal stenosis, etc. But if it is only a tight vagina, then it can be resolved quickly by the use of dilators. But I would not recommend you to do it your own without having a consultation with an expert. I hope it has helped you. If you require any further queries, please do not hesitate to contact 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: I am having testicular pain for the past about eight months. Ultrasound report is normal. Please suggest me yoga exercises and should I avoid something in my diet. ### Response: Hello. Learn the Sudarshan Kriya yoga session, which will be much more beneficial. I hope you satisfied with the answer kindly feel free to ask again." "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 cataract surgery. I can see objects only with the rigid lens and it is blurry. I cannot read anything. My eyes still get hurt by bright light and my pupils are big. Why? ### Response: After the cataract surgery, pupil may remain dilated due to surgical trauma to constrictor pupillae muscle or iris is damaged and becomes atrophic. Make sure you are not using any dilating" "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: What are the long-term cancer implications of receiving 1500 to 2000+ mSv of radiation due to I-131 treatments and substantial diagnostic testing? ### Response: Hi. The I-131 treatment aims to destroy the remnant thyroid cells in the body. Short-term side effects of RAI (radioactive iodine) treatment are as follows: Radioactive iodine may also affect ovaries, and some women may have irregular periods for a few months. Both men and women who have had RAI therapy may have a slightly increased risk of developing leukemia in the future. Though this is an extremely rare complication" "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 high fever of 103 degrees Fahrenheit, continuous sneeze and throat pain in the morning. Please advise. ### Response: This seems to be a streptococcal throat infection with a possible tonsillitis if you have difficulty in swallowing as well. High grade fever confirms a bacterial infection and hence, you have to be started on broad-spectrum antibiotics. I do suggest the following medicines. Consult your doctor, discuss with him or her and take the medicine with consent. You should be relieved after three doses ideally. Please take rest and start cold water tepid sponging for 15 minutes for around four to five times a day to reduce the fever. Please take bed rest for the next 24 hours. Streptococcus infection. 1. Acute tonsillitis.2. Pharyngitis. Acute pharyngitis. Saline warm water gargles thrice a day. Revert back after five days to a family 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 wake up by 8 AM I immediately go to clear the bowel. After that, I feel somewhat relaxed but after few minutes I start feeling bloated and then I take a cup of tea and after 15 minutes again I rush to the bathroom. Then I feel completely relaxed but after breakfast, after few hours, it starts getting bloated but when I go to the bathroom I am not able to poop but I feel very upset in the stomach and bloated. So after my afternoon lunch, by evening 6 to 7, I eat some light food and after a few minutes, I need to rush to the bathroom to poop. I went to the doctor many times but nothing worked for me. I am plannig to take the digestive enzyme. Can I take it? Please suggest. ### Response: Hi. I have gone through your query. Your symptoms could be due to hyperactivity or any stomach infection. Avoid tea, coffee for few days. Avoid junk food, spicy, and fatty food. Do not remain empty stomach for a long time. Include more salads and fibrous food stuffs in your diet. Avoid taking more protein in your diet. This tablet you have to take one in the morning and one in the evening before meals." "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: Do hand job and body to body massage have some HIV risk where the lady was not fully naked? Only the top part was naked. ### Response: No, you will not get HIV because of body massage or hand job, unless, you have an ulcer or cut injury or she should be positive and she should contact your ulcer or cut with her saliva or vaginal secretion or other body secretion. You may get a bacterial infection if the person giving hand job did not wash hands. So, no need to worry." "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 57 year old male. I just had a blood test. Results: Hemocrit 60.0 (h), Blood Urea Nitrogen 24 (h), MCV 96.6 (H), MCHC 31.9 (L), Creatinine 1.36 (H), Basophils 2.1 (H), All other labs were normal. ### Response: Hello. BUN levels represent the balance between urea production (liver), urea breakdown, and urea elimination (kidneys). Therefore, BUN is an indicator of kidney health and/or liver health. A high hematocrit could be due to many reasons and is not an indication of iron overload. Your hematocrit is not that high. Serum iron, TIBC, and serum ferritin levels are better indicators of iron overload in hemochromatosis. Your MCV is only slightly elevated. So, there is no need to worry about that" "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: What are the treatments available for chickenpox in an adult and secondary bacterial infection of the skin due to chicken pox? ### Response: Treatment for chickenpox in adults is tablet Acyclovir 800 mg five times a day for seven days. For secondary bacterial infection, you can apply Soframycin (Framycetin) ointment over the skin lesions three times a day for one week. You can also take some antihistaminics like tablet Allegra 120 mg (Fexofenadine) once daily to prevent pruritus. Hope it helps. Consult a general medicine physician online to know more about chickenpox" "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 15 weeks pregnant and have been suffering from urinary tract infections on and off for the last month. I gave my urine for culture and it showed up Klebsiella one lakh count. My gynecologist advised to take Norfloxacin 400 mg twice a day but the internet has a mixed review of the same with concerning how it will affect the fetus. Is it safe to consume the antibiotic? ### Response: Hi. I went through your query. Norfloxacin can be given in the second trimester of pregnancy that is after 13 weeks. Your urine culture report shows that it will be sensitive to Norfloxacin. Klebsiella is a very resistant bacteria. You will need a prolonged treatment with Norfloxacin. Also, please do ensure to repeat the culture after treatment is complete to make sure that the bacteria is completely gone because at times it needs extended treatment to completely cure the problem. Complete eradication is necessary as Klebsiella in pregnancy is not a good thing. It can cause abortions and pain." "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 some kind of infection (itchy red skin) on my penis hood. I visited one urologist for the same problem. Liver function tests, sugar and thyroid tests werte done. All were normal. He advised me to use Miconazole nitrate gel. I used it and got instant relief. I used it for 20 days, but there is a problem. Whenever I stop using Miconazole nitrate gel, my problem returns. What could be the reason?Earlier I used Sternon-G gel, but there was no relief. ### Response: You must be suffering from balanitis (fungal infection) that is why Miconazole 2 % antifungal cream worked. Do not apply Sternon G (Betamethasone and Gentamicin) as it contains steroid. Please send the current condition clinical photographs so that the oral medications can be advised. Are you diabetic? Does your partner suffer from itching problem in the groin area? You can apply Miconazole 2% cream or Sertaconazole 2% cream or Clotrimazole 1% twice daily. Consult your specialist doctor, discuss with him or her and take medications 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: My dentist said that I should remove both teeth in the photo due to them being infected. Both the teeth have their nerves removed and one is broken. I would like to ask for a second opinion as I worry that I will have issues with chewing after the removal due to the position of the teeth. ### Response: Hi. I have viewed your X-ray (attachment removed to protect patient identity). It looks very clear that the teeth are infected and the root canal treatment that is done is not appropriate. The teeth need to be re-treated or removed but the line of treatment depends on certain conditions of teeth. For this, I need a few more details. Please provide the following details so that I can guide you better. Please get back with answers. Revert with more information to 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: My son is this time more than 6 years of age who is an allergy, asthma, and chest infection patient from six years of age. We have continued the treatment with different medicines just like liquid, power and tablet forms. Please help me and suggest an idea for permanent treatment. ### Response: Please upload previous blood reports of your son if you have done. If not get a complete blood count done along with serum IgE values. We must find out what he is allergic to. If the IgE values are raised you will have to do a skin prick testing. For allergy and asthma first and foremost treatment is allergen avoidance. This combined with pharmacotherapy yields good results in most of the individuals. In a few, we may have to progress to immunotherapy. Please upload relevant investigation reports" "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 19-year-old male. I was playing basketball with my friend and his knee went hard into the lower outside of my lower left calf. After that, it began to hurt and now it has been about six hours and I struggle to put weight on it. It sends pain down into my foot and ankle and moving my foot up and down hurts my calf and leg. My leg also does not seem to be bruised but it hurts to touch where his knee hit me. ### Response: Hi. Start applying cold pack in the place where it hurts. Avoid weight bearing on the injured leg. Weight bearing will aggravate the injury to become more. Avoid movements in the left ankle joint. You might have injured several tissues when you got hit by your friend\s knee and there are chances of even a hairline crack in the bone during your injury. You may need an X-ray done. Contact an orthopedician or physiotherapist to start getting treated as splinting of the joint is very essential. Delaying it will make things worse rather than any better." "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 is 71 years old. He had two stents ten years back. He has no BP or diabetes. From last 20 days, he is suffering from right index finger sensation like insect biting and then feels depression in right side chest like something release. It is not continuous. It is happening around three to four times a day. What could be the reason? ### Response: Depending upon your description of the problem it seems most likely that your father is having some neurologically related problem regarding the affected area. Most commonly the nerves in the wrist might be the culprit especially a nerve known as a median nerve. There could be a problem associated with nerve impingement at the level of the spine as well. An MRI of cervical spine would help to rule that out. The depression in the right side of the chest needs to be confirmed that it is not related to a cardiac thing. Hence, doing an ECG should rule it out. On other routine evaluation, we need to be sure that his blood pressure and blood sugars are within normal limits. So, please check those out. 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 had kissed a sex worker accidentally in the lips/mouth area. No sexual contact or intercourse happened. I am very worried from the last few days about catching an STD from the saliva of the female. Now, after three weeks, I have developed a painless red lesion on the side of my tongue from the last two days and it is painless but not like an ulcer. Kindly advise if it can be an STD like syphilis. ### Response: Hello. I have noted your concern and I have viewed the image (attachment removed to protect patient identity). It is not an STD (sexually transmitted disease). It is perhaps due to pressure from molars. I suggest you take a B Complex vitamin once a day. Regards" "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 sneezing problem (more than a year) every morning when I woke up. I forced to sneeze vigorously at least 20 times in the morning. Please suggest any medicine in Siddha to cure this sneeze.I have been taking allopathy medicine for three months but it gives more side effects, drowsiness, and cough. And if I stop that medicine I get sneeze again. Please help. I took a test for eosinophilia and lung function tests, they are normal and I am currently taking Montec and Furamist nasal spray. ### Response: They are not good for long term use due to side effects. According to Siddha Medicine, this condition can be treated as follows: 1) Avoid exposure or cold air (AC), dust, mist, etc. They can activate the immune system in the nostril, thus sneezing occurs. Sometimes, AC also makes" "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 26 years old and diagnosed with rheumatoid arthritis when I was 23. Since then I have been on 15 mg of Methotrexate and Hydroxychloroquine. Since I have been on medication, I hardly have no symptoms, but recently arthritis seems to be flaring up for three weeks now. I have pain in my feet again, some stiffness and tiredness. Does this mean the Methotrexate is no longer working? My ankle also clicks every time I walk. I am worried about my joint damage? I did my blood test, liver and kidney function tests. All tests are normal. Please advise. ### Response: Well, it is a possibility that Methotrexate dose is not sufficient enough to stop the disease. 15 mg is the dose we use for starting and we normally go higher up. In my experience, 15 mg normally proves inefficient in the long run. But since your disease is flaring, and as you said liver functions are good, you need to increase the dose to 20 mg or 25 mg. Secondly, for the flare you are having, you can take a short course of steroids, Prednisolone 10 mg to be tapered over three weeks and stop. That will help to stop the disease." "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 premature ejaculation and very mild erection. Recently, I was under medication for a kidney stone and consumed Veltum 0.4 for about a month. ### Response: Hi. For premature ejaculation and erectile dysfunction, you can take tablet Tadaza (Dapoxetine, Tadalafil) (10/30). Tablet has to be taken one hour before the act and should not be taken more than one in a day. Along with this, please try to indulge in foreplay and enjoy the act with your partner. There are some more things I would like to know. Do you have any problems urinating? Does your penis tighten during morning time as you wake up? If you have problems related to the above two questions, please visit a urologist, otherwise, you can continue with the above treatment." "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 25 years old. My penis is thin and 4.5 inches long when erect. Should I marry or not? ### Response: I have read and understood your problem. Size of the penis varies from person to person, like other physical features like height, etc. On an average, it ranges from 3.5 inches to 5.5 inches on erection. Your penis is within this range on erection, so do not worry. , which is harmful. So most people have wrong ideas about penis size. Sometimes, vacuum erection pumps help to increase the size but can cause injury if not properly used. To marry is your decision but you are fine." "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 low-grade inflammatory arthritis. I have awful joint pain but minimal swelling and occasional slight inflammation in blood tests. The RA test is negative. Systemic steroid injection gives massive improvement. My consultant started me on Arava recently. At the same time, I have been weaning myself off Tramadol after being put on this irresponsibly by a pain consultant. Within a couple of days of starting Arava, a background headache began and a few days ago this reached an agonizing peak. The only thing that helped was Aspirin. My BP was raised and my Lisinopril has now been doubled. I stopped the Arava. My current medications are Lisinopril, Simvastatin, Omeprazole, Duloxetine. The headache is better but still in the background. So, I have the double issue of this and stopping Tramadol.My question is - Is the headache caused mostly by the Arava? And how long should I wait before seeing GP again? My BP is much better. I stress I am prone to migraines in any case. ### Response: The headache is likely to have been caused by a combination of the Arava (Leflunomide) and your raised blood pressure. Although we cannot know how much each of these contributed? Anyway, if your blood pressure rose a lot on Arava it is probably best not to have this again. Perhaps Methotrexate would be better for 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 have gotten two different opinions from two pediatricians about my 8 months old boy. One says my boy has Hirschsprung\s disease, and the other says it is just constipation. The first doctor did a rectal exam, yielding no explosive stools, and he wants my son to get a barium enema. The second doctor did not do a rectal exam and just felt my boy\s stomach, and said it is not hard and has good bowel sounds. She told me to up his apple juice or water to 8 oz per day with probiotics. KUB was done and shows lots of stool in the large intestine, so the doctor told me to give Miralax and liquid suppository.My son did have suppository a week before the visits with hard poop smear in each diaper ever since. During that time, I had been reporting to my first doctor about my son\s constipation. My son started with gentle solids at six months. He is today exactly 8 months old, weighs 21 lbs, and has over 90 % growth in the growth chart. He does not have weight issues. He never had a fever, no blood in stools, has passed his meconium, and had a few projectile vomiting in his lifetime.My son does not fit the HD diagnosis, but my doctor says because of the rectal exam yielding no explosive stool it means it is stuck in the large GI. Is there harm in performing barium enema? My son already had an x-ray, which shows lots of stool in the large intestine. I also just gave him Pedia-Lax, and he had a good bowel movement for the first time since two weeks. I am attaching a picture. I will give him Miralax this weekend with 8 oz liquid a day with probiotics and no solids for now. Is barium enema an old school method?I am so torn because the first doctor in a specialist and has 50 years of experience, and he is adamant that my son has HD even after consulting with his colleagues. Could this just be a bad case of constipation? Maybe, I did not insert the first suppository correctly, and maybe my son did not get enough liquid this whole time, this second liquid suppository really helped. The second doctor has eight years experience, and she is so conservative. She does not want to give a rectal exam or even suppository. She says my son is at a low risk and does not have HD. Should I see a gastroenterologist or my son before we proceed with the barium enema or should we just get it done at this point and see the results? I just did not read anything about a barium enema after online research. ### Response: Hi. There seems to be a lot of confusion that has been created. See here are my valid points: You will need to get evaluated by a pediatric surgeon, who will be able to shed light on this matter." "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 my sinus surgery 15 days back. After four days nasal cleaning was done. After it, I got severe pain for five to seven days. But after that it reduced. But still, it persists. Please let me know how much time it will fully go away. I am clearing that I had all type of sinuses and my surgery time was three to four hours. Currently, I am taking nasal cleaning, spray, and antiallergic tablet. I also took antibiotics for 15 days. ### Response: Are you not taking any anti-inflammatory medication? You should take paracetamol one gram twice daily. it will reduce swelling as well as pain" "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: About two weeks ago I chipped my front tooth. I went into my dentist this past week to get it smoothed out (very minor) but he also noticed a horizontal fracture across the middle of my front tooth. He does not want to jump into anything too quickly so said just to watch it and if it cracks off he will cap it. Since then I have noticed only when I put pressure on the tooth to bite down I have discomfort, but nothing constant. Should I be concerned about the pain? Is there anything I can do to help protect the fracture like having a sealant put on? And should I be concerned about the idea of a cap changing the way my face looks (looking unnatural, wanting to continue whitening my teeth, etc.)? ### Response: Hi. I had gone through your question. I can understand your concern. As per your history, you had a recent tooth damage with microfracture, that means you have been put on the wait and watch. If your tooth is vital after a month or two and fracture has not widened, you do not need any treatment. If there is any discoloration or pain than the crown is the option. Nowadays the crown are totally in compliance with your dental shade and it does not looks artificial in any case if done properly. If you can upload a picture of the broken tooth taken in natural light, I can tell you does it need an immediate treatment. As of now, I do recommend you to use fluoridated toothpaste. Also, keep your teeth clean by brushing at least twice daily because chipped off teeth are highly prone to caries or cavities." "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 50-year-old female, overall healthy but recently having issues with tiring easily when biking and doing stairs. EKG was fine. CBC showed low WBC, low anion gap, and vitamin D deficiency. I had a low (99.4\xb0) temperature earlier today. In light of Covid-19, and being that I work in public, should I be concerned?I currently on Focalin and Triamcinolone acetonide. ### Response: I have gone through your detailed history and studied the lab results. (attachment removed to protect patient identity). As per your history, you feel feverish and tired. Your TLC (total leukocyte cont) is low. Record of temperature is 98 degrees. So firstly you have a viral fever, but there is no cough or difficulty in breathing so Corona is not the main diagnosis, but do keep in mind. If you have not been with any corona case, take rest, take tablet Tylenol 1 bd if you are not allergic to it. Keep isolated from a crowd. Then your symptoms are due to a bit of vitamin D3 deficiency. Keep me informed. Viral infection. Corona to be a remote possibility. Bed rest, Tylenol 1 bd. Take rest, avoid public gatherings. Tell me in three to five days of any fresh symptoms." "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 abortion, D and C, two months ago. After that, I got my regular cycle on the next month, and it was normal. Last month starting there was a one-day spotting, which again started on the mid of the month and lasted for four days. And after some days I had periods with a dark brown colored discharge but not of that adequate amount, but it lasted for six days like a regular period.But I had contact last month after which only the next spotting kind of discharge came as I told. I had progesterone from this month for four days to regularize my cycles. But I have not got my cycle till today. It is more than six days now. I usually used to get my period on the 5th day after progesterone. But this time I did not get my period till now. I do not want to be pregnant now. What should I do? ### Response: If there is a history of sexual intercourse after abortion, then I would suggest you do a blood test and serum beta hCG (human chorionic gonadotropin) after 10 days of intercourse. Also, I would advise you to do one pelvic ultrasound and serum beta hCG to rule out any retained product of conception. If everything is fine, then you can take OCP (oral contraceptive pills) for three cycles to regularize your periods. Please do a pelvic ultrasound and serum beta hCG and send me the report." "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 intercourse yesterday. In the beginning, the condom was not there, can say for one to two minutes for three to four penetration. After that condom was there and semen came after masturbating for 10 minutes. Can I get pregnant with precum? ### Response: The chances of getting pregnant with precum are very low. It also depends on the time of your cycles. If you are not in the middle of your cycles say day 13, 14 or 15 of the monthly periods, it should be a safe time." "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 23 years old. I am obese and have a family history of cardiac arrest. My father got cardiac arrest at the age of 53. I have consulted the local cardiologist and gone through ECG, echo, TMT, lipid, hs-CRP and other blood tests. All the tests were normal except heart rate, which was 110 and also high BP. I am taking Rosufit 10, Nebistar 5 and Cilaheart 10. Currently, I am feeling warm in the left side of my chest for a short span of time. Sometimes, I have slight pain in my left hand and feels like a pinch type of pain in the center of the chest when I inhale and exhale. Is it normal? ### Response: Hello. This kind of chest pain occurs during stress and anxiety only. We label them nonspecific cardiac chest pain. But, we should always keep in consideration cardiac chest pain and acid reflux. It is important to differentiate between the all. However, the cardiac chest pain is severe and crushing in nature. It increases on activity like walking and exercising. It also gets radiated to left arm. Since your ECG and other cardiac workup are normal, the pain is not due to cardiac issues. For acid reflux, I would advise you to take a combination of Pantoprazole and Domperidone once a day. Your increase in heart rate might be possibly because of anxiety 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 need a psychiatric opinion for my good friend who has been treated for catatonic schizophrenia.She is a 27 year old European woman.She had in total three episodes of catatonia that required hospitalization.But I suspect it may have been depression instead, since she volunteered hospitalization.She has been given Solian (amisulpride) from 2011 to 2013 and then in 2014.Then she had problems of too high prolactin and they changed it to Abilify (aripiprazole).She also gained a lot of fat (about 40kg in 5 years) and seems to keep getting slowly bigger, since she is often hungry, probably as a side effect of the medicines.She is not taking other medications and she is otherwise healthy.She declared that she is not afraid any more, after switching from Solian to Abilify, but she feels unhappy.She appears much less talkative and lively than she used to be years ago. She is less confident too.I suspect that she may have depression rather than schizophrenia and I noticed that she has significant anxiety, victim mentality (quite important) and some sleeping problems.She is insecure and she dropped out of several educations in the last couple of years.She has abusive parents and she went back living with them.She has recently received cognitive therapy but she felt insulted and not helped.She and I wish to find a solution for her. ### Response: I can understand your concern. I have read the query and after reading the history of hers I can tell you that these symptoms suggest more towards some neurotic illness specifically depression rather than catatonic schizophrenia. In catatonic schizophrenia patients show symptoms like negativism, echolalia (automatic repetition of words spoken by other persons), echopraxia (involuntary or automatic repetition of the movements of other persons), waxy flexibility etc. She has developed illness in episodes and not continuously, which also points more towards depression because psychotic illnesses run a continuous course. Her symptoms like lack of confidence, anxiety, poor sleep, feelings of insecurity, feeling of unhappiness, less talkative etc., suggest depression. There is no history of any suspiciousness, no history suggestive of hallucinations which weakens diagnosis of a psychotic disorder. So, in my opinion from available history her diagnosis is more likely to be depression rather than catatonic schizophrenia. Even in severe depression individuals may present with depressive stupor which can mimic a catatonia. Please visit her doctor again and ask for reevaluation of diagnosis. Aripiprazole can help in psychosis but in depression its use is limited. In my opinion there is need to add some good antidepressant." "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: Dear doctor,I had a small stiff boil in the middle of my eyelid for months. Then it disappeared and another one appeared in the outer corner of the same eye (right eye) and kept getting bigger and smaller and still has not disappeared.Then, about six months later, when I blinked it hurt, and I felt another boil under my eyelid and when I looked it was full of pus and I did not disturb it. The next day when I woke up, my whole eyelid was swollen and hurt really bad. But the pain went down in three hours or so. I then realized that another boil was inside my eyelid. The boil burst by itself though and now I have three boils in my eyelid and the third one is in the inner corner of my eye. Is this serious? ### Response: Hi. Your history indicates recurrent inflammatory swellings of the glands of the eyelids in the form of hordeolum/stye (focal infection of the glands of the eyelid). Since these swellings are recurrent and multiple, you require evaluation to treat the underlying predisposing factors. However, no need to worry as this is not a serious condition." "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 pre-seed lubricant safe to conceive? Is naturally not lubricating a cause of concern? TTC two months: How many months will it take to conceive naturally? TSH 5.2. Is it normal to conceive? ### Response: Hello. Pre-Seed (Vitamin E, Chloride salts, etc.) lubricant that mimics fertile cervical fluids to support sperm on their journey. Unlike most other lubricants, Pre-Seed fertility-friendly lubricant is pH-balanced and isotonic, so sperm can swim freely. So it can be used. As you have been trying only since last two months, so I would like to comment that the chances of even natural conception with each cycle across the world are 30 to 35 %, so you need to be patient. Thirdly, the TSH (thyroid stimulating hormone) levels of 5.2 are high and make you a hypothyroid which easily affects fertility (attachment removed to protect patient identity)." "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 varicocele. I am attaching my ultrasound and semen analysis report. Please clarify me if it is infertility. Can I join the gym? I love to exercise. I feel no pain and all my body functions are good. I have varicocele for almost five years now. I am not on any medication. My age is 23. My height is 5\7"" and weight is 62 kg. ### Response: Your reports are not suggestive of infertility (attachment removed to protect patient identity). You have a good sperm count with good progressive motility. Generally, sperm count less than 20 million is an indicative of infertility. You can join a gym and can do exercise. On the contrary, it is better and will benefit to improve your fertility chances. Varicocele does cause infertility as accumulated blood in testes increases temperature in the testes that is detrimental for sperm production. My advice for you is use tight underwear so that testis should not hang down. Also, use loose clothes that will maintain air circulation around the testes and hence will decrease the temperature of the testes. Do not work in hot environments and do regular checkups of sperm count." "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: Yesterday, I gave my dog a flea bath using a shampoo containing pyrethrins and piperonyl butoxide. I am nervous about the effect this might have on my pregnancy. I washed my hands repeatedly after I realized this. Will it affect the brain development of my baby? ### Response: Hello. These chemicals have more effect when they are used early in pregnancy. Local application, just on the hands alone, will not cause any harm to your baby. Be assured and relax. Your baby is safe. But, do not repeat any more flea baths for your dog during pregnancy. Get the work done by someone else. Take your pregnancy medicines regularly for proper growth of the baby." "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 small bubbles over my skin since the past three to four months. They come and go in an hour but there is severe itching in that period of time. Please help me. ### Response: From the description provided, it seems that you are having urticaria. Urticaria is characterized by red itchy elevated lesions that disappear in a few hours. Right now you may take an oral antihistamine like Cetirizine to help these lesions resolve and give you respite from itching. I would advise you to visit a dermatologist nearby for proper examination and blood tests to rule out the cause for the same." "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 attaching my recent ECGs along with readings of aerobic capacity and VO2 max. The VO2 max and aerobic capacity are estimated low as exercise was interrupted after five minutes in the speed of 2.3 Kmph whereas I could have gone on for at least five more minutes with speed of 3.5 Kmph. I have undergone stenting two years back. There were no symptoms but thallium stress test and then angiogram indicate a blockage. I am also attaching my ECGs of six months back when I have been advised a pacemaker. I did not follow the advice as my ejection fraction was 73% and I did not have any symptoms of blackout or fainting. I am currently on Crestor 5 mg, Telma 20 mg, occasional Asenapine 2.5 mg, Oxetol 1200 mg, Lamitor 300 mg plus some nutritional supplements.Can you tellIf there has been any improvement in the ECG.What would my aerobic capacity and VO2 max go up to if I was allowed 10 minutes of exercise on the treadmill reaching a speed of 3.,5?Any other observations or advice on your part. ### Response: Hello. I have gone through your history and your reports (attachment removed to protect patient identity). You are not symptomatic, ECG (echocardiogram) indicated a rhythm block. You are having a high-grade atrioventricular block which is the availability of the rhythm and not the blood flow. You have to assess the blood flow of heart by doing angiography. If the blood flow is good, the pacemaker will regularise your heartbeats. If there is a problem with the blood flow, it has to be tackled first as it can be a cause for this rhythm blockage." "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 constantly worrying about little things and I am emotional most of the time. I feel tired all day. Please advice. ### Response: Generalized anxiety, social anxiety, and related low mood symptoms are quite common in adolescents. It is positive that you are insightful about your symptoms and seeking help. Have an open talk with your parents and trusted family members about your worries and difficulties. It is important not to isolate yourself as it will worsen things. You can practice some self-help interventions to manage your anxiety like, 1) Try progressive muscle relaxation exercises. 2) Deep breathing techniques. 3) Exercise regularly for at least 15-20 minutes daily. 4) Eat healthily and sleep regularly for at least eight hours. 5) Develop some relaxing hobbies like listening to music and watching exciting programs on TV can help to provide a useful distraction. If anxiety is persistent, you can consult a doctor locally and have some counseling or talking therapy to manage your anxious thoughts and develop positive coping strategies." "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 prematurely gave birth to twins on the 18th at 25 weeks and two days. The reason behind it was told to me that my regular gynecologist did not put some closure on my uterus to avoid premature birth, which is a common issue in twins. Mine was a normal delivery. My boy was born at 865 g and girl at 585 g. They have now survived for over 45 hours in the NICU. The doctors have just been telling me that the children are alive and breathing. That is all they tell me. I am still very worried. What are the chances of such children to survive in NICU after they have survived for several hours in most odd conditions? I know they are going through the toughest challenges to breathe through their underdeveloped body but I still want to get a generic view. All their body parts have been found to be growing and fine in the last level-2 ultrasound. ### Response: Hello. Both your babies are extremely premature as well as extremely low birth weight. The main complication that arises is due to incomplete development of lung. So, immediate surfactant therapy and oxygen support would be required. The next common complication is sepsis. Complete asepsis is to be maintained. Tertiary level NICU (neonatal intensive care unit) care which should be handled by qualified neonatologist is the primary requirement. A complete aseptic environment is to be created. In my practice, I have very mixed experience in the prognosis. I have seen these babies succumbing mainly to the sepsis. As per me, the baby with more weight has a better prognosis. It also depends on the level of NICU care being provided" "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 do wanna know what is the optimum temperature that could be felt on upper thighs and near testicles. My bike heats up abnormally and when I tested for the heat levels the heat reaches a maximum of 45.6 degrees C near upper thigh which in turn also provides heat towards testicles. I could not concentrate on work and I do not get proper sleep. I also have undertaken medications and the abnormal feeling near testicles is gone. But whenever I ride the bike I could feel the same issue for the next two days.Kindly provide me your suggestion regarding what is the optimum temperature that could be felt on upper thighs and I want to know whether 45 degree C near upper thighs will cause any issues because I will be driving the bike at this temperature for at least one hour a day. May I continue using this bike for my daily usage? ### Response: I have gone through your query. The purpose of the testicles being outside the body is to keep them cooler than the rest of the body by about two degrees which is essential for optimal function of the testes. Prolonged increase in temperature in the region of the scrotum will definitely affect testicular function in the long run. This happens over a period of several years and not in few weeks or months and the extent of damage also cannot be predicted as the body has excellent defense mechanisms to maintain a scrotal temperature in spite of external environment" "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 had an angioplasty before two months. He is fine now. But, he is getting restless in eating by avoiding most of the food. Please instruct me the food items which my father can eat. ### Response: Hi. Limit red meat and salt to minimum. Spices can be taken to add flavor to food if low salt diet tastes unpalatable. Avoid processed foods, canned foods, sweets, and soft" "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 problem to defecate completely. It takes me more than 20 minutes to defecate completely. I also take more than two minutes to pass urine completely. I am very healthy. I consulted a doctor, and I have done various tests and examinations such as defecogram, balloon expulsion test, rectal manometry, and colonoscopy. The doctor told that I have pelvic floor dyssynergia-type 1.I underwent biofeedback sessions to get relaxed and to correct my way of passing stools. Even after that also, I am unable to clear my bladder. I am still taking the same amount of time. I do not have a habit of smoking and drinking alcohol. I have used all the laxatives and medicines given by the doctor. But they did not help me. I usually have a walk for 20 kilometers a day. At that time, I had some relief. But as soon as when I stopped it, I have developed the same problem. Please help me. ### Response: It is a complex problem. Exercises like kegel exercise and medication can help. Urinary issues also occur due to constipation and dyssynergia. Use Docusate sodium 200 mg twice daily. It is a good stool softener, and you can use it for a long time." "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 urologists have recommended circumcision to improve my symptoms and to be able to look inside the urethra, etc., and wants to perform the procedure under general anesthesia. Can this also be done under local or epidural instead, as I am having anxiety about the general method? Am I overreacting, maybe to a common method? Currently, I am taking Flomax once a day. ### Response: Regarding the type of anesthesia for circumcision and cystoscopy, it can be done under local anesthesia or spinal or epidural anesthesia or general anesthesia. Local has the following benefits of no risk related to anesthesia. Spinal or epidural has the benefit of good analgesia, post-operative pain control for a few hours, reasonable safety. The" "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 unable to sleep at night. I tried a lot but cannot sleep at all. It is after 5 AM that I feel like sleeping. Please help me to sleep at night. My age is 19 years. ### Response: Hello. At times, if a day or two we cannot sleep on time say 10 or 11 PM and suppose we sleep at 5 AM, then we will wake up after 6 to 7 hours, that is 11 or 12 PM in the afternoon. So, if this becomes a pattern in some days and our biological clock get adjusted with this new sleep and wake up time, this is called phase delay sleep problem. If you have only sleep disturbance, no other mood or behavior problem, then try sleep hygiene measure. Define your wake up time no matter when you slept, wake up at fix time. Do not use your bed for any other purpose except for sleep. Do not keep tossing and turning in bed if you cannot sleep. Get up, sit on a chair, start reading a book." "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 unprotected sex with my fiance. After sex, within 48 hours, I took two ECP tablets. After taking it, bleeding started for two days. My menstrual date was a week back but I did not get it. Also, I face some kind of a different taste in my throat, have a headache and troubled heart. In every month I take one dose of ECP and every time when I take ECP, bleeding start for two days and I successfully get my periods. But now after sex, I took ECP and the same bleeding started for two days but I did not get my periods. Is this any sign of pregnancy or any infection or whatever? ### Response: Hi. Your periods can become irregular after taking ECP (emergency contraceptive pill). It may be early or delayed by one week. You may also have spotting. You have taken medicine correctly. The urine test will not pick up early pregnancy. Please do serum Beta hCG blood test now to rule out pregnancy confirmatively. I would like you to start on monthly contraceptive pills, to avoid such situations in the future" "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 some skin infection for quite some time now. I have tired a few medicines for the same and I got a laser treatment once. Can you tell me what the issue is based on the images and also the possible treatment that I should undergo? ### Response: You seem to have eczematous dermatitis. I suggest you use a potent topical steroid like Tenovate-Gn (Clobetasol propionate and Neomycin) cream or Halovate-F cream (Ulobetasol and Fusidic acid), twice daily. In addition, I suggest you take an oral antihistamine like Cetirizine 10 mg tablet once a day for a few 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 30 years old male. I had oral sex before six months, and I am sure I had no sex. After two months, I developed molluscum contagiosum. When I consulted a doctor, he said it has to be removed, and it is STD. As soon as he said it is STD, I got tested myself for STD panel where all the results were negative except HSV 1 and HSV 2. The IgM was equivocal.I consulted a homeopathy doctor, and he said, as it is equivocal, we need to get retested after 12 days and meanwhile, he gave me medicines for 15 days. After 15 days, I got tested for HSV, and the results were negative. But I had a greenish discharge for one day and white discharge for two days from my penis during the medication. After that, I never had any discharge till now. I got tested again after a month for chlamydia and gonorrhea using PCR where chlamydia came positive. When I consulted a urologist, he treated me with Doxycycline 100 mg for ten days, and 15 days after the treatment, again I got tested for chlamydia and gonorrhea using PCR where chlamydia came as negative, and gonorrhea came as positive.When I showed the report, the doctor gave me Azithromycin 1000 mg and Cefixime 400 mg only as a single dose. I waited for 12 days. Again, I tested myself where both the results came negative. After three weeks, I was having pain in the testicles, and I visited the urologist. The doctor did a physical check and asked me to get an ultrasound test of the scrotum where the reports came as right epididymitis and the doctor gave me the following medicines. They are Ceftriaxone 250 mg IM (this injection was given on my right-hand vein), Ofloxacin 300 mg (twice a day for 10 days), Hetrazan 100 mg (thrice a day for 21 days), Trypsin Chymotrypsin tablets (thrice a day for 20 days), Drolgan (morning and night for five days). Before three months, I got married, and still, I have not started any physical relationship with my wife as I am afraid. I request you to help me. I have pain in my testicles. There is a mild pain in the penis. The pain lasts for two to three minutes. ### Response: Hi. I have gone through the report (attachment removed to protect patient identity). You are having epididymitis and post effects of gonococcal infection. You have also got infected by herpes simplex which will occur recurrently. Even though you are treated with allopathic medicines, some residual symptoms will remain in your body. Gonorrhea can cause epididymitis, a painful condition of the testicles that can lead to infertility if left untreated." "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: For over four months now, on my upper, outer gum, I have had an abscess. It comes and goes but never completely vanishes. It does not hurt at all. My tooth or molar looks fine. I would not even know it was there if my younger did not scrape over it.Occasionally it has a small pussy head and it runs vertically. Any clue what it is without taking an X-ray? If it is an infected root can I reverse it with a clean diet and swishing with Peroxide or something? ### Response: Hello. You have a periodontal abscess. The surfaces of the root of the tooth will then be smoothed out by scaling and planing below the gum line. This helps the tooth heal and prevents further infections from occurring. It has to be done by a dentist. Try using Chlorhexidine mouthwash for a month. It may help to reduce your condition" "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 husband gets sharp cramping in the lower right side of the abdomen over a period of two months. It happens once or twice a week and lasts for a minute. We checked for appendicitis and kidney stones and all the reports are negative. We did a CT scan of the abdomen and it came normal but with a finding of stage 1 fatty liver. Can you please help me understand what is his issue? ### Response: I will definitely help you. Right lower abdomen pain has many reasons including appendicitis and kidney stones. There are some other reasons like indigestion of food, infection of the small intestine, or worm infestation. This may be functional also in which no cause is identified. So if a CT scan is normal and there are no other complaints like vomiting, bloody stool, urinary complaint, constipation then it must be functional due to indigestion. Avoid fatty and spicy food and lots of water have to be taken Give two-hour gap between dinner and going to bed. Please get back to me if any of the above symptoms are there and attach an investigation report also for better help." "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 girlfriend has severe period pains that are certainly endometriosis. Her recent scan showed endometrium was 16 mm thick. She has crippling pains, and she is completely immobile during her period, and sometimes in between. It is getting worse month by month. She is infertile. It is painful going to the toilet when on her period. She often has migraines. She has huge agonizing pain, that does not feel better with Ibuprofen or Paracetamol. The pain starts two days before her period and majority of it ending 1 to 2 days after she starts bleeding. She describes the pain as an extremely heavy weight pushing down on her abdomen, vagina, and bottom.This is happening from the past 6 to 7 years, but it is getting worse over the past 6 to 7 months. A local doctor prescribed Clotrimazole and Tinidazole. I personally think a Progesterone cream is the best course of action, yet it interferes with the Clotrimazole, so I do not know what course of action to take. We did try the Minidril pill, but it messed up her hormones pretty bad, and she started feeling suicidal, so we stopped. The pain has started happening midway through her cycle now and is getting worse and worse. She becomes completely immobile, not even able to get herself to the toilet, and I have to carry her. I will attach the ultrasound scans so you can see for yourself. Unfortunately, the imagery is the best we have. Please let me know what you think the best course of treatment we should try without having to see a gynecologist. ### Response: Hello. I did go through the ultrasound report (attachment removed to protect patient identity). Although it reads normal, endometriosis is a laparosocpic or operative finding. The symptoms she has correlates with the condition. She may be helped with hormonal medicines. However, in cases which do not respond, surgery is needed. A laparoscopy-guided surgery, which includes removal of the endometriotic nodule and breakage of adhesions may help followed by oral contraception pills for few months. Regards." "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: What are the physical findings seen in breast cancer? Please explain about the pathophysiology observed in breast cancer. ### Response: These are the physical findings found in breast cancer. There can be a painless lump or a change in breast size, skin changes, nipple inversion, nipple abnormalities or discharge, and axillary lump. The pathophysiology shows damage to DNA, and genetic changes lead to breast cancer. It is also linked to other factors such as estrogen exposure, smoking, age and family history. Some individuals inherit defects in BRCA1, BRCA2, PTEN (phosphatase and tensin homolog) and P53 (tumor protein). People having a family history of ovarian or breast cancer can have an increased risk of getting breast cancer." "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: What is the procedure to control muscular dystrophy? ### Response: Most of the muscular dystrophies are genetic diseases, like myotonic dystrophies, Duchan- baker dystrophy. If someone has that, no treatment discovered yet, we did not have anything to cure disease, rather diseases are progressive. But dystrophy is due to some medication like statins medication or steroids, we can discontinue medicine and dystrophy will be reversed. Hopefully, I answered your questions. In the meantime, an aggressive fluid should be given to prevent kidney failure." "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 30 years old. I met with an accident some nine years ago which resulted in a chip fracture of the left shoulder acromion. After nine months, I had a shoulder dislocation in the same shoulder which was corrected by a bone setter at home. Recently, the same shoulder again got dislocated while sleeping which was corrected again by a bone setter at home. Below are the conclusions from the MRI report: Avulsion of the anterior glenoid from the glenoid margin in the anteroinferior position suggestive of a Bankart lesion. Concave deformity of the posterosuperior lateral aspect of the humeral head with underlying marrow edema suggestive of a Hill-Sachs lesion. Subchondral cyst in the greater tuberosity beneath the attachment of the supraspinatus tendon. Please advise me on the above. Also, please advise if any shoulder braces or supports are available in the market which can help avoid further dislocations. ### Response: This professional advice provided by me stands subject to the actual examination of report or image and is based entirely on inputs provided to me. It should be correlated with the clinical findings. Regards" "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 on the 4th day of periods and took i-pill after 69th hour. Is there any chance to get pregnant? ### Response: Hello. There are no chances of pregnancy as you had sex on the 4th day of your cycle and you were in your safe period when ovulation would not have taken place and hence no chances of conception or fertilization. Moreover you have taken an i-pill as well within 72 hours so it is like double protection." "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 cold sore appear on my mouth which I very rarely get (I have had them, although pretty rare since I was young). My partner also gets cold sores, however, he gets them quite frequently, and has been since he was young. When I saw mine appear a few days back, I was wondering if it is possible to get a cold sore from giving oral. If that is the case, does that mean that my partner should get checked for STD? If my partner needs to get checked for STD, how could he have caught an STD? ### Response: Hi. Most of the cold sores are due to HSV-1. If it is associated with genital lesions then more chances of STDs are there. If only cold sores, it is due to less immunity. Giving oral may or may not be the cause. As prevention, you both check for STDs but they are unlikely to be positive in your case. If one has cold sores, the partner gets it easily. Apply Zovirax (Acyclovir) ointment." "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: The back of my right neck where the bottom of the skull is, I feel a lot of crepitus. This has been going on for a year and a half, after my face and cheeks became thick (and hard), fat, and bloated (unevenly) for some reason (only my cheeks, everywhere else, I was as thin as before) for some time (now it is back to normal since about a year).The crepitus is painless, but it feels like my neck vertebrae and skull are grinding every movement. And whenever it is at the peak, I feel very congested and frustrated. Also, a lot of times when I look up at the ceiling, my neck in the skull base area audibly cracks (I can feel something snap), which has not happened before this. I am not sure what the problem is, kindly help. ### Response: Hello. I read your concern. In my opinion, you should get a proper investigation of your upper cervical area. Crepitus could be due to any bone on bone rubbing due to improper positioning of your vertebra (improper alignment) caused due to bad posture. Do not worry if you could be sure if there are no other complicated issues associated with an MRI neck, you can do stabilization exercises and get back regularly. Kindly get an MRI neck and revert. Keep icing your neck frequently and stretch your neck muscles gently. I hope this is helpful for you for 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: Hi,I am a 32 year old male. My MRI report says: Posterocentral protrusion of L4-5 disc is abutting the L5 nerve root bilaterally. (In MRI it is black between L4-5 and kind of poking the nerve). My back pains occasionally and I think it is the nerve which is hurting, because the pain is like a sting. Currently I am taking rest and doctor said that he will check if physiotherapy can be started after a couple of weeks. I am afraid of the pain especially when it is near the neck or shoulders. I am able to walk and work. I am being treated by a spine specialist. Please let me know if I have to go to another doctor like a neurosurgeon and can I lead a normal life in future. ### Response: I am not sure of your neck symptoms as the neck has nothing to do with your lower back and from your description it is not clear if you have any leg symptoms or bladder symptoms. However I need to see your MRI scan to be able to make a judgment on the further management. Revert back with the reports to a spine health specialist online for further follow up" "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 24 years old. Not too long ago, I got a small rash on the head of my penis; it was like three to four little red bumps. It was a bit itchy but not to where I would always feel the nerve to itch. I saw online that using antibacterial aloe vera gel would help. And it did go away after like three days. But then every now and then I get the same rash. It is not itchy, or I do not notice it until I look. No blisters of any kind and it just itches occasionally. I am not circumcised so if maybe I got an infection. I do not know what it could be. ### Response: Please attach pictures of your lesions for proper diagnosis and treatment. There can be infection, eczematous disease or inflammatory disorder. So, please send your lesion picture for appropriate diagnosis." "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 facing memory problem. Day by day I am feeling like I am getting down like forgetting most of the previous things specially related to my academic life. I am losing my learning capabilities. I am finding hard to memorize things now. ### Response: Hello. At your age usually the problem is due to loss of concentration resulting in decreased memory power. Practice relaxation techniques like breath relaxation excercises daily as it will help you relax and focus and eases your anxiety. Study in small shifts of half an hour followed by a rest of five minutes. Set small targets and try to achieve them. Foods rich in antioxidants and omega fatty acids also helps. If still problem persists, then consult a psychiatrist in person 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 have a deviated nasal septum on the right side of my nose. I also have difficulty in breathing although I have deviated right side septum but still, I face breathing problems in the left side. I also sometimes feel pain on my face but my major problem is that if I use nasal sprays, I get well for 1 or 2 hours but then again I have breathing problems. I am also unable to understand if I have a right side deviated septum. So, why do I have difficulty in breathing from the left side and also if my left nose gets open my right side closes and if right opens left closes? Kindly help me, please. ### Response: Having read through your query, I can understand your concern. Patients with DNS can have nasal obstruction on both sides. First, because the septum can deviate in an S-shape giving rise to obstruction on both sides. Second, on the side opposite to DNS, there may be enlargement of another structure called Inferior turbinate secondary to DNS. This is called paradoxical obstruction. Third, excessive use of sprays can lead to mucosal atrophy or thinning and a subjective feeling of an obstruction. You may share your CT to guide me further. You should go for surgery. It is a minor procedure that can be done even under local anesthesia." "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 swollen tear duct. The right tear duct is swollen, does not hurt or itch. It has been there for a few years now. No changes in the size other than getting larger. ### Response: From the photo you have attached (attachment removed to protect patient identity), it does not look like a tear duct swelling. It looks like a swelling arising from your conjunctiva and the exact diagnosis would only be possible with a slit lamp examination. But, I can tell you that it is a harmless swelling as it has been gradually increasing since two years and has not caused you to have any symptoms yet. It does need a visit to the ophthalmologist, although it is not an emergency. If you have a blocked tear duct, you will have symptoms such as constant watering, frequent infections which cause pain in your eye and discharge. I would like to know if you are suffering from any of these problems. Previous eye infection. Slit lamp examination. Conjunctival cyst. Conjunctival granuloma. Slit lamp examination and management depending on findings. Revert with more information to 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: I am a 22 year old male. I have little penis (3 inches) and for increasing my penis size, I do stretching exercises like jelqing and on doing jelqing, I have leakage in my penis and I do masturbate 3 times a week and jelqing time duration is five days in a week and I also do exercise for my height means for increasing my body height. So will it affect the body? Is masturbation right or wrong? I have attached the reports you had requested for. ### Response: Hello. Your reports are normal (attachment removed to protect patient identity). So, no medicine will help. Height and penis size cannot be increased at your age. Masturbation is normal and not harmful. Be careful while doing jelqing. If you do it vigorously you may damage the penis" "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: Recently my husband had gone to semen analysis and doctor mentioned that he has low motility but not sure how serious is the issue. Here are the results of semen analysis volume 1 ml, the viscosity is normal, reaction alkaline liquefaction is 25, fructose is positive. Total sperm count is 90 mill/ml, rapid progressive motility 10 %, slow progressive motility 20 %, nonprogressive motility 10 %, non-motile sperms 60 %, live sperms 40 %, dead sperms 60 %, normal forms 80 %, abnormal forms 20 %. The doctor said that he has an infection and suggested Popson tablets and he is taking tablets from the past three months. Also, he has undergone circumcision three months ago as frenulum tear is happening frequently. Could you please suggest how serious is the issue? ### Response: Your husband is suffering from asthenoteratozoospermia where motility is very less and dead sperms are high, likely due to infection, yes. The life cycle of sperms is 120 days and hence at least three months of treatment is required with sperm energizers and antioxidants after two weeks course of antibiotics to increase the motility and number. The present count is the cause of male infertility and hence non-conception." "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 28 weeks pregnant. All my fetal scans taken so far shows, my baby has only one kidney, which is the left one, and it is working normally. I have attached the document. I doubt whether there is a left kidney somewhere down, not sure, but if it is there, it would be very small. But for now, let us say the baby has one normal kidney. After delivery, what is the process of ultrasound and blood tests? Will it be done immediately or after a couple of days? And throughout the pregnancy, if all scan result shows normal kidney, then what is the chance of problem to the kidney in future? ### Response: But still there is some risk of development of some problems later in life : 1. Development of high blood pressure. 2. Urinary tract infections. 3. Decreased kidney functions. The development of these problems is variable. This entails: 1. The baby should go for a scan after birth. 2. Need follow up with a Pediatric Nephrologist. 3. Regular checking of blood pressure and urine for infection and protein loss must be done. 4. The child should protect his kidney and reduce the risk of complications later in life by eating a healthy diet, doing plenty of exercise and not smoking. 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 had dry cough for literally more than two months. So, I got my chest X-rayed and it was totally normal. I have been a smoker for five years, but gave up smoking from the past three months. In these three months, I must have smoked 15 cigarettes. I went to the chief general physician and he gave me two tablets Unicontin 400 half and Montair FC one tablet, both in the evening with a gap of two hours. With a single dose, my cough disappeared. So, should I continue it or leave it? Are they safe? ### Response: Hello. Continue the medicines for the whole duration that the doctor has advised. If you stop the medicines now, the symptoms will recur. However, after the full course, the chances of recurrence are less. Avoid smoking if it is leading to such problems in you. Smoking leads to cancer as well. Do eat healthy food and exercise well. Nutritional diet and healthy lifestyle will prevent a lot of diseases. Hope to see you back in good health soon. Do write back to me if you need any support. Happy to help 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 wife is 24 weeks pregnant. I am having doubts regarding her daily diet during pregnancy. She is taking one banana early morning, coconut water daily once and milk thrice a day. My doubt is, is it safe to take banana and coconut when pregnant? And is it safe to take milk thrice a day? Four months back, her hemoglobin test was done in the laboratory report 8.0 g% is noted. What are the precautions to be taken to increase the hemoglobin? ### Response: Hi. I have read and understood your problem. If her blood pressure is normal, then there is no harm in taking one banana and coconut water once daily and milk thrice a day. Diet during pregnancy must contain green leafy vegetables in it. Her hemoglobin is low, she should take Iron and Folic acid tablets. Only food will not increase her hemoglobin. Also, do her TSH test, sometimes thyroid problem also causes low hemoglobin." "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: Actually my friend\s wife while checking the VDRL test in the first trimester got a positive result, but her husband got negative at the same time, and the doctor told her to do the RPR test then it is negative. What it means? I have a doubt weather she is positive or negative? Please clear my doubt. ### Response: Some nonspecific antibodies sometime might give false-positive results. Your RPR, however, is negative. So syphilis is less likely. But you cannot rely on these two screening tests. You can investigate her with a more advanced confirmatory test like FTA ABS (fluorescent treponemal antibody absorption) or TPHA (treponema pallidum hemagglutination) test for syphilis. 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 got liposuction surgery last month. I was in the hospital for two days and then I was discharged. I come from a small town so I had to go a bit far from my hometown for the surgery. My doctor claims that he has 22 liters of fat removed from my body. My bodyweight before surgery was 90 kgs and post-surgery it was around 79. I got liposuction in my thighs buttocks abdomen and arms. I searched online and it says that this much amount of fat removal from one surgery is not healthy. To give an idea of my BMI my height is 5\2"". The problem is it is already 21 days since surgery, and I have one of the drains which my surgeon kept open still draining, it started to drain post 7 days of surgery and it is on the back of my right thigh, and this is the third that opened since surgery but the two drains have already closed and clean, I still have swelling all over my body and I am facing a bit of problem in walking normally. Because of the lockdown in my city I am unable to meet my surgeon and get post-op care, but he suggested that any general surgeon can help me so I consulted a general surgeon in my town and he said everything is fine. Also, I have skin necrosis on my left thigh. I do not know what I should do? As I have read online that most of the patients get well after 21 days of surgery and here I am still going through drain let alone nowhere close to healing completely. ### Response: I think you were done a tumescent type of liposuction. You do not have any immediate complications as per your description, so I think it was done nicely. But prolonged complications in" "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 type 2 bipolar disorder. 10 years ago, I was diagnosed and treated for depression alone. I am a 42 year old female. I got married and have two kids. I stop the medication for five years and then I started to take it for the last one year. I am taking Lamictal 200 mg every day, but that is not enough. I feel depressed most of the time as there is no supportive groups or good psychologist in my place. Please help. ### Response: Hello. If Lamictal (Lamotrigine) is not helping much, then you can discuss with your treating doctor regarding either substituting it or adding another medicine for bipolar disorder. Certain non-pharmacological methods that will assist are as follows. Follow a flexible routine and exercise regularly. Do meditation daily for at least half an hour in the morning. You can join self-help groups online. Listen to music as it helps in relaxation and removing anxiety. Certain music have been found to be especially relaxing. Besides, you can also consult a psychotherapist on this platform." "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, aged 67, got her hip bone joint fractured. She got operated and InterTan nail got implanted. But nail part got displaced from the hip side and now touching hip bone causing pain. She is weak, having low bone density and suffering from other diseases as well (rheumatoid arthritis, glaucoma, hypothyroidism, hypertension, and asthma). What should be next course of action? Does new bone formation will occur in case if plaster will be done or does she needs joint replacement? Will plaster worsen her situation? How safe will joint replacement at her age and what will be implications in future? Which one will be beneficial for her considering her overall health status? Please suggest best way forward. ### Response: She requires implant removal and joint replacement. This is a relatively safe procedure. Plaster cannot be applied over this" "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 intercourse, I had to deal with burning pee. And although it has reduced stinging now. It still is there. And also. My periods ended like four days back, so I wanted to know if I should still take the pill if I had unprotected sex but he did not ejaculate in me. ### Response: Hello. From day 1 to 10 of the period it is the safe period. There is no chance of pregnancy as there is no ovulation happening during this period. So you need not take any medication. So relax and do not worry. These symptoms could be because of some urinary infection. Please get yourself checked by a gynecologist and get a complete urine examination and vaginal swab test 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: My son is 18 months old. He was born with ankle clonus, but it was completely gone after a while. So, he no longer has clonus. He also has possible tongue fasciculations. I say possibly because the pediatrician said that it was difficult to tell if they were or not. He is always sticking his tongue out and has an active tongue.My question is, is tongue fasciculations in a baby/toddler always a sign of SMA? I am horrified by what I have read online. Is it possible that he is fine? I am desperate to know if tongue fasciculations always mean something bad. He is healthy and thriving in all ways. ### Response: Hello. There are many abnormal neurological signs in adults which are usually present in normal chil" "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 and I are currently trying for a baby. She went to the hospital today to do a check on her progesterone levels as today is her 10 th day after ovulation. Her result showed that her progesterone level is 23.5. What does this result mean? ### Response: Your question is regarding the interpretation of the progesterone level in the female. You have to know that after ovulation in female in their menstrual cycle, progesterone level rises. The level goes down once menstrual the bleeding stops. So the normal range of progesterone varies in different phases of the menstrual cycle. Your wife\s progesterone level seems to be appropriate in the secretory phase means after the ovulation period. So menstrual-related problem is not causative for your infertility problem. I suggest you have sexual intercourse around the ovulation time that is between 12-18 th days of the menstrual cycle to achieve conception. Your semen analysis also should be done for primary workup. I hope this will help you. Let me know if I can answer any more questions." "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: Today when I was taking my bath, as usual, I cleaned my penis shaft and cleaned the area under my foreskin. After dried my body, I saw 10 drops of blood on the floor and the bleeding continued for two minutes maximum. I have a short frenulum problem (but not serious). I am an unmarried male. Never go for masturbation and never go for sexual intercourse with anyone. Now I am feeling mild itching inside. Kindly suggest. ### Response: Hello. You seem to have short frenulum. Bleeding can be due to trauma during cleaning. If it recurs kindly see the source or exact site. For itching, you can take tablet Levocetirizine on demand. You can also apply Lignocaine 2% jelly locally (which may decrease some sensation for some time). Avoid aggressive cleaning of glans. Do not worry you will be fine." "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 21 years old female. I punched in the back of my head three months ago, and I have been having headaches, dizziness, and hard time catching my balance when I stand up. I daily wake up and go to bed with a headache. I have tried Tylenol, and nothing seems to help. I am not taking any medications. ### Response: I went through your post, as you have mentioned in your post that you were hit on the back of the head and now have giddiness and difficulty in balancing, I would suggest, 1. You will need an MRI brain and cervical spine to role out any abnormality of the brain stem and cervical spine due to trauma. 2. The imbalance is caused by either the problem of middle ear or cerebellum which can be differentiated by clinical examination, so consult a neurologist. 3. Meanwhile, you can start tablet Betahistiine 16 mg twice times a day that will help. I hope you are satisfied with the answer." "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 21-year-old male. When I talk to someone they said I have bad breath, and do brush and come back again. But I always clean my tongue properly. Most of the people whom I have talked about said I have bad breath. ### Response: Hello. Bad breath or halitosis is a common problem. There are a number of potential causes and treatments available. Simple home remedies, and lifestyle changes, such as improved dental hygiene and quitting smoking, can often remove the issue. The best method to reduce halitosis is good oral hygiene. This ensures that cavities are avoided and reduces the likelihood of gum disease. Treatment: 1) Mouth rinses and tooth pastes. 2) Brush your teeth after you eat. 3) Floss at least once a day. 4) Brush your tongue. 6) Adjust your diet. I suggest taking Metrogyl 400 mg thrice daily for three days, tablet Taxim (Cefixime) 200 twice daily for three days, and Pantocid-D once daily for three 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: My mother is 44-years-old and has spondylosis for past two years. What should I do to decrease this gap in her neck? She has started physiotherapy from eight days ago. ### Response: The spondylosis has caused a reduction in the intervertebral spaces. This occurs due to the weakness of the muscles of the neck. I will advise following the exercises which help regain the muscle strength and improve the space in the intervertebral cervical region. Activities include static neck exercises and neck stretching exercises." "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 loose stools and diarrhea for a long time. Can you tell me what bacteria are present in the human fecal sample? ### Response: Hi. There are lots of bacteria present in the stool such as staphylococcus, E.coli, Vibrio, Campylobacter, Shigella, and clostridia. To identify the causative bacteria, a stool culture can be 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: My mother observed a lump in her right breast before two months ago. The doctor advised for full abdomen USG, mammography, and FNAC. The results showed duct cell carcinoma (NST) with a lesion measuring 12 x 15 mm. Surgical Oncologist has advised for surgical removal of a tumor (BCS surgery) followed by radiation and chemotherapy. He suggested, my mother, to undergo four to eight sessions of chemotherapy, depending upon the biopsy report of the tumor. I wish to seek a second opinion depending upon the requirement of chemotherapy and radiation therapies and also want to know the possible side effects. ### Response: Hi. The current treatment for the early breast cancer is breast conservation surgery and sentinel lymph node (axillary node) sampling. There are oncotype testing to personalize the treatment which gives the magnitude of benefit for a particular individual. Radiotherapy is mainly given to reduce the risk of local recurrence. Side effects of radiation are skin reactions in the short term and hardening of the breast in the long term. Chemotherapy, not sure whether your mother needs chemotherapy. If the nodes are negative with strong ER (estrogen receptors) in positive status, we could avoid chemotherapy altogether." "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 is 26 weeks pregnant and she is suffering from cold and cough for the past two days. Also, she is having a chronic nose block from her 12th week and using nasal spray for relief. She is finding it very hard to sleep for the past two days because of continuous cough. Her cough is without phlegm. Please suggest some safe medicines.She is taking calcium and iron tablets along with Eltroxin 50 mcg for thyroid. ### Response: Any infection is not good for pregnant women. Please confirm if your wife has any fever. Meanwhile, you can take the following measures to help her feel comfortable: Dabur Honitus cough syrup two teaspoons thrice a day. Honitus ginger cough lozenges once in two hours. Give ginger slices soaked in honey or raw to suppress the cough. Also please provide the following information: Any fever? Any sputum while coughing, if yes, what is the color? Any breathing difficulties? Any lower backache, spotting or leaking of fluid? I would suggest visiting an ENT specialist for examination as well." "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 penis is in erection stage 5 inches, so is it normal? Secondly, recently I got married but I am not able to enter due to early ejaculation within 1 minute. ### Response: Hi. Size of 5 inch is absolutely normal and is in fact above the average penis size of most of the males. So no need to worry. Immediately after marriage due to lack of experience a lot of males suffer premature ejaculation and they ejaculate even on touching the vagina. This is normal, just do not lose confidence. Medicines like SSRIs like Dapoxetine can be used to delay the ejaculation time." "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 25 year old uncircumcised male. My condition is not disturbing my life, but for the sake of clarity, it would be nice to consult for a primary opinion on whether it is necessary to physically visit a urologist. I had a minor yeast infection a few months back. While clearing them off, I just found out for the first time in my life that I had a partial phimosis. For the past few weeks, I tried doing retraction exercise and now I can easily retract my foreskin, to view the whole glans and clear off the excessive smegma. The smegma softens after a period of time and gets lesser every time I shower for the past few weeks. However, I am a bit troubled by the fact that the bottom end of my urethral opening appears swollen. Previously, when I was not able to retract my foreskin, the appearance is like a small red bump. Upon revealing the whole glans, I see that it is a red part of the penile opening and it is like a straight line of red skin from the bottom end of the urethra opening until the end of the glans.When I raised this issue with my GP, who treated my fungal infection, he said it was probably a birth variation or minor inflammation. I told him (from what I recall), I had always had this since probably teenage or even younger. It does not concern me, but I just want to be more informed of my own well being. I have not been sexually active and just very recently solved my phimosis. Could it have been caused by the residual urine on my penile tip, since I am uncircumcised? Does this condition require serious medical attention? ### Response: Hi, I think the red line you are referring to is nothing but frenulum. It is a normal structure and since you do not have any symptoms attributable to it, I really do not think that you need to see a urologist in person. It would add better clarity, if you can attach a photo of your penis showing the lesion. Revert back with the urologist 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 problem is killing me. I have low self-esteem with glossophobia whenever I talk in public. I have a hideous feeling whenever I contact people. It is damaging me to the core. I want to come out of it. Please help. ### Response: Hi. I can understand your concern. Anxiety problems are very crippling. They stop you from doing things which you can do, and they reduce your career growth. It is very distressing to see ourselves in that condition. We have treatment for all the types of anxiety disorder. You can get better with the treatment. Treatment plan includes both medicines and psychotherapy." "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 got pregnant in march this year and got it aborted through medicines (Cytotec). I took two doses as the first dose failed to work. Till this month, my monthly period cycle was absolutely fine. I was supposed to have periods on the 21st of june. Still I have not got my periods. I did a my pregnancy test onthe 26th or 27th of june and it was negative. I took an ECP on 28th to get my periods. I have realized that after this, I am not going to affect my cycle anymore and no more unprotected intercourse. I used to have periods always on time. Can you please guide me on health repercussions because of abortion pills and ECP? Have I done something terrible to my health and what to do if I am pregnant again? Can I get it aborted through medicines again? I will never affect my cycle hereafter. ### Response: Health issues because of abortion pills are that you may continue to bleed for 16 days or so, and also there may be incomplete abortion or some times no effect at all (failure) as you have already experienced. So it is not possible to continue pregnancy also after taking the pills (abortion or ECP) as there will be congenital malformations in the baby. Yes, of course, the cycle date will change every time. ECP is meant for emergencies only and not to be taken after every unprotected sex. If you are pregnant again, I will advise you to get a scan done and rule out any chances of ectopic pregnancy before taking abortion pills at any time. You can take it again if required, but then consult and follow up with the doctor is a must. After you are clear with all issues, I will advise you to take contraceptive pills regularly to avoid all this, and this will regularize your cycles also and nothing to worry." "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 I have a panic attack or panic disorder because I experience hand trembling, chest pain, feeling choking, light-headed, difficult to breathe, numbness, nausea, a sudden fear of death, sometimes fainted, and tightness in my throat but my parents do not believe me. I am sick, and they do not want to bring me to the psychiatrist because they do not believe me. ### Response: Hello. You are right, these are panic symptoms. You can get yourself checked for a thyroid function test and a clinical examination from a doctor nearby to find out if there is some other reason for these episodes, which can happen in thyroid problems. If your doctor finds your tests and examinations are normal, then you can show this as proof to your parents and seek help from a psychiatrist for these anxiety symptoms. It may take some time but let us hope they listen to you. If not, you have a right to get yourself treated for your discomfort." "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: HIV tridot antibody test done at 6 weeks, 8 weeks and 10.5 weeks. All negative. Are there chances it will turn positive at 12 weeks now? Test done with blood taken from vein. ### Response: Hi. Following is my opinion for your asked question. HIV tri dot antibody test is having good sensitivity and specificity in ruling out HIV as like that of fourth generation ELISA. Usually tri dot HIV test is able to rule out HIV after six weeks of exposure. However, HIV test can be considered conclusive in ruling out HIV after three month of exposure. So, I suggest you investigate with HIV rapid test after 12 week again. You can revert back with HIV report after 12 week of exposure to 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: I am having a high borderline cholesterol. Can you suggest me a diet chart? I have attached reports herewith. ### Response: Hello. I have gone through the attachments (attachment removed to protect patient identity). Your weight is on the higher side that is one of the reasons for high cholesterol. Here are a few nutritional tips: Please feel free to contact again for any further help." "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 anxiety disorder taking Prothiaden 25 mg to feel sleepy could not get up early in the morning. Will Manasamitra Vatakam solve the problem? ### Response: There are very few studies that support the efficacy of Manasamitra Vatakam for treating anxiety disorder. In one study, it was found to be helpful in anxiety disorders and have some effect in reducing daytime sleepiness. But it is one study, and with only that, I would not advise its use. Such a" "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 daughter is 17 years old. She had a cold for about four days when she started complaining of bad ear pain. She was seen in urgent care a week ago and was diagnosed with a middle ear infection. The APRN noted her ear was pretty angry and prescribed Amoxicillin 500 mg. She is supposed to take two pills in the morning and two at night, which she has. She also suggested to continue Mucinex D (which is how I was treating the cold). Her severe ear pain did resolve in a day or two, but she still complains of ear pain intermittently. I am worried about taking Mucinex D for so long, but even if she does not take it she complains of ear pain. She is also saying that she cannot hear out of the ear. To be fair, she says the pain is not as bad initially, but I am still worried. I gave her a Claritin last night thinking it may help, but it just made her stuffy. I know we still have three days on the antibiotic, but should it be completely cleared up by now? Should I take her back to the doctor? Or try something else? ### Response: Complete the course of antibiotics. Take Mucinex D (Guaifenesin) once or twice a day, like how you have been taking for another three to four days. If Mucinex D has an antiallergic component then no need for Claritin or Allegra. Otherwise, add either of those to be taken once a day. This will help to clear out ear secretions. Let water not enter the ear while bathing. Let her take rest and refrain from going to school or playing until she is better. After the course of antibiotics gets over it will be prudent to show the ENT specialist once so that he can look into the ear with an otoscope and check if the problem has resolved or not." "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 daughter is 17 years old. She has cold allergies and at the time of cold, she gets a fever and she gets weak and after taking some of the medicine, her fingers start to vibrate. So what kind of medicine should I give? ### Response: Colds and fever is a viral illness that follows seasonal change usually. For fever Paracetamol 1000 mg thrice a day should be given after food only if there is fever and for colds, she can take Chlorpheniramine maleate or Dcold. Also, give her steam inhalation preferably with sterile water." "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: Dear doctor,My 9 month old daughter had an immunization for measles. It was given on her right arm and the area is abscessed. She is not consuming food properly. What to do? ### Response: Hi. You need to consult your nearest pediatrician immediately. If untreated it can lead to complications. Read on what our experts say about injection abscess, its treatment options, and preventions." "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 microcytic hypochromic anemia and mild anisopoikilocytosis with ovalocytes seen. No hemoparasites seen. What can I do? Currently, he is taking Cyclosporin 100 mg and previously, he used to take Prednisone 30 mg. ### Response: I have seen your attached reports (attachment removed to protect patient identity). As per the reports he is having autoimmune hemolytic anemia because of reticulocyte count high, normoblast is seen, DCT (direct Coombs test) positive, ICT (indirect Coombs test) positive. So for that continue prescribed medication that is a steroid that will be beneficial in your case. In autoimmune condition antibody forms against own cells so Prednisone will be helpful that has been prescribed to you. Consult hematologist regularly for follow up" "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 in the 13th week of my first pregnancy. I had two episodes of postcoital bleeding after which USG was done and showed low lying placenta (lower placenta is covering the os). I had been on bed rest and pelvic rest for the past one week and taking Susten 200 BD apart from Folvite. Is it fine for me to go to my work place (I am a pathologist have to sit for three to four hours only)? Any other precaution? ### Response: Hi. Please avoid intercourse and vaginal douching. Repeat USG after six weeks for a level 2 scan and look for placental migration. Continue Susten (Progesterone tablet)." "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 it necessary to have a LEEP surgery in CIN1? ### Response: I have gone through the attached reports (attachment removed to protect patient identity). Your results showed cervicitis with metaplasia and suspected CIN1 (cervical intraepithelial neoplasia). In a colposcopy, it should be discussed in detail. It needs treatment soon. Mostly, cervical cancer occurs due to infection with human papillomavirus. CIN1 is a precancerous lesion, and if left untreated, it results in cancer in coming years. Usually, CIN1 is treated with a loop or large loop excision of the transformation zone (LLETZ). So, it is better to have it to prevent its maturity to high-grade cervical cancer in the coming years." "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 26-year-old female. I have joint pain in widespread bilaterally in elbows, knees, and ankles. I also have muscle tenderness on my neck and shoulders and back pain from a herniated disc. I take Diclofenac 75 mg PRN for pain. I have had laboratory work done and I have seen a rheumatologist. My initial labs: ANA positive 1:160 speckled. CRP was elevated. My anti-DS DNA, CCP and RA factor were all negative. Secondary lab work through ELISA showed negative ANA and all other autoimmune laboratories were negative except for positive anti-phosphatidylserine/Prothrombim A at 44 units. Slightly low vitamin D but I take supplements. I eat a plant based diet and exercise twice a week. My other medical history includes depression and anxiety for which I take medication. My question is despite my labs being negative, why do I still have joint pain and muscles aches? ### Response: Hi. I would like to ask you a few more queries: 1. Is your sleep pattern fine? Morning fatigue? 2. How frequently are you taking Diclofenac? 3." "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 18 month old baby is not sleeping throughout the night. How do I get him to sleep through the night? Also how do I get him to stop breastfeeding? ### Response: It seems your baby has not yet developed day and night cycle, or she might get hungry at night and gets up for feeds. I hope she is growing well and must have attained her normal mile stones for the age. No medication is required to make her sleep. You can continue breast feeding up to 2 years of age as recommended. Develop a routine for food and breast feeding. At this stage, baby needs four meals and three to four times breast feeding. Make an alternate, give breast feeding when she wakes up, after two to three hours give breakfast, like that. If she sleeps for good hours during day time then, you need to make her engage in some play to reduce day time sleep. It will take time, but slowly, she will develop a proper cycle. I am sure things will change." "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 29 year old male, and I have been having slight giddiness kind of feeling. I am not able to tell if it is giddiness since I did not fall or have any balance issues. This has been there for a week. I had the same symptoms two weeks back. It feels like some kind of pulling sensation in the head, and I do not have a headache. It feels that the pulling sensation is towards one side in the area behind the ears and back of the head. I sit for a long time in front of the computer. What would be the reason? I have erratic sleep patterns, and I sleep at 1 AM. Though I have adequate sleep, I sleep very late at night, and hence the meal pattern is also altered. I have been very stressed from the past two weeks. Would that too be a reason? I have been working out regularly for three months, and I have stopped exercising from last two weeks due to foot pain. ### Response: Hi. It could be benign positional vertigo, which is more common. I guess you might experience giddiness when you suddenly turn your head. It is mostly because of imbalance in the middle ear fluid, usually following ear infection, which is responsible for maintaining our posture. It is definitely treatable. I suggest taking tablet Cinnarizine 8 mg, twice daily for five days. If not relieved, then consult an ENT specialist for further evaluation. As there is no loss of balance and blood pressure is normal, neurological causes are not looked into at initial stage" "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 5-year-old daughter often gets cold, cough, and end up with a fever and slight wheezing. No history of wheezing in the family. What test and medication have to be done for wheezing? ### Response: Hello. Your child may be tending to develop asthma and allergy. When investigating the child with wheezing, it is better to get her clinically examined by the pediatrician or a pediatric pulmonologist. The tests required include a chest x-ray and complete blood count in most cases. Medication is to be given after confirming the condition and might include bronchodilators, inhaled steroids, anti-allergic preparations, and nebulization when needed. Please keep the child away from dust pollution and allergic plants. Allergy and asthma. Chest x-ray, complete blood count. Eosinophilia. Asthma. Bronchodilators, inhaled steroids, anti-allergic preparations, and nebulization Protect from dust and pollution." "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 not sure I am over-stressing, but I have noticed when I drink cold icy water I can feel it go down to my stomach. I hurt my tummy muscle four weeks ago, and still not 100 percent cured. It still burns and I get acid reflux as well my throat is dry and sore. My breath is smelly and I get sinus problem and feel like phlegm is going back down to my throat. ### Response: As for the feeling of cold water going down your thirst and the acid reflux, both indicate an inflammatory condition esophagitis and gastritis. This can be treated with a proton pump inhibitor Controloc (Pantoprazole) once daily and an antacid Ranitidine before every meal. The bad breath could be due to inflamed gums or an infection such as H.pylori. So I recommend you get a test for H.pylori infection and consult a dentist to examine your gums. Bad breath can also be due to sinusitis. Sinusitis can also be the cause of the post nasal discharge (phelgm at the back of your throat) and can be treated with an anti-inflammatory Ibuprofen twice daily and an antihistaminic as Cetirizine or Zyrtec once daily before going to bed for 10 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 happen to see swollen lymph nodes at the back of the neck in my 1 year old baby. I have consulted a doctor last month. He gave antibiotics for five days. But still, I see the swelling (from last month 20th, he has boils like prickly heat on the head, forehead, and hands which heals but comes back. I am very worried. Please suggest something. ### Response: As long as the child is not chronically ill, is gaining weight, feeding well and not having any other problems, you need not worry. Also, as regards to the lymph node, you should keep a check if the size is increasing or decreasing and if there is any sinus (hole) formation on the skin overlying the lymph node and report to the doctor" "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 got my periods for the past 60 days. Now I have planned for trip in the next week. My doctor advised me to take Deviry tablet twice in a day for five days. Can any one let me know by when will I get my periods? I have started taking the tablet yesterday night. ### Response: Hi. After completing a five days course, you will be getting your periods within a week or so. However, if you have a doubt then get 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: I have PCOS and had unprotected sex the day before my period, and my partner ejaculated in me. The next day I was supposed to get my period, but I did not get it. Since then I have had minor pregnancy signs. Last week I took two home test, and both were negative. Now, two weeks and a few days later I noticed brownish pinkish discharge and now I am bleeding lightly. Is this implantation bleeding? ### Response: PCOS causes irregular cycles. Hence you have had a gap between the periods. Scanty menses with the minimum flow is common in PCOS. Since the urine pregnancy test is negative, there is no chance of pregnancy. You could be having the discharge due to a new cycle. However, consult a gynecologist personally and get an examination 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: My brother had an eye trauma. So, he had laser surgery for retina after two months of trauma. But he masturbated the next day of laser surgery (after 19 hours). Will that cause any problem to his retina or retinal nerve? Will it increase intraocular pressure? Please give a detailed answer as we are worried. ### Response: Hello. Masturbation will not have any adverse effect on laser treatment of retina or retina. There may be a minimal increase of intraocular pressure with masturbation but that must be non-significant. Kindly share the file to guide you better." "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 (34) and my wife (30) have been trying to conceive for about 15 months. Due to a slightly low AMH for her age (16 pmol) my wife was recommended to go straight to IVF from our fertility clinic. With all of the above, no issues were found and we are diagnosed with unexplained. My wife went for vaginal swab testing in preparation for the IVF where although no major STDs were found they discovered a large amount of E.Coli bacteria colonized within the reproductive tract (presumably vagina and cervix). There was a small number of leukocytes found too. The doctor wrote a prescription for antibiotics which he said should clear it out. Our concern now is, could the E-coli be the reason for infertility? My wife has not taken antibiotics for a long time and we are presuming that she could have had the bacteria there for a long time. I have read that E-coli does pretty much clump sperm together and stop them from moving. Do you have any advice on the matter? ### Response: Hi. Since the vaginal swab shows E-coli (attachment removed to protect patient identity), it would be better to undergo a course of antibiotics for you and your wife in order to improve chances of IVF. If you wish you can request your doctor to go for IUI if both fallopian tubes are patent." "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 these on my penis, ears and inner thigh. I have had them for over 10 years and they did not get red or inflamed. Also, you cannot pick them off. I am married and it did not get spread to my wife. What is it? ### Response: Hello. Can you please upload a picture? So that, I can review it. They may be simple skin tags, but it is hard to tell without a picture. Please also share if you have any history of STD (sexually transmitted disease) in the past and if you were tested for any recently. Revert back with the photos 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: My baby is 11 months old. On starting of 10th month I had a problem in my breasts and stopped feeding by doctor\s advice. I thought cows milk is better than formula because it is natural so I am giving it for the past one month in very diluted form. Four days before we switched to the formula since cow milk is not available. After that he passes stools many times for two days and got fever. When consulting a pediatrician he advised not to give cows milk and suggested only formula. But now after giving for a day, he passed mucus in stools.Is my baby allergic to formula? He is fine with cows milk, can I give the same? Please help. ### Response: Cow milk should not be given until 1 year of age usually, as it may cause calcium and iron deficiency. Any change of feeds in babies can cause some change in stool pattern. Which formula are you giving and how do you prepare it? Proper concentration is very important. Have you started weaning? And how many times the baby is feeding milk? If only two or three times then you can continue with cow milk but do not dilute 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 mom had cough and cold which continued for a week. We conducted X-ray which indicated too much cough congestion in the chest and TLC count was 18K. One day, due to too much cough she vomited, and she was injected with a medicine to stop it and it worked. Next day, we went abroad for a week and as soon as we came back, we reconducted the X-ray which still indicates congestion is there and TLC count is now 15K. But she is getting fever since two days reaching up to 103. Crocin is not reducing it. I am really worried. Is it a viral fever? Or is it because of congestion. I am attaching the prescription/ medicines which she is taking as well as the latest blood report. ### Response: Hello. It is not a viral infection but a bacterial infection as her TLC has increased. Also, diabetic patients are prone to such infection. Treatment is antibiotics, which she has been started by her physician. In most patients, this resolves with a week. Continue other medicines as prescribed. We should see a response in 24 to 48 hours. If there is no improvement in fever, cough, or increase in her symptoms like increased shortness of breath, visit a hospital as her antibiotics will need to be escalated and she may need higher IV antibiotics. If you have electronic BP apparatus, then monitor BP twice a day. Excessive fall in BP or decreased frequency of urination are some of the warning signs. Repeat TLC, urea and creatinine test to see antibiotics response. So overall, a majority of the patients recover well but some amount of risk is always there in such infections. Hope this helps you and get back if you have any doubts." "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 30 years old and having hairfall problem from the past 2 to 3 years and I used Minoxidil for a year but no use and slowly it looks like my male pattern baldness is increasing. The thing is last week I had hair tonsure. I noticed a lot of grey hair has come which makes me concerned. The only mistake I did was started to hair dye from past 1 year once in 4 months to cover a few grey hairs but now they have increased like anything and I almost look like an old person. My question is: Is there any possibility to reverse this greying or at least slow down the process and also how to stop this male pattern baldness or slow it down? Please suggest any vitamin tablets or anything that could slow down the process or reverse both male pattern and grey hair problem. ### Response: Regarding your hairfall- Does anybody in your family suffer from baldness or premature greying? What is the percentage of Minoxidil you have been using all these days? Did you consult a dermatologist till now? Hair dye never increase the chance of greying. You can use the hair dye regularly. Male pattern baldness is genetically programmed and the Minoxidil is a useful medication for this. If you do not find good response with Minoxidil, then you can start the tablet Finasteride 1 mg daily one tablet for a period of 6 months. PRP injections might help you in the hairfall. Tablets containing Calcium Panthenoate might reduce the speed of greying of hairs. This can be tried for a period of three months." "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 1-year-old son has not started saying any word like mama or dada yet and I am worried. It could be sign of autism, though he turns when his name is mentioned, plays with his siblings, etc. ### Response: Even though the child turns when his name is mentioned I would advise you to first get a hearing screening done to rule out hearing issues. Next, about the autism. So it would be very harsh to label this child as autistic. Not just that, an autistic child generally does not play well with others. If the hearing is normal and other developmental milestones are normal, you need to wait for another 3 to 6 months. Some chil" "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 46 years old male, weighing 67 kg, height 176 cm. Current symptoms are weight loss (lost about 5 kg in one month), feeling hot. Sweating, problems falling asleep, difficulty focusing on one task, forgetfulness, change in bowel habits (experiencing loose motion sometimes), palpitations, nervousness, fatigue, heat intolerance (not able to hold hot objects like hot teacup). The blood test results show thyroid-stimulating hormone (TSH) 0.008 milli-international units per liter of blood (mIU/L), triiodothyronine (T3) 2.3 ng/ml, thyroxine (total T4) 17.8 \xb5g/dL, thyroid scan result is suggestive of thyroiditis. ### Response: Hello. From what you have mentioned and from the reports you have attached (attachment removed to protect patient identity), it appears that you have thyroiditis. Your results show that you have hyperthyroidism but not so bad but your scan results suggest thyroiditis which needs no treatment, so, therefore, you have two choices, either you wait and watch till your thyroid gland recovers from this crisis by taking bed rest and Aspirin. My personal advice would be to wait and repeat your thyroid function test after two weeks. Till that time we can be sure whether treatment is necessary or not. Till that time take strict bed rest. Keep a watch on your pulse rate and blood pressure." "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: What are the difference in symptoms in testicular cancer and a varicocele? ### Response: Hello. Testicular cancer will have painless testicular lump, swelling of scrotum, swollen lymph nodes, or weight loss. Best to differentiate between two is ultrasound scrotum." "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 know the signs to notice in a baby when he/she is ready for a sippy cup. What are the milestones that a baby needs to meet before they can be ready for a sippy cup? Explain the reason for each milestone or give examples for each milestone and why it is important for a baby to meet these first before trying a sippy cup. ### Response: For sippy cup baby should have developed some gross motor and fine motor milestone. Baby should be able to sit without support so that it reduces the chance of aspirations and better suck swallow coordinations. For fine motor milestone, he/she should able to develop radial and pincer grasp to hold the cup by himself. It should be offered after six months of age because outside milk is easier to digest because of gut maturity. Primitive neonatal reflex like moro and tonic neck reflex will disappear, so he/she can sit and flap. 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 a 21-year-old male and I weigh 57 Kg. I am 5 feet 6 inches in height. My symptoms are a cough for one month. I am currently on tablet Levosure 500 mg, tablet Ventair 10 mg, and syrup Adovas. Please help. ### Response: Hello. The symptoms you provided are typical findings of this season. If you have a productive cough which is yellowish or greenish, it indicates a bacterial infection of the respiratory tract. It could be a case of bronchitis and Levofloxacin should work. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. If not, you could get a culture and sensitivity test of the sputum and switch to another antibiotic according to the report." "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 wisdom tooth pain and I am currently traveling. Can you please suggest some good pain relief medicine and once I am back home, I shall get it treated. Please find the attached X-ray. ### Response: Do not worry. I checked your attachment (attachment removed to protect patient identity). Pain is due to impacted wisdom tooth which has also damaged adjacent tooth leading to caries. You may require disimpaction and restoration of adjacent tooth by root canal. Right now you take the following medicines: Ofloxacin 200 mg with Ornidazole 500 mg BD for five days. Tablet Acelofenac 100 mg with Paracetamol 325 mg, Serratidopeptidase 15 mg BD for five days after taking food. Tablet Pantoprazole 40 mg OD for five days. Mouthwash Hexidine three times daily for 30 seconds by rinsing oral cavity. You are also advised to maintain good oral hygiene." "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 took an endoscopy test. Tell me what the impression means. Is it serious? Now, I am having pain in the throat when bending, and pain in chest when burping. How can this be healed? What medicine can I take? Please advice me. ### Response: Nothing to worry. There is some acidity issues as well as possibility of reflux of acid from stomach to food tube (esophagus). Need diet modifications. Consult your specialist doctor, discuss with him or her and start taking the medicines 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 am male, 35 years old and weight 70 kilos, height 173 cm. Every year I do a medical checkup. In a recent medical check-up, there was a note related to heart rate (bradycardia), the result was 49 bpm. I also have checked manually and also using pulse meter, the result around 51 to 55 bpm. In the last eight months, I do morning run three times a week (30 minutes). Actually previously instead of running, I also have done sports exercise (static bike) with the same intensity. One thing that differs with the previous conditon is I lost 8 kilos (in 7 to 8 months time). There is no symptom related to my health, instead, I feel comfortable and fit. I have consulted with the cardiologist and he said it was okay as long as I do not feel any symptom (faint, dizzy, etc). But the doctor quite worried regarding the heart rate at night since based on ECG result (using Holter monitor for a full day), it showed the heart rate plunged to 35 bpm at night (sleeping). The doctor gave me Terbutaline sulfate, with a low dosage (two times a day at 2.5 mg). My question is whether bradycardia is related to my sports activity? Does it relate to my weight loss? Is there any reference related to normal heart rate for atheletes (with sports heart) when sleeping at night? ### Response: Hi. It is quite common and normal for regular athletes to have sinus bradycardia, I saw some with heart rate down to 40 to 45 bpm daytime. At night usually, the HR is slower and it can get down to 35 bpm. As long as you remain asymptomatic that is no lightheadedness and no fainting or collapses, then no further action is required. It is not related to weight loss which could be secondary to increased physical activity and exercises. If weight loss is not deliberate, then this needs to be investigated. Weight loss and bradycardia could be seen in malnutrition patients and people with severe depression sometimes. I do not think it is the case here as you do regular exercise which is a good sign. Please be assured." "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 will be having prostate TURP surgery in five weeks. My Urologist has recommended daily Finasteride four weeks before to reduce bleeding during the surgery then stop. I am worried that Finasteride has been linked to prostate cancer. Is this true? Is there an alternative medication to reduce blood loss? I know the Finasteride is just for four weeks, but I am still concerned. Is there any research on short term use? ### Response: Before I begin, let me assure you that there is no evidence that Finasteride causes malignancy when used for short term such as four weeks. As such, both Finasteride and Dutasteride can be used for reducing the vascularity of the prostate. Dutasteride is a good alternative. But Finasteride has better action in reducing vascularity in the short term. In short, let me assure you, there is hardly any chance of malignancy by using either Finasteride or Dutasteride. Do not worry, be positive and wish you a very uneventful and successful recovery, post-surgery." "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 26 years old. I have a problem with hyperthyroidism during my pregnancy. I am in my fourth month of pregnancy with TSH- 0.07, T4- 161, T3- 2.34. What are the complications with this? Is it good for me to take PTU. ### Response: Hyperthyroidism in pregnancy is usually treated with Propylthiouracil 50-100 mg/day. Your hormone levels are still very high, you need to increase your dose. Pregnancies complicated by uncontrolled hyperthyroidism may result in higher incidences of spontaneous abortion (miscarriage), preterm labor, low birth-weight babies, or stillbirths. Complications of pregnancy, including pre-eclampsia (a condition associated with hypertension, low blood platelet count, protein in the urine, and mental changes) may also occur. So please increase your dosage. Another thing I want to highlight is that you should do TSH (thyroid-stimulating hormone) receptor antibodies and to see what is the cause of your hyperthyroidism. Is it Graves' disease. These antibodies can enter from the mother\s blood to the baby\s blood and stimulate the baby\s thyroid gland. These antibodies should be measured in the mother during her second trimester of pregnancy because the values that are greater than five times normal have been associated with hyperthyroidism in the baby at birth." "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: Actually, I had casual sex with a CSW a month back. I did my HIV 1/2 antigen and antibody test 15 days back, almost after 26 days. I got symptoms of swollen glands under jaw and stiff neck, as well as, joint and muscle ache. Today I got small ulcers in my tongue. Can you please tell me about my test accuracy and my symptoms? ### Response: Sensitivity is up to 92 percent in your case. You need to repeat testing after 12 weeks" "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: Good Evening. I had tumor in uterus, was admitted in hospital last month and successfully Uterus, Fallopian tube, Lymph nodes all were removed. Biopsy report came after a week. It says Tumor involving more than 50% of thickness of the myometrium., Lymphovascular space invasion present, FIGO : STAGE II. Doctor advised for IMRT and we completed 12 days. But now due to Pandemic situation doc advised her not to come hospital. Doc advised we can finish the next 13 days sitting once this pandemic is over. I am worried if we stop inbetween will it impact in later stage. Because i am diabetic and having BP. Can you please give me the clear direction. should i continue the IMRT or considering the current situation should i stop for a while. ### Response: Dear, I am sorry for your predicament. it is indeed difficult time due to pandemic. ideally there should not be any gaps in treatment, since gap result in increased chances of disease recurrence. I would advise to continue treatment, however considering the pandemic, the decision to continue radiation is associated with accepting the risk of developing infection, with you having dm and htn, you are at a higher risk from getting infected. please discuss this with your treating radiation oncologist, every hospital has some policies, example in my hospital we are continuing the existing patients, but not starting any new patient. I hope I am helpful, kindly revert in case of any further queries. regards" "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: Hi,My wife has regular periods. All tests are normal. Her follicle develops into a big cyst every month. Doctor says it is because of subserosal fibroid. Is this correct? ### Response: Hi. You should consult a gynaecologist and get her hormonal profile done to rule out other causes if any. Follicular cyst may be because of PCOD (Polycystic Ovarian Disease) or it may be because of subserosal fibroid and also it can be because of hormonal changes. Subserosal fibroid is nothing but a uterine fibroid. Hope I have answered your query. If you have further questions, 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 had unprotected sex on the 11th and the guy did not ejaculate. I was worried since it was the 20th day of my menstrual cycle and I have an average of a 32-day cycle. So, I took an I-pill within seven hours. My last period was on the 23rd of last month and the next period is due on the 24th of this month. I track my period using an app and it said that I have medium chances of pregnancy. It has been 10 days since I have taken the I-pill. I am worried that there is no bleeding yet. I took a pregnancy test and it came negative. Can you explain why my bleeding may not have started yet? ### Response: So, the best would be to get a serum beta hCG test done now. If the hCG levels are less than 5 mIU then you are surely not pregnant and can wait safely for a few more days to allow your 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: For my work which needs concentration, I need a noise cancellation headphone which filters out sounds. Is there any chance of hearing loss or impairment with use for 10 to 12 hours a day? ### Response: Hi. Yes, you should not use headphones for more than three hours in your case. It also depends on what frequency and what decibel of sound the noise cancellation masker will have. You can rather use ear plugs." "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 very bad toothache. The whole left side of my face or jaw is hurting badly. Can I go to the regular doctor for this until I can meet the dentist? I do not know what else to do. ### Response: I have gone through your question. I can understand your concern about your pain. The pain looks like because of erupting wisdom tooth as you mentioned the hole in the jaw. If the hole is in teeth, it can be acute apical periodontitis. In the former case, you need to take medication like Ofloxacin plus Ornidazole combination twice daily for five days. In the latter case, take Augmentin 625 (Amoxicillin and Clavulanic acid) twice daily for five days. For any confusion, send me a picture I will provide you with a better possible treatment plan. For immediate relief, take Ketorol (Ketorolac) DT tablet, it will provide you with an immediate relief. If you get the above-mentioned medicines, you do not have to visit a general practitioner and it will provide you with a better time to visit a dentist." "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 kneed really hard in the groin 10 days ago while playing basketball. The pain is more of an ache that does not last long. There was immediate swelling in my scrotum around the veins and arteries above my left testicle and some minor discomfort but continued to play. I had minor discomfort the next few days while swelling went down. There has been no discoloration. I have been able to go to the bathroom fine. There is now a pea size lump around or in the veins or arteries that causes minor pain when pressure is applied. It is firm but soft at the same time. What could this be? Should I see a urologist? ### Response: You have had a blunt trauma to your scrotum almost a week back and since then have had a decrease in the swelling and no urinary complaints which are good signs. Was there ever any blood in the urine immediately after the incident? From your description, it appears that what you have is a scrotal hematoma which is resolving gradually. So you need to worry. All you would need is some scrotal elevation which will ease pain and swelling. But I would still advise you to visit your urologist to make sure the pain is just in the scrotum and not involved the testes, which is not possible without a clinical exam" "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 32-year-old woman. The one with whom I am in love sometimes behave rudely to me. He remains silent whenever he dislikes anything that I say. I am a bit outspoken, and I am unable to control this. His silence kills me. I find it difficult to do routine work. I feel so sad and shattered. He will not answer my messages and will not pick up my call even if I had called 50 times a day. I feel like hurting myself. I suffer from depression since childhood, and I am taking Amitriptyline since the last 13-14 years. How can I divert my mind and focus on my work during those times? It happens almost twice a month. We are together for five years now. ### Response: Hello. It looks like you and your partner have different personality styles and deal with conflicts differently. For example, if you are an extrovert, you would like to talk your way through issues. This is a natural way of responding to some people and not to be taken personally. If your partner is otherwise fine and treats you well, it may be helpful to have an open and honest discussion with him when both of you are calm. Write down your thoughts if direct talking can be difficult and ask your partner to reply. Both of you have to respect each other and learn to form your ways of dealing with conflict as a couple. It is natural for all couples to have disagreements, try not to overthink in such situations. Try relaxation techniques and carry on with your usual routines. If needed, you can try counseling or couples therapy. Also, look after your emotional health. Consult your doctor to review your mental health and the need for continuing anti-depressants. 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 2.5 months pregnant now. And I have developed gestational diabetes and consulted with a gynecologist in the nearby polyclinic and made HbA1c (blood sugar monitoring test) and the result is 6.4 % reference range normal up to 6%. Before pregnancy diabetes range used to be always in normal range. Nowadays blood sugar while fasting is 130. Do I need to start insulin? I need your advice.I am 24 years old. My height is 5.2 feet and weighs around 105 kg. ### Response: Try to eat more vegetables like green leafy vegetables and not potatoes which contain high carbohy" "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 an ultrasound of my abdomen yesterday and got the results today. My ALP is 155 and AST and ALT is within the normal range. I am not taking any medication at the moment, but I would like help with understanding what this means \liver parenchyma has increased and coarse acoustic texture and correlation with liver function studies are advised. There is no intrahepatic biliary ductal dilation. No discrete masses are demonstrated sonographically\. ### Response: Your liver function has normal SGOT (serum glutamic oxaloacetic transaminase) and SGPT (serum glutamic pyruvic transaminase), and slightly elevated ALP (alkaline phosphatase level), which has not much significance. I am more interested in the serum albumin level, serum globulin level, and serum GGT (gamma-glutamyl transferase) level. Revert with more information 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: My age is 30. I am conceived about 45 days and I had an abortion tablet. I started bleeding and it continued for one week and a light spot for the next one week. I only had heavy bleeding for three days. Now, I am getting little spots in the morning time and no bleeding in the night till today. Please help me. Is it normal or anything serious? But my legs are paining lot. ### Response: Hello. The continuous bleeding in the form of heavy bleeding and clots indicate that abortion has been incomplete and still products of conception remain in the uterus. It is suggested that you should get an ultrasound pelvis done soon to rule out any products of conception. If they are seen, then you would have to undergo dilatation and curettage (D and C) for complete removal of products. Meet your physician soon 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 am an 18 year old girl. I have been feeling very weak and tired. I am not getting sleep during the night and so I sleep throughout the day and wake up in the evening. I smoke and drink. Last weekend, I felt horribly sick after drinking. I get major headaches at times on the right side of the corner of my head. I have completely reduced smoking as I feel nauseous after I smoke. I got typhoid and dengue before seven months. I had jaundice 4 years back and since then I get pain in my stomach if I dance or run. I want to get healthier. My weight is 44 kg and my face has literally gone including dark circles. My eating habits are pretty bad and I eat after long hours. I really want to get healthy and look better. I want to have stamina as I have become very weak. I used to workout at the gym, but I would feel sick all the time during that phase. Please guide me. And yes, I go through horrible pain during my periods and I go through bad PMS phase. ### Response: Hello. CBC (complete blood count), liver and kidney function test, electrolytes, vitamin D and vitamin B12 level, TSH (thyroid-stimulating hormone) and anti-HIV antibodies. I suggest Vitamin B12 1000 mcg daily and Vitamin D 5000 IU daily. Consult your specialist doctor, discuss with him or her and take the medicine with consent. Revert back with the reports 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: My 71 year old mother got a couple of ischemic strokes nearly two months ago. She was then given a strong blood thinning injection which led to a couple of blood vomits and a hemorrhage as well. During the hospitalization as well as afterward, she has been taking Pradaxa 110, etc. (prescription attached). She was hospitalized for about a month and relieved at the end of the month. Now, all went well until last week, when she complained of severe pain in the lower right limb. We did a CT aortogram (report attached) to identify the blockage since the limb was turning green and there was no pulse identified. The blockage was found to be behind the stomach area. She was operated on the same day and the clots were removed, but the cleaning happened on a dead vessel. Now, again after the blood thinning medication, there is another clot identified in today\s MRI in the brain. The blood thickness has raised to 35 and so, an injection has been started. She went through a mitral valve replacement 12 years ago. She has undergone a knee replacement on the left leg and has got both her retinas replaced as well. I am requesting your advice to be able to stop the formations of the clots and blockages, which continue regardless. Any other advice or suggestion is welcome. ### Response: I have gone through the files attached (attachment removed to protect patient identity). I strongly recommend she switch over to these medications and visit a cardiologist if you are not under the follow up of same. Hope this helps you and get back if you have any doubts" "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: What can be the muscular thing right out of my anus? I had a normal delivery a month ago, and it is almost healed. When I pass stools, I feel pain in that place with bleeding. While passing stools, the muscular thing gets torn, and blood comes out. This started a day before yesterday and now happening every day. What is the treatment for it? ### Response: It is anal hemorrhoids (attachment removed to protect patient identity), and it is very painful. You may be suffering from constipation, or you must have been eating very spicy food. The treatment is sitz bath, and it means you have to sit in a tub full of warm water. It gets relieved, and you have to do this for two to three times a day. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. You may apply ointment Pilex over the area. Stop eating spicy food and take syrup Duphalac (Lactulose) two spoons daily at bedtime to avoid constipation. If it is not relieved, then you have to consult a general surgeon." "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 hepatitis C positive with IgM + IgG of 14.2. This test was conducted five years ago. What is the significance of this? I have full medical test including LFT from two months back including sonography where things were normal. Do I need to worry about this? Does it require a treatment or the count is within limits? ### Response: Hello. You need to get the hepatitis C quantitative assay (RNA level) done and need to get treatment depending upon that. There is no need to worry. Your other labs are fine (attachment removed to protect patient identity). But please be under the strict follow-up of a nearby gastro/ hepatologist. Regards" "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: Just tonight I started having an irregular heartbeat. I have no other symptoms. I am not weak or dizzy or lightheaded. It has been going on and off for about five hours. ### Response: I understand your concerns. Your symptoms are most likely due to heart arrhythmia most likely AFib (atrial fibrillation), the most common arrhythmia which causes palpitations and may be completely asymptomatic. The other possible causes include SVT (supraventricular tachycardia) or other heart arrhythmias. Please provide me with more details in order to reach the appropriate diagnosis. Is it the first time you have this symptom? Do you have any health problem (thyroid or heart)? My advice is to perform ECG (electrocardiography) and send me the report. Measure your blood pressure" "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 37 years old. I have a ganglion cyst on the palm side of the wrist in right hand since three months. The cyst is solid. This cyst does not cause any pain since now. I have contacted with a surgeon, he has advised for surgery of this cyst. Is there anyway except surgery? Like medicine? Is this cyst malignant? If it is operated, can it be further developed in future? ### Response: Hello. Relax and do not worry. Yes, it is a ganglion cyst. It is very common and not malignant. It will not regress with medicines. It requires surgical removal as suggested by your doctor. Go ahead and get the surgery done. Recurrence chances are one percent" "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 20 years old female, who weighs 224 lbs, and I am 5.4 feet tall. I have what looks like a pimple on my crotch. It keeps coming back in the same spot and produces white pus and a lot of blood. Is there a chance I have an STI? I have had it since before I became sexually active. I always use a condom. I have attached a photo of the pimple. ### Response: I have seen the photo (attachment removed to protect patient identity). It looks like superficial folliculitis, which might be caused by bacteria or fungus. Shaving or wearing tight clothes that rub the skin can irritate the follicles leading to folliculitis. Most likely, this occurs when the improperly cleaned hot tub or swimming pool is used, wearing tight clothes, and using an infected shaving blade. You need to see a gynecologist. I also suggest you get your fasting blood sugar checked and get yourself tested for HIV (human immunodeficiency virus) and other tests for STIs (sexually transmitted infections) if not tested before. Hope your query is answered, but if you still have any other question, please revert. Best wishes." "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 took a pill of 200 mcg yesterday night and two pills of 200 mcg of Mifegest kit today morning and I am having lower back pain and abdominal cramps.So, when will bleeding start? And is it risky that I cannot handle it by myself at home? ### Response: How are you doing? The first pill dislodges the embryo from the uterine lining and you may have some vomiting tendency, but no bleeding. Then the second pills make the uterus to contract and open the cervical canal and the dislodged embryo falls out. The ideal way of taking the pill is to have the first pill and then have the second group of pills after 48 hours of the first pills. Thereby, you give enough time for the embryo to separate from the uterus. The bleeding usually starts within a day or two of the second pill. It is the second pill, which is making the uterus to contract and the cervical canal to open, that is causing the cramps. You can have any of the painkillers like tablet Meftal spas or Cyclopam or Spasmo Proxyvon two to three times a day. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. The bleeding depends on the duration of pregnancy. If early, like less than six to seven weeks, the bleeding will be like periods. If later than that, it will have few clots and the bleeding will be more than normal but can be handled at home. You will need the doctor\s help only if there is no bleeding or too much bleeding. Usually, it will resolve in two to three days. Hope I have clarified your query, Do write back if you have any more queries. All the best." "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 has coronary artery disease. He has a blockage in three arteries, one artery is cured by putting stunt, but some other doctors tell to do bypass surgery, but my father is afraid of surgery. Is there any treatment without surgery? ### Response: Hello. I have gone through the reports. There are two best available options for CAD (coronary artery disease) at present, one is a bypass, and the other is stenting. Other available options are not high and are only adopted is either is two is not possible. Considering multiple blockages, bypass remains the treatment of choice, however, if not willing for bypass then stenting is another reasonable good option. Sometimes we may not be able to open 100 percent blockages, but in those cases, we can keep him on medications for that as a blockage in the less critical vessel. He may undergo stenting as well, but stenting for such complicated lesions is tried in the higher center like PGIMER, etc. So, overall, if not willing to undergo bypass, then stenting may be a reasonable option and should be tried. I hope this helps you and get back if you have any doubts." "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 pass stools five to six times a day, and I feel very weak. I am suffering from thyroid issues. So, I took Thyrox 50 and then the levels got corrected. So, I stopped taking them. Yesterday my thyroids were tested again. I am attaching those reports. Should I restart the medicines and if so, in what dosage? ### Response: Hello. I just read your query and went through the reports (attachment removed to protect patient identity). Hope you find my advice of some benefit. Good luck." "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 more than 70% hearing loss in the left ear. The doctor has recommended tympanotomy or tympanoplasty. Is it effective? My mother is 55 years old. Would she get any benefit from this surgery? Is there any complication associated with it? Is there any non-surgical procedure to treat it? However, her x-ray shows fluid accumulation around ear and nose. Her audiography shows more than 60% to 70% hearing loss. Please help. ### Response: I would recommend you to undergo a test called tympanometry in which we will come to know if there is any collection of fluid in the middle ear or if there is any damage to the bone of the middle ear. Also, let me know what kind of hearing loss she has. Is it conductive or sensorineural? It will be mentioned in the report of the hearing test. If she has only fluid in the ear, then it can be" "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 conditions are serious from a few days. My symptoms are hoarse voice, nasal congestion both nose and ear, coughing, sore throat. Please suggest me. ### Response: Hello. You seem to be suffering from acute viral upper respiratory tract infection which is a common type of nose and throat infection in this season. I am going to prescribe generic names of the medicines so that you can get it in your place. Tablet Cefixime 200 mg two times daily after food for five days. Tablet Chlorpheniramine maleate and Phenylephrine, Paracetamol (fixed dose combination) three times daily for three days after food. Xylometazoline nasal" "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: Post MI (after one year) ventricular bigeminy is diagnosed. I am describing my cardiac problem. Please give your valuable suggestion. My problem is exactly one year back which was MI. Treatment started after 20 minutes with Reteplase and other drugs. Next day at 9 AM, I underwent angiogram and noticed RCA 99 % block, kept stent. After six months, I developed ectopics around 20 per minute. The drugs were changed to Bisoprolol, Metoprolol, Sotalol but there was no use. The cardiologist advised for EP study. What next? Do I need a device? I am sending briefly about my cardiac MR study and Holter report. ### Response: I have gone through your reports (attachment removed to protect patient identity). Most probably, these VPC (ventricular premature contraction) are due to the scar in the RV (right ventricle). As advised by the cardiologists, I would also advise an EP study (electrophysiology studies), which, if positive, that, induces a VT (ventricular tachycardia) which needs an ICD (implantable cardioverter-defibrillator) implantation. The second option is ablation of these VPC\s. It works better if you have a structurally normal heart, but you have LV (left ventricle) dysfunction. Also, ablation is fine if you have recurrent ICD shocks. So summing up, I would advocate an ICD if VT is induced" "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 chest heaviness and lightheadedness along with muscular spasms. ### Response: Hello. I went through your post. Lightheadedness and feeling of fainting are either due to low blood pressure or an abnormal rhythm of the heart. You will need a BP check and ECG so that any abnormality could be picked up. Regards." "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 severely anemic patient. I have been on iron and B12 shots for three decades, but still, there is no improvement. I have got enlarged spleen, IBS, and also no absorption from the gut. I had undergone so many tests but nobody seems to have answers. I stay exhausted, dizzy and pale. Can anything help my severe anemia? ### Response: Hi. As you are on iron and vitamin B12 shots, I would assume that it could be nutritional. It is obvious that no absorption from the gut and also IBS will complicate it. Enlarged spleen could be due to increased destruction in spleen or production of cells in the spleen to improve anemia (extramedullary hematopoiesis). I would like to know the following details:" "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 husband has not removed his contact lens from his eyes in over 10 years he says. He cannot remove them. Please let me know what he should do. ### Response: If contact lens has been there for the last 10 years, then it would cause a lot of problems like redness, watering, itching, pain, blurring of vision. I do not think the contact lens is still there. You should still consult an Ophthalmologist for an eye exam to ascertain it, and get it removed if still present. Please follow up with what the doctor advises and any other 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: I have vitamin D deficiency. The test report says that the count is 2 ng/mL. I had an oil massage last week. Now I have joint pain, tiredness and I get depressed very soon. Is it related to the body massage? Is there any cure for it in ayurveda? ### Response: Hi. According to your attached reports (attachment removed to protect patient identity), your BMI (Body Mass Index) is 27. This suggests that your weight is more than normal. You need to reduce your weight. Obesity also leads to low level of vitamin D in blood and increases joint pain. You have mentioned that you have undergone body massage. As of now you can start with Bonton granules 1 teaspoon with milk twice a day and tablet Asthiposhak 2 tablets after food twice a day. Continue with your current medication. Revert back with the answers to the above questions to an ayurveda 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 am a 42-year-old man, active in sports. Recently about five days back, while playing football on a concrete floor, I slipped and fell on my lower back (coccyx area) and injured myself. I, however, can carry on my daily activities at slightly slower speed now, and there is slight pain on bending forward.Since two days, a big boil has appeared near my rectal opening. It is dark yellow in color, may be filled with pus, not sure. It is painful whenever I pull in my pelvic or butt muscles. Stools are normal, luckily the boil is above the rectal opening, so no problem in passing stools, but while washing, I can feel the boil and it is painful.I have pain also while walking. I have three questions.1. Did the fall I had lead to the boil? Or are these two independent problems?2. What is the reason for the boil?3. How to treat it quickly? ### Response: 1. This is most likely a bacterial infection affecting either hair follicle or perianal glands. 2. It does not seem likely that it is related to your lower back injury. 3. The causative agent is mostly the bacterium known as Staphylococcus aureus. 4. 5. Most of the patients get better with antibiotics and anti-inflammatory" "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: Hello,I am writing to ask about some symptoms I have been experiencing. I am 57 years old. For almost a week I havehad persistent low grade fever (never more than 100.5). After the end of the week, today I no longer has a fever. We did a blood test and found abnormally low amount of platelets: 127 Thousand/ microliter. When we did the blood test six months ago, it was at normal level of 166 thousand/ microliter. During the fever I had no other symptoms,: no cough, no throat pain, no runny nose, no breathing issue, etc. Even though the fever seems to be gone since today I am very worried as to what may have caused it, if it could be linked to a serious disease. So far the platelet count is the only abnormal thing showing up in the blood test. ### Response: Hello, Keeping into the current circumstances , your fear is completely justified" "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 who had unprotected intercourse two days ago with a female who had tested negative on Oralquick two months ago. Turns out she has been quite active and I am debating on doing PEP. I can see her on Tuesday and she said will take another test but that will be 96 hours. I can start PEP tomorrow but it may not be needed if she tests negative. My questions are if I start PEP can I stop if I find it is not needed? How much does one trust an Oralquick test? I read they can have 7 % false negatives. Does taking Acyclovir have any effect on HIV or PEP? Should I do PEP? ### Response: Acyclovir has no effect on PEP (post-exposure prophylaxis). Yes, it would be wise to start PEP and later you can stop it. Oraquick is not reliable after two days of exposure. 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 have a rash that is kinda itchy and it is too warm to touch. It appeared in my lower abdomen and nothing is coming out of it. My environment did not change and my food habits did not either, despite including bananas in my diet. ### Response: I have gone through the images (attachment removed to protect patient identity). There are two possibilities: In my opinion, your lesions are more likely to be of herpes zoster infection. Either visit your physician as early as possible or consider the following treatment. Consult a specialist doctor, discuss with him or her and start taking the medicines 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: My 15 year old son is showing a lot of anger and aggressiveness. Please see his attached files for the details. I want your second opinion. I need your opinion on the possible treatment of my son to reduce his extreme angriness, lack of patience, and restlessness. His exams are around the corner, and I want treatment done before his exams. Or else, the medicines will make him sleepy during his exams. He is very sincere about his studies, and his behavior is normal, but I want him to work with a cool head and take precautions in life. I have also attached his prescription. Are these medicines correct for him or do you suggest any other mild treatment? Please guide me. ### Response: I have seen all the attached reports (attachment removed to protect patient identity). I would like to know a more detailed history about your son: Revert with more information to 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 am 42 yrs old. I had my last period on 3rd. I had unprotected sex on 21st. I had an I-pill on the same day. My usual menstrual cycle is 26 to 28 days but there are no symptoms of periods. Is there any reason to worry? When will I get my periods? ### Response: Since you have taken an emergency contraceptive pill within 72 hours of intercourse, there is no chance of pregnancy. The delay could be because of hormonal changes due to the pill you have taken. So relax and do not worry. However, if you have a doubt then get a urine pregnancy test done with early morning urine sample to ensure that you are not pregnant. Do get back to me with reports so that I can 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: I have been taking Ashwagandha, Turmeric, Amal powder and Brahma supplements. I am scheduled for a colonoscopy in three days. It is a preventive screen. I last took them a few days back. Should I reschedule my colonoscopy? ### Response: I just read your query. You can go for your colonoscopy because these are all herbal supplements and as you have stopped all these, they will be flushed out of the body in a week. After colonoscopy, if you are re-scheduled for other investigations, then do not start these till then. Even if you are not, then you can take after two to three weeks." "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 penis size is small. Please advise what can be done. ### Response: The size of the penis has no roles in sexual intercourse. Even a person with a small penis but good erection can satisfy any girl. Only a few centimeters of the vaginal wall has sensitivity. What is the size of your penis? If your erection is normal, then stop worrying for that. Jelqing is a home-based exercise that can be utilized to improve the size. The exercise is done in the semi-erected penis and some good lubricant can be used during this. Milking like action is done from base to tip in semi erected penis and this is repeated for around five minutes. This should be done 2 to 3 times a day and if done properly this provides good results. You can learn about this from the internet too." "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 turning 40 in a few days. For the past two months, I have been having gas or burning sensation, etc. Three weeks ago, I noticed some black specs but could not tell whether it was blood, so went to a local gastro clinic. We did a series of test endoscopy, abdominal ultrasound, blood test, stool test. All were normal. However, while doing the abdominal ultrasound, there was an observation on the prostate. Prostate was normal in size and echotexture. Tiny cyst measuring 3X2 mm seen in the midline. No free fluid noted. The overall impression is abdomen: no sonological abnormality detected, pelvis: tiny midline prostate cyst. I just wanted to know what can I do about the prostate cyst observation. ### Response: Hi. The prostatic cyst is a fluid-filled bubble in the prostate which is usually harmless and present since birth but becomes detectable in adulthood. You should not worry about it. If you have urinary problems, you can contact again." "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 thalassemia major with factor XIII decficiency, HCV+. I transfuse platelet or FFp daily and RCC weekly. All these things are reacting in my body. My ferritin level is 15000 after chelation therapy. This also reacts badly every time. I am 28 years old. How much time do I have to live more? ### Response: Based on your query, my opinion is as follows: The serum ferritin level of 15000 is definitely too high. Along with HCV, the prognosis is somewhat poor. However, without knowing the amount of iron deposition in tissues like the liver, heart, etc, and also the amount of damage to liver secondary to HCV infection, it is difficult to say anything. If all are functioning well, then 5 to 10 years should be easily managed well with therapy. Need to reduce ferritin levels, improve nutrition with protein rich diet and need to have a positive outlook. Liver biopsy for serum iron and amount of damage based on liver function tests and histopathology examination could be helpful in further management." "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 25 years old. I have a small acne on my penis. Shall I use Surfaz-SN to remove the acne? If that is not useful, then please suggest me a correct cream. I do not like to go for surgery. ### Response: I have read your concern. With your description, it seems that you have developed molluscum contagiosum. Please get a review with a picture for better evaluation and the best possible treatment of your concern. Revert with photos 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: It has been four months since I have been suffering this problem. I have been to the sexual clinic. They say that all my tests were negative. They keep saying it is a non-sexual rash. I have had this white spot near my urethral opening for three months which is what is worrying me. What is it? On the corona, I also have this rash which seems to be spreading around the penis head. What is it? I have attached the images. All the STD and HIV tests were negative. ### Response: Hello. The spots near the tip are a normal variation perhaps due to the keratinized mucous membrane near the tip as it is exposed and therefore it has a slightly rough texture. They are not warts. I am more concerned about the rash on the corona of the glans. It looks like eroded skin along the circumference of glans. I would like to rule out the possibilities of either candida or yeast infection or STDs (sexually transmitted diseases) like genital herpes." "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 43-year-old female. About a year and a half ago I noticed Raynaud\s in one finger. I had three episodes in two years. I have lost most of my eyebrows. Recently, I got three episodes of Raynaud\s in both hands, and most fingers. I have joint pain that comes and goes in all joints. I have widespread muscle pain that comes and goes. The intensity changes. I am fatigued and just noticed that upon awakening, my fingers are a little swollen. I cannot get my ring off until about one or two hours after waking up. I have had plenty of bloodwork ANA\s, ENA, Scl 70, centromere, PM Scl, all of the scleroderma and lupus testing along with Sjogren\s. ANCA, P ANCA, CPK, ESR, RF, and ds DNA tests.The only test that was abnormal was C3 and C4 decreased and elevated anticardiolipin IgM. My WBC was also low. Since 99 percent of lupus is shown on positive ANA, what could this imply in the absence of a positive ANA? ### Response: " "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 muscle twitches from head to toe for say 12 months. About four weeks ago, my left thumb started twitching involuntarily and it would not stop 24 x 7 not even during sleep. This morning, I felt the right thumb started to pain. My blood tests are clear and so are my MRI of the brain and spine. The GP said that I have to wait for four months to see a neurologist. I have also suffered vertigo on and off for the last 12 months. I have been stressed the last two months but this started after the stress calmed down. Can you kindly help? I am on Nexium and a contraceptive pill. ### Response: " "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, aged 70 years, lost five kg of weight in two to three months. Usg and CECT confirms a right renal mid-lower polar well defined large 11.3*10.6*12.0 cm soft tissue density homogeneously enhancing mass with internal regions of non-enhancement is observed with no obvious calcification or fat content.The lesion appears to be containing renal fascia with increased peripheral vessels likely mitotic mass lesion of the right kidney (RCC). The right renal vein and IVC is patent. The mass is seen to indent the right psoas muscle, but a flat plane with the adjacent structures is nearly maintained. The urine test and renal functions are normal, and there is no evidence of metastasis. Kindly tell me if it is benign or malignant, and what are the possible line of treatment? Please help. ### Response: As per the report, it is renal cell carcinoma (RCC) and it requires further evaluation. In the treatment of RCC, first of all, surgery is needed to remove the tumor and if required the kidney too. Then after confirming the diagnosis on histopathology, chemotherapy, or radiation is required. Please consult an oncosurgeon immediately. I hope it helps you. If you have any further queries, please ask 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: Initially, I had cold and cough, which now turned into sinus. I had Almox 500 mg for five days. For sinus I normally used to take Novamox 500. Sinus got cured but still I have some cold and cough. It has been 10 days. Since yesterday there are times when I blow my nose or spit, the sputum is red. ### Response: Hello. Acute sinusitis should be treated with 10 days of Amoxicillin and what you are having is acute on chronic sinusitis. I would suggest completing the course for next five days. Continue the steaming and use saline nasal spray. Do not blow your nose so hard. Allegra (Fexofenadine) is a good medication, but sometimes can cause nasal" "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: This is a request to analyze my MRI report. I would expect detailed guidance with what kind of treatment we have to proceed? What is the prescription for the condition and how long to use the prescribed medication? Please reply with the prescription as soon as possible. Please let me know the cautions and care we have to take. ### Response: I can understand your concern. I have gone through the report you have attached. (attachment removed to protect patient identity). The next step is an arthroscopic correction (surgery) for ACL (anterior cruciate ligament) repair. 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 a woman, 23. I am 5\2"" 137 pds. I am currently taking Cetirizine. I have been coughing badly for the past 5 months when I got my new job at a preschool. I went to the doctor, he prescribed me the before mentioned drug. Although, when it gets really cold, I cough phlegm and other times a dry cough. I would like to have a second opinion on what I should do because I am tired of coughing. ### Response: In addition to Cetirizine you need to take a bronchodilator medicine that will help bring out the phlegm better. It is available in the form of inhalers. Take 2 puffs thrice daily and gradually taper over a period of 2 weeks. Whenever the climate changes or you start coughing start on the inhaler. Second, when there is excessive mucus, in addition to the inhaler take ambroxol 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: My daughter is 21 years old and has major gaps in front teeth. What is the best way to fill the gaps? ### Response: The best way would be the usage of braces for the gaps between the teeth. If the gaps are less and present between a few teeth only, you can go for veneers. Considering the age, going for braces would be a better option. Still, seeing the patient directly and reviewing with a radiograph would give the best treatment planning. Consult a dentist soon" "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 visited three ophthalmologists, and all of them have prescribed me a different CYL and SPH powers for both the left and right eye. I am confused. I do not know which one is correct. How can I decide the power of the glasses? Please help me. ### Response: I understand your problem. You are having a problem in deciding the power of glasses to be made. I can give you the following suggestions. Choose the power which is felt the best when you are undergoing testing. Choose the power which has the most precise vision, with no distortions, with no variations in the size of objects, and there is no eye strain. Most patients will get satisfied with this power. This test involves instilling dilating eye" "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 35 years male who had low-risk penetrative activity (as used condom properly and no breakage) with a female of unknown status. On the 30th day (four-week mark), I had HIV 1 and two antibodies screening test. Serum equal to HIV 1/2 by flow through immunofiltration (seems rapid test) from the reputed lab for which HIV one and two both came negative.On the 44th day (6th-week mark), I again had HIV 1, and 2 antibodies screening test, serum equal to HIV 1/2 and P24 COMBO TEST (CMIA) from the same lab and resulted non-reactive on the next day. Kindly guide am I safe or is it the end of hope for me as I am searching like crazy every hour and any abnormality like cough, pimple, uneasiness in the throat (no pain while swallowing food), etc. is being looked as a symptom of HIV. I am looking for the ray of hope. ### Response: Do not worry about it, and you are unlikely to experience infected. Firstly, you had a very low risk of transmission as you used precautions and also the status of the partner is not known. Your combo test at sixth week almost rules out the possibility of HIV. However, it is recommended that you test yourself at three months and six months post exposure to be doubly sure. So, stop thinking about it as you are unlikely to have HIV and get yourself tested again at three and six months to be sure. I hope this helps you and get back if you have any doubts." "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 not able to concentrate while studying. What is the problem with me? ### Response: There could be many reasons for this issue. If you always had problems with concentration, and not just while studying, but have a short attention span, it could be attention deficit disorder. If the problem is of recent origin and you are getting stressed out with the burden of studies, it could be anxiety. If you have lost interest in studying and some other activities, it could also be depression. Besides psychiatric disorders, being distracted by something else which is on your mind or you do not find the study interesting could be other reasons for lack of concentration. The treatment depends on the exact cause of your problem. Consult me if you feel that any of these explanations could be the cause and you need more help, information, and advice about your problem and medication if 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: Dear doctor,I am 33 years old and I am using glasses for the last two years. My glasses numbers are right side is 3.5 and the left side is 1 but it is difficult to read books or newspaper. Can you help me? What can I do to solve the problem? ### Response: There could be two things that can cause a difficulty with your reading vision. Firstly, you could have developed premature presbyopia and although this is less likely given your young age, this condition is on the rise nowadays. In this condition, you will find it comfortable to read if you simply keep your books or mobile phones a bit farther than usual. In case you have this issue, kindly get your eyes re-examined by an ophthalmologist or optometrist to include near vision correction as well. Secondly, in case you have recently changed your glasses the problem could lie with: These can be rectified once again by examination by your ophthalmologist or optometrist" "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: What is the stigma around mental health? Why it is there? How can people help break the stigma around mental health and what advice do you have for people who want help but stigma is keeping them from getting it? ### Response: Hello. Stigma for mental illnesses is as old as civilization itself. Persons having mental illnesses were considered as evil. Mental illnesses were thought to be due to past life sins. A person having any kind of mental illness whether neurotic or psychotic was considered as ""mental"" or ""crazy"" or ""lunatic"". Progressively these all resulted in failure to acknowledge the mental illness and individuals develop thinking that what others would think if they consult a psychiatrist. Stigma is there because of cultural beliefs. Even in western countries, people have hesitation in consulting a psychiatrist. What will others think about me? People will make fun of me if I consult a psychiatrist, psychiatric medicines will make me emotionally numb, I will become dependent on medicines, etc., are the reasons there is a stigma for mental illnesses. Psycho-education is the most important method to break stigma. Awareness in public about mental illnesses, acknowledgment by celebrities that they too suffer mental issues are the factors that can help to break the stigma. Making people believe that mental illnesses are like any other medical illnesses, and these occur because of change in neuro-transmitters also help in reducing stigma." "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 is a kidney transplant patient. He had his transplant a year ago. Right now he is having wet cough and cold. It started yesterday. He is taking Pangraf 1.5 mg, Cellcept 500 mg, Septran and Wysolone daily. Which medicines should we give him for cough and cold? ### Response: First of all, most of the cough and common cold are upper respiratory tract infection (URTI) issues, which are self-limiting and respond without antibiotics. But since he is on immunosupressants, he would be considered for antibiotics if he develops any high grade fever or severe coughing. For URTI, I advise to take an antibiotic like Azithromycin only in case he has persisting fever. Otherwise in most cases of URTI, it is due to viral infection and it gets better within 5 days. He should do warm saline gargles at least 3-4 times a day and do steam inhalation. He should also take Paracetamol on as or when required basis for fever and body pains.Please share my opinion with your doctor, before acting upon 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: I ate a pineapple today from a street vendor. I saw him cutting the pineapple fresh, and so I ate it. When he was delivering it, I saw a black dry, flaky large sore on his hands. He was not wearing any gloves. Now I am worried about having an infection from this event. I am getting paranoid. Please advice. ### Response: Hi. Usually, gastric acid can kill almost all the microbe present in the GI (gastrointestinal) infections like dysentery, hepatitis, and viral gastroenteritis from eating contaminated food. But the route is feco-oral. If he has not washed his hands properly, then there is a chance of having fecal contamination of food. It is unlikely to have a skin infection or blood infection spreading this way." "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: Please suggest me a way to cure my constipation. I am suffering from my childhood. Now, my age is 45. I am taking medicines for the past four years. Before two years, I got TIA attack. I took both ayurvedic and homeopathy medicines for constipation. After a few days, I got peripheral neuropathy. I took allopathy medicines for three months, and I was taking homeopathy medicines too along with it for constipation. I had no relief from my problem. I was taking tablet Dulane 20 mg, Pregab 150 mg once a day, tablet Insumin plus. ### Response: I can understand your difficulty due to constipation. People who naturally have vaatha type of prakriti (lean body) has the higher chances of constipation. When taking more" "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 24 year old female. Last week, I suddenly saw blood in my stool, and I have a small lump in my anus. I consulted a doctor, and she gave me Dulcoflex and an ointment. It was fine for 10 days, but now again I feel that lump and saw blood in the stool. What could be the reason? Are there any home remedies for this? I had my periods last week. ### Response: This is anal fissure, and that lump is an anal tag. I suggest you try doing the following: Do not worry at all. You will be absolutely fine. Consult me again after fifteen days. Revert after 15 days to a surgical 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 took a blood test and found out that there is a folic acid deficiency. What is the standard dose taken for the folic acid deficiency? Should I have to take a B12 supplement along with it? If so, what is the dosage? ### Response: Hi. For folic acid deficiency, you can take a dose of 5 mg per day for three months. For vitamin B12 deficiency, you can take Mecobalamine 500 mcg once a day for three months. Did you test for vitamin D deficiency?" "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: What should we do when a person is mentally unstable because of something that happened in the past? How can he get over it? ### Response: Your post does not have many details, but I presume that you are seeking advice for someone who has been emotionally disturbed by some past traumatic event. Usually, people recover from emotional trauma with support and passage of time. It depends on the severity of symptoms and the trauma involved. Family and friends should offer the patient psychosocial support. Support the person to look after themselves and provide a listening ear whenever needed. Try to distract them from pensive thoughts by joining in music, movies, plays, etc. Encourage them to go exercise regularly. Patience and perseverance are needed in helping them to recover. If the person continues to be mentally unstable despite family support, you can consult a doctor for further assessment of mental health and support accordingly." "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 back, I had ear pain and according to the doctor, I had a fungal infection and got my ear cleansed and prescribed some drops for my ear to be used. As I used those ear drops my ear pain got increased and it turned into a very severe pain that I start feeling that some fluid was dropping from my throat and felt like that was a fluid from my brain, also felt like my brain is drying from inside. And I could not sleep because it feels like something is frozen in my brain.I am feeling better now but I still feel tensions in muscles and do not see any further progress in my condition. I feel like I have head muscle weakness and got to have some X-rays or something. Please advice. ### Response: Hello. I understand your concerns. Regarding your ear pain, it is most likely what is called otitis externa which is an infection of the outer canal of the ear most likely fungal. Wet ear is the most common cause also called swimmer\s 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: I am a 26 year old male. My height is 190 cm and weight is 85 kg. I do exercise with weights regularly. I have noticed that I have reduced feeling in the skin on my shaft. I cannot feel normal touch, but I can feel the pain if I pinch it with my nails. To best describe it; it feels like my penis is not there when the head was covered by foreskin. I just noticed it two weeks ago. Is this due to nerve impingement? I do not have any back pain or radiating pain down the legs. There is no trouble or pain with defecation or urinating. There is no tingling or pins and needles on the shaft. Rarely, I feel some burning or numbness feeling. I do not notice any discoloration or anatomical abnormalities. Is this a sign of diabetes? But, there are no symptoms such as polydipsia, polyuria, etc. I do not remember any trauma to the penis. I do not ride bicycles at all. I have been to a urologist and done an ultrasound of the penis and testicles along with a Doppler. But, there is no finding to be worried.My libido is very low. I get erections during the night or if I really concentrate on erotic thoughts. I have not tested testosterone levels, but I suspect them to be normal. I do not really mind the reduced feeling in the shaft. But, it would be nice to get it back. I am worried by thinking that it may spread or this is a start of a more serious disease. ### Response: This is a localized numbness that we are bothered with. Disease starting from this region without any other associated symptoms is quite rare and without them we may not think of a systemic pathology right away. Have you tried nerve tonics? I suggest back strengthening exercises and Pregabalin 75 mg once a day for two weeks. Vitamin B12 levels and HbA1c should be helpful. Consult a specialist doctor, discuss with him or her and take the medicine with consent. Lack of erections may suggest a more systemic disease, but we need to have more a detailed talk before we can attribute symptoms." "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 I insert Triamcinolone inside my vagina to clear yeast infection? ### Response: Hi. Triamcinolone is not indicated for yeast infection. You should use an antifungal like Clotrimazole vaginal pessaries for 14 days. I also advise you to use a condom during sexual intercourse. Consult a gynaecologist online regarding the severity of the infection and the need to take oral antifungal" "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 to know whether my child is affected by TB or bronchitis? I have attached his ESR, blood test, TST and chest x-ray. Kindly suggest. ### Response: I have seen the reports. (attachment removed to protect patient identity). The very first thing why you suspected that your child may have TB (tuberculosis)? What are the problems he is having like prolonged cough, are any swelling in the neck or any contact with a person who is known for lung TB? Looking at his weight, he seems to be growing well. Except for MT (Mantoux tuberculin test) which 15 mm positive, all other tests are normal, x-ray findings are non-specific. Best if you can get his sputum test to isolate germs (in this age group it is done by gastric lavage), or if he has significantly large glands in his neck, then a needle biopsy of the gland which a safe and easy procedure. There is a very fast and accurate test known as PCR (polymerase chain reaction) to confirm the presence of TB germs. If there is a contact with a confirmed case of lung TB, then with this MT result, you need to start medication. 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 a 49-year-old male. 100 kg. 180 cm. I exercise Cardio regularly however carry a little extra weight. I suffer from anxiety and are presently on inderal lyrica and Prozac. Over the past 2 weeks I have noticed my resting heart rate on my smart watch is about 48 bpm. Traditionally it has been around 58 bpm. Other than anxiety I do not have any symptoms. What could be the causes of this and is this of concern? ### Response: Hello. I understand your concerns, do not worry you will be fine. The Inderal you are taking is what is reducing your heart rate. A 48 bpm to 58 bpm is not bad so long you are not experiencing symptoms like fainting or shortness you are fine. I advise you to countinue to monitor your pulse to make sure your heart rate isnt dangerously low. For now it is not a cause for concern." "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 is suffering from OCD. She always washes and cleans everything, even electronic things. She will not touch anyone who come from outside. If in case she touches, then she does take bath immediately. If there is any fly at home, she will watch and wash all those things. ### Response: From what you have described, it seems to be a case of OCD (obsessive compulsion disorder) only. One thing I want to ask is whether it causes stress to your wife or does she consider her habits as alright. In case, we finally came to a diagnosis of OCD it requires proper treatment that is medications and psychotherapy. Pattern breathing exercises like Sudarshan Kriya will also help her. OCD can be cured if treatment is taken properly. 1. OCD.2. OCPD (obsessive-compulsive personality disorder). OCD. Medications and behavior therapy." "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: Recently, I got a lipid profile done, and the triglycerides level was 207 mg/dL, apart from that everything was normal. As it was a festival season, I had a lot of drinks and food for three days before the blood test. My doctor told me to take Razel (Rosuvastatin) tablets for 3 to 4 months after food and told me to control my diet. Is it necessary to take medicine? Can the triglycerides level be reduced only by controlling my diet at this stage? And even if I take the pills, will it cause any side effects? Please explain. ### Response: Hi. I will try to explain in detail about the lipid profile. Triglyceride levels in the lipid profile depend on the fasting status. If the blood sample is taken in fasting, the upper limit is 200 mg/dL. But the value changes with the food taken by you. In your case, there is no need to take the tablets as your LDL (low-density lipoprotein) and HDL (high-density lipoprotein) cholesterol are normal. You need to do regular physical activity and control your diet. Rosuvastatin usually does not have much effect in reducing the triglyceride level. It will decrease the LDL levels instead, so no need for medicines" "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: Yesterday, my son went to a local salon for a haircut. He received small scratches on the neck while getting his haircut. I noticed that it was done with a used blade, which was not cleaned properly. Is there a risk of an HIV or other viral infection due to this? Please guide me. ### Response: The likelihood of HIV (human immunodeficiency virus) transmission, in this case, is 1 in 300. Firstly, you are not sure that the person, on whom the blade was used previously, was HIV positive. So, in the case the person\s blood was on the blade, it would have" "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 months back I met a girl and we ended up back in my room. Long story short, she performed oral on me for about 30 seconds and I performed oral on her for maybe about the same, less than a minute, no intercourse. About two weeks after my friend came down with a cold and so did my brother, that Sunday I felt a little weird too but had gone to the beach. At the beach, I ended up swallowing a lot of seawater accidentally. That entire week I had headaches, stomach felt weird every time I ate and a little sore throat. So my mind went back to the day I met that girl and started freaking out. Three weeks after my oral exposure, I did an HIV RNA test with a fourth generation duo combo test and came back negative. My headaches continued for a little over two weeks on and off. After 25 days of the exposure, she did RNA and fourth generation which also came back negative. During the fourth week, I did another fourth-generation myself and also negative again. On week five, I went to a clinic, did a rapid blood drawn test and a NAAT test, and all came back negative. Week six (42 days) did another fourth generation and was negative. 52 days little over seven weeks I went and did an HIV 2 RNA test, and today at 53 days did an HIV RNA test and fourth generation duo. After all, these tests, am I in the clear? If I had HIV symptoms for a few weeks already would I test positive by now? Does it matter if I got her tested to give me reassurance? ### Response: Hello. As you had enough sea water inside, it would have caused a sore throat. In all the tests you are found negative especially fourth generation which is very authentic and correct. So, no HIV infection is there. You have done a very good job to test the girl which is also negative. So, no HIV is possible. So, you are free from HIV" "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 lean body and my height is 6 ft and weighs about 65 kg. I want to build body in the gym. What should I do? ### Response: As far as gaining muscle mass is concerned there are two important things. One is doing regular work out and the other more important thing is diet. In diet you should remember that proteins are the part of the diet which form the muscle mass. If you are a non-vegetarian you can eat eggs, chicken and if you are a vegetarian you can eat lots of pulses and soyabeans and nuts. You better take your meals more frequently like three major meals and three snacks. There are good protein shakes available in the market too if you are ready to spend some money too. But they should form a part of your meal as they also have importance in our body for the normal functioning of the body. 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: Dear Doctor,I want to delay my periods for a week. Earlier my periods have been very sporadic.Just wanted to know whether, is there any way which can help in delaying the periods by a week without disturbing the overall cycle? ### Response: Hi. From your question, I understand that you want to delay your next menstrual cycle by a week. Your answers for the above questions will help me treat you better." "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 a decayed tooth at the upper backside region. Now, I have got a sinus infection. Can I consult a dentist soon? ### Response: I can understand your concern. You may need to take antibiotics if the sinus infection is present with a swelling. You have to consult a dentist soon. In case, if you have any other issue, please upload a picture of it. I want to confirm it whether it is a pericoronitis or pulpitis with sinus involvement. Take tablet Augmentin 625 mg (Amoxicillin with Clavulanic acid) twice daily for a week. Take tablet Aceclofenac twice a day for a week. Keyword - Antibiotic for sinus infection" "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 13 year old son has periods of dizziness (around one minute or less) and fainting since one month. He also has wheezing and coughing since seven months. ### Response: Hello. Firstly, I would like to let you know that the dizziness your son is undergoing could be due to a number of reasons. I would like to brief on the concern. For now, I suggest: Do not worry, your son will be fine. Do not take stress, it is nothing dangerous" "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 CT scan today and two punctate stones were found in the mid-lower portion of my right kidney. I was advised they measured 1 to 2 mm. I currently have urologic issues of possible stricture near the tip of the penis. In addition, I have a lifelong urine flow issue where the flow is not strong. I have not spoken to my urologist yet but given my history of possible stricture and weak flow, I am concerned about my ability to pass these on my own. I would like your opinion on my options. Is lithotripsy an option? Can these stones get bigger? Does the location of the stones have any significance? I did have calcium oxalate stones seven years ago. At the moment, I do not have bad pain. A recent urine culture found no infection. If these are calcium oxalate too, anything I can do to may help dissolve them given they are small? ### Response: Hello. Relax and do not worry. 1 to 2 mm stones in lower pole are very, very small in size. As far as treatment is concerned, they do not require any treatment like lithotripsy because they are very very small. Regarding precautions, you should take precautions to prevent their increase in size. 5 liters per day. You need to take food containing low in oxalates. There are so many foods having oxalates. A complete list you can get from the internet. So, avoid these foods. You can follow up with the ultrasound every six months to check for an increase in size. Regarding stricture, you require may be a cystoscopy and optical urethrotomy as adviced by your urologist" "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 just hit on the right side of my neck with a basketball. Part of the basketball hit my chin, so my neck cartilage did not take the entirety of the impact. The basketball was probably traveling around 20 mph, I do not know for sure. As a large object, it probably did not exert that much pressure per area. Regardless, it happened in a fraction of a second. I do not have any noticeable wheezing or any hoarseness right now. However, I have some mild shortness of breath. I do not know whether this is related. Because I also have asthma and silent reflux, I have a pulse oximeter and a peak flow meter, both values of which are normal presently.I have some mild neck pain too. My cough is normal (no blood), and I do not have any difficulty swallowing. Can I wait a couple of weeks to get an indirect nasal laryngoscopy from an ENT in my area, and then depending on the result, symptoms then, get a CT/MRI a week thereafter? Or should I go seek emergency medical care now? ### Response: Normally larynx is well protected by protruding mandible. Most of the impact is received by the sturdy mandible. However, since the impact was on the side of the neck, the laryngeal framework might have received some impact. I would like you to palpate your neck for tenderness and if you can also feel for crepitus of the thyroid cartilage if any. Also, look for any swelling. If there is anything like that or if you develop any hoarseness or dyspnea you may pay a visit to ER. In the absence of these, you can wait and take some analgesics in the meanwhile." "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 age is 28, and I think I am suffering from sexual weakness like premature ejaculation and erectile dysfunction. I want my young days back. I think it is just sexual weakness. Can I take Damia drops? What is the dosage and till when I have to take for six months or a year? ### Response: I suggest you have Agnus castus 200 three times a day at every eight hourly for at least 10 days. This medicine will help with both premature ejaculation and erectile dysfunction problems. Please also inform me if you have diabetes, high blood pressure, or any other diseases, so I will help us to do more and appreciate the treatment. I would also like to suggest you do some physical exercise daily in the morning for at least 30 minutes." "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 suffering from throat pain, red tonsil and entire jaw and neck pain. My wisdom tooth also paining for the last two to three months. When I visited an ENT doctor for my throat pain, he said that I do not have any problem inside the neck. He also advised me to visit a dentist. I had medicine antibiotics for throat pain, but still pain is there. Can you please help with that? Is that wisdom tooth causing pain in my throat? ### Response: Hi. I have gone through your query and photograph (attachment removed to protect patient identity). X-ray of painful wisdom tooth. Revert back with the x-ray report to 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 am diabetic for past four years. I am taking Tablet Glynase MF for diabetes. My FBS is 200 mg/dL, PPBS is 300 mg/dL and Hba1c is 8 %.Kindly provide proper drug and diet for managing blood sugar. ### Response: Follow the diabetic diet and exercise daily for at least 30 minutes. Here is a sample diet to help you understand the diet. Continue your ongoing treatment and also take Tablet Volibo 0.2 mg (voglibose) twice a day before lunch and dinner for seven days. Follow up after seven days with your fasting and postprandial blood sugar levels" "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 2-year-old baby developed small red pimple like bumps on her body about three weeks ago. The bumps were not itchy and were just on her stomach, back and limbs. We initially thought it was eczema, as we already know she suffers from this or measles, but she is up to date with her vaccinations. We took her to the doctor and they said it was a viral exanthem and it should clear up. Not but a few days later, she spent the day with the babysitter and they said they were out and forgot a diaper so it is possible that her urine was on her longer than normal. Later that night, she started saying her butt was sore and come to find out, she had a cluster of bumps in between her butt cheeks and a little on her labia, which her buttocks were the only part that was sore due to the acidity from her urine.Bumps also appeared on her face, most exclusively around her mouth (not on lips and not inside the mouth). But later on, she developed bumps on her nose and along her jaw up to her temple and some on her ears. We took her to the ER because it was clear that whatever she had, had progressed for the worst. She saw the doctor and as we were in the hospital room, she started saying she was itchy. She had never been itchy before, but now she was itchy all over and more and more bumps started to appear. Now on the tops and palms of her hands, tops, and soles of her feet and a lot more on her limbs. The only place that does not have bumps as of right now is her neck. We were confused because these bumps were never itchy before, but now she complained about how much it itched. It seemed to itch the most on her feet. The doctor diagnosed her with impetigo and prescribed us Mupirocin ointment and Amoxicillin and Clavulanic acid (Augmentin) to take orally. We were also told to give her Benadryl in conjunction with it. It is been a few days and it does not look like there is any progression in ridding her of this infection.Now she has some bumps that are inflamed and look white which kind of resembles a mosquito bite or something. Other bumps have a tiny black center to them. She ended up scratching her leg and within hours, it became inflamed in white and had tiny black dots in the center (not sure if dried blood or what it is). Then the surrounding area broke out even worse into tiny bumps like an actual rash. So much so, that her whole leg looks just red. Her other limbs started looking this way as well. It definitely looks worse than it ever did before and we are afraid that it is something more serious and the doctors we have been taking her to, keep misdiagnosing her. Please help. ### Response: Hello. Your description gives me two possibilities, one is skin infection which we term as pyoderma, which has a severity range of being mild to very severe. An antibiotic like Augmentin (Amoxycillin and Clavulanic acid), Mupirocin would definitely help. Did she have fever anytime? Second is an allergic rash for which might have gotten infected is another possibility. If there are no pus formation or oozing bumps, we can apply mild steroid creams, which takes care of both itch and rash. And the antibiotic covers the infection. So you can Tryptophan the cream which you were using for eczema before if you have it. I do not know if you can get it over the counter. It needs slightly longer duration of treatment as it has been there for three weeks. Some tests like a swab of the wound can be sent if lesions are not responding to Augmentin. A picture would have been more helpful. Continue Augmentin, Mupirocin, and Bena" "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 consistent twitching in the bottom lid of my left eye. It has been ongoing for about for two weeks tomorrow. ### Response: This eyelid twitching can be caused by a number of different problems. In case you have only the eyelid twitch and have no other problems in your eye or other bodily diseases, we label such cases as essential blepharospasm. To reduce this, I suggest you do the following. Avoid tea or coffee completely for a few days. Get around eight hours of sleep at night. 5 percent 6 to 8 times a day. In case you have any other symptoms with the twitching or have already tried doing the things I just mentioned, please let me know. I would appreciate if you could share your doctor\s records, relevant test results with me, I will do my best to help." "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 11 weeks and 4 days pregnant. I have done glucose challenge test (GCT) one hour and the result was 174 and glucose challenge test (GCT) two hours was 174 with 82.5 grams glucose but fasting plasma glucose was 82, HbA1c 5.5 and estimated average blood glucose level was 111.15. But I did these tests at 10 weeks and our doctor said this is high sugar and sent to an endocrinologist to show our test report but when we met with him during consultation he said this was not appropriate time (10 weeks) for glucose test as you did this earlier and he recommended to do the same test only at 24 to 28 weeks, and there is nothing to worry he said.I am worried about this confusion as both the doctors gave different advise. Kindly help me to overcome this situation and what to do next for my baby and for me. My doctor also said to go for NT scan and double marker test. Kindly reply me I am waiting for your fruitful advice. ### Response: Hi. How are you doing? Let me start by saying that you are absolutely fine. Your endocrinologist has given you the right advice. Let me give you a few facts as per WHO and world standards: You and your baby are absolutely fine. You do not need to worry. Trust me you are absolutely fine, nothing needs to be done. Hope I have clarified your query. Do write back if any more queries and for your feedback" "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 36-year-old female. I had two chemical pregnancies this year, and I am childless. Due to my age, I decided to investigate more. The thrombophilia panel test results recommended me to see a hematologist. I have positive results (heterozygous) for MTHFR C677T, PAI 4G by 5G, AGT M235T, factor XIII Val34Leu, and fibrinogen 455 G by A. Will I need special treatment for a future pregnancy? Please help me. ### Response: I have reviewed your case. It seems that you had two miscarriages. So, you have to know a little detail about your condition and to understand thrombophilia. The risk of abortion is none to minimal in normal pregnancy whereas intermediate and high in heterozygous and homozygous mutation respectively. In your case, as you have twice pregnancy failure, I have two recommendations. Try to do APLA test (antiphospholipid antibody workup) which is just the extension of thrombophilia work up. During future pregnancy, usually in your case, we need to give some medications which can maintain your blood flow, and it can prevent the micro clot formation in the placental blood vessels, and hence the chances of abortion will get decreased. You can discuss with your hematologist regarding the test suggested and about the" "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 36 years old and had unprotected sex with my husband on 18th at night. Although he pulled out we are suspecting pregnancy as there can be 1 % chance of ejaculation. I had my last period on the 7th and usually, I get my periods one to three days before the expected time. I took Unwanted 72 on the 21st afternoon. But after taking it, I was feeling stomach and back pain in the lower region along with cramps. Though I am not feeling any other symptoms of pregnancy like nausea, vomiting etc, which I even did not have during my first pregnancy except stomach pain like periods. Will Unwanted 72 will be effective in my case? Can it stop fertilization/implantation? Am I pregnant or is it a side effect of the emergency pill? I am still feeling pain but it is less now. When can I expect my next period or when should I go for pregnancy kit test? I am already having a kid of 2 years and do not want a second one. In case I am pregnant, please guide me how to get it aborted. ### Response: In your case, the unprotected intercourse took place at a very fertile time and the delayed intake of Unwanted 72 might render the pill useless. It is highly possible that you still might get pregnant despite the pill. However, the symptoms of back pain and stomach cramps are usually expected after taking the pill. So these symptoms are unlikely due to pregnancy and more likely due to the pill as pregnancy symptoms develop usually around five to six weeks of pregnancy. Expect your next periods to be a little delayed than usual and may look abnormal as well, like blackish in color. If your periods get delayed by over a week then take a pregnancy test and check. If positive, let me know and then we can discuss further. All the best" "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: HelIo doctor,I am a 17 year old girl who through a series of mistakes has pushed my friends away. School is a constant battle and I feel alone and defeated. I am lonely and continually depressed. Please help me. ### Response: From the available description, it appears that you need to manage stress appropriately. Mistakes are a normal part of our life and there is no point in regretting them. Whatever might be the situation, you need to move forward. Identify the problems in school and start working on them, one by one. Once you identify the problem, it will be easy to make a list and solve the easiest first and then proceed further. At the same time, it will be appropriate if you can talk to your old friends. Saying sorry and admitting mistakesmelt almost all the problems in buddies and I am sure they will embrace you with the same warmth if you move a few steps towards them. Having said this, take the help of elders in your family because they can provide valuable advice. I can assure you at this stage that you are not alone and help is available. Whatever comes to your mind or whatever problem you face, do not hesitate to write back to me. I will be glad to assist you. If you find any difficulty in handling such situations, you can write back to a psychologist counsellor online with specific details for further guidance" "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 31 years old, who weighs 160 lbs and 5.10 feet tall. I drink alcohol on and off since I was 18 years old. Once I got back from deployment, I drank pretty hard with friends. I would say 3 to 8 beers every other night and then 12 to 16 on weekends. I quit drinking cold turkey a month and a few weeks ago, but then I started having weird symptoms. I get panic attacks, my heart would race, and I would get dizzy and light headed. About the same time, I hurt my lower back using an ab roller. Now, my heart still beats faster than it normally does, especially in the mornings when I first get out of the bed. It almost slows back down to normal when my wife and I go on walks though. My back is still hurting as I am waiting for my MRI, but I have been to the ER four times in a month with chest tightness and a racing heart. The last time I went, I was given Morphine, which brought all my vitals back to normal. Am I at risk for alcohol neuropathy or could the racing heart and sometimes shortness of breath be attributed to a potential back injury? ### Response: Chest tightness and racing heart can be because of some cardiac problem like rhythm disturbance or ischemic heart disease, or it can also be due to severe anxiety or panic attack. But it does not seem to be related to the back injury. Chronic alcoholismis a risk factor for developing heart problem also. For back pain, you can get an MRI of the spine. As you have consumed alcohol for such a long time, there is a possibility that it might have affected your nerves already, which may be subclinical and can be looked for by doing the following tests: If your heart tests come out to be normal, you can meet a psychiatrist for proper de-addiction treatment and also a treatment for your anxiety and panic attacks." "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 are living in a building. It has four floors. We are on the third floor. There is a mobile tower on the roof. Is there any harm to the baby and us due to the tower? Please advise us if there is any harm, then what to do? The baby is three months old. ### Response: Hi. Normally, it is said that radiations from the mobile tower are not carcinogenic. However, there is no proof for that. This statement is based on research. Currently, there are no guidelines stating that one should stay away from mobile tower radiations, so there is nothing to worry as such. Your child should not be affected by that. No special precautions are warranted." "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 Sacroiliitis caused by AS and hypermobility, which I manage without tablets, and by doing exercises, stretching and seeing an osteopath once a month to prevent flare-ups. I have also been refered to a rheumatologist with suspected fibromyalgia and I am still waiting for the first appointment. I have now found out that I am six weeks pregnant and have a few questions.Can I still see the rheumatologist regarding fibromyalgia and treatment for sacroiliitis? How will pregnancy affect my sacroiliitis? Will I get more pain? Are there risks in giving birth? How could I be affected after giving birth? ### Response: To answer your questions in turn, yes, that will be fine to see a rheumatologist, they should be able to help you. It is hard to say how pregnancy will affect sacroiliitis. Some people improve during pregnancy and some people worsen but there are things that can be done even whilst you are pregnant. The rheumatologist can help you with this. There are not any actual extra risks giving birth, your joints are inflamed but not damaged. After birth your symptoms may worsen or improve, it is difficult to know at this stage, but again there is plenty that can be done to help. So it would be good to see your rheumatologist shortly after birth. 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: My uncle is 52 years old. He had an issue when he was in his young age. His nerve got pinched and due to that incident, he is not able to walk properly. He has gone through so many tests recently. But we are not satisfied with the treatment. Please, clear whom should we consult. ### Response: I reviewed all his tests (attachment removed to protect patient identity) and would explain that they indicate a possible genetic disorder which causes progressive paralysis. Unfortunately, there is no cure for these disorders as the brain cells and spinal cord cells die gradually. I would recommend consulting with a geneticist and performing genetic analysis. Physiotherapy is the main treatment for your uncle" "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 recommended the injection Fondum based upon the ECG. The ECG report says the blood supply to one valve is less other all is fine, already taken one. Also, other medicines as Rosumac gold (Aspirin, Rosuvastatin, Clopidogrel), Sorbitrate. Should I take balance two injections of Fondum or consult a cardiologist. Had done an Echo two years back and that was normal. ### Response: Please send me ECG so that I can guide you accordingly that what to do next. Please tell about the age of patient, symptoms, and any blood tests performed." "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 22 years old and I had sex a week back. My partner ejaculated outside the vagina and I took unwanted 72 the other day. Is there any chance of getting pregnant? ### Response: I have gone through your history and understand your concern. As you took Ipill on time, there is no chance of pregnancy in your case. Delayed menses can be due to hormonal imbalance caused by Ipill. Get your home urine test if you missed your period by seven 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 had a dental examination and scaling done last week. After that, I had a very bad bitter or metallic taste in my mouth when I eat or drink along with a stinging sensation on my tongue. I also had sensitivity in my teeth. The only difference during this visit was an ultrasonic scaler was used, instead of manual scaling. I had never undergone scaling with an ultrasonic scaler before. The scaling was extremely uncomfortable. I had a bad taste in my mouth after scaling. But, it got worsened later in the evening when I tried to eat. Could this procedure have caused some nerve damage? Please help me. The next day, I also had a headache and felt nauseous after scaling. The bad taste, stinging sensation of the tongue and tooth sensitivity has got worsened badly. I have never experienced these problems after a scaling and a dental examination. I do not have any amalgam fillings. I have a history of sinus infections and TMJ pain. ### Response: Because of the irritation and vibrations of the ultrasonic scalers, sometimes, the salivary glands become hyperactive and secrete bicarbonate to counteract any acidic ion present in the mouth. Till now, you will be apprehensive. You can feel it. Do not get panic. Nerve damages never happen with scaling" "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: What are the long-term consequences of bad posture? Please explain. ### Response: Hi. Poor posture is likely to cause structural changes or fixed musculoligamentous issues. The outcome and timing is dependent on the starting point. By this I mean, if this starts in early childhood, one will notice the changes by late adulthood. The severity of symptoms and actual clinical effects do not follow a straight line path and many other factors, including genetic, environmental, etc., play important roles in expression of symptoms. Further, the cause of poor posture such as muscle weakness, bony cause, trauma, neurological. etc., have their own natural history. Poor posture is likely to cause backache, stiffness, increased likelihood of sustaining injuries to the hip, knee and shoulder, appearance anomalies, etc., and in extreme cases, breathing problems due to sustained pressure and lack of space for expansion of the lung." "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: From young age, I have had little red dots all over my legs and not much hair. I am a 31 year old male and I want to know the problem. There might be ingrown hairs, but I do not know. I have more of them hair especially on the back. ### Response: I have read your concern and examined your given pictures (attachment removed to protect patient identity). Revert back after two weeks 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: My brother is undergoing psychiatric treatment form last 10 years. He is being advised a few medicines which he is taking from last so many years. I see his condition getting worse. I need help and a second opinion. ### Response: Hi. He is suffering from schizophrenia as per your history. He is taking antipsychotics. Schizophrenia is a progressive disorder which leads to cognitive impairment. I am sorry but there are medications which can only control the disease but cannot cure. You can try different antipsychotic medications if he is worsening. He can take tablet Clonazapine if he is worsening on medication or can post on ECT (electroconvulsive therapy) therapy if severe behavior problem. it is sure that he has to take medication for lifelong." "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: There is shoulder pain going into arm and hands. It intensifies with moving the neck. ### Response: I have read your concern and below is my opinion for your case. It can be nerve compression pain due to a bulging disc in the cervical spine area. I suggest you get your detailed neurological evaluation. You should get investigated with cervical spine digital X-ray to check whether any bulging disc or spondylosis is present. According to the cause, specific treatment is given. You can consult a nearby orthopedic surgeon for detailed 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 20 years old. I have not got my periods this month. My last period was on the third of last month. I usually have a cycle of 32 days. Still, I did not get my periods, and I am worried because my boyfriend touched his penis near my vagina. Am I pregnant? Please help. ### Response: Just touching the penis near the vagina is unlikely to result in pregnancy unless there is a discharge that contains sperms. In your case, you need to do a urine test for pregnancy using Preganews card to exclude pregnancy. If pregnancy is excluded then wait for your period till 14 days beyond your expected periods date. If periods do not occur by then you will require some investigations to find out the 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 had an unprotected sex with my fiance a week ago and now I missed my period. I am scared that I will become pregnant and I do not want it now. Please help me to stop pregnancy. Please. ### Response: Firstly, please get a serum beta hCG test done to conclusively rule out or confirm pregnancy. If the hCG levels are more than 5mIU then you are pregnant else you are not. If positive then you may require to get an ultrasound pelvis done to confirm the location of pregnancy as to if it is intrauterine or an ectopic pregnancy. If intrauterine then you can opt for termination of pregnancy by a medical method under a gynecologist supervision" "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 mom had headaches and backpain. So recently, my mom went for an ultrasound scan and was diagnosed with a bulky uterus. The size of her uterus is 83x41x61 mm, and they also found an intramural fibroid sized 57x33x38 mm. Could you please help me understand what exactly this means and is there any complication? ### Response: Hi. How are you doing? Let me start by saying that it is nothing to worry. Let me explain. These masses are like stones and are hormone dependent. So, they grow till she has periods. Once periods stop, her hormone supply stops, and the fibroid starts shrinking. Intramural Fibroid never become malignant. If you randomly take scans of 100 ladies, 50 to 70% may have fibroids of different size. It is a dictum that, no asymptomatic fibroids need treatment. I would simulate it to, if you have a huge boil on the face, which does not interfere with food intake, just leave it alone. But even if you have a small boil on the inside of the mouth, it really hurts, then you may need treatment. Intramural Fibroids need treatment only if: If she has no symptoms, just leave it. It will shrink as her estrogen hormone is reduced. To further help in reducing the size and bleeding in periods, I suggest trying tablet Ormeloxifene (Sevista 60 mg or Novex DS), twice weekly. She can have it for a year or so and stop it after a scan. The fibroid would have shrunk. This medicine is cheap and has no side effects. If she is anxious or has any of the symptoms, then surgery and removal of the uterus with fibroids would be advised. Hope I have clarified your queries, do write back." "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 seen at Emergency Care and diagnosed with a sinus infection. My eardrums were red and there was fluid behind them. I was prescribed to have Zithromycin 250 mg (Z-pak), which I have been taking. Now, four days later, my left ear is completely plugged, and the right ear is somewhat plugged. My hearing is affected. I also suffer from tinnitus. This infection has made the tinnitus louder and much more intrusive. Should I hang on for a while longer, or do I need to be seen by my ENT doctor immediately? ### Response: Hi. Since you had sinusitis,it is very likely that the infection has spread to your ear which is causing the blocking sensation. I would also like to know whether you are suffering from tinnitus for long? Have you had age-related hearing loss earlier as well? Do you have ear pain? Either it can be just the infection in resolving stage which will take around two to three weeks after the infection subsides or it is possible that you are getting sensorineural hearing loss. To confirm this, audiometry is required along with impedance audiometry." "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 severe toothache and after getting permanent tooth filling done tiny pieces of tooth started to break. Now completely the tooth is fallen and when consulted a doctor he told dental implant of the tooth must be done because RCT can be done but as there is no root so the cap might come off again and again. Please help. ### Response: I am unable to understand your question completely. If there was no root then how was the filling done? And which tooth are you concerned about? Answer me with a photograph of the same in your follow up. As far your problem is concerned, permanent fillings do not come out that easily provided it is manipulation and filling and post filling procedures were all done correctly. Secondly, yes you can go for RCT only if there is a healthy supporting root. As far as the implant is concerned, you can opt it will be a perfect choice if you wish you may also go for prosthodontic bridge provided your adjacent teeth are healthy enough to give support. In the bridge, we take the support of one or two adjoining teeth and thus there is a set of 2 to 3 crowns which get fixed on healthy teeth hence your absent teeth gets a crown." "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 an injury in the left SI joint two years ago. Because of it, I am lying, walking and sitting only on my right side. Now left side is fine, but I have developed tingling and burning pain in the right lower back. My MRI, x-ray of spine and SI joints are normal. Blood tests for ankylosing spondylitis, RA factor, hemogram, LFT, KFT are normal. Pain in the right lower back continues. Pain is like pins and needles and also like burning. I had a bone scan done which showed some abnormalities. I have enclosed my bone scan report for your reference. Please advise the treatment for persistent pain in right lower back area. ### Response: Hi. I also need from you few clinical details: 1. Mechanical back pain.2. Inflammatory polyarthropathy or spondyloarthropathy. Follow up with the investigations reports to an orthopaedician and traumatologist 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: The first day of my last period was on the 2nd of March, it lasted till 6th of March. I had unprotected sex on the 10th of March, but he did not ejaculate inside me but there is a chance that pre-cum may have gotten in. So for safety, I took contraceptive pills (Postinor 2) on the 11th. On the 16th, I noticed light bleeding, and it lasted till 19th. I am yet to see my period for this month. Although, I usually experience irregular menstrual cycles, is it possible I am pregnant? Or has it worsened my case of irregular menstrual cycle? ### Response: I have gone through the details and the sequence of events you mentioned and totally understand your anxiousness. The effects vary from a person to person. As you already had a history of irregular periods, it is difficult to predict just based on the sequence of events whether you could be pregnant or not. So a definitive test would be to check for a urine pregnancy test, preferably with an early morning urine sample. If that is negative, then you can rest assured that you are not pregnant. And you can take the medications mentioned below to get your periods and get yourself evaluated for the cause for your irregular periods. Regarding your irregular periods, I see that you are slightly overweight for your height. So mostly this could be due to PCOS (polycystic ovary syn" "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 10 month old daughter has been sick for five days. She had cough with congestion and flu without fever. The doctor has given her Ciprofloxacin for five days. From today, she has a fever of 38 to 38.9 as I checked from her armpit. Kindly tell me what should I do? I have given her Paracetamol 5 ml also. It works for the hour. After that, the fever comes again. Kindly advice me as there is no good doctor here. Please help me. What to do? Is that normal or not? ### Response: I understand your concern. I suggest you give her Crocin (Paracetamol) 5 ml every four to six hours (Paracetamol 5 ml equals 125 mg). If fever is persistently more than 100 F, give her syrup Meftal P 2.5 ml (Mefenamic acid 5 ml equals 100 mg) every six hourly. In between fever, do tepid sponging of the whole body. The whole purpose is to bring down the temperature so that she should not throw febrile convulsion. Usually, fevers are viral fever and do not require antibiotics. Why was Ciprofloxacin given? Just check with the doctor, usually, in chil" "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 thought that I had hemorrhoids because I feel bulge at my anus, that is poking me around my anus, and it is irritating me while sitting, walking, standing causing itchiness though I did not see any skin tag. I am only 19 years old boy and I weigh about 52 kg, my height is 5.4 feet. I do not want any surgery, but I want to get cured of this piles permanently without any surgery. ### Response: First of all, you should be confirmed that it is hemorrhoids. If it is external or internal hemorrhoids, external cause pain and internal cause bleeding. Also, let me know if you have constipation. If yes, use capsule Colace 100 mg BID and avoid constipation, take a sitz bath twice daily. Sitz bath is simple. Take warm water in the tub and sit in it for 20 minutes, do this procedure for 15 days. If it does not improve, get it checked with some doctor to see if really there are hemorrhoids or something else." "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 m a 26-year-old. I do not have any job now. I worked for a project of a private company. Then I tried some other posts, but nothing worked. I was good at studies, so I decided to prepare for a government job. I have a fiance. He is too preparing for the government job.I do not know what my father needs? He always shouts and this the third time when he beat me. For no reason, he has his inner frustrations. My fiance says I cannot marry you until I get a government job. I like to paint sometimes. What should I do? If you can help, I will be very grateful to you. ### Response: Hello. You should try your freelancer if you can do. Create your own business, do not get worried about a job if you do not get it. Be hopeful and relax. Everything will be fine. Do exercise daily for 30 to 45 minutes and lose your weight which will help for even PCOD. Do meditation for 10 to 20 minutes. Spend time for your creative hobbies for 20 minutes like do painting as you enjoy. Do not overthink. Ask your father about his problem. Now you are not a child, talk openly and be assertive if you need to be. Do not be afraid of anyone in life. Live your life, not just spend. Do not think even about your marriage with your fiance. Just wait and watch. Do not be insecure. Make your self capable enough to do anything." "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 swollen lymph node in the armpit with very little pain. I have been experiencing fatigue and weight loss for last few weeks. I have gone through some routine lab test and found that some test results are out of the normal range. Iron profile: iron 153, UIBC 96 (low\x80\x8c), TIBC 249, saturation % 61.40 (high). Are the above results an indication of any health issue or disease like hemochromatosis? ### Response: Serum iron is a bit on the high normal side and TIBC/ UIBC is on the lower side. The rest of the reports are fine. ESR is normal, so it makes the possibility of chronic inflammatory illness to be less likely. However, your iron profile is not complete, serum ferritin value is not there. You should request the laboratory to test it again. Ferritin will indicate the amount of excessive iron in the body. If ferritin is elevated, then it suggests iron overload in you and in that case you will need further investigations like HFE mutation testing, liver, and cardiac MRI, etc. So, on priority, you should get serum ferritin level done to look for a possibility of iron overload. You also request for CRP test as an alternative evidence for any inflammatory disease. It is similar to ESR. Meanwhile, do you have any history of blood transfusions, family history of any blood disorders, acute febrile illness recently? Regarding lymph nodes, small and painless lymph nodes size 1.5 cm are considered normal for armpit. So it is better if you can get it examined by a local physician. Hope this helps you and get back if you have any doubts" "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 it right to have unprotected sex without a condom? Can I take an emergency contraceptive pill after it? ### Response: Hi. An emergency pill is meant only for emergency and during accidental contacts. It should not be used for a routine purpose. It is better to go for a consistent method of contraception like condoms and oral contraceptive pills. Cyclical oral contraceptive pills have very less failure rate when compared to emergency pills. Emergency pills have high doses of hormones, and it causes delayed or irregular bleeding." "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 sore throat and trouble swallowing. I had Candida albicans in the throat and saw an ENT two days ago. He said it was almost gone but I have an inflamed papilla. Could that be the reason? I have trouble eating and drinking now. ### Response: An enlarged papilla can be due to infection and inflammation. Apply Candid Mouth Paint (Clotrimazole Topical) to the tongue and oral cavity four to five times a day for a week. I suggest you take an oral antifungal also. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. Is there any history of diabetes? It would be better if you can send me a picture of your throat so that I can suggest you better and prescribe you accordingly" "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: This is regards to my urticaria problem. I had a chronic urticaria three years back, for which I underwent a course of Loratidine and Xyzal-M for close to one and a half years and was keeping well. All of a sudden, I had a severe outbreak of hives last week and was put on Dazit-M, Allegra 180 and Xyzal along with Methylprednisolone (8 mg).This time it is so severe and after three days it is not coming down. I need your advice on my current condition and if my medications are appropriate. ### Response: Hello. You have already been prescribed steroid which is Methylprednisolone for three days and some other antiallergic medicine as well. I will recommend you to be patient for one more week and continue the same medication. If in case there is no improvement, only then I will recommend having another short course of steroid. Meanwhile, I will ask you to please avoid readymade or take away meals, use bland products for washing, avoid perfumes deodorants, etc. I know this is difficult to do but avoid as much as you can. You can apply topical steroid lotion mixed with vaseline lotion in equal parts and then apply on your hives two times daily. Please continue with your oral medicine in addition to this. In case you have any breathing difficulty then see a doctor on an emergency basis. Next time please send a picture of the lesion as well to know the extent of disease too." "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 sore throats on and off for a couple of years now. One of my tonsils is bigger than the other. I have not been feeling well lately. I get constant sore throats, extreme fatigue, headaches, swollen right side of the neck, some minor difficulty swallowing, a low-grade fever, and not hearing well. I have been beyond tired. Recently, I have had things that look like mouth ulcers. I am worried about tonsil cancer. Does this look like it? I am currently taking Zoloft and Adderall. ### Response: Chronic tonsillitis is a recurrent infection of the tonsils. Tonsils are lymphoid tissue present in the throat. When they get infected, they cause pain, soreness, headache, fever, and malaise. Tonsils" "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 of 20 years old. He has gained 18 kg in last two years. Now he weighs 91 kg and height 5\10"". We had a blood test, and T3 and T4 are normal. TSH is 0.692. Is there a problem with his thyroid function? ### Response: Hello. TSH (thyroid-stimulating hormone) levels should be 0.5 to 5 depending on which international unit is used. Kindly check with your lab, whether that is normal for the age. Usually, they will give you a printed report only if it falls within the range, then no need to worry. His BMI (body mass index) is more compared to his height and weight. He needs to reduce his weight to minimum 80 only for his height. Kindly ask him to join a gym or any training programs or yoga. Do some dieting and breathing exercise. Ask him to walk for 30 minutes a day, especially brisk walk. The diet should be strict with no fat, more fruits, and vegetables. I hope this info helps you sort out your problems." "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 had intercourse, and there was quite a lot of bleeding. The next day it stung quite a bit, and when I urinated, it was painful to sit down. I inspected my vulva with a mirror and found a tear or rip at the base of my vulva. I searched, and I think it is at the posterior fourchette. It is 10 days since this, and there is no longer pain and discharge or bleeding. However, I can still see the tear, it is red. How long should it be before this seals over and should I avoid having sex until it does? Also, how common is it for this to happen, and will it happen every time I have sex? ### Response: According to the history given by you, apart from a vaginal tear, the following reasons can also cause similar symptoms: 1. Firstly, women can bleed post-sex if intercourse is done soon after the periods, but this does not cause pain. 2. Secondly, virgin girls can bleed initially for a few times. 3. Lastly, intercourse done without proper arousal or foreplay makes the vagina less lubricate, causing pain and bleeding. You should visit a gynecologist for a detailed examination because sometimes tears can be deep-seated and be missed causing future problems." "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 24 years old and married for 4 years now. I am 5.2 and obese. This is my scan report. Can you please tell me if I can conceive this month? I previously had PCOS. Currently, I am using ayurveda medicines. I heard that delayed ovulation rupture does not cause pregnancy. Also, my husband has teratospermia. Please check the attached documents of follicular study and semen analysis and suggest the needful. ### Response: Hi. I have gone through your query and reports (attachment removed to protect patient identity)." "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 premature ejaculation problem. It happens under 15 seconds. Please advice the prescription or medicine to cure it. I am 27 years old. ### Response: Hello. It is commonly associated with performance anxiety. With repeated practice of intercourse, it will be cured. If no improvement, then you can take help of psychiatrist or sexologist. Local topical Lignocaine jelly application after erection can extend the duration. Master and Johnson start and stop technique are also beneficial. Behavioral counseling also can be 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 think I have social anxiety, but I am not sure if it is affecting my life enough to do anything about it. I do not want to tell my mom, but I am sure therapy would help as I am very insecure, have a negative mindset, and generally I am very paranoid of what others think.I do not know how I will hold a job as I hate others observing me and hate confrontation and I am worried about interacting with customers, etc. Is social anxiety an essential one to get treated? How to tell my mom without making her worry. ### Response: I understand you are quite worried and frightened about your problems. Social anxiety is common, and it is all about what it does that affects the people more. Your worries about your inability to hold on to a job and avoiding social situations are valid. It is very important to treat social anxiety because if left untreated it will gradually keep increasing and you may end up feeling frustrated and depressed as well. Regarding explaining this to your mother, you can read and find it easy to understand articles regarding social anxiety and ask your mother to go through that. First of all, you need to make her understand that it is an illness like diabetes or hypertension. If it is an illness, it has some symptoms and a proper course and treatment as well. If you had diabetes, would your mother pity you? No, she would ask you to consult a doctor. Similarly, in this case, you will need medicines as well as therapy to overcome your symptoms and gain some control of your life. No one needs to pity you for anything. Once you start viewing this from a rational point of view, you will be able to explain it better to your family. 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: My mother is 64 years old and diabetic for 12 years. Recently she visited a dentist to get a denture. The dentist told that two pre-molars (1 up and 1 down on left side) have to be root canalled even though there was no pain in them because those teeth were not in good condition which he said after looking at an x-ray. I do not have any of those x-rays. So, the root canal was done on those two teeth, and cotton was placed there and asked to wait for one week. There is no pain at all. After one week, the cotton was removed, and the cement was placed. Within a few hours, the pain started, and it was increasing pain. The dentist then removed the cement and again placed cotton and asked her to wait for one week. No pain at all. Again on cementing, within few hours pain started a lot. Again cement was removed, and cotton was placed. This cement and cotton alternation has been going on three times (for three weeks), and the dentist says it will work at some point in time, and the cement will be permanent. He says the pain during cement is due to the gas pressure from the gas release by the microbes sitting on the remaining disintegrated pulp. If even finally it does not work and pain does not go away while with cement, he said he would make an antibiotic injection or spray on those teeth. I do not have any x-rays, so this is the only information I can give.My question is, Does this procedure look normal and logical? ### Response: I need those pre-operative x-ray to make any comment, but as you do not have them, I can only make decisions based on your explanation. Through your explanation, it does not seem normal. There was no need for a root canal; rather, the dentist could use those teeth for denture support. But as she is a diabetic and periodontal loss of attachment is common in diabetics, so maybe those teeth did not have enough strength to support, that is why all this procedure has been done. Be sure before the final cementation of those teeth, cementation should not be done with pain. If pain persists, there is no other solution for a root canal treated tooth other than extraction, and then full mouth or complete dentures will be provided to your mother. Kindly reply me back with the x-ray if you find 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: I defecate almost five times a day. My stool is hard most often. This caused me an anal fissure which I am currently recovering from. My diet is high in protein. I eat fruits and salad on daily basis. Is this normal? Could it be a sign of colon cancer? I am currently taking Daflon for anal fissure and Dulcolax for hard stools. Please help. ### Response: Your symptoms are unlikely to be due to colon cancer. Colon cancer can be present with variable symptoms such as constipation, vomiting, bleeding through anus and significant weight loss. I suggest you take Movicol (potassium chloride, sodium chloride, and sodium bicarbonate) two sachets per day for hard stools. Consult your specialist doctor, discuss with him or her and with their consent take the medicines" "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 oily skin. I have lots of dark spots and acne on my face. Currently, I am using Clincitop gel. My face skin has turned dark where my body color is normal. I have also lost my skin complexion. How should I get rid of this? Please suggest me. ### Response: Hi. Please send good quality photographs of your face taken under natural light for more detailed opinion.Revert back with photographs 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: There are small white lines in my nails of the hand. One of my friends told me it is a symptom of calcium deficiency. Please help me with this issue. ### Response: White spots or streaks are normal and nothing to worry. But, parallel white lines that extend all across the nail known as Muehrcke\s line are a sign of a low level of protein in the blood. Low levels of calcium which is termed as hypocalcemia has symptoms mainly of neuromuscular like cramps, tingling sensation, numbness, perioral anesthesia, etc. So do not get confused about 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: I had unprotected sex and took I-pill after 48 hours. Will it work? I do not think ejaculation happened. However, I am nervous. ### Response: Hi. Since you have taken the emergency pill within 72 hours of intercourse there is no chance of pregnancy. So relax and do not worry. However, if you have a doubt, then get 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: I am a married, 27 year old female. For the last two months, my cycle was like 35-36 days cycle. Now for the past two days, I am having brown color discharge from the vagina, but not always. I had intercourse until 10 days back. What could be the reason for this discharge? Please advice. ### Response: I understood your problem. It seems that you are suffering from hormonal imbalance. Did you recently take any new medication? Or are you undergoing any stress which can cause this? It does not seem like a pregnancy issue as that would not cause a brown discharge so early. Besides it is highly unlikely to get pregnant by intercourse on 22nd in a cycle of 35 days. You can take hormone pills for two to three months to stabilize your hormones, and the problem should resolve. But before I prescribe you the medicine, I would like to know if you are under any medication? Have you got any test done for the same?" "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 it all right for a newborn baby of 4 days to be given a normal bath? I read that only sponge bath should be given to the baby till the umbilical cord comes off and is completely healed. ### Response: In this cold winter, it would be preferable to give a sponge bath with lukewarm water, cleaning all areas of the body. One has to be careful that the baby is not exposed to cold. Keep the baby warm. Breastfeed the baby as it gives the mother\s warmth also." "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 sister met an accident before four months. Now, she is suffering from ACL injury. According to the doctor\s suggestion, she did POP for a month followed by arthroscopy. She is following the exercise under the supervision of a physiotherapist post arthroscopy. She can find recovery, but it is very little and slow. A slight improvement is seen while bending the legs. But it is not complete. Straight legs are not recognized while walking. How long it takes to have a complete recovery? Please suggest. ### Response: Usually, it takes three months to have complete recovery after arthroscopy with good physiotherapy done regularly. The treating surgeon decides the frequency of doing exercise. Ideally, you should be able to bend the knee for about 90 to 100 degrees in three weeks post surgery." "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 week I had sex with a guy with expired condoms. I saw the packets only after sex and found that they are expired. Is this a problem? Could I be pregnant?Also, I am not sure if this is linked or not but three days ago, I had a really sore, stinging and itchy vagina. I have had thrush before and do not know if this is what it is? I got Canesten thrush combi internal and external cream packet and have been rubbing some cream on my vagina for the last few days. It does not feel as weird burn as much as the first day but still feels weird. About half an hour ago, I inserted the internal cream. My vagina has been feeling really weird, but it feels like a urine infection in a way but does not burn to urinate. I do not know if this is thrush or an infection like a sexual infection from an expired condom? I have not gone to the doctor. When I did put a finger inside the other day there were some white bits on my finger. My opening to the vagina hurts and is sore when I try to finger myself. Could I be pregnant? Or could I have got a sexual infection due to an expired condoms? The soreness started a few days after the sex with expired condom. I feel uncomfortable and do not know what to do? Is it true that once period comes it clears up? Please suggest. ### Response: If the condom is expired it means it may break easily if it has not had breach then it is as safe as normal condoms. According to your information, three months have passed after this incident and during these three months did you had normal periods? Normal period means no pregnancy. The ideal thing would have been if you had uploaded an image so that one could see what is there. And yes, you have to avoid sex for a few days until soreness settles." "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 18 years old. I remember when I was 8 years old, a staple entered my right eye. I think it went under my eyelid and I did not tell my parents about it. I did not feel any irritations or as if something is in my eye. What should I do? Will I go permanently blind? Please help me. I am afraid. ### Response: Hello. I advise you not to jump to conclusions and scare yourself. You will be just fine" "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 had my thyroid test done. I am attaching the reports of the same. The note reads that a physiological rise in total T3 and T4 levels are seen in pregnancy and patients on steroids. Does it mean that I am pregnant? I am worried. ### Response: Hi. Your thyroid level is upto normal level. The preference range given in the reports is for pregnant female (attachment removed to protect patient identity), not for non-pregnant female. And Thyroid levelnever determines pregnancy. If you had unprotected intercourse and delayed menses, then you can go for UPT test for confirmation of pregnancy." "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 went to a beach and I ordered for coconut water. Possibly when the coconut water was given there was a straw that the coconut vendor put in the coconut with his hands. On that day my lips were chapped or cracked. I drank the water by the straw. After that, I saw that the fingers of the coconut vendor were bruised and blood might have had been put on the straw by him accidentlly which might have had touched my chapped lips. If in case if the coconut vendor had HIV, could it be possible that the blood on the straw could have had touched my chapped lips and infected me? ### Response: Your risk of HIV (human immunodeficiency virus) acquisition is unwarranted in this case. HIV can only be transmitted by sexual contact, through the exchange of contaminated syringes or needles, blood transfusion or there can be vertical transmission from HIV infected mother to her child during pregnancy, delivery or through breast milk. HIV cannot survive outside the body or even in the old healed lesions or bruised sites." "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 scratched by a cat in my left foot and a little blood went out. It was like three or four days until now, when I noticed that my left foot is a little swollen. Am I already infected by rabies? ### Response: Hello. Because of the dog bite, inflammation can develop and in inflammation swelling can occur and pain also can be there. The incubation period for rabies is two weeks. So, you are not having rabies but to prevent it if you are not vaccinated then get rabies vaccine because it is not too late. The vaccination schedule is at 0, 3, 7, 14, and 28 days for non vaccinated person. If you are previously vaccinated then the schedule is different" "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 girlfriend is having light cramps and today she observed slight spotting. Her last two menstrual cycles were 32 and 37 days long and her last periods started a month back. We engaged in unprotected intercourse one week later once with us stopping and taking protection in between. I did not ejaculate inside her. We are concerned about a possibility of pregnancy. ### Response: I can help you with this. With the history I think her periods are a little irregular. The time of sexual intercourse is not much near her ovulation time and if you have not ejaculated inside, the chance of pregnancy is very rare. If you have had no unprotected intercourse thereafter, and if she by chance had become pregnant, urine pregnancy test should show positive by now. So to be on safer side it is better to do a urine pregnancy test now even though she is having spotting. If it is negative now then definitely she is not going to be pregnant due to the sex. So then you can wait for another week for her to get her periods. Finally light cramps and spotting may be preceding her normal periods. Urine pregnancy test Review with urine pregnancy test result" "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 sinus problem and very frequently, I have sneezing and coughing problem with phlegm. Recently, I suffered from a cold and since then I am getting a blood stain in the morning while sneezing and while clearing the throat in the morning. One month back, I got a chest X-ray and it was perfectly normal. Can you please specify what should I do? What could be the problem? Should I go for throat and nose endoscopy as the doctor suggested? ### Response: Hello. Was the blood while coughing bright red or altered maroon color? If it was bright red, then it could be from upper respiratory tract only. It can be due to just trauma. So, do not worry about it at all if it repeats also. Suppose you are getting maroon-colored blood then you should be cautious. Get endoscopy done that time." "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 31 year old female, who never really suffered from headaches before this year. I did have occasional (what I called) tension headaches, mild pains behind one eye that would last a few hours, and that is about it. Last year, I gave birth to my first child, by C-section. 2 to 3 days after the spinal anesthesia, I developed positional headaches that were incredibly intense. I was told they were related to the anesthesia. I could not sit or stand up, and the pain was the worst thing imaginable. I would actually cry on the toilet when I needed to go. On a scale of 1 to 10, it was an 11. When I lay down, it got better, a 2 to 3 out of 10. The pains went away after 6 to 7 days, and I got back normal. However, during these seven days, I did experience once a scintillating scotoma, which was almost identical to the auras that precede migraines. A lot of blurry shining lights that gradually grew larger and became a sparkling fortification spectrum in a C-shape, which grew even larger until it left the vision field towards the left side.Then I had no problems whatsoever for the next six months or so, until one and a half months ago, when I started having the aura again, and it happened six times so far. I have been very overworked and overtired when they started, with the baby starting solids and not sleeping well. It has been so far five times on the left side of the vision and once on the right side (although the same day I had it on the right side, a few hours later it also happened on the left side, the same day). The transition of the scintillating scotoma from a dot to a large C leaving my field of vision lasts about 30 minutes, and it is every time the same. I do not have any other symptoms, although I had mild nausea a couple of times during the aura.The headaches that follow are mild. Like a stronger pressure in the back of the head, on the opposite side of the scotoma. So, it has been mostly on the right side. A couple of hours after the aura, I can always feel a sharper pain on the right side, inside my head, towards the back of the head (occipitally), usually when I move, bend over, cough, strain, etc. It is every time on the same side in the same spot. This pain disappears after a day or so. But for the last two weeks or so, I have been left with a slightly painful pressure in my head that is pretty constant daily. It sometimes goes away especially when I am relaxed, but it comes back when I am more tense and active. It feels a lot like a tension-type headache. There is also a sensation of a \full head\ and a bit of lightheadedness like I am not focusing my eyes well (but not actually losing any balance or visual acuity). There is no particular pain when moving, coughing, bending over, etc. like I have during a migraine. But I do feel more pressure in the back of my head on the right, not sure if it is psychological, or it is really something there. I should also mention that I did not take any medication for the migraines, and once tried Ibuprofen for a tension headache, but it did not really work. Sometimes, a glass of wine works better actually.My brother started having the same aura (he described it to me in detail, and it is the same thing I have) when he was 35, which was five years ago. His headaches are mild to moderate, but they are behind his eye and not at the back of the head like mine. He also does not have the head pressure every day like I started to have, and his migraines alternate sides, not like mine which are pretty much on the right side of the head (left vision field). I am scheduled for an MRI next week, so I will find out more soon. But I wanted to hear your opinion since I am so very scared that I have a tumor in there, something really bad. I very much want to see my baby grow up and be there for him. I am super worried, and I just had another aura yesterday evening, and now I get the sharp pain in my right occipital area when bending over. Do my symptoms really seem like migraines or maybe something worse? I have read that I am a bit too old to start having migraines (31) and that the pain should be more intense and not always on the same side (which is indicative of brain tumor?) and that they should be on the front of my head not at the back of my head. Is that true? ### Response: I read your query and understand your concerns. I hope this answers you. Feel free to contact me back if you have more questions or doubts" "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 semen analysis and it showed agglutination stage 2 moderate. Can someone help explain his results? ### Response: Hello. Sperm agglutination is basically agglutination or sticking of sperm head and tail. If the agglutination percentage increases then this could prevent sperms in fertilizing the ovum. If the counts are normal and motility is good then there is no need to get worried. Some laboratories have started using staging for this agglutination. But having positive agglutination does not mean that semen sample has some serious issue." "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 fishy odour, white and milky dischargecoming from my vaginal area. I am a 28 year old female. What could it be? ### Response: You are suffering from bacterial vaginosis. This is a common vaginal infection of women who are sexually active. Please use the following: Follow the advice and you should be fine. Revert back to a gynaecologist online if the symptoms persist" "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 eyes get watery when I talk to people or when I am nervous. Why is that happening? ### Response: Hello. Our autonomic nervous system also controls lacrimation or tearing and for some emotional changes can activate the autonomous system and hence tearing. There is no specific medication for the same. But you can try using mild anti-allergens like Olopatadine or Naphazoline or Ketorolac to reduce any co-existing eye allergies and reflex lacrimation. Also, look out for nasi lacrimal duct obstruction." "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 23 years old. My thigh and arm have more hair than other parts of the body since I am 15. I want to get rid of it, so please suggest me treatment. ### Response: It is a widespread problem among boys. The issue of more hair is not uncommon since accepting it or not we are a hairy race. Causes include mainly genetic (80 %), race. Did you also start to plucking the area as many boys do? This could mean that you put your hair follicles into growth phase sooner than desired. Also, it is a known scientific fact that rubbing, teasing, and plucking sets the hair cycle in motion. The best alternative is to use a hair removing the cream. If you are looking for a more permanent solution than laser hair reduction is the way to go." "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 diabetes since the last 11 to 12 years, and I started taking medicines given by my family doctor. Presently, I am taking Glimisave M2 (one tablet in the morning and evening), Dynaglipt 20 (one tablet in the morning), and Absolut 3G (one in the evening). My health is fine, and I do not have any other diseases. Recently, my blood sugar level showed up high, so my family doctor advised me to consult a diabetologist to control blood sugar level. Please help me. I have attached my test reports. ### Response: I just read your query about your high blood sugar levels and from the lab results (attachment removed to protect patient identity), it appears that you have uncontrolled diabetes and dyslipidemia, that is, high cholesterol. Do let me know if you need assistance or if you do not understand anything. Hope you find my advice of some benefit. Good luck." "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 known 16-year-old son misbehaves with others, not staying at home, does not care about his family, passes the time with his bad company, behaving rudely to parents, and not studying properly. Parents have no control over him, and he does not care when they request him to focus on studies. He does not ask what we say. All these happen within two years of time when he joins with a new circle of friends. Last time he tried committing suicide, writing a statement against his parents as a reason for his death. After his suicide attempt, he is forcing his parents to give him expensive things. Nobody can speak even a single word against him, as it is right or wrong. Otherwise, he will take the next step to attempt suicide. He is not under the control of anybody. We think he needs treatment to stabilize his mind. ### Response: Hello. I can certainly understand your concern. I have worked through your attached query in detail. As per the description, the possibility of a conduct disorder or a borderline personality disorder should be considered here in your child. Detailed mental status evaluation is required in a head to head interview with your child. It is advisable to consider the expert guidance of a child psychiatrist. An inpatient requirement is also high. 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 18 and struggling with anger issues and impulsive behavior which I am unable to stop. I seriously think that I am quickly getting depressed and developing anxiety and repulsive behavior. I have had many past incidents which might have reflected upon my change in attitude change, and so I want to get rid of this. Please help me. ### Response: Hi. I can understand the difficulties faced by you because of the impulsivity. Since you are only 18 years old, I would not consider any medications right now. However, I would advise you first to appreciate the bodily changes that come when you become angry like clenching of teeth, feeling body muscles contracting and increased respiration. Secondly, I would advise you to leave the situation or place which makes you angry. Then you can close your eyes and take deep slow breaths through your nose. While doing so kindly focus on your body muscles individually in a series like the first face then neck then trunk and so on. And also while taking deep breaths, you can count from 1 to 100. By doing so, you can manage your anger and thus your offensive behavior." "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 76-year-old father went for a routine checkup where his X-ray report mentioned non-homogenous opacity in right mid and lower zones. Also, his TLC level was 15.7. I do not want to see him in pain if he would be advised to undergo any surgery or go for chemotherapy. He is old aged and has undergone angioplasty twice. He coughs during the night and sometimes in the day.He is a non-smoker and does yoga regularly and morning exercise. He is fit and does not have a fever. In view of the above description, please advise me the proper course of action. ### Response: Hello. Most probably he has a chest infection or pneumonia which will require a course of antibiotics and a follow-up X-ray after one week. The good news is that he will require no chemotherapy or surgery" "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: Usually, I let my cats go out and play in the backyard. They frequently bring in fleas and bugs in the house. So I get flea and bug bites. I usually get red bumps on the areas of my legs and lower legs. But recently I notice that there is a confined area that looks like a scab. This is how it happened? The area was really itchy so I started scratching it a lot. After this I noticed a fluid or watery stuff coming out of it. After this, I noticed a scab formed in that area. It is dark red and looked strange.So I took a picture of it and asked a doctor online. He said it was an early form of cellulitis, and suggested some antibiotics for it. I did another consultation with a doctor online, and he said it is a minor allergy like dermatitis from the flea bites and suggested some cream and antibiotics. I am confused. So, I went to my doctor today and she told me she does not think it is cellulitis. However, she can prescribe me antibiotics in case it is cellulitis. I heard most of the time if someone has cellulitis but there being treated with antibiotics the prognosis is very good and the infection leaves in about seven to ten days. If you do not take antibiotics it can be life-threatening. Is it true?The antibiotic I was prescribed was Cephalexin 500 mg one capsule four times a day for 10 days. Is taking four times a day means like in the morning, afternoon, evening, and night? I thought of takiing it twice a day. I am confused. I am going to take a picture of that area. Please let me know if it is cellulitis? It looks like a scab though. Can cellulitis or even minor cellulitis look like a scab? In your opinion should I take the antibiotics? Does it look like cellulitis to you, or just a flee allergy reaction that got itchy? I have attached a picture. ### Response: I have reviewed the attached photograph and can appreciate the scabbed area. (attachment removed to protect patient identity). It is not cellulitis at all. It is because of the intense itching the area has excoriated and then turned into a scab. No need to take oral antibiotics. You can simply apply topical antibiotics like Neosporin ointment on the affected areas twice daily for seven to ten days. This will resolve the scab. Do not scratch it and let it fall off on its own." "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 to go to urine a number of times especially in the night and that was beyond control. I am male, age 56. ### Response: Hi. Are you having diabetes? If sugar is high in blood, this complaint will be there. If the prostate is enlarged and inflammation of the prostate is there, then urination will be uncontrolled. Go for the following test: 1. Blood sugar fasting and post-prandial. 2. Urine analysis and culture and sensitivity. 3. Ultrasound abdomen to rule out enlarged prostate." "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 severe stretch marks problem, which is increasing day by day. What can I do to get rid of it? And also I want to remove the old marks which are present near my belly, armpits and above shoulder. Please help. ### Response: Hello. Please do mention your age whenever you ask any query in the future. If your stretch marks are new, then it will be reddish. If it is old it will be whitish, the response to new stretch marks are good whereas old ones respond less to creams and ointments. Please try shea butter or cocoa buttercream in the day time and Retin-A (Tretinoin 0.025 %) cream at night for a month. If you do not find any response, then you have to visit a doctor to undergo laser therapy." "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, and for the past week, I had pain while urinating, especially at night. Sometimes the pain lasts after I urinate and feels like there is acid or something still in my urethra or something, it is hard to explain. I am not sexually active, so I cannot be an STI. I think it may be a UTI. I have some Amoxiclav which I had prescribed for a skin infection and never used so I am taking Amoxiclav for this but not sure how long should I take it for and standard dosage? Currently, I am taking it three times a day, so far pain (I think it is subsiding). Should I get checked at doctors if Amoxiclav does not work? ### Response: Frequency, urgency, and burning micturition, pain while urination all can be symptoms of cystitis or urinary tract infection. Most commonly, it has two types, either complicated or noncomplicated UTI. So your condition comes in non-complicated UTI." "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 daughter was born a week back. Upon leaving the hospital her jaundice levels were at 10.2. The follow-up appointment was yesterday and after doing a bilirubin test it went up to 11.2. The doctor stated I should start supplementing with formula as I am breastfeeding. However, she was having 6 to 8 diapers a day with breastfeeding. Please guide. ### Response: Hello. Also the blood group of the baby and mother should be known along with G6PD status." "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 made a tattoo almost six months back. Even at the time of receiving tattoo, the artist used multiple needles in which I saw changing few and missed some. I asked him about needle changing to which he said he did. My concern is what are the chances of contracting HIV in worst-case scenario that he did not change a few needles. Also till now I never had any fever or body pain or infection around the tattoo made. ### Response: Hello. Needle can transmit HIV only if the needle was freshly used in another person send the amount of blood collected in the needle is significant. This is because the HIV virus dies very quickly outside the body. In my opinion, the odds of transferring HIV infection in the above scenario are quite less as the chances of both these conditions are present together is very less. It is a good point that you have not had any fever or other symptoms. Testing is being mentioned because we are talking about the worst-case scenario. In short, testing not needed ordinarily after tattooing, however, if you have much doubt about due precautions taken by the artist, you can go for 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: I was born 14 weeks premature and was told that do not circumcise that young. I believe I have a condition called aposthia, but I need help in identifying what it is? ### Response: Hello. I have seen images sent by you. (attachment removed to protect patient identity). Aposthia is the absence of skin covering glans. In the flaccid state, there is definitely a skin covering your glans. In erected state definitely glans skin gets pulled behind the coronal sulcus. So I do not think you have any abnormalities." "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 teeth of yellowish color. How can I whiten it? ### Response: It may be due to calculus deposit on the tooth surface. Please visit your dentist for scaling and if you get any further deposits even after scaling, you must go for polishing your tooth to get a white surface. Stains and calculus. Oral gingivitis. Oral prophylactic treatment (scaling). 1. Use mouthwash.2. Brush twice a day.3. Gargle mouth after every meal." "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 21 years old. I am suffering from pimples and their dark spots. What happens is one or two pimples appear and vanish in two to four days leaving dark spots behind. The same thing repeats again and again. Now there is a lot of dark spots in my face. I do not use oil in my hair and also avoid oily foods. Pimples contain something whitish. What should I do? Please suggest. ### Response: Hello. I can understand your concern. You need to take proper medicine for the treatment of pimples so that dark spots will not appear. Seborrhea or hormonal imbalance. Acne vulgaris with post inflammatory hyperpigmentation. Revert back after six weeks 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 took Clearblue ovulation digital test a week back which showed LH surge. I had intercourse three days before and three days after the test. Since then I have been feeling really sick, but not vomiting. I am really sensitive to perfumes and I have started to feel faint and lightheaded even though I have just eaten or had a drink. I have been getting cramps around my tummy area (like I would the day before my period starts), my bra feels tight, my boobs do not look big but bra feels tight. I have been getting pain around where I get pubic hair if that makes sense like sharp tugging pains. I have stopped getting the discharge. I am not sure what it could be. Please, could you advise if it is too early for pregnancy as I am due to start my period between 20th-22nd of this month or do you think it is a virus or bug? ### Response: As you had LH surge, so the ovulation would have occurred after 36 hours post-LH surge and practically the intercourse after the test would account for possible conception, but the symptoms of pregnancy are never so early. However, the earliest you may test for pregnancy is after eight days post intercourse with a serum beta hCG test which can give conclusive results" "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 acid reflux problem. To the maximum it will cause problems like twice in six months. Shall I eat pineapple for the acid reflux issue? What if I eat pineapple daily or alternate basis and manipulate my liver to produce less acid for the future? Also, due to this habit, I can get rid of antacids or other medication. I am also getting nervous and dizzy while traveling due to excess acidity and that cause motion sickness. ### Response: Hi. Acid reflux, also known as GERD (gastroesophageal reflux disease), is a condition related mostly to the esophageal sphincter incompetence. Severe cases require surgery to reinforce the sphincter. As for the pineapple, there are controversial opinions among doctors. Some of them do not recommend it because it is a highly acidic fruit and can worsen the symptoms. While others recommend it as it may have good effects due to Bromelain. You can try it for a week and see how your heartburn goes through. If you decide to avoid" "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: CPAM type 3 lesions, but ratio is 0.6. Will it cause a serious problem after birth for my baby? ### Response: I have gone through your history and understand your concern. As there is no chromosomal abnormalities in your baby, there is most likely no problem in future but continuous monitoring is important in your case." "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: Today my 2 month old puppy accidentally touched my teeth while I was petting him, but I did not see any scratch or blood. So, do I need to get a vaccine? I am really worried about the matter. Please let me know. ### Response: Hello. If your puppy did not bruise or abrade you, then there is no need for any vaccination. Vaccination is required in cases of exposure to rabid wild dogs, not pet dogs. Now, considering the fact that this puppy is your pet, I assume you would have got it vaccinated earlier. Still, I would advise you to get a course of rabies vaccination. It is under the name of pre-exposureprophylaxis and consists of three to five injections. It is always better to take precautions rather than regretting." "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 stupidly just flushed my retainers down the toilet. I had braces removed eight years back and have been wearing them religiously every night since. Unfortunately, there is a storm here. So, all the dental practices are closed. I am worried that my teeth will move before I get an appointment next week. I have a mold of my top and bottom teeth from when I first got my braces removed but I had to change my retainers after getting new crowns and a porcelain veneer in my two front teeth. So, the new ones I flushed down the toilet are different but I would say only slightly. Is there a benefit of wearing these molds until I can get a replacement retainer? ### Response: Hello. It is quite unfortunate that you flushed your retainers and I completely understand your concern regarding the relapse of your orthodontic treatment in the absence of retainers. Now, coming to your question regarding the old retainer, you cannot wear the old retainer as it is not going to help you since a minor change in dentistry means a lot. But, do not worry. Only a week of not wearing the retainers would not make much of a difference since you have been wearing them for quite a long time. My advice to you would be to wait for your appointment and get the retainers" "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 recently suffering from extreme burning back pain on my shoulder blade area. For a few months, I have had this strange clicking feeling in my neck, on the same side where my shoulder blade pain is happening. Not a normal joint crack, it felt weird, bothersome. It was infrequent, but now, the weird clicking happens almost every day. A few months before I was vitamin D deficient but am taking supplements. Maybe the deficiency contributed to this? I am wondering if it could be my neck or if they are just knots from stress, but I have never had this bad of a burning sensation before. What I could do? Is this common? ### Response: As you have a burning sensation and unlocking sound in the cervical spine, it could be related to the nerve entrapment. I will advise you to take a neck collar and do hot water fermentation for a week post which you can update me so we can plan the exercise for strengthening the muscle. Meantime, please take an MRI of the cervical spine. It is common in cervical spine degenerative changes that people tend to have nerve entrapment and with conservative management, they respond well. Waiting for your reports." "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 doctor prescribed Diflucan (14 days / 200 mg) to treat urinary candidiasis. I just took day 6 of Diflucan. I am feeling a little better but still have achiness in pelvic area, bladder. My question is how much longer until I get full relief? Is this normal? ### Response: Hi. I suppose you have urine culture proven urinary candida infection for which this tablet Diflucan was started. Usually for urinary tract infection, it is given for 1 to 2 weeks depending on patient symptoms. You can continue till two weeks till sypmtoms subside and then repeat the urine culture test for documentation of complete resolution. You should also check for your blood sugar as these infections are common in diabetic person and high sugar can lead to recurring infection. Burning sensation in urine or achiness as you described is most probably due to infection. A sonography of abdomen and pelvis is advised to rule out other causes such as stone disease as cause of infection." "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 27 years old and really worried about developing anaphylaxis to a local anesthetic. Even though I have had it twice without any problems, I would just like some information on how likely this is to happen and some information to help me put my mind to rest and stop worrying. ### Response: Hello. Anaphylaxis may last lifelong. Also, if you have not experienced a severe reaction in the past, you are unlikely to develop the same in future. Do not worry. Just be aware and keep rescue medicine always with you as standby" "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 26 year old male. My weight is 60 kg and height is 5\8"". I grown up with great responsibility of family, but never fulfilled it up to the mark besides living my life in fear from society. I managed good academics and some standard over time. But, I have also developed very poor social skill, dependency to some extent and fear while facing anything new. I do not want to move from a situation where I have fixed myself.Three years before I had a breakup and also was idle without job. This had caused me severe stress and crying episode about which I did not share with any one. I got job, but did not feel happy about it. The emptiness and worry followed me. I got into another relationship which was lovely. I got involved in alcohol drinking and smoking. I faced a time where job stress killed me every day and I detached myself from everyone, felt emotionless even with my family, drowsiness and no sense of reality. I became so casual that only thing I wanted is nothing should worry me. If anything worried me I tried to solve it immediately with a step which might be job threatening. I lived without any pleasure, confidence, goal and routine. I did live my life, but never felt any connection as I have become a robot. Forgetfulness, short term memory loss and no attention or interest at all. Today I have improved myself and do not drink regularly; I do exercises, do talk with family and some friends, watch television and got a better job. But still, I am not happy. My forgetfulness and excessive worry is with me still. I find that my brain is continuously busy in something, but I am not aware of that. I feel very tired and lazy. Socially frightened, poor, and I am not clever enough. However, I am very polite, helpful to others and have good moral value. I found that I have not added a strong value and get easily convinced, irritated and people make fool of me. It is like I have got stuck and trapped and I have not moved on. I want to put an end to this. Please help me. ### Response: I have gone through your query in detail and would like to summarize your current symptoms: Along with medicines, here are few tips for better results: Social anxiety disorder. Major depressive disorder. Antidepressant medicines and lifestyle changes. Avoid alcohol and increase physical activity. Follow up if you have any queries to a psychiatrist 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 did a lot of tests to see if I am bipolar because I have a lot of similar symptoms. They all had the same answer that there is a high possibility that you are bipolar, go to a specialist. I already have a psychiatrist, but I do not know how to talk about it. Could you help me because I am desperate? ### Response: I can appreciate your dilemma. I will suggest discussing your concerns with your psychiatrist. Write down all the reasons why you think you may have bipolar disorder and discuss it with your psychiatrist during your next review. Screening tests in the search may give approximate guidance, but they not very specific. For example, many teenagers have significant mood swings, which may inadvertently be flagged up as bipolar. A proper diagnosis can be made only by a comprehensive assessment, including detailed background history." "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 52 years old and had an MRI for worsening migraines for the last six months. I have had migraines for 31 years. The finding was a few foci of T2 and 3 mm T2 prolongation within the left frontal subcortical white matter. No associated restricted diffusion or abnormal enhancement. No additional parenchymal signal abnormality. The ventricles and midline structures are of normal appearance.Impression or conclusion: Minimal left frontal chronic microvascular ischemic changes. No findings of an acute intracranial process or abnormal enhancement. What does all this mean? My neurologist said to take seizure medicine for the migraines and my brain is fine. Currently, I am taking 12.5 mg of Amitriptyline every day and Sumatriptan when needed. ### Response: Hi. See, your MRI report is normal (attachment removed to protect patient identity) and has nothing to get worried. I would like to know a few things: Revert with the asked details for a better help" "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 used to play sports. Now after a gap, I started walking and later doing some fitness workouts daily. During walking my muscle below the knee is getting more strained and paining (issue only for right leg). Please give me a right solution. ### Response: I read your concern. I feel you should do proper warming up and stretch before doing the activity. This will definitely reduce your tightness, pain, and discomfort. Do some basic stretch and strengthening and use good footwear. Apply ice on the painful area frequently. Get an iced bottle and roll your leg on top of it for a while say for 10 minutes." "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 oral sex before months. I did the following tests.1. HIV combo 4th generation (CMIA) during 2nd, 3rd, 4th and 5th month after exposure. All results are negative.2. HIV combo 4th generation and ELISA during 7th month. All results are negative.3. HIV test from ICTC center in general medical college hospital in the ninth month with a negative result.4. STD tests are also done.5. HCV on ninth month by ELISA method.Now 11 months have passed and I have lymph node under the jawline on both sides. Both lymph nodes are equal in size as that of green peas. It is moving but I do not have any pain. Is it lymph node? Do in normal body is there such type of lymph nodes present? Or is this symptom of HIV? Is this a serious condition?I am 32 years old with good health. I have attached all my reports.Please provide information on what is my status? Should I need to test more or not? What is the size of the lymph node in the normal body under the jaw line? Some say that HIV test may take nine months in some cases, what are they? Sometimes I feel muscle pain and some mouth infection, is ti sign of HIV? As per NACO, there may be very rare chance of some persons to show positive after nine months. Who are they? ### Response: I have gone through the details and reports. (attachment removed to protect patient identity). The chances of transmission of HIV by unprotected intercourse with an HIV positive person is very low (1/200 to 1/1000). If protected it is nil. Chances of transmission by oral sex are almost nil unless there are bleeding wounds in both. The risk is nil. If HIV antibodies tests are negative \x80\x8bafter three months and are repeatedly negative until nine months. It is conclusive that you are free from HIV. You can allay fears of HIV totally. There is no need for further HIV tests. Other STDs too are negative. The symptoms are nonspecific and do not suggest HIV. The lymph nodes swellings may be due to simple respiratory infection or tonsillitis. Antibodies are formed by two to six weeks latest by three months. In the very rarest of rare cases who has immunosuppressive disease it may be positive by six months. They have severe symptoms and signs of immunosuppression since childhood. You need not worry about such issues. Forget the episode and lead a normal life." "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, husband and wife, are (A+) same blood group. Also, our son is the same blood group (A+). He also had ASD problem treated and surgery also done completed. Will there be any problem for him in the future? ### Response: Hello. If the surgery was done at an earlier age then the prognosis is good. Prognosis also depends on the size of ASD and whether a pulmonary vascular obstruction is present or not. If no pulmonary vessel obstruction is present then the prognosis is very good. As far as risk is concerned ASD patient sometimes can develop atrial arrhythmia like condition in the future." "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 24 years old. I am suffering from myopia for the past four years and now suddenly my vision increased by 1, before it was -2.50 and now it became -3.50. I am really very depressed. Please suggest how can I improve my vision? ### Response: In myopic persons, their refractive power can increase during the growing phase of their body (chances are more when there is a family history of myopia). Please get your eyes checked regularly. Once the power stops changing in last 1 to 2 years you can opt for LASIK surgery to get rid of spectacles, till then you can use contact lenses." "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 this mole on my back. I think it has been there for a while. My GP took one look at it and declared completely benign. I was wondering what sort of mole it is? Is it worrying? I used sunbeds frequently for about a year when I was younger. Never since. ### Response: Hi. Most likely it is a benign melanocytic nevus (attachment removed to protect patient identity). The worrying signs are a sudden change in colour, a sudden increase in size and shape. If you want to confirm whether it is benign or not, you can go for dermoscopy (noninvasive technique), skin biopsy." "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 suffering from massive stress for the past 34 months. I have severe pain in neck and shoulder area. My head is tight, and stress levels fluctuate, racing my thoughts and giving me sleepless nights. Please suggest me medication that will help me flush all my stress and pain. I was earlier diagnosed with a generalized anxiety disorder. ### Response: Hello. I can understand your problem. Anxiety might be one of the main contributory factors for the symptoms you have. Racing thoughts, heaviness in the head, pain in neck and shoulder, excessive stress along with sleeplessness, etc., could be because of anxiety. If you have impairment in functioning, then please visit a psychiatrist for evaluation. Escitalopram or Sertraline or Paroxetine can be used. These" "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 five month period of pregnancy has been completed for me. I had a screening test for Down\s syndrome which came positive with a risk of 1:69. Should we need to do a diagnostic test which is amniocentesis? What will be the percentage after birth if the amniocentesis test is negative (It means that there is no Down\s syndrome)? Please see the attached report. Please advice. ### Response: I have gone through the attachment (attachment removed to protect patient identity). Sensitivity at 19 weeks is doubtful. Amniocentesis is a good diagnostic test. It will be a confirmatory test, and you can be relieved for the rest of pregnancy. This is the most reliable test. Also, you can do a good anomaly scan by a fetomaternal specialist. They can diagnose any abnormalities if present. Each test has a specific time, and if it is taken at a different date, the result may vary. But amniocentesis is the most diagnostic test. I do not think there are abnormalities." "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 now 18-year-old son fell from a height 14 years ago. He got a minor injury. I consulted a neurologist for a CT scan just for my satisfaction. But, the doctor said no he is absolutely fine. I am still worried whether in future he will suffer from a brain tumor because of this injury. ### Response: First of all, I would like to inform you that head injury is not a major risk factor for a brain tumor. Most of the brain tumors occur because there are genetic predispositions and mutations in germline cells and no such event occurs due to head injury. Secondly, since he just fell down and there was just a minor injury, I can assure you that there is no risk from that fall during his lifetime" "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 7 year old daughter has difficulty in breathing. Sometimes, she also makes noise while breathing. She has frequent cough and pain in the throat. The doctor advised a few medications. There was a little relief after two days. After exemption of medicine, the breathing difficulty, cough, and throat pain still persist. Please help. ### Response: The following precautions are very important for your child: We have to rule out throat infection (tonsillitis), chest infection and asthma, to find out if the symptoms are due to allergy. Get an x-ray chest and complete haemogram done and revert back to a pulmonologist 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 my doctor to do PSA test. The PSA came back normal at 1.0 ng/mL. However, he also did prostatic acid phosphatase test which was high at 4.5 ng/mL. My question is whether prostatic acid phosphatase test is valid for screening or not? Should I need to do these tests again? I had prostatitis symptoms in the past. Now, it seems to be fine. ### Response: Hi. I have gone through your query. Prostatic acid phosphatase (PAP) has been replaced by PSA (prostate-specific antigen test). It is better in the detection of prostate cancer compared to PAP. The elevation of PAP levels alone is not a cause for concern. I hope your treating doctor has done a rectal exam to find out any prostate nodules. If it is normal, then it is not necessary to repeat the tests. Hope this helps you. Feel free to revert back with any questions" "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 a cyst in the brain, maybe from birth. Cannot remember exactly, though it is not giving any problems, but should I worry about it? Attached is the picture. ### Response: Hello. I reviewed your uploaded photo (attachment removed to protect patient identity) and would explain that this is not a cyst in the brain. It is a benign sebaceous cyst under the scalp skin. It is not related to the brain. So there is nothing to worry about. If the cyst grows, I would recommend consulting with a surgeon and remove it with simple surgery and local anesthesia. Hope to have been helpful" "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 sexual intercourse with a sex worker when the condom broke. I was distraught so I ran to a hospital and they started my first dose of PEP after 12 hours of exposure. The regimen given to me for 28 days is Lamuvidine plus Tenofovir and Lopinavir and Ritonavir. Is this regimen right? I talked to another doctor and he told this is basic PEP and not of much help. He also prescribed PEP. ### Response: Hi. As per my experience, the regimen you are taking is fine. You can continue with the PEP (post-exposure prophylaxis) you are already taking and need not stop and start another one as discontinuing it may do more harm than good" "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 having a fever for the last five days and has dipped slowly from 102.5 F to 100.4 F in five days. The fever is backed up by a cough also. For the last 36 hours, he is having a continuous dry cough for which our physician suggested Levolin syrup 2.5 mL thrice a day. Please opine. He is also on Crocin Suspension DS and RespiCare and Bresol. He has also taken these in the past. Please help. ### Response: Hello. Your child is having viral upper respiratory tract infection. His fever will subside in another two days. Viral fevers last for five to seven days. A cough will remain for a few days. I suggest instead of giving syrup Levolin (Levosalbutamol/Levalbuterol), nebulize him with 1.2 mg of Levolin every six hours. This is a much lower dose than syrup and acts on lungs directly." "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 these small painless bubbles on my arm for a long time now (almost two years). First, there were not much but now they are spreading all over my arm slowly. It makes me uncomfortable in wearing short sleeve clothes. Please help me. ### Response: Hello. These are comedo or blackheads (attachment removed to protect patient identity), are small bumps that appear on your skin due to clogged hair follicles." "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 a progressing bald spot on the top of my head. I am a 33-year-old female. Please tell me why this is happening and how I can fix it. ### Response: I have viewed the image (attachment removed to protect patient identity)" "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 irregular periods. After an ultrasound, I came to know that I have multiple cysts over the periphery of ovaries. I want to conceive as I am trying for two months but failed. Tell me what to do. ### Response: Hi. It is because of hormonal changes. There is nothing to worry about. Lifestyle modifications, fiber-rich diet, plenty of fluids, vegetables and fruits, exercise, yoga and weight loss will help you. Get started with Folic acid supplements. Try during your fertile period which is between 12 to 24 days of your periods" "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 blocked nose. I have consulted a doctor and he told I am suffering from allergy and it is incurable. I am worried. Please guide me. ### Response: I have gone through your case and can well understand your genuine health concern. A blocked nose can be from an infection of upper respiratory tract also. If you have a fever and throat pain along with the blocked nose, then it is due to some infection. And yes, allergy is incurable. There is no permanent treatment for allergy as such, but it can be controlled 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: My period was due on 22nd this month. Last period was on 22nd of last month. Usually I have a 28 to 30 days cycle. I was on antibiotics for cold and cough infection. I had unprotected sex on 24th of this month and took an Ipill within four hours. I am yet to get my period. Do you think there is anything to worry? Please advice. ### Response: Hello. No, there is probably no chance of pregnancy as you were near to your due date and you have taken Ipill as well so nothing to worry about. Ipill usually makes periods delayed." "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 get frequent cold, and it will be severe with a fever of 102-103 degrees. My head remains heavy, and I have thick mucus when I blow my nose. I usually get sneeze with a change in outside temperature. Please help. ### Response: From the way you have described your symptoms which include recurrent fever, cold, and heavy head with nasal discharge. It is very apparent that you are suffering from chronic sinusitis, and whenever you have acute attacks it leads to the above symptoms. For treatment: 1) During acute episodes when you have fever and cold, at that time you will need a seven days course of antibiotics and decongestants. Take Amoxy-Clav 625 mg (Amoxycillin and Clavulanic acid) one tablet two times a day after food, and Wikoryl (Paracetamol, Phenylephrine, and Levocetirizine) one tablet twice a 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 suffering from alcohol red flush. Please suggest some treatment. ### Response: I can understand all your concerns. You are having an asian glow. Unfortunately, there is no cure" "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: Please see my symptoms:Headache.Hands slightly shaking.Nervous ticks (meaning I make a flinching motion).Please also note that I feel anxiety daily. ### Response: Hello. Since when are you having anxiety? Sweaty and shaky hands are a manifestation of anxiety." "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 LMP was a few months back. I did not get periods after that. We thought I was further along when I found out I was pregnant a month later. I went for an ultrasound and there was nothing on the screen. I went back three weeks later and the baby was measuring 6 weeks 1 day. Is it possible to ovulate that late with no period? ### Response: Congratulations on your conception. Yes, it is possible to ovulate late. In fact one of the causes of delayed periods is delayed ovulation. Make sure you take your Folic acid supplements and get your routine investigations of pregnancy done (blood group, complete blood count, urine r/e, fasting blood sugar, TSH, HbsAg, HIV). Routine antenatal investigations Folic acidDoxinate if required With reports" "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 18 year old female. I have noticed that my vaginal opening feels lumpy and possibly a bit swollen, and I am panicking. It does not hurt, and it is not raw or itchy either. Please help me put my mind at ease. ### Response: Hi. How are you doing? At this young age of 18 years, I do not see any reason for you to get tensed. Hope I have clarified your query, do write back. All the best" "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 writing to get a second opinion for my mother. She is 40 years old. She had a seizure on the day before yesterday. She had got it for the first time during the gestation of her second child 18 years ago. She is using Tegretol 200 mg but not regularly. She has a history of high bp, but since two weeks it is normal (120/80 mmHg). On doing an MRI scan, the reports showed right maxillary and bilateral ethmoid sinusitis. Is this sinusitis related to seizures? During the seizures, she gets froth from the mouth and tongue bite. For the first few seconds of seizure, she is conscious, but later she is not able to hear and later on she is good. Sometimes, she says that she forgot things and is not able to sleep properly. Since the past five days, she is snoring during sleep. Does this cause any complication in the brain? Is this dangerous? ### Response: Hello. She is having epilepsy which has recurred due to irregular sleep, stress and irregular treatment. The sinusitis is not related to the seizures. Her snoring while sleeping does not produce any complications in her brain. Her memory problems may be predominantly attentional deficits rather than memory loss per se. Regular treatment will keep her seizure-free and there is certainly nothing else to worry about." "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 my wisdom teeth pulled out. All four of them. I cannot open my mouth all the way to even stick my toothbrush to brush my teeth. What should I do? I got them pulled a few days back and just been brushing the front and sides of my teeth and using a Qtip to wash the back teeth. Another concern I have is that my back teeth have white pus on the top of them. I believe it is the scab from the extraction, it is on my other teeth and I am worried should I try ripping them off. I do not want to hurt myself though or should I just leave it alone? Will it cause any problem like make bacteria grow? Should I try rinsing my mouth out with salt until I can properly brush my teeth? ### Response: Hey. That is perfect you got rid of all your wisdom teeth at once. Now you are facing some temporary postoperative difficulties that will end soon and you will be relieved. It will take most likely a week to open your mouth properly, so it is fine if you cannot brush teeth at back. After a few days, you will be able to do the proper cleaning. Regarding the white scab, it is the dead tissue formed that is not much harmful, it will shred away itself during this phase of healing if you are doing your rinses properly. Take a cup of lukewarm water and add 1/4th teaspoon of salt in it and do its mouth rinses five times a day. It is mandatory for two weeks. If you will skip it then some re-infection in the bone can happen which is very painful. So, it is better to be safe than sorry. Hopefully, everything will be good soon." "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 tooth pulled a few days back. The pain started getting bad the next day. Pain medicines are not working, running a fever and vomiting every day since. ### Response: Send a picture of the area if possible and radiograph if you have. I feel the doctor must have taken precautions as you are on contraceptives which are likely to induce it. Send your details further. I think you should do one thing. Ask the dentist if it is a case 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: My wife has pain in the area below the left shoulder for the past one week. The pain is there even when she deep breathes, moves her left hand, or does any movement. She is a feeding mother, has overweight and had a cesarean delivery a year ago. She had a similar complaint but reduced after rest. But this time it has not reduced. We tried an external application of counter pain and used hot water pack. She suspects sometimes during feeding that she sleeps on one side which is causing this problem. I have attached the image of the area where she has pain. Please help. ### Response: Hello. I feel that the pain is coming from the neck and this is a fairly common pain diagram for neck issues. She needs to look at her posture and as she is feeding this is even more important. Also holding the baby may make things worse. See a good physio and do some neck exercises which will help." "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 mild pain from one of my vertebrae for about eight months. It is one of the thoracic vertebrae. I am not certain of which one it is approximately in the middle of my back. It feels slightly sore when I bend backward. Also, if I press with my thumb on the spinous process. I am wondering if it could be a fracture and I worry a little bit about bone cancer. There is no lump. It does not hurt unless I move a certain way. I think it might have started when I was doing some yoga poses lying on the floor. ### Response: Eight months period is quite a long time and I feel you should not ignore it. A few things I want to know. Do you have any other ailment, like diabetes or hypertension or hypothyroidism? What you do and how much physical activity you have in your daily routine? Have you noticed fever and weight loss in these eight months?" "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 having a dream about a guy since two years. Every day it is the same. I wake up in the middle of the night even before I can see his face and am unable to fall asleep after that. I am scared, but do not know where to go or ask for help. No one will understand me if I tell them about this. Please help me. ### Response: Hello. It is a type of sleep disorder which is treatable. Maintain proper sleep hygiene, that is, maintain a proper routine. If you still having the same problem, you can take tablet Zolpidem after consulting a psychiatrist" "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 with my fiance a month ago, and I did not use the condom. After 15 days the testicle pain started with abdominal pain, and then the small bubbles at penis glands. Now with the tiredness of the head, the headache is accompanied, and the sweat is high. I used to get testicle pain in only summer, three or four times per three months. The urine albumin present 1+ in the urine test, the urine epithelial cells 15 to 18 and the urine RBCs 10 to 12. What it could be? ### Response: I have gone through your query. I would like to know a few more details to answer your question better. Have you have had any fever, rashes or joint pains in the last two weeks? Based on your symptoms, it is most likely that you either have a urine infection or some infection of the genitalia. The urine test reports also suggest the same. It would be necessary to have a complete physical examination to find out what is the exact infection and treat it with medication which should be able to get you back to normal. You may require a urine culture test or urethral swab test to pinpoint what the infection is. I would suggest you to visit your local urologist at the earliest to get the tests. I hope this helps, feel free to revert with any other questions or concerns." "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 49 years old, moderately active, all biochemical parameters mid-range normal. Fasting sugar levels steady at 147 to 149, PP 159 to 250, drops to 80 to 105 at about 6 PM, after lunch at 1.30 to 2 PM. I am having (Glycomet Trio1 and Glycomet GP1) twice a day. Am unable to understand how to get these levels down to fasting. ### Response: Hi. I understand your concerns. Great fluctuations in blood sugar level are common in diabetics. Your treatment is suitable but it may require some small modifications. My advice in order to have better control is that you have to eat a small meal between the main meals. Stay strictly with the diabetic diet. You can miss one dose if you are not going to eat the meal or you are going to eat a very small amount of food. If you tolerate Metformin well, I suggest that you increase the dose to 1000 twice daily after food and decrease the dose of Glimipride as Metformin decrease the sugar level back to normal but not causing hypoglycemia like Glimipride (after consulting your physician). Measuring HbA1c will give us a good idea about how the blood sugar was controlled over the last three months. I need to know about your meals timings and your medications timings . Do you take both medications twice, so that you are taking four tablets in total or you take one in the morning and the other in the evening? So you take only two tablets? Please provide me with your feedback. For further advice, please do not hesitate to send follow up 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: I am an 18-year-old female, approximately 5 feet, and weigh 115 pounds. I have not been feeling myself the past few days. So, this morning I checked my temperature and it was 97.5, and now it is 96.1. This worries me as my temperature normally stays around 98.9. I am feeling worse today but cannot pinpoint exactly what is wrong. I just generally feel bad. Is this something I should worry about? ### Response: Hello." "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 a herniated disc at L5-S1 and bulge at L4-L5. I have some lower back pain, but I also have pain in the groin area which seems to move also in the testicle. My question is, could the pain in the groin area and in testicles be caused by this herniated disc? ### Response: Hello. Well, the pain of L5-S1 disc herniation typically is pain on the backside of the thigh and radiates down to the leg on the outer aspect and to the foot. The nerves of the groin region are more below. But, as in your case, if the disc prolapse is big then it can also compress nerves of the groin region and can cause pain. Do you have any bladder issues or any numbness in 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: I am having cough since 5 days. I have noticed little blood in my cough. I am worried about it. What should I do? ### Response: I would like to know the following information in order to rule out other possibilities. As you have said you had cough. I would like to know more about your cough. It helps break up your congestion, makes your throat moist and will keep you away from getting dehy" "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 not prescribed by my doctor to have Potassium chloride tablet. But, I had one tablet per day for the past two days. Is it fine to take? What will be the side effect? Please help. ### Response: Potassium chloride tablet should not be taken without monitoring. Serum potassium level should be done once in every three days. Hyperkalemia (elevated level of potassium) is a very dangerous thing. It can precipitate many sorts of arrhythmias (abnormal heart beats) and excessive levels can even be fatal. You have not mentioned the reason for which you had Potassium chloride tablets. Are you hypokalemia or are you on diuretics? As of now, as per your query, potassium tablets should not be taken without monitoring your serum potassium level." "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 line of white and black patches in my lower gums. What could it be? ### Response: Hi. Your chief complaint and attachment show pigmentation which can be due to various reasons (attachment removed to protect patient identity). Your chief complaint is incomplete so it is difficult to arrive at a proper conclusion. If it is from birth, then no problem and if is a recent finding then you need to forward further history about" "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: One minute I am fine and the next minute I just want to disappear. I have had extreme feelings of abandonment for awhile. So I now avoid any new relationships. I am currently not taking any medications for my psychological issues. I have in the past but decided a year ago to try life without them. I am sure I have a borderline personality disorder. I have been diagnosed in the past with clinical depression, but situations and life choices caused that disorder to occur. I no longer consider myself atypical depressive because I cycle between feelings of joy and despondency. I know medication is most likely my only respite, opinions? ### Response: I feel that you have been already diagnosed with BPD (borderline personality disorder). The moods which you face are very characteristic of this. Depression is a likely disorder with BPD. I would suggest you at least undergo therapy sessions for cognitive behavioral therapy if you do not wish to take medications. Let me know if I can help you more" "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 a lot with pain, discomfort and not concentrating on my studies, a small pimple like structure raised at my anal section. I think it is haemorrhoid. When I am making bowel movement, I was suffering a lot. Please help in solving this issue. ### Response: Hello. Based on your description, it might be haemorrhoid or perianal abscess. If it is in a lower grade, some medical therapy may be proven to ease the pain and inflammation. But a medical consultation would be neccessary to determine that condition. Anyway, you can try a local cream containing Betamethasone and Lidocaine twice daily. A stool softener such as Lactulose would help for an easier and less painful bowel movement. Keep a watery diet with soups and high fibers foods. Have plenty of liquids. Sitz baths would help a lot. If it is an abscess, an antibiotic can be started. Continue this medication for about two weeks. If no improvement, the surgical solution must be taken into consideration." "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 niece got a fever for the past eight days. Also, low WBC count. The doctors tried all the tests, antibiotics and medicines, but still, the fever is not controlled. She got fits 15 days back and the doctors prescribed Eptoin tablets. My question is whether Eptoin reduce the white blood cell counts? ### Response: Hello. It does not usually affect WBC, but very rarely (like all the" "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 is pregnant for about five weeks. So the doctor suggested Duphastone three times, JC Folate one time, Myocyst two times a day. My wife has got miscarriage two times before that and she was also treated for PCOD last one year. I am scared about Duphastone. ### Response: Hello. I have gone through the case summary. As she has had PCOD, in such patient, there is a deficiency of pregnancy hormone Progesterone. So we have to give from outside to support pregnancies. There is a history of two miscarriages. Can you tell me where did they occur and at what time of gestation was the heartbeat present? When the ultrasound was done? I think we should start tablet Ecosprin 75 mg once a day if not yet started. There is no fear about Duphaston as it is safe during pregnancy. Many studies have been done to know about the safety of Duphaston. So you should not worry." "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 reactivated Epstein-Barr for a year. I recently got a blood test, which said, faint monoclonal band detected in the gamma region, repeat blood test in six months. There is no immunoparesis, and my levels have risen in the last four months, but still in the normal range. What does this mean? Could this be transient due to an infection? The IgM remains positive, the PCR undetectable, but I am still sick. Could it be chronic fatigue? I have had a similar experience recently with positive IgM for Cytomegalovirus, but undetectable PCR. And even one positive for Lymes and another negative. Could it be cross-reacting antibodies or something more sinister? I am currently taking Cipralex and Risperdal. ### Response: I have gone through your query, and I can understand your concerns. Hope I have answered your query. Please feel free to contact if you have any further queries." "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 having UTI from 10 days. First I took Cefixime 200 two times for five days, after seven days symptoms reappeared. Then I took Levoflaxican 500 for 4 days, all symptoms had gone but more white particles are coming in urine. What should I do? Will it go away in 10 more days? ### Response: Hello. You have to do a urine routine microscopy and urine culture test for confirmation of eradication of all infection if there is residual infection left it may cause recurrent UTI. The cause of white particles are not clear, but it is rarely a cause for concern as it most probably is either pus flakes or mucosa from urethra or bladder, neither of them requires any special treatment. If your culture is suggestive of infection further antibiotics will be required depending on the report." "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 query regarding my current pregnancy. I had a miscarriage last year at my 16th week due to amniotic fluid leakage, the doctor could not tell the reason for it.And now I am pregnant again with 16 weeks too and this time my doctor suggested me to consider cervical suture as my cervix size is 26.9 mm and I really did not want to do it considering the risks. I will have another scan at 18 weeks to check the size again. But I am really worried as I had four miscarriages and I do not wanna lose this too. Currently, I am taking Aspirin and Progesterone. Could you please kindly advise me on this? ### Response: Do not think twice. It is better you get a cervical stitch done. Considering your history and present cervical length, it would be better if you go for cervical suture. Obviously, as the gestation increases the cervical length would shorten up more. The cut off is 25 mm, so no point in waiting. Another thing is strict rest, avoid any strain like constipation, cough, sneeze, strenuous exercises, etc. Short cervix. Cervical stitch. Strict rest, avoid sitting positions, as it increases the pressure over internal os. When necessary." "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 kid is 28 months old. He is having a cough and cold for past five days. Last night, fever started at 102 F. Until now, fever is on off. I am giving him Mefanac-P for fever from today. Can I go for blood and urine investigation? ### Response: I understand your concern. A child with a history of fever and cough-cold for five days definitely needs further investigation. Do blood test (CBC) to rule out bacterial infection. If he is having difficulty in breathing you must do X-ray as well. Do warm saline gargles three or four times a day so that throat inflammation can be controlled as it can also give fever and cough symptoms. Urine test as of now not required, if no burning sensation during the passing of urine. Meanwhile, you can continue fever medicine and cough syrup. Review with report" "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 40-year-old male with a weight of 98 kg and a height of 185 cm. I felt choking last month and I rushed to the hospital. It was there I got to know that my blood pressure was very high. In fact, I have been hypertensive for some time now. I did a series of tests including lipid, ECG and echo. The cardiologist told me that I have left ventricular hypertrophy which has got me scared to death.The following are my echo results. The chamber summary is normal except dilation of the left atrium but the LAD is 30.4 mm.IVSD 13.8 mmIVIDD is 50.8PWD 12.3 mmIVSS 16.3lVIDD 34.6EDV 130 9mlESV 41 5 mLSV 89.4mlEF at 68.32%FS 35.82%IV mass 337.3 gIV Mass - c 270.4gLAD 34.6 mmRVD 34.6 mm Both diastolic and systolic functions are normal. The wall motion of left ventricle and contractibility are normal. Aorta valve is normal. Mitral valve is normal. The pulmonary valve is normal. IVC is normal. Pericardial space is normal. Tricuspid is normal.The cardiologist did not tell me the kind of hypertrophy I have and I want to know it, please. Am I likely to drop dead? I am on aggressive blood pressure control taking Losartan 50 mg and Carvedilol 6.25. Blood pressure is always under 120/80. I eat a lot of fruits and vegetables and also have 30 minutes of walk four times a week.Please, will LVH recess over time and can I live for another 40 years? ### Response: Hello. You are hypertensive for a long time and that is why you are having left ventricular hypertrophy due to left ventricular remodeling. If you control your hypertension there can be reverse remodeling of your heart and your LV (left ventricle) will normalize in time. I suggest you take medications as prescribed consisting of ARB (angiotensin receptor blocker) and beta blocker that will make your heart normal again in time" "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 mom\s platelet count was 6,000 and they did platelet transfusion for six pints and it came about 1,00,000 and after that, today again it became 13,000. What will be the disease condition and what is the treatment to be followed? ### Response: You have not mentioned at what time she got her platelet transfusion and now after how many days the platelet count has been decreased. , are some of the causes. As your platelet count" "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 26 years old. I have retracted my foreskin before just once when flaccid by applying much pressure. I have never had sex before or have tried to retract the foreskin. I have no problem with masturbation. I have also not tried any stretching or any exercises. Now, I am slightly nervous because I may get married soon and I wanted to know if everything is fine. ### Response: Hi. The foreskin retracts itself on erection and if you had no problem for masturbation, there will not be any problem for sex as well. Foreskin never comes in the way of sex. Hence, you need not be anxious. Basically, the foreskin slides easily during sex and one should not forget to pull it back after sex. So in essence, retractability of foreskin is not a deciding factor for sex. Do not worry and just enjoy." "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 unprotected sex with my partner on 18th, and 19th of last month, where 18 was the next day after my periods. Took i-pill on 21st morning because he was not sure if he has ejaculated inside. But also he ejaculated sperm outside too. Now I have missed my periods which is supposed to be on 17th of this month. Also, I had five days of spotting a week after the i-pill. I am 22 years and my periods are regular. Is there a chance of pregnancy or will periods have missed this month because of hormonal imbalance? ### Response: I can understand your concern. According to your description, the possibility of pregnancy is less in your case. As usual, ovulation is not possible the next day after periods. But emergency contraceptive pill may not give accurate results after 72 hours of unprotected intercourse. The spotting and delay in periods could be the side effects of the pill. Better to go for a urine pregnancy test once to rule out the possibility of pregnancy. If the test is negative, better to wait for one more week and you may get periods. 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: My neck cracks every time I turn it. Been going on for about two years. There is pain daily. I have never been to a chiropractor. It is tense, and my head sometimes feels heavy. ### Response: Neck cracking could be due to bad posture loading your facet joint. So, while sleeping and otherwise, maintain good posture. Symptoms are due to upper neck structures involvement. If it bothers you too much, go for a couple of chiropractic mobilization. Otherwise, frequently icing your neck will help you to get rid of symptoms. A couple of exercises will get you out of this issue permanently. Hope this is helpful for you. Kindly revert back to me in case you need any further help in this regard" "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 complicated wisdom tooth removal one week ago. My gum was cut and I have stitches (dissolvable). I still have jaw pain, pain in what I believe are the glands in my neck, some ear pain and the extraction site is still sore. Is this normal? ### Response: Hi. I have gone through your query. Mild discomfort and reduced mouth opening along with swelling are normal for 3 to 5 days after extraction. Since you are telling about the glands (lymph nodes), you will need antibiotics too. Follow the instructions given by your dentist. Do lukewarm salt water gargling. If mouth opening is reduced, do the mouth opening exercises taught by your dentist. You may take Mox-CV (Amoxicillin and Clavulanic acid) for five days twice daily after food (if you have not taken any antibiotics prior). If you are allergic to this medicine, do not take it. You can mention it here or to your dentist and the medicine can be changed." "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 question regarding Cocaine use. I have never used it before and did a few lines on a bachelor party. I clearly was not thinking and impregnated my wife within 24 to 48 hours of use. How concerning is this? I also had multiple drinks of alcohol. ### Response: The sperms ejaculated are formed 3 to 5 days before the actual sex process. If you have never used them before and used it only a few hours before sex then there should be no problem of malformations in the baby. Neither is alcohol. I must emphasize though that as you might already know, cocaine use is significantly detrimental for your own health and must be avoided." "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 24-year-old male. My complaint is that I have a breast lump in my right breast lower outer quadrant. I noticed it three days ago. I have pain at that site. I also noticed redness in the surrounding areas. I have poor beard growth and chest hair so I suspect that it could be gynecomastia. Can gynecomastia be tender and painful? I also suspect myself having Klinefelter though I do not consider my genitals to be of small size.I am a medical student and I am worried that the lump could be a carcinoma as I have learned that there is an association between Klinefelter\s and carcinoma. Please help me. ### Response: Most probably it is gynecomastia as it is common in young age and may cause pain, Although, breast cancer is rare in males, it is more aggressive with rapid growth and spread. I suggest that you take painkillers and send me a photo of the red lump Also if you have noticed any swellings in the armpits please tell me. In general, you should not worry, but be a little cautious" "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 been suffering from acute back pain and leg pain for the past one year. She is unable to stand or walk for a long time. She is 73 years old. Also, she has type 2 diabetes and high BP. Her MRI revealed a diffuse bulge of L4-L5 disc with ligamentum flavum hypertrophy causing severe canal stenosis with compression over transversing and existing nerve roots. What is the meaning of above? What treatment is necessary for her now? ### Response: Hello. The following is a radiological report (MRI) of her intervertebral disc status. Revert back with the reports to an orthopaedician and traumatologist 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 itchy burning or pain sensation during urination since last 4 to 5 weeks. Prior to that I had sex with unknown person so I am thinking it could be STDs. The symptoms become more when the urine become more frothy such as after drinking beer or drinking little water. I am really confused and undecided on what to do next or whom to approach as no urologist available near my stay.Another important point to note is that I did have a bit of burning sensation (during urination) on occasion since childhood but it used to happen only once or twice in a couple of months but since 4 to 5 weeks (as stated above phrase), it has become regular burning sensation every time I pass urine. Here I will mention some symptoms I could experience:Sometimes finding difficulty in starting urination (due to fear of the pain of course).Burning or pain sensation during urination. It has become a bit itchy since having sex with an unknown person as described above. Feeling the frequent or urgent need to urinate.Sometimes when I try to force urination, seminal fluid with sticky white jelly-like liquid discharge could be experienced. These are the most imminent symptoms. I had burning sensations on occasion since childhood but it became more and almost every time I pass urine now since having sex with unknown sex partner couple of weeks before. I am 28 years old male. I have gastritis related problem. Right now I am taking medicine only for gastritis, Pan D, and digestion tablet Unienzyme. ### Response: Hi. I have gone through your query, based on your symptoms, it does appear that you might have either an STD or UTI, both of which are partner sure unprotected sexual contact. I would suggest you visit your local general surgeon or urologist for a detailed clinical examination to confirm, a urine analysis and urine culture and an examination of the discharge from the penis. Based on the reports or clinical findings, you will be started on appropriate antibiotics. There is no cause for undue concern as both conditions are easily treatable. I would also advise you to be cautious in the future about unprotected sexual contact" "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 scratched by my pet vaccinated dog today few hours ago. Also there was no bleeding in my hand. But there is some redness there. So guide me that it is still necessary to have ARV. Also before 5months ago i was vaccinated with arv when there is scratch of dog then . ### Response: Hello. Although unvaccinated animals are more likely to transmit rabies, vaccinated animals can also do so if the vaccination of the biting animal was ineffective for any reason. A history of rabies vaccination in an animal is not always a guarantee that the biting animal is not rabid. Animal vaccine failures may occur because of improper administration or poor quality of the vaccine, poor health status of the animal, and the fact that one vaccine dose does not always provide long-lasting protection against rabies infection in dogs/cats. The scratch on your skin comes under category II for post exposure prophylaxis for which anti rabies vaccine is indicated . And although you have taken the vaccine 5 months before and your dog is also vaccinated there are very minimal chances of you or your dog having rabies but there is a very miniscule chance. But according to the guidelines you should get vaccinated again. Make sure to clean the area of scratch properly and thoroughly with soap and water. Observe your pet for the next 10 days and see if it's health deteriorates which if does would be a strong indication to get vaccinated." "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 meatus is red and has a small spot on one side. There is a constant burning sensation when I urinate. I am frequently urinating in small amounts. Recently, I had a DRE, and they told me that my prostate is enlarged. I have a foul smell from my penis. I never had this problem before. I have difficulty in emptying my bladder. ### Response: I have gone through your query and the picture (attachment removed to protect patient identity). It looks like a urinary tract infection which has resulted in some inflammation around the meatus. I would like to know whether you had tenderness in your prostate during an examination. It is necessary to do a urinalysis and urine culture and to start with antibiotics if there is any infection. Also, ultrasound can also help to identify any prostate enlargement. You can visit your local urologist for getting tested. Once it is controlled, the other symptoms will get subsided soon." "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 26 year old married woman. I have missed my period. When I tested using a Prega News kit, the result was positive. I do not like to have a baby now and I want to terminate my pregnancy with the help of MTP kit. Please advise me how and when to take medicine for termination. Do I need to take any other medicine with MTP? Please tell me in detail. I do not like to go hospital for this. Is it safe to get it done at home? ### Response: Hello. Firstly, your decision of not reporting to the doctor itself is very wrong and trying to abort at home is further wrong as MTP can lead to a lot of bleeding complications which you cannot manage at home after taking the medicine as a dosed protocol. The MTP kit (medical termination of pregnancy) is available in the market as unwanted, but the instruction to take the medication is not accurate for requirement of dose depends on the period of gestation first. Hence, it is necessary that you should undergo an ultrasound pelvis to locate the pregnancy first whether it is intrauterine or ectopic. Once intrauterine confirmed, then the tablets can be taken in a scheduled manner under your local gynecologist supervision in a sequential manner with Mifepristone first and then Misoprostol. Sometimes, Misoprostol has to be continued till 2000 microgram maximum dosage in case of failed abortion with the initial dosage, which may lead to surgical abortion or D and C (dilatation and curettage). So, it is recommended that you should meet your gynecologist first and do not attempt any home abortion. It is not safe at all." "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 having loose motion since last four days. Our doctor gave Rantac, Nutrolin B, and Cyclopam. Till three days his stool was watery but today we observed blood in that and is experiencing acute pain while having loose motion. After that, our doctor suggested giving a half tablet of Lopro and 6 ml Oxaflo 100. After giving this, his loose motion has stopped. But, he is complaining about stomach pain and headache. Please suggest. ### Response: I understand the situation you are facing. Stomach pain and headache could be related to the infection. Continue giving Cyclopam (Dicyclomine) for stomach ache and Paracetamol for a headache. If not getting relief with these measures, consult your doctor for reevaluation and further management." "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 suffering from painful uterine fibroids. She has also been diagnosed with hepatitis B. Please advice us regarding the operation for this uterine fibroids. ### Response: Hi. We are here to help you. The presence of multiple uterine fibroids causing pain or symptom warrants surgery to remove them. Presence of hepatitis B will not hinder from surgery. However, following investigations should be performed before surgery: She should receive vitamin K 10 mg injection once a day for three days prior to surgery. And avoid taking painkiller. Revert back after the tests 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: I had my wisdom teeth removed three weeks ago and on the third day, it felt like I ripped my stitching. A few days later it was bothering me so I put my finger in my mouth and I felt an opening along where the stitching should be. So I decided to feel the other side to compare that side was closed. So I went to see my dentist she said that it was healing fine. But days later it still bothers me so I bought a dentist\s mirror and checked it out. I only saw a bump, but I felt the opening so I put it in between my cheek and teeth and there it was an opening and some white yellow stuff. I think this poking white thing was a part of my molar, cause it was hard and the opening has been getting bigger and it is hurting more. What should I do? ### Response: Hello. I can understand your concern regarding dental health. In this condition, I would strongly like to suggest you to consult your dentist again for a clinical examination of the affected area and condition of it for better results. She will examine the area in which you are feeling hard might be because of bone. Because there are very less chances of root piece after extraction of wisdom tooth. If a root piece will be there, then she will remove it after taking an x-ray. So, consult her earlier. 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: My vaginal opening is too loose without any sex. I do not know what is the reason? Can you please tell me what is the reason? ### Response: Hi, Welcome to ilciniq.com. How are you? Hope you are fine. I have read your problem carefully. There is some lack of information. Your age, profession, height, previous sexual history, etc. You should remember that a loose vagina is a myth. It is a misconception. The vagina is elastic. With your age, it may lose their elasticity. So opening may lose their elasticity. Vaginal opening may be loose. If the looseness is fixed and not progressive you can wait. If loosening is progressive you should consult with a medical specialist or gynecologist-obstetrician. There is some exercise of pelvic muscle which may help such as Kegel exercise, pelvic tilt exercise. Do not be panic. Lead your normal life and observe." "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 25 year old married female, trying to become a mother. I have a left-sided pelvic pain, frequent urination, and vaginal discharge. My last menses was on the fourth of this month. Can you tell me if these symptoms are related to pregnancy? ### Response: How are you doing? Hope I have clarified your query. Do write back if you have more queries" "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: White patches are found on the cheeks of 9 months old baby boy. And also, there are some white patches near the eyes. What is that? ### Response: It is due to calcium deficiency. I suggest giving a calcium supplement like Calcium Sandoz tablet to the child. Consult your specialist doctor, discuss with him or her and start taking the 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 had protected sex with my partner six days before. I consumed one tablet of Ovral l within 24 hours of the intercourse as a safety measure and because that was the only tablet available immediately. We have a doubt that the condom may have broken and do not want to risk being pregnant. Is that one tablet of Ovral l enough to avoid it? (Similar to I-pill or unwanted 72). Also, because I got scared I consumed two tablets of Ovral l today morning. I need help with the right information and further guidance to avoid pregnancy and any side effects caused by these pills. ### Response: Hi. The dose of Levonorgestrel is quite low in Ovral L compared to Unwanted 72. So the effectiveness for prevention of pregnancy, the two tablets of Ovral L may be sufficient. Now onward, please use regular protection and do not depend much on Unwanted 72. If the 72 hours have not passed, then you can take Unwanted 72 else or equal amount of Levonorgestrel, if it is already more than 72 hours then wait and watch for your scheduled time of the menses and if you miss your period then consult a gynecologist immediately." "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 4 year old kid has tooth abscess with pus on the upper arc of front teeth. The pus drains and again comes. We have given antibiotics but the problem again comes. What should we do now - tooth extraction or pulpotomy? ### Response: Pulpectomy is suggested as the front milk tooth has to remain at the position for about 7 to 8 years till the permanent tooth comes out. Else, the growth will be affected. If the kid cannot remain calm then extraction is possible" "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: Actually, I feel sometimes pain in my right testicle for last two months. Sometimes also feel burning sensation, weakness, heaviness in the right leg. For past four months, I was under severe stress, anxiety, and depression due to an unprotected sexual exposure .five months back. It caused self-guilt feeling inside me. Had medications for that. Checked also for HIV (duo combo), VDRL and HBsAg. All were negative till 100 days after exposure. Last month I saw blood in my sperm which got treated and the reason was excessive masturbation because after 15 to 20 days, I masturbated but it was all clear. No issue. For my mind satisfaction, I chose for testicular USG, urine culture and PSA test. All were normal. I want to know if all reports are fine and normal then what is the reason of the testicular pain and burning sensation in the leg. ### Response: Hi. Testicular pain can happen due to any cause like a simple infection of virus or bacteria. So you do not have to worry about it. The burning sensation of the leg could be due to some allergy or something. Your problems are in mind and not the body. You are anxious and guilty as you said. Kindly calm your mind with yoga or meditation. Do activities which interests you and get involved in that. If you still have problems then come for follow up after two weeks to us" "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, I had a kidney stone but it was small and went through the urine. Now, the problem is, I got common cold, fever, and cough. Common cold and fever were gone after taking medicine but the cough remains. I thought it will be alright after some time but it did not get better and I have cough until now. It is already two weeks. Now, I feel pain in my right kidney side while coughing. Is it normal? Please advice me. ### Response: After careful analysis of the history you have provided, I would like to let you know: Firstly, the pain that you experience in your right kidney area as mentioned, would be an outcome of the chronic cough. Chronic cough leads to muscle strains and tear. Secondly, there is also a chance for recurrence of kidney stone. Having said that, I would like to know: As of now, you do not need to worry as chronic cough is the most likely reason which is quite a common scenario. For now, you need to: Do follow up with details for the above queries. Stay healthy and positive" "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: Every antidepressant I take causes me a lot of hyperhidrosis. Which one on the market is less likely to cause hyperhidrosis? Fluoxetine? ### Response: Hello. You can also discuss with the treating psychiatrist regarding adding Cyproheptadine or Benztropine for hyperhi" "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: Here are my immunohistochemical results of peripheral blood: Absolute lymphocyte count 5812/uL reference (1000-3300) with CD19 (B cells) 62% reference (3-20%), CD45 positive, CD10 positive, and CD5 negative.How do we know it is leukemia or not? Doctors in our town cannot interpret the result. The percent of B cells is high. Abnormal. Please help. ### Response: At the age 55 years, if persistent lymphocytosis is seen, then CLL (chronic lymphocytic leukemia) should be ruled out. For that, monoclonality should be confirmed by flow cytometry investigation and need bone marrow study apart from peripheral smear examination report if needed. In CLL usually, peripheral smear examination report shows smudge cells and more than 90 % lymphocytes. So, provide peripheral smear examination report and bone marrow aspiration study report and flow cytometry report if available. The mentioned markers are of B cells but CD5 is negative, so further workup is needed as mentioned. Hope this will help 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 got my periods exactly one month back. I had unprotected sex with my boyfriend seven days back. I had one I-pill after two days at lunch time. My periods are regular. Will the tablet consumption affect my periods? Is there any possibility for pregnancy? Kindly help me. ### Response: Hi. Hope your periods are regular of around 28 to 30 days. In that case nothing to worry as you had sex very much after ovulation period. And no need of I-pill also. You should not be taking I-pill frequently. It is an emergency contraceptive pill." "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 enlarged spleen from the last two years. I am 24 years old, male. My spleen size went from 13.4 cm two years back to 14 cm to 14.4 cm four months back. My CBC report looks normal and I have vitamin B12 level as 349 and vitamin D as 11.13. I have MCV level 102.4 and MCH level 34.2. Monocytes are 0.13 absolute. Can you please guide me on what needs to be done. I had peripheral blood smear, malaria, hepatitis tests too. All were under limits, as of now I do not have pain. Other doctors suggested hematologist. Please help. ### Response: I have reviewed your query and below is my opinion. The various causes for enlarged spleen include infection like malaria, Gaucher disease like storage disorder, hemolytic anemia, leukemia, lymphoma, infections, liver disease, etc. The CBC and peripheral smear examination report do not suggest leukemia. Hemolytic anemia also can be excluded as bilirubin level is normal. Liver disease chance also very less as reports are normal related to that (attachment removed to protect patient identity). As you have persistent spleen enlargement, it is advisable to investigate with spleen biopsy or FNAC for histopathology examination. It will help in identifying the underlying specific cause if present. You can consult a surgeon for a detailed evaluation and examination. Then, if needed, the surgeon will suggest you visit hematologist." "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 with my fiance last week but with precaution. Two days later, I got my periods. Is there any chance of getting pregnant? Also, please suggest can I take I-pill now as it is just 72 hours post-sex? ### Response: Hello. If your due periods have come on time then there are no chances of getting pregnant. So, there is no need for I-pill. Basically, with a regular menstrual cycle, your unsafe period starts from day-8 to day-18 of your cycle" "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 had a hearing test which indicated mild hearing loss at the 4k Hz level. The audiologist said not to worry about it at all, protect my ears and it will very unlikely worsen. He even mentioned that it may reverse itself. I am only 32 years old, so I understand any recording above the 20DB mark is not ideal. The values are for 250, 500, 1k, 2k, 4k and 8k Hz levels. Left is 10, 5, 15, 20, 25, 20 (air conduction), left is n/a, 10, 10, 20, 25, n/a (bone conduction). Right is 15, 10, 15, 15, 30, 15 (air conduction).So my direct questions are would you agree that this is a mild case of hearing loss and there should not be anything to worry about at this stage provided I look after my hearing and ensure I am not exposed to loud sounds too often? Is it likely that this will not worsen (excluding any age-related hearing loss as I get older)? Are my audiologist\s comments that it may even reverse itself accurate? How severe is this level of hearing loss and what implications will it mean? ### Response: According to the reports indicated (attachment removed to protect patient identity), there is a dip at 4k which indicated a noise-induced hearing loss. Many people suggest that it is not a thing to be worried about, however, we cannot neglect it completely. There are various kinds of hearing loss having various reasons. In this kind of audiogram, it is clear that you have exposed yourself to loud sounds. Now as you have clarified you use headphones for 1 or 2 hours. Let me inform a headphone noise can have a different effect on different people. Some people are more susceptible to hearing loss. Check your work environment if it is noisy you may suffer from hearing loss too. It is not much likely to increase if you are careful. Your audiologist comments are not entirely accurate. The 4k dip is likely to reverse when the 4k area in the organ of corti get enough of blood supply to reverse the damage. The loss is not that severe which will affect your quality of life. But we need to be careful." "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 abused weed, alcohol and cocaine in a span of 20 days. Last two days he had cocaine twice, even though that was the first time and did not sleep. Then, he travelled and became sick with 104 degree fever, cough, swollen tonsils and right knee numbness. His blood test result showed RBC count 13.4 g and WBC 11300 with leukocyte 16%. This happened before a month and he is still coughing. He just had medicine to reduce body temperature. Please help. ### Response: Hello. 1. HIV RNA by PCR (not the antibody testing)2. Monospot test.3. Throat swab and culture.4. Hepatitis C RNA by PCR. It would depend upon the results. If you can get the results to me then it would be great. I suggest tablet Ibuprofen or Diclofenac sodium every 8 hours for fever. Consult his specialist doctor, discuss with him or her and take the medicine with consent. Revert back with the report 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: I have pain in the bones, joints of hands and feet especially in the morning upon waking up. It has been consistent for the past couple of months. Please help. ### Response: I have gone through the reports (attachment removed to protect patient identity). There is a high RA factor and low vitamin D. I would like to take a few more details on the history part. But it would be better if someone can examine the joints as it is a long treatment which patient will need. Does she have early morning stiffness? If yes, then for how long? Any" "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 35 year old woman, and I have tested 20/20 vision all my life. I believe I am experiencing eye strain from overuse of computer, but unfortunately, I cannot cut down on my computer use because it is integral to my profession. My symptom is a slightly blurry vision, which begins at 6 to 8 feet from my eyes, it feels worse after using computers. However, recently a friend offered to let me try on her very light prescription glasses, which made my vision clear. My vision gets tired and blurry when I use a computer, but my vision was clear when I went on a vacation. ### Response: Hello. I hope this helps. Contact your optometrist or ophthalmologist to arrive at a solid conclusion" "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 prescribed to have Duoluton-L pills for 21 days to be taken after 5 days of my D and C. She also advised me that I will get my normal periods after 21 days. Do I need to take all the pills? Or can I stop after taking around 16 or 17 pills? ### Response: Actually after any abortion, the patient might experience some spotting for a few weeks as well as irregular cycle. This pill will help you to subside this flow and will try to re-establish your regular cycle pattern. Moreover, there is an incidence of ovulation as well as pregnancy just within two to three weeks of abortion and achieving a pregnancy so soon is not recommended also. This pill will help you to maintain contraception. I suggest you to not only complete this course, but also restart a fresh pack after a gap of 7 days and to continue as for the next four months. Consult your doctor, discuss with him or her and take the medicine with 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 been experiencing bleeding, pain, and discomfort during sex. It started about three weeks ago when my fiance and I had multiple sexes in a day for almost a week. At first, the bleeding was very little, only during intercourse, and stopped immediately after the intercourse. We had sex before three days, and the bleeding was minimal. But now the bleeding continues. I can tell that it is coming from my vagina wall (near the entrance) instead of the uterus.Neither of us has STI or STD. I am on combination pill Rigevidon for almost a year. The pain goes away immediately after intercourse, and it is not that intense. What could be the problem? I also do not have a yeast infection. ### Response: Hello. The most common cause of post-coital bleeding is either vaginal mucous frictional lesions, and the other is cervical erosions or cervicitis (lesions over the cervix which bleed due to frictional injury during intercourse). It is essential that you should get speculum examination, and pap smear done to check for cervicitis, and any vaginal mucous lesions if any. Please avoid intercourse. If diagnosed then this may require a course of antibiotics for the next 10 days as would be advised by a gynecologist after evaluation. Please consult 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 had a miscarriage two weeks back. The baby had no heartbeat or growth even after nine weeks. So, the doctor gave me tablets for abortion. And she advised taking rest and abstinence from sex for three months. I am confused about that because I am eager to have a baby now. Please suggest. ### Response: How are you doing? Sorry to hear about the loss. Hope God gives you all the mental strength to face it. Hope I have clarified your query, do write back. All the best" "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 chest pains that are dull feeling in random parts of chest at random times throughout the day and night. Been having them for 2 weeks now. I have a newborn child, 9 months, and I do not sleep alot because he does not either. That has been going on for 9 months, the lack of sleep. I am 34 years old with no health issues and no family history of heart disease or issues. My doctor did an ECG and said it was normal with an abnormality. I went to a cardiologist and he did an ECG and said it was normal but scheduled me for a echocardiogram and stress test to rule out anything. Am I just having anxiety, which is what everyone keeps telling me, or could it very well be heart related? I am scared. ### Response: Hello. I passed carefully through your medical history and would like to explain that your ECG seems to be within normal ranges. Nothing to worry or panic about. The lack of sleep has played a role in exacerbating your clinical symptomatology. Anyways it is rationale to follow your doctor advise and pass through the recommended tests cardiac ultrasound and stress test." "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 fasting sugar result was 87, and postprandial was 61. Why is it so? I had a usual breakfast, including carbs with some amount of protein. What could be the possible reason? Also, I struggle a lot with weight loss. ### Response: A slight variation in fasting and PP (postprandial) glucose levels can occur. It is not unusual." "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 some allergy on the head of my penis and inner skin of my penis. My inner skin of penis is always red and I have this problem for a long time. Please help. ### Response: From your description, it can be balanitis but to rule out herpes genitalis please send a good quality image and revert back. Is it associated with itching or burning sensation or pain? If sexually active does your partner suffer from a similar complaint?" "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 to get a spectacles removal surgery but because of a thin cornea, I cannot have LASIK. So, the doctor suggested SMILE. But now I have read some disadvantages of SMILE. There is one more called Contoura Vision which is considered to be the best. Can you please guide me that with a thin cornea, what should I opt? SMILE or Contoura Vision? I do not want ICL. ### Response: Hello. Each procedure has its own pros and cons. SMILE (Small Incision Lenticule Extraction) is a good technique with good results. I did in many patients and the result was very nice. It does not correct any imperfections of the cornea which can be done by the Contoura vision. So first it has to be clear whether your cornea apart from thin has any other issues? From my side, you can opt any one" "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 want an explanation about my EEG report. I will try to explain my problems. After taking antibiotics, I had neurological reactions to them. They are memory loss, brain fog, and had concentration problems. Later on, we discovered that I have sensitivities to a lot of medications and chemical sensitivity. So I would like to explain the EEG report which was done during my reactions to antibiotics and brain problem. Can antibiotics slower the brain activity?My EEG report showed these results. My essential activity was appropriate. I had a relaxing and intermittent alpha rhythm with a frequency of 9 to 10 Hz and an amplitude of 30 V. There was alpha activity occurring intermittently from my parietal region to the temporal and central areas. The diffuser was the interpolated low-amplitude beta rhythm. My reaction to closing and opening the eyes was appropriate. A central and temporal had an intermittent rhythmic theta activity with a frequency of 6 Hz. Temporal and frontotemporal are rare theta waves or a tiny group of theta waves. During my deep breathing, I had no response to waves. The phenomenon of tracing was reflected during IFS. ### Response: I have gone through the report (attachment removed to protect patient identity). There is a critical finding seen. You have a slow activity (theta waves) in the temporal and frontotemporal lobe. It correlates with the memory problems, and for the confusion you had. Coming to the point, I would recommend repeating the EEG (electroencephalography) after some weeks after taking the antibiotics. It may be a temporary brain dysfunction due to a possible allergic reaction or a metabolic disorder. We cannot say that taking antibiotics slows the brain activity, but it causes a temporary malfunction of the brain, probably due to cell swelling or cell dysfunction (electrolyte imbalance)." "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 bump on the shaft of my penis. It is not painful and it is the same color as my skin. The bump is only visible when I pull back the foreskin. However, there is a small cut visible when the skin is more extended. It is like the bump is covering the small lesion. There is also another lesion nearby, also visible when the skin gets more extended. This time, no bump, but it is like the skin is covering the cut as well. Do you know what it could be, and what should I do?I have been taking Fucidin, as I thought it was the same issue as I had before, but it seems different this time. ### Response: Hello. I have seen images sent by you (attachment removed to protect patient identity). Yes, there is a bump on the penile shaft. It appears because of repeated small trauma may be during masturbation or sexual intercourse. At present I want you to apply Mupirocin topical ointment twice daily for two weeks. It will heal. Avoid masturbation or sexual intercourse" "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 late by 10 days for my periods and the pregnancy test is showing a blue line on T-part. I took an emergency contraceptive after an unprotected sex one month ago. Please help me. ### Response: Hi. Since you have taken the emergency pill within 72 hours of intercourse there is no chance of pregnancy. The delay could be because of hormonal changes due to the pill you have taken. Also, you say that you have a negative pregnancy test. So relax and do not worry. However, if you have a doubt then get 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: I am a 63-year-old female. I started getting flashes in the right eye a couple of days ago, and now have a floater in the shape of the flashes. I was not too worried. But today flashes have started up again in the same area. Given the pandemic, eye doctors are only open for emergency care, and I really do not want to get exposed. At what point is this situation an emergency?I am currently on estrogen patch, Sertraline, and Nexium. ### Response: Flashes can signify many conditions affecting the inner layers of the eye starting with the vitreous (the gel structure pressing down the retina - in high myopes it is usually dissociated) where floaters are usually located. If you have high blood pressure or diabetes, elements of blood can form in that space and start floating (floaters). The way to detect if it is in the vitreous is to look sideways and if the floater follows the motion of the eye (slowly in the same direction) then it is in the vitreous and does not require quick intervention. If the distortion is in the same position in whatever direction you look then we are talking about the retina and retinal detachment which should be urgently excluded. If you are seeing a halo around the source of light then your eye pressure might be increased and requires urgent attention." "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 I spent a day at the beach, I noticed red marks along my shoulders, arms, and chest that looked like sunburns. After a couple of days, though those spots turned brown, and the rest of my body looked like it had not tanned. I was wondering if this could be vitiligo or something else. Kindly advice. ### Response: You seem to have got Berloque dermatitis (those reddish-brown patches) (attachment removed to protect patient identity) due to sun exposure after some perfume or fragrance or plant contact on the skin (phytophotodermatitis) which typically causes these irregular and odd-looking patches. The whiter skin is your normal skin rather than vitiligo. Did you use any perfume or was in contact with plants before sun exposure?" "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 cracked nipples that have failed to heal for the past five weeks. I am a nursing mother, and I am not able to feed. ### Response: Hello. Please apply Purelan 100 (Lanolin) to the cracked nipples and express the milk to prevent engorgement and feed the baby that milk (store in hygienic conditions) along with some top feeds if required. Reduce the latching of the baby to enhance healing. Till you have healed completely feed the baby expressed milk and top feeds. I hope this should help." "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: Due to work, I have been away from my wife for more than two years. I had a few sexual encounters with sex workers here. I had unprotected oral sex and protected vaginal sex twice last year, protected oral sex and protected vaginal sex once last year, unprotected oral sex and protected vaginal and anal sex early this year, and protected oral and vaginal sex last month.I am going to visit home soon and I am very worried about passing on any infection to my wife. During the period of these encounters, I had a severe rash on my chest eight months ago. I have seen a dermatologist and she ordered a blood test and then treated me with two anti-allergic shots. I had this before as well. The skin allergy is a problem I had for years, but usually in the belt area.I was reading online regarding the potential risk of STDs like herpes, syphilis, gonorrhea, HPV, and viral hepatitis. I am really concerned now and want to go for a full test, but this is pretty expensive. So, do I need to get tested considering I did not have any symptoms but the rash I mentioned above? ### Response: I read your query and understand your concerns. I hope this answers you. Feel free to write back to me if you have more questions" "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 47-year-old female. I have hemorrhoids that are really causing me pain these days. Can you suggest me any over-the-counter creams or medications? Do I really need to see a doctor? ### Response: If it is an external hemorrhoid or if thrombosed or thrombophlebitis, it may cause pain. Eat a high-fiber diet. Avoid spicy food and alcohol. Use syrup Lactulose 30 ml at night. If symptoms have not improved please consult your physician. He will examine you locally to know whether it is a fissure or internal or external hemorrhoids and treat you accordingly" "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: From the last eight years, I have a numbness in my toe, the one next to the big toe. Now, it slowly spread to just above the knee, and in the area above the ankle which is below the knee on the right leg. There is no sciatic pain on either side. I have mild diabetes from 10 years.My MRI result eight years ago was as follows:Degenerative disk disorder between L3-L4, L4-L5 and disk prolapse and disk herniation in L5-S1 and mild compression noted in L5-S1. Tarlov cyst at the level of S2.Yesterday\s MRI result was as follows:L2-L3, diffuse disk bulge noted causing anterior thecal sac indentation.L3-L4, diffuse disk bulge noted causing anterior thecal sac indentation and compromise of bilateral recesses.L4-L5, diffuse disk bulge noted causing anterior thecal sac indentation and compromise of bilateral recesses.L5-S1, diffuse disk bulge noted causing anterior thecal sac indentation.Nerve conduction study:Bilateral moderate sural sensory axonal neuropathy in lower limbs. ### Response: I have read your query, seen the attached pictures (attachment removed to protect patient identity), and understand your concerns about the compression of nerves and diffuse disc prolapse at the lower lumbar region. I hope this helps you. Feel free to write back to me if you have more questions" "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 pregnant. The ultrasound shows five weeks \xb1 two weeks of pregnancy. My symptoms are fatigue, emotional, indigestion, and anger. I am on Pantocid for five days. I want to abort my pregnancy. Please tell me which method is better - surgical or medicine? ### Response: If your ultrasound scan shows five weeks of intrauterine pregnancy, then you can go for a medical abortion by taking tablet Mifepristone 200 mg orally stat and after 48 hours of taking this medication, you can take tablet Misoprostol 400 micrograms orally and repeat the same dose of tablet Misoprostol orally after six hours of taking the first dose of Misoprostol or you can use tablet Misoprostol 800 micrograms vaginally as high as possible before going to bed. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Do not take the above medication in case: You may experience bleeding per vaginam which is little more than the usual periods. But, in case if it is heavy and not stopping after two to three days, kindly contact your nearest gynecologist immediately" "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 26 years old. Yesterday night, I went out with my friends and I drank for the first time. We drank quite a lot and my last drink was a glass of red wine. After coming back, I felt sick and puked. My vomit was red colored. I vomited quite a lot. I was wondering if it was blood, but then it was so much that I do not know I would be standing after vomiting so much blood. I do not have any other symptoms. I am otherwise fit. It happened last night and I am perfectly fine since morning. I was wondering if it could have been blood and do I need an endoscopy or was it the red wine coloring the vomit? ### Response: Hi. Nothing to worry much. It will be most probably the wine with some amount of gastric juice. Retching during vomiting will cause small erosion and bleed. This is a self-limiting one. Just observe the color of your stools for the next three days. If the stools are yellow (as usual), then you can leave it alone. If it is black (like hair or tar), then you have to get a blood test done and probably consider endoscopy. Hope your queries have been cleared. Do revert if you have any further concerns." "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: For the last six weeks, I have a feeling like a lump inside my throat on my right side. No pain, no problem with swallowing. It also feels a little dry if that makes sense, and it is worse when I workout with open mouth breathing. I think my tonsil is bigger on that side although I do not think it is inflamed as it is not red. ( I have photos I can show you).I did call my doctor but with the virus, he cannot tell over the phone so he put me on 250 mg AZ and it made no difference. He ran an ultrasound and bloodwork and it showed nothing. He wants to send me to an ENT but with the virus, they are not taking appointments. If I show you a photo can you give me input as to what this can be? ### Response: The pictures are very clear. (attachment removed to protect patient identity). It appears you have a milk reflux problem that is causing these symptoms." "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 boyfriend and I are planning to have intercourse next month without a condom. Could you suggest which birth control pills I could use? When should I start having the pills? As it is a one-time activity (as he will be traveling abroad) how soon after the act can I discontinue the pills? ### Response: Hello. In that case, plan to have sex during your safe period, which is between day one to ten of your periods. During the sustained period you need not use any medication or the contraceptive pill. There is no chance of pregnancy as there is no ovulation happening during this period. However, if you have a doubt, then get 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: I have severe pain and swelling in the back side of the right knee. My MRI was inconclusive. Please explain. ### Response: Hello. I viewed the MRI of you knee (attachment removed to protect patient identity) and there are suspicious mild thinning of the articular cartilage in the bones of the knee and minimal fluid in the knee joint area. These changes are slight and not likely to cause any severe pain in the knee. The other causes of a severe pain surrounding the knee at your age can be due to changes in the blood flow in the arteries and veins. You may discuss with your doctors and get a right lower limb arterial and venous doppler test done. This will tell if there is any block in the vessels or a clot causing the pain. This kind of pain is felt in the muscles and soft tissues of the leg." "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 39-year-old female. I take Nature-Throid for hypothyroidism and Wellbutrin for anxiety. I have recently been feeling full quickly and tired. My blood work came back normal. An abdominal CT scan was clear and a vaginal ultrasound was clear. What could be causing this? ### Response: I have reviewed your health query and can understand your worries. Hope this helps. Please feel free to ask more if you have queries" "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 writer, so I use my computer a lot. Pretty sure I have a repetitive stress injury. My father has Carpal tunnel, so it would not be a surprise at all if I have something similar. The pain is triggered when I type, and more so when I use my trackball. More than anything, my arm burns, the skin is hot, red and rashy. I can feel the same thing in my left arm, but it is more milder and takes more strain to hurt. I know I should back off and rest, but I feel like I cannot do that without giving up on writing. I wrap it and ice it. I take a couple of Aspirin every day to deal with inflammation, nothing seems to be helping. If I go to a doctor, I am afraid they will just tell me to do what I am already doing. Is there any point in seeing a doctor, or is there something more I should be doing at home? I am willing to see a doctor, I am quite short on money, and if I am just going to be advised to ice it and rest, I would rather save my money. ### Response: Sorry to see that you have persistent symptoms. It is not clear from your description that you actually have any hand symptoms with crampy pain on typing with index thumb and middle fingers most affected as that would fit into a carpal tunnel like picture. If it is your arms that are bothering with burning pain, then it seems more like a neck problem with cervical spondylosis most likely possibility especially if you have morning neck stiffness or pain and stiffness after a period of rest. The treatment of which is going to be strengthening your neck along with neck exercises, posture correction, using the laptop or desktop for shorter durations, analgesia, Pregabalin tablets 75 mg twice a day and moist heat to the neck rather than the arms. You also can take Diclofenac tablets 75 mg two times a day after meals if you have no asthma, hypertension and no known allergy to this tablet. 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 a sudden loss of erection. I got weakness in erection due to aggressive masturbation. I cannot maintain it, and my skin also became red. Is the problem due to a venous leak? ### Response: Hi. Masturbation is fine and will not cause any physical problems or sexual problems. Sudden loss of erection is due to some stress in your life. Sometimes, stress can cause temporary sexual weakness. Reduce your stress, be relaxed and do exercises. Venous leak is very rare condition. Your skin may be red due to friction with tight clothes or due to allergy or infection." "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 ectopic pregnancy last year and now am 11 weeks pregnant (normal). Can I travel through flight for more than 20 hours? I have thyroid. Right now my thyroid level is bit higher. I am on medication for thyroid. ### Response: Please ensure that you are not a high-risk pregnancy as per your obstetrician before traveling. Air travel is allowed during pregnancy (except high-risk cases like threatened pregnancy, high BP, diabetic, twins), just keep the following things in mind especially for more than four hours stretch flight." "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 taking warfarin, and my INR is 2.8. I am a woman, and I am a virgin, I never had complete sexual intercourse involving penetration. My question is if I have my first complete sexual intercourse and lose my virginity while on warfarin, could it be dangerous and cause a hemorrhage? ### Response: Duration of therapy can be up to six months (only if risk if thrombosis high then life long anticoagulant is given). So for this six month while on warfarin you can delay intercourse if possible. The risk of bleeding depends on the following factors that are based on clinical correlation. 1. Smoking history. 2. Abnormal liver function and renal function. 3. CBC (for detecting anemia). 4. History of bleeding and stroke. 5. Recent Myocardial infarction. 6. Old age (greater than 65 years). INR motoring regularly needed for not crossing INR above three. Consult a physician for examination and clinical correlation for assessment of risk bleeding. I hope your concern is solved." "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: There is a yellowish bump on the conjunctiva, near my cornea in the left eye. After waking, both eyes are red, especially around the bump. Also, it seems that in both my eyes, towards the nose a brown margin emerges from the limbus. What treatment do you recommend for that? ### Response: It is harmless and sometimes can be inflamed leading to pain and redness (rarely occurs). I would suggest you use lubricant eye" "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 going through a mental breakdown. I give up on everything very easily. If I am at home, I tend to cry a lot thinking about my future. I am scared that my future is going to be bad. I try making up myself and getting strong. I get angry immediately and hurt others verbally and then feel sorry for my behavior. I am unable to change myself though I know I am wrong. Please help and let me know if I am going through depression. ### Response: I read your query and understand your concerns. I hope this helps you. Feel free to write back to me if you have more questions. Regards" "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 itchy bump around the nail of one of my toes, the second one. It has happened in the past years, usually when the season gets warmer. It started about a month ago and grew into a quite itchy, sensitive and swollen area. It is now turning to purple. I tried antifungals before, but it was hard to know whether they made a difference. Please help. ### Response: I have read your concern and examine your pictures (attachment removed to protect patient identity). Ingrowing nail. 1. Gram staining and culture.2. 1. Acute paronychia without obvious abscess can be treated nonsurgically like in your case.2. I suggest tablet Augmentin 625 mg thrice daily (combination of Amoxicillin and Clavulanic acid) for 5 days and 1% Clotrimazole plus Fusidic acid cream twice daily for one week.Consult your specialist doctor, discuss with him or her and take the medicine with consent. Cut the nail from the side as it grows from the side and cause recurrent problem. Also, do not use tight foot wear. Revert back after a week 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 am suffering from gastric problem for the last one and a half month. I lost 4 kg due to depression. I did my whole body checkup and all the reports are clear. But, I am having pain in my right hand muscle as well as have body pain. Is it due to depression? I studied about leukemia on internet and I am afraid that I am having the disease. Please help. ### Response: Hi. I have gone through your query. There are many causes for weight loss. Weight loss can be due to depression. Even any chronic infection in body can cause weight loss. If you are not taking proper diet due to gastric problem, then this might also the reason for your weight loss. As your reports were normal, there is less chance for having malignancy. But, still if you are in doubt you can repeat your investigations. Body pains can be due depression. Take bland diet. Have fiber rich diet and avoid fatty and oily food. Get the following investigations done as soon as possible.1. Complete blood count test.2. Differential count test.3. Gastroscopy. Revert back with the reports to a general 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: Is it possible to increase height after 28 years? My weight is 68 Kg. ### Response: As your age is 28 years you cannot increase your height by yoga or any other exercises. In men the skeletal maturity (growth plate maturity) is attained at the age of 18 to 22 years after which bones cannot grow further. Hence, there is cessation of the vertical growth in humans. You have not mentioned your height, so I cannot determine your BMI. If at all your BMI is towards medium to obese, definitely through yoga and stretching exercises you can remodel your body so that you can appear taller rather than short and stout." "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 do not have any dental issues. I have been getting regular dental checks. How do I keep my breath fresh all day? ### Response: It is good to know that you go for regular dental check-ups. Breath can be kept fresh by maintaining oral hygiene. The basic oral hygiene maintenance is more than enough to keep you healthy and fresh" "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 3 years 3 months old and weighs 14.1 kg. His fever, cough, and cold started from 100.3, so we gave Crocin 240 mg / 5 mL syrup 4 mL every 6 hours on the first day. As it was a viral fever, it was 103.5 at night. The doctor told us to continue 4 mL for 4 hours and give a sponge bath, and if the temperature is more than 102, Meftal-P 100 mg suspension 6 mL is prescribed. Today at 10 AM it was 102.5 (it was 101.3 4 hours back ), so we gave Meftal 6 mL, and within 30 min he became active. The dose is not printed in bottle unlike in Crocin, so I want to double check the dose 6 mL for every 4 hours if it is 102.5. ### Response: Hi. Please give Meftal 5 mL (6 hourly) if the temperature is above 101 F or if not controlled on Crocin (Paracetamol). You can give Meftal (Mefenamic acid) 4 hours after giving Crocin." "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 daughter got fever since last night. It has been 24 hours and her fever is between 102 and 103.5 degree Fahrenheit. She has no other symptom till now. She is 22 months old. We are giving her Fevago drops. What can we do for her? ### Response: Hello. This could be a viral fever, so continue giving Paracetamol that is Fevago every 4 to 5 hours irrespective of fever. If fever is above 101 degree Fahrenheit, then start tepid sponging and give Meftal-P syrup (Mefenamic acid) instead of Paracetamol. If the fever goes beyond three days, then we can evaluate or investigate for causes of fever other than viral by means of a blood test and urine test. Generally, viral fever may last for three to five days and no need of antibiotic at this moment." "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 my second anomaly scan at 18 weeks and the reports showed the impression that the placenta is at posterior wall mid and lower part grade I. The lower margin of the placenta is 3 cm away from internal os. Also, there is a breech presentation. What does it mean? The doctor told me to take bed rest and to avoid heavy work and sexual intercourse and keep an eye on any kind of vaginal bleeding. I am really tensed about the condition. Is it life threatening for my baby and me? What other precautions do I need to take? Should I go for another ultrasound after one month to check whether the placental position has improved or not? Also, I am a working woman and need to travel approx 40 km daily. What should I do? Also, I wanted to ask if I can fly at around 23 weeks. ### Response: Breech presentation at this gestational age has no significance. The placenta is 3 cm from os means that it is slightly in the lower segment. No need to take bed rest. Just avoid jerky traveling. It is not life-threatening. There is a slightly increased risk of bleeding. It will ascend in future. Get a repeat ultrasound few days prior to traveling. If everything is fine, then you can travel. A flight journey is safe in the second trimester" "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 pain in my knees and around the ankles, since the last two weeks. It all started when I walked around in high-heeled shoes one day. After that, I got my periods and the pain got aggravated. The pain has decreased, but is still quite bad. Also, I recently went to get a Pap test done, but due to insufficient cells, the test could not be done. ### Response: Hello. It is unfortunate that you are suffering from knee pain and it got aggravated by periods." "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 wondering if there is anything that can be done to lighten a circumcision ring? Any prescription creams or lasers? ### Response: I would not advise you to use any creams over the penile area to lighten the pigmentation. Since it is a very sensitive area, applying depigmentation creams can lead to side effects if it contains steroids. Depigmentation creams containing kojic acid and others will not help either. It is normal skin tone (attachment removed to protect patient identity), and you should not consider any topical applications. And lasers to reduce pigmentation is not advised over the penile area" "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 having stomach problems for the past three days and I have been trying everything and not seem to work. Today I tried Zantac 150 and I feel really bloated and feel like I am out of breath. Is this normal? Please help. ### Response: I understand your concern. Bloating could be due to indigestion issues. Zantac (Ranitidine) will help reduce the acidity of the stomach but not immediately. Take antacids after the meal and at bedtime. Plus, take enzyme digest to help ease digestion, together with Simethicone" "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 teeth are all over the place and I have wanted a brace for years but the dentists keep telling me I need to wait till my teeth fall out as they will not put me to sleep to take them all out but they have not even noticed that I have a tooth which grows out of the gum to separate ways and it causes me a lot of pain. Currently, I am taking Quetiapine, Fluoxetine. ### Response: Hi. Usually, by 13 years of age, all milk teeth should have fallen out. If not, then you can ask them to be removed. Also, as the permanent canines are growing out from sideways you can ask your dentist to remove the milk tooth directly below it as soon as possible to allow it space to grow. If your dentist is not doing it, then go find another one. Braces can be put after all milk teeth are removed." "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 28 years old. My height is 5\4"" and weight is 70 kg. We have been trying for pregnancy for a year. My husband\s reports were all normal. I am having PCOS, but my periods are very regular. I am on Oxetol 300 mg for partial seizure since one year. I am also taking Metformin 500 mg thrice daily for five months. I have not used any contraceptive pills still now. My insulin levels are also normal. Please help me out. I am getting very much depressed. ### Response: Having seen your PCOS reports (attachment removed to protect patient identity), it is suggested that you should opt for controlled ovarian stimulation and intrauterine insemination procedure." "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 21 years old female and interested in starting birth control pills. I have done all my checkups and everything was okay for me to start them when I get a period. But my periods became light and irregular and I could never predict when I am going to have one, so it has been a conflict when I should start the pills. Also, I want to become sexually active, but I do not know whether the pills will protect me from pregnancy if I take them on any day of the cycle. I want to protect myself this coming month but I do not know will and how much would they be effective if I did not start them on my period? And is it okay to stop birth control after the first pack, due to the fact I have a long distance relationship and do not need to be constantly protected? ### Response: Hello. Ideally, birth control should be started from day 3 of your cycle regularly to stay protected. It is mandatory to start the pack in the proliferative phase. However, if started by seventh or eighth day, then an additional barrier contraceptive is advised to allow the effect of the pill to ensure thereby preventing pregnancy." "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 an ear infection, with some discharge. Our local GP tested the discharge and found evidence of several bugs, prescribing Otomize ear spray (Neomycin, Dexamethasone, Acetic Acid). He wears hearing aids, and at his last audiology appointment (three months ago) there was evidence of perforation. The GP examined his ear and could see no evidence of a hole, although we have previously had conflicting information from the GP and audiology about the existence of a perforation. I have reservations about using the Otomize spray as I have read that it is ototoxic, but I am concerned that the infection will cause more damage if left untreated. Should we proceed with the spray? ### Response: If there is a perforation or even the slightest doubt of it, Neomycin in the optimize spray can enter the middle ear and pass through round window membrane and cause permanent damage to the inner ear and thereby sensorineural hearing loss. Hence that spray is best avoided. Two" "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 extreme stress and depression. I had a relationship for six years which was extremely deep, and it broke all of a sudden, and it leads to extreme depression and suicide attempts. After two years, I got recovered and then I started another relationship in which I was very happy. But I was still afraid to love again. I was doubtful whether this guy too will cheat me or I may lose him. I was very happy with him, but now he is always fighting with me and makes reasons for the fight. This literally kills my mental health. I cry a lot and it literally breaks me. So I cannot even talk well to my parents. We are in a long-distance relationship and I love him very much and miss him a lot. As I cannot bear this distance, I cannot tolerate this sadness when he fights. Now I am worried whether he too will leave me. Besides this, another reason for my stress is unemployment. So how can I deal with this? ### Response: Hello. I can imagine how difficult it might be. You are having adjustment issues, trust issues on the surface. Secondly, there also might be cognitive distortions that are making you feel vulnerable and having frequent fights. There also might be self-esteem issues that are making you continue the relationships which you are not comfortable in. I would suggest you start counseling therapy session. It is important that you spend some time understanding yourself. To be a part of a happy relationship, first, you have to be happy with yourself. 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 a 30 year old female. I have been trying to conceive for a year with endometriosis on ovary. My husband is 32 and normal. My AMH is 1.85. I am planning to get laparoscopic surgery. Can laparoscopic surgery reduce my AMH further more? What should I do? ### Response: The laparoscopic surgery will definitely reduce your symptoms and the endometriosis of the ovary will be taken care of. Since AMH (anti-mullerian hormone) is a hormone, post surgery the effect of it would be a little difficult to state now. Please get your surgery done and then repeat the test." "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 sore throat for a month now. It is mostly on one side with pain on the right side. I also have a white bump on the same side on the tongue. It is white and soft to touch. I took antibiotics and also did throat culture but only commensals were reported. Before this, I had body pain and intermittent fever for almost months and heat rash on the skin. ### Response: It looks like oropharyngitis, but one month is a prolonged phase, so we have to rule out other cause. Kindly tell if you have any history of diabetes or oral ulcer, or prolonged fever." "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 three months baby is avoiding breast while feeding. Is there any other option to make her drink breast milk without direct feeding? ### Response: You can express breast milk (either manually or by using a breast pump) and give that milk to the baby using a spoon. But the reason for avoiding breastfeeding needs to be evaluated. Nose block is a common cause for refusal to feed." "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 is 2 months and 5 days pregnant. She is having pain under her right armpit for two weeks. It pains only if we touch it. Is there any issue with this?She is taking Pregnacare medicine. ### Response: It seems like she might have some furuncle (boil) under her armpit. It would be useful if you could share any picture of the lesion, so that accurate diagnosis and advice can be given. But as she is pregnant so I would recommend to consult your local doctor as well and avoid using any over the counter medications without any authentic advice. For now, she must wear loose clothes made of cotton and keep the armpit sweat-free as much as possible. 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 suffering from typhoid from the last 10 days. Now, I have completed my seven days course. I want to ask when to report again that I am typhoid free. And I eat banana, wheat bread, milk, peanut butter, and do 30 minutes workout. Is it fine for after cardio and will this diet cause my liver to swell? ### Response: You finished typhoid fever medicine course, but you see typhoid fever otherwise called enteric fever, so the main infection pathology is in our intestine wall gland. So intestine will be inflamed and weak so better take easily digestible food. Do not strain too much with your work-outs for some more days. Otherwise, typhoid will relapse." "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 infection in my foot and it is on my right foot above the ankle. That particular part is a bit swollen and sometimes pus and some blood come out when I clean it. And because of that infection, my foot is swollen and I am experiencing pain while walking. I am going to a clinic tomorrow but till then is it advisable to take Amoxyclav 625 (one tablet) to reduce the swelling? ### Response: Hello. Yes certainly, you will need antibiotics to kill the bacterias. So Amoxyclav 625 (Amoxicillin and Clavulanic acid) is a good choice. So you need to have it three times a day for five to seven days depending on the response. You can certainly take it now and it should be taken after food and it is better if you have it with some antacids like Rantac 150 (Ranitidine) or Pantoprazole or Rabeprazole. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Also, it will not act immediately to reduce the swelling but its action will take 24 to 48 hours. For immediate relief, you need to have some painkiller medicine like tablet Diclofenac or Ibuprofen, or Paracetamol 500 mg whenever needed. Also, you need to apply some powder like Neosporin thrice a day till the wound heals" "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 I concentrate on plain wall or dark surface, I can see tiny dots and fuzziness sometimes. I have consulted eye doctors, and the test results are fine. I have been observing this from my childhood, and I am not taking medicines for it. Is it due to vitreous liquefaction? Does it happen to everyone? ### Response: You are right. It happens due to vitreous liquefaction with aging. The condition you are describing is known as floaters. They are perfectly normal. It occurs earlier in myopes or people using minus power glasses. They are a matter of concern only if you see a sudden shower of floaters. It may be due to pigment release from a hole or a break in the retina. In that case, a dilated retinal examination is required to be done by a retina specialist." "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 serum creatinine is 1.88 and triglycerides serum 454, I am diabetic my HbA1c is 7.4 but I have stopped the medicine for six months and following a strict diet and exercise. Please suggest. ### Response: Hello. How many years of diabetes? Any ongoing kidney issue? With creatinine 1.88, you need to revise your diabetic medicines and make sure that it does not lead to an advanced level of kidney issues like diabetic nephrology. If you are not on medicine than you need to restart as improving sugar and cholesterol will slow down the kidney damage process" "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 the mouth ulcers or canker sores on the side of the tongue be herpes virus? I also had a couple of mouth ulcers on the inside of my lips, but they appeared and vanished in a couple of days. I never had a cold sore on the outside of my lips but did not know if mouth ulcers could still be from oral herpes. I also had a headache and dry mouth. ### Response: Herpes usually causes sores on the hard mucosa in the oral cavity like palate and gums whereas ulcers on tongue, lips, etc., are often canker sores. I could not see any ulcers in the image (attachment removed to protect patient identity). Kindly upload more images." "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 22 years old with a weight of 96 kg. I have been participating in sex from the last year. It is happening frequently and when I am alone, I am now masturbating almost daily even for once and I finish so early. I cannot last long. Is that anything to do with masturbating or frequent participation in sex? ### Response: Hello. The excess masturbation has shown relation to premature ejaculation. So it is advisable to restrict masturbation frequency two to three times a week. It is also important to learn when to slow down stimulation by distraction technique to prevent early ejaculation. Master and Johnson\s techniques are also beneficial. Topical Lignocaine jelly can be applied after erection to prevent early ejaculation. A pelvic exercise called Kegel exercise is also beneficial. However, if you do not have an improvement in early ejaculation with all these methods then consult nearby sexologist or psychiatrist for detailed 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 have been diagnosed with temporal lobe epilepsy following a Tonic-Clonic seizure before nine years. From then before two years I was seizure-free having been put on Lamotrigine.Before two years I had another TC seizure and my dosage was raised (cannot remember the dose precisely), and I was seizure-free for almost a year when I had another TC seizure.At this point, my dosage was raised again to 125 mg twice a day. Despite this, I have had a number of absence seizures. This seizure was followed by a 24-36 hour period of not just extreme tiredness but very strange mental sensations, including what felt like a rush of intelligence as well as frequently repeating thoughts and unexplainable strange thoughts (not distressing - more like feelings of another time as well as what I guess are best defined as nonsense, thought trains about advanced concepts such as genetics or psychology).Following this, I had an MRI which reported nothing abnormal, say for a small number of tiny foci of T2 hyper-intensity within the all white matter of both hemispheres, non-specific. The areas of the left frontal lobe where there has been previous EEG evidence of epileptogenic focus were normal.All of the above paragraphs is directly quoted from the radiologist\s letter to my GP. Since then, I have had two absence seizures with similar post-seizure symptoms.My Lamotrigine dosage has increased to 200 mg twice a day. Now I am having regular nocturnal seizures (two to four weeks), which leave me similarly confused and with the same weird thought patterns. I had one about three days ago where these symptoms were particularly acute, and have worried me greatly.In all cases, I recovered quickly and found sleep to be a major contributing factor to my recovery. Now, just over 48 hours since my last seizure, these symptoms have again subsided. They have occasionally appeared prior to seizures, making me think they are auras, but they do not seem to be anything like the aura descriptions I have read about.During a recent appointment with a clinical nurse, I was put on a new prescription of Brivaracetam (2x 25 mg) alongside the current Lamotrigine dose. I have yet to begin this.The fact that there is a little reference online to these symptoms is quite distressing to me, particularly given how bizarre they are. Are these potentially a result of the point of epileptogenic focus? Might they be a reaction to the Lamotrigine?My current medications are Fluoxetine 40 mg per day, Atorvastatin 40 mg per day, Metformin 2 x 1000 mg, 10 units insulin Glargine, Lamotrigine 2x 200 mg, Brivaracetam 2x 25 mg (yet to commence). ### Response: Hi. As per the given information, I can understand that these symptoms are the effects of seizure, and unlikely to be due to Lamotrigine. The primary goal of the therapy is to control seizure episodes for which you have been prescribed Brivaracetam, you must start the new medicine along with the old one, with which the symptoms must go. MRI (magnetic resonance imaging) scan may not reveal epileptogenic focus other than hippocampal sclerosis and some volume loss. The best way to find epileptogenic focus would be EEG (electroencephalogram), if possible can be done later if seizures are not controlled with the prescribed medicines." "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 27-year-old male and have pain, numbness and bladder control issues. Kindly guide me. ### Response: Pain numbness and bladder control issues point towards spine pathology. If you have done some MRI, then please upload the images else I would recommend a dorsolumbar spine MRI" "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 my last period a month back. I had unprotected sex six days later. I did not take any pills also. Now, my period is late by 16 days. Last week when we had sex, I took a pill. Is there any chance for pregnancy? ### Response: Hi. As per your query, you had periods a month back. But six days later in which month did you have unprotected intercourse, last month or this one? Also, when did you take the pill? Please specify for further guidance. Revert with more information to 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 an angry and a miserable person to live with. My poor fiance is constantly getting sucked into my expert level fight tornadoes. I am a master at it. It is like I am enjoying every bit of it. I truly do not want to. I wish I could change. I know it is a problem but it is always after the fight. I never seem to intercept my behavior and change it before it occurs.I also know there is likely no black and white answer to my question. I am on a waitlist to see a psychiatrist but it is likely going to be a while. Can you maybe help me find a temporary fix? I do not want to be this way. ### Response: Following tips can help you tame your anger. We are basically trying to prevent you from acting out. Practice relaxation techniques like breath relaxation exercise daily. Whenever you feel like getting angry, breathe slowly and deeply from your diaphragm. You can either do reverse counting from 20 to zero or imagine a relaxing imagery while deep breathing. Many times logic defies anger. Try to tell yourself that anger is not going to solve the problem. Retrospectively think of an alternative behavior in that situation and try to change it. Regards" "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 taking Triphala churna in morning empty stomach and in at night bedtime for constipation. Now my problem is at which time should I take Bramha rasayan. I have to take Triphala two times for constipation and digestion issues. Please suggest me the time for Bramha rasayan. ### Response: I just read your query. See if you have mild to moderate constipation then take two teaspoons of Triphala powder at bedtime with lukewarm water. Do not eat anything after taking Triphala powder. You do not need to take it two times if it is solving your problem. So you can take Brahma rasayan in the morning one teaspoon or as advised by your physician half an hour before breakfast with lukewarm milk or lukewarm water." "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: What do the following mean?Diffuse ectasia at proximal and mid section of LAD.LCX continuing as Om1.Long course of PLV and extending to inferolateral walls of the left ventricle. (super dominant RCA). ### Response: The LAD vessel, that is left anterior descending artery is showing ectasia which means it is slightly enlarged in caliber, but there are no blockages. Also, other things which are mentioned is description of the vessel, the way they are supplying the heart but there are no blockages or any abnormalities. According to it, right-sided vessel is giving long branches and supplying a large part of the heart, but there are no abnormalities. So overall, other than the enlargement of the vessel, there is no abnormality and it is not a cause for his chest pain. Does he smoke? If yes, he should quit it gradually. The report does not appear worrisome" "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: In a few sentences, what is the Mediterranean diet? What food categories are typically eaten on the Mediterranean diet? In a few sentences, what health benefits come from the Mediterranean diet? And anything else you would like to add. ### Response: Hello. It is way back to our ancient times we are in diet emphasis on eating a primarily plant-based diet like fruits, vegetables, legumes, grains, and nuts replacing butter with Olive oil using herbs and spices instead of salt. A vegetarian-based, fish and poultry food diet are typically found if you look food pyramid. It has a great impact overall with weight reduction, heart-healthy diet as well to manage HTN (hypertension) and cholesterol." "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: What are the benefits of doing regular yoga? Ideally would like the quotes to focus on mental health and physical health. ### Response: Yoga is very popular nowadays to maintain physical and mental health. Yoga means addiction. It is an addiction to different body organs in such a way it helps to remove the attention of mind from their subjects and concentrate on the particular points. Yoga is not only asana and pranayama. However, it contains Yama, Niyama, Asana, Pranayama, Pratyahara, Dharana, Dhyana, and Samadhan. These eight are collectively known as Astanga yoga. Yoga helps to coordinate our routine life, regulates body metabolism, relaxes the mind and improves mental health." "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 has white tongue since 20 days, used probiotics from 10 days but problem did not solve. But no sore throat and no discomfort while eating anything. He feels lymph nodes near right side of neck, back side of ear and near arm ankle from last one week. Got some pimples on his face and one or two on chest and stomach. Fourth generation HIV duo tests (p24 and antibody) done on 6th, 20th and 35th day and came as non-reactive. He is in a little worry as symptoms are still there (white tongue and nodes). A kid kissed on his blood wetty pimple of him, did that kid get infected? It was done 24 hours back. Is it good to go for PeP? Please suggest. ### Response: Hi. White patches on the tongue can be oral thrush caused by candida albicans seen in severe imunosupression especially stage 3 or 4. Pain on swallowing can be from involvement of the larynx and oesophagus of the thrush seen in stage four. Persistent lymph node is also common. The kid should be put on PeP very important just to avoid getting infected, because there could be an open wound in the child\s mouth through which the virus can gain entry." "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 on 40 mg Pantoprazole twice a day for GERD. I just took 50 mg Voltaren for a bad back and I am worried sick. I checked online and it said no drug interactions. I have not yet taken my nightly dose of Pantoprazole, should I not take it? ### Response: I went through your query. In fact, anyone who takes painkillers like Diclofenac has to take Pantoprazole to prevent Diclofenac-induced gastritis. So, relax and take the regular dose of Pantoprazole. Regards" "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 36 years married since a year back, I had a history of six times laparoscopic ovarian cystectomy and my doctor did ovarian drilling twice, and I found AMH low and my period was normal every 30 days with the average amount, I used the ovulation kit for three months and there was no positive result (anovulatory). I want to get pregnant as soon as possible. Please advice for me. ### Response: Hello. If you had checked with ovulation kit in the cycle while taking OCP (oral contraceptive pills), they bound to be negative. If the period is regular every 30 days (as you mentioned) and still kit showed no ovulation, it might have given a false negative result which is familiar with ovulation kits, especially if monitoring is not done as advised on it). It is very rare for all cycles despite being regular to be anovulatory (it is ok if an irregular period is anovulatory). Still, considering your age, multiple surgeries, and low AMH, you can go for ovulation induction (initially at least with clomiphene citrate). You need to consult a doctor for a prescription and further ovulation monitoring. Controlled ovarian stimulation with injection FSH (follicle-stimulating hormone) and IUI (intrauterine device) will give a better chance of pregnancy than ovulation induction alone." "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 have a question. I was looking at my anal and I was just curious why is there a red line on my anal and I took the pictures after I pooped. Does it look normal or like any STD? ### Response: I have gone through your case. Most likely it is candidiasis which commonly occurs in such areas when body folds have some friction and on top of it, moisture and tight clothing promote it. No, it does not look like to be part of STD. However, if you have a history of unprotected sex you need to undergo some blood tests to be on safe side" "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 very sore area behind the last tooth on my upper right side of my mouth. It hurts terribly to chew and swallow because of the location of the soreness. I am 52 years old and never really had problems with my teeth. Also, the area does not look red or has any open sores, just swollen. It started about two days ago. ### Response: Hi. There are three possibilities about this soreness, either there is some problem with the tooth, may be it is fractured. Secondly, possibility is that you may have got trauma due to biting or food like fish sting stuck there. Third possibility is that due to trauma from biting you may have developed an ulcer. Now if your tooth is carious, fractured, then you may require antibiotics or it may require to be restored or extracted. If it is irritating mucosa around then we need to contour tooth to relieve area. Third, if there is ulcer then you may require the topical gel for one week. You can send photograph of the area if possible." "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 discuss about one of my family members. He is a teenager and he is 14 years old. I want to discuss his up and down moods. Is it just because he is a teen? His mood is very strange I think so when he is really happy or high I call it, he does stuff like he has enough energy to last forever and he has these ambitious plans and ideas he wants to do. When he is like, I say he is losing touch of reality cause he says he sees stuff that are not there and sometimes he feels like a religious person like ""God"". And sometimes there are voices in his head to tell him to jump off the bridge for fun or something like that and I know off these episodes only last about a day or two or even a week, but I know he has depression. But anyways when he is depressed he tends to have no energy at all to do anything at all and he is always tired and he becomes suicidal. What in your opinion he has? Please tell me the cause. I know he is depressed but why does he tend to be high? ### Response: As per your history, I find that the patient sometimes is high and sometimes depressed. Though some more details about the symptoms are required, however, I may say that the patient is suffering from bipolar affective disorder. As the name suggests it has two poles. The first pole is depression which is very common where the patient feels sad, has decreased energy and pleasure and can have suicidal ideas. The second pole being mania where the patient appears high, they talk continuously, talk high things about themselves, highly energetic. Sometimes they have psychosis associated when they hear some unusual voices in their ears called hallucinations. This condition requires urgent psychiatric intervention." "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 28 year old male. I have been diagnosed with RA. And another rheumatologist told me I do not have enough symptoms for RA. However, I have been using Methylprednisolone 4 mg for almost four years every day. And this helps me completely get rid of any problems. If I do not take it for a day all my joints start to swell and it is unbearable. The second rheumatologist prescribed Methotrexate to me and now I am taking this for already four months together with the Methylprednisolone. But, I still cannot get rid of the Methylprednisolone. How dangerous is it taking this drug for already so long? Will it prevent me being able to have children? What is my best option? I am open to travel to any hospital in the world. Symptoms started four years ago. ### Response: Well, it is a tough spot you are on. It will be difficult for a new rheumatologist to diagnose if you are already on steroids and the symptoms get masked. But I will try to simplify it for you here. Could you let me know the results of rheumatoid factor, anti-CCP antibody, and ANA? If they are negative, it will reduce the probability of rheumatoid arthritis. Steroids on a long-term basis are always harmful. It can cause cataract, osteoporosis, and diabetes mellitus." "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: Recently, I slipped from the bike and hurt my right knee. Though it is causing less pain during normal walk, it is hurting a lot while walking on stairs. I visited an orthopedic surgeon and he told me to take an MRI. The MRI report is as follows. Impression: Grade 3 tear involving the posterior horn and body of lateral meniscus, extending into the inferior and outer surfaces and associated with parameniscal cyst measuring 11 x 5.3 mm. What does it actually mean? My surgeon informed that I require arthroscopic partial meniscectomy for treating this issue. Is it compulsory? If I had to undergo surgery, then how many days will it take for me to get back to normal like going to the office, walking? Are there any complications associated with surgery in future? Do I need surgery immediately or can I extend this to somewhere around a month? In case of surgery, will the cyst be removed along with the tear? My surgeon informed that the cysts are very common for everyone. They have least impact on pain and there is no necessity of removing the cyst. Please help me out. ### Response: It would have been ideal if you had posted your MRI films for me to see as without them I can only comment and answer your questions with limited knowledge of your condition. Revert back with the MRI film to an orthopaedician and traumatologist 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 21-year-old female with a really bad skin condition. The acne outbreak happened about a year ago, a time when I stopped the birth control pill, Diane, which I was on it for over five years due to a negative side effect I had swollen legs. Then I was on Almina 28 for about three to four months, with no positive impact on the skin condition. Please help. ### Response: Hello. I think your acne is due to hormonal imbalance, and there are other natural ways to treat this condition. You will need some more work up to find the leading cause. And some more detail in history to find a permanent solution. Lab test suggested are, 1. Complete metabolic profile, including liver enzyme levels. 2. Thyroid-stimulating hormone levels (TSH). 3. 4. Check for A1C to rule out pre-diabetes. 5. Estrogen and progesterone levels. 6. Complete blood picture. Until you get complete workup, I can suggest simple remedies. To get rid of acne, I recommend your system with natural remedies. 1." "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: How do Melatonin supplements work? Does taking Melatonin actually help you fall asleep and stay asleep? Are there any potential side effects or drawbacks to using Melatonin to fall asleep? Are there any health benefits of taking a Melatonin supplement? Is it safe to take Melatonin on a nightly basis? If so, does your body get used to it? ### Response: Hello. Melatonin is a natural hormone found in our body. The Melatonin pill works the same as this natural hormone as per studies. It helps regulate sleep-wake cycles. It also helps fall asleep and stay asleep. It worked for my patients. It is usually safe. I have prescribed for short term only. No side effects so far. If the sleep is improved, patients overall status improved too. Do not recommend to take regular use. Advise frequent consultation and short term use 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 think I might have UTI, since I suffer from burning sensation while urinating, and then cloudy urine at the beginning. I did urine examination routine, in which leukocyte esterase was positive, nitrites negative, and high pus cells in urine 8 to 10. Also did urine culture after that and nothing such came in it. I had unprotected vaginal sex four months ago. Is there any chance, that this is not UTI but some STD? Please help me. ### Response: I have gone through your query and your reports (attachment removed to protect patient identity). I would like to know a few more details to answer your query better: It is unlikely for an STD to present for four months after sexual contact, also your symptoms are more suggestive of a UTI. It is possible to have a negative urine culture because of sampling errors (the urine specimen given may not have had an adequate bacterial load) or organisms that do not grow in culture or infection of the prostate gland. You would require a detailed clinical examination by a urologist to ascertain the probable cause of UTI and also rule out STD. I would also advise a repeat urine analysis and urine culture and serological tests if you are concerned about the possibility of STD\s from the unprotected sexual contact" "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 and my fiancee became physical last week. Now we are in doubt that she might be pregnant. We need some help and suggestions regarding this. ### Response: Hi. There is no contraceptive that will work now as it has been a week now. Emergency contraceptive works only within 72 hours. I suggest you wait for her period and if it gets delayed by a week do a pregnancy test and check. If positive we can handle the issue as per your need. All the best." "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 saw a doctor for abdominal burning and pain in the throat after one night of drinking alcohol. She said I had gastritis but I did not say I had diarrhea as well. What shall I do? Currently, I am taking Lansoprazole. ### Response: Hi. The current medicine will help in improving diarrhea as well, if associated with gastritis. Take the medicine for at least a week. Try to be on a bland soft diet for the next few 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: My urine is foamy. I am confused whether everyone will get bubble and foamy urine while urinating. Please explain me. ### Response: I appreciate your vigilance. Mild frothing of urine is usual, but excess of frothing denotes protein leakage in urine. What is your age? Do you notice any swelling of your feet and face? Do you have any other medical problem? To be sure get a urine routine microscopy report and follow up with that. Revert back with answers to the above questions to a nephrologist 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 feel my ears plugged from last week, and nothing I am doing is helping. This happened to me about a month ago, and the doctor prescribed steroid nasal spray, Reactine, and Sudafed. It cleared up within two days, but it is doing absolutely nothing now. I do not feel as though my sinuses (nose) are plugged, but now I am getting a headache. I am getting worried, and is this something serious? Please help. ### Response: Hello. The symptoms of aural fullness or plugging of ears can occur due to acute otitis media most crucial cause for which is eustachian tube edema secondary to allergic or acute rhinosinusitis. Did you have symptoms of nasal stuffiness, sneezing? Do you have any earache and decreasing hearing? How long have you been taking medicines? What kind of headache do you have? Is it persistent, or does it occur in clusters? Is it associated with nausea and vomiting?" "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 teeth have become totally yellow. Even whitening toothpaste does not work. I tried to clean them myself but, failed. What products can I use or how can I clean it myself without visiting a dentist? ### Response: I have gone through your complaint and seen the picture attached to it (attachment removed to protect patient identity). Hope it helps. In the case of any other problem, you can contact us. Regards" "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 28 years old, and my teeth are weak. Till date, I have lost three molars and one premolar. I am using caps on that place. Now, I have a slight movement on my central incisor. Please suggest me a treatment or medicine to prevent myself from the early loss of a tooth. ### Response: I can understand your concern. It looks like a condition called chronic periodontitis, in case if you do not have a decayed tooth. For that, you need to take medication like Ofloxacin 200 mg twice daily for a week, tablet Metronidazole 400 mg three times daily for a week. Use mouthwash Chlorhexidine twice daily, and also, brush your teeth with an ultra-soft brush. If there is bleeding from your gums, you can also have vitamin C supplement. Consult a dentist and do oral prophylaxis for two to three times. If you upload a picture of the tooth, I can be able to provide you a better possible treatment plan." "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: The dermatologist has said that I have urticaria (hives) and prescribed Deflazacort 6 mg and Hydroxyzine HCl, but I am 28 weeks pregnant. Can I take those medicines? Suspecting it is chickenpox. The itching started 10 days ago, rashes started five days ago. Appears to be small red bumps on thighs and hands. Then appearing as water blisters and healing now. ### Response: Deflazacort is corticosteroids and can be used as per need but can interact with diabetic medications and will act as an anti-inflammatory and can give side effects like weight gain, mood variations, vomitings, etc. Suspecting chicken pox at 28 weeks, you need to report urgently to treating obstetrician. If you tell within 24 hours of the appearance of the lesion, you can have medications like Acyclovir. If severe symptoms, it can be given orally as well. Chicken pox first needs to check as urgent before treatment for IgG and IgM as well ( IgM recent infection and IgG already immunized petient). In pregnancy, the vaccine could not be given as it is a live attenuated vaccine but after 20 weeks if patient reports within 24 hours of having confirmed leisions of chicken pox could have medical treatment. Take it seriously and just report to your treating obstetrician to have proper examination and treatment accordingly. But it seems you have spent most of the infectious and symptomatic period already but better to have a check up immediately and do have electronic fetal monitoring to check fetal well-being. Continue Iron and Calcium supplements. A healthy balanced diet with less salt, sugar, oil and spice. Have isolation, try to avoid chil" "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 daughter has been diagnosed with a cylindrical power of -2 and -2.5. Can that be cured to normal if she takes healthy diet and eye exercises? Will it increase with age as she is 5 years old? ### Response: According to what you have mentioned, your daughter has myopia (short sight). There is no research that supports diet or eye exercises to improve the condition. However, avoiding excessive near work (such as using mobiles, tablet, computer) helps. A 6 monthly checkup with the ophthalmologist for refraction testing (with and without cycloplegia) and fundus examination is needed to monitor progression. In most cases, with the use of refractive correction, improvement is seen. In some cases, the refractive error may progress (pathological myopia), wherein the retina also gets involved. Hence, fundus examination by an ophthalmologist is necessary. Diet rich in vitamin A (carrot, papaya, etc.) can be given to support the retina" "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 met with a car accident three weeks ago. I was injured and had trauma to the chest wall muscles. My chest muscles went into spasm periodically, but has subsided somewhat. My right side lower chest is the only area still hurting. After rest for a long period or sleep, when I activate the muscles in that area I have cramps. My question is, will chiropractic service help alleviate the pain? ### Response: 1. 2. Get myofascial release (MFR) and strengthening.3. Go with local gel application and ice massage 4. Ultrasound therapy." "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 severe anxiety problems which cripple me. I feel trouble in concentrating on my studies and other daily activities. I have PCOS and suffering from depression. I am an introvert, and my body is swaying all the time. A feeling of constant motion present like a boat ride. What can I do to live a better and happy life? How do I get rid of the anxiety?Last time when I had anxiety and depression, I lost 15 kg weight. Also, my hemoglobin and other vitamins levels were reduced. I am currently under Shelcal 20 and Autrin. In the past, I was on Venla 25 g. ### Response: You should work on your weight loss. It will help you with both your PCOS and depression. Do the daily exercise for 30 to 45 minutes. Do meditation for 20 minutes daily. Avoid junk foods, eat healthy joint cooked foods. Take enough 6 to 7 hours of sleep. Spend quality time with family and friends. Spend time for creative hobbies like read good books, write journals, do paintings, etc. Live your life, do not just spend." "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 on dialysis for kidney failure and I have noticed a fluctuation in my monthly blood work for the creatinine and BUN levels. At the beginning of the year, my creatinine was 11 and it has decreased every month to 7. I was also making more urine as I went along. All of a sudden, last month my creatinine jumped back up to 10. I have not changed anything in my routine or treatments. Does anyone have any ideas? ### Response: I have worked as a chief in a hemodialysis center for 20 months. Once the kidneys have failed and the patient is hooked up on dialysis, the creatinine value is always high. At this time we do not care about the creatinine values because once we start dialysis on a patient, it is assumed that his kidneys have incurred permanent damage and he cannot come back to normalcy. At this juncture, we use the patient\s creatinine value as a measure of protein intake. If a dialyzing patient\s creatinine value is high, it is assumed that he is having good protein intake through diet and high creatinine value is desirable in dialysis patients, since intake of much proteins gives them a long life. So the" "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 eating a hot curry last week when the top of my mouth blistered over as if I had burnt the hard palate, which I thought was unusual as I felt the heat on my tongue first but did not. The blister has gone but left a small dent in my hard palate which I am concerned about as it is leaving a bad taste in my mouth. Is this common? ### Response: Hi. Yes, this is common. You do not need to worry. The mucosa of palate is very sensitive as compared to the tongue. So it gets affected easily. You just put an Oral gel Clinica (Chlorhexidine with Metronidazole) gel on the spot for three days and three times a day. Then give me a followup after five days. Hopefully, everything will be fine. New mucosa on palate grows after almost 10 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 45 year old male. I have recently checked my blood test and my liver function test shows 1.6 total bilirubin, 0.6 direct bilirubin and 0.9 indirect bilirubin. What might be the problem? I have high blood pressure and fatty liver. My current medication includes Covance 25 mg, Concor 5 mg and Storvas 5 mg. I am worried. Please advise. ### Response: Considering your indirect bilirubin being high (attachment removed to protect patient identity), it is generally a sign of hemolysis (breakdown of red blood cells). Did you have a recent fever? You also have fatty liver, which may also cause this. I would suggest you to repeat the test after two weeks. Revert back after two weeks 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: I am having pain in the right lower abdomen for a week. Ultrasound suggests subacute appendicitis. CBC, LFT, and KFT are normal. I do not have a fever. What are the treatment options? Is surgery necessary? Can this be treated with medicine only? Currently taking Oflox 200 twice a day. Will Oflox 200 cure this? Please advise. ### Response: Hello. Subacute appendicitis is the inflammation of the appendix. The usual treatment is surgery after a course of antibiotics. The best judge of this is a surgeon who has examined you as clinical signs of local guarding and peritonitis are of utmost importance for the timing of surgery. Treating only with antibiotics gives a possibility of not recurrent symptoms. Untreated appendicitis and partially treated also has its complications. So my opinion would be to be in touch with your doctor who can examine you to see signs." "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 itching inside my penis since three days. When I urinate, the itching gets increased and after urination, it subsides. There is no rash. Please advice. ### Response: Hello. Is it inside the penis or on the penis head? Do you have any other symptoms like fever, slow flow of urine, or straining to pass urine? Any history of recent sexual activity? It looks like a urinary tract infection at present. Waiting for your answers" "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 and I were intimate on the 10th of this month. I used I-pill on the next day. Due to that, I got bleeding on the 22nd which is my period date for four days. Now, I have cramps and back pain but not getting periods. Is it a sign of pregnancy? ### Response: Calm down. You already got your menses, but still, have cramps. It can be a side effect of the pill. Were your menses regular and was the bleeding normal bleeding as you have in your menses? Revert with more information to 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 29 years old. Since the last 10 days, I am having a serious red swollen tip of the penis with burning and stinging after urinating. Initially, I thought it might be because of UTI. So, my doctor had written for urine routine test and urine culture test which came negative. But the red swollen tip is still there and its burning. Ever since I got this, I am observing I am not having erection or urge of any kind. My doctor then wrote for CBC, PSA, sugar check (in case of diabetes), serum creatinine, ultrasonography of abdomen and pelvis. These reports came to be negative. He currently had given me Augmentin 625 Duo if there is any bacterial infection. I am worried as the tip of my penis is red, swollen, looking like lips and burning for more than 10 days now with no libido or morning erection at all. Please suggest me what to do. ### Response: I understand your concerns. I have checked all the attached photos (attachment removed to protect patient identity). Most probably, you have urethritis which may be caused by many organisms. I have two questions in order to exclude any serious infection: You should not worry as this infection is less likely to affect your erection, infertility or any other sexual functions. I suggest: Azithromycin 1000 mg capsule once daily for atypical organisms. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. Follow safe sexual practice all the time" "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 the NT scan at 11 weeks and 4 days and the NT was 3.3 mm. After that, I got the double marker test done which came back normal, with a risk of 1:624 for T21 and 1:685 for T13 and T18. I was asked to do the NT scan again and at 12 weeks and 2 days, the NT measured 2.8 mm. Also, the fetal heart rate which was 163 BPM at 11 weeks increased to 180 BPM at 12 weeks. I hope the results are normal. I do not want to do the amnio due to its associated risks. Is there anything to worry about? ### Response: Hello. I have gone through your query. However, if you have a doubt then get 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: I had a routine echo done a couple of weeks ago and just got the results yesterday. The sheet says moderate pulmonary hypertension with peak pressure 54 mmHg and central venous pressure of 15.0. Since I only picked up the results no one explained it to me but set up an appointment with lung and heart specialist in six months. What does all this mean? I am a hypertensive and pre-diabetic. Currently, I am on Lisinopril 10 mg. ### Response: This means pressure in the pulmonary circulation has increased likely due to lung problem (if echo is not showing any abnormalities other than this). Likely this is related to obesity although we need to rule out other causes of pulmonary hypertension by doing CT scan and other few investigations. Do you have shortness of breath, any other symptoms to suggest some cause? You should focus on healthy lifestyle and weight loss" "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: Today, I plucked a nose hair. I work in a hospital setting, so I guess; I am around with a lot of germs. I read that plucking a nose hair can lead to a cut and some infection inside the nose. Then, this infection can reach the brain and cause loss of vision, headaches and fevers. Is this true? If so, how easy would it be to get this infection from a plucked nose hair? ### Response: Hello. Your concern is correct. Plucking nasal hair can injure or break the skin or nasal mucosa leading to the root infection that may spread to the brain. The triangular area in and around the nose forms the dangerous triangle or dangerous area of the face. Due to special blood supply, it may lead to the intracranial spread of infection retrogradely through valveless veins that may result in meningitis or brain abscess or cavernous sinus thrombosis. It is not absolutely dangerous, but yes, if you are unlucky it may lead to folliculitis or nasal or facial infection and may spread to brain though rarely. Hence, do not repeat that. Use a clipper or scissors for that purpose. For now, you need not worry if you do not acquire folliculitis or nasal infection." "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 49 year old male. I have a constant problem of excess mucus in throat. I feel as my food pipe is inflamed. I cannot eat anything. Whenever I eat something this mucus problem gets aggravated. ### Response: I am trying to understand your problem with the limited symptoms you have provided. Now a days laryngopharyngeal reflux disease (LPRD) is a condition where there is feeling of lump or mucus in throat and the main cause is little acid reflux from stomach. If you do not have any pain on swallowing, any nose block or sinus infection there is high chance that you have LPRD. I would suggest you start on tablet Esomeprazole 20 mg twice a day for 15 days. Meanwhile get CT scan of nose to rule out sinusitis. Revert back after 15 days to 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 recently had an accident while cycling and twisted my foot. The foot is quite swollen. I have attached X-rays. Are any of the bones in my foot broken? What should I do to recover? ### Response: Hi. How was your day? I have gone through your query and the attached X-rays in detail and understand your concern. There seems to be an incomplete fracture of the midfoot bone which is the main cause of the swelling of the foot. The first thing you should do is get the foot plastered in a below knee plaster cast or splint for at least one month. Do not bear weight on this affected limb during this period. Keep the leg elevated over a pillow. You should take analgesic anti-inflammatory tablets along with proteolytic enzymes like Trypsin, Chymotrypsin or Serratiopeptidase. Supplements of Calcium and Vitamin D3 should help." "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 an abortion four months back. My period returned seven weeks later and ever since then I have been spotting randomly every few days. I was 13 weeks pregnant at the time of the procedure. Is this normal? If not, what could it be? There are no other symptoms aside from very very light cramping. Previous history of the same issue: I did have the Nuvaring before I got pregnant and was taken off of it due to an estrogen-induced stroke. I then tried the mini pill. Current medications: Sertraline. ### Response: Hi. Please ensure if you had a complete abortion or there are still bits of retained products of conception in your uterus by doing a transvaginal scan. Since it was a second-trimester pregnancy, there may be chances of RPOC, which can lead to irregular spotting or bleeding. In such case, you may need a D and C (dilatation and curettage) to get rid of RPOC. Secondly, Sertraline reduced the efficacy of birth control pills, and hence failure rate increases. So ensure to take additional precaution using condoms, if possible." "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 29-year-old female. I have low back pain with bilateral hiop and leg pain to the knees for several years. I have fibromyalgia, scoliosis and my left leg is 7m shorter than my right leg.My MRI result indicates:Large broad-based right paracentral disc protrusion at L4-5 and compresses the descending right L5 root and encroached on the descending left L4 root. The disc causes moderate to moderately severe central canal stenosis.Shall central protrusion at L5-S1 contacts the descending right S1 root. No nerve root compression is identified. Mild degenerative template signal L4-5 noted.Can you explain these to me in labor terms and suggest the most likely treatment options? I have don\t just about everything but surgery and chiropractic care have been the most effective but I have had chronic pain for years, sometimes debilitating. Is rather not have surgery but is it inevitable? My ana test is negative. I am currently taking Gabapentine. ### Response: Hello. Vertebrae has a central canal where the nerves from the brain run to reach the legs. At each vertebrae level, there is a shock absorber called the disc. Often this gets displaced due to the pressure put on it and it starts to put pressure on the nerves that run down the leg leading to what is called sciatica. You have a disc between number 4 and 5 vertebrae that is the source of your pain in the legs more so than your spine and lower back. You have not sent me the films for me to judge the actual size of the disc, not everyone requires surgery. You should be on Pregabalin 75 mg twice a day. You should be having physiotherapy or chiropractic treatment which seems to be working. If a good trial of six weeks to three months is over and you have more leg symptoms than back, then you need attention surgically." "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 has very tight tendons on the sides of his penis that cause pain with erection. He has attempted to stretch out the tendons, but they go right back, and he is concerned about damaging them. He gets relief from the pain when he presses down on the penis. He has also heard a popping noise. He saw a Urologist today and was told there was nothing wrong. Any suggestions? ### Response: During vigorous sexual activity sometimes there is a partial tear of the superficial layer of tunica of corpora cavernosa leading to such description. If he is able to achieve the erection with no ecchymosis, redness or blackening, it is fine. Ask him to share a picture of an erect penis in two directions." "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 23-year-old male, 5.6 feet, 140 pounds. So about two months ago I had to feed some puppies. They did not want to eat from the plate so I fed them by hand, their dog food. I always was an anxious person so I eventually thought about it. Read the ingredients of the dog food and read meat flour. My mind went straight for mad cow disease risk. I thought I am sure these dog food have spinal itssue, brain, bone in the meat flour mix. Did my research and I am correct. Many dog food companies do that. So it is impossible to get rid of every trace of dog food from my clothes, keyboards, pockets, etc. I already did that but you know I was not aware of these for the time I was feeding them.My question is, in the worst case how much time do I have before the symptoms start? First expousure might been two months or a month and a half ago. I am thinking of blowing my savings and traveling before the symtoms start and then after I confirm the disease, do not even know what to do. ### Response: I understand your concern and would explain that usually cows affected by this disease are isolated and their meat is not used in industry, but it is burnt under specialist supervision. Anyway, the period from the first contact with a mad cow product and the disease symptoms may be as long as 10 to 15 years. So just do not think about it. I am sure that nothing bad is going to happen." "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 19 years old. Can a Maryland bridge or any bridge move up, down, right or left? ### Response: Hope this answered your query. In case you need more clarification, you can reframe your question and get back" "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: 10 days ago I had oral sex with CSW while drunk. I visited the GP the next day who gave me PEP, now nine days. Yesterday, I saw a hairy black tongue and freaked out. Visited local clinic, was prescribed mouthwash and Miconazole cream and did HIV 1 and 2 antibodies, due, hep B and VDRL- all negative.Also saw a small purple patch on the right forearm. I am not sleeping, worried sick.I want to know the risk of HIV and if confirmed very low, what is probably going on with black tongue and a purple patch on the skin. Intend to get the HIV PCR test done in RSA on day 13. Please advise. ### Response: First, as per the history of 10 days contact, you will not possibly have HIV related symptoms. Second, the rash appears to be localized and not related to HIV or contact, it indicates local allergic reaction (attachment removed to protect patient identity). It resolves automatically or uses tablet Cetirizine. Finally, using PEP after exposure is very good and it nullifies any risk. There are no known cases of getting HIV, post PEP use. So, continue PEP as advised. You are negetive and have very low chances but they are nullified by using PEP. So, worry not regarding HIV." "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 fibrous dysplasia a life-threatening disease or just a cosmetic problem in the upper mouth? Can CT scan show the overgrowth of bone in the upper mouth? ### Response: Hi. I had gone through your question. I can understand your concern. It is not a life-threatening disease but, it is a cosmetic problem and may sometimes be a physiological burden that it may cause difficulty in certain functions like chewing or speech. You need to be in follow up with the dentist. Also, take a histopathology to rule out any unwanted lesion as early as possible" "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 the last four weeks before my period and after 25 hours, I drank ECP and bled after four days. Then, I have not gotten my period this month. I went to the gynecologist yesterday and she said that she saw a dominant follicle on the right side of my ovary which will almost rupture. So, here are my questions:What does this dominant follicle mean? Do pregnant women have a dominant follicle when they are actually pregnant?Am I only ovulating right now? Am I safe from pregnancy?After how many days from now should I expect my period to arrive? ### Response: Every woman, every month, produces an egg which matures and gets ready for fertilization. The mature ovum is called dominant follicle. No, pregnant women will not have a dominant follicle. Yes, you are ovulating now. Since your scan is clear, there is no chance of pregnancy. It usually takes 12 to 14 days from now to get your periods" "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 47 year old male, height 178 cm and weight 81 kg taking Olmesartan 40 mg for BP daily morning. Occasionally, I drink from two years and diabetic. My diabetic doctor had not prescribed any medicine and suggested exercise with diet control and I am doing so. Nowadays, I feel weak, pain in the neck, both hands, and shoulders during sleep position and low sexual interest as I live a bachelor\s life from the last four years due to my son\s education. My question is, can I take Vigorex after lunch? ### Response: Hello. I have gone through the message you have sent. The reason for hyposexuality is multifactorial" "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: Since the last two weeks, I am finding blood in stool when stool is hard and when I find hard to pass stool. It starts when I eat ginger or drink turmeric milk. Please suggest to me. ### Response: You may be suffering from constipation with internal hemorrhoids or fissure in ano. You have to avoid spicy food, low fiber diet. Use high fiber diet with plenty of liquids. Use Metamucil or Benefiber for stool bulk formation. Do regular exercise and yoga. If symptoms not improved you may use syrup Lactulose 30 ml after dinner for five days if necessary. He will examine and treat you accordingly." "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 30 year old male. My height is 155 cm and I weigh 63 kg. I am facing hair fall for one year. Now it is even more severe. Till last year, I was having dandruff problem also, but after mundan (hair tonsuring), there is not much dandruff but hair fall has not stopped. Below are the symptoms.I used to wash my hair once in 3 days earlier. But within 2 days, my hair becomes wet even without applying oil. Because of that reason, nowadays, I wash my hair once in 2 days. Because of any reason, if I do not have a hair wash for 3 to 4 days, my head smells very bad and becomes wet. I do not know about my hair type, so I used to change my hair shampoo frequently between anti-dandruff and anti-hair fall. I got married four years back. Till that time, there was no hair loss and I had not observed any baldness. My father has baldness but, he got it at 40 years of age. But now, it looks like I am in the final stage of becoming bald. I have attached pictures of the same. I travel to South Korea very frequently for a minimum of 3 months a year. This weekend, I am traveling to a foreign country, so I need to buy any medication for hair fall (if needed) before going. I want to know my hair type and remedies for hair fall. ### Response: Hi.I have worked through your query and have understood your health issues. I have gone through the pictures (attachment removed to protect patient identity), I assure you not to worry. This is the most common disease of men at this age. It is actually the male pattern baldness and you are lucky that you had noticed at such an early stage. It is stage 2 baldness and has just started." "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 complicated cataract RE with pars planitis. My doctor started conservative treatment and after two months he advised me to go for the surgery for cataract. I wanted to go with a multifocal lens in my eye to avoid specs after surgery. But the doctor suggested me to go for monofocal as the eye is having infection pars planitis. Is the doctor right to choose a monofocal or should I go for a multifocal lens? ### Response: Your doctor is correct in choosing monofocal as the amount of useful vision you will get would be less and the inflammatory reaction due to pars planitis may cause you to get lesser vision post surgery than what you had before it. Another option, however, is that you can wait for around three months after your pars planitis has resolved, and when there is no residual inflammation, then it is a good option to have multi focals implemented, provided your vision potential is good. 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 think I might have an yeast infection, I have thick white discharge, itching, and today the discharge is a little greenish. What should I do? ### Response: If its appearance is like curd, then probably it is yeast and you can take a single dose of tablet Canestein 150 mg to treat 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: These are my daughter\s bloodwork results that were done nine months back. I was never told about any of these results until I recently asked for copies of her medical record. This year she had irregular and heavy menstrual bleeding and developed a large hemorrhagic ovarian cyst with torsion, which had to be removed/corrected with surgery. Now, she is on Tylenol, multivitamins, omega 3 supplements, Colace (Docusate sodium) for constipation after surgery. Do these results show her to be at risk for any other issues/health problems? Should I seek a second opinion?Prothrombin Time: 13 secondsActivated Partial Thromboplastin Time: 32.6 secondsFunctional Protein S: 61% (L)Free Protein S: 92%Total Protein S: 106%Functional Antithrombin III: 140% (H)Factor V Leiden mutation: single R506Q mutation identified (heterozygote) (H)Coagulation Factor VIII Activity: 116%Von Willebrand Factor: 133% ### Response: Hello. Protein S deficiency causes an increased risk of developing blood clotting disorders mainly thrombosis. It can be hereditary or acquired. Acquired protein S deficiency is seen in liver disease or vitamin K deficiency. Your daughter is heterozygous for factor V Leiden mutation which further increases the risk of thrombosis and developing clots. It is advisable that you consult with a hematologist to determine if she might require any monitoring or prophylaxis" "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 22 year old female. Why does the area, which I believe is my ovaries, hurt when I stretch? The pain would be in both the left and right side. When I sit down for a long time or when I defecate, it hurts a lot in the area. During my periods, why do my legs go numb? Every month around the time, I experience leg numbness, back pain, pain in the butt area, and pain my stomach. I understand the stomach pain, but why do I have pain in other areas? When all this pain starts, I get panicked, as I do not know what to do. I try sitting down for a few seconds, which helps but then, my back pain starts. I try to walk, but the pain is not relieved.I start feeling sick and throw up. I start getting suicidal thoughts, and I just want to put myself out of this misery. When I take two painkillers for the pain, I end up sleeping the entire day and get up only to use the restroom. I do not eat, and I would end up going days without eating until I feel better. So, I just want to know what is the cause of this. This will help me explain my physician to help me better. I feel like this would affect me trying to go to work. I am trying to find a job, but I feel that if I take so many days off for the pain, my boss will fire me.I was thinking of getting a partial hysterectomy to stop it maybe, so I will have to deal with the pains, and I can stay on the job. But I am not sure if my insurance will cover it. Do you have any suggestions? Sorry for the long query, I just really need help. The last physician I had could not help me in the way that I needed help, so I stopped going to her. I need more of professional help. ### Response: Hi. From the history you have given, it sounds like something is affecting the neuromuscular area on both sides at the pelvic or may I say the deep groin area. Hope I have been of help to you, do write back. All the best" "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 20 years old. I have one kid and I am seven months pregnant. Since I started puberty, I got a lot of health problems. The left side of my underjaw is not fully grown. It feels like pieces are missing. You can also see the big difference between the left side of my chin and the right side. My cheekbones are also not fully grown. I have poor blood circulation and my face gets very very swollen. Mostly in the morning, my face looks quite normal and my skin color as well. Later, in the day, my face gets swollen and big and also when I eat and when I eat a lot and unhealthy it gets more swollen. When I lay down the swelling lessens. I also have mental stress and an anxiety and I have a scoliosis. I get tired quickly and my skin is very dry. I have dark or purple undereyes and dark patches on my ankles, knees, etc. ### Response: Hello. I just read your query. See the issues like scoliosis, underjaw shape, and underdeveloped cheekbones are anatomical issues which are related to the natural structure of your body. They can not be corrected with the help of medication. You may take help from artificial modern techniques, which you can learn from a nearby physician. The poor blood circulation, swelling on face, stress and anxiety, tiredness can all be related to pregnancy. I advise you not to take any random treatment or any supplement without consulting your gynecologist. This is the crucial time of your pregnancy. So visit a nearby gynecologist and ask for the help for all the issues you are having." "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 bad throat and unable to speak. I have started Augmentin 625 since yesterday with no relief so far. ### Response: Antibiotics usually take some time to show their effect. Since you have been started on antibiotics and anti-inflammatory medication from yesterday, finish the course as directed and you will be fine. If you feel ill after completion of course, then we will go for a chest x-ray and throat swab culture and sensitivity test for specific antibiotics to treat your infection. As such, Augmentin is a broad spectrum antibiotic (combination of Amoxicillin and Clavulanic acid). Meanwhile, do salt water gargling two to three times a 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 have done a gastric sleeve surgery before seven months, and I recently did a rhinoplasty surgery last month. Am I allowed to have Accutane 20 mg for a period of 3 months and will I gain weight from it? ### Response: Accutane also known as Isotretinoin prescribed for the treatment of acne used as a last resort if no other treatments are showing a promising response. Gastric sleeve surgery is not a contraindication to take this medication and it will not cause any weight gain. Although in some studies it has been noticed that Accutane is better avoided when a cosmetic procedure such as rhinoplasty is undertaken for up to a period of six months. Remember that your doctor has prescribed this medication because he or she has judged that the benefit to you is greater than the risk of side effects. 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 want to ask about halitosis. I already went to the dentist and the dentist said that the problem is not in the mouth and it could be in my stomach so here I am. I hope you can help me because I am at my wit\s end right now. How do I know if it is in the stomach? What should I do? I do not think it is acid reflux because I already take PPIs for more than one month and it seems to be still there. Please help me. ### Response: Halitosis or bad breath usually originates from oral or nasal passages. The cause of it is bacterial decay of residual food and debris. Most common causes of halitosis are periodontal diseases, dental caries, oral cavity infection, and coated or uncleaned tongue or decreased salivation. Other causes which are thought of after ruling out the above are a tonsillar abscess, any esophageal pathology which allows collection of residual food in esophageal like a diverticulum or motility disorder like achalasia. Lung pathology like lung abscess can also be the cause of halitosis. Gastritis due to H.pylori can also cause halitosis. Also, bezoars in the stomach can also be a 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 had stomach cramps and I have taken 17 different pills over two days. I think it might be a small over-dose of pills. Please help. ### Response: Hi. Self medications can be dangerous and can risk the lives. It is better to get liver function tests done to assess the extent of damage to liver, though risk is minimal in your case." "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 a slight pain in the left side of my chest while taking a deep breath. Can you help me with the medicine to cure this pain? ### Response: I had gone through all the data posted. We need more details of the problem. 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: My 3.5 year old daughter has irregular bowel movements with a recent problem of mucus in stool. Earlier also, she did not poop regularly. I use laxative when she does not poop for two to three days consecutively. Recently, she has a problem of mucus in her stool for approximately a month. She always complains of pain or cramps around her navel before a bowel movement. I got an ultrasound, which revealed that she has a mildly enlarged liver. When I consulted a local pediatrician, he stated that mild enlargement of the liver might be there in children, and nothing has to be done. He prescribed a medicine named Livosil B. We used it for 2 to 3 days, but my daughter is still suffering from irregular bowel movement and mucus in stool. Please help me. ### Response: Hello. Kindly answer these questions for a better understanding of your child\s problem. Regards. Revert with more information to 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 had brought a blackhead remover which includes a stainless steel needle with a blunt tip and a loop online. I used it carelessly without cleaning it yesterday. Now, I am scared to death of contracting HIV from it. Please help me. ### Response: Hello. HIV (human immunodeficiency virus) cannot survive for long outside the human body. It is unlikely that using a comedone extractor without cleaning could spread HIV. Kindly mention if there was any bleeding when you attempted to remove the blackheads" "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: This is regarding my 16 years old son. He is currently in class 10 and giving his board exams. He is academically oriented, has been always good in studies and wants to maintain his good image in front of his peers and teachers. Since last two months, he is having a few problems as follows:He is having problems in his eyes and feels that his attention is drawn to his blinking and he has to blink consciously as he feels his automatic blinking does not happen. If he does not consciously blink his eyes start watering and irritating. He feels this is affecting his concentration in studies. I had shown him to an eye doctor a month back and he said it could be due to dry eyes and prescribed teardrops which he is using regularly since then, but there has been no improvement. Moreover, my son feels it is a problem with his mind and he is not able to get his attention off the blinking of his eyes.Not sure if there is a connection, around two months back he was reading the chapter of involuntary and voluntary actions of the human body in his biology book and that some actions are both voluntary and involuntary. He says his problem started around the same time. He also says that he feels suffocated and often needs to breathe voluntarily. He read about it in the same chapter.He also says that he has to swallow his saliva consciously or voluntarily, something he read about too in the same chapter. Overall he complains more about his eye problem and little less about the above two problems. He is an only child. He does not open up easily but once he does he talks a lot. At home with us and with his few friends at school, he talks a lot. He loves to follow sports. He is not very active but has a normal height (5 feet 8 inches) and weight (65 Kg approximately) for his age. He is myopic since the age of 9 and has the following approximate power: Left eye: -5.5 spherical and -0.5 cylindrical, right eye: -6 spherical and -0.75 cylindrical. We give him nutritious food at home and he is not fussy about food. He has a regular sleep schedule of around 7.5 hours at night. He is worried before going to sleep that he will not be able to sleep due to conscious breathing problem but he does fall asleep and sleeps well after that. Also, he is afraid of lizards and feels that he suffers from the phobia of lizards. He does get scared of insects very easily. Please advise. ### Response: I read your query and understand your concerns. From the available description I do not think it is serious problem and diverting attention from the areas of concern should be the prime strategy. In case the simple measures of diverting attention do not help him I feel seeking opinion from psychiatrist should not be delayed. The description clearly indicates that there is anxiety problem, the child is more conscious about his body, have a neurotic pattern of thinking. However few of them may need medication for a certain duration depending upon the severity and response. 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: My wife was suffering from thyroid. TSH value initially (eight weeks pregnant) was 4.98. Now all the tests are good. We are using Thyroxine tablet early in the morning. After 10 days, once again we went for the test. Now TSH value is 4.5. Can you please explain is there any problem occurring to the baby in the womb? ### Response: Hello. Your TSH (thyroid stimulating hormone) is 4.5 which is within range. But in pregnancy, thyroid hormone requirement is increased and so it is advisable to maintain TSH between 2 to 3 in a hypothyroid patient. In pregnancy, TSH monitoring is advisable at one monthly interval. You can increase the dose of thyroid supplement to bring TSH more down. I suggest you consult an endocrinologist for examination and get prescription accordingly." "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 22 years old. I experience heart palpitations with a skipped beat for three years. When I exercise (run), I experience heart palpitations and I cannot breathe freely and naturally (exercise intolerance). I consulted a cardiologist and he says nothing is wrong with my health. After taking echo, I noticed mitral valve prolapse in that echo but he says it does not require treatment but I do not know whether my problem is due to this mitral valve prolapse. Should I take any medicine? How to cure it? ### Response: Your symptoms could be related to anxiety. I agree with your doctor that mitral valve prolapse is not a serious medical disorder. Anyway, it can trigger ectopic heart beats especially during straining physical activity. Anyway, if the problem persists, I would recommend performing an ambulatory 24 to 48 hours ECG monitoring and some blood lab tests. If all these tests result normal, you should consider anxiety as the main cause of your complaints" "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: What does my MRI results mean? Severe mid-back and lumbar back pain, numbness in hands, muscle cramps in legs, constant pain. ### Response: Hello. I read carefully your MRI images (attachment removed to protect patient identity) and would explain that these images indicate just chronic degeneration of the vertebral column. There is no disc herniation or compression of spinal cord. Coming to this point, I would recommend performing a physical exercise to help against chronic back pain. I would like to see more images of the cervical vertebral column. Could you please upload the MRI report for a more professional opinion?" "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 and I had unprotected sex 11 days after her period started. She took an I-pill within an hour of the act but she has not experienced any withdrawal bleeding even after six days. Is it normal or is there any chance that she is pregnant? ### Response: I have gone through your problem and understand your concern. Your partner is unlikely pregnant, as she has taken I-pill within one hour. Remember, that I-pill has a failure rate and is not 100 percent foolproof. So, keep continue watch, do urine pregnancy test on or around 17th." "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 unprotected sex with a girl, but a sperm has not come because I was inactive as I have drunk. This happened last month. After 23 days, I had RNA PCR, and ELISA both came negative. Then after 7th week, I had antigen, antibody test, which came back negative. In the 10th week, I went for Elisa test 0.4, and it was non-reactive. After completion of the 11th week, I went for Tri-Dot and that also came negative. Should I wait for one week, or is it sufficient for me? Please help me to come out of this situation. ### Response: Hello. Guidelines says that you should repeat the test after 12 weeks of exposure, but because you have undergone test many times, you are almost sure that you do not have HIV. But it is better to repeat once after 12 weeks. You need not be anxious as most likely it turns to be negative as there is no hint of any symptoms and on previous test results." "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 it possible that anxiety causes episodes of bradycardia? ### Response: But bradycardia can be found in a person with anxiety disorder because of other factors: If you are taking beta-blocker class 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: I am a 35 year old with no heart problems, not taking any medications, no known inflammation, no abnormal body temperature, no allergies ever. Overnight, I only sleep 3 and a half hours maximum, and when I wake up my t-shirt is all wet like I was running a marathon. My eyes are red in the morning too. This has been going on for the past 30 days. ### Response: Increased sweating without any predisposing factors such as cardiac problems or any medication-overuse, but associated with eyed issues, can be a sign of increased thyroid gland activity known as hyperthyroidism. Associated symptoms include increased appetite, loss of weight, diarrhea, intolerance to high temperature, tremors of hands, etc. There may be increased pulse rate in this condition. You may need to get thyroid function tests which assess thyroid hormone levels which can diagnose the condition. If thyroid function test is normal then anxiety can also present similarly. You need to consult a physician or an endocrinologist for detailed clinical evaluation to identify the exact cause of your symptoms" "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 and I had unprotected sex 10 days ago. She took an I-pill the very next day. Two days after the first sexual encounter, we again had sex and she again took an I-pill the very next day. Her LMP was a week before the first sexual encounter. She is also having a vaginal infection. Will she get pregnant? Will she get her menstrual periods on time? ### Response: Hello. Since you have taken an emergency pill within 72 hours of intercourse, there is no chance of pregnancy. She can have late or delayed periods because of hormonal changes due to the pill. But definitely, she will be getting her periods." "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 I undergo a dengue test even without a fever? Been feeling sick intermittently for like three days now. I would suddenly feel sick like as if I have an illness, and I can feel it in my body. But every time I check using a thermometer, it will only show an average temp like 36-degree Celcius. It has been on and off feeling sick. ### Response: I have read your query carefully, and I want to suggest you that for your current symptoms dengue test is not necessary. You can undergo a dengue test if you have one of the following symptoms with fever, nausea, vomiting, rashes, aches, and pains (eye pain, typically behind the eyes, muscle, joint, or bone pain). For your current illness, please take these medicines, you will be fine. 1. Tablet Dolo 650 (Paracetamol) twice daily for five days. 2. Tablet Azithromycin 500 mg once daily for three days. If you want to go for a test, then please prefer CBC (complete blood count) and submit your report." "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 attention deficit and disturbed memory problems. It affects the speed of my work. Presently I am taking tablet Fenofibrate 145 mg once daily and tablet Avital once daily for high triglycerides and disturbed lipids. Kindly suggest a treatment for my above problems. ### Response: Hi I have thoroughly read your query. But only with this much detail of symptoms, it is difficult to reach the diagnosis. So, please elaborate on your symptoms and answer a few questions. Revert back to me with the following answers, so that I would be able to help you better." "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 one sided throat pain for a week now when swallowing, usually have cobblestone appearance on the back of the throat, now my throat pain is slight and maybe more on to the side of where this lump above my tonsil appeared. What does this look like? Could this be a tonsil stone? ### Response: It appears more like a cyst within the tonsillar tissue. If no symptoms then we can leave it as it is. But since you have pain with congestion and cobblestone appearance of the posterior pharyngeal wall, I suggest you take some decongestants and Tylenol. Try for a few days and review with us with a fresh picture. Please do some warm saline gargles also. If you feel better in a few days then you may continue the medicines for five days and stop. But if no improvement then you may need antibiotics or a culture swab and then antibiotics." "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 experienced difficulty in retracting the foreskin and pulling it down over the penis head (mild phimosis). With difficulty, I manage in 10 minutes. Do this fornightly to clean the penis. I wish to avoid circumcision and understand the application of Lignocaine gel will help. Should I apply it on penis gland or head or on top of the foreskin? ### Response: Hi. I can understand your concern about your symptoms. The application is a local anesthetic. Wherever you have pain when you retract foreskin (mostly skin will have pain). You can apply Lignocaine. You cannot apply Lignocaine inside of your foreskin since you have phimosis. So the external application is only possible. Considering your age, kindly rule our other causes of phimosis. Keep blood sugar under control and take antibiotics and apply the local moisturizing gel." "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 46 years old male. I have a weight of 60 kilograms and a height of 164 cm. I am diabetic for the past ten years. I have an Hba1c of 8.3 %, with no other health issues. I do exercise regularly, and I am taking a healthy diet every day. I am using Gemer 2 mg twice a day, and I am unable to bring Hba1c below 7.5 %.I have an FBS of 130 mg/dL and PBS of 220 mg/dL. Sometimes, I sweat in the morning. When I check my sugar levels, I have an FBS of 120 mg/dL. I am not interested in increasing the dose of Metformin to 1000 mg twice as a concern of weight loss. Would a change in medicine help me to reach my Hba1c target? Please advice. ### Response: Hi. You are taking Gemer 2 mg (Glimipride with Metformin) twice daily. Please say whether you take Metformin alone and tell about the dose. If you are on Gemer 2 mg only, then you can take Glycomet 500 mg (Metformin). You do not need to begin with Metformin 1000 mg directly. Diet and exercise help you a lot. Loss of weight will help to control sugar levels better. Your FBS (fasting blood sugar) is fine. Your PBS (postprandial blood sugar) level is high. So, I suggest controlling diet. If there is no improvement, you can consider taking Metformin." "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 16-year-old male. I have tonsils. What is the treatment for it without surgery? Homeopathy is required. ### Response: Hello. I am guessing you are having repeated episodes of tonsillitis, where you have been given antibiotics. Maybe your doctor has suggested surgery. There are some effective Homeopathic remedies for tonsillitis. You can take: 1. Baryta Carbonica, 6x dosage, if you have chronic enlargement of your tonsils. 2. Belladonna, 30c dosage, if the tonsils are extremely red and there is a lot of inflammation with fever. 3. Mercurius Vivus, 30c dosage, where there are pus and foul-smelling breath. Try the one that matches your symptoms best. Take a dose every hour of your chosen remedy, and if there is an improvement, give another dose, up to four doses. It would be helpful if you consult a Homeopath in your area, who could look at your tonsils and help you to find the best remedy. For the prevention and treatment of tonsillitis, you can take a naturopathic remedy called Berberis Formula by Genestra, which you can likely order through your local health food store or order online. It prevents and treats bacterial infections. At the first sign of tonsillitis, take two capsules, twice a day until the infection is gone. Or, if you cannot easily access this medicine, you can take Goldenseal tincture, (in" "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 been taking my antidepressants (Escitalopram), and I had a breakdown in front of my family who do not know anything about my depression, suicidal thoughts, and OCD. And I am currently locked in the bathroom and cannot stop crying, and I cannot see my therapist in a month. Kindly help. ### Response: Your present condition may be due to not taking medications, it aggravated. Besides, the problem you are facing cannot be hidden from close relatives, especially family members. It is a part of you, which cant be ignored. And believe me, they will accept you as you are because they love you much. By some insight, they will get to know about the problem as well that it is manageable with adequate therapeutic interventions. Sometimes it is good to have some people by your side, and I am glad you have some who would truly care and understand you. Be strong, you have come much far and took all the burden on your own." "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 acid erosion or decay in the back of my bottom front teeth. They are chipping at the gumline. I have a past history of bulimia and although after years I have finally recovered. Long ago, I have had decay in the back row. What is a good home remedy for now that I can use? I am currently pregnant. So I cannot go to the dentist for X-rays or anything such. Please help. ### Response: Hi. I have gone through your question. I can understand your concern. I will recommend you to brush your teeth twice daily after breakfast and before going to bed. You can visit a dentist but keep in mind do not go for any X-ray but there is no problem with filling (dental restoration) (attachment removed to protect patient identity). Use ultra soft toothbrush because erosion of teeth increases more and more abrasion too. So do not use a hard toothbrush and also limit your tooth brushing up to 2 to 3 minutes only. Avoid painkillers during the pregnancy period and use desensitizing toothpaste if you feel any sensitivity." "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 want a professional and honest answer. I suffer from anxiety and OCD. Yesterday, I was dealing with patients post them having cosmetic injectables. There was pinpoint blood from the needle insertion points. I am thinking the worst case scenario and not saying this happened, but my mind is playing with me - what would happen if I then applied makeup to that person with a brush and double dipped into the color without sterilizing, then used the brush again on another person and so on? Could that contract an infectious disease? I am worried sick. ### Response: Our main concern here is regarding the transmission of HIV (human immunodeficiency virus), hepatitis B and C. Now, in the scenario you are explaining, it is less likely for any virus or infectious disease to transmit to other, but small risk of transmission remains. There are two reasons. Considering you are applying makeup on intact skin, so in that case, it is unlikely for any infection to transmit. Secondly, if you are applying it on the skin where you have given injections, then a small possible risk is there, but risk is further reduced by the deactivation of viruses by colors. So overall, there is a minute risk may be less than 0.1 percent, which is really small. So, I think you should stop worrying about it and use a separate container from next time. Hope this clears your doubt and get back if you have any doubts" "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 21 years old. For the past two months, I have been experiencing pain while urinating and I also have pain when my bladder is full. I had taken a urine test and the test said I had an infection for which I was given antibiotics. The pain has come down, but a mild pain is still persistent. I took a urine culture test later. The report said there were no bacteria. Then, I had an abdomen and pelvis scan done. The report was normal. But still,I am experiencing pain. Please help. ### Response: Hi. Usual causes of such symptoms include urinary tract infection (UTI) or urinary stones (renal stones). When routine tests turn out to be normal, a frequency volume diary may be made. Next would be a urine flow test and a sonography for residual urine volume. If these are normal and pain persists, cystoscopy can be performed in office settings. There are certain diet and behavioral changes to be made and some medications which will help cure BPS. Consult a urologist online with the reports of the above-mentioned tests" "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: How many hours of sleep do I need as a 17-year-old? Are six hours of sleep enough? What happens if I sleep eight hours per day? Does my brain become more active or dull? ### Response: I feel that one should not sleep less than seven hours daily. This is the minimum to maintain a healthy mind and body. And also, you will not feel sleepy in the day. The brain becomes more alert if you sleep about eight hours a day, but it also depends upon the work and activity that you do" "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 redness in the foreskin and glans which becomes bright red when subjected to friction and becomes normal or very light red. This redness comes and goes often. It has been there for a year and above. I took all viral tests and it is negative for all. I used Candid B ointment with no results. It is still the same light red in glans as seen in the picture. Sometimes, foreskin becomes red then and there and disappears without any clue. 1.5 years before I had oral sex and got sharp teeth scratch in glans for which I doubted and took tests but it is negative for all the parameters and sugar is also normal. Kindly advise in this regard and what should be done for the redness to disappear. ### Response: There are no active lesions in the photos. There will be some amount of redness with friction. Do not worry about it much. It appears there are no symptoms like itching. Avoid friction or irritation. Do not do forceful masturbation. Avoid using harsh soap or cleanser. Do not wash too frequently. Wash the area twice daily with warm water. You can apply the Candid (Clotrimazole) cream twice daily if too itchy or redness." "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 periods are delayed by a month and was prescribed Regestrone 5 mg twice daily for three days. How soon can I expect to start bleeding and is it normal to feel nauseous after taking that dosage?Until when is it legal to get an abortion for a woman without any complications or failed contraception? ### Response: As you asked, yes, it is common to have nausea after taking Regestrone pills, as it is a hormonal pill. Your periods will stop only after stopping the tablet and should be getting any time between 7-10 days after stopping it, as it varies from person to person. MTP (medical termination of pregnancy) can be offered till 24 weeks of gestation, if the pregnancy is assumed to be constituting grave injury to the physical or mental health of the woman. Although they have not clearly mentioned, as the scenario you mentioned, any unwanted pregnancy (arising due to rape or contraceptive failure) can be a grave mental injury to a woman. Also in your scenario, I would like to know, why would a woman consider a termination of pregnancy at an advanced gestational age, if neither there were any complications nor it happens due to contraception failure. But one needs to get it approved by two registered medical practitioners for going ahead with the termination of pregnancy. 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 taking 100 mg Tramadol and 60 mg Priligy (Dapoxetin) for the treatment of premature ejaculation before having sexual intercourse. The result is my intercourse time has increased from two minutes up to 45 minutes without having ejaculation. With Priligy or Tramadol alone it is around a maximum of five minutes. My question is, can this dosage combined cause serotonin syndrome or is the dosage still at a moderate level? Would it help to reduce the risk if I reduce Tramadol to 5mg and Priligy to 30mg? ### Response: My advice to you would be a safer way out. You should continue with Dapoxetine 60 mg and avoid Tramadol. If you do not get adequate time, then add up anesthetic jelly. You need to apply it on your penis 20 minutes prior to intercourse and wear a condom. You would get a wonderful time I am sure of that. 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 this skin condition called pityriasis versicolor. My regular dermatologist prescribes a single dose of Fluconazole 450 mg and it recurs after a few weeks or months. Could you suggest something better to me like a skin cream? ### Response: I have seen your query. I suggest using topical Clotrimazole cream local application twice daily and use 2 % Ketoconazole shampoo applied once daily for three consecutive days per week till the clearance of lesions. Other oral antifungals in case of relapse are Ketoconazole tablet 400 mg once per month or Itraconazole 400 mg once a month for six months can cure the disease. Consult your specialist doctor, discuss with him or her and start taking the medicines 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 drank alcohol last night. Since morning, I am vomiting everything that I am eating or drinking, including water. I had Ondem, but still, I have vomiting sensation. Please help. ### Response: Hi. If Ondem (Ondansetron) also not helping, then it is suggested to get a saline infusion. You may try mouth dissolving preparation of Ondansetron and Pantoprazole. Heavy and sudden alcohol may cause pancreatitis. Take it seriously as no water intake will make it worse." "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 pressure pain in the head, sometimes back and neck pain. MRI findings says right maxillary sinus retention cyst, also, mild chronic sinus inflammatory changes are noted. What does that mean? ### Response: Hello. It means that you had mild sinusitis (sinus infection) for a long time. The changes are prominent at the maxillary sinus. The maxillary sinus is an air-filled bony space below the eye and front part of the cheek. Retention cyst means that due to the long-standing infection, the secretions from the mucosal lining of air-filled bone space have been collected and formed a fluid-filled bubble-like structure. If you have some symptoms, it needs to be treated. If you do not have any symptoms, you can forget this findings." "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 30-year-old male. I had cheek biting on the left side and left upper wisdom tooth was removed a month back. After that, cheek biting has subsided. Now, I have noticed white line and patch adjacent to lower left wisdom teeth and some white dots over cheek. Near it, there is no pain. Similarly, I have mild cheek swelling on the right side and white spot on the right cheek with no pain. Can you suggest the management without tooth extraction? I am enclosing my OPG and photos. Please give your advice. ### Response: The white patch and line seen on the buccal mucosa may be due to the cheek biting. The upper left wisdom tooth has been extracted hardly one month back. It will take another 3 to 6 months for these white patches to disappear. If it still persists, do trimming of the sharp cusps of other third molar teeth or extract them. Traumatic keratosis" "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 HbA1c ie average blood sugar level of the last three months is 7.3. I am taking Janumet 500 mg twice daily, but recently my morning blood sugar level in empty stomach is always 140 or more. Why? ### Response: Your present values are a little high. Let us make two changes. 1. Please make tablet Janumet 50/1000 mg (Sitagliptin and Metformin) twice a day. 2. Add tablet Empagliflozin 25 mg once a day before breakfast. Recheck your fasting and postprandial after 15 days and let me know. Add some antacid tablet if you feel bloating or gaseous distension. Please consult your treating doctor, discuss the suggestion and take the treatment with 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 am a 55-year-old man. I have been suffering from depression for the last five months. I have been feeling tired and hopeless. I want your help for recovery. I am currently on Fluvoxin 50 mg BD. ### Response: I understand your concern. Depressive disorder or depression is a neurochemical disorder. A suicidal tendency is one main symptom of depression. You should be able to distinguish between mental disease and mental disorder. Your problem is a mental disorder and not a mental disease. These mental disorders are usually treated with a combination of medicines and other modalities like awareness, meditation, psychotherapy techniques, lifestyle changes, etc. Regards" "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: 3 to 4 years ago, I remember myself being very flexible, but now I am not. I play hockey five days a week and I am very active. Legs are not flexible and suffer from cramp a lot. Similarly, my lower back always seems to have knots and always aches. I also suffer from shin splints a lot (very common). Please, can you tell me how to prevent these things and increase my flexibility? Aside from this, I have started to lift weights, to try to build up biceps. My wrists seem to hurt whenever I do it meaning I have to stop. Is there any other way of building biceps or is it something else which I am not doing right. ### Response: You are playing a very active game that requires stamina as well as muscle strength. You need to check your thyroid profile, calcium level, 25 (OH) vitamin D level, serum electrolytes, etc., to comment further. If no specific cause is found, then you should take a high protein diet and under physiotherapist guidance, muscle building exercise can be 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: What can I do to increase my height? Does dancing help in increasing height? ### Response: To increase your height, you should eat a healthy diet and more fruits. It is advisable to do regular exercise like cycling, walking and running. Dancing does not help much in increasing height. You have a young age, and your height will increase gradually. If there is no improvement in height, then you can consult a nearby doctor and check your thyroid hormone profile." "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 is 20 years old, female. Before some days ago she was sense less on a train and then this again happened with her. She consulted a doctor and he says that she is suffering from the first stage of conversion reaction disease. But the doctor could not suggest any medicines but he says that the last stage of this disease is paralysis. Doctor says to my friend that do not take any tension and to keep her mind free all the time. She was feeling weak what will she do? ### Response: Hello. I have read and completely understand that you feel quite concerned for your friend. As you have mentioned that she has been diagnosed by the doctor as having conversion disorder, it is quite probable that she may undergo these conversion attacks at any time. There are purely psychological reasons behind this disorder, no medical cause lead to this condition. Therefore, generally, no medical treatment could be found a cure for these attacks. If the doctor has suggested this diagnosis after complete assessment then there may be no further need for the tests. If complete testing has not been administered yet then you may go to a psychologist for confirming the diagnosis after keenly observing her medical test reports. Needs to be differentiated for the types of conversion disorder according to the DSM-5 (diagnostic and statistical manual of mental disorder) criteria. Conversion disorder. Generally, no particular medication is prescribed for conversion disorder. However, some doctors may suggest medication after observing the patient\s current condition (beware these medications would reduce anxiety or tension but would not cure the conversion disorder). The effective treatment for conversion disorder is found to be psychotherapy. Consult any psychologist or psychiatrist specialized in conducting psychotherapy sessions. Or you can suggest some online consultation sessions. Treatment mode can be cognitive behavioral therapy plus psycho-education. Must take expert guidance on how to deal with the patient behaviorally. Family members, closed ones of such patients also need guidance because their mishandling can increase the frequency of conversion attacks. Do take follow-up if you feel the need." "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 was about six years ago, and I was giving oral sex to a guy. During it, my teeth cut my lips. He did ejaculate in my mouth, but I did clean out my mouth immediately. On two other occasions, he came on my vagina, no penetration and cleaning took place. He was my first sexual partner outside being molested as a child. I do have a history of cold sores. He is straight. What are the chances I contracted HIV? ### Response: The chances of transmission of HIV by unprotected oral sex is almost nil in the scenario mentioned. The chances are also almost nil if there is no penetration (skin is an effective barrier). It may be better to go for HIV antibodies tests to be totally relieved of anxiety. The chances of HIV tests coming positive is almost nil. Herpes can be transmitted by skin to skin contact or by intercourse or kissing." "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 ago, I felt a pop while playing football. My physiotherapist said Ihave torn my cartilage and so, he advised me to take rest. It felt good. After 18 months, when I played football again for some half an hour, I felt the pain. So, I visited a different physiotherapist, and he advised me to go with some exercise for a 4-6 week every day. I am visiting him every week. While playing in the pool on Friday, it gave way again, and I could not straighten my legs. ### Response: Hello. As you had this injury persisting from 2 years now, I will advise getting a proper examination with the physiotherapist you been seeing for now and provide me the reports. Because the muscles must have got weaker and there will be a muscle imbalance due to which there is difficulty in straightening the leg now. I think an MRI of the knee will be helpful as in the beginning what I feel is it was left untreated and due to which it has become a chronic injury. Doing balance board training should help regain the correction of the muscle imbalance. Also, do reverse jogging and provide good core stability exercise. In my clinical practice of over 12 years, most sports injury cases take up to 12 weeks which has helped them to have a good outcome score." "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 intense shocking pain around the bottom two teeth from a partial denture with wires. My X-rays show no cavity. I suspect enamel erosion. I have only five teeth. Do you recommend Valplast partials, teeth bonding, using fluoride, or another option? ### Response: I have read through your complaint and the relevant details. I suggest you consult a dentist for a thorough check-up and choose the new dentures wisely" "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 flavored hookah injurious for our health or not? Please suggest me. ### Response: Hello. Yes, it is injurious to health. However, it is considered less injurious than direct smoking, but still, it can cause all the harmful effects as that of smoking. So if you are concerned regarding health, then it should be avoided" "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 really spaced out and detached from my surroundings. It is like I am in a dream. It is like there is a glass between me and the world and everything just seems really surreal and far away. I also have a lot of brain fog. Some memory problems and confusion. I feel like this all day long, but it gets better and worse throughout the day. I have been experiencing this for about a month now. I have had a blood test, neurological exam (done by a family doctor and not a neurologist), and a brain scan that all came back normal. Does this sound like something could be wrong with my brain? ### Response: Hi. I read your query and understand your concerns. I hope this helps you. If you have more questions feel free to write 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: I recently (a few hours ago), had my finger hurt by a pan really hard. A part of my nail has turned black and the remaining part is a healthy pink. I have a throbbing pain. Will it heal on its own (growing the fingernail out) or will the nail turn dead and fall off? ### Response: If your fingernail is totally black, it will fall off automatically within one or two months. Since it is half black and is paining severely, it is advisable to visit a surgeon. A surgeon will assess the condition and will do the needful. The blackness is due to necrosis and can lead to infection if not treated on time. There are chances of bone involvement which can lead to complications. Meanwhile, you can start taking Amoxycillin-Clavulanic acid 625 mg twice daily for 10 days to prevent the spread of infection." "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 suffering from frequent urination for the last two days and slight pain in the left side abdomen. The urine test found 10-15 hpf RBC and the USG report came back normal. What does this mean? ### Response: Hi. I suggest the following treatment. Please consult your specialist doctor, discuss with him or her and take treatment with consent.1. Tablet Tamsulosin 0.2 mg.2. Tablet Tolterodine 2 mg at bed time.3. Syrup Noculi B6 (Potassium citrate) two tablespoon with half glass water twice daily for seven days. Revert after 15 days to a urologist 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 blood pressure is 140/90 since one year and I am using Telmikind 40 tablet in the morning. Today, I visited the cardiologist and he suggested 2D echo and ECG. The reports show mitral valve has AML prolapse and no MR. Kindly clarify this. Is something wrong? I am attaching the reports. ### Response: Hello. I have gone through your reports (attachment removed to protect patient identity). Your ECG is normal. In the echo, there is AML (anterior mitral leaflet) prolapse, which means there is slight backward bulging of the valve leaflet. This is mild and there is no leakage in the valve. The risk associated with this is of valve leakage called as mitral regurgitation and it is not there. In most of the individuals, it is benign and does not lead to any complications and some may develop leakages. In you, it less likely to develop leakage as it is not there at present. So, nothing to worry about it now, but get an echo once in three to five years just to keep a check over it. Hope this helps you and get back if you have any doubts" "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 every erection without orgasm, my testicles start hurting along with abdominal pain. Kindly advice. ### Response: Testicular pain after erection may be a signal that you are having epidydymo orchitis because the epididymis and testicles are the organs where your sperms are stored and produced respectively. So if the pain comes when there is a history of trying to ejaculate that may suggest inflammation somewhere in these organs was there a previous history of STI (sexually transmitted disease) before this incident, pain from the testes is usually referred to the lower abdomen. We also need to be mindful of testicular torsion.I advise you to do urine MCS (microscopy, culture, and sensitivity), semen analysis MCS then scrotal scan to see the testicles anatomically for any scarification." "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 48-year-old male. My eyes and the entire area around my pupil have become red. They are hurting me a lot. I went to a doctor, and I was diagnosed with conjunctivitis. I was given Erythromycin ointment to get relief, and I am not feeling better. The area around my eyes is swollen. I am sensitive to light, and it hurts me a lot when I strain them. I do not have this problem before. I am not hypertensive, and I am not diabetic. ### Response: Hi. I have gone through the images (attachment removed to protect patient identity). You have infective conjunctivitis. Erythromycin eye ointment is an antibiotic ointment that helps to get relief from this condition. But it will take some time. I cannot say whether it is viral or bacterial. If it is viral, the disease will get relieved in 10 to 15 days. You should do cold compresses three to four times a day in both the eyes. You should not touch household items too much as it can spread to other members of the family." "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 an STD test done five or six days after unprotected sex with a new partner. The tests came back negative, but I have learned that you should wait for different windows of time before getting tested for certain STDs. This was about seven months ago. Today, I went to my gynecologist to get tested again (for chlamydia and gonorrhea) to ease my mind. She said that the original tests were likely accurate given that just barely enough time had passed to be tested, but suggested to get another test for peace of mind. I did not think, until after my appointment, to ask if the Doxycycline I am currently taking for my acne (100 mg, twice daily) would alter the results? I am wondering if the results I get in a week\s time will be accurate? And if you think the original test was likely accurate in the first place? ### Response: Hello. I have gone through your history and understood your concern. As the incubation period of organism are different in every infection usually first test should be done after 10-15 days of exposure as your is done little early. But as you are not having any other symptoms along with this we can rely on your test results. But Doxycycline may affect the test results." "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 27 years old female. I am taking Dronis 30 mg from the last month. My period cycle is 27 to 28 days. But, I was getting my period from 30 to 32 days. Is it normal? This time, I got my periods after 37 days. Is this normal after taking Dronis or is it irregular? I am also trying for pregnancy. ### Response: You will not become pregnant if you take it. You should stop it if you want to become pregnant. The cycle is normal when it is from 21 to 35 days. Nothing to worry. If you have irregular periods, do serum TSH (thyroid stimulating hormone) and serum prolactin on empty stomach tomorrow morning and let me know your report. If you have any hormonal imbalance, it can be corrected with medicine and your periods will be regular and you will become pregnant. Also, do USG pelvis by transvaginal scan to see if you have PCOS (polycystic ovarian syn" "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 baby is having a fever. Morning around 8 it was 100. I have given him Crocin. Around 12.30 his temp was 101.3. So I have given him Meftal P. Now (5.30) again the temperature is 100.3. What should I give him now? Crocin or Meftal? What should be the time gap? ### Response: Hello. I got your concern. Initially, it looks like a viral fever. Let us wait and watch for the pattern of fever. Yes, for fever, if less than 100 F, do just tap water sponging all over the body. If 100 F to 102 F, give Paracetamol as and when the fever comes with a gap of six hours between two doses. If fever is more than 102 F then give Meftal with a gap of eight hours between two doses of Meftal. Avoid Meftal as much as possible. Give more food and more liquid. If he is dull, not taking orally, then go to the doctor." "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 burned myself with a curling iron. It did not appear bad at first but a scab is forming. Will the burn leave a scar? ### Response: I have gone through the clinical images (attachment removed to protect patient identity). It appears to be a superficial burn but there is a risk of a superficial scar. It will not be very prominent and can go with time as you grow. I suggest you apply some ointment like Polysporin (Polymixin and Bacitracin) twice a day for early healing, prevention of infection and subsequent prevention of scarring. Usually, burns which heal within 10 to 14 days hardly leave any scar. Do not apply any steroid-containing ointment. I suggest you get yourself examined by a local dermatologist for better care. Hope this helps you and get back if you have any doubts" "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: Dear doctor,I am taking SNRI/ SSRI for around 20 years. Five years ago, my general anxiety got worse. So, my doctor switched from Citalopram 10 mg to Escitalopram 10 mg (one per day). Citalopram was taken five years to 10 years ago, before that Zoloft 20 mg per day. Now my GAD is getting worse. A friend of mine had a good experience with Buspirone. Could you explain me the general difference between Escitalopram and Buspirone? ### Response: Escitalopram is an SSRI (selective serotonin reuptake inhibitor) and helps improve serotonergic neurotransmission in the brain. The" "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: Eighteen months ago, I had a reconstructive surgery on my penis to treat penile curvature. Two weeks post operation, hematoma exploded so I got wound breakdown. Skin necrosis ensued and I lost a small part of my penile skin. No graft or flap was used. I now have hyperpigmentation and very noticeable wound scar. For the hyperpigmentation, I have been using Hydroquinone and Mederma Intense Patch. I have been using it for two weeks. There is an improvement but the skin is getting sensitive, red, and inflamed. Should I still use it? If not, how to remove hyperpigmentation from the penis skin? What about the wound scar? Will it shrink and disappear with time or there are other solutions? I need to know what I can do to remove both hyperpigmentation and wound scar from the penis skin. I have attached pictures for reference. ### Response: It is good that you have explained the condition in full detail and with good quality pictures (attachment removed to protect patient identity). I advise you not to use it for more than 15 days with a month\s gap in between. If it is along with any kind of steroid then not more than 10 days. The scar seems to be still in an immature state. I suggest the onion peel based ointment such as the Contractubex Gel should work. You can use it twice 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: I am a diabetic since I was 30 years and have heart issues from 15 years. Had bypass done eight years back. Now, lVEF is 25 %. Now, if I walk 50 to 100 meters, I feel breathless and after motion or urine, again feel breathlessness. Is it related to any kidney issues? And also, please suggest can angiography and angioplasty can happen without any risks? Recently, was admitted due to fluid retention in lungs. In 15 days after discharge, I feel same breathlessness and eructations, burps start continue for 15 to 20 minutes. Kindly let me know is this a heart block or kidney issue. ### Response: Hello. I reviewed your ECG and would explain that it indicates left bundle branch block. Regarding the shortness of breath, it is related to heart failure. Of course, the renal function may be compromised (as it is very common in heart failure). I would like to know your current therapy. The fluid in the lungs is another common feature of heart failure. An optimization of your therapy could help improve your situation. Regarding angiography or angioplasty, it can be performed in this clinical situation safely, if it is indicated by the doctor. But, first, it is necessary to evaluate your kidneys, by performing renal function tests, in order to be sure that there is no risk from IV contrast." "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 24 years old and having extreme hair fall. My center of the scalp has already started showing up. Please help. ### Response: Use Trichospire hair kit and Qilib men lotion twice daily. I hope it helps. If you have any other question, please do not hesitate to contact us." "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 is suffering from intestinal cancer. It is a tumor and the tumor blocked his intestine. D2 is completely blocked and then today he had a surgery in which all the spreadings is removed. Stomach bypass is now done but the main tumor is not removed and they said it will be after chemotherapy but chemotherapy is very late and cancer cells will spread. Please tell us what all would be the consequences. ### Response: Hi. It was emergency surgery done to relieve the blockage, complete surgery will be done after chemotherapy because chemotherapy will further shrink the tumor and will make the surgery more feasible. Since surgery is done now, chemotherapy can be started only after healing of surgical wounds which takes 3 to 4 weeks. So, this is the only option. So we need to hope for best and tumor should not spread to distant sites." "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 lost 5 kg in one year. I also have hair loss. I do not know the problem behind it. Please help me. ### Response: You are having a weight loss of five kilograms in one year. It can be due to anxiety, over-exercise, and due to less food intake than a requirement. You can rule out such common cause if it is present. If this is not the issue, then investigate with serum TSH (thyroid stimulating hormone) estimation to rule out hyperthyroid. You can do test for HIV using Elisa, and fourth generation testing if it is suspected. You can do a chest X-ray to rule out any lung problem if it is present. Any chronic infection can also lead to weight loss. So provide your history if it is present. You can consult a physician for a physical 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: My gynecologist removed most of a polyp in her office with a local anesthetic and NSAID shot. However bits are still attached to the uterine wall because she was afraid of puncturing wall if I move. I had a colonoscopy with Propofol and had only had a bit of dizziness when I stood up, but it gone within a minute or two (I actually could have driven myself home). I had wanted to do without anesthetic, but the doctor said there was no way to get a local that far up. However, my gynecologist is afraid I could still move under Propofol and wants a general anesthetic. I only get to talk to an anesthesiologist at the hospital where once I schedule a surgery so I want to find out about perhaps using an epidural or spinal anesthetic. Basically, I want the least amount of anesthetic that will allow me to stay awake but keep my legs from moving. I have a high tolerance for pain. So, can I get some thoughts on this.I am currently taking Levothyroxine sodium 50 mcg and some vitamin supplements. ### Response: Regarding your query, your surgery can be done under spinal or epidural anesthesia. It is a much safer option than general anesthesia. You will be pain-free for hours after surgery. You will be absolutely awake during surgery and will not be able to move your legs even a bit. The only thing is you will not be discharged on the same day of surgery which is not a big issue. So in my opinion, unless spinal anesthesia is contraindicated for you, ask your anesthetist if spinal anesthesia is feasible. Do not worry everything will be fine." "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 weight 55 kg and height 5 feet 10 inches. I want to know how to increase the weight as I had tried so many ways to improve it but failed. Please help. ### Response: Try the below suggestions if you already have no done it, 1) Try to have a mini-meal or snacks (like boiled cereal sprouts, nuts, etc.) apart from your regular meals. 2) If your level of physical activity is more, accordingly you have to increase your calorie intake. So either limiting the physical activity or increasing the calorie intake necessary to gain weight effectively. This can help better absorption of nutrients like iron, protein from the gut. 4) Protein supplement" "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: Do I have parasites in my feces? Please check the attached report. The small black pieces are cigarette ashes. ### Response: I have gone through the attachments (attachment removed to protect patient identity) You have quite a heavy parasitic infestation. From the picture, it looks like Ascaris or hookworm. It is difficult to identify since it is not clear. I would advise you to consult a doctor locally and take appropriate medications since the medication differs for different parasites. Please do not delay" "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 got my periods for three months after taking the i-pill. I am not pregnant. Please suggest what is wrong with my health. I have PCOS too. Is this the cause of a missed period? ### Response: Have you checked the pregnancy test? If it is negative then PCOD (polycystic ovary disease) might be the most probable cause. PCOD causes irregular periods along with some hair growth. You can confirm it by the ultrasonography. Even thyroid problems can cause irregular cycles. So, get your TSH (thyroid-stimulating hormone) checked" "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: About 45 days ago, I received a trauma to my right eye in a street fight, after which a large part of the cornea became blood red. After three weeks, the redness went away and the eye started looking normal, but I am still having a lot of discomforts. I am listing all the symptoms below. There is a pain in the whole eyeball and sometimes in the bony region surrounding the eye. A mild dull pain which goes away on some days. It is particularly noticeable after spending a few hours looking at the phone or a computer screen. There are difficulty and mild pain in eye movement and focusing. There is a slightly blurry vision and increased watering of the eye. There is a feeling of something caught in the eye. Photo-sensitivity in the affected region of the eye especially noticeable upon opening the eye first time in the morning. A tiny light grey scar in the affected area of the eye. Awareness of the affected eye. It also feels like I am seeing with only the unaffected eye. The eye becomes slightly red after taking bath or splashing water and remains so for about an hour. None of the above symptoms were present before the trauma. The unaffected eye is free from all those symptoms. Both eyes look perfectly normal and white except for the tiny scar in the affected eye, though I am not sure if it is a scar.I went to an ophthalmologist earlier this month and he said that there was swelling in the eye and everything would become normal soon. He prescribed two eyedrops which I am attaching here. After the treatment, the symptoms became milder and less noticeable than before but did not heal completely. So, I went to another ophthalmologist two days back. He examined the eye and said it was normal and only prescribed artificial tear drops. He checked power too and said there has been no vision loss in the affected eye but things do look more blurry with that eye. I was not convinced with his opinion because I am feeling all the symptoms I listed above. I do not know what to do. Please help. ### Response: Hello. I went through the attachment (attachment removed to protect patient identity)." "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: Hello, doctor,I am anxious about my heart. I cannot tell what is causing me to feel like this. I have a stiffness in the side of my neck with some pain in the upper left part of the back. I am able to pin point it. The chest feels weird on the left side. The ECG, chest X-ray and CBC were normal. How can I make sure I am not having a heart attack? ### Response: In all probabilities, it is not a heart attack. Neither your symptoms nor the investigations are compatible with a heart attack. I think you should stop worrying about a heart attack. From your description, it sounds like a cervical spine problem like spondylosis or disc problem. In which case, there will be stiffness, pain, and tingling due to compression of the nerves between the spine. You will need to check your vitamin D levels. If it is inadequate, you will need to take supplements. Get an X-ray of the cervical spine in anterior-posterior and lateral view. You may further need an MRI if the X-rays are not informative. The treatment possibilities are as follows: For the time being, you can have tablet Neurobion forte once a day, which is a nerve vitamin and Diclofenac gel for local application. For pain relief, you can have tablet Ibuprofen 400 mg whenever needed up to three times a day or Diclofenac 50 mg whenever needed up to two times a day. You can visit an orthopedician for these investigations. Hope this helps you and get back if you have any doubts" "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 57 years old, and suffering from joint pain for the last 20 years and still not able to get rid off it. We just got her full body checkup done. Please help. ### Response: Hello. I understand you told me about joint pain in general. It will be better if you let me know which joints are affected and how severe it is? You can send me the reports as well." "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 30-year-old female with normal menstrual cycles. I began taking Vitex a month back and stopped after 20 days. I took way too much. The bottle said to take two pills a day but the pills are 400 mg a piece. I now realize that this is way too much. I am concerned because I got my period two days late and it is very heavy. I know this is a normal response to how much Vitex I took. I am just worried that my body will not be able to go back to normal on its own. I am worried that I will need to go on birth control pills to correct this issue. I am looking for guidance on what I should do. Should I wait to see how long my period is? Should I go get birth control pills? Is there anything natural I can do to fix this? ### Response: Hello. I just read your query. See two to four days late or early periods are considered normal if you get menstruation every month and do not skip any cycle. As far as heavy bleeding is concerned, it can be due to the herb. But wait for another cycle. I will not recommend you to take birth control pills right now. The herb contents will wash away from the body very soon as you have stopped taking it. Wait for your next menstrual cycle and watch for the bleeding and other things. Hopefully, it will be corrected automatically." "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 married for 10 months. We just started planning a family. My periods used to be irregular before marriage but post marriage they had become regular. I had unprotected sex during ovulation. Now, I miss my period. I am having lower backache, thigh cramps, fatigue, and frequent urination. But, the HPT is negative. Why? I have a history of hypothyroidism, and the reports are normal since last two years. I am on regular Eltroxin 100 mg. ### Response: The fact that urine pregnancy test is negative after 10 days of missed periods and that you have been experiencing PMS symptoms now, indicate that your menses are likely to start soon. It is advised that you should get a hormonal profile done with FSH (follicle-stimulating hormone), LH (Luteinising hormone), prolactin, testosterone, and estradiol levels. Also, an ultrasound pelvis to check for endometrial thickness and possible uterine cause or adnexal mass. If menses did not start soon, ultrasound shows endometrium thickness more than 9 mm and pregnancy is again ruled out with a serum beta hCG test (more confirmatory), then you can opt for a 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: Last week, I have done a septoplasty and the dressing was taken out yesterday. Now my nose bleeds a lot the whole day and then it was normal. Today I woke up and there was a lot of blood in my nose and it was dry inside. Is it because I missed out taking the nasal spray while I was asleep or any other reason? ### Response: It is normal to have some bleeding after septoplasty operation." "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 not sexually active, and a few months back, I tried boxer without washing it and got a pimple on the penis, took antibiotic cream, and it went off in three weeks. It did not hurt me. A few months later, I have got another pimple in penis, did herpes test, and the IgG was 3.80 positive and IgM was 0.935 equivocal, and the swab was positive. It did not hurt me but took a month to go. Two months later, I got a bunch of small blisters, and the doctor recommended to take antiviral pills for five days.My question is, as it never hurt me, will it in the future? Also, will it get worse or better?Does suppresive therapy work? How long will it take? ### Response: Hello. A most common symptom of herpes is the burning sensation. Sometimes this is masked too. There is a high possibility that if you get it again, you might have a burning sensation. But every patient has his resistance, and response is different. For acute reactions, antivirals are given for five to seven days depending upon clinical presentation. But for chronic cases in which patients have repeated infections, prophylactic treatment is given for six months to one year. In my opinion, it works to relieve your presentation. So it will help you and will not make the situation worse. It is important to take antiviral therapy even if you do not have any symptoms because vesicles are highly infectious and contain millions of viral particles, and you could transmit to others. So it is better to get treated." "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 36 years old. I am feeling a chest pain from the last three days. About nine months ago, echo, angiography, etc., were done which were normal. Still, pain is felt. ### Response: There are many causes of chest pain: So, please tell me the nature of the pain and is it moving somewhere, is it associated with efforts, food, or movement? Also, sometimes it is the spasm of the coronaries that cause the pain and the angio is free. I recommend further discussion and follow up in order to reach the appropriate diagnosis and start the management." "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 do not know how to explain my situation, but shortly, I have an emotionally abusive father and two siblings younger than me. He drained me emotionally for 18 years, and now he is aiming for my siblings. I am now used to his anger issues, insults, the traumas he manages to give my mother and me. But he is going too far, and I cannot stand him hating my siblings.I always wanted him to go away, and I hate him. Today after he beat our cat just because it tried to run away from home, I decided I want him to die. But when he comes home from work as nothing happened, everyone in the house acts like he is not a monster, this is a habit we all have now. So when he is not home I pray that he should die and not come back, but when he is at home I serve him his food, his tea, etc. and have cheerful conversations with him.I hate him, but when he is in front of me, I cannot act the way I feel. I am not even forcing myself to work happy, and it just happens like I am a robot. What kind of situation I am in? I am sure I want him to die, but he is too good at taking our entire family hostage. I am afraid of losing my sanity completely. I know when I am alone, I act like a crazy person. I do not know what is wrong with me. Please help. ### Response: Hello. Abusive relationships are quite painful to live in and survive. Especially when these are closed ones like father-child, siblings, etc., they left marked emotional pain through in life if left unhealed. I am afraid you did not mention anything about my mother. Her role here is also important to understand the core problem. It seems she is also one of the victims. Sometimes when chil" "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 recently diagnosed with genital herpes. I am sure I got it from a person with type 1 (had regularly cold sores in the past and probably transferred it to me through oral sex). I was wondering, is there still a chance I might infect that person genetically? Or how high is the chance? We both have the same type of herpes, but my partner only experienced oral herpes before, and I have genital herpes.Can someone who already had oral herpes develop genital herpes themselves? Or does herpes only occur at the place of infection? I want to know how high the risk is of me infecting my partner genetically (same type) when I am not showing any symptoms. ### Response: Genital herpes can be transmitted to your partner sexually because it is an STD (sexually transmitted disease), whereas herpes simplex (HSV-1) can be transferred from one person to another via infected oral secretions while in close contact. But at times, there is a possibility of getting genital ulcers when you are infected with HSV-1. Hence, I would advise you to undergo lab test to know if you are infected with the virus or not. And if you are positive for HSV, then you will require Acyclovir, which is an antiviral medicine. Till then, I would advise you to take preventive measures to avoid transmission to other partners. If you have any further queries, feel free to contact 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 homocysteine level is 54, BP 80/135, LDL 144, HDL 46, GGT 55, SGOT 37, average three months blood sugar 105 and other findings normal, ECG normal. USG finding normal except grade one fatty liver. So, the doctor has given Udiliv 300 two times daily and cholesterol medicine 10 mg daily. Should I take it? I walk for an hour daily. ### Response: Hello. Your homocysteine is elevated. So is your MCV which suggests the possibility of vitamin B12 and folic acid deficiency. So, you need to get these tested and treating the deficient one will cure your homocysteine levels and risk of heart disease. Next, you may try having a healthy lifestyle as well. So, you need to have low salt, fatty, and oily diet, and regular exercises at least 30 minutes a day and need to repeat lipid profile after eight weeks to see the response" "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 witnessed bleeding in my left ear all of a sudden. I am listening to recordings and on phone calls continuously for the last one month, to have a clarity of what other person is talking. I am using high volume. Please suggest. ### Response: Your question was incomplete. Did you have pain or having pain now? How much was the bleeding? Is there any swelling in and around the ear? Did someone hit you on your ear? Were you exposed to sudden loud sounds like a cracker? Did you use earbuds or put any other object in your ear? If the answer to all these questions were no then we need to examine and evaluate the site from where it is bleeding and the cause for bleeding." "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 recently been diagnosed with Molluscum contagiosum in the genital region and was sprayed with liquid nitrogen at the dermatologist\s office to treat it. I first noticed the spots a few weeks before my visit to the dermatologist. I have been with my current girlfriend for about five months. But, I am pretty confident that I did not contract it from her. The last time I had sex with someone else was about six months ago. Is it possible to spread Molluscum contagiosum while the virus in your body without any symptoms? Can a person be tested for Molluscum contagiosum virus while no spots have presented? Will I pass it on to my girlfriend? Will it spread after recovery? Is there anything I can do to speed my recovery beside the liquid nitrogen freezing? Should I get tested for other STDs? ### Response: Hi. At times in females the lesions go unnoticed. No, there is no need to check for molluscum. But, you get tested for HIV because of recurrent genital molluscum contagiosum and HIV are associated." "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 herewith attach the medical reports of my son aged 17 years old who had pancreas problem. He does not have any bad habits. He is taking medicine as per doctors advise. Mild home food is being given. But still now and then he reports mild stomach pain. Kindly clarify the following:What is the root cause of this pancreatic problem?How long we should give mild food and when can we give him normal food?Whether the mild stomach pain he reports is normal or any further investigation is needed?Whether it is completely curable?What is the home remedy?We are very much worried since he is very young. When he gets mild stomach pain he gets disturbed. Kindly advice. Currently, he is taking Bronac 1-0-1 and Panlipase 0-1-1. ### Response: Hi. I understand the anxiety you have regarding your son. He has pancreatitis. Is this the first time he is getting this? Does he take alcohol? Did he have any injury to the abdomen? Have you checked his serum triglycerides and calcium? Is he on any long-term medications or recently started in any medicine before the attack of pancreatitis? The cause of the problem is not clear in your son\s case. It may be a genetic predisposition for pancreatitis which is the common cause in this age group. Please do the other tests which I have asked. Also, he needs a scan called MRCP (magnetic resonance cholangiopancreatography)" "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 18 years old and I have been having big problems with making friends since I was 7. I go to school and I do not talk at all (only if someone or teacher asks me something). I just cannot find any topics to talk to people and the worst is that I do not know what should I say back when I somehow succeed in starting the conversation. Besides all my life I feel like I am the one that jumps around people and tries to talk to them and they just do not care so I quickly give up and end up alone.And my house is so stressful too, it is so loud because my parents scream so much and I spend most of the time locked in my room because when I hear them screaming it feels so stressful (all this stress is like sitting on my back and I cannot make it stop). Is it even possible for me to make friends? It has been half a year since school started and everyone is occupied by their friends. How can I stop blushing when I am given too much attention? Is it possible that I have some kind of mental illness or maybe autism? ### Response: First of all, this is not a serious mental issue. Just remain relaxed. You have social anxiety most likely and this anxiety is resulting in symptoms like blushing when you are getting attention, difficulty in making friends, etc. This is social anxiety and a lot of individuals of your age develop. So do not think that you have any abnormality. Just continue to make your efforts to make friends and you will gain confidence with time. No need to get worried." "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 go to bed, my eyes start watering, mainly the left one. When I get out of my bed and look myself in the mirror, my eyes are red and my eyelids swollen. When I wake up in the morning, I have the same problem of tearing eyes, redness and eyelid swelling. I sleep on the left side, and the left eye is more affected than the right. After I get out of bed, the redness and swelling clears in half an hour to 2 hours, and I keep fine the entire day. I have had 3 conjunctivitis in the left eye in the last 6 months, confirmed by a general doctor all the three times. I have been diagnosed with Xanthelasma on the upper eyelid on the left eye by a general doctor 4-5 years ago. Please help. ### Response: Hi. Xanthelasma is nothing to do with your problems. It is due to high cholesterol levels. Your watering problem may be related to previous conjunctivitis attacks. Do you have irritation during watering or blurring of vision after conjunctivitis? This is more common in viral conjunctivitis. It may take its own time to complete normalization. However, it is not a serious problem. You can send pictures of your eyes and old records for more clear diagnosis and treatment. Do follow-up for any doubts." "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 gone for the Mantoux test and the report stated 15 mm raised surface. There is a swelling on the left side of the neck near the shoulder. Firstly we went to a homeopath because we thought that it is a stone. After 3 to 4 days it started paining after that we went to the mentioned doctor. He has given those medicines and has written some of the tests. And now he has written a new test called FNAC (which I do not know). So today my mother has gone for the test and yet the report is pending. ### Response: I have reviewed your query and here is my advise. The swelling could be due to infective enlarged lymph nodes, reactive node enlargement or tuberculosis. You cannot rely on the Mantoux test. It is not the test for tuberculosis. To confirm tuberculosis and to rule out the nature of lesion you need to investigate with fine needle aspiration cytology. In this investigation, a needle is inserted into an enlarged node and material taken outside over slide which is stained and examined under the microscope. It is five minutes OPD procedure, so do not worry about that." "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 70 years old. My blood pressure is usually normal. However, it spikes. This morning I woke up feeling nauseous, dizzy, cold feet, shaky and it is 146/86, pulse 84. Why does this happen? ### Response: Hello. After reviewing your medical history, I would like to explain that you need to closely monitor your blood pressure values for a couple of days (several times daily) in order to conclude on your average BP trends. It seems that an abnormally elevated high BP value may have caused your complaints. Anyway, it is necessary to discuss with your doctor on the possibility of performing a medical checkup, including a careful physical exam and some laboratory tests like complete blood count, thyroid, renal and liver function tests, fasting blood glucose level, blood electrolytes level, an ECG at rest. In case several BP values result abnormally high you may need to start an anti-hypertensive therapy. You should discuss with your attending doctor on the above-mentioned issues." "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 having continuous twitching in my right bicep where the tendon meets the elbow. This has been happening for last seven weeks and the vibration of the twitching when I am resting my elbow (say on a table while using a mouse) is quite large enough for my entire arm. I have no associated muscle weakness in the right arm and an EMG and NCS done last week have come clear saying it is a potentially benign fasciculation. A full MRI scan of the spine and brain has shown no abnormalities. My concern is that the twitching has not stopped for such a long period. Is there cause for concern for this to be a motor neuron disease? Currently, I am taking Lyrica 75 mg and Rejunex CD3. ### Response: Hi. If the nerve conductions and EMG (electromyography) have come clean then there is nothing to worry about. Fasiculations are generally considered significant only if they are associated with weakness or wasting." "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: Nine weeks post septoplasty/turbinate reduction. My nose feels swollen and tender on the inside. It feels like there is dry and ice cold air going up my nose. How long does it take to completely heal? I have used nasal rinses, sprays, etc. ### Response: Septoplasty is corrective procedure. The wound on your nose will heal fairly quickly, and your breathing is likely to improve shortly after the procedure. However, the overall healing process can be slow. Cartilage and other nasal tissues can take up to a year to fully settle into their new shape. Tips for a quicker recovery include: elevating your head at night to keep the swelling down, not blowing your nose forcefully after surgery, wearing shirts that button up in the front so you will not have to pull clothing over your head. Slow nasal breathing exercises (after permission from your surgeon) can help recovery faster. Nasal rinses, if advised should be continued. Wishing you speedy recovery." "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 under the treatment of infertility. And I have started my first cycle of IVF. Before the start of the cycle my ovary size is: Right: 81 mm and left: 79 mm. Treatment plan: For 12days I took Recagone. Total dose 1700 IU. After 12 days in the hospital, they took my embryo and sample from my husband and we choose blastocyst for embryo transfer. It was planned after five days of sample collection. Hospital did the sonography before one day of embryo transfer and they told, at this point transfer is not possible due to your ovary size is big. We asked for the report and they told its volume is around 385. Now they are telling, we have to free my sample and need to wait until my ovary size becomes normal. After that we have to start for the next cycle with the new cycle cost. We asked for the reason if we transfer with the present condition then what will be the risk? They explained that it might be dangerous to the mother if I get pregnant. I am a little bit confused now. What should I do? I have done all the precautions which they explained. I took leave for 20 days to complete this cycle with success. But at last the hospital is telling we have to wait and need to start a new cycle. IVF cycle cost is really high. So please guide me what should I do? Should I take the risk of waiting until my ovary becomes normal? ### Response: This is a known side effect of Follitropin injections if not related. Now that embryos have formed this cycle, they can be freezed for utilizing them in the next normal cycle. Presently they cannot be used as hyperstimulation syn" "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 uncle is suffering from breathing problems for ten days. Now the condition is that he cannot even inhale oxygen through the nose. He is inhaling through his mouth. And he is so weak that he cannot use the restroom by himself. Doctor adviced him to do echocardiography. The report shows the presence of fluid in the left lungs. We admitted him to the hospital immediately. Doctor removed the fluid of about 1.5 liters out of 5 liters, and the fluid is reddish. Again they did a CT scan, and they are telling that a lump is seen in the upper side of the left lung. They want to do a biopsy. But we do not want to do so because, if it is a malignancy, then we do not want to operate that. Please suggest what to do. ### Response: As you said, your uncle is suffering from left pleural effusion with left lung cancer. Also, your doctor has rightly said that we must do a biopsy of the lump, to find out the exact type of cancer to start appropriate chemotherapy or radiotherapy as per the report. It is not necessary to do surgery all the time. But if he is having a recurrent collection of pleural fluid, then he might need a procedure called Pleurodesis to close the space around the lungs to prevent the recurrent filling of fluid. So it is up to the wish of the patient and relatives to start chemotherapy or not after the diagnosis of cancer is done. Otherwise, you can continue with only symptomatic (palliative) treatment and frequent tapping of fluid to relieve dyspnea. 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 was just wondering about a medication. Can depression and anger issue get worse with Fetzima if only taken for a day? ### Response: Hello. Fetzima (Levomilnacipran) is an SNRI type of antidepressant used to treat major depressive disorder. When was the medication started and what is the dose you are on? Usually it will take about a week or so for you to get used to the medication and therapeutic effects will be apparent in around a month or so. Some patients can experience anxiety, agitation, irritability when starting the medication but they settle soon as your body adjusts to the medicine. Fetzima extended release capsule is usually started at around 20 mg once daily and then gradually increased to 40 mg once daily. Depending on your response and tolerability, dose can be adjusted between 40 mg to 120 mg once daily. Continue regular reviews with your prescribing doctor. If sideeffects persist, consult your doctor for an earlier review." "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 22 years old. I have problems with my penis it is 4 inches when erect and the foreskin is very tight and sometimes I feel pain while urinating. Are there any methods to increase the size of the penis? ### Response: Coming back to your query, I will let you know that the average penile size (erect) is 4.7 inches so your\s should be quite normal. If you do not have difficulty with intercourse and your partner is satisfied then I do not think there is a need for any medications. (medications has a limited role and has side effects too). If you feel there is phimosis (inability to retract foreskin) get circumcision done. It is is a very basic procedure and will let you to urinate better. Moreover, there is no hygiene-related problems after circumcision. You can try some non invasive methods to increase the size and strength such as penile pump, jelquing in this when penis is erect apply any lubricant (oil) around base of the shaft and milk towards the end. It helps to increase in both length and girth. Try to shed some weight. You can give a try of tablet Tadalafil 2.5 mg once a day for 1 month and see the results, it will not make you dependent so do not worry." "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 these marks which were initially boils. I have had these marks on my chin before but was not so bad, but the other day I had three boils and it made the marks on my face look more standing out as before they were not noticeable. I used hot water on my boils and I think that it brought out the marks on my face. Will they fade? As they are depressing me as they look like spots or a scar when they are not a spot. How do I get rid of it? Please help. ### Response: I have seen your query and concern and examined your picture (attachment removed to protect patient identity). With your descriptions and given picture, it seems you have a hypertrophic scar (raised scar due to excess collagen deposits). If you will not treat them, it will remain as such, but rarely can it subside too. It is a reaction pattern of the body to injury. It can be treated by intralesional steroid injection like Kenokort (Triamcinolone acetonide) 10 mg/ml, 0.1ml/cm2 intralesional at the gap of three weeks interval, given by a dermatologist." "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 age is 26 and having iron deficiency anemia. My Hb level is 11 but ferritin 18. Sometimes, I felt shortness of breath. Now, I am taking Iron medicine but when I quit taking iron tablets, my situation gets worse with time. ### Response: You can complete the course of Iron medication for 2 to 3 months according to your doctor\s prescription. It is not advisable to take Iron tablet randomly. Usually, at 11 gm Hb level, dyspnea does not occur. For your breathlessness, I suggest you investigate with chest X-ray and spirometry investigation. For that, you can consult a pulmonologist for chest examination. Meanwhile, complete the full course of Iron medication." "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 is 49 days pregnant. Today we met our doctor. He said that the fetal size is 0.63 cm, but still, there is no heartbeat felt. The doctor asked us to wait for one more week. Is it normal? Please clarify my doubt. My wife is worried about this. This is our second baby. ### Response: How are you doing? Hope I have clarified your query. Do write back if any more queries. All the best" "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\s hemoglobin is 5 g/dL. Her feet and face are swollen, what do I do? ### Response: Hemoglobin of 5 g% is very low and an indication for blood transfusion. As you are saying her face is swollen, she might be landing into a heart failure. There are multiple causes of severe anemia. She requires admission and evaluation. Consult a general medicine physician online for further guidance" "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 wondering if I could ask a few questions about a potential ectopic pregnancy? I recently started new birth control (after not taking any sort of birth control for three months) called Drospirenone and Ethinyl tablets, USP (3mg/0.02mg) and I am now on day 22 of taking the pills. I had unprotected sex within the first week of taking the pill. However, I have always had a really light period and rarely got a period when I was previously taking birth control. The last day, I had unproductive sex was exactly 19 days ago. However, about five days ago, I started to have more intense cramps on the same side and I am also bleeding. This is what it felt like last year before I took a test, just way less severe. I looked online and learned that I can take a pregnancy test at least 19 days after intercourse, so I just took one, and it came back negative. I am not sure if I am having an ectopic pregnancy or it is just too early to tell if this could be a side effect of the new birth control? Or if this is just my regular period (despite it starting in the middle of my pack)? ### Response: You have to know that contraceptive pills will prevent a future pregnancy if you have taken the pills for seven days. After that, you can have unprotected sexual intercourse. So before that you have to use another form of contraception. Also, if you have had sexual intercourse not in your ovulatory day (that means at first day of your cycle), the possibility of a pregnancy is low. The urinary test has a high acurracy, if you perform that after a week of menstrual delay. I read that you have experienced a rupture ectopic pregnancy last year. The typical symptoms of an ectopic pregnancy are missed period, abdominal pain, cramps, and spotting. I recommend you a b-HCG (human chorionic gonadotropin) blood test. You can repeat that every 48 hours to detect a future pregnancy. It will double its value in an intrauterine pregnancy, meanwhile, the rise of b-HCG value in an ectopic pregnancy has another pattern less than a normal pregnancy. Also, the COC and the medication that you take can affect your cycle. I would recommend b-HCG blood test at first. If you have the bleeding within your expected date without delay, it would be your cycle that has come." "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 19 years old. I have a kidney stone of 5 mm in my right kidney. When I had stomach pain, I consulted a doctor before three weeks. He gave some medicines. Since from morning, I have increased pain during pee. Please help me. ### Response: Hi. You may have sudden pain due to the passage of kidney stone from the kidney to the ureter. It also causes difficulty in passing urine. A kidney stone of 5 mm can move out soon by 90 %. If the pain continues to be severe or if you have vomiting, or if you cannot pass urine for more than 12 hours, I suggest you revisit your local urologist soon." "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 pain and light bruising below my left hip since a week. It was not caused by banging/slamming into something. I was doing stomach crunches and then went for running. I felt discomfort initially while running, then got progressively worsened.Movement was matched with intensive pain for 36 hours, then steady, milder pain ever since. I cannot tell if it is muscular or a crossed nerve. There is no noticeable swelling, there is just bruising and pain with movement.What is the diagnosis and remedy? ### Response: I can tell you a general protocol for soft tissue management which consists of : Revert back to an orthopaedician and traumatologist online for further follow up" "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 severe stomach and back pain at the same time. Suggest some quick remedy. ### Response: Hi. I have read through your query in detail. Please find my observations below. Severe pain in abdomen radiating to the back might be due to many conditions which require evaluation. This has to be taken twice daily for pain that might be a spasm. This should reduce any spasmodic pain that you are having. Once pain is stable then please consult your doctor and get examined clinically. If required the doctor might ask for an ultrasound scan abdomen to be done to know the cause. Above mentioned causes are the commonest and there are many other conditions which might cause a similar pain. Clinical examination and investigations are important." "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: Precum touched the vaginal opening and we had intercourse with a condom. What are the chances of becoming pregnant? Should an I-pill be taken to avoid it? ### Response: Hi. The chances of pregnancy are only in the midperiod five days, that is if you had sex in day-12 to 18 of the cycle. You can count the days as first day of your period is the first day of your bleeding. For example, you had four days of periods, then count the first period-free day as day-5 and so on. Secondly, you had protection (condom), that means there are no chances of pregnancy. As per my experience, there is no chance of pregnancy. If some precum touched without a condom, then there are chances, provided your menstrual cycle falls in the ovulation period, that is the 14th day of your period plus or minus two days. Yes, to be on safe side, you may need an I-pill although the chances are too slim for a pregnancy" "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 2.9 years old and has a problem in the upper four teeth (x-ray attached) and doctors are suggesting for RCT (root canal treatment) as they are very much decayed. So I just wanted to confirm the same. ### Response: I have seen the x-ray. (attachment removed to protect patient identity). If the child is cooperative and can sit through the procedure then it is fine to have pulpectomy procedure i.e. root canal treated. If your child does not have any pain or swelling and the tooth does not appear to have some large hole or pink fleshy growth inside which can be seen, then it is fine to let it remain like now and use fluoride toothpaste for kids to prevent further decay. It is difficult to have a cooperative child at this age so do not put too much stress on the kid if he is very afraid. If you see swelling or if there is pain then go by your pediatric dentists advice and do a root canal." "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: What to do when we find blood in our semen? There was a blood clot in my semen when I ejaculated during unprotected sex, but I have had unprotected sex regularly. The next day I masturbated to see if I still have it and this time blood was mixed in the semen. Although, it does not hurt and when I urinate it does not burn. I sometimes forget to drink water, but I still drink enough. Should I take a hepatitis shot or urinalysis? Do I have STD? Should I be concerned or will it go away? This happened to me before two years ago but it subsided. ### Response: Hello. Blood in semen with no other symptoms is very likely idiopathic or no pathology. After a period of abstinence sometimes aggressive frequent sexual activity leads to hematospermia. Majority of times it is self-limiting. Unprotected sexual intercourse will not give rise to this (rather it causes urethritis). Seminal vesicle can occasionally be infected from the blood. Just once examination by surgeon or urologist to feel seminal vesicle per rectum is preferred. For the present episode, wait for some time that it will resolve on its own." "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: Before eight years, my daughter underwent breast surgery. After that, she had a baby who is 18 months of age now. Before a month, she felt pain in one breast and went to GP. He did an X-ray, which showed a tear in one of the implants. Yesterday she visited a surgeon.He informed her that there is no chance for any replacement surgery until the inflammation clears up entirely. He said he could take out the implants, but will not replace it until the swelling gets clear completely. She is advised to take Ibuprofen for the reduction of inflammation. She was advised to visit the surgeon after a week.My concern is whether the leakage from the silicon breast implant is going in her body? How dangerous is this leakage? Is it safe to take these implants out and inserting new ones at a later date after healing? ### Response: I can assure that silicon from the ruptured implant will stay there only and it will not go anywhere in her body. Your surgeon is correct in telling you that the replacement can be done just after the inflammatory response settles down. It is better to remove the ruptured implant and wait for a replacement with a new one until the active inflammatory response gets resolved. Taking time for an inflammatory response to settle with Ibuprofen is also a good option. Because after that, you can undergo only a single surgery rather than two" "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 found out that I was four weeks pregnant last Tuesday. I took Misoprostol sublingually three times on three hours interval. Later that evening, I had serious cramps and diarrhea. I bled a little and passed out blood clots twice. Then the next day, I noticed I was passing out blood tissues. I felt the drug did not work. Two days after, I took another 4-pill of Misoprostol. I had fever for some few hours plus diarrhea and cramps. I bled a little few hours later. Was the abortion successful or not? ### Response: Medical abortion is available once a pregnancy is detected via ultrasound (usually around five weeks) up to nine weeks (63 days) gestation. The abortion is achieved using a combination of two medications which work together to terminate a pregnancy. If you feel it is incomplete abortion, I suggest you meet your doctor and get a scan done to confirm that the abortion is complete. If it is not complete, the doctor may advise you what to do next. If it is crossed nine weeks, he may plan a surgical method. Please consult your gynecologist at the earliest. He/she will examine and treat you accordingly" "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 undergoing medication for vertigo and ear infection as per the doctor. My symptoms were head spinning at regular intervals (when heads start spinning I am unable to sit also), nausea, dizziness, and headaches.I went to an ENT and did an MRI and audiometry test. MRI is normal but my audiometry shows a significant hearing loss. As per the latest findings, my right ear has hearing loss with continuous ear ringing and headache on the right side behind the ear. Also, the doctor said that this is happening due to weak nerves of hearing and balancing. Please suggest.I am currently on Vertidiz, and Diligan 25. ### Response: Hello. Please upload the reports of audiometry and MRI (magnetic resonance imaging). How much of significant hearing loss is there? Is it nerve-related or conductive loss? Did you have any ear discharge before the problem started?" "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 experiencing a receding gum line and decaying teeth in my front two bottom teeth. I am desperately afraid of the dentist. I am also scared of losing the affected teeth. I need to know how to proceed with my treatment. Is there a way to make it better? I am currently on birth control pill. ### Response: I checked your given picture (attachment removed to protect patient identity). Unfortunately, there is nothing better you can do but visit a dentist and get scaling or cleaning of this hard plaque and tartar done as soon as possible. It was a plaque that gets hardened, turned into tartar and started pushing gums down the neck of the tooth, and this will eventually cause loosening of teeth. So, it is better to get it cleaned. Better to be safe than sorry. You can do saline water mouth rinses for arresting of gum recession till you get an appointment of the dentist. (Take a 1/4th teaspoon of salt in a cup of lukewarm water and do its gargles for 2 to 3 minutes). Stay happy and blessed." "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 baby after four years of marriage. My sex life is not good. I am not getting intimate with my husband as he wants. Please help me out. ### Response: Hello. You need to avoid anxiety. Develop trust and comfortable feeling. You need to talk to each other and share your feelings. Deep breathing, walking, and yoga exercise have to be started. Foreplay involvement" "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 problem with my left eye called astigmatism. My vision without glass is 1/10 and with glass it is just 3/10. ### Response: Please send me your investigation report and other relevant details to comment further.Revert back with the reports to 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 rubella is 3 IU/mL non-reactive and I am six-weeks pregnant. Do I have rubella infection? Are there any chances of any birth defects? ### Response: Hello. Rubella is a serious infection to affect pregnancy. Your blood report only states that you had a rubella infection only some time in life. It does not seem to be an active infection. You get it only once. So all you need to know is that that was an infection that happened long back and will not be present in the body now to affect the baby. So you do not stand a chance of rubella-induced malformations. For your information, rubella is like a common cold. You could have had it any day before pregnancy" "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 developed anxiety problems due to severe work-related stress. I work in the IT services with timings from 2 PM to 11 PM. So, I go to bed by 1 AM and wake up around 6.45 AM every day. Due to stress, I am having palpitations. I had a full echo, ECG, and a treadmill test to rule out cardiac problems and the results were normal. I was advised Betacap 20 mg and Restyl 0.25 each once a day. I have been taking these medications for close to one and a half years now. However, during a Siddha camp in our office for stress, they reviewed my medications and have advised me to take Ashwagandha 400 mg twice, one in morning and night each along with my allopathy medications. Also, I have lost my sex drive due to stress. I would like to take advice on this medication and dosage. Will these ayurvedic supplements cause any interactions? ### Response: After three months, you can stop Betacap" "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 abroad on vacation, and I had an important question, which could not wait until I saw my primary care neurologist when I am back home. Five months back, I was involved in a serious hit and run accident (me being the victim). I sustained numerous injuries, the most prevalent being a traumatic brain injury (SAH). I was released from the hospital after about a month and returned home to continue recovering with my family.After months of recovery and PT for my femur surgery, I am just now beginning to get back on my feet, and I am planning on returning to work as a professor at the end of next month. During my last neurological examination, the CT scan found that my third ventricle has grown from 4 mm to 6 mm. This worries me tremendously since the research I have done online signifies that this may indicate hydrocephalus (attached is the radiologist findings).My question to you is, can my third ventricle enlarging be anything other than hydrocephalus? Is this a common occurrence after a traumatic SAH due to an accident? If it is indeed hydrocephalus, is the only treatment a shunt? Is there a less invasive treatment? I am really scared beyond words, and I am hoping that I do not end up with hydrocephalus. What is the usual timeline for the hydrocephalus to develop after SAH? I will be sure to get a full check-up once I see my neurologist in a few weeks, but I just cannot wait any longer for an answer. ### Response: Hi. I read your query and understand your concerns. I hope this helps you. Feel free to write back to me if you have more questions" "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: The last few days my wife says that she feels sick. After that, I took my wife to the doctor. She suggested a few tests named HB electrophoresis, ferritin, TSH, PPBS, USG lower abdomen, CBC, PBF and urine test.Result:Hb%: 10.2, platelet-266000, RBC-4.28, WBC-7300, MCV-74, HCT/PCV-32%, TSH: 4.39, normal urine, pus cell: 1-2, epithelial cell: 1-3, PPBS- 5.9, USG- normal, S. ferritin: 10.98 ng/ml, HB electerophoresis: Hb A- 71.3, Hb E-25.3, HbA2 - 3.4.Doctor comments: Blood disorder, Hemoglobin E trait.Kindly explain the report. As far as I know, HbE trait patient generally has higher ferritin level but in my wife, it is lower than normal. I am afraid about my 1-year-old baby boy and next baby and generation. Please suggest to me. ### Response: Hi. The serum ferritin level is not high in every case of hemolytic anemia. Your electrophoresis report is suggestive of HbE (attachment removed to protect patient identity). It is a case of a mild form of hemolytic anemia. In that case, the ferritin level might not be raised. Along with low ferritin, your red blood cells count is also low. Usually, in hemoglobinopathy, red blood cells count is high. So your wife\s complete diagnosis is HbE trait with secondary iron deficiency anemia. So you can give your wife Iron tablets to raise the hemoglobin level and ferritin level. HbE is not a major hemolytic disease, so you need not worry about your child or future child although your child acquires HbE trait. HbE trait patient lives a normal life. I strongly recommend you to get investigated for hemoglobinopathy by electrophoresis because if you have trait then your child can acquire HbE disease. So revert back with your electrophoresis report as well." "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 undergone a brain MRI today to rule out acoustic neuromas (among other causes). MRI was prescribed by my ENT doctor because I was very stressed. Gadolinium was injected during the MRI. It turns out the MRI was pretty normal, no tumor, no anomaly or else. I found some asymmetric white surface on a series of four pictures. I think it might be something as normal as blood circulation. However, I would like someone to definitely reassure me or tell me what it is since I am the kind of person to freak out easily concerning health.I have chronic left ear problems since last year. Ear fullness when chewing, diagnosed as otitis media with effusion, untreated-bilateral, unconstant tinnitus for one month (worse when lying down, disappears when walking or doing activities outside), issues with balancing ear pressure (ear becomes blocked during car trips or when eating). I never had ear problems before. However, my sinuses are fragile and prone to irritation (air dryness). I frequently suffer from acid reflux, post nasal drip, sore throat and my septum is deviated. Currently, I am taking Nasacort, Solacy, and Levothyrox. The lab tests performed are thyroid hormones: High count of thyroid antibodies (Hashimoto\s disease), hearing tests were done twice: one showed a loss in low frequencies. The latest one, done one week later (done by ENT) showed no loss, only minor damage at 4000 Hz in left ear. Tympanogram showed low compliance. MRI was strictly normal. ### Response: Hi. There is the right internal carotid artery near the right cavernous sinus in the area inside the circles in your images (attachment removed to protect patient identity). It is a normal image and the slight brightness is likely due to variation in the signals due to the magnetic field" "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 shaved my pubes and hair between my anus two days ago. Few hours after shaving, I experienced severe itching, so I applied moisturizer and baby powder. But today I noticed a few red bumps and rashes around my penis and between my anus. Also, the skin on my balls has become dry and is peeling off. Please help. ### Response: Hello. Some skin types are sensitive to blades, and the reaction that you described looks like hypersensitivity of your skin to the blade. Also, it could be because of using an unclean blade. I suggest you use the Montair LC tablet Levocetirizine, Monteleukast) two times a day for three days for controlling the skin rash. Also from the next time consider using a trimmer instead of a blade. Please get back to me if you have more questions." "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 27 years old and going to get married after three months. I am facing premature ejaculation. I have a bad dream after two or three days regular basis. So fearing about marriage as I have this problem. Semen maybe not thick enough and ejaculate after only 12 to 15 strokes. Need valuable suggestions from your end. ### Response: Hello. 1. It is a part of normal sexual life. It is nature\s way. You will not get any sexual problems on account of this. You can happily get married. 2. Semen thickness varies from time to time, depending on many factors. It does not have to be thick. It should become thin soon after coming out of your body. Otherwise, you may have difficulty in conceiving. So, do not worry about semen is not thick. 3. You can overcome premature ejaculation by using proper medicines and following techniques such as start-stop technique." "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 writing on behalf of my wife. She is 28 years old. She has PCOD. We have been trying for a baby for the past three and a half years. My wife conceived thrice, but all the times, the pregnancy got aborted in the second month. We have checked with infertility specialists in my area. We both have conducted all the related tests, and my count is normal. I do not know how to proceed further. What should be done now? What are the precautions we must take? Kindly advise. ### Response: I read your query and understand your concern regarding your wife\s recurrent miscarriages. These are some measures to reduce the chances of repeated abortions. You must have tried some of these in the past, but you need to try it again for a successful pregnancy" "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 weeks ago I consulted for candida balantis, and took Fluconazole, Levocetirizine and Candid cream, for a week. It was fine but as the dose got over, my itchiness in penis came back and now I have got cut and rashes and redness in my foreskin and penis. I have uncircumcised penis. ### Response: Hi. I can understand your concern for your symptoms. It looks like balanitis (attachment removed to protect patient identity). Infection- unprotected sex, unhygienic sex practice. Diabetes- can be checked by blood sugar. Using local cream Lobate GM for local application can help you. If you had unprotected sex, need to do TPHA , HSV 1+2, IgG, HSV 1+2, IgM, Chlamydia trachomatis IgG, HIV 1 and 2, HbsAg, urine complete analysis." "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 on my second week of birth control pill in my pack and I have not missed any pill since starting but last night I vomited 5 to 5 and a half hours after taking my pill. It was my 11th pill in the pack. Should I treat it as a missed pill and take another? I also had sex without a condom after the incident and I wanted to know if I am still protected and will I continue to be protected? ### Response: I have read your concern. If you have been on a pill for more than a month and this is your second pack, you have nothing to worry if you just missed out one pill. Since most probably you have vomited out the pill, you can take another pill for today and then continue as once a day every day. You do not have to take a double pill. You will continue to be protected and just continue with the pack. The problem will only arise if you have not been consistently taking it, if you just missed it today because of the vomiting, it will not be too significant. Hangover. Gastroenteritis. Gastroenteritis secondary to alcohol intake. 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 am 21 years old and I am masturbating for the past 5 to 6 years and now I stopped because of my stomach issues and now I face premature ejaculation problem when I chit chat with my fiancee. Please help me how to stop this. ### Response: Hello. First of all, I would like to mention that masturbation does not cause any weakness or sexual dysfunction contrary to popular belief. What you are facing right now is not premature ejaculation. It is the lubricating fluid that comes out from the penis when aroused not semen. So relax." "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 had to get an emergency refill on my birth control because I was going out of town and realized I did not have enough to last the whole trip. The one I originally used was a generic version of Yaz and the one I got was a different generic version of Yaz (called Gianvi). Since taking Gianvi, I have experienced nausea and vomiting, breast tenderness, and fatigue. I did not experience any of this with the one I usually take. Is this normal or likely? Even though they should technically be the same? I last had sex around a month back, but I will not have access to a pregnancy test until I am back from my trip this month. I have read that birth control can mimic pregnancy symptoms, which is why I am wondering if this is the case. ### Response: Hi. Yes, you are correct. These symptoms like nausea, breast tenderness could be due to hormonal variations caused by the pill. Better to continue pill as per schedule. I hope you have not missed a single pill. If completed course without skipping the dose of the pill, no risk of pregnancy." "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 doctor asked me to take 10 mg of Inderal three times a day. I accidentally took 20 mg this time. Am I in danger? ### Response: You need not be worried about having taken 20 mg of Inderal (Propranolol). The range of dosages of Inderal is very wide. You are not in danger. Revert back to a cardiologist online for further follow up" "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 swallowed a square magnet. Will it harm me? ### Response: Hello. You should get an upper GI endoscopy done, if the magnet is in the reach of the endoscope, it should be removed on an urgent basis. According to you, it is a single magnet. A single magnet will rarely cause symptoms, but if you have ingested multiple magnets or magnet along with a metal object, you need to get them removed as soon as possible. For the single magnet, the size of the magnet will decide the course if it has reached into the stomach or small intestine, if it is less than 2.5 cm in all dimension, it should pass down in stools (there are 85 percent chance that it will pass down). Just check your stools for the next 24 to 72 hours. If it does not pass for more than 72 hours or size is larger than 2.5 cm, or the longest dimension is more than 5 cm, you should reach out an endoscopist to get it removed with a grasping forceps. 1. X-ray abdomen erect to look for the location of the magnet.2. Upper GI endoscopy, if it is in reach of the endoscope (that is till first or second part of duodenum)." "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 are couple married recently. We want to plan a baby. However, due to ongoing covid-19 pandemic, can we plan it now? Is it safe? ### Response: Dear, good afternoon. Coronavirus dont have any known impact on people planning pregnancy. however infertility treatment can be deferred. for your family, I would advice that corona may continue for few more months as claimed by many studies, so u may have difficulty in visiting hospital for routine visits. if you can wait for more time, it will be ideal. there are many tests and medicl conditions or factors which are required to be paid attention to for planning family. you can contact me subsequently for detailed family planning advice. Pls let me know if I can be of any further help. best wishes after 2 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: This is the 9th day after wisdom teeth extraction and I still have a painful swollen gland under my jaw. ### Response: I know it is a bit hard for you at this stage after wisdom tooth surgery. Some of the times the wisdom tooth surgery is a little aggressive because the tooth is lying deep into the bone and to remove it a lot of work has to be done. And some of the bone has to be removed to achieve this. But do not worry this is a temporary phase and you have been through most of the hard time. Hot and cold application in the beginning may help to reduce the pain and swelling. You can still apply the cold application. Also, take the pain killer your doctor gave you. In case you do not have any prescription medicine left, try over the counter painkiller like Ibuprofen 400 mg at least three times a day. Use Listerine mouthwash and clean the area with a soft brush. 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 suffering an erection problem for the last three years. I am married for the last 1 year but I never did satisfaction and natural sex with my wife. My problem is I used to do a lot of masturbation heavy masturbation with oil so it is erect for a while and again loose.One more thing my penis would not get erect or discharged if my wife do handjob and sex, it gets erect only when I touch. I am trying a lot to discharge in my wife\s vagina but I could not do so because at the end movement it is going to loose. One more thing I cannot masturbate with my dry hand because I need some oily lubricants to erect my penis. After marriage also I am doing masturbation. Due to heavy masturbation, my penis shrinks and sometimes I forgot things. I am not able to remember anything. ### Response: Anejaculation is a condition where a man cannot discharge semen. It can be absolute when he cannot discharge in any situation and situational when he cannot discharge in certain situations but can discharge in other conditions. If he can ejaculate with masturbation but not with sex then it is a psychological issue. Psychological issue is due to inhibition when a man cannot ejaculate in the presence of another person. It can be overcome by gradual desensitization. He can rub his penis on any body part of the female like buttocks, thighs, breasts, belly, etc, and try to ejaculate. The female can also masturbate him. It is a long" "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 started having knee pain and recently it is unbearable. We did an X-ray and the doctor gave her medicines but there was no relief for her. She is also taking medicine for hyperthyroidism. Please advise. ### Response: Your mother appears to have severe osteoarthritis which is wear and tear of the knee joint due to age. I hope she does not get recurrent fever and is not suffering from any other joint conditions. Considering the severity of involvement, she may need total knee replacement after an initial assessment. In the meanwhile, avoid squatting, climbing stairs or sitting on the floor. Using a walking stick also will improve her pain. Hope that 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: My age is 28. I had a unprotected sex a month back, but only the top part of penis inserted ingto the vagina. It was not a full sex and the sperm was on the outer part of vagina. Actually I am confused. Later I took an Ipill after one hour. I missed my periods this month. I took a pregnancy test with showed negative result. After 7 days today, I took a test with Prega kit and Cipla kit .Both results are negative. But I am so tensed about my periods. Am I pregnant or is this the side effect of I-pill? ### Response: As pregnancy test is negative, you can wait for 10 days more for the periods to start. If no periods by that time then repeat pregnancy test. If test is negative even after 10 days then you can take tablet Norethisterone 5 mg twice a day for 5 days to get period. You should be getting periods within 15 days of finishing the tablets. The delay in periods could be a side effect of I-pill. Follow up with me in need." "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 with my partner. We used the condom but at the end, we found it broken but according to him nothing slipped inside but for safety I took i-pill within two hours. After this, I got bleeding within six days of i-pill intake and it lasted for five days and was the same as regular periods. So based on this I was expecting my second period on 16 th of this month but till date I have not got my second periods. During this period several times I did a home pregnancy test and all found negative. Till today I did not get my period. What is happening inside me? What is the expected date that I can get my periods? Is this a sign of pregnancy? Should I do the test again? Please help. ### Response: Hi. After having sex, five days later you got your periods. This indicates that 100% you are not pregnant. Now the delay in your next periods is due to the effect of i-pill. But there is no need to worry. No need to do any further pregnancy test as there is no chance of pregnancy. Just wait for one or two weeks and you will have your normal periods." "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 developed swollen gums from about six months and four months ago, my front gums were also swollen. During the course of two to three days, my front teeth began to develop a gap. Within a weeks time, one of the teeth became loose and more dislocated. My nearby dentist suggested me to put a cover on the teeth after filling it from the bottom. I do not want my teeth to remain dislocated and fixed in that position. I want my teeth back in the normal position. ### Response: I have gone through your images (attachment removed to protect patient identity). This is midline pathological diastema,that means there was either an aggressive infection or the formation of a cyst (midline palatal cyst) that cause the gap. This can also happen due to trauma. You do not want to build up your teeth with filling material. But in case if there is any primary cause, you need to treat it first. Please reply to my following questions: I need an IOPA (intraoral periapical radiograph) and OPG (orthopantomogram) of the region to view the cause. Brush twice daily with an ultrasoft brush" "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 16 year old. I have social anxiety and depression. I find it hard to talk to people, especially in public. I also have a problem with talking about my feelings face to face, making the idea of a therapist very nerve-wrecking. I am not sure if I would talk. I would probably just be too nervous to talk to him/her.I love animals. I love the company of them and feel safe around them. I am homeschooled, so I do not have any real-life friends. My family does not treat me the best, often blaming me for everything, insulting me and putting me on the spot in uncomfortable situations instead of getting me help. I am very lonely, but my anxiety makes it really hard to interact with people face to face, and very difficult to get a job. I have the idea to get a therapy dog. I believe it would help me in many ways, such as increase my exercise (which is a known depression-reliever), build self-confidence, offering a distraction, making me more courageous in public, enabling me to work, and much more. With that in mind, here are my questions.Do you believe that, for my case, a therapy dog would be a better form of therapy than an in-real-life, face-to-face therapist? Or, at least to begin with, then I could move on to a real therapist. ### Response: A therapy dog can help in relieving anxiety. But, since your anxiety is related to social situations, I do not think that a therapy dog will relieve your social anxiety. The anxiety will go away with exposure or by systematic desensitization. You have to take the first step for that. Talk to your parents about this and convey to them that you find it hard to interact with people and tell them directly that you have anxiety. This will be the first step towards treatment. Once you see the doctor, with time, your anxiety will go away and your conversation skills will improve" "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 38-year-old male. I have been struggling with fatigue for two months. I have never been like this before. I am a very active person. But, of late, there has been a lot of stress. I had started some multivitamins. After ruling out lots of possibilities, the doctor suggested it could possibly be adrenal fatigue. The symptoms seemed to fit the diagnosis. I did a few tests and got the results today. Saliva cortisol: 8 a.m. 0.97 (normal being between 0.61 and 1.31), 12 p.m. 0.50 (normal being between 0.26 and 0.75), 4 p.m. 0.16 (normal being between 0.13 and 0.51), 8 p.m. 0.14 (normal being between 0.08 to 0.40), DHEA 916 l (normal being between 436 and 1014), and TSH 3.69 (normal being between 0.60 and 2.49), mildly elevated. Please let me know your thoughts. ### Response: Hello. I understand your concern. I can assist you in this regard. But, before coming to any diagnosis, I would like to know the following. Let me know the details as early as possible" "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 unprotected sex a month back and after 4 to 5 hours, I used unwanted 72 and next day again I used unwanted 72. My menstruation has been missed. I tested my pregnancy through Prega news pregnancy testing kit and report was negative but my periods did not start. Then I used the unwanted kit (Mifepristone and Misoprostol) after taking this bleeding did not start again. I did the pregnancy test and the result was negative and my periods have not come till now. I am worried about my periods. Please tell me what is the problem I am having white vaginal discharge. Sometimes this is watery and sometimes it is slightly thick. Am I pregnant or not and why my periods are not starting? ### Response: Hi. You have taken emergency contraceptives twice and then abortifacient as well. If you have taken twice that further disturbed inside hormones then again you have taken abortion-inducing tablets and pregnancy test still negative but combined effects of hormones made things irregular. For your satisfaction do have serum beta hCG (blood pregnancy test) immediately that will remove your confusion regarding pregnancy. No need to take more hormones please as it will further complex things. Wait and watch. Let the body to respond already externally induced hormones gradually it should come to normal. In case of heavy bleeding or pain, dizziness or fainting better to report to the gynecologist tertiary care center" "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 burning sensation and pain in my vulva. I checked with a mirror and there is excess skin at the bottom and it is painful when I touch it. I am just wondering what could this be. What can be done to stop this irritation? ### Response: Hi. Vulval pain (vulvodynia) or irritation is very common. You need not be worried as it usually resolves with just proper hygienic precautions and minor treatment. The reasons for this could be due to a condition called friction-induced skin infection or skin tag or other skin conditions like lichen sclerosis. But proper physical examination is needed to find out the actual diagnosis and suggest an appropriate treatment plan according to the etiology." "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: Got a piece of gum basically flapping over my bottom, back left wisdom and this is causing some pain and also causing some food particles to get stuck. Is this dangerous? ### Response: Hello. You might need a small surgical procedure to remove this flap of tissue from over the wisdom tooth to allow proper cleaning of the area if the wisdom tooth itself has space to grow. If it does not have space enough, then the wisdom tooth may have to be removed. Please send clear pictures of the area to help me diagnose further and guide to the best treatment option for you. Use warm salt water gargle twice a day for a week or two along with an antibiotic gel." "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 migraine type headache on the left side of my head and it also stiffens my left neck muscles. I have this headache recurring many times a day. I also have problems with digestion and nausea. I am unable to sleep well at the night time. When I sleep in the morning, I still have a headache. What should I do? Headache triggers when I listen to music. ### Response: Indigestion and constipation can also be related to a headache. So treat your indigestion problem with Rabeprazole tablet for five days. Simethicone tablet can be used for the gas problem. Tablet or sachet is available, and it can be taken after dissolving in water. Fruit juice and fiber diet can be taken more. Whole grains, fruits, green leafy vegetables can be taken more. In a migraine, if the pain is unilateral, throbbing in nature, you can take tablet Ibuprofen to get relief. Consult your physician for examination if 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 have been suffering from tooth problem for the last 6 or 7 years. The first few years I was feeling pain, I visited some dentist near me, they gave me medicines for relieving pain. After that, my tooth corners started desquamation, and now from the last few months, a small ball full of blood and matter appeared on the gum of that tooth. Kindly tell me what is that ball and what should I do now? ### Response: I have gone through your question. I can understand your concern. I would have provided you a better possible diagnosis and treatment plan if you would have uploaded a picture. You can take Ofloxacin 200 mg twice daily and Metronidazole 400 mg thrice daily for five days. Your problem will be solved. But it is not a permanent solution you either need to get a root canal treatment done or get it removed. To check whether there is any chance to save this tooth, I need a photograph of your tooth with this ball." "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 feeling unwell for a long time. These are my recent blood results. My doctor says that my hematocrit, RBC count, hemoglobin and mean cell volume have been out of the normal range for at least 10 years as that is how far back he can see. I think it should be investigated. What do you think?Haemoglobin concentration 161 g/L [120.0 to 150.0], total white blood count 9.6 10*9/L [4.0 to 10.0], platelet count - observation 327 10*9/L [150.0 to 450.0], hematocrit 0.491 l/l [0.36 to 0.46], mean cell volume 83.8 fL [83.0 to 101.0], mean cell haemoglobin level 27.5 pg [27.0 to 32.0], mean cell haemoglobin concentration 328 g/L [315.0 to 345.0], red blood cell distribution width 12.5 % [11.6 to 14.0], red blood cell count 5.86 10*12/L [3.8 to 4.8], neutrophil count 6.3 10*9/L [2.0 to 7.0], lymphocyte count 2.6 10*9/L [1.1 to 3.5], monocyte count - observation 0.5 10*9/L [0.2 to 1.0], eosinophil count - observation 0.2 10*9/L [0.0 to 0.5], basophil count 0.1 10*9/L [0.0 to 0.1], percentage neutrophil count 66 %, percentage lymphocyte count 27 %, percentage monocyte count 5 %, percentage eosinophil count 2 %, percentage basophil count 1 %. ### Response: Hello. Your hemoglobin and hematocrit values are slightly high. Your RBC count is only marginally elevated since the upper limit of normal is 5.5 million/cu.mm. With these values, there is a suspicion of you having hemochromatosis or an early stage of polycythemia vera. In hemochromatosis, there is iron overload and the two main tests required are serum ferritin and serum transferrin saturation. Genetic testing is confirmatory. For polycythemia vera, the red cell mass needs to be determined and preferably a bone marrow biopsy. Testing for the JAK 2 gene is confirmatory. It is better to get these conditions ruled out since they require treatment." "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 brother, 46, has ALD cirrhosis. He was admitted to a hospital. Day-6 now. And is undergoing withdrawal and other treatment. MELD score is 22-24; ammonia 40 (down from 70). Low platelets, lot of bruises from falling pre-admittance. Signs of advanced hepatic encephalopathy. Treatment includes Rocephin, Librium, Lasix, Lactulose, Keppra, Magnesium and multivitamins, Presnison, Rifaximin, and Spironolactone.Prognosis is very unclear as assessments are day by day. Due to the UNOS policy, any transplant (including live donor, which I would do) will not happen for six months due to a waitlist. It is almost a death sentence and unfair. Especially in the context of a live family donor.What else can we do to immediately treat his degrading condition from a medical perspective? He has zero energy, cannot feed himself, barely can talk. Just last week, he was walking around and fairly alright (according to wife). Can we introduce alternative medicine? ### Response: First of all, you need to understand that alternative therapies do not work in acute severe states. You can consider them later once he recovers. At this point of time, apart from medical management that is already being done, you can discuss with your doctor for liver assisted therapy in which there is a machine that acts as a pseudo liver. This is used till a liver transplant is arranged. The second option is shifting him to countries where you can still go for emergency transplant provided you have a donor. Discuss with your doctor regarding partial liver transplant in which a live donor can give a partial portion of his liver to him. That donor can be from your family. You need to check if your hospital provides these facilities" "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 an anterior bulbar urethral stricture that is 20 % closed. I had two episodes of prostatitis, post-void dribbling and frequent urination with occasional mild burning and some mild spraying at the end of my stream. The urologist is recommending a repeat cystoscopy with dilation, but my urinary symptoms are fairly mild. I was on antibiotics previously. Urine analysis was bland with no infection. So, I am wondering if this dilation is even necessary or just to leave it alone? ### Response: Hello. When were you diagnosed with stricture? Where were you treated at that time and what treatment was given? Yes, I also feel that you should repeat cystoscopy and get it dilated as it invariably recurs. So, better to undergo cystoscopy and get it dilated as without that it may recur with more narrowing" "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 18 years old and my penis size is too small due to a lot of masturbation from the age of 14 years. I am in depression due to my penis size. Please help me. ### Response: Masturbation does not cause a decrease in the size of the penis. It is incorrect to think that or believe that. Most of the young boys are obsessed with the size of the penis. The fact being that size of the penis does not authenticate virility. There is no golden rule that describes or validates the size of the penis as long as you are able to achieve an erection for the purpose of copulation. I suggest you stop obsessing over the size of your penis and if you can please try to divert your mind by indulging in other hobbies." "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 55-year-old male. Routine CBC report shows hemoglobin 17.1, hematocrit 51.5, and platelets 255 (up from 201 last year). Should I be concerned about PV? ### Response: In polycythemia vera, hemoglobin level is usually more than 17.5, and hematocrit is more than 55. So you need not concern about polycythemia vera. The chance of secondary polycythemia also seems to be very less. So you need not worry about your CBC (complete blood count) result as per my opinion. If you have a history of persistently elevated hemoglobin for a long time, then only further investigation is needed or else do not worry. You can attach your reports to guide you further. I hope I have answered your question." "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 it bad for the back if I keep high arch during bench press? Can it hurt the back? ### Response: When you are arching your back excessively, it reduces the range of motion, and it makes the exercise so easier. The only disadvantage is that you will not use your muscles through a full range of motion, and a less strength is used. Also, remember the principle of individuality during exercise. All the individuals will require a different position to practice a particular group of muscle exercise. Please do these exercise under guidance." "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 baby girl is 3 months old and her weight is 4.5 kg. The cesarean was done at 37 weeks. She was 2.5 kg at the time of birth. I am using Lactogen 1, as the breast milk of my wife is very very low. I informed the pediatrician who takes care of my baby that we are giving 3oz but my baby after taking 1.5-2.5oz is refusing to accept as she is sleepy and we are unable to intake her anymore. Sometimes the baby is sleeping for four to five hours without consuming and sometimes she is sucking her fingers after two to three hours and when we are giving the feeding bottle she is taking 1.5-2 oz. The main problem is that we failed to understand whether my baby is hungry or she is sleepy as in both the cases baby sucks her finger. After explaining the same, the pediatrician said that she has not gained much weight and advised to have urine and blood test for CBC and TSH. When I asked him that whether can I change the formula milk he said that all are same and if we wish, we can change but has not given any suggestion. Please help me whether I need to change the formula milk and can use Dexolac 1 by replacing Lactogen 1? I cannot afford costly formula milk. Also, please guide me that how much oz I have to give and how much gaping is needed? Also when the baby is sleeping, shall I awake her and give the feeding? Please suggest. ### Response: Hello. No need to change the formula milk, continue the same formula milk, as the baby grows there is no hard and fast rule that the baby takes milk every two hours. The feeding should be on demand, whenever the baby wants milk she will cry. The best method to see whether milk is enough or not is to see the number of times the baby is passing urine. If it is six times a day that means the milk is enough. Since your baby was preterm the growth might be a little slow, you should be worried only if the baby is not tolerating feeds like if she is vomiting too much or having too much of loose stools." "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 minor to in some cases moderate toothaches from time to time due to a chipped root canal. I have not had any issues until recently. It has been around four years since I had the root canal done but never went back to get the crown. I have not gone because of dental anxiety. I have not had great experiences at the dentist in my life. The pain and sounds of the tools make me weary.I take pain relievers (one a day usually, maybe two). The toothaches are not so bad, but they are bothersome, to say the least. I take primarily Acetaminophen capsules 500 mg.Toothache details:It is weird. Let me explain. I have recurring moderate toothaches (three to five a day) for a few days in a row, then I have a minor one maybe once a day for a few days then the cycle repeats. It is like a pattern. No toothache has been that serious but I do recall having a couple of low-end severe toothaches that did bother my sleep. Those, however are rare. These toothaches have been going on since two months. They are again, not constant. I do have times when I do not really have much or any pain, the most active toothache time is evening. ### Response: If you have not put a crown until now on the root canal treated tooth, then yes it can get infected and cause pain. The pain will only increase. So, it is better to go back to your dentist, get an X-ray done and get an opinion. If the root apex is again infected, you may need retreatment or you may lose that tooth. You will need antibiotics also" "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 18-year-old female, taking no medications, and I am 5\3"" in height and 180 lbs weight. Since last night, I am having severe chest pains. I cannot sleep, and when I try to eat, my chest hurts more. It hurts all the time, but the severity comes and goes in spurts. I am not sure if this has anything to do with the chest pain, but just today, I was lying on my right side and moved to my left side, and I heard and felt a sloshing in my chest or upper abdomen area. What could it be? ### Response: Hello." "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 dog had bit me in my finger eight years back. At that time I did not take any vaccine or treatment. Is it possible that I can get affected with rabies in the future? What is the diagnosis system of rabies? If I get diagnosed with rabies then what I have to do? ### Response: Hello. No need to get panicky over the dog bite. You are fine. Rabies testing on humans is performed on samples of saliva, serum. Saliva can be tested by virus isolation or reverse transcription followed by polymerase chain reaction (RT-PCR). Serum and spinal fluid are tested for antibodies to rabies virus. In animals suspected of rabies, they have to be killed and their brains are examined for the presence of this rabies virus. Rabies is usually fatal. So the best thing is prevention. So if you have a pet dog get it vaccinated." "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 using Nano Leo Total. I want to improve my sexual activity a lot. How can I do it? I am happy, and I am not in a depression. I feel very normal. But I am workaholic, and I work very hard for a long time. Does it have an impact on my sexual activity? Please suggest me. ### Response: A busy life will not have an impact on sexual life, though it adds to fatigue, at the same time, workaholic maturity increases with confidence. Consider taking either Sildenafil or Tadalafil. Tadalafil is long-acting, and it is best suited. This will make erection harder, and it will increase the time too. Take 10 mg on alternate days and also take another tablet on the day of sexual intercourse. It helps to maintain an erection. Apart from medicines, you can think of taking supplements. Nano Leo has L-arginine. But I advise you take L-arginine in a dose of 1500 mg. Tantex Forte and Confido are herbal" "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 my wisdom teeth pulled out a couple of times back, now I am putting on braces. My orthodontist said that I have to remove my premolars in order to make room, but I feel like you could just push back my molars somewhat where the wisdom teeth used to be. Is it possible? Very similar to the bottom except he wants to remove one front tooth to make room but I feel like you could just push back the molars a little bit to make room. ### Response: Hi. First of all, you have to understand the fact that not all wisdom teeth are functional. What I mean is most of the wisdom teeth are removed not to create space but it does not serve the purpose to chew well instead of harm the surrounding gums. And in orthodontic treatment, the molars cannot be shifted because that will collapse the whole contacts between the teeth. There is a rule that the molars have to hit each other at certain points only then it helps you in chewing your food efficiently. Hence, there is no harm in pulling out the premolars in order to gain space, because there would not be any gap left behind after the treatment is completed. So, I advise you not to panic because you are losing your premolar tooth but that is definitely going to help the treatment become a success." "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: Yesterday I took a mouthful of soup which is extremely hot and I realized it only after swallowing it. It is so hot that I felt like it had been in the microwave for too long. I felt the heat going down my throat, burning from the esophagus into the stomach. I rushed in and drank water, but it felt like the damage was done. Today I am struggling with eating and drinking. The pain down the center of my body is excruciating when I swallow something. I am having constant pain in the middle of my chest and back, sort of under my ribs, and the back of my throat feels like I have the worse sore throat ever. I feel sick all the time. I have two questions. Can I take some Codine to numb the pain, or will this make my stomach worse? What medicine can I take to help my insides heal? ### Response: I understand your concern. There may be small burns, as you know, that happens to our tongue when we have something very hot. There is nothing to worry about. I will advise you to stick to a bland diet for the next three to four days. Any spicy food will make it worse. Have more of cold milk, cereals, and curd. These being cold will soothe the lining while passing through the tract. You can take Paracetamol, for your pain, but only after the food. Also, take Sucralfate two tablespoons twice daily, after food for the next three to five days based on your symptoms. This syrup will form a protective coat around the area that has the lesion and help in healing. You should be feeling better in a couple of days. There is nothing to worry about. 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 a 26 year old guy, with one kidney. One year ago, I made a CT scan with contrast. A week after this event, I started to have white stuff in the urine. If I am sitting, there are white things floating on the surface. If I am up, it starts to foam a lot. So, I did a blood and urine test. All the results were good. So my question is, what is going on? I have no specific symptoms, only a burning sensation on the urethra sometimes. With one kidney, my mind is going crazy. ### Response: I have seen the reports (attachment removed to protect patient identity). I can help you further if there is any other 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: My father is 57 years old. He is having 102.3 fever and also some confusion and disorientation. The physician he consulted did blood work and concluded it to be viral but the delirium started after the consultation. Getting worried. I can send the blood reports across. Please help. ### Response: If he has a fever and is delirious, it is not something that should be managed at home. ), ischemia (lack of blood flow), etc. So, I suggest that he should be seen again by his physician. The alternative would be to get him hospitalized. In the meanwhile, give him Acetaminophen (Tylenol) to keep the fever down. 650 mg can be given four to five times a day. Temperature itself can cause delirium. Please upload the blood work, so that I can take a look at them as well." "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 girl baby. She has completed seven months. Actually, my baby problem is weight. She has 7 kg now but she looks like five months baby structure like weightless. If anyone of them take my baby they ask (why baby like weightless and look like five months) but she eats well and breastfeeding is also well and more very active girl but the main problem is she looks like weightless. So I need a reason for weightless structure. ### Response: Hello. A baby gains to be double the birth weight by six months of age and triple the birth weight by one year of age. The weight of your baby seems to be fine to me. Continue to breastfeed, give adequate complementary feed in the form of cereals, pulses, fruits, other protein sources palatable for a baby. No need to worry, let the baby grow naturally" "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 40 years old. I have been suffering from heavy menstrual flow for the past 11 to 12 months. I had a heavy flow with clots for the last two months. Now, I have been menstruating for the past 10 days with heavy flow and clots. It started exactly at the cycle period date and continued for five days and again on the seventh day, it started again with heavy flow. I have had a cyst, high levels of prolactin which have been treated during this period. Last month my doctor recommended the endometrium biopsy but the report was normal and the diagnosis was late secretary endometrium. My current medications include Ovuloc, Femilon, Meprate 10 mg two times a day, Iron tablet, and pause MF (on SOS basis). Can you please advice? ### Response: Your biopsy report is good. The medicines you are taking are also good. But instead of taking hormones daily I recommend that you put in a hormone-releasing intrauterine device called Mirena. That remains in your uterus without problem. Delivers the hormones where they are actually needed, cutting down the side effects of excessive hormone intake plus you get rid of the daily responsibility of taking your pills. However, as per the ultrasound finding of a bulky uterus, you may have adenomyosis which is causing this abnormal uterine bleeding. Adenomyosis is a condition that affects the wall of your uterus. Unfortunately, it does not respond well to hormonal treatment. Please get an MRI of the pelvis done. If that shows adenomyosis you may still try Mirena but if that is ineffective, you may even need surgery." "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 32-year-old female. Recently, I got tested for rubella. I checked it in three places, and they showed different results. I am testing it as I am willing to get conceived. My first test result showed IgG of 6, and the other result showed IgG of 5. All the three results showed a negative IgM. When I was 11 years old, I got a vaccination for rubella twice. Please suggest. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). As per the laboratory reports, one thing is clear that you are not immune to rubella as the titers of IgG are below the required level. You are in a safer zone as you have appropriately vaccinated in childhood. In rare cases, due to numerous reasons, we do not develop complete immunity. Do not plan for pregnancy now. Get re-vaccinated again, check the titers and then think about conceiving." "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 rheumatoid arthritis and take Trikata, Sinhanad guggul and Shalaki. I also use psyllium and ginger tea. I take massage with sesame oil and maharanayana oil. For how long must I take this therapy to feel better? Is this therapy alright? How is your experience with rheumatoid arthritis? ### Response: Hello. I just read your query. The medications you are taking are all good, but rheumatoid arthritis is an autoimmune disease. So, you have to take medicine for a long term. The effect of rheumatoid arthritis varies from patient to patient. In some people, after taking proper medicine, further damage to joints can be prevented. However, in some, it persists even after taking medicine. So, I advise you to follow your doctor\s advise and keep on repeating your investigations after some time. Also, do ask your physician about Panchakarma therapy. It is also very helpful in rheumatoid arthritis. I hope you are satisfied with my answer" "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 times my chest is swelled, and some times it is normal. If I pressed that it is hard and gives pain. What could it be? ### Response: According to your age, there must not be any cardiac anomalies. But we should also rule out, as sedentary lifestyle nowadays. Need for a proper description for swelling like size, when increase or decrease, soft, hard, pulsatile, any associated symptoms or not, pain, burning sensation, etc.As of now, with such brief history, we can suspect a muscular change such as increasing in size and giving rise to pain, for that symptomatic treatment to be given. chest X-ray and USG thorax. Tablet Buscopan 1-0-1 and as and when required for excessive pain. Volini gel for local application two times a day. Avoid heavy weight lifting." "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 24 year old male. I work as a software engineer. Over few days, suddenly my arm muscles are shaking for a few seconds and it will be normal after sometime. Also sometimes, I am not feeling well. Are these the symptoms of diabetes or any other health issues? ### Response: Hi." "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 iron deficiency anemia before three months. On my latest check-up, I have seen that my iron level has reduced (5.74 g/dL to 5.72 g/dL) while my serum iron level has got higher (36 mcg/dL to 39 mcg/dL). My RBC level is normal. But my hemoglobin level got higher (11.3 g/dL) as my UBIC is still high. I made a urine test too, as I had white things in my urine for almost three months. My results say the leucocyte clusters are typical and there are 15 to 20 % epithelial cells seen. My doctor advised me to take Ciprofloxacin antibiotics. From yesterday, as I started using Iron tablets, I saw my stool in two colored like some of them are black (because of the iron), and few ones are light brown. When the stools are dropping, I have a feeling of something is hurting me. It quickly passes away, and after it has gone, my anus starts to burn. Is this a sign of bacterial infection? There was no blood in my stool. ### Response: The black stool is because of iron intake. You can have a burning sensation while passing stool because of proctitis like inflammation or due to piles. For that local rectal and proctoscopy examination is needed. Anal water sitz bath is beneficial, and if piles is present, then Cremaffin syrup (Sodium Picosulfate with liquid Paraffin) can be taken. Your white color urine is due to the presence of pus cells and it can be suggestive of urinary tract infection" "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: Seeking the specialist insight on foods and spring allergies.What are some foods that can help fight or reduce the symptoms of spring allergies? What makes each of these foods effective? Are there any foods that might make spring allergies worse? How long do you have to be eating these foods on a regular basis for them to help? ### Response: Hi. As per Ayurveda the Kapha that increases and accumulates during extreme winter is liquefied by the hot sunrays of spring season. This weakens the digestive fire causing various diseases. Hence, the aggravated Kapha is to be quickly pacified by various means. Following precautions should be taken in spring season. 1. Intake of diet should be light and" "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 tooth is rotting away below the gum line. I have not been to a dentist because I could never afford it, but now I think I might need one really bad, so what should I do? ### Response: Your thought is exactly right. It is high time you visited a dentist. Tooth rotting below the gum line is not a good sign. The dentist would tell you to take an X-ray. If it is non-painful and if the x-ray reveals that the infection has not touched the pulp, you can go for a filling. It is advised that you see the dentist as soon as possible because once the infection spreads deep into the roots, even a root canal treatment would not be possible. In that kind of a scenario, removal of the tooth becomes the only option. Basic procedures cost is less. The expenses of treatment increases if not treated in time. I hope this answers your 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: Testicular biopsy and micro TESA could not find a mature sperm and FSH is high. Is any more treatment possible such that I could become a biological father? ### Response: Hi. How are you doing today? The results do not look favorable. As per your blood results, testis has atrophied, confirmation done by biopsy (attachment removed to protect patient identity). So, as per reports, there are no sperm-producing cells in testis. No one can make these cells artificially with medicine. So, unfortunately, you cannot be a biological father. The only option is donor sperms." "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 35-year-old male. I have a problem in my skin, especially, on joints. I have had already consulted a dermatologist and she suggested consulting a rheumatologist based on the symptoms. Due to COVID-19, I could not consult but now it is spreading very fast. Could you please help?I also have vitamin D deficiency and taking D-rise and Lobate S ointment. ### Response: I have gone through your query and reports. (attachment removed to protect patient identity). Your vitamin D is significantly low for which you are already on the supplement. I want to ask you about skin problem and joint pains. Since the prescription was not fully loaded, I could not figure out the exact diagnosis of what the dermatologist has said. Did they mention about psoriasis? As psoriasis and joint pains can be related. If you could attach a picture of the skin lesion, it may be helpful. Is there any early morning stiffness in the joints? Any backpain or neck pain? Any one in the family with a history of skin problem? Do let me know these answers and picture of your skin lesion 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: I have 8 mm renal calculi in the right upper ureter. Please help. ### Response: CT KUB (kidneys, ureter, and bladder) is 95% accurate to diagnose urinary stones. Since your right kidney is blocked, I need to check on your kidney functions by doing a blood test called creatinine level, especially if you have other medical problems like diabetes or hypertension. I also want to make sure you do not have urinary infections after this if kidney functions are normal and no infection then we can try medical therapy for 4-6 weeks with capsule Tamsulosin (Contiflo) 0.4 mg at night daily for six weeks the possibility of passing the stone is 25%. If you need more urgent treatment with a 70% stone clearance rate will be shock wave lithotripsy. If you got pain again in spite of medication or you got high creatinine level then endoscopic ureteroscopy DJ stent will be the best first-line option. On follow up after treatment you need needs calcium level, phosphate, and uric acid. I hope this helps. Creatinine, urine analysis, and culture. 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: My 2-year-old daughter has raspy breathing, and a rough cough followed with a runny nose for the past two days. Today started running a slight fever of 100.3 with green diarrhea that has turned yellow that smells very bad. She also keeps pointing to her belly as it hurts. Kindly advice. ### Response: Hello. I just got your concern. It is like a typical viral infection. Give more water, liquid, and homemade food. If she has a fever when measured with a thermometer kindly make a note of it. If her temperature is more than 100 Fahrenheit, give Paracetamol syrup with a dose of 15 mg per kg. Keep a gap of minimum six hours in between two treatments. Is she pointing her belly and complaining that it is hurting it is possible then maybe some spasm? You can give Dicyclomine syrup. For cold and runny nose you can give Cetirizine syrup 2.5 mg one time a day. Look for breathing if she is having more cough and breathing then please visit the nearby pediatrician. If she is looking dull, not taking anything from the mouth and sleepy, then please go to the pediatrician. Stool routine. Dysentery. Viral gastroenteritis. Oral rehy" "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: Dear doctor,I have penile papules and want to get rid of them. Is there any way or medication? Please suggest. I got tested for all STDs and everything is negative. ### Response: Can you tell me the duration of complaints? Is there any associated itching or urethral discharge? What is your marital status, and if partner also having any complaints? Revert with more information to an HIV AIDS 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 testosterone report is attached herewith. Does it need to be improved? ### Response: Hello. I read your query and understand your concerns. I have seen the reports that you attached (attachment removed to protect patient identity). I hope this answers you. Feel free to write back to me if you have more questions" "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 hypothyroidism two months back and started on Armour 15 mg. Four weeks later, upon recheck, my TSH dropped four numbers which were good but I had some palpitations for a short time each day. I just switched to Levothyroxine 50 mg and the palpitations are maybe one hour a day. Any suggestions or is it just going to take more time to adjust to a thyroid hormone? ### Response: Have you checked your heart rate during the episodes of palpitations? Nonetheless, the palpitations will get better when you take Levothyroxine dose gradually. So no need to worry about it. Just continue taking the thyroid medicine and your symptoms will improve with time." "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 just had a wisdom tooth removed a few days ago and the pain is still present but manageable. The pain has also spread a little around the jaw and up my face slightly which makes me think I have an infection. I am doing saline rinses a few times a day. My question is I have some Flucloxacillin at home. I am wondering if that would help as I think I had Amoxicillin last time. I was allergic to Aspirin when I was very young but have taken Ibuprofen since and been fine. Do you think Flucloxacillin will help and be fine to take? ### Response: Hello. After third molar surgery, the swelling in jaw bone is common, and cure after 3 to 4 days. It is not due to infection but it is due to body defense reaction. So do not worry about this and wait at least four days after extraction. Amoxicillin is a most popular prescribed medicine by the dentist after extraction. So I suggest you take medicine as advised by your dentist. If you want to change any medication you should take permission from your dental surgeon." "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 month ago, I had a dental trauma on my lower three incisors. The teeth have moved slightly from their original position. My dentist has advised me for a root canal for all the three teeth. Now before two days, he started the process, and one of my teeth has turned black. What can I do now? ### Response: I can understand your concern. I feel that the dentist has to stabilize your teeth first if they are mobile. It can be done by splinting. RCT (root canal treatment) is usually done to the teeth if the trauma has involved the pulp. Discoloration or pink teeth usually occurs in injury. If the RCT is done, place a crown over the treated tooth, and the discoloration will go off definitely. I can guide you better if you send the photograph of the teeth with an X-ray." "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 19 year old skinny male. My BP was 158/100, but that could be because I was anxious at the doctor\s. I have no prior health conditions. What could be the causes of a high blood pressure for me other than anxiety? ### Response: I understand your concern. Your age is 19 and your blood pressure is high. Regards" "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 taking consciously healthy, and a vegetarian diet with my partner. But, I have an issue with portion control. When I was growing up, food was not always available to me. So, when I had food, I ate a lot, and that habit has followed me into my adult life too. I am curious to retrain my mind. So, that I can get better control to eat. ### Response: Hi. Portion control is very important to maintain a healthy body" "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: Every once a month at least I get a flare up of diarrhea where I go at least six times a day and nothing seems to settle my stomach. The stool itself has a weird texture, almost sand-like. Most of it float down but some do float up and there is mucus in it. Other symptoms I am experiencing are lethargy, feeling of being full yet hungry, loss of appetite, and dry mouth. Any idea of what this could be? ### Response: Hello." "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 47 year old male weighing 90 kg with a height of 5\9"", suffered with fever as well as cold routinely in the last month. My doctor advised me some blood test as my BP at the time of consultation was 130/110 but I was not having BP problems. The last checkup reveals normal BP 120/80. The antibiotic given to me works and I do not have fever after that. The blood test advised to me by the doctor shows normal reading except creatinine 1.19 and increased uric acid. My uric acid is normally on higher side and I was prescribed Zyloric tablets. Please advise me whether I am having any kidney related problem or not. My BP is normal without medication. What should be my line of treatment ? I have attached my lab reports including KFT, hemogram and urine test. I am worried. Please review the reports and help me. ### Response: I have gone through your reports (attachment removed to protect patient identity). For a better judgment you need to get a repeat serum creatinine as well as uric acid done. This should give us a clear idea. In case if it is still high, you would require to get further investigations. So, get the repeat test done and write back to me with reports." "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: Hello I feel pain at my lower left side of abdomen,, Also It's hard to pee ( feeling burning) the symptoms looks like I have Urolithiasis. I need to make sure ### Response: Hi, I understand your concerns. You are finding it difficult to pee and there is a burning sensation. These may be due to urinary tract infection (more likely) or stones. In your urine report there are a few microorganisms and red blood cells are also present -these are suggestive of urinary tract infection. Please get an urine culture sensitivity report and an ultrasound of kidney,ureter and urinary bladder. Plenty of fluids is advisable and antibiotics have to be taken on basis of your culture report. Signs and symptoms of kidney stones can include severe pain, nausea, vomiting, fever, chills and blood in your urine. Diagnosis of stones is based on urinalysis and radiologic imaging, usually noncontrast helical CT. Treatment is with analgesics, antibiotics for infection, medical expulsive therapy, and, sometimes, shock wave lithotripsy or endoscopic procedures. Hope this helps. UTI UTI Urine Culture sensitivity Ultrasound of kidney,ureter and urinary bladder. Urolothiasis UTI Plenty of fluidsAnd antibiotics according to urine culture report. Plenty of fluids,genital hygeine." "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 Ashwagandha a general medicine? Is it fine taking it for OCD along with other drugs like Nootropil 800 and Serta 50? ### Response: Ashwagandha is a well known Ayurvedic herb. Mostly used as a general tonic to rejuvenate the body. It helps to reduce stress and anxiety by regulating the nervous system. Ashwagandha is serving as a medicine in several forms like powder, tablet, capsules, syrup, paste, etc. It has several benefits. It improves body immunity, reduces mental stress, provides healthy sleep, improve vital activities and several others. Yes, you can take Ashwagandha as general medicine. But dose and duration of medications should be according to your body condition. And yes it is fine to take this medicine in OCD (obsessive-compulsive disorder) along with other 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 am a 24 year old female and my weight is 133 lbs. I will be nine weeks pregnant tomorrow and my nausea, hunger, and discharge has pretty much stopped. This is my first pregnancy. ### Response: I can understand you are worried about your health at this point of pregnancy. Hope it helps. Please feel free to revert. I would be happy to assist" "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 18-year-old male. I believe that I have a testes infection. When I lie down, my testes hang low, and when I do exercise, they become very tight. They also become tight when I wake up in the morning. Sometimes they move from being tight to hang low. I feel uncomfortable. What could this be? ### Response: Testicles are very sensitive organs. It is recommended to wear inner wears loosely, and it should not be tight. It has to be free to give enough space and enough aeration to these sensitive organs. When you sleep, do not sleep with your underwear. Have a sleep free of clothing. Do you have any pain or visible swelling? Is there any rash or sores present on the testicles? If not, the scrotum may have some small opening where the testis can hang below the normal area." "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 with my fiancee on 21st and as a precaution, I gave her Unwanted 72 on 23rd. She got little bleeding which was thick on 4th and it continued till 8th. Now, she was expecting period again on the 4th this month, but it did not come, and therefore she took a pregnancy test on 7th and that was negative. When will she get her periods? Is there any problem? ### Response: Hi. Since you have taken the emergency pill within 72 hours of intercourse there is no chance of pregnancy. So, relax and do not worry. The delay could be because of hormonal changes due to the pill you have taken. She should be getting her periods within a week or so. If you have a doubt, then get yourself checked by a gynecologist and get a pelvic scan done to rule out the exact 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: My granddaughter was normally born on 11 April 20. Her birth weight was 2.6 kg, currently weighing 3 kg with persistent jaundice. Her total bilirubin is 3.47 and direct is 3.19. She is breastfeeding along with formula as per pediatrician suggestion with couple of blood tests and ultrasound. The ultrasound was tested for biliary atresia and was negative. I am recently seeing oil in her stools. Pediatrician has evaluated it as conjugated hyperbiliruminemia. It would be nice if you could review and let me know your opinions. Is this could be the reason for not gaining weight? ### Response: Persistence of direct bilirubin at two months of age needs to be evaluated properly. Most importantly, what is the color of her stool? Is your doctor told you anything about the liver whether it is big or normal? There are so many causes, but most important and serious and need timely intervention is extrahepatic biliary atresia which as per information has been ruled out. Other common causes can be neonatal hepatitis or some metabolic disorder. The list of causes is long so better if you can share all the reports (blood, urine, sonography, Torch titer, TFT, enzymes, alpha 1 anti-trypsin, etc), I can advise you on how to proceed further and whether it needs further investigations." "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 seem to have a recurring spot on my back. Feels like a bite but it never heals and never goes away. It also has a brownish dark area on the skin around it. No pain. ### Response: Exactly how long it has been there? Please send few more close up photographs? Any family history? Any history of diabetes mellitus or hypertension or any other medical illness?" "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 grandmother aged 91, fell in the bathroom about a month back. She was able to walk and did not have any major symptoms. Since two weeks, she has had difficulty walking and lower back pain. She had an x-ray two days ago. As she is in complete bed rest, developed bed sores. I need a review on the x-ray and help with the treatment. ### Response: Hello. For me to help you with your query, I need to see the x-ray of the lower lumbar area. Kindly attach the x-ray and follow-up with the same. Revert with more information to an orthopaedician and traumatologist 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 wondering if I need to be concerned, or what is the probability if any, would I have at developing a blood clot if I have no blood clotting genetic issues (factor v, etc), not on any hormones (was on birth control pills for 12 years but been off for almost four years), no recent surgery, do not and have never smoked. I am just going to be moving 12 hours away and someone I know developed a blood clot in their leg after a 12 hours drive and did not have any risk factors (smoking, hormones, etc) to their knowledge. I got a little nervous about this possibility because I had a friend who died of a PE. Also, should I take Aspirin before the trip and wear compression socks or would that help? I am a 31-year-old female who only takes prenatal vitamins, Vitamin B12 1000 mcg chewable, Citalopram 10 mg, and occasional Excedrin as needed. ### Response: Hi. I can understand your concern. Before I can answer your question, you mentioned that you are taking prenatal vitamins. Just curious if you are pregnant or plan to do so? Do you have previous unplanned or accidental abortions? Please let me know." "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 noticed a white cloudy area around the rim of my cornea a couple of days ago with no pain. After a couple of days, I used a rigid gas permeable contact wear. I have now woken up with pain in the same eye and it is now bloodshot around that one side. I decided not to wear the contacts today and I have worn the glasses only. I visited my optometrist and he has prescribed a steroid drop. I am looking for a second opinion. Of note, I have worn glasses for 25 years. I have used the RGP lenses for 12 years. Had a white patch on the edge of the cornea approximately five years back. This was attributed to contact irritation and healed after a few weeks of not wearing RGPs. Please advice. ### Response: Hello. This is a corneal ulcer. The probable cause is trauma due to lenses or infected contact lens solution. You can have devastating consequences." "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 29 years old. Last year, I was diagnosed with adenomyosis after an ultrasound. Previously, I had undergone ovarian polyp removal. My gynecologist has told me that there is no problem with me to get pregnant. However, everything I read online says differently. We plan to start trying for baby by next month. Is there anything I can do to help with the process? I am just confused with my doctor\s words, as we have waited a year and the disease has more likely spread. I have been taking progesterone since the diagnosis. I just want to prepare myself mentally before trying. ### Response: Firstly, let me tell you that sonography is not always suggestive of adenomyosis. It cannot diagnose it. For diagnosis, you have to send biopsy of the uterus. In adenomyosis there is pain before, during and after menses. There is also focal and diffuse type of adenomyosis. Whatever you read on the internet is about diffuse or generalized adenomyosis. A few things on focal adenomyosis are available because most of the time it goes undiagnosed or has very mild symptoms that do not hamper routine. So, just focus on the present and start trying for pregnancy. In fact, if you get pregnant and pregnancy goes up to term or near term, then there is a chance of cure from adenomyosis theoretically. If you do not have the symptoms of clear adenomyosis, then there is a chance that it is not adenomyosis. So, do not worry and take chance for a year. If you do not get pregnant, then consult a gynecologist as normal people." "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 2-year-old daughter had been eaten up by mosquitoes, and those areas are red, bumpy, and some have red rings around them. These bumps are itchy to her, and they look infected. Does that mean she is allergic and what can I do to help her? ### Response: Hello. This is the normal reaction to mosquito bites. You can also give about 2 ml of Bena" "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: 40 days back while I was walking on the road and unaware of a sleeping dog beside me I stepped on it and it had bitten me. After, reaching my home after 15 minutes I washed my leg and I have not found any blood wound but firing type feeling was there and later I met one physician doctor after a week and he told that I do not need any vaccination for this but after a few days I have felt the inflammation through ears and I have informed him and he told me that it happened 20 days back and you are looking extremely good. If you are really affected you will not be like this. But, now I have the inflammation and itching on my face and toothache today too. If these are the symptoms of the dog bite, please let me know and suggest which medication can I get. ### Response: From your history, it seems like the dog just brushed against your leg. If so, then it is a category 1 wound and requires no vaccination other than local wound cleaning with soap and water. However, if there was a visible scratch (even without bleeding) then it is category 2 and might need vaccination. Rest assured, the symptoms on your face and tooth are not related to rabies. Take some pain-killers and it might clear on its own. Do let me know if you have any further doubts regarding this" "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 24 year old female. I visited a dentist a week back for pain and swelling at the back of the throat at the retromolar region. The dentist took an X-ray, but no wisdom tooth was present. The dentist prescribed antibiotic Metronidazole and I completed the course. The problem is my ulcer at the region does not heal. Is it normal that the ulcer does not go away? ### Response: I hope it helps you. If the problem persists, you can write to us or visit a dentist with a specialty in oral medicine and radiology" "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 64 years old mom was recently diagnosed with ovarian cysts and is undergoing a hysterectomy plus oophorectomy two days later. During the same routine health checkup when her cysts were diagnosed, her urine report showed RBC of 6 to 8/hpf. Is this a possible UTI? And if it is, why should not our surgeon correct it before the operation? I asked him about it, and he said it would be taken care of when she gets admitted. I wonder why?I am particularly more worried about it because she also has a left artificial hip from the past two years which should not catch any infection. I remember her orthopedician asking for a urine culture a few days before her hip replacement and giving her antibiotics for the UTI immediately after that surgery. So, why is this surgeon not bothered to correct the UTI pre-operatively? ### Response: RBC (red blood cells) in urine does not mean UTI (urinary tract infection). Pus cell in urine indicates UTI. Up to five pus cells per HPF are normal. 2 to 4 is in your case. So, it is not UTI. There are many causes of RBC in urine. Is she on any blood thinners, like Ecosprin (Aspirin) or Clopidogrel which can cause mild RBC in urine. So, that might be the cause and not UTI" "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 Cortisone shot in my knee, 10 minutes later started to feel seriously dizzy. I cannot walk straight, cannot hear, my eyes felt so heavy, almost passed out, heart palpation. ### Response: Hi. The dosage of Lignocaine depends on your age, weight and presence of other systemic ilnesses. The" "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 an abortion before 10 days due to a major cleft lip and palate to the child. When can I start planning to conceive again? Can I take a Pp26 tablet and CC74 tablet before three months of pregnancy to prevent this defect? I have attached my report. ### Response: Yes, it is important to take the above folic acid supplement to prevent cleft palate and lip and also neurological defects in the fetus. Take three months before conception and continue throughout pregnancy. Good luck" "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 36-year-old woman with family history of heart disease. For a couple of days, I have been feeling discomfort in my chest, like my heart gets squeezed and I have chest discomfort on the left top part of my chest, like six fingers down my clavicle. I also have a lot of fatigue, specially from 10 AM to 1 PM. The discomfort gets worse when I am laying on my back and I can feel my heart moving in my chest in an unusual way and the squeezing feeling coming and going. I have had anxiety disorder for almost 20 years but this does not feel like my usual anxiety. I am worried and not knowing exactly what to do. ### Response: Classical cardiac chest pain is a sensation as if an elephant is sitting on your chest. It lasts from a few seconds to minutes and could be provoked by exertion. What you are feeling is classified as atypical chest pain but you also have palpitations. Do you have a way to check your blood pressure and heart rate? Please let me know." "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 persistent bad breath and bad taste in my mouth. I have excellent oral hygiene, and my dentist said my teeth and gums are all healthy. My doctor said that it could be sinus drainage, but I have dealt with this for years even when I have no drainage. It is ruining my personal life with my wife and my social life as well. Please help. ### Response: Hi. Did you get any CT scan of your sinuses done before to rule out sinusitis? Yes, sinusitis can cause such symptoms and to rule out that a CT scan is needed. So if you have any of these symptoms, then it can be due to sinusitis. Have you tried mouth gargles for the same symptoms? If not, then you can use mouth gargles as that will help. Also, tonsillitis causes such symptoms. Kindly send me a picture of your throat and oral cavity. Sinusitis or tonsillitis. CT scan of paranasal sinuses (plain). Revert with the report to 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 possible high-risk exposure four months back, and I am worried about HIV infection. I got a fourth generation PCR, PCR for HIV2, and viral load, which were all normal. I still have symptoms like diarrhea and joint pain. Just last week I did a CD4 panel, and this is the results, the absolute CD4 helper is 937, percentage CD4 is positive, the absolute CD8 suppressor is 886, percentage CD8 is positive, lymphocytes is 32.8, CD4/CD8 ratio is 1.06, WBC is 12.2, and neutrophils absolute is 8.9. My concern is the CD4/CD8 ratio, I read that a number below 1 might be HIV, and I am so close to 1. Also, my WBC and neutrophils are high. Do you know what it means? ### Response: Let me answer your questions step by step. Hope your queries are answered, but if you still have any other question please do not hesitate to ask" "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 9-year-old daughter has recently been diagnosed with a mild high frequency hearing loss in both ears. Her hearing levels are only very slightly below normal and it is not impacting her day to day in a noticeable way so, for the moment, the audiology team are just monitoring it. My worry is that I accidentally caused it when she was a baby. There was one time when she was a young baby (maybe 2 months old) and she was in a rear facing car seat in the front of my car, i.e her ears were near the speakers at the front of the car. I turned the engine on and the radio blasted out really loud, I think it was probably on volume 12 or 13. I turned it down straight away and she did not cry but now I feel awful that I may have damaged her hearing. Please could you tell me how likely it is a one-off incident like this would have caused it? ### Response: I understand your worry. I would say it is possible to develop such a hearing loss due to what we call acoustic trauma, noise-induced. However, we can never be sure whether the loss is due to that incident or due to some other or if the loss was congenitally present. What you can do to prevent further deterioration is prevent her from listening to loud music, keep her away from loud sounds, try and use noise isolation buds when there is excessive noise outside, eat a healthy diet and meditate. Rather than worrying about what could have caused the loss, I think it will be prudent to prevent any further damage to the ear and guide your daughter on the right path to achieve what she wants to. 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 18 (unmarried) and I have missed my periods on first two days and I suppose I might be pregnant (unplanned) as I am not having any symptoms of my monthly periods. Me and my fiance had a pullout in 6-10 seconds after he inserted the penis in vagina but there was just a pre-cum which he had already wipped away and there was no ejaculation taken place (sure). Is it a sign of pregnancy? Can I consult a Gynecologist alone without parents or guardian? Can I terminate the pregnancy by medication as it has been only 6 days? What should I expect? Please help, I am stressed. ### Response: Please do not get worried or panicked. Get a beta hCG test done. It is a blood test to confirm pregnancy. A value less than 5 means you are not pregnant. Even if it is positive, you do not need to worry. You can get it terminated by medicines (You will need to get an USG done first). You can visit a gynecologist without parents and your privacy will be respected. Please make sure you visit a qualified gynecologist and do not visit quack out of social fear. Gynecologists are professional and will not meddle in your private life and will help you get rid of pregnancy without risk to your life." "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 26 months old. The doctor has advised taking Menactra vaccine (Sanofi). Though this vaccine is not listed in IAP compulsory immunization schudule, is it necessary to take this? What are its side effects? ### Response: Hello. Menactra Vaccine (Meningococcal Vaccine (Group A, C, Y, and W-135)) is given to prevent meningococcal disease. It is not mentioned in IAP (Indian Academy of Pediatrics) compulsory immunization schedule. But in some places where meningococcus is prevalent, this vaccine is generally advised to be administered. This vaccine has some side effects like low fever, redness or pain at the site of vaccine injection and irritability. But these are very mild in nature and can occur with other vaccines also. In my opinion, it would be better if you give the vaccine to the child because meningococcal is a fatal disease and management is very difficult if the disease occurs in a child" "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 17-year-old girl and I weigh 60 kg. I am 4 feet 9 inches tall. I think I am not growing since I was 13 years old and my mom is a few inches taller and my dad is 6 feet. I have not taken any medication for this. Please help. ### Response: You seem to have gained a lot of weight for your age. This is one of the major reason for not growing taller. Also, you may have acquired your mother\s genes in terms of height. The good part is you still have a few years to go before you stop attaining height. You should see a dietician for a protein-rich diet and you must lose weight. Also get a lot of exercises including stretching exercises and also skipping. Yoga can do wonders too if done properly" "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 a scratchy throat and constant clearing throat, cough and slight joint pains from the past two weeks. I had unprotected sex 24 days ago and I am frightened that this might be the symptoms of HIV. Please clear my doubts. ### Response: I have noted your concern. These are not specific symptoms of HIV infection. Anyways I suggest you screen for HIV by a fourth generation HIV screening test at four weeks because unprotected sex is a risk for transmission of HIV" "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 symptom similar to gonorrhea and chlamydia with chronic testicles pain and swelling at the tip. Glans has a weird color, and pain under the abdomen sometimes. The urine test reveasl negative for STD. I am waiting to see a urologist and it has been for a year, now symptoms seem to change and getting worse and I am getting worried. ### Response: Hi. From history, it seems you have pain in testicle and at the tip of glans. I need to know about frequency of urine at night, urgency to pass urine, sense of incomplete voiding? How is the flow of urine? Any straining to pass urine? Unprotected sexual exposure? Constipation? How is the pain in testes aggravated? Any associated swelling or redness of scrotum? Kindly share a picture of the glans abnormality you describe." "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 septoplasty and turbinoplasty 16 days ago. After the surgery, they asked me to come back after two days for packs removal. Then after two days, I went to the hospital, other doctor look after me and he just removed one pack, even I asked him to remove the packs on both sides but he refused it. I then came back home, after two days, I cannot able to eat or even drink anything as my mouth smells very foul and the whole nose got swelled. Then, after seven days I revisit a doctor, then the doctor who did the surgery on me looked inside my nose and pulled out the pack hardly. Then after this, my nose shape changed badly and I cannot breathe normally now, what I can do now? ### Response: Hello. I understand you underwent septoplasty and turbinoplasty and you have not completely recovered. After septoplasty post-operatively it takes about two to three months for complete healing and recovery. You must put Solspre nasal spray two puffs four times daily for about a month in either nostril. 5% menthol paraffin nasal" "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 unprotected sex last week, and within three hours, I took Unwanted 72. It was the 11th day of my period. I usually have a 28 to 30 days cycle. Even after five days, I do not have a sign of withdrawal bleeding. What should I have to do if I do not get withdrawal bleeding? ### Response: Hi. If you have taken Unwanted 72 (Levonorgestrel) within 48 to 72 hours of unprotected sex, with a proper dosage without vomiting, then you can have bleeding within one to two weeks. If these requirements are fulfilled, then there is no need to worry, and you can wait for bleeding. If you do not observe bleeding even after three weeks, then it is better to have hormonal induction after doing a pregnancy test (beta hCG). If the pregnancy test comes negative, after two to three weeks, you take tablet Primolut N 10 mg (Norethisterone) twice daily for seven days and then again wait for bleeding for one to two weeks. Menstrual cycle usually gets disturbed due to externally induced hormones and until it gets rid of the body." "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 suffering from a kind of skin infection. This infection occured across his fingers and leg. I am attaching photographs for the same. ### Response: I have viewed the images (attachment removed to protect patient identity). This seems like psoriasis vulgaris rather than skin infection. Psoriasis usually presents as" "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 habit of eating fennel seeds a lot. Could this be the reason for not getting pregnant even after trying for two years? ### Response: Fennel seeds can normalize your gastrointestinal tract and nervous system. It balances excess pitham. It helps in balancing heat within the uterus, that is very much essential for getting pregnant. So, daily consumption of fennel seed life long will never affect the pregnancy. You may continue consuming it. Please check gynecologist or Siddha or Ayurveda doctor to evaluate why there is a delay in conception. Please check for your husband too. The reason may be identified for specific treatment." "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 80-year-old grandmother who went in for a triple heart bypass a year back. But she now suffers from swelling throughout her body. The diuretics will not help. How do we get this fluid out of her? ### Response: Getting rid of these fluids is dependent on knowing the cause of its accumulation. She may need to increase the dose or change to intravenous diuretics (to be taken in the hospital). We should check also protein levels in the blood and liver and kidney functions. Follow up with cardiologist. Treating the cause is mandatory to prevent further attacks." "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 severe bad breath problem after taking fever medications for a week. Does it come from my stomach? Please help me, as I am embarrassed. ### Response: Bad breath is due to the destruction of good bacteria in the intestine by antibiotics. I suggest you try probiotics, such as Lactobacilli, thrice daily for two weeks. You will feel better." "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: This query is about my mother. She is 57 years old. She has these dizzy episodes since last two to two and a half years. They are very short most of the time, lasting for a maximum of few seconds. It happens most of the time when she gets up from the bed or changes position on bed. She shows excellent response to both Vertin and Zevert. She took Vertin 24 mg BD for three months and then left it. She was alright for three months after leaving the medicine. But, last night she had symptoms again, same lasting for two to three seconds. She does not have any other symptoms. Her balance is perfect. She has a migraine for the last 10 years. My query is should we start her on Vertin or Zevert again? For how long? And should we go for any other investigation? Can it be something serious? ### Response: I read your question and would explain that your mother symptoms seem to be related to an inner ear disorder. There is nothing to worry about, as her situation improved with Zevert and Vertin once. For this reason, I would recommend starting again Zevert (Betahistine) for a month, with the same dose. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent. If her complaints persist, I recommend consulting with an ENT specialist and performing labyrinthine tests. A Doppler ultrasound of the cervical arteries would help exclude possible vertebrobasilar insufficiency. Hope you will find this answer helpful" "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 torn rectus femoris from AIIS as well as significant anterior and lateral heterotrophic ossification for past one year. The soreness in the area of the tear has increased and I have noticed a freqeuent amount of vibrations in my leg muscles as well as soreness in my muscles too. ### Response: Hello. I read your concern. As you tried with conservative management and still have not much of improvement, I suggest you try an orthopedic surgeon opinion on reattachment of rectus femoris surgically. Keep working on your glute and hamstring strength and core stability exercises. I would recommend you to not to indulge in any activity like kicking and running (I know you will not do as pain limits the movements). This includes a certain position of the leg as well. Fix up an appointment with an orthopedic surgeon as soon as possible and get evaluated and surgically fixed. Until then keep icing it to avoid pain and spasm which will help you to maintain your current situation and prevents from worsening." "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 health anxiety, and I am scared of ALS. I started getting muscle twitches all over my body about six months ago. It started after I stopped taking Valium 10 mg daily for seven months (in suppository form). However, they still occur. I have discontinued Benzodiazepines (Valium and Xanax) for about seven months. I am very focused on my every movement. I have done two neurology exams (one by a psychiatrist and one by a neurologist). Both were normal. I also did two EMG on the same day. The psychiatrist did an EMG, a paraspinal EMG and tested 28 muscles altogether. His impression was healthy except for isolated fasciculation potentials in the right medial gastrocnemius. However, the above muscle was silent at rest with standard motor unit configuration and usual recruitment pattern. He said the study was healthy and did not suggest any motor neuron disease. The neurologist tested again because I made him do it. He did the nerve study and EMG directly on my right hand and arm where I am complaining as well as left hand, left arm, and left leg. He did not find any fasciculations and said it is all normal. The doctor told I do not have ALS. Both the doctors said there is no need to repeat the test. My questions are:Would the EMG directly pick up on the right hand if ALS were present?Should I be concerned about these fasciculations which can turn into something?If the fasciculation is due to ALS, will they show any other issues on the EMG?Can anxiety make fasciculation worse?Is it possible to focus on a body part so much? ### Response: Hi. Of course, anxiety can trigger this clinical situation. As your EMG (electromyography) was normal, we can exclude any possible ALS (amyotrophic lateral sclerosis). ALS patients also have an abnormal physical exam (neurological signs). So, I do not think that you suffer from ALS. I would just recommend performing further tests: If all these tests results are normal, I would recommend discussing with your doctor on the possibility of starting Clonazepam, which is a Benzodiazepine which can help reduce anxiety and fasciculations. It is better tolerated when compared to Diazepam when used for a long time (it does not lead to addiction and tolerance)" "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 platelet count is 1.38 to 1.51 platelets per microliter of blood. I need to increase my platelet count at least 1.65 to 1.70 platelets per microliter of blood for some medical purpose. I am taking papaya leaf juice. Can I take Dexorange? ### Response: I need to know for which purpose you have done CBC (complete blood count) investigation. Kindly mention any clinical complaint if present for giving more comment and also want to know how long your platelet count remains low? Or is this only for the first time? Platelet count should be at least 1.5 platelets per microliter of blood, and your platelet count is slightly low that is 1.38 platelets per microliter of blood. If you have no clinical complaint, then I do not think you have to investigate further. Papaya leaf extract syrup and papaya fruits can be taken to improve platelet count. Peripheral smear examination report can be done to check platelet morphology. Your all other parameters are within the range" "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 30 male. I am suffering from central diabetes insipidus for the last three years. My all body, skin, and mucous membranes like penis glans, nose, nostrils and eyes have extreme dryness and frequent nightfall 4 to 5 times in a week. Please advice medicine. currently, I am taking Desmopressin. ### Response: Central diabetes insipidus is a very rare case of diabetes. It is due to lack or very less secretion of ADH hormones. ADH, vasopressin. The treatment plan would be to suppress extra urination and need to reduce" "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 baby is now 1 year old. I got copper T inserted after 3 months of my delivery. I still have prolonged and heavy periods followed by spotting lasting for up to 10-15 days. There is no other issue that I face. Is it because of copper T insertion or can there be some other reason too?Will the copper T removal solve the problem? How will the removal regularize my periods? What are the other birth control methods which are safe (I am not much inclined towards hormonal methods since they lead to weight gain etc)? ### Response: I have read and understood your problem. How was the bleeding before pregnancy and for 3 months after delivery? Was your delivery a normal or C-section? Whether the copper-T is properly placed or not or to see some other cause for heavy bleeding you need to take a transvaginal ultrasound -TVS. Sometimes if the bleeding continues then removal is the treatment, the period will regularize if it is due to copper T. If the cause is something else and the spotting continues, you will have to get treatment. There are medicines which can reduce the amount of bleeding. You need a clinical check-up." "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 depression and anxiety and anger Issues. So, I used to get sleep paralysis a year ago but then it stopped happening itself. I never had panic attacks even with this severe depression. But a week ago I had my first panic attack and then I started having pain in my collar bone, left arm and head. So, like I would get triggered when I see someone crying or someone\s death. Also, I cannot sleep at night I fear so many things that will happen to me if I close my eyes and two days ago I tried sleeping at night and I had SP. Then I did not sleep the next night and yesterday I tried sleeping again but I was getting scared every time I fell asleep. I would wake up by a shake and also I bit my tongue from places while I was asleep and it hurts now. Please, tell me what is it? What should I do? ### Response: You seem to have anxiety attacks along with a sleep disorder. The anxiety can be treated with medications from a psychiatrist. For the sleep issues, there are tests such as sleep studies available which can help diagnose what exactly it is. Usually tongue bite in sleep is unusual and seizures should be ruled out. So you can get a sleep study and EEG done and consult with a neurologist for sleep problems and with a psychiatrist for anxiety" "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 was diagnosed to have herpes zoster. Also, her doctor says that the herpes has caused ulcers. I would like to know in how much time it will heal? Is herpes zoster a dangerous one? ### Response: Hi. As you know, Herpes zoster is a viral infection. It takes 7 to 10 days for the lesions to heal. But, in patients who are diabetic, old age, secondarily infected and with an incomplete antiviral dose or seropositive it can take up to 15 days to get cured. In elderly age group even after the skin lesions heal the patient might experience intense pain in that particular area. It is called as postherpetic neuralgia. Kapsi gel can be applied (Capsaicin) once the skin is completely healed to relieve pain. Consult your specialist doctor, discuss with him or her and take the medicine with consent. How many days before she was diagnosed? What is her age? Please send images of the area. Revert back with the answers to the above questions 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 have attached my crossbite image. I would like to know about the treatment or brace that is suitable for me. What is your opinion about alignment? Can Invisible alignment treatment correct my problem? Please explain. ### Response: Hi. OPG (orthopantomogram) and lateral cephalogram for complete treatment plan. Anterior crossbite. Revert back with the reports to an orthodontist 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 19 years old, and I want a beard on my face. What should I do? Please help. ### Response: Hello. I read your query. First of all, I want to tell you that beard growth is related to your hormones, mainly testosterone. Sometimes in some men, it took longer to grow a beard. You are still in your teen years. So do not worry and wait for some more years because as you will grow older, you will get more facial hair. The beard growth also depends on genetics too, so watch out your father and uncles too for their growth. Because some men get full facial hair in the late twenties. There is no food, supplement, or vitamin to increase the beard. So beware of these kinds of ads or supplements. Some people use testosterone gels or testosterone pills to increase their beard, but in the long run, these things have potential side effects. My suggestion to you is wait for some more years because you already have some facial hair and they will increase with time, so you do not have to worry. After some years, if you do not get as many hairs as you want, then you can opt-out for facial hair transplant. But do not do it so early because you are too young and you will get your beard to grow naturally after some years. I hope this helps. Failure of gonads or testes in men. Serum testosterone, FSH (follicle-stimulating hormone), LH (luteinizing hormone), Prolactin levels. After two months." "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 met with an accident. I have severe pain in my neck and upper back. It is a seatbelt injury. It is keeping me awake at night. What should I do?I did CT and x-ray. ### Response: It is a whiplash injury, as you have mentioned. You can apply a cervical collar for the stability of your neck. Remove the collar during the night and wear it during the day time. You can go for isometric exercises (hold both palms on the forehead, then try to push your head forward while resisting with your palms). Repeat the same exercise with hands at the back of your head, i.e., on your occipital region. Do not apply overpressure, and it should be done slowly, repeating ten times, twice daily. Apply hot water bag at the back of the neck and upper shoulder region twice." "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 49-year-old male. Is it possible to suffer from an ischemic stroke as a result of ankle surgery? The stroke is on the left side of the brain causing paralysis in my right side. I am healthy otherwise. ### Response: If you were immobilized for a few days after the surgery there is a possibility in the development of deep vein thrombosis in a male above 40 years of age. If suppose that thrombus got dislodged, it may traveled to the brain resulting in ischemic stroke. The possibility is low, as almost all the venous origin embolus are filtered out in the lungs before reaching the brain but in case you have any defect in your heart then, it is quite possible. The other possibility might be any carotid narrowing which lead to the development of an intra-arterial thrombus formation other than thrombus origin in left side of the heart." "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: The last week two weeks I have been getting peeling in my mouth like on my cheeks. And I wanted to know if that is from loose fitting dentures or if I have not been cleaning them properly. ### Response: Hello. Usually, vitamin B complex deficiency causes such peeling of the oral mucosa. If you are using dentures for a long time, then it may be the reason for this.Take a multivitamin once a day and eat a good healthy wholesome diet." "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 will be traveling abroad in two and a half weeks for a 10-day visit. It has suddenly dawned on me that my last tetanus shot was 20 years ago.Online I have read I should have had a booster but four to six weeks before the trip. Should I get one or am I good for now? I am a cancer survivor since 16 years. Not sure that matters. ### Response: I understand all your concerns. Tetanus toxoid (TT) has a great role in preventing serious tetanus infection which could occur anywhere and anytime. Moreover, the TT is a weak toxoid with little adverse effects on our bodies. A booster dose is required for all the population every ten years. There is no contraindication in case you are a cancer survivor. I recommend that you take the vaccine as soon as possible before you travel. It is a 0.5 ml injection intramuscular." "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 20-year-old female with a weight of 55 kg. I had an abortion of one month with Cytotec and what I experienced was a blood clot with no bleeding. The second day, there was a blood clot. Until now, there is no bleeding. I have pain in my belly. Was the abortion successful? ### Response: Hello. With Cytotec (Misoprostol) alone the success rate of abortion is around 75% to 85%. How much of the dose have you taken? The bleeding will last for four to five days. If you feel you have not bled properly and if you are having more bleeding than usual then get a gynecological ultrasound to look for retained products of conception.and the Cytotec tablet." "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 my right side bottom wisdom tooth is coming as there is a ball on the back side of my gum that is really swollen. It almost feels like a pimple and the area around it has white lines on the inner cheek wall. What should I do? ### Response: Hello. If there is not much pain, it is better to let it grow fully. It may take a month or two to fully come out. If it does not, and the area gets painful then better to get an X-ray done for its exact position. Use warm salt water gargle twice a day for a week or two. Use a chewing gum on that side, it helps in faster growth of the tooth into occlusion." "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 gave oral sex to a man, whose HIV status was unknown, six weeks ago. I have now rash under both armpits and a swollen lymph node in my neck. I am attaching pictures of the rash and the lymph node. Could this be ARS? ### Response: Hello. I saw the attached pictures (attachment removed to protect patient identity). If with treatment, the lymph node swelling goes down, then it is not HIV infection" "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: People called me stupid and annoying it is not that I do not understand. It is that I cannot focus, I have a tough time focusing, and I would not deny I am annoying. I never sit still I am wandering around the house all the time I told my dad I would not sit still even if I was glued to the sit and he said I believe that. People complain about the fact I talk a lot, and I talk fast. I climbed a broken fence I love climbing fences when I was 12 I let my friend push me across the road in a shopping cart, and I let my friend push me around in a shopping cart on a bumpy ground I do not think before I act. I get very mad when people talk badly about me I get easily frustrated I get crazy if I cannot find something or if mess up on something I will pretty much get mad over anything I have a low tolerance when it comes to anger. ADHD runs in my family. ### Response: You are reporting symptoms which are suggestive of ADHD (attention-deficit hyperactive disorder). How are you managing at school? Further assessment, including developmental history from parents, corroborative information from school will help to clarify the severity of your symptoms and also to rule out other conditions mimicking ADHD. Effective management of the underlying condition will help you to function better. I will advise discussing with your parents and consult your doctor locally who can refer you for further specialist assessment as needed. Depending on the evaluation, medication or behavioral support may be recommended.Meanwhile, you can try some strategies to improve your functioning. Exercise regularly, make a reminder list for essential weekly activities to avoid missing deadlines, minimize distractions by avoiding TV, mobile during your work hours, etc. 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: Should we buy into the idea that dairy is not so great for us? Are the alternatives as healthy as we are led to believe? What about the option of just giving up milk and not trying to replace it with anything, is that a good idea? Do you have advice on choosing the best milk alternative? ### Response: Hello. The idea of quitting dairy is quite controversial. There is a lot of debate on this topic. If you are giving up milk products, you might have to replace it with some other form of protein like sprouts, nuts, etc. The alternatives to milk these days are soy milk, almond milk, oat milk, coconut milk and rice milk. While these are easily available in supermarkets, it is very important to \read the labels\ of any food item you buy. This rule applies to these alternatives for milk too. I personally have read labels on packs of almond milk, soy milk, etc., and found a lot of chemical additives in it. Follow a basic rule - if you do not understand an ingredient or if it sounds like a chemical name, it probably is not good for you. If you buy milk, try to buy organic milk which is free of antibiotics or hormones. If you really want to give up milk and move to other alternatives of milk, then it is a good idea to make it in your kitchen. Almond milk, coconut milk, and oats milk can easily be made at home. You can check online video resources for this. I hope that 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 suffering from a skin condition for about four years in groin area as you can see in the attached pictures. There is a dark brown area with sharp borders on upper inner thighs where scrotum touches thighs. There is no itch, pain or burning sensation and it is not raised and also very plain. I went to a dermatologist and he diagnosed it as a fungal infection by just seeing it. After taking antifungal tablet and applying topical cream for about 35 days there is no noticeable improvement in the appearance of the affected area. If it is a fungal infection then it will itchy. I ignored it for four years because nothing seems serious in it. The picture was taken before treatment and all the others are of today. Can you see any improvement? I am getting married soon. Please tell me what is it. What treatment should I go for? ### Response: Hello. I have gone through the pictures (attachments removed to protect patient identity). Revert back with the asked details 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 am inquiring for a friend who underwent L4 - L5 hemilaminectomy surgery. He is recovering except for the persistent numbness, pins and needles and swelling in his left foot. It is more pronounced in the afternoon to evening. He is a teacher by profession. He has reported this to his doctor, but his doctor has no answer to the numbness, etc., and just asked him to report to him every now and then and wait for complete recovery. This is why we are reaching out at least to get an opinion or advice what could the symptoms be. ### Response: Surgical retraction of nerve that may have caused it to bruise. None, if symptoms are not progressively worsening. Recurrent disc herniation. Gabapentin or Pregabalin and NSAIDs." "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 26 years old. Two years back, I found that I have autoimmune hepatitis. At that time they did Fibroscan, in that kPa is 14.5 (F4). Last one year I took medicines (steroids) and I stopped. Now it again came back and doctors did a biopsy, in that it is showing:Portal and lobular hepatitis with areas of confluent hepatocytic necrosis and Ishak fibro score are 0. Is it possible for my fibrosis to come from F4 to F0? How is my liver now based on that biopsy report? ### Response: In autoimmune hepatitis, it is possible to decrease the fibrosis. Or other possibility may be that, initial fibroscan was done in acute inflammatory state hence it may be falsely high. We need to compare it with the liver enzymes at that point of time. Autoimmune disease may be episodically triggered by various factors. You must continue the medication." "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: Almost 40 days back I saw bright red drops of blood coming out when I was passing the stool, I saw blood(bright red/red) in my stool for next two days and then the problem went away but I became conscious.Since past week I\d noticed very small amount of blood in my stool.But last night I saw my stool covered in bright red/red blood. I am also constantly seeing mucus/jelly type substance in my stool. One other thing I am worried about is I often see grey/dark grey liquid thing on my stool I am not sure its blood.I do feel fatigued, but I am not feeling any kind of pain anywhere in my body. Even when passing the stool I dont feel any kind of pain. But my urge to poop has increased lately.My age is 23 and weight is around 77 kg my height is 6 ft. ### Response: Hello dear, hope you are fine. The presentation you described is likely to be a hemorrhoids (biles), that causing blood in the stool. The fatigue you described maybe due to loss of blood, that caused anemia. I recommend that to confirm the diagnosis, to be examined by a surgeon, so to make sure it\s only hemorrhoid, and no other masses there causing your symptoms. I also recommend to have blood test, CBC , so to check your hemoglobin. once diagnosis is confirmed, we will discuss the management (which mostly include having high fiber diet and oral laxatives)." "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 detected with 4 mm stone in right vesicoureteral junction. It gives me immense pain. The doctors have performed flush therapy twice. But there is no good result. My serum creatinine is 1.4 mg/dL. They have given me Neeri syrup. Can I take tablet Cystone along with this syrup for the stone to get dissolved? What can I do now? ### Response: Hi. I can understand your concern. 4 mm stone can be dissolved quickly. You are taking the right medicines for this. You can add tablet Cystone along with it. In the case of pain, which is not bearable, you can take painkillers. Avoid spicy and fried junk foods" "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 wake up from my sleep, I feel empty. I am not willing to do my work. I neglect my study. I always stay alone in my room. I am feeling lonely. I got a breakup. After having a breakup, my depression got worse. I am crying every day for around seven months. I am unable to focus anymore, and I am unable to do my work. Please help. ### Response: You are in a troubled situation. Having an empty feeling and negative thoughts occurring on an occasional basis are quite reasonable. It does happen to everyone. But having a low opinion, and feeling empty for so long, around seven months is not healthy. It indicates that you need help. Without proper treatment and care, it will get worsen further. Try to follow these steps. It can help you. Try to follow your daily routine work. Do not be alone. Try sitting with people. Do deep breathing exercise. You can try meditation and yoga. Eat a healthy nutritious diet and avoid taking junk foods. Try to have psychiatric counseling soon." "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 facing acute sore throat for the last one month and now feeling pain also in the left side from centre of the throat. I am doing gargle with salt water and taken TUSQ D also but no good relief. In addition to this I am facing gastic problem and constipation also. ### Response: Hi Only this syrup and gargling will not help you completely, it say some kind of throat infection maybe acute pharyngitis or tonsillitis and you need antibiotics for that otherwise this may progress. Are you allergic to any particular medicines, so that I will prescribe you some medication?" "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 been diagnosed with probability of lower GI bleed in proximal jejunal small bowel loops through nuclear scan. She is a heart patient and had been operated in the past and got her two valves replaced. She has to take blood thinning medications like Warfarin. My mother had low hemoglobin due to blood loss in stool. But, it used to get resolved with changing the dosage of Warfarin. But, this time, she is getting blood loss on more frequent duration and thus doctors asked to do nuclear scan to check for any GI bleeding. She has been advised to undergo surgery to get GI bleeding treated. Please advise if there are still possibilities to cure her with medications. If surgery is required as a last resort, then which one would be less threatening? ### Response: Hi. Warfarin induced bleeding. Once stool color changed to normal from black, can proceed with CT scan abdomen to find out the cause. Jejunal ulcer. 1. Medical management, if general condition is stable.2. If general condition is unstable, then required more than 5 bottles of blood transfusion. If active bleeding is continued even after dosage modification of Warfarin, then consider surgery with high risk." "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 50-year-old type 2 diabetic male with HBP and dry eye disease and diabetic retinopathy. Medicines: 100 units of slow Insulin, Valsartan 320 mg, Amlodipine 10 mg, Escitalopram 10 mg, Xiidra eye drops. After years of high HbA1c of around 10.5 last year has averaged around 6.5. HBP runs around 150/105.I have managed to radically improve glucose control over the last year but my blood pressure has remained the same. I have some retinopathy issues and my ophthalmologist and optometrist want my glucose to stay at or below 6.5 and my BP to be 120/70. I have tried a variety of diuretics like HCTZ, Spironolactone, and Chlorthalidone, each for about 3 to 4 months but I suffer from severe dehydration whenever I take a diuretic. My eye doctors also tell me that diuretics can worsen the inflammation associated with both my dry eye and retinopathy. To add insult to injury, when I was taking the diuretics, my BP was still running at about 150/105 with no real noticeable difference.My question then is relatively simple. I need to lower my BP to a safer rate but my doctor has run out of ideas for a third BP medicine that is not a diuretic. Can you suggest something (no-diuretic) that I could suggest to him? ### Response: Reduce salt intake. Avoid alcohol and caffeine and nicotine in any form. Take plenty of fruits and vegetables. Reduce weight, do daily exercise. Take sleep of good quantity and quality, at least six hours uninterrupted sleep at night and 1 to 2 hours at day time. If you snore, treat it. It is one of the main cause of resistant hypertension. Then, you may take beta blocker as next addition such as Metoprolol succinate 50 to 100 mg per day, Atenolol 50 to 100 mg per day or Nebivolol 2.5 to 10 mg per day. Also, the option is for alpha blockers such as Prazosin, Terazosin, and Doxazocin. Also other options. Consult your primary doctor with these ideas. If still BP is not controlled, follow-up with 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: I am 22 years old. I am trying to conceive for the second time. I have a 3-year-old son and it was a natural birth. I am not on any medication. My period was always regular and I get them every month. But about 3 months ago, my period days changed from the beginning of the month to the middle, when it was all messed up I was getting a period twice a month but that has stopped. About two days ago, I thought I was getting my period but I am lightly spotting it is a light red color it is not dark or anything it is more faint. When I am usually on my period I bleed a lot. I have been pregnant before and know the symptoms but would it be possible? I do not understand this light spotting, am I on my period? Do you think can I be pregnant? Or it can be my cycle changing? ### Response: There are multiple reasons for not being able to conceive. First, it depends on the time for which you guys are trying. Only after a year of unprotected intercourse, we can start the evaluation. And that you have conceived once naturally means the mechanics are all correct. I see that your BMI (body mass index) is high. That could be the reason for irregular periods. You must work on your weight and bring the BMI between 18 to 25. If you are concerned about your cycles, you will be prescribed contraceptive pills. If you want to conceive they might start the evaluation depending on the policy." "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 already talked to my very own Cardiologist but have not really gotten much. They just told me I have been having a lot of tachycardia lately but with a normal rhythm. They told me I should be fine but I feel I am not. Three months back, I had gone into cardiac arrest due to a drug overdose when I got a laced pill full of Fentanyl when I tried to get the old medication I was once prescribed, Adderall. It took 12 mg of Naloxone to bring me back to life. Then about six months ago I had an ER visit because I decided to take what I thought was MDMA with some friends for a party. I do not take drugs anymore. The drug test only came back for Amphetamine and I took around 200 mg of the drug Methamphetamine. I started to go into cardiac arrest again but was luckily brought back to normal levels. It was a scary experience which haunts me now causing anxiety whenever I notice my heart rate go up. Three months ago I started to display worse symptoms. My cardiologist only put me on a heart monitor for three weeks but said I had a lot of tachycardia with a normal rhythm. I am not quite sure whether it is just anxiety or if my heart may actually have problems. I am only 18 but I feel these close calls might have put a toll on my heart. I just need somewhat of an answer on whether these experiences could have caused one term problems to my heart at my age. I do not do any drugs anymore. I vape but that is all. I get chest pains through the day and sometimes will get light headed and cannot think clearly. I will space out and not pay attention to anything else around me. I am worried it is a heart problem or could be PTSD cause from those events. Any information will help. ### Response: Likely it is an anxiety only causing you tachycardia. If possible please attach your reports like monitoring report, and echo if you have. Echo will tell us whether there are any residual effects on the heart of your previous problems. You should get a thyroid test done to rule out hyperthyroidism if did not have recently. You may use a portable monitor which is a mobile-based portable system to keep watch over heart rhythm. It is better you get started on Ciplar which is a beta-blocker that help to control heart rate and anxiety. Consider regular exercises to tone your heart" "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 software professional. I work in shifts from 2 PM to 11:30 PM. Recently, I got a complete health check-up done and found to have microscopic hematuria. Before this health check-up, I used to take medicines for headaches (Saridon and Headset tablets). I used to drink alcohol thrice weekly. Now sometimes I get headaches, feel dizzy, and have gastric problems like burning sensation in the stomach. I do not have any other problems like pain in the abdomen, back pain, etc. Is this a severe threat to my health or kidneys? Is this curable? What type of diet do I need to follow? Please give your valuable advice. ### Response: Hello. I have gone through all your reports (attachment removed to protect patient identity), and except for the microscopic hematuria, all your reports are fine and there is nothing to worry about." "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: Why more mothers are choosing to exclusively pump their breast milk? How does it work for them? Kindly explain. ### Response: Mostly breast pumps are used by mothers who need to prepare for the child in advance due to their business. Most of the working ladies are using breast pumps to empty the breast in advance and to have milk as per need. Breast pump helps to maintain breast production by emptying breast if used properly. Emptying of breast even if the baby does not need at present but after some time helps to maintain milk production and also can be managed in hectic routine of working ladies. Some time sick babies are unable to suck, so in those timings, breast pump helps fully for mother to empty breast as engorged breast can give her symptoms as well. Babies taken care by maids can be well fed by breast milk even in a tough working schedule of the mother with the help of a breast pump." "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 suddenly felt out of balance and threat of falling. Occurred frequently. Took MR brain with angio. In observation, the report said the following. Chronic lacunar infarct with gliosis in left corona radiata. Discreet diffusion non restricted subcortical FLAIR hyperintensities noted- small vessel ischemic changes. Cerebral and cerebellar atrophy prominent cerebral sulci and ventricular system. No evidence of acute infarct, hemmorrhage or space occupying mass lesion noted. I had a TIA issue 18 years back, which lasted a few minutes and became fine. Last 17 years there was no issue. Can you please interpret the report and tell me if there is any serious problem. ### Response: I read carefully your MRI report (attachment removed to protect patient identity) and would explain that it indicates small repeated strokes due to small vessel disease of the brain. For this reason, it is important for taking daily Aspirin 100 mg or 80 mg and closely monitor your blood pressure values. It is also important checking your blood lipid profile and taking statins (Atorvastatin) in case of increased cholesterol levels." "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 15 years old. His neutrophils count became 1000 from the first one which was 800 before a week. After 15 days, again the neutrophils count is 800 now with total WBC of 2600. He is healthy, active and has no infection. Please note that his dad had a blood count this week and his neutrophils were also 1500. Please give me your opinion. ### Response: Hi. Based on your query, my opinion is as follows: Nothing necessary for now. If any serious infection, then evaluation maybe necessary. Continue usual lifestyle with a protein rich diet." "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 husband and I have been trying to conceive for five months now. The past few months I have been noticing severe breast pain throughout my entire breast and fullness of both breasts from ovulation until the time I get my period. I read that this could be indicative of a hormone imbalance? My periods are regular and I typically have 30 days cycles. ### Response: Symptoms you have described are effects given by hormones produced before menses and after ovulation. As you are trying to conceive as well and active sexually, the body tries to respond to that too. Attempts for trying to conceive stimulates and activates hormones more efficiently. So those hormonal presence gives effects as well, like breast tenderness. If the pain or tenderness is there all over the cycle and on a specific side only then you need to worry and consult breast specialist. Hot fomentation, warm baths and then oil massage could be helpful. Have folic acid daily. Try to have a complete treatment of any health issue you have. A daily walk and exercise to have normal BMI. Hormonal changes of the cycle. Massage, hot fomentation, warm bath. Can have tablet Postan 500 mg for severe pain. Folic acid, sex in the fertile period." "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 33 year old unmarried, healthy male. I have a steady girlfriend with whom I have sex regularly, as well as casual one night stands with other girls. I always practise safe sex, i.e, a) always use a condom b) never have uncovered oral sex (c) never have anal sex (d) always keep my penis covered with my undergarments till I put on the condom (e) always ensure that I pull out with one hand on the condom so that it does not slip out. I wanted to know what else can I do to prevent myself from any STD. 1. What are the chances of kissing my partner causing STD and should I avoid this? 2. I heard that a person can get herpes just through skin contact. Is this true and if so, what precautions can be taken for this? 3. Is there any vaccine I should take for herpes, hepatitis A and hepatitis B? 4. I do not use a lubricant, but use lubricated condoms. Is this the correct thing to do? 5. Can I try anal sex with my girlfriend. Is it safe? 6. Is it better to wash the penis immediately after intercourse to reduce the risk of STDs or should I just wipe the penis with a dry cloth after taking out the condom? ### Response: Hi. I appreciate that you are very much conscious and alert while having sex and take all preventive measures. 1. Kissing can spread some diseases only if the other partner is infected .These diseases spread through saliva . There are so many diseases which spread through kissing like mononucleosis, certain kind of viral infections and sore throat and some other. I guess you are much concerned about STDs (Sexually Transmitted Diseases). HIV is present in saliva but till now no HIV case had been reported through kissing. But hepatitis B cases are reported and well documented and hepatitis A & C as well, so here I will advise you not to kiss women about whom you are not aware of their health status. 2. Herpes viruses are of many types and can spread through skin contact also. Here I think you are concerned with genital herpes virus which causes STD. This usually spreads via sexual intercourse but can also spread through body fluids like blood, saliva, oral sex (without a condom) if your partner is infected. 3. No, there is no vaccine available for herpes. But you must get hepatitis B vaccination done as it is a fatal disease. 4. If you are using lubricated condoms then no need to use a lubricant unless your partner is not comfortable without a lubricant. 5. Anal sex is usually not advisable as it can cause intense pain and injury inside your partner\s anus and not safe for her. But if you insist and want to do, then apply a lubricating gel and can do at your own risk. 6. Washing genital organs after having sex is advisable." "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 having a filling material applied to the gumline where it is receding a good solution? What are the risks with such a procedure? I have receding gums on three upper teeth and three lower teeth on the left. I have no pain or problems. I have all my teeth and they are generally healthy. ### Response: Hi. I have read through your medical history and the present complaint as well. First of all, I would like you to know that receding gums is such a normal thing to happen especially at your age. You have also mentioned that there is no pain or decay in those teeth you point out. Ideally, filling procedures do not work for gum recession problems but only for decay or abrasions close to the gum lines. The reason why fillings are not recommended is that you lose normal shiny tooth surface and the bulk while the cavities are prepared and there are many chances that the filling material might show microleakage hence paving way for tooth decay. There are as such no particular risks for this kind of procedures with your medical history kept in mind. But I also would like to take a look at those teeth which are of concern in order to help you with a better treatment plan" "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 abscess in the lower molar. There is much pain, swelling, painful jaw and lymph nodes. The dentist prescribed Amoxycillin and extraction scheduled for nine days from today. I have been on the antibiotics for 48 hours. The pain is getting worse, not better. Should I look for another dentist who has an opening for an extraction sooner? ### Response: I can understand your problem. A tooth abscess is a painful condition and needs antibiotic cover along with painkillers for relief. So, first of all, please let me know if are you advised any painkillers along with Amoxicillin. If yes, please write the name of the painkiller. Please revert with answers" "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 31 year old female. I am having tinnitus in my right ear. My PTA hearing test says R - 17 dB and L - 10 dB. My doctor informed me that there is slight nerve damage and it is causing tinnitus and slight hearing loss. He said that there is no cure for it. Please help. ### Response: Hello. Your PTA (pure tone audiometry) showing minimal hearing loss in right ear and normal hearing in the left. I do not think this minimal hearing loss cause the tinnitus unless the hearing loss is progressive. Tinnitus is not a disease. It is a symptom due to many underlying disease, so we need to exclude the cause for the tinnitus first. Next time please mention whether you are diabetic or hypertensive of having hearing impairment or heaviness in ear. Also mention whether the tinnitus is continuous or periodic or pulsating in nature. For the next seven days do valsalva maneuver 20 to 30 times a day, the procedure of which you can get in YouTube. Then take some medication as written below for seven days. Please get a tympanogram if possible. Tympanogram. ETD (Eustachian tube dysfunction). 1. Valsalva maneuver as advised.2. 3. Capsule Zincosule-4G (Multivitamin) one capsule twice a 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 a 48 year old. I was never sick, I never go to a doctor. I do not take medications. I have worked out for 30 years five times a week. Nothing real heavy these days (treadmill three times a week - fast walking). Symptoms started about a month ago with intermittent dull stomach pain and mostly on the left side. It progressed to dull testicle pain - again mostly on the left side. It is usually not stomach and testicle at the same time. There are no noticeable lumps in the testicles - both feel the same to me, but the pain is more on the upper top of the testicle from what I can tell. I believe there are some tubes or cords there naturally and to me, it feels like the left side does feel more cordy (for lack of a better word). I have occasional groin tightness.Symptoms I do not have:Any masses or lumps.No tiredness/fatigue.No bulges anywhere so I do not think it can be a hernia (I do not remember feeling anything).No pain urinating and no blood in urine or feces.No lower back pain but an occasional stab in my mid back (probably referred pain?).My main symptom these days is the dull testicle pain on the left side upper top. Sometimes, I do not have any symptoms at all and almost never when I am working out. But for a month now, I know it is there and it is annoying and the last two days, I feel like the dull pain is slightly greater at times in the left testicle. Again, I am not one to run to the doctor. Anything, I have ever had has gone away if I gave it time. The pain/discomfort is not that great but it has been at least a month. After doing a tonne of research on the internet, I have seen so many conditions where my symptoms fit but none that pinpoint just a few symptoms I mentioned. ### Response: Hello. As per me, there are two possibilities. This is quite common in people who do regular workout and exercises. I will only suggest you if possible get an ultrasound scrotum done. It will be normal only but just in case to rule out other things like varicocele. Regarding pain, I will not ask you to take any medication at present. Only thing is you should wear proper scrotal support, that is, you get special support for testis apart from underwear. That should be worn during workout and testis should not hang loose during a workout. Apart from this, I think nothing is to be done. If you go by internet, then there will be many causes listed and it will only confuse you more." "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: Dear doctor,I participated in unsafe sex with a girl and after one and a half years, I have been tested with CMIA test rapid antibody test and ELISA test and all results are negative for HIV 1 and 2. But, the tension in my mind was not cleared and every day I am suffering from this thought did I get infected with HIV. This is because I am getting skin allergy on my shoulders and chest. Shall I go for marriage or not? These questions are running through my mind every day. Are these tests enough to confirm that I am not having HIV? Shall I start my personal life? I will be very thankful to you. ### Response: Hello. I have noted your concern. I request you to kindly upload a few images of the allergy/rashes on your shoulders and chest so that I am able to have a look and guide you better. As far as your HIV screening is concerned your test results are conclusive. Regards" "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 lost partial vision in my left eye. I was diagnosed with retinal ischemia by an eye specialist and after an angiogram he suspects a small crystal of plaque to be blocking the blood supply to a portion of my retina. He told me I should see a cardiologist fairly soon, as he has worries about where that plaque is coming from and that I am a possible candidate for a stroke. The earliest I can get into see a cardiologist is still a week away. I am wondering if this is more urgent than that. I am 54 years old, currently taking Prednisone and Methotrexate for recently diagnosed psoriatic arthritis. I also have controlled blood sugar with Metformin and cholesterol with a small daily dose of Atorvastatin. I feel fine except for the vision loss. ### Response: There are chances of cardioembolic stroke (some clot or infected vegetation) particle that your ophthalmologist is suspecting. Your Cardiologist will do echocardio and see if any source of that in your heart. For prevention of stroke you take one high dose of Aspirin 325 mg and Atorvastatin 80 mg and then Aspirin 150 mg with Atorvastatin 40 mg every day. If it is not infected vegetation (as in infective endocarditis) then you can prevent stroke and any other infarction." "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 22 years old and I have blurred vision in my left eye. It started when I was 17-years-old. I also have an allergy in my eyes. I consulted with the doctors, and they suggested lasik surgery for me. ### Response: Hello. If you have allergy problems, then you are not an ideal case for any refractive surgery procedure like Lasik (laser-assisted in situ keratomileuses). First of all, the actual cause of blurred vision is needed to be diagnosed, whether it is a refractive error or you need glasses. Then to get rid of glasses Lasik is one option. But if your cornea is affected due to allergy (allergy can affect cornea) and the clarity is changed, then Lasik might not help. So you need to get an eye examination from a specialist and then get diagnosed for the exact cause of blurred vision. You can send your prescription if you already have consulted to an eye specialist. Then we can discuss the appropriate treatment option for that cause. You are welcome for any queries." "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 is 47 years old. Suddenly in sleep, she felt palpitations two to three days back and we went to the hospital and found ECG normal. Echo test is normal, Trop I test is normal but TMT is positive. The doctor advised to go for angiography but another doctor says that before angiography we should go for stress echo test. Please advise what has to be done first. ### Response: Hello. Firstly, let me know if she has any risk factors like hypertension, diabetes, deranged lipid profile or family history of heart disease. Usually, what we do, since angiography is an invasive test, we make sure that the patient needs it or not. So initially, subjects the patients to minor tests like TMT (treadmill test) or stress echo or stress thallium. If either of the tests is abnormal then it is better to subject to the patient to angiography. Now, in our case, since her TMT is positive, it is better to subject her for angiography. There is no harm in having stress echo, but suppose it is positive then certainly she will need angiography. But if it is negative then we can again land up in a dilemma of which test to be relied upon. Then she will need some more tests like stress or CT coronary angiography to prove TMT was negative. So it is better to get an angiography done and clear all our doubts. There is sufficient evidence of abnormalities and angiography is a gold standard test. Also, discuss how strongly was TMT positive. If it is strongly positive then nothing to think and go ahead with angiography and if it is mild positive then you may think of stress echo. So overall, it is better to undergo angiography and no harm in stress echo if your doctor insists." "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 teeth whitening at the dentist office which was done with a light and some paste put on my teeth. The light was on for 10 minutes and then new paste was added. This was done three times. The Dentist then confirmed that the process was successful and the teeth became 3 to 4 shades whiter. After the procedure, I noticed that the surface of my teeth felt rough. My dentist told that it is normal and all teeth will become smooth like before after a few days. It has been now five days and I have not noticed any difference, my teeth are still rough from the surface. Should I be worried, or how long (days) this effect can last? I believe it is due to enamel dehydration. ### Response: Hello. This roughness will go eventually. In some people, it goes in a week or in two depending upon the tooth quality. Do not worry, just make sure you maintain your oral hygiene properly. And if it does not go, well, then I would suggest you visit your dentist once again because the treatment you had is bleaching in which chemicals are used and then the dentist will help you to correct. But at least give it time like one more week to get smooth surface again. After cleaning and whitening, it is normal to have a rough surface due to removing dirt from 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: I recently began doing cardio exercise and noticed that my heart rate would go upto 160-170 beats just after a few minutes of exercise. I got some anxiety about it and purchased a portable EKG monitor. Everything showed up normal when taking it while resting. But it shows ST depression after working out. So I consulted my family doctor, he has done an ECG, and nothing showed up. I tried explaining to him it was showing some change after exercise, but he seemed to like it was not a concern and said it is normal to show a change after exercise. But I read something that, showing ST changes after exercise is a bad sign and can be CAD. Is it something I should be concerned about? Or is ST depression normal after exercise? ### Response: Heart rate going up might be related to you being unaccustomed to activities. At your age, normally you are expected to attain a heart rate of 180 bpm with exercise. So nothing to worry about it. Some ST depression does occur during exercise, but it is physiological and upsloping, and can only be commented upon after seeing it. However, considering your age and no symptoms while running, it is likely a physiological depression. If you can get tracing, then that would be confirmatory. 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 a discolored broken tooth with a hole. Is there any way I could have an infection, there is no pain in the area, and I can feel the tooth when I press with my tongue. ### Response: Hello. I have read through your concern. I assume all your concerns are based on one tooth. Two scenarios are happening there. 1) The nerve of that tooth might be dead, which is the reason for not feeling any pain and causing discoloration in the same. 2) The nerve is undamaged, and the hole is small with external stains (which causes the discoloration).I would advise you to see a dentist physically and take an X-ray of that tooth, which helps in better diagnosis of the situation. If the nerve is alive and the discoloration is because of the stains, you may need to have a cleaning and fill the hole with dental fillings. If the nerve is dead, you may need a root canal treatment with a crown or filling 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 am suffering from iridocyclitis in my right eye since last six months. Every time when I stop my Pred Forte eye drops, it recurs after one month, till now it has recurred three times. I have tested for TB, anti-nuclear antibodies, anti-CCP antibodies, HLAB27 all are negative. But still the problem is not going. I have hypothyroidism since last five years, my ophthalmologist is not able to find out any reason for the same. Kindly suggest what should I do, whether it is related to autoimmune disease. ### Response: I have gone through your history and investigations (attachment removed to protect patient identity). Well firstly iridocyclitis (anterior uveitis) is mostly an autoimmune problem. We can only find a definite cause in 30 percent cases. So, when it is a single episode we tend to ignore it but when you have recurrent episodes (more than twice a year) we need to treat it. So, even if all are negative and you are getting recurrent episodes it needs to be treated. HLAB 27 method done is an outdated one. You can request them to do by PCR method as it holds importance in your diagnosis. You can discuss with your ophthalmologist. My preference would be Methotrexate but we will need to discuss with your ophthamologist once." "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: What are the causes of sleep disturbances? What are some ways to tell if your sleep troubles are sleep anxiety and not a hormonal problem? What is the difference between sleep disturbances that are caused by hormones vs stress? How might someone address each of these different causes of sleep disturbances? ### Response: Hello. First, we should know the patient\s gender. Then, if female, ask if the sleep problems are all the time or more evident prior to periods due date? Then, I would ask both female and male patients to run a thyroid function test. While female patients to also check sexual hormone levels in the blood. Stress makes it difficult to fall asleep and keep asleep and altering sleep quality. Estrogen will cause an increase in body fat in women more around the tummy. This will cause snoring and sleep apnea. We should ask patients more details about their sleep like, is it difficult to fall asleep? Why? Do you wake up during the night? How many times if yes? Why? In this way, we will find more details about the sleeping problems my patients are having. Sometimes, they can sleep but they are so anxious and feel not enough to sleep." "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 got my AC joint separated while mountain biking. It is grade 5. I am getting surgery and I want to know whether I should use an autograft (hamstring) or allograft from a cadaver. I am very active in outdoor adventures and sports. ### Response: Hi. I am sorry to hear about your injury. The good news is that there are many modalities available for AC joint injuries (acromioclavicular joint), which are showing promising results." "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 6-week-old daughter has got white hypopigmented areas on bilateral groins and both inner thighs more in the left groin. Also, they seem to be appearing near the umbilicus and upper chest. We are very worried about it and want to know if there is any treatment available for it. Your opinion will be appreciated. I have attached reports for your reference. ### Response: I have gone through the attachments (attachment removed to protect patient identity). She seems to have trichrome vitiligo which is an indication of active disease. I would like to know the duration" "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 55-year-old female is in coma. Her vital status are fine, but her eyes still shut, and head surgery completed 11 days back. Please help. ### Response: She has significant brain insult in the form of left-sided brain infarct and left-sided brain blood clot or bleeding. She may need surgery to remove one part of the skull and preserve in the abdomen for future reimplantation. Consult a neurosurgeon for a decision about surgery. I want more details about her pupils and corneal reflex and breathing pattern. I think she must be on a ventilator, so monitor her properly, go for surgery if your surgeon says. Prognosis is not right if she recovers then also she will have weakness in right side and speech problems." "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 recovering from bronchitis and a viral infection. I had high fever and cough, but not much sputum. I took Cefoprim antibiotics. It has been two weeks now. I still have a cough and feeling very tired. I also feel very sleepy. Please tell me if this is expected. ### Response: Hello, Welcome to cliniq.com. Consult your specialist doctor, discuss with him or her and start taking the medicines 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: My partner has a cold sore. I kissed him before it actually looked like one. I already carry HSV1, but I have never had a cold sore. Did I put myself at risk? ### Response: Hello. Herpes simplex virus (HSV) if once acquired stays lifelong. When it is dormant it does not produce cold sores. When there are risk factors like stress in any form, physical stress, mental/emotional stress, recent illness, surgeries, prolonged sun exposure can trigger cold sores. When there are active sores with blisters and fluid in it, the person who does not have HSV can contract the virus and produce cold sores. Since you already carry HSV, you can have a cold sore with above-mentioned risk factors and it may not increase the chance of getting a cold sore as there were no blisters at the time of contact (kiss). Hope this answers your 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: About six hours ago, I started seeing a transparent floater which I had not seen before, and then three hours later, I started seeing light flashes at the edge of my visual field in my left eye. Can I wait for three more days to see my doctor? ### Response: If you have access to an ophthalmologist on this weekend, then get a thorough retinal evaluation with indentation done. The symptoms you are describing are consistent with posterior vitreous detachment, a process which by itself does not cause a decrease in vision. However, it can pull onto retina hence causing a retinal tear in the process. If that is present, it needs to be lasered within a day or two. If you do not have high myopia or have a family history of retinal detachment, then you are low-risk patient and can wait another two days if it is imperative. Physiological. Peripheral retinal 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 41 years old. My office colleague is giving me mental trauma by gossiping about my childhood physical abuse. Sometimes suicidal thoughts come to my mind. How should I tackle it? ### Response: The first thing that you have to fix in your mind is you have done nothing wrong in that abuse episode, it is a matter of shame for that person who had done it and to those who are making fun of this. Be confident and set in your mind that you will never get disheartened, say to your own mind that you have fought very well with the circumstances and done your best to overcome that. Suicide can never be a solution to anything. Do people stop gossiping after you? They will keep talking, no matter or anyone else .one more thing, rule out other features of depression. If present consultant a psychiatrist. For the current situation try to talk with them and ask them if the same event had happened with someone to their relative or close one, will they keep talking like this? Do regular yoga and meditation. Take a healthy diet, proper sleep. Try to involve yourself in other activities and be happy." "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 routine urine examination shows: Trans-hazy.Reaction - 6.0pH.blood - ++.RBC - 15-20 hpf.Pus cell - 2-5 hpf.Epithelial cells - 4-6 hpf.Please review my report. ### Response: Hello. First of all what problems you were having when you got your urine test? There is blood in your urine. Causes are many like bleeding disorder, kidney stones, inflammation in the kidney (nephritis). So I need to know what problems you are experiencing to make a diagnosis. Also, please mention whether you were menstruating at the time of giving the urine sample?" "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 pain and loose motions since morning but at present, the frequency of loose motion has increased. Please advise us medicines for instant relief. ### Response: You are most likely suffering from a case of gastroenteritis. Probable cause of loose motion may be food poisoning." "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 left-sided crampy stomach pain and chest pain which is mostly located under breast, near ribcage. About two years ago I got Streptococcal infection, pneumonia and bronchitis at the same time. In ER, they prescribed Amoxicillin. But it did not work for me as I am allergic to Penicillin and Amoxicillin. That is the only time I can remember being in this pain. Three weeks back again I had Streptococcal infection. My doctor said that I might have flu and I am on Azithromycin now. I am wondering are stomach cramps, chest pain, back pain, and labored breathing symptoms of flu? Please do the needful. ### Response: Hi. I have read your query and understood your health concern. Infection by Streptococcus or viral. 1. Complete blood count.2. Chest x-ray.3. Nasal and throat swab culture.4. PCR." "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: Ten days ago, my dad collapsed on the street. We rushed him to the hospital and made an echo. Also, he was suffering from high blood pressure but, nowadays his blood pressure is low. This was the first time it happened to him after he took Avodart and Tamsulin. His reports read as follows: LA PSL 4.1 cm, aortic root 3.8 cm, LVEDd 6.0 cm, LVESd 4.8 cm, IVSDd 1.2 cm, LVPWd 1.1 cm, FS 19%, EF 39 %, and RV 1.8 %. I wish to know what these heart echo results mean. ### Response: He probably fell due to low blood pressure induced due to Tamsulosin. However, there are possibilities like heart rhythm abnormalities and rapid heart rate as his heart function is also low. The echo report indicates that his heart function is low and it is 39 percent. The normal functioning is around 55 to 60 percent. A low function is likely due to coronary artery disease and blockages leading to heart damage. So, I suggest he have ECG (electrocardiogram), Holter monitoring, and angiography followed by angioplasty if needed. Hope this helps you and get back if you have any doubts" "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 a wet cough with blocked nose having no fever. The doctor has prescribed medicines like Montral syrup and Levolin syrup and Metaspray nasal spray but no relief until date. I also medicate him with nasal drops of Otrivin. Please advise me whether can he continue with the same medicines. Please advise accordingly. ### Response: Hello. Your son\s symptoms are most probably due to viral upper respiratory infection which is not a serious condition. The medications prescribed are sufficient but you have to watch for fever and the color and amount of excreted phlegm. I suggest you add an expectorant like Ambroxol Syrup 5 mL three times per day which will help him to excrete the formed phlegm. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. Follow up within one week" "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 22 years old and I have a problem of blood in the stool for two days. I do not feel pain and any other symptoms but sometimes constipation exist and my long toilet interval is once every two days (most common). Sometimes rarely on every day or three days interval. Are there any home remedies and is it normal? ### Response: Constipation is very common due to the active lifestyle considering your age and history. The blood in stools can be due to chronic constipation. As it does not pain while you pass stool it confirms constipation. Include fiber rich food like oats, corn flakes, and fruits like banana, apple, and watermelon. Try having some of these food for dinner. And if you eat nonvegetarian foods make sure you eat an equal amount of green vegetables with it. On an Indian diet, you can have roti instead of white rice. Following this routine would surely improve your constipation." "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 I was bitten by a stray cat eight months back. I do not know if it landed its fangs on my finger but I noticed a very small dot sized wound on my finger. I have received three PEP regimens and the last regimen was six years back. I did not receive the last shot on that year but my two successful shots are complete. I frequently experience muscle twitches in my foot and legs because I love to walk home. I am seeing small white circles in my peripheral vision but when I look into it it is like disappearing. Is this a fruit of my imagination? Am I covered with that vaccine? Do I have rabies? ### Response: Hello. I have read through your question and would like to tell you that the chances of getting rabies from a cat bite are very less. And since you have received a regime of anti-rabies it erases the chances of getting rabies. The muscle twitches you are experiencing may be happening because of some other reason. Most common reason being electrolyte imbalance." "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 want to know that if someone (who is not suffering from any epilepsy or seizure disorder) has mistakenly taken Dilantin 300 mg daily (sometimes 100 mg) for 15 to 30 days, what will happen? Is he going to suffer from seizure disorder or other health issues? What has to be done to stop taking this medicine safely? ### Response: Usually, no side effects would happen in such case. It is not that the person would develop seizure disorder on stopping the medicines. It should be slowly tapered and stopped under the guidance of your physician. In case the person is a pregnant female she needs immediate attention" "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: Please guide me regarding fibroid treatment as I am trying to conceive since the last four years. ### Response: Hello. Fibroids are the most common benign tumor in the uterus. It occurs in 40 % of the women. They can cause infertility, but not every fibroid causes infertility. They can lead to an altered sperm movement if present in the cervical canal, causing infertility. What does your report read? Revert with more information to 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 small colorless bumps on my arm and a couple on fingers of my hand. They do not cause any pain or itching. But, I have noticed that they were not present on my arm earlier, and I would like to avoid these spreading elsewhere. Kindly suggest the causes and treatment. ### Response: Hi. I have gone through the picture (attachment removed to protect patient identity). These tiny skin colored papules are called lichen nitidus. It is a harmless condition. In about 70 % of cases, it is self-limiting which means it resolves on its own, no treatment is usually required. If it is itchy, then use Mometasone cream, mix one part of cream with two parts of moisturizer and apply a thin layer to the affected area at night for two weeks only. Mometasone is a moderately potent topical corticosteroid. It should not be used continuously. Use it for two weeks. Take a break for a week then again use it for another two weeks if the skin lesions are still present. Olesoft moisturizing lotion (Olive oil with Sodium lactate) is fine. You can use any moisturizer or lotion but do not use cream or ointment because the ointment will be thick and can clog the pores. It is better to use lotion during summer" "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 fungal infection from the last two years, continuously used many ointments but no benefit observed such as Ketoform, Dermiform, Sertaconazole, Luliconazole, Ring ring , Btex, Ring Guard and currently using Dermex cream. Please give me appropriate medicine name or advice. ### Response: You have tinea corporis. The creams that you have used are steroids that are not to be given for fungal infection. Application of these creams has aggravated your situation. Topical treatment can be used for relief but you need to be started on oral medicines for complete relief. To start you on oral medicines, you first have to get LFT test done and then follow up with the report. Meanwhile, you can use the creams mentioned below for now. Tinea corporis. LFT. 1. Lulifin cream twice a day, Amlorofine cream twice a day. tablet Levocetirizine 5 mg twice a day for itching." "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: Pus cells 8 to 10, my urine RBC is 6 to 8 and now I have the menstrual period. I feel I have a fever and cramps in my left side leg and hips side feel pain little bit and headache. What does it mean? ### Response: Hello. As per your clinical history is concerned, please follow like this. Discuss with your doctor about the prescription medications like Nitrofurantoin to clear the infection and Paracetamol for pain and fever. Do follow lifestyle modifications like this." "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 year back I had my first sexual contact. I gave him a blowjob and he did anal to me unprotected. I got tested for HIV with CMIA test two months back and it came out negative and non-reactive. I have heard the window period is 90 days. I tested after 250 days. So is this test conclusive? I do not want to go to test again. I have not had sex since then. ### Response: Yes, an HIV screening test is considered conclusive at 12 weeks and beyond after risk exposure. So you do not need to test any further. Your test result is reliable and conclusive" "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 28 years old. My height is 5.8 feet, and my weight is 83 kilograms. I have belly fat, big thighs, and hips. Please suggest. ### Response: Hi. With your height and weight, I have calculated your body mass index. You have a BMI of 26.8 which means that you are overweight. The first thing to do in your case is to assess your diet and activity. Please explain about the count of calories taken by you every day. You should be consuming 1600 to 1700 kcal per day. Try to do exercise for 30 minutes for at least five days a week. It can be any activity like walking, jogging, swimming to dancing. If you do these exercise for one to two months, and if there is no loss of weight, then it is necessary to see the thyroid hormone levels." "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 took i-pill after 40 hours of intercourse due to the suspected entry of precum. Now I am experiencing mild brown discharge. What does it signify? Moreover, I am on my homeopathic medication for irregular periods which I resumed this month on 9th. Last month I had my periods on 10 and I took i-pill on the 3rd of this month. Please help. I do not want to get pregnant. ### Response: Hi. This discharge is mostly a side effect of i-pill. So, please relax and wait for your period. The chance of pregnancy is very less. Still, if you miss the period, then check for pregnancy." "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 looking into veneers and invisalign to fix the gap between my front teeth. I am not sure what would fix them. So, I am looking for some initial advice. I have attached a picture for you to view. ### Response: I have gone through your query and attached photograph (attachment removed to protect patient identity). OPG (orthopantomogram) to check the condition of the roots of the upper front 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: I have noticed mole like spots in my eye and light colored yellow red patch. I do not have any problem in vision or itchiness. I noticed it two months back but I do not know when did it develop. I have attached the photograph of the eye. Is it a tumor? ### Response: Hi. I have gone through the picture you sent (attachment removed to protect patient identity). It is totally normal. What you are mentioning as a mole is like spots. Those are normal melanin pigments deposited in the conjunctiva. They are not a tumor. You should be concerned only if you notice a sudden change in growth or color. Otherwise, it is totally normal to have different variations in eye color." "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 schizophrenia for more than 25 years. I had Clozapine for 15 years and now I am on Aripiprazole. I stayed away from alcohol for eight years. Before six months, I had alcohol once. Now, I am having some tactile hallucination. Is it due to alcohol abstinence? Will it disappear? ### Response: It means, it is due to your illness schizophrenia. Are you on any antipsychotic now? Revert back with the answer to the above question to a psychiatrist 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 a complex case, as stated by my dentist. I had braces five years ago, but my teeth went back to their previous state, overlapped, like they were tightly fit into a small place, apparently because of the shape of my mouth. Also, I have fear from getting braces the second time, that it could cause harm to my teeth and still they would stay the same. Is there another solution? I am 18 years old now. ### Response: I can exactly tell you about your case on seeing radiographs and clinical pictures of teeth if you can provide. While, your query is telling me you had a relapse of orthodontic treatment. Now you have two options. 1. Go for invisible tray ortho treatment (in which invisible trays are given instead of metal brackets). This is an expensive one and treatment time is prolonged. Your teeth will not weaken in it as bracketing will not be done. 2. Go for conventional metal bracketing ortho treatment. Get it done and do get fixed retainers at the end of treatment, that is, the invisible wire at back side of teeth that prevents teeth to come back at their previous positions for your entire life. This is not expensive, a bit economical and treatment result is fast. If your teeth get weaken at end of treatment, get them veneeres or get filling of composites done on them. All will be fine then." "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 mild cold symptoms over three weeks ago. Because of this global pandemic I got stressed and started feeling chest pain and abdominal muscle pain, etc. I did not have a fever, like not a single day. So I know that chest pain can occur due to stress and anxiety and to make myself feel better I went to the doctor\s office so my doctor can listen to me breathing with a stethoscope. She said that my lungs are totally clear and that there is no strange noises. She said that I should take vitamin B and I was diagnosed with oral candidiasis. Now I am feeling a sort of bubbly feeling at the top of my chest and in my throat but only when I lay in bed and I feel like there is something stuck in my throat and I have a bit of discomfort when swallowing. So if my doctor said that my lungs are fine, what can it be? ### Response: Hello. Most common symptoms of Covid-19 are fever, cough, and dyspnea. You mentioned you do not have fever, cough nor dyspnea so it is least likely you have Covid-19. Moreso, your lungs were clear. However, since we are in a pandemic, observation and self-quarantine is still advised. Yous symptoms of lump sensation in the throat and difficulty in swallowing may be caused by gastroesophageal reflux disease or GERD. Stress may have triggered it. I recommend you take Omeprazole 40 mg one tablet for two to four weeks. Avoid eating spicy, oily, fatty, and dairy foods." "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 33 weeks pregnant. In my previous pregnancy, I had a c section at 33 weeks as my water broke. Presently, I am taking Aspirin tablets daily. My doctor prescribed it. But I have a doubt that will it cause excessive bleeding in my delivery? As I am near to delivery is it safe to take these tablets?I am currently taking Ecospirin 150 mg, Diamet Metformin 500 mg, Orotate 3D, Folsafe D, Wysolone 5 mg, and Iron tablets. ### Response: I totally understand your concern, but please do not be stressed. All you need right now is to relax, keep calm, and take some rest. Yes, Ecosporin is totally safe during pregnancy, and mostly your gynecologist will continue it until 36 weeks at least. But I would like to know the reason for starting Ecosporin and also the steroids ( Wysolone) because you have not mentioned it (could be related to previous pregnancy events which need to be known in detail). And also if you go into labor you can stop it then, the effect usually does not last more than a day, and the dose that is given in pregnancy is very low. So definitely there is not much risk of bleeding. 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 married for ten months. I had a miscarriage of 10 weeks baby. Now again, I expect five weeks of pregnancy. At my first miscarriage checkup, the doctor said that I have a fibroid of 3.2 cm within the uterus at the intermural side. Also, at that time, my TORCH test was positive. T and R were positive, and I took medicines. Will I have a safe pregnancy this time? What can I do? Please suggest. ### Response: Hello. There are two things, one is to have a pregnancy, and the second is the growth of the pregnancy. Both are different and require different approaches in the treatment point of view. As you said, there were T and R positive. If it was IgG (Immunoglobulin G) positive, then you need not worry. It suggests the past infection. But as you have taken tablets and completed the course, no need to worry. You said that you have a fibroid around 3.2 cm intramural. It is true that fibroid can increase the chance of abortion. But it is also true many pregnancies with fibroid goes up to the term without any complications and have delivered the baby normally. So, continue the treatment prescribed by your doctor. Take maximum rest. Avoid heavy weight lifting, intercourse, jerky work, and work while bending. And hopefully you will have a normal pregnancy." "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: Why does anesthesia awareness occur and what is done to monitor it? ### Response: It occurs mainly because of inadequate depth of surgical plane achieved. So in general terms patient is under the effects of anaesthesia but they are still aware about their surroundings. Nowadays monitors called as BIS (bispectral index) monitoring can be helpful to prevent awareness during anaesthesia" "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 PCOS, and I missed my last two periods. Can I take Meprate or Deviry? In case I am pregnant, I want to keep the baby. Will these medicines cause abortion? ### Response: Hi. How are you doing? You can definitely take either of the medicines, they both are the same. In PCOD (polycystic ovary disease), as you are not ovulating, this hormone will be deficient. So, taking the pill meprate will cause bleeding, only if you are not pregnant. If there is pregnancy, this same progesterone hormone is produced by the ovary to support the fetus. So, these medicines will not cause abortion, but it will support it further. These medicines are very safe whether you are pregnant or not. It can never cause abortion. Hope I have clarified your doubt, do write back. All the best." "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 34 years facing early ejaculation problem as well as thin semen. I want stronger erection with maximum delay time. Please help me. ### Response: It is called premature ejaculation. The 3 to 7 minutes of intercourse with reaching up to climax can be considered normal duration. To increase duration and achieve climax you can practice Master and Johnson start and stop technique. You can take the help of a psychiatrist in learning this technique. Performance anxiety is a common cause of premature ejaculation. If the anxiety problem is present then Fluoxetine like medication can be prescribed. Behavioral counseling and yoga are helpful in such a situation. You can consult a psychiatrist for detailed 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 a 31-year-old. I was asked by my doctor to go for a USG for irregular periods. In the report it is mentioned as, a well defined oval hypoechoic lesion with mild intralesional vascularity measuring 48\xc3\x9744 mm is noted in the left adnexa, could be suggestive as left tubo ovarian mass. Can you please tell me is this dangerous and can be cancerous? ### Response: The next best would be a per vaginal examination to rule out PID (pelvic inflammatory disease) first and then a course of antibiotics and if still, the TO-mass persists then diagnostic laparoscopy and removal of the mass and then sent for histopathology to establish the diagnosis." "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 32 year old man. I have been experiencing panic disorder, OCD symptoms and excessive levels of anxiety. In the last few months, major changes in my life have happened. For instance; quitting my job and moving to another city triggered my anxiety symptoms. I usually feel drowned in fears, health anxiety, fear of losing my mind or becoming delusional, losing my beloved ones, etc. I cannot get rid of those running thoughts. I learn that I have mild Hashimoto\s and a kind of mild rheumatologic problems. Also, in the last few days, I feel extreme depersonalization. I strongly feel that I am going to lose my mind and this unreal feeling with dizziness accompany with my anxiety.Three months ago, I visited a neurologist and he prescribed Cymbalta for my neuropathic pain like symptoms and high levels of anxiety. One week later, I visited a psychiatrist to confirm if the medicine is right for me. And, according to my history, the psychiatrist decided to stop Cymbalta and we started Risperdal. I think he had been thinking I have something like borderline disorder. Then, we gradually changed the treatment. I think the psychiatrist thought the responsibility of my anxiety is Duloxetine, however, he could not understand I was more anxious before it. One month, when I took both Cymbalta (30 mg) and Risperdal (0.5 mg to 1 mg) was one of the most peaceful periods of my life. But, the following month I stopped using Cymbalta and my horrible thoughts came back, they are much stronger than before. Nowadays, I am on 1.25 mg Risperdal. Also, I have been on Fluvoxamine for two years for my panic attacks around 15 years ago. Please help me. ### Response: Hi. Please write back with these details so that we can have a better picture. Meanwhile, I have these thoughts about what you have described in the query. Irrational beliefs. Rational emotive or cognitive behavior therapy. Revert back with more details to a psychiatrist 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 years ago, on a trip after walking around all day, my big toe on my left foot began to hurt. When I removed my shoe, I had bruising under the nail. I contributed it to the new balance shoes I was wearing. It got worse and I eventually I lost the nail on that toe. The nail grew back, and it was fine. A couple of months ago, the same toe became inflamed around the bottom of the nail bed. It was sore to the touch. It again went away, and the toe was fine. Last night I woke up with the same toe throbbing. The nail bed was once again inflamed, and this time, there was bruising under the nail. Any idea what may be going on? ### Response: Judging by your description, it looks like a subungual hematoma. Usually, it is resolved by a procedure known as decompression. It is an OPD procedure performed by a licensed physician. I would suggest you plan your visit to a local physician as soon as possible to avoid the possibility of complications in a hematoma. bruise. Subungual hematoma. Decompression. Cold compression." "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 taking cocaine and alcohol once a week for 20 years. On the first of this year, I started getting a cough and breathlessness. I continue to do my binge until four weeks ago when I was diagnosed with mild left ventricle dysfunction.I then had a chest CT scan and lungs come back clear. I had an X-ray another day, and I have got an enlarged heart. I have no family history of heart problems. I know this is done through cocaine. I have been clean for four weeks, but I am still experiencing breathlessness. Can you please tell me if this can get better? If so how long does it take? Because I have no improvement and I have been working out too for the last four weeks. ### Response: Hello. Your reports are showing mild LV dysfunction (left ventricle) with no lung disease (attachment removed to protect patient identity). Still, it will be useful if you provide your ECG and echo cardiography report." "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 pain in the right lower abdomen for 10 days. The ultrasound had shown mild inflammation of the appendix. Doctor then suggested a CECT whole abdomen. However, in the past, I have had difficulty keeping down the contrast they ask to drink. So the doctor advised CT Scan with IV contrast only and left out the drinking contrast part. The result of the CT scan came normal showing no Appendicitis. My query is, can the CT scan be done without drinking the contrast? Will it be accurate? Is IV only CT scan without the drink reliable? Is it surprising that USG showed mild appendicitis, but the CT scan did not? Please advise. ### Response: The appendix is a tubular structure measuring less than 5 mm in normal people. When there is appendicitis, the appendix enlarges to 8 to 10 mm or more in diameter. Ultrasound scan has an accuracy of 50 percent for appendicitis in most patients. You have been found with a likely 9 mm appendix before some days. The CT scan was done before a week. It is possible that the inflammation of appendix decreased in a week and so the CT scan finding with only IV contrast showed near-normal appendix and no features of inflammation surrounding it. An oral and IV contrast CT is always better to look for appendix related problems." "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: How can we treat a sore throat? Please explain about the OTC medications taken, and the home remedies followed to cure a sore throat. ### Response: Hi. These are the home remedies followed to treat a sore throat. It gives immediate relief. Grated ginger with green tea is quite helpful. Ginger has anti-inflammatory properties with a strong taste. It helps to calm a scratchy throat. Aspirin dissolved in warm water and salt water gargling is beneficial. It can be followed for a few days to reduce the inflammation. Do not" "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 having trouble with my weight recently. I am a female with a height of 5\7"" hoping to be 125 lbs. The lowest I have hit was 126.6 lbs, but that was about a month ago. Now, it ranges from 127-128 lbs. I am eating 1800 calories a day on days I do not workout intentionally (three days a week) and 1900 on days I do. My workout routine is quite different. I do two workouts a day, four days a week. My first workout consists of 70 minutes of brisk walking, and 20 minutes of abdomen exercises afterward. My second workout (which is about six hours later) is 10 minutes of squats, lunges, sit-ups, etc, and 20 minutes of brisk walking. All in all, that is eight hours of exercise a week, not including unintended exercise like skating, shopping, being on my feet all day, etc. I would love to be 125 lbs. My waist ranges from 26 inches to 26.5 inches, but I would love to get it to a steady 26 inches. I have toned my abs, but again, I would love to lose these last few pounds. What do I do? ### Response: I have understood your concern about losing weight and you are working hard also for that. Your protocol for doing exercise workout is quite satisfactory but you can add 20 more minutes of aerobic exercise and resistance exercise combined. See weight reduction and gaining both depends upon your metabolism and energy intake and expense. Even though you work out well but not maintaining the diet then, you may not get the results that you need. Proper vegetable diet is compulsory. Avoid non-vegetarian diet, bakery items, and outside junk foods which will reduce unwanted calories. Take homemade food whatever and how much ever you want. Just do daily exercise and add yogasanas for 10 minutes, pranayama practice 10minutes at the end of each exercise sessions. So collectively I prefer you need to do daily exercise and pranayama practice." "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 36 year old female. I have a cluster head ache for the past five years. I feel severe pain behind my eye, which normally ends with vomiting. This happens for three to four days at a stretch. I do not want to undergo any surgery immediately. Hence, kindly advise me medications to reduce the pain. I am a nursing mother. ### Response: Hello. I read your query and understand your concerns. In case you feel it is something else, as you can infer from the above description, or feel that Naxdom 250 is not helping enough, feel free to ask me. 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: Are Halloween colored contact lenses safe? Do people who need prescribed contact lenses be using them? ### Response: Ophthalmologists do not recommend colored contact lenses. However, they may be used occasionally for not more than a few hours. The reason is that compared to regular glasses, most colored lenses have a lesser tendency to allow oxygen to pass through to the corneas, thus causing damage to the corneal cells. This problem does not depend on whether the user is a prescription lens user or not. It depends on the quality of the lens and a few biological variables of the person using them. 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 36 year old female. I am currently breast feeding. I am suffering from severe UTI since 20 days. My gynecologist suggested Ceftum, Citralka, and Urispas for three days. After taking the course I was fine for two days. But, after two days, the UTI symptoms came back, but not as severe as the first time. I continued taking the same medicines again for three days. Still, there was discomfort, though the severity had reduced. I got a urine test done and attached the results. My gynecologist then put me on Nitrofurantoin, three tablets per day for a week and from the second week, I was asked to reduce the tablet to two per day. I have taken a total eight tablets, but there is still a burning sensation while passing urine, especially at night. Is this medicine effective? Will my UTI be cured by this medicine? For how many more days will there be a discomfort? Do I have to try a different medicine? Also, my gynecologist told me that if this medicine does not work, I will need to take a five-day injection course of Amikacin 500. Should I go for it right away? ### Response: I have seen the reports sent by you (attachment removed to protect patient identity). You are suffering from a urinary tract infection with E.coli. Nitrofurantoin is the correct medicine, as per your urine culture report. As the infection is severe, your symptoms will require some time to resolve completely" "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 viral infection. I have a fever and cold. What can I do? ### Response: Hi. Usually, 95 % of respiratory infections are viral. At this point, you can take medicines for cold for five to seven 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 25 years old. I am healthy, no medications, regular periods of 28 to 30 days. My partner and I have been together for seven years and we have been TTC for five years with no luck. I have given up hope for a long time. End last year, I started seeing a chiropractor because of lower back pain. Early this year, my period was a week late and I felt different. So, I decided to take a pregnancy test. I had two positive digital tests and another positive on the first response with two lines that appeared. I was definitely pregnant. I could not believe it! The only thing I had done differently was to see a chiropractor and it was instant that I conceived. Unfortunately, I had a very early miscarriage. Just two days after my positive tests, I began to bleed and confirmed with a doctor it had been miscarried. To this day, I still see a chiropractor and we keep on trying to get pregnant but it is not happening. I am back to feeling hopeless. I still cannot believe I saw three positive tests. I thought I would never see that for myself. I was so close. It gives me the slightest hope that maybe it will happen for me one day. Is there any information you can give me? Why is this happening to me? What might help me? ### Response: Hello. There are multiple factors which need to be evaluated in a secondary infertility case, the male and the female. Considering that you became pregnant, the male factor is healthy with motile and healthy sperms. It is now important to get your hormonal profile done along with an ultrasound pelvis to rule out PCOD (polycystic ovaries disease), hypothyroidism or hyperprolactinemia which can cause delayed follicular development or immature follicles which do not ovulate. You may be experiencing anovulatory cycles. Hence follicular monitoring should be done for a natural dummy cycle to check for follicular growth." "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 with my husband on the fourth day of my periods. One day while passing urine, in my vagina there was a burning sensation and it started paining in the abdomen area below the stomach on the right and left sides. After that on the next day, I had no pain. After that, again the next day, I had sex with my husband then again it started paining and burning during urination. In short, there is burning sensation while urinating and a persisting burning sensation after urination.Yesterday, we did not have sex but in the morning since 6 a.m., I am having a burning sensation in my vagina which is not at all getting fine. What can be the cause of this? And what should I do? Please help. ### Response: Most probably, you are suffering from a UTI (urinary tract infection). So, get a urine examination done. Investigations to be done include urine routine and a urine culture and sensitivity. Follow up with the report" "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 weeks ago, I noticed my left tonsil seems slightly enlarged and I have a lump with white head right behind it. A little background for the past six months, I have been experiencing daily low fevers and severe night sweats which are undiagnosed. My PCP told me it was just a tonsil stone but I am almost positive it is not. It looks nothing like any that I have seen in my research. I would love to submit a photo for a second opinion. I will eventually make it to an ENT if needed but with the coronavirus, I would like to wait if it is nothing to worry about.Most labs (done prior to lump) looked normal except I had a positive ana with a low titer 1:40. My CRP was considered normal but 5.1 which says I am high risk for heart disease. I am a pretty active, healthy 34-year-old so while considered normal, it seems off to me. Chest x-ray looked normal. TB test negative. ### Response: Hello. You are right it is not a tonsillolith, it is a tonsillar cyst. Indeed, it is nothing to worry about and such a small may not even need any treatment. Furthermore, your tonsils are not that grossly enlarged or even congested to give you the spikes of fever. Low-grade fevers and night sweats need to be evaluated for other more important causes like tuberculosis. Have you done any serological tests and baseline blood tests?" "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 20-year-old male. I currently have a tingling sensation in my left leg, on the right side of my calf. I have recently had a long journey (approximately 10 hours, with stops every three hours) the sensation has lasted for about a week. I am not on any medication or have any health conditions. Please help. ### Response: This may be due to your long journey where all your joints will be flexed for quite a long time inspire of the rest you had in between. If it is in a bike, your lower spine has also been flexed, which will cause a small inconvenience to the nerves which pass through the foramen of the spine. It simply may due to a vitamin deficiency, or be due to disc problem. Rule out any disc problem, see an orthopedic surgeon, do a spinal MRI. If everything is fine, do some exercises for the leg and the spine and take some B complex." "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 husband has an eye infection for the past two months. The doctors diagnosed that it is a fungal infection pythium keratitis. This infection might be from crops. They said that there is no anti fungal for this type of fungus and asked to apply Itral eye drop hourly, Zaha four times a day, Homide two times a day. A corneal ulcer is created and a white like thing is in the cornea. Vision is blurred due to this. Could only identify the objects. He is under treatment for the past 30+ days. Do we have treatment for this? ### Response: Hi. In case the organism is pythium as you have said, it has been found that it does not respond to available antifungals. Previously patients have been managed by corneal transplant to remove the infected organ so that it does not affect inner parts of the eye. Your decision will depend on how well the infection is responding to the treatment being tried. If it is increasing despite all the medications, a corneal transplant may be the only way forward. Better to keep serial photographs of the eye for comparison and easy decision making." "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 tonsils are not symmetrical. I first noticed just two months ago that my right tonsil looks like a kidney bean with a small hole on top while my left tonsil looks oval in shape with a much larger hole. My right tonsil looks like there is a lump of the bottom of it. I am 28 years old and I smoked for just under 10 years and I have not tested positive for HPV. I do not have any lumps that I can feel, have not lost any weight, do not feel regularly sick. I did have a sore throat a month ago and my left tonsil did feel infected. I did push quite a few tonsil stones from it. I am worried that the asymmetry of my tonsils may be an indicator of cancer. ### Response: Tonsils are our lymphoid organs which protect us from infections. The shape of tonsil can vary from person to person and asymmetrical shapes are not at all indicators for cancer. The holes you mentioned are called crypts which lodges food particles which can form stones. Hence, regular salt water gargling is advised. A sore throat you had was because of smoking which is a normal phenomenon of a tonsil infection. Hence you need not to worry thinking abnormal shapes of tonsil for cancer which is pretty much normal in all individual. Finally, regular gargling and antibiotic for a sore throat will relieve your problem. If at all tonsils are troubling you a lot, you can get them removed." "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\s age is 60 years, and six months back her WBC count was 26000. She got admitted for two days and was discharged, at that time her WBC count came to 9000. Now from the last month, she was feeling tired, so we checked the WBC count, and it was 14,000. We went to the general physician, who gave her antibiotics for a week, but again after a week, her WBC was same. The doctor told us not to take any medicines, and to wait for ten days. But, after ten days, her WBC count is up to 15,000. So, the doctor has suggested seeing a hematologist. I am worried about this situation. What can be the reasons for this? I am also attaching her latest reports. Is it necessary to do bone marrow test? Is there any side effects? ### Response: Hi. I have seen your attached reports (attachment removed to protect patient identity). Consult a nearby hematologist for examination with keeping all this in mind." "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: There are multiple cracks in the palm with pain. If I touch anything, I get a wound. I can see that the wound surface is hard and blackish. What is this? ### Response: From the description provided, it seems that you could be having eczema or psoriasis. Right now, just use a good emollient like Cetaphil Dam over hands multiple times a day and apply Cosvate G cream (combination of Clobetasol propionate and Gentamicin sulfate) two to three times over hands. Further management would depend upon the response and exact underlying cause of the disease. Also, use a mild soap like Cetaphil to wash hands. Avoid exposure to detergents, hard soaps, chemicals, etc. Visit a dermatologist in person for physical evaluation and further management." "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 got my CBC report. It was normal, but lymphocytes were 3.04. Then again I tested after two days, everything was normal, and the lymphocytes were 2.57. I asked a general physician. He said, they would fluctuate every hour, and the doctor saw my latest reports and told everything is normal and healthy. I am a fearsome person. So I tested for blood smear. I read that the blood smear will show abnormal cells. If you have any blood disorders, the report will show you. The reports came in which RBC, platelets are adequate, and there is no hemoparasite found but, it says mild lymphocytosis. My general physician says there are no abnormal cells like blast cells or anything found. So it is normal. Can you tell is this normal? I am getting feared and worried. I tested because of my fear of getting cancer. Please help. ### Response: Hi. I have reviewed your query, and I will surely help you to remove your fear. The mentioned history does not suggest any abnormality, and you have lymphocytosis only. As per the reports you have attached (attachment removed to protect patient identity) abnormal cells like blast cells, prolymphocytes are not seen. So, leukemia is not present. In leukemia, the total count will be high, which is not present in your case. So do not get worried. You can attach your reports so that I can also 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: I am just 10 days away to be 20 years old. I have been seeing black dots or I may say they appear differently on my eyes. They do not go away. I always have them with me. They irritate me because I normally see them the most or clearly when I am out in the daylight. I sometimes find it hard to face the light meaning like looking around on a sunny day. These things do not prevent me from seeing. I see even from afar but I see well when there is no much light because I cannot stand light well when I am watching something. I have read somewhere that they are called floaters and can cause blindness. I have started to see just one dot and now I see some more not too many but irritating. It has been years. However, I have only tried to tell a doctor but he said that there is no problem and I have not done any treatment. So, I need your help, please. ### Response: You have correctly described your floaters. Only thing is that it is perfectly normal as they are part of aging and will only increase with time. They develop as the vitreous jelly inside our eyes liquifies with time. So they move when your eye moves. They do not cause blindness on their own. They are a matter of concern only when there is a sudden shower of floaters associated with flashes. In that case, you will need an examination of your retina after full dilation of your pupil to rule out any break in your retina which if not lasered on time may proceed to retinal detachment." "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 patient of oral fibrosis. Is it curable or not? And leaving tobacco is how much helpful? ### Response: Hello. Oral submucous fibrosis is a common premalignant condition. Main causes are tobacco-gutkha, beetle nut. In this condition the most important thing is to stop the habit immediately. There are many treatment therapies available like steroids, vitamin therapy, an oral exercise which are helping to improve the condition. Some time there is a need for surgery. First, you stop your habits and see your dentist as soon as possible. He or she can examine and tell you about treatment plan according to your condition." "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: The patient is a 17-year-old male. He has got injuries and fractures of the head and neck in an accident some days ago. There is a pain in the head and neck. He can move his hands and legs. He is conscious and can talk. He is getting irritated due to a tight collar in the neck. I have attached all the reports. Please check. ### Response: Hello. I have gone through the attachments (attachment removed to protect patient identity). The patient has second neck bone fracture along with head injury with small hemorrhages (areas of bleeding) in the brain. He requires surgery for neck bone fracture which can be done only after brain injury is settled. Until the surgery is done, he needs to wear the hard collar on the neck. That is a must. Only after the neck surgery, he can remove the collar" "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 tested positive for chlamydia IgA IgG. Negative IgM. I am HIV positive but undetectable viral load and CD4 724. ### Response: A high title of IgA and IgG antibodies to chlamydia generally indicates active infection but it is an auxiliary test and should also be supplemented by a more specific nucleic acid amplification test (NAAT) on a urine sample. A NAAT test specifically detects chlamydia antigen" "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 brother who is sick since a month. I am feeling very helpless without him and I am deprived of sleep. I keep thinking about him the whole day. How can I overcome this situation? ### Response: Hi. The pain of near ones makes you feel helpless. This weakens your strength somehow. Symptoms like lack of sleep, disturbance, and tension occur when you feel stressed for any reason. But you have to be strong for your brother. If you feel low, he will become worse and lose his willpower to fight the illness. Follow these to be mentally strong: Unless you make yourself equipped with strength, it will not be beneficial for your loved ones. For a psychological counselling, consult a psychiatrist 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 mouth and throat ulcers lasting for the past eight to nine days. No fever, cough, ordifficulty breathing.I consulted a doctor over the phone and took three days of Azithromycin, Dologel, andsome pain relief medicine. After no improvement after three days, the doctorchanged the medicine Candid mouth gel, Alusil. I have been taking thisfor the last three days. Still there is only minimal improvement. ### Response: Can you kindly share the pictures of the lesions? Are there any blisters? How did the lesions appear in the first place? If it is not responding it might be oral herpes." "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: Ten days back I checked my report. All reports are normal. Only platelets are 590000. I have no symptoms and no fever about that. ### Response: Hello. The increase in platelet count can be because of a primary cause like myeloproliferative neoplasm or secondary reactive cause. Secondary cause includes some inflammation, infection, hemorrhage or anemia-like condition. You can take a healthy diet with more vegetable and fruits for a few days. If you have a secondary cause, then platelet count will decrease and will fall within a normal range in a few days. But if platelet count does not decrease in a few days, then you have to consult a hematologist for examination to rule out the primary cause. He will suggest you investigate with Jak-2 mutation and bone marrow aspiration study according to need. So repeat your CBC (complete blood count) after a few 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 got these scars post scabies some eight years back. I want to know of a procedure to remove them immediately. ### Response: I understand from details and image (attachment removed to protect patient identity), given that there is dark pigmentation mainly on the lower portion of both buttocks. I recommend you to use a thick moisturizer body cream twice a day which helps in softening and renewing the skin. Avoid wearing tight-fitting clothes that may rub over this area. Very important if you have any itching, please seek to get the symptoms treated first before moving on to pigmentation treatment. Once the skin is softer, a skin lightening cream containing Glycolic acid or Kojic acid can be applied at night to the affected area." "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 seen a rheumatologist and all my tests on autoimmune diseases are normal. He even ordered hand X-rays and they are normal. My fingers are forming knobs on them and hurt constantly. My movement is getting more and more limited. I can barely bend my affected fingers. I feel sick all the time. My body is constantly hurting. Fatigue and exhaustion are with me all the time. ### Response: I suggest you to start Pregabalin or Duloxetine to see the response which will be helpful in chronic fatigue syn" "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 retinal detachment surgery 7.5 months back with silicon oil. Four months back silicon oil was removed and at the same time cataract surgery was also done. This was my right eye. The vision in the eye is 6/9 with glasses in the operated eye and 6/6 in the other one. Since the first surgery 7.5 months back I am on Predforte eye drops. When I taper them off to 1, the eye starts getting red. My last eye exam was a month back and the retina specialist suggested to have one drop morning and evening for another 14 days. He said there is a subtle infection in the eye. However, when I stopped taking the drops after 15 days, the eye got red again and I restarted it and the redness was gone. I am worried about when I will be able to stop it. Can you please explain what may be the reason and how harmful it is to continue? The eye doctor (retina specialist) asked me to recheck after three months. ### Response: Hi. You might be suffering from inflammation, not infection. A steroid is usually given to control inflammation. The principle is to continue on the lowest possible dose of steroid which can keep inflammation in control. In the meantime, it is important to keep an eye on side effects of a steroid-like rise in intraocular pressure. You are on a low dose, you can continue but check with your surgeon periodically." "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 sharp pain in my tailbone area when I am sitting or standing up. This has been going on for several months and has not improved. I recently saw a doctor. He diagnosed it as a curve in my lumbar and suggested I see a chiropractor here. Is there anything else I could do to fix this problem? ### Response: Yes, it is worth having a second opinion and clearing your doubts. But I think your doctor is absolutely right about the cause of pain. This is due to a slightly curved spine in the lower back causing the tailbone pain. Chiropractic adjustments and physiotherapy should help solve this problem. You should also try out anti-inflammatory medications to reduce the inflammation around your tailbone causing the pain while sitting. Medicines like Ibuprofen or Naproxen (for about 5 to 7 days). This medicine should only be taken if you are not allergic to it and if you are not suffering from bronchial asthma. If you have a lot of pain while sitting, you should use a doughnut shaped pillow or cushion for a few weeks. But yes, your previous doctor was spot on with the diagnosis. Coccydynia." "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 32 year old female with asthma. I have cervical disc herniation for 10 years. Over the past 5 months, symptoms were back with tingling, weakness and shooting pain in arms. I tried medications like Celebrex, Lyrica and also massage, physiotherapy, chiropractor and acupuncture, but the symptoms are getting worse. I did an MRI neck around 3 weeks ago which showed straightening of cervical spine due to muscle spasm. MRI indicates cervical spondylosisdeformans C5-C6 - broad-based disc herniation with right paracentral disc protrusion causing anterior thecal sac indentation with bilateral neural foramen narrowing. Impingement of bilateral exiting nerve roots noted [LT > RT]. Posterior osteophytes were also mentioned. Now, for the past 2 weeks, I have increasing twitching in the thumb especially left which is becoming almost continuous. Is that a sign that the disc is worsening? ### Response: Hi. A herniated disc in the neck can cause three potential problems: As long as you do not have spinal cord dysfunction or significant weakness due to nerve compression, then you can try nonsurgical treatments like physical therapy, pain medication, or steroid injections. If you continue to have significant arm pain or neurological symptoms for more than 6 weeks or develop weakness then you may need surgery. An EMG/NCS (Electromyogram/Nerve Conduction Studies) test looks at the function of your nerves in the arm. It might be helpful if you get this test done to confirm that the MRI findings and pain you have correlate, before deciding whether to undergo surgery." "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 stray puppy bit me on my right-hand fingertip just little hard when I was feeding it (80 days back) but there was no bleed and scratch. And the puppy died after three days of biting me. Cause of that is adult dogs had bitten the puppy.I had three doses of vaccination six years ago and also I had antibiotics vaccination last six months ago. I am a drinker. If the vaccines are still in my body or now what can I do? Please give me a needful answer. ### Response: Hello. The one which you mentioned six months ago, was it a full course of vaccination? Because, six years ago, you just had three doses. So if six months back was a complete vaccination course then you should receive the booster dosage of vaccination. Some amount of vaccination will always stay in blood but its always advisable to take booster dosage with every exposure. So overall, if you have received the complete vaccination in the anytime in the past, then booster should be taken with every exposure even if it occurs two months after vaccination. Booster dosing involves two dosages at day 0 and day 3" "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 it possible for C-reactive protein level to raise from 6 to 15.9 in 24 hours in my child, although there are no signs of sepsis? ### Response: C-reactive protein (CRP) is a marker of infection and inflammation anywhere in the body. It takes at least six hours for CRP to raise in the blood, once the infection starts and it continues to raise up to 24 hours at least. Though there are no signs of infection clinically, that is, the child is well symptomatically, it is still possible that CRP raises. Inference: Consult a paediatrician online for further help" "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 25 years old and my menstruation cycles had been irregular since the start. After 1.5 years of irregularity (missing periods for many months), I visited the gynecologist and after seeing all my tests results, my doctor told me because of my obesity I had irregularity in my periods. He prescribed me Diane 35 for the first 21 days post that I got my menses and thereafter he asked me to continue with the normal course of Krimson 35 of one tablet a day for 21 days. Thereafter my menses became regular while being on the medicine. After one year, I discontinued the medicine out of fear of side effects and thereafter my menses continued irregularly again.During my late teens and early 20\s my menses were highly irregular (missing for more than 4 to 6 months) but from last two years, it occurs monthly either with heavy bleeding for 1 to 2 days or very light bleeding or spotting for 10 to 15 days. I am not on any medication right now nor do I have any other symptoms like cramps or nausea or any other menstrual symptoms. However, I still continue to be obese and did develop some levels of facial hair around my chin area. Could you please let me know, if I could go back to starting Krimson 35 to get everything back on track? Will there be any kind of side effects? Will there be any difficulty in conceiving at a later stage of my life? ### Response: Hello. With your history, it seems that you need to decrease your weight which is the single most important factor in your menses. There are others but first, we have to control this. Yes, of course with irregular menses it can be difficult to get pregnant. No need to start Krimson 35 (Cyproterone Acetate and Ethinyl Estradiol) but need to do some test may be. And try to reduce weight. From history, it seems that you have PCOS. Do one sonography and consult a nearby gynecologist for a good 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: Yesterday, I had a colonoscopy and today I had a bowel movement that was bright green. Should I contact the doctor who performed the procedure or is this normal? I am a 32-year-old female. ### Response: Hi. Bright green color stool could be due to the presence of bile in stool. During a colonoscopy, you were given laxatives that might have disturbed your intestinal flora that is responsible for the yellowcolor of the stool. Also, stool must have passed rapidly through the gut. Other causes could be: 1. Fat rich diet will increase the release of bile pigments and if it moves rapidly, your stool will be green. It occurs during a period of stress or infections. 2. Rarely diet rich in green leafy vegetables can cause green color stools, if malabsorption ensues or due to not chewing properly. 3. If you have any other symptoms like abdominal pain, bloating, nausea, vomiting or green stools, do not stop within the next 12 to 14 hours. Then I would suggest you consult your doctor. You can take probiotics to build up your intestinal flora." "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 days ago, I had sudden pain in my lower right abdomen, along with nausea, vomiting, and fever. The pain subsided to a dull ache, which I still have now, the pressure is bad at the moment. I have been to the doctors twice, and I have had a urine test, which came back positive for a UTI. I am on Trimethoprim for three days, and the pain has not gone. As well as this, I am finding it very difficult to pass gas and stools. I am not convinced this is just a UTI. ### Response: I went through your post. You have pain in right lower abdomen along with the history of vomiting. The differential diagnosis are many, but I will mention two important diagnoses: Regards" "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 18 year old male. My weight 46 Kg.I have been masturbating since 2010 till now.But now, I have been facing problems like premature ejaculation, nightfall, other problems like loss of appetite, weakness and poor memory. I ejaculate 3 times within 1 hour. I also watch porn videos. There is a swelling in my penis. I have attached pictures of the same.But I have no pain. Sometimes I have a burning sensation.My testicles start paining after 20 minutes of ejaculation and the pain goes away after 2 to 3 hours.And I do not feel hungry after masturbation.Is there anything wrong?I want to quit masturbation. So please guide me quit this forever. ### Response: Hi. I read your query and understand your concerns. First of all I would like to inform you that masturbation is completely a normal phenomenon. Before we proceed further, I request you to do the following tests: Once you are done with these tests, consult a sexologist online for further follow up" "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 seven weeks pregnant and I want to do abortion but I had a baby boy with a C-section six years ago. So I just wanted to know if I can abort. ### Response: Hi. I can understand your concern. If you have decided for abortion, you can undergo but under strict supervision. You have to consult your gynecologist, confirm the gestational age. Up to eight weeks, medical termination is possible. But better to be under admission to prevent untoward effects like excessive bleeding, severe pain, very rarely scar dehiscence." "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 43 years old female. I have a marble size lump on the right tonsil with difficulties in swallowing and pain. I had a swollen tonsil for over eight weeks, and the lymph nodes present in the neck are slightly swollen. I was under treatment for thrush. Currently, I am taking Nystatin oral suspension. Please help me. ### Response: Please explain about the antibiotics given for you and how long you used it. Please say whether the lymph nodes in the neck are still present. Please tell whether you can palpate it. Please explain whether you had a fever and any bleeding problems. Please say whether a culture sensitivity of the throat swab is done or any other blood investigation is 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: The inability to achieve orgasm because of masturbation. I recently got married on before two months. I have been doing masturbation earlier, but now while having sex with my husband, I did not feel orgasm had done or not after he finishes then I had to do masturbation because I had not done. ### Response: Hello. It is a small complication of female masturbation. Since you had the exposure to orgasm, you expect the same or more during sex with your partner. Medical fact vaginal penetration will not give female climax or orgasm, clitoral manipulation can. Talk to your partner, explain your needs directly or indirectly. Teach your partner how to give orgasm to you in an understandable way. Take your time, sex after female orgasm have good fertility rate." "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: The radiologist stated scattered white matter lesions but does not tell the location, or size. They state as unsure etiology or clinical significance. The ordering physician suspects MS due to symptoms like disorientation, incontinence, and body pain.If the radiologist suspected MS would not they state the size and location? And diagnoses suspected disease or kind of lesion? Was this a poor report? Or was he basically not sure of what is going on? I leave it up to the ordering doctor. I have done blood for lupus, arthritis, Lyme disease, and complete blood test. ### Response: The few scattered white matter lesions could mean that there are areas in the white matter of brain which are seen as small pinhead size on T2 and flair sequence. This is commonly from small vessel ischemic changes and is seen usually in older age and slightly uncommon in the young population. The cause is sometimes unknown. Suspicion of MS (multiple sclerosis) is by diagnostic criteria and matching it with clinical examination. There is McDonalds criteria for imaging in MS and if the radiologist did not mention any findings which are under these criteria then it is unlikely to be MS from this scan. The criteria specify that the patient might require a subsequent MRI scan and the new scan is compared with the old one to make a probable diagnosis of MS in you. It is clear that the findings are less likely to be from MS on this scan. Talking about radiologists, every person has their comfortable style of reporting and I feel mentioning the location of the larger white matter lesions would have been good for your ordering doctor. I will not say this is a poor report but surely it can be improved by providing the size and location of the larger white matter lesions. 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: This is regarding the treatment given to my son for viral fever. He is 8 years 3 months old. When we observed my son\s fever, I gave his 5 mL of P250 for three days. On the fourth day, I visited hospital due to continuous fever. As the blood report confirmed it as viral fever, he was prescribed with P 250 and antibiotic pills 100 mg (four tablets). Also, he was given Piperacillin and Tazobactam injection (half morning and half evening) for the next three days. My son has become weak, did not eat food and had vomited. After three days of injection, he was little better and had some food. We had another blood test after three days of injection and I have attached the report. Again, the doctor advised us to continue the same injection and he had the same for the next two days. Now, my son feels better and eating all kinds of food. Now, we are yet to meet the doctor for follow up and blood test. I am so worried about his blood test reports. Please guide us doctor. ### Response: Hi. I went through your child\s history as you have provided and also saw the blood test reports (attachment removed to protect patient identity). Arbovirus. Total count, platelet and packed cell volume (PCV). 1. Rickettsia.2. Malaria.3. Typhoid. Viral fever. Avoid mosquito bites." "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 platelets are usually on lower side ranging from 100000 to 120000 since last one month with no physical symptoms. All other tests are all right like LFT, TFT, and abdominal ultrasound, vitamin B12 is 206 while the iron is 90, urine is also clear. What can be the reason behind low platelets and what are the options for treatment or any further investigation is required? ### Response: Hi. There are many causes of low platelet. Low platelet is known as thrombocytopenia. The causes include different types of hemolytic anemia, viral infection, dengue, ITP, uremia, kidney disease, etc. So I suggest you investigate as follow for primary workup: CBC to check for hemoglobin level, peripheral smear examination report to check for any schistocytes, if present (to exclude hemolytic anemia), urea, creatinine estimation to exclude kidney disease, IgM dengue Elisa testing to exclude dengue, ANA estimation to exclude autoimmune disease. You can revert back with reports once done. You can take papaya fruit more to raise platelet." "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: Lower back pain unable to put pressure on legs to walk. 3 weeks ago I was lifting my dog into the car. I got a sharp pain in my lower back..went away in about two days. Today I was lifting my two year old into an inflatable tube, While setting her down I had the same pain but on the mid right side of my back. This pain continued all day. Then while bending down to get a dish out of the dishwasher I got a horrible pain in my lower back. The pain knocked me to the ground. My husband had to help me off the ground to the bed . Since then I have not been able to put pressure on my legs to walk without horrible pain. ### Response: Hello, You need to be examined to determine if this is a back strain or a sciatica from a pinched nerve. Is there any numbness in the leg, does the leg feel weak apart from the pain you feel while trying to walk, can you control your bladder well ,does the pain worsen upon straining ? If the answer to the questions is yes then you have a disc prolapse and you will need to see a doctor and perhaps a MRI too. In three mentioned to need to take anti-inflammatory tablets and muscle relaxant top help with the muscle spasm and apply Ice to the sore area on the back, rest in bed but not absolute such that you walk as much as to feel comfortable" "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 mom had a heart attack at my house. They did a stunt and then she had some brain bleed and had mini strokes. She was in a coma and recovered, even had a temporary tracheotomy. She went to a rehab facility and was very dehydrated so bad she had to go to the ER. The doctor said her sodium was the highest he had seen.Well, as they slowly dropped it she began to talk again with her voice. Then as the sodium levels got back to normal she had started whispering again. Do you have any answers for this or anything that can help me? She is currently under Synthroid, depression medicines, and anxiety medicines. ### Response: Hello." "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 severe skin red rash problem in both inner thighs. The rash is so itchy and it has completely destroyed my life. It looks like fugal like ringworm or jock itch. at past also, i was suffering from same thing but that time it was scaly like liquid was coming out with foul smell. And i visited a doctor and the medicine i used had cured me. i forgot the medicine tablet taken but had use itraconazole dusting powder and fluconazole lotion. At that time my mother and i have visited the doctor at same time coz she also ha d fungal infection but completely different then mine. Now the current situation is very bad. it is so irritating and itches a lot. but no scaly liquid is coming out now. The same thing now can be seen in my neck and face. Please i need a good dermatologist attention. I am in great suffer in this pandemic and lockdown so i am searching online for medication. I have recently taken arzole capsule once weekly for 3 weeks. And used dipsalic ointment and also clotrimazole cream which shows no better treatment. I was so depressed and used steroid cream called dermicom oc plus only two times as it shows some severe bad red rash so i discontnued it. I live in hot and humid climate and had wore tight clothes in past. The area of rash is always at little more tempreature. ### Response: You seem to be very distressed by the problem. As I can see in the picture it is Tinea. Since it is extensive it is important to start proper treatment with oral antifungals for a good length of time to clear the infection. You have been using steroid creams which is going to worsen the infection and make it spread further. So you should stop using dipsalic and other steroid applications and start proper treatment. You should get your LFT and KFT done and you can follow up with dermatologist. Usually itraconazole or terbinafine are given orally along with some creams like luliconazole or sertaconazole, etc. Itching can be controlled with antiallergics. Treatment of family members with infection is equally important. Let me know if you have more queries 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: My father\s fasting sugar is 297. But my father is feeling better, no weakness, not feeling tired. Why? ### Response: Blood sugar levels fluctuate in the body every minute. If sugar level continuously remains on a higher level, then it is very dangerous to the body because it can create some serious health issues like diabetic neuropathy, nephropathy, retinopathy, ketoacidosis, and coma. So, kindly start him on treatment either oral hypoglycemic agents or human Insulin. Take medicines regularly. Low insulin level in the body. Fasting and postprandial blood sugar level, HbA1c. Diabetes mellitus, hyperglycemia. Diabetes mellitus. Tablet Metformin 500 mg BD." "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: Why am I getting bumps or boils on my stomach and now on my back leaving five black marks on my stomach and there are three new boils or bumps on my back that hurt really bad. How can I make them go away? Please help. It hurts when touched. ### Response: Hi. Repeated boils on the body suggest that you may be closer to a source of infection or the treatment has been inadequate. Squeezing of boils may also lead to the spread of infection. If you have not found relief with antibiotics, you may require testing of pus from the boil to see which antibiotic suits you best. Marks that are left behind after the boils are healed will fade eventually. This can be hastened by skin lightening creams. Excess sweating, repeatedly wearing the same clothes and using unwashed towels. Pus culture and sensitivity. Miliaria, folliculitis. Mupirocin cream for the boils. Biluma cream to the marks once healed. Use a sweat absorbing body talc. Timely treatment of boils." "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: About a month ago, I developed what I thought was a pinched nerve in my neck. I had numbing and tingling in my left arm and my hand would go numb while sleeping. However, over the next couple weeks the numbing, tingling, moved to my right arm then my legs and feet to include muscle twitching/ spasms. Now, these symptoms have mostly left my arms other than occasional slight sensation in my fingers. However, my legs and left foot continue to have this sensation. I do not have any pain other than the sensation and can move normally. However, exerting myself seems to elevate the sensation. I visited my doctor and they ran a complete set of lab work and everything was normal other than slightly low vitamin D. Also scheduled to MRI on the spine to rule out MS. After doing some reading, I think I developed a case of peripheral neuropathy. My question is could this be something else? Is it possible that with rest it will go away? Are there any supplements I could take to help? Any other thoughts or suggestions? ### Response: I read your question carefully and would explain that your symptoms are not typical of a peripheral neuropathy. They could be related to a bulging disc in the cervical vertebral column. That is why it is necessary to perform a cervical spine MRI study. MS (multiple sclerosis) would be an exceptional diagnosis at your age. Vitamin D deficiency may lead to muscle twitching and also joint pain, associated with chronic fatigue. As it resulted low, it is necessary to take vitamin D supplements. I would also like to know if you checked vitamin B12 levels and thyroid hormone levels. Vitamin B12 deficiency can mimic this clinical situation. Regarding peripheral neuropathy, I would recommend performing a nerve conduction study (electroneurography) to exclude this possibility, although it is really less likely that you suffer from this disorder. Hope you will find this answer helpful" "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 to know that having unprotected intercourse in the sixth day of the periods lead to pregnancy and also took I-pill within 24 hours. And after a week got bleeding which is persistent for three days now, had cramps the first day of the bleeding and far nothing but little bleeding is still there as it happens during the last days of the regular period. The questions are:Is there a chance of pregnancy?Is this withdrawal bleeding? If yes, then for how many days should I expect it?Which date should I calculate my period date now?Subsequently, when should I take a test for HPT? ### Response: You may however get a urine pregnancy test done after seven days now to be doubly sure. The date hence to be calculated from is from day one of your 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 suffering from nasal blockage for the past 1.5 months. Generally, I have cold and cough problems from past 10 to 12 years, which becomes worse during the weather change. Earlier, I had breathing problem, but have been experiencing nose blockage now. The nose will be blocked from both the sides during the day if I sit in AC room. I feel better if I keep moving or stay in a warm room. The doctor has suggested me to go for surgery. So, I wanted to check if surgery is the only option or can it be treated with medication. Also, I wanted to know if I go for surgery, then what are the risks involved. ### Response: Hi. An ENT doctor would have advised you to undergo endoscopic sinus surgery and septoplasty. Surgery is the treatment of choice , because your problem seems to be chronic (from longer duration). If you do not want surgery, then you can take nasal spray (a combination of steroid and antihistamines) for a month, mucolytics for a week and antibiotics for 14 days. Early morning jogging is really good for patients having sinusitis. Please follow the advice for a month and check if you have any improvement in your symptoms. Since the pollution levels are high in your locality, I would advise you to do exercise and jogging at home itself." "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 wisdom tooth. Is it necessary to remove it? ### Response: I have gone through your question and I can understand your concern. If it is giving you any sort of problem or giving you discomfort, you need to remove it immediately. There are chances of cyst formation in some cases too, if the impaction is not treated. You can delay it but my opinion is to get it removed." "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: The patient is a 59-year-old male with whose weight is 52.3 kg and height is 166 cm. His PSA was 247.5. He had a TRUS guided biopsy, and the report is as follows.1. Moderately differentiated adenocarcinoma.2. Gleason grade 4+4.3. Perineural invasion present.What does the biopsy report say? What will be the next step? What medicine should the patient take at the initial stage before any surgery? The patient is on Tamdura for the prostate issue and Diamicron MR 30 for diabetes. ### Response: Hi. I am sorry to know about the problem. The biopsy report says that prostate has a cancer disease. Since PSA is very high, it means that there is a chance that it has spread outside the prostate. The next step will be PSMA PET scan to find out the areas in the body affected by prostate cancer. If this scan is not available, you can get an MRI scan of the abdomen to check local involvement or lymph node involvement along with bone scan to find out bone metastasis. The treatment depends on the stage of disease. If it has spread to bones, then bilateral orchidectomy (removal of testes) is the standard treatment. If the patient does not want orchidectomy, then can get regular injections (once in 3 months) to suppress the testicular function. Other than these, there is a need for calcium supplements and iron supplements. Please consult the Urologist for regular follow up, since the treatment needs to be modified according to the response of PSA and clinical factors. PSMA PET scan or MRI abdomen with bone scan. Metastatic carcinoma prostate." "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: Age - 33 years Height - 164 cms Weight - 67 KgI am suffering from sore throat so I took Augmentin 625 before 12-13 days back but found no improvement but I started suffering from Stomach pain and excessive gases. Now I am taking below medicines as per prescribed by ENT specialist that are 1.Allegra M tablet 2.Rinifol capsule 3.Esoz D 40 capsule 4.Acinil O surup for ten days.Two days remaning to finish course.Stomach pain and blown stomach due to gas is still there. ### Response: Well it is not uncommon to have Gastric upsets after a course of antibiotic. And antibiotic like augmentin are notorious to cause this. This occur secondary to effect of augmentin on decreasing the amount of lactobacillus microorganism which are normally present in the human gut and help digest the food. You should take yougurt, Kefir (fermented yougurt), Kefir. and there are certain diets with probiotic activity you can start taking it. Plus take Tab Ecotec twice daily for 4 weeks, and Tab Levosulpiride 75 mg once daily half hour before meals.for 2 weeks. You can continue with acinil O syp. while rest of your current medication can be stopped. I hope this will correct your microbiota and will bring the same healthiness as before. good day Antibiotic induced dysbiosis Small intestinal bacterial overgrowth Antibiotic induced dysbiosis Let me know in one week time how you respond to above regimen, if persistent of symptoms I would consider testing and giving some safe antibiotic therapy for 2 weeks." "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: For three months now, two days after finishing a 21-day course of antibiotics to clear an E.Coli UTI, I have redness on my meatus and lighter redness on my glans and also intermittent irritation of the foreskin. All this with no itching, no discharge or pain whatsoever. I have been tested for UTI again and also all possible STD\s and all are negative. I was sent to a dermatologist and she told me it might be a yeast infection and prescribed a two time 150 mg of Fluconazole which had absolutely no effect. I also prior to all my visits to the doctors tried treating myself topically a week at a time with multiple creams such as Canesten, Fucidin, coconut oil, shea butter which all do nothing but hydrate the skin. I have been taking probiotics and antifungal supplements, following a low sugar diet for almost a month and nothing cuts it.I am starting to wonder if it could be something else than a fungal infection since nothing I have tried is working. Could it be bacterial? Are symptoms different? And if my symptoms are causing no pain could it be something else than an infection? ### Response: Hi. I have gone through your query and would like to know a few more details to answer your query better. Based on your history of medication, it is unlikely for any bacterial infection to be persistent for such a long time and without any overt symptoms. Fungal infections may persist and may require prolonged treatment sometimes, a simple skin scraping test can help diagnose it. Another possibility is non-infectious inflammation, which is common around the meatus and glans called BXO (balanitis xerotica obliterans) which in early stages can cause similar symptoms but needs a clinical examination to diagnose. I would advise you to visit your local urologist who can clinically examine you and identify your problem." "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 constant lightheadedness, feeling like drunk all the time, fatigue after a couple of hours and clicking sound when swallowing in both ears since last eight weeks. Yawning also causes a clicking sound. Ear fullness in both ears, some weird very low buzzing sound in the right ear but also shows up in left ear but goes away. The audio test is normal. Ear pressure test is normal for the left ear but not for the right. MRI, CT scan are also normal. Endoscopy shows normal eustachian opening but some allergic inflammation. There is no fever. I have been prescribed Betahistine 16 mg 3 times, FM 24 1 tablet in the night. I am a type 1 diabetic and have Addison\s disease too. I am on Hydrocortisone three times daily for Addison\s disease, Insulin three times for diabetes and Thyroxine for hypothyroid.Now, this may be eustachian tube dysfunction, but my doctor has not communicated properly about how much time it takes to resolve. Do other people have similar problems? I have heard stories of people not recovering for 20 to 30 years. What does that mean? ### Response: We need to have a look at your reports and investigation films for correct diagnosis. Kindly upload all the reports and relevant investigation films and get back to us. Eustachian tube dysfunction does not take that long to heal. Appropriate medicines will help you get relief from the problem. Do revert back for further help" "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 doubt regarding the HIV rapid tests. I want to know whether the tests cover the O type and another rare type of antigen or they only cover M type. I underwent a RNA PCR, two Duo combo and two antibody tests after a risky exposure. All were non-reactive. What is haunting me is are the tests missing out any rare type? Do they even check for O type? Secondly, most testing kits as I saw on the net are using gp41and gp120 for the antigen. Is gp41 also common for O type or is it for M type only? How to rule out O type infection? Please help. ### Response: Hello. I have reviewed your query and here is my advise. As far as HIV infection is concerned, M strain variant of HIV1 is a common type. O subtype is very rare. However, let us move onto your question. Rapid diagnostic test and CMIA usually detect M strain of HIV effectively. However, depending on manufacture, a final comment can be given. But RT PCR usually detects all strain for HIV. Kindly mention after how much time of exposure you have investigated with RT PCR? I am asking this question to rule out window period for HIV." "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 31-year-old male. For no reasons, my upper back has formed acne in the back of shoulders and in the mid-upper back. I tried Benzoyl wash, Vanoxide Topical, and Doxycycline. There was no success. I am now using Hibiclens foam wash, Clindamycin and Benzoyl foam, and a Sulfamethoxazole tablet two times per day. This second regimen has only been going on for five days. How long can I expect results?I also shave my shoulders which I know puts me at risk for folliculitis and other related conditions. However, I have never shaved my back and therefore do not understand how this occurred. Just when I think things look better, a trip to the gym and shower right afterward, it always makes things look worse. Am I wasting my time trying to fix this? Of note, I had a very severe acne on the upper back and face when I was a teenager. I was on Doxycycline in the past. ### Response: Perhaps it is Pityrosporum folliculitis. It is usually itchy and favors back and looks similar to acne. Do they itch in your case? Pityrosporum folliculitis would require oral antifungals. Anyways acne that is unresponsive to usual antiacne medications oral and topical usually respond to oral Isotretinoin. Consult your specialist doctor, discuss with him or her and with their consent take the medicine" "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 and I had sex on the 16th. After two hours, she took an I-pill for the first time. She is not on any birth control pills and she told she got her period on the 25th. I am scared whether it is periods or anything regarding pregnancy because she has a problem of irregular periods. The last period she got was on the 5th two months ago. Please help. I need a good consultation on this. ### Response: As her period was irregular and the last one was two months ago, it is a bit difficult to predict the chances of pregnancy quite surely. However, I-pill is a very effective medicine to prevent pregnancy. So, considering her irregular period and bleeding, do a pregnancy test first after 14 days of intercourse. And, if negative then repeat weekly for two more weeks. If all three are negative, no pregnancy. Moreover, the chances of her getting pregnant is very less. It is all precautionary to be on safer side" "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 unprotected sex two days ago. After sex, I took the morning-after-pill straight away after two hours. When should I get my period after taking the morning-after-pill? If I get my period does that mean I am not pregnant? ### Response: The morning after pill or emergency contraceptive has to be taken within 72 hours in the proper dosage as recommended to avoid pregnancy. Emergency contraceptive affects the menstrual cycle, prevent ovulation, fertilization, and implantation differ in different types of contraceptives. Scheduled menstrual bleeding could be disturbed due to externally induced hormones. As body get rid of hormonal effect, gradually periods take a previous pace for menstrual bleeding or period bleeding as was before taking I-pill, depends on the body\s response. Less chances of pregnancy if taken properly in proper dose within 72 hours with no history of vomitings of medication or I-pill." "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 RA two years back and I am taking treatment for the same. My left knee is affected badly and the swelling is not coming down. Initially, I was not able to walk, but now I can walk slowly but cannot climb the staircase or fold my left leg completely. Recently I am getting a pain in my left wrist as well. I have attached the files. ### Response: I went through your post and have seen the reports (attachment removed to protect patient identity). Your rheumatoid arthritis is not controlled which is evident from your high ESR (erythrocyte sedimentation rate) of 60. The reason for this is that you are not adequately treated. Regards" "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 pimples, red, and brown spots on the face. Moderate acne. Mainly on chin, cheeks, sides of the nose and between eyebrows. Is it hormonal acne? How do I fix it? Large pores on the face but dehydrated, sensitive skin. Red pimples with white pus. Varies from large to small sizes. Leaves large brown acne scars that still have not faded. Not painful but sensitive to touch and harsh acne treatments. After changing products, the face is irritated and red, and the skin feels sticky. Combination skin, with oil on T-zone. Acne mainly on the chin area. Is it hormonal acne? How do I fix it? ### Response: I have seen your query. With your description, it seems you have developed grade 2 to 3 acne. See acne concentrated over chin indicate hormonal acne. If you can share a few pictures, it will be helpful in exact grading of acne, which further leads to proper treatment. You can use 1 % Clindamycin gel during the morning and use 3.5 % Microbenz gel during the night. Use face care face wash twice 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: I am 35-years-old. My cholesterol level is 222, triglycerides 87, HDL (cholesterol) 60, LDL (cholesterol) 156 and non-HDL (cholesterol) 162. Kindly advice. ### Response: Hello. Do you have diabetes, hypertension, family history of a heart attack in young age? Do you have deranged kidney function? Answers to these questions if not, it is critical to decide medicine. If these are not present, then medication is not required at this stage. Only lifestyle and dietary modification are necessary. Avoid more than one egg yolk per day. Do regular exercise, such as jogging, cycling, brisk walk, etc. Avoid a sedentary lifestyle after three months repeat fasting lipid profile." "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 full blood count done and the report mentioned that there were microcytic normochromic cells noted. What does the report mean? Am I anemic or vitamin deficient? What do I do to get better? What are the concerning signs from this report? I do usually feel fatigued and lazy. How can I improve? ### Response: Microcytic RBC (red blood cell) means that the size of the RBC is decreased. 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: What is seasonal affective disorder and recommend products that can help people manage their symptoms? ### Response: Hello. Seasonal affective disorder (SAD) is a type of depression related to seasonal changes. I would like to call it winter mood changes as it often happens during the winter time. Mostly related to lack of sunshine. During the spring and summer, everything changes and the symptoms are not present. With regards to treatment, often advise increasing lightening of the place where the patient lives. Being in contact with people will help overcome the mood changes. No real cause, mostly related to lack of sunshine (winter). Should rule out other pathologies. Only increase lightening in the place the patient lives. And be involved in social activities." "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 daughter got a fishbone embedded in her throat. It was shown in the x-ray. But the doctor was unable to view it when he went through the throat with an endoscope last night, and it was close to an artery. What can be done? ### Response: Kindly provide me the x-ray films and the endoscopic picture (if you have). Where was the fishbone stuck exactly? Does the doctor said about the level? What are the present complaints? When did it happen?" "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 30 years old. My height is 166 cm and weight is 56 kg. Can you please suggest some medicines (Vitamins, minerals or something) to increase my height by few cm? Can I take some anabolic steroids (for short duration) to increase my muscle mass?At this point I just like to mention that I am diagonosed with Crohn\s disease and taking Azoran 100 mg, Folvite and Razo daily. In my breakfast and afternoon snacks I take eight slices of bread, two boiled eggs, two bananas, one spoon of AlbumenCare (protien supplement). In lunch and dinner I eat rice and dal and boiled vegies. I do not take fish or meat. ### Response: Hello. Unfortunately, after the age of 30, it is a little less likely to increase the height further, however doing stretching exercises, using Vitamin D 50,000 IU once a week and B12 1000 mcg daily may help to improve the posture and give you an extra cm or so. Also, remember if you ended up using steroids of any sort then please do get a bone scan to look for osteoporosis (weak bones) which can result in loss of height." "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 took Plan B pills 34 hours after intercourse and one week later I had dark brown spotting. Then, I started having a red bleed during the week of my period, but it was not heavy. Now towards the end of my period, it is very light. I have period cramping and bloating. Is this because of Plan B or could I be pregnant? ### Response: You have experienced a very normal behavior of bleeding patterns after Plan B usage. The bleeding ideally starts after one week and starts with scanty, then the flow increases and then decreases again. This is a normal endometrium shedding pattern after Plan B. You are unlikely to be pregnant now after your periods and bleeding. Just likely that your next menses may be delayed or earlier and maybe heavy, this would be because of Plan B, so just maintain a menstrual calendar for the next three months. Cramping and bloating shall subside after your period as well." "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 been suffering from knee OA. It is more on the left than the right. Her age is 54. She feels pain while walking and as a result of that she is unable to reduce weight. Currently, she is taking Jointace tablet, but there is no relief. Can you suggest some alternate option other than painkiller? She is also on Ecosprin, Rosuvas and Telma. ### Response: Hi. Degeneration of knee. 1. Calcium and vitamin D supplementation.2. Co-Rosiflex Sachet one per day for three months.3. Viscosupplementation injections. Revert back with the answers to the above questions to an orthopaedician and traumatologist 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 29 years old male. I was suffering from rumination, anxiety, depression, hopelessness and had a panic attack 10 months back due to problems in my career, loneliness and some problems at home all at the same time. I consulted a psychiatrist who diagnosed me with mild depression and OCD 10 months back. He started with Sertraline, but it did not suit me. So, he shifted me to Paroxetine, beginning with 12.5 mg and gradually to 50 mg. As of now, I am on 50 mg Paroxetine and 7.5 mg Tetrafol for four months. Almost 90% of my symptoms are cured and I am no longer feeling depressed. The only problem is that I am still suffering from anxiety which is seriously hampering my studies and concentration. I have borderline high TSH.I also suffer from mood swings, e.g., sometimes I feel very good and confident, but at other times I feel very low and full of anxiety. I want my anxiety to be cured, and the drug should be such that it does not induce sleep as I have to study for long hours. Here I must tell you that I eat healthy food, fruits, nuts and regularly do exercise so such suggestions will not solve my problem. My major concern is the day-to-day anxiety which is hampering my studies, and I want that to be cured. ### Response: Hi. Now your main concern is anxiety. There are few options available such as increasing the dose of Paroxetine CR to 75 mg or adding Propranolol or Buspirone. You can try any of the options. Consult your specialist doctor, discuss with him or her and take medications with their consent. Another thing is that you need to do regular exercise, progressive muscle relaxation techniques or yoga, as these things improve your mood as well as induces relaxation thus decreasing anxiety. Also, try to feel the anxiety and do not react to that, live in present moment. By doing this, you will be better able to tolerate anxiety" "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 to have my mother's MRI read by a radiologist. Her doctor ordered her to have an MRI done and she had one done yesterday. My mother has had neck pain for at least a year now and her doctor believes the problem is arthritis, but not sure. My mother went to a physical therapist and had several shots in her neck for pain, but that did not solve the problem. I have sent the files of the MRI. ### Response: I have read through your query in detail and have gone through the MRI (attachment removed to protect patient identity). Please find my observations below. In conclusion, pain in the neck is possible with this kind of an MRI finding and might be considered a finding that is to be managed medically. Surgery is not required in this case as the findings are mild.Physiotherapy and nerve pain relief medicines are the first treatment of choice." "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 33-year-old male. Height is 5\7\\ and weight 71 kg. Yesterday while masturbating I somehow ejaculated but could not have an orgasm. Post that I became very worried as to what may have caused that. Never experienced such a thing before. Also, I have never had any erection problems in the past. I have had physical relationships as well. Now, I am having trouble getting an erection. Not sure what the problem is. I tried masturbating post that. Though I did manage to reach orgasm but could not complete erection. ### Response: Hello. I can understand your problem. This was absolutely normal. Sometimes due to distraction right at the time of ejaculation results in poor or no orgasm and this is normal. This does not show that a person is weak. Remain relaxed for this. You got an orgasm after that but had a poor erection. This occurred because you were worried and had an anticipation that you will not have a good orgasm. This worry resulted in poor erection. So stop worrying, avoid masturbation for a few days and avoid anticipating. You will get a good erection." "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 upper stomach pain, nausea, loose stools, fatigue, gas. I had one episode of vomiting (regurgitation) about five days ago, and the symptoms all went downhill from there. I am taking Aspirin, Zoloft, Prednisolone, Cellcept, Hydroxychloroquine, Amlodipine and Clonidine. I have lupus (SLE), anxiety, and GERD. I am also 18 years old and 200+ lbs. ### Response: The symptoms that you mentioned are consistent with acute gastroenteritis. Please follow the following diet, take the following medicines and do the following investigation. Diet: BRAT diet which is short for banana, white rice, apple sauce and white toast (bread). Stop eating all vegetables and fruits except bananas and potatoes. Avoid dairy products, caffeine" "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 I am going through anxiety because I failed in my exams and I am scared to tell parents. I do not know what to do. It is mentally exhausting. Please help. ### Response: Hello. Failure in exam is quite common and always remember that it is only a temporary setback. Almost all successful people would have failed an exam at some point in their life. Do not put too much pressure on yourself by hiding it from your parents. It can be a difficult burden. Your parents may be upset, but eventually, they will get over it. After initial disappointment settles down, they will support you. Learn to develop coping strategies to manage frustrations. You will come out stronger in the long term. Try to distract yourself and relax for some days. Then plan to retake the exam with better preparation. Make sure you eat well, sleep regularly, listen to relaxing music, talk to supportive friends and family. If anxiety is just situational nothing to worry, it will get better when the situation improves. But if it is persistent, you will benefit from some counseling to manage anxiety." "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 depression. I consulted a doctor and he prescribed me tablet Nexito and Lonazep. After taking the tablet for a month, I stopped it now. I am suffering with headache again. Should I continue the medication? ### Response: I can understand your concern. Depression is a mood disorder and the disorder occurs in episodes. The treatment also should be continued for a long duration. You have stopped taking the" "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 had an oral thrush. I was taking Candid Mouth Paint and Hexidine Mouth Wash to clear it. It was cleared after two days of using but after two days it started to get black in color. I was still using the above medications, but now I have stopped taking the all oral medications. Do you have any idea what could be causing this? Is this a yeast overgrowth? Is there any medicine that can clear this up? I showed this to a dermatologist. She said to discontinue all the medications as this would clear up. I just needed a second opinion on this. ### Response: Hello. I have gone through your question and I can understand your concern about your erythematous tongue." "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 20-year-old female. Yesterday I had my ovulation day. I had unprotected sex with my partner. But we had not done a penetration. He pulled out before he had the precum. But we are scared. Is it necessary to take an I-pill? If yes, then what are the side effects? My period is expected after two weeks from now approximately, and I have regular periods till now. ### Response: You were under an unsafe period, and even pre-cum also have live sperms. You are at risk of getting pregnant. You need emergency contraception within 72 hours of intercourse to avoid unplanned pregnancy. The most common side effects of I-pill are a headache, nausea, and bloating which can be prevented by increasing the intake of water. It indicates the absence of pregnancy." "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 taken a pregnancy test a few days ago and it turned out to be positive. I took two tests, just to make sure and they both were positive. I was supposed to have my period on March 29, but conception happened on March 14 and the first day of my last period was February 29. I do not feel any changes at all, is it possible that that may not be true at all? Or the tests I took were not accurate? If I got my period this April 29, what does it even mean since I already missed my supposedly period on March 29?I am currently taking Myra e and Poten cee. ### Response: Hello. As you checked twice for urine pregnancy test and it turned out positive, it implies you have been pregnant. It is not necessary that everyone experiences nausea and vomitings or early signs of pregnancy similarly, some may not feel any symptoms, or some have mild symptoms. The urine HCG (human chorionic gonadotropin) tests are definitely an accurate way for testing pregnancy, rather than just relying on symptoms and they cannot be wrong as you had missed your periods too, and it tested positive twice. And if you are pregnant, you would not be even getting your periods again this April too. It would be advisable to get an ultrasound to confirm the pregnancy if in doubt, the site (intra or extra uterine), the gestational age, and the fetal viability. Also, you can start using Folic acid tablets. Routine antenatal investigation. Tablet Folic Acid 5 mg daily. Avoid sexual intercourse in the first three months." "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: What are the everyday habits that could affect our teeth? I want to get some insight on how certain practices such as smoking, biting nail, opening things with the mouth, etc., affect the teeth. ### Response: Hi. Smoking adversely affects the gum health as the gum disease becomes less apparent in smokers and they show symptoms once the condition becomes severe. Secondly, it can cause pigmentation leading to smoker\s melanosis (brown to black pigmentation of gums). Other ill effects can be oral and lung cancer. Opening things using teeth can make them attested gradually by making them sensitive and more prone to decay and fracture. Holding needles and pins in between teeth can cause notching of teeth which disturb the appearance as well as cause sensitivity of teeth. Tobacco chewing habit can cause teeth staining, per cancerous conditions like leukoplakia, oral submucous fibrosis, and even the deadly oral cancer. High sugar intake can cause an increased incidence of tooth decay." "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: How to remove black spots caused by acne? So many black spots are there on my face. ### Response: Hi. I can understand your concern. It would be of great help if you can send me a picture of your spots. You can apply Clear Z cream on face. It will remove black spots and make your skin glow. I will be happy to help you further. Wish you good health." "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 girlfriend. I have bought condoms to have sex. We are ready to have sex. We are planning to avoid pregnancy. We are planning to have intercourse once a year. Can condoms prevent the condition of pregnancy? What is the best method used to prevent pregnancy successfully? Please suggest. ### Response: Condoms should be used properly. It can prevent the condition of pregnancy. There should not be any breakage or leakage through the condom. If there is any doubt, your partner can take Unwanted 72 (Levonorgestrel) within 72 hours of intercourse. If you have the sex once a year, then using a condom is suitable for you. But if it is decided at least one to two months before, then she can start oral pills at least two months before and continue taking it till the full month of intercourse. If it is a regular activity, then she can take oral pills as contraception. It is 100 percent effective. Condoms have a failure rate of 20 %." "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 25-year-old male. My weight is 82 kg. I have sudden rashes on my body and back of the neck. I get this at least once in a week. Please help. ### Response: Hi. You are suffering from urticaria. Since you have not mentioned the duration to say it is acute or chronic. It is of two types exogenous and endogenous. If you can pinpoint any cause like eatable or after wearing some clothes or any contact it is exogenous you have to avoid that. In endogenous it is due to internal factors in your body which you cannot change. But it is sometimes assiociated with some other diseases. So I would advise you about some investigations. 1. Complete hemogram. 2. Thyroid function tests. 3. IgG levels for follow up. Treatment: tablet Bilastine." "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 69-year-old male with 74 kg weight (constant for 45 years), 174 cm height, BMI 24 and nondiabetic. My blood pressure is under control, i.e., 130/70 mmHg with Temsan 40 mg one tablet a day and Metolar 25 two tablets a day. CBC, urea, creatinine, urine reports are all normal. Chest X-ray is normal along with ECG. I am suffering from chronic idiopathic constipation from the past 12 years. I have managed my constipation with fiber supplements, ayurvedic medicines, regular walk (8 km every day), good diet with fruits, etc., in the past. However, two years back, I had sinusitis and was given a heavy dose of antibiotics Cefuroxime Axetil 500 mg two tablets a day for 10 days. This heavy dose completely disturbed my motion, and I have not been able to pass stool normally for last 15 months even with fiber supplements and ayurvedic medicines. To overcome this, I have taken following medicines prescribed by the doctor:Lactifiber two to three spoons at night in warm water.Pegred 2 spoons at night.PEG fiber powder three tablespoons at night.Ganaton Total.Pruvict 2 mg (Prucalopride).Above medicines were not at all helpful. Then, I was prescribed with the following:Tablet Cremalax one tablet at night.Pruvict 2 mg at lunch.Syrup Lactihep 3 tablespoons before bed.Movical sachet at night with glass of water.The above combination worked like a miracle. I thought that my constipation problem is solved once for all. However, the effect lasted only for 4 to 5 days, and my system is back to abnormal. Currently, I am managing my constipation with tap water enema which I inject through the anus and wait for 5 to 10 minutes for the pressure to get generated and relieved. This allows emptying my bowl very well with great relief and a good appetite. I was in abroad for four months and has gained weight of around 3 kg. I walk every day around 6 to 8 km and do yoga to strengthen belly muscles. My fasting sugar was 65 mg/dl two weeks back. There is no fatigue. I have a good sleep during day and night, and currently, I take Shelcal 500 one tablet a day. Please let me know what course of action comes to your mind. ### Response: Bowel frequency can vary from 3 per day to 3 per week. It can have individual variation. Its always better to reduce the amount as well as the frequency of laxatives. Dietary changes, liquid intake, etc., should constantly be maintained for sustained response. You need to do a few tests if not done before as follows: Regarding diet, avoid all constipating foods" "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 15-year-old very healthy, active and fit daughter had the flu shot two weeks ago. Today she woke up this morning with lethargic, chills, shivering, cough, headache and body aches. She is sleeping on and off. Eating a little. It is unusual for her to get anything. No medications or health issues, although she fainted after the flu shot that may have been the needle itself. She was ok after that. Her temperature has been 38, dropped to 36 after Nurofen and is 37.2 again. Medicine is wearing off after 2 pm. ### Response: Attack of flu is unlikely to come. However, it is possible to have some other viral infection leading to such symptoms like fever, cold, running nose, chills, and temperature. Plus an antihistamine like Cetirizine 10 mg once a day, or Allegra (Fexofenadine) 60 mg once a day also is good. Also give enough oral liquids, preferably oral rehy" "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 PCOS and have not had a period for over a year. Now, I have a partner and we do not use protection. Two days ago, I woke up with a light bleed and that lasted for a few hours and disappeared. Then, the same thing happened today and I bled for a few hours. I took a pregnancy test and it was negative. I have body pain and my breasts are tender. ### Response: With so much prolonged amenorrhea, ovulation is unlikely to have occurred and pregnancy is less likely. Kindly use barrier contraceptive (condom) for three weeks and repeat home pregnancy test. If it comes negative, then pregnancy is almost ruled out. Absence of menstrual cycle for such a long term is not desirable, as it increases the chance of endometrial cancer by unopposed estrogen exposure to endometrium. Kindly consult your doctor for the same and for other risk reduction strategies." "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: How effective is Plan B one step if taken less than an hour after sex? The condom broke and we also used vaginal contraceptive film with the condom. ### Response: Emergency contraceptives either work by preventing or delaying ovulation or implantation of a fertilized egg. So, it depends on how early is it taken after unprotected intercourse, or what period of the cycle is it taken. Vomiting, diarrhea, some medicines do affect the efficacy, unfortunately. In your case, since you used vaginal film also, chances of pregnancy are bleak. But to rule out all chances, please do a pregnancy test, if you miss your periods. Hoping, that you get regular periods." "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 using birth control pill (Crisanta LS) from last 2.5 years.This month I started on 13, and I doubt I missed 1 or 2. After 13 days of starting the pill, had safe sex with a condom, but we doubt that it broke. To be safe, I took two dosages of Unwanted 72 the next day and stopped regular birth control. After eight days, I got bleeding, and it lasted for five days (same number of days as my regular period after stopping pills every month). What was that bleeding? Was that my normal bleeding or withdrawal? I am confused as this was near to expected period. Then, I did HPT, and it came to be negative. What are my chances of pregnancy? Does this bleeding confirm that I am not pregnant?Somebody suggested that I can start my regular birth control pills and I started. After 10 days, I got my full abdomen ultrasound done. It indicates that no focal lesion was seen and endometrial thickness is 4 mm. Uterus size is 88 mm - 43 mm - 42 mm. Do the thickness and report confirm that I am not pregnant? What is the normal thickness at this stage if I am pregnant? Also, the doctor suggested me to stop birth control pill until I get my regular period. Is that correct? When should I expect my next period? As I had regular birth control pill for 10 days, will it affect my next period? ### Response: Hello. So, it is normal. There is no pregnancy at all, as is confirmed in the ultrasound pelvis with ET being 4 mm. ET would have been more than 16 mm with decidual reaction if you had been pregnant. Latest bleeding becomes your LMP now (last menstrual period)." "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 30 year old woman. I found blood in my stool this morning, for the first time in life. I am sure that is not period. Is it a sign of bowel cancer? ### Response: I assure you not to worry a lot as things can be settled with proper care and follow up. There are some reasons for fresh blood in stools, with stools, before or after stools other than menstrual blood.First of all, it may be hemorrhoids. You may have felt some dilated small lesions on the anal opening before or after passing stools ( if this was bleeding hemorrhoid). It is due to a disease named portal hypertension and you need to follow it up and it will settle down with treatment. Your general surgeon is the person to decide the stage of hemorrhoids and treatment goes accordingly. He may do proctoscopy, colonoscopy or digital rectal examination. The other cause is anal fissure bleed. When stools get hard due to constipation and when patient forcibly defecates, it causes a breach in the mucosal lining of the rectum and anus and it bleeds in the form of fresh blood. Lactulose syrup, whole grain foods, dietary fiber supplements, plenty of fluids and a good physical activity will help improve this condition. But it may also need treatment with antibiotics to avoid severe infection. General surgeon consultation for a physical examination is my suggestion. Last but not least is the cancerous growth. It is serious but less likely in your case. But if you have a family history of colon cancer, have a change in bowel habits, lost weight, loss in appetite, constipation or diarrhea, You may be having cancer. A general surgeon will diagnose with colonoscopy and barium tests through radiologic studies. Go to a general surgeon in person for proper evaluation and treatment." "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 suffered from cystic acne. I used Clindamycin and Epiduo gel. It cleared my acne, but left black and red marks. I have attached the pictures. Which type of scar is this? Is there any topical cream to remove the marks? Is a chemical peel or Retino A effective for this? I also have some holes in my face. Suggest me some treatment. ### Response: Hi. I have read your query in detail and do understand your concern. I have also viewed the attached pictures (attachment removed to protect patient identity)." "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 29 years old and I am worried about bone cancer. I have had two CT scans for kidney stones around my abdomen area as a total of 7 msv. I also had a CT scan of my head. I read that the radiation can cause bone cancer. Should I be worried? Is it a low dose and not to worry? There is no cancer in my family. ### Response: It is true that radiation may cause cancer but that is one person among one million people. Also, there is no family history of cancer, so not to worry. Eat antioxidants fruits, exercise daily, and make your mind positive" "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: For the past two days, I have been having pain under my armpits beside my left breast. The pain sometimes also goes down my arm into my collar bone and sometimes into my shoulder blade. Please help. ### Response: Hello. From what you have mentioned, there are many possible causes: So please provide me with answers in order to reach the appropriate diagnosis. Most likely this is a benign condition but we have to exclude serious causes as well" "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 always had decent dental health, except for flare-ups with stress. Recently I noticed sensitivity along with bottom front teeth. When I pulled out my bottom lip, I noticed that the gum surrounding one tooth looked puffy. Not red, or sensitive, but it sticks out, it does not lay flat against the tooth like the others. Is this something to be concerned about? I am doing natural treatments with herbs, vitamins, etc. Could it be a periodontal disease? ### Response: Hello. Puffy swollen gums are a sign of periodontal disease. The cause of the periodontal disease is microbial deposits on the teeth (dental plaque). The plaque when mineralized become tartar (calculus). The calculus, in turn, attracts more plaque, and the disease process continues. At later stages, it may lead to bone loss and mobility of the teeth. I would suggest you to please visit your dentist and get your teeth cleaned, your dentist will be able to assess the stage of periodontal disease and if required will refer you to a periodontist. Get your oral health check-up done every six months so that any changes in the oral cavity can be treated in the initial stages. Deposits on teeth. Clinical examination and IOPA. Scaling and root planing, if it has reached the advanced stage then further periodontal treatment. Proper brushing of teeth and regular check-up." "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 26 year old female. My skin is in a terrible condition, and I do not understand what is going on. I am extremely scared. When I was 24, I took Accutane to clear up cystic acne. This was my second round of Accutane. I had also taken it when I was 16, but the acne came back. This left my skin very dry. But, this is what I regret more than anything: I started using Retinol (OTC) and exfoliating my skin with microbeads because it was dry and flaky. Because I liked the effect of Retinol, I switched to Retin-A Micro (0.1 %) while exfoliating every single day. I did this for about a year. But, I started to become concerned I was using such powerful medicine on my face. So, I stopped using Retin-A and stopped exfoliating. It has now been three months since I stopped using Retin-A or any type of exfoliant. My skin has rapidly deteriorated since, becoming gray and my pores opening up. My skin is losing any glow and becoming dull and bone-dry. My skin is so sensitive to the sun that if I expose it to any sunlight, I get awful sunspots. So, I am bone-pale and look awful. My skin looks dehydrated, crepey, spotted yet pale, and is tough and dehydrated, porous and saggy. I could not regret what I did more. I do not look like I have real skin anymore. Please tell me, is there any possibility that my skin will return to normal if I leave it alone for a year or so? Will I ever be normal again? Will my skin ever be able to tolerate the sun again without sun-spotting like crazy? I used a broad-spectrum sunscreen every single day for the last three years or so. ### Response: You are right. You should not have used a topical retinoids-based cream for such a long period as you are aware it makes the skin photosensitive. It will take time for the skin to heal. Along with the broad-spectrum sunscreen which you are using, consider applying a moisturizer such as Epitheliale AH cream. Also, it will not cause acne. Stop all other applications and scrubs. Use Cetaphil cleansing lotion to wash the face. There is a procedure called as Oxypeel where a jet of water is sprayed on the face followed by a mask. It helps 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: My right tooth is infected. I have done a filling in the tooth before two years. Now, the infection has spread to the roots. I am unable to use the right side because of this problem. Please tell me the solution. ### Response: As per your history, you are suffering from apical periodontitis, as the infection has spread to the roots. The problem is due to pulp exposure. So you can take medication for at least three to five days. Take tablet Augmentin 625 mg (Amoxicillin and Clavulanic acid) twice daily for five days. Take tablet Lyser D (Diclofenac with Serratiopeptidase) twice daily for three days. If you are not allergic to these medications, or if you are not taking any other medicines, you will get rid of pain and swelling by this medication. After the infection is over, consult your dentist and get a root canal treatment 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 have papillary hypertrophy in the eye. I get red eye, mild itching, and irritation. I am taking Olopatadine and KT eye drop and lubricating eye drop for five months. The symptoms are subsided but flare up sometime. It means I am fine until I take medication but symptoms come back if stopped. So there is no improvement in my condition. Any advice? ### Response: Hi. Unfortunately, allergies are chronic diseases and do not get well permanently. Once you notice mild symptoms, you can start Olopatadine without KT (Ketorolac) and lubricants. No need to worry. They should eventually decrease with age." "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 husband is a 30-year-old. Last week, he went to the gym the first time after a year and did heavy biceps exercise with high repetitions. After two days, his arms were swollen, and he was not able to make his arms straight. Yesterday we consulted with a nephrologist, and he told to do tests for CPK and serum creatinine. The CPK level was 15850 which is very scary to us, and when the doctor saw reports, he said that it is a muscle breakdown but did not tell us to have an IV therapy and asked to drink lot and lot of water.We are quite worried about the kidney failure thing and wanted to know that is there really no need to admit in the hospital? Symptoms,1. After a day of rough biceps exercise, arms were stiff and swelling, which has resolved 40 % by now.2. Urine is clear, and the color is almost like water. The average urinate time is 10 to 15 seconds.3. No other symptoms of pain other than both hands which have a dull ache.His report says,Yesterday CPK was 15850 and creatinine was .96. Today it was 15400 and Creatinine was .86My question is, should we get IV, or it will it decrease over time? How is his kidney doing? ### Response: My opinion is that he should be admitted to the hospital. Good that he has enough urine output so far. The best is to admit him for close intravenous 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: A couple of weeks ago, I woke up with a bad headache and a very stiff neck. It was so painful that I could not make it through a regular day without crying and intense pain. Since this time, I have been to the doctor four times and each time, they gave me more medicines. I have also been to a chiropractor four times because one of the doctors recommended it after he took an x-ray. The headaches have gone away. I suffer from headaches and this pain is so different. Now, I have constant pain in the back of my lower neck and only on the left side. The stiff neck has improved and I can manage a day but I am still in intense pain. The only medicines I am taking at this time are over the counter medicines. What do I need to do? ### Response: Hello. Your symptoms may be related to occipital neuralgia, which is an irritation of the occipital nerve, which lies in the back of your head. I would like to know what were the results of your neck x-ray. This neuralgia can be exacerbated by cervical spondyloarthritis. I recommend starting Indomethacin twice daily if you have no contraindications to it (stomach problems or high blood pressure). I recommend consulting with a neurologist for a careful physical examination. I hope this helps. Cervical spondyloarthritis or intracranial cause. Neck x-ray, brain CT (computed tomography) scan. Indomethacin. Anti-epileptics (Valproate, Topiramate or Lamotrigine)." "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 depression. But for some reason, I do not want to take antidepressants. I have been taking it for the past one year. And have stopped it. But sometimes I get very depressed. Can I take my antidepressant like Desvenlafaxine sometimes? As needed? Or maybe any other antidepressant which I can take a couple of times and then be antidepressants free? ### Response: You have not mentioned the severity of your depression. If you have the first episode of depression. and you were stable on medication for more than six months then you can try to stop the medication. But if you have again depression then you need to take medication. You also try to manage your depression by non-pharmacology management." "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 lax les is 38 cm with inflamed gastric folds and severe antral gastritis. Presence of diverticulum and ulcer near the pyloric ring. I have constant nausea, bloating, and throat tightness. ### Response: Hello. Gastritis is an inflammation of stomach mucosa. It happens due to Helicobacter pylori a bacterial infection, smoking, alcohol and also certain medicines like Aspirin. Presence of diverticulum also causes gastritis. You are taking good medicines to your concern, continue them. You can add Panchsakar Churna 3 gm twice a day with warm water after meals and Arogyavardhini Vati 1tab twice a day after meals. There may be need of surgical removal of diverticulum." "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 19 years old and from the last two years, my sore throat is not going away. I am having a lot of post nasal drip. I tried taking OTC anti-histamines, nothing helped. Today I noticed a hard lump under the chin at right side right at the point where throat begins. What is causing it? ### Response: Delving into the details, the constant post nasal" "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 planning for a baby. I need suggestion on that like counseling. I have only acidity problem. ### Response: Hello. Kindly let me know how we can help you. Do furnish your age and your spouse age and also married life." "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 19 years old female weighing 53 kg and of height 155 cm. I do not have any emotions except for smiling too much and sometimes feeling anger. I used to be a little violent. I do not feel love or sadness or guilt or jealousy.I do not miss my friends or my family while I stay far away for college. I do not feel anything when doctors say my mother might be suffering from cancer. While I was around 10, my grandfather passed away, and I said there is no need to cry as it is similar to a chicken dying.I do not feel shame or embarrassment. I sleep with my lights on and always with somebody in the room. As time is passing by, I am feeling that my humanity and empathy are disappearing.I feel there is no need for any relationship but I am not antisocial. Is this normal? ### Response: I have read your query carefully. First of all, I would like to reassure you that you are completely normal. Each individual is having a specific personality and you are having a schizoid personality which is not so uncommon. Features like less emotional, less empathetic about others emotions, less sensitive, less requirement of friends, etc., are few characteristics of schizoid personality and it is completely normal. It will not impact your life in the future. Slowly when you will grow, your personality will become more mature to deal with and understand social emotions" "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 bump on one of my top row teeth (it is located on the inside of the tooth, not noticeable from outside) that seems to be quite hard. I picked at it out of habit thinking it was a piece of food but it seems to be on the tooth. Is this just some uncommon tooth shape or is it something else? ### Response: To get a clear idea of your problem, I would like to have a picture of your tooth. As per your description, it could be an anatomical structure in your upper molar which is called \cusp of Carabelli\, which is absolutely normal and you do not need to worry about 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: I have two cysts on my right upper jaw on tooth number 3 and 4. I have attached the OPG x-ray of that area. I also have a soft tissue growth in my right and left maxillary sinuses. Under these circumstances, what should I do? Should I visit a dentist or an oral surgeon? Please tell me. ### Response: I have seen both the x-rays that you have attached (attachment removed to protect patient identity)" "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 18 years old. My height is 5\9"", and weight is 130 lbs. I am not due my period anytime soon, and I am on birth control. For the past few days, I have been getting severe pains in the bottom of my abdomen. It started a few days ago with sharp pains on the right side just up a bit. By yesterday night, it moved down to where period cramps usually are. They are not cramps, but they do feel like cramps. It is present consistently and sore to press on my stomach on the both sides. I do not have a fever, vomiting, diarrhea or constipation. What could be wrong? ### Response: There could be ureteric calculus if the pain is sharp and shooting or a renal stone dislodged from the place. You need to get an ultrasound done to rule out any pathology. It needs further physical examination as it could just even be a muscular spasm, which happens if there is a muscle pull during day-to-day activity or exercise. There could be an ovarian cyst as the site you specified looks near to the ovaries, but less likely as you are on a birth control pill. More likely there could just be a gas problem as it is the commonest reason for pain there. I presume passing urine is not an issue. Please visit a doctor for a prescription of an antispasmodic tablet." "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 keloid I guess at the center of my chest from past one year and a new one developed since a few months back. I took treatment but was not effective. I used to take Isotretinoin capsules daily and apply Clobkare cream. One major problem I face with them is they rub against the shirt and irritate especially the new one. Is there a tape or something I can apply to them while exercising and going out because I also have hair on that area. ### Response: Hi. Keloids are a type of scars which itches or irritates when something touches it. Do not apply any tapes or plaster because if you try to remove the tape you will pluck your hair which in turn induce keloid formation. You can plan for intralesional Triamcinolone injection along with cryotherapy.this will help in reducing keloid." "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 my MRI pictures for back-pain. Could you comment by looking at the pictures? ### Response: I have gone through your MRI pictures (attachment removed to protect patient identity) and to me, it looks quite pristine. Can you kindly tell me your age and a brief description of your symptoms? The intensity of back pain on a scale of 1-10? Is there any associated leg pain, numbness, weakness in your lower limbs, paresthesias (burning or electrical shock like sensations in limbs), etc? If you have already consulted a doctor who might have prescribed you this scan, please send me his prescription paper so that I can see your exact neurology and other clinical findings. I need all this information because normally we have to correlate the MRI (magnetic resonance imaging) scans with patient\s clinical findings so that a diagnosis can be arrived at. So if you can send me all these details, I should be able to see them and advise you accordingly. If you just want information on how these scans look like, they appear fine to me with good disc heights and no obvious foramen compression of any nerve roots." "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 with my fiance 10 days back. It was the 12th day after my last period. I took I-pill within two hours of intercourse. But I did not have withdrawal bleeding. Is there any chance to get pregnant? ### Response: I have gone through your history and understand your concerns. As you had I pill, the chances of pregnancy are not there in your case. You just wait and watch for your menses. Regards" "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 are married for three months, and my wife has not got pregnant yet. We are continuously tracking the cycle and ovulation days since the first month to have effective intercourse. We barely skipped a day during the fertile window for the last two cycles. My wife also gets early pregnancy symptoms to some extent every now and then but conception is not getting through. ### Response: Hi. There are a few precautions that can be helpful. Three months time is just start so not to worry actually if she has regular cycles. I will advise some healthy lifestyle habits, some precautions. Have a balanced weight and BMI by having a daily walk and exercise. It reduces the risk of medical issues and hormonal imbalance. Have recreational activities to have better emotional and mental health. For males, better to quit smoking as it reduces fertility and can show some effects on the fetus. Have complete treatment of any health issue you have. A woman should take Folic acid daily if normal BMI and no chronic health issue, then 0.4 mg and if high BMI and health issues then 5 mg daily. Have sex in the fertile period of the cycle, check positioning during sex to have better penetration and female better to stay asleep after sex to move semen gradually to the destination rather than move and wash away in the toilet. Actually, investigations and treatment need to be taken after complete one year of unprotected sex without conception." "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 OCD (Obsessive\x80\x93compulsive disorder). How can it be treated by psychotherapy? ### Response: Hi. As you might be aware, OCD is a chronic, relapsing, and debilitating disorder. It has four themes of manifestation that decides the nature of treatment likely to be effective. So, to determine which form of therapy is more suitable for you, a psychiatrist can guide you after having a complete assessment. Regarding psychotherapy, the most commonly used technique in the psychological treatment of OCD is exposure and response prevention (ERP). This is a psychological method which involves exposing a patient to an anxiety-provoking situation and then stopping them engaging in their usual safety behavior. This helps them confront their anxiety, and the habituation leads to the eventual extinction of the response. 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: Four months back, I had issues of stomach bloating and frequent bowel movement. My DP did an endoscopy and found out the I had erythematous gastritis. He had prescribed medicine for one month. The issue of stomach bloating and frequent bowel movement issue got resolved. But now and then I keep getting stomach bloating issue. And even if I press my stomach inside below the ribs area and right and left of mid-belly there is a mild pain. Please assist with my below queries: Is erythematous gastritis a serious sickness? Does erythematous gastritis result in stomach cancer issues in the future? Why does my stomach bloating problems occurs now and then? Are there any other tests to be performed to confirm no other underlying issues in my stomach? ### Response: Erythematous gastritis is simply inflammation of stomach that can occur due to excessive stress, faulty lifestyle, alcohol, and painkiller abuse. Now following are your answers: It is not serious. You just need treatment for long duration. Unlikely to result in cancer. Take a combination of Pantoprazole and Domperidone once daily for a few weeks. You can ask your doctor for tablet Mebeverine. No further tests are required. You need to correct your lifestyle. Walk, exercise, meditation helps greatly." "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 12 weeks pregnant, and for the past three months, I have severe constipation. I consulted the doctor, and she suggested me to take Duphalac syrup. I tried, but there is of no use. The same problem persists. Will it affect my unborn baby? ### Response: Constipation is common in the early stages of pregnancy. It is due to the chemical increasing in your body, which is required for your baby to grow. So the baby is fine, no need to worry about it. For constipation, I suggest you should take Duphalac syrup two tea spoon at night every day. And if it is not working, then take two times a 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 have puffy nipples on both sides since I was 15 and now I am 23. I think it is gynecomastia. I am male and 6\1"" and 82 kg. I need to know about the treatment and is there any risk factor? ### Response: Hi. Gynecomastia might happen due to an imbalance of hormones estrogen and testosterone in men. First, the condition should be confirmed by consulting the endocrinologist. Most cases resolve with time and few require treatment if there is any cause that is responsible for it. Some medicines to be taken under prescription for gynecomastia includes Tamoxifen and Raloxifene. These have side effects and should be taken only under the recommendation of an endocrinologist." "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: How long will a Benzodiazepine that is Valium and Nitrazepam remain detectable through urinalysis? The drug has not been used so long, may be of seven to eight days. What is the best method of detoxification? ### Response: 1. Taper off the Valium (Diazepam) and Nitrazepam by 10% every four to seven days.2. In case of higher dose, reduce the dose by 10% per week. Revert back in a month\s time 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: Three and a half months ago I started with numbness, burning and tingling on the left side of my face. I had been very sick with a chest cold. One week later I had blisters on my upper left palate, I went to the doctor and she said definitely shingles. Now l never had any pain or sensation really in my mouth or on my palate. The blisters did run liner towards the back it was not like a typical cold sore cluster. Now I do get cold sores once in a blue moon on my right side lingual gum and palate. I am still having numbness and tingling. So now my doctor thinks it may be trigeminal neuralgia and never was shingles. I am a healthy active 39-year-old woman. I am looking for a second opinion. ### Response: Hello. You should know that trigeminal neuralgia is a common complication of shingles or herpes infection. As blisters appeared the first time, it means that the herpes infection was present (probably HSV1 (herpes simplex virus, which is typical in this region). It is quite common to have symptoms before the blisters appear. The fact that the numbness persists, it means that the trigeminal nerve remains irritated by this past infection, causing the trigeminal neuralgia, although less typical (trigeminal neuralgia is typically associated to short periods of shooting nerve pain, alternated with persistent numbness in the same region). Anyway, I would recommend performing IgG and IgM for HSV1 virus and also a brain MRI study" "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 left leg sciatica. There is no back pain, but there is a referred pain down to the heel. I have recurring flare ups once in every six to eight months. I am currently taking Advil 3200 mg per day and ice. I feel great once the Advil kicks in. I got a selective nerve block on L5-S1 before two months and it did nothing to me. I cannot do anything during the period of flare up. I am 46 years old and in great shape.I had an MRI lumbar spine without contrast. The findings are as follows: The vertebral bodies are of normal height and marrow signal intensity. Small hemangioma noted within the posterior aspect of L5. The spinal cord is normal in morphology and signal and the conus medullaris terminating at L1. L1-L2 and L3-L4 there is neither central canal narrowing nor neural foraminal stenosis. There is mild facet arthropathy. The impression was L4-L5 paracentral and posterolateral disc protrusion. This preferentially narrows the left lower recess and abuts the descending left L5 nerve root. L5-S1 broad based left posterolateral disc protrusion. This preferentially narrows the left lower recess and abuts the descending left S1 nerve root. Mild to moderate central canal narrowing at L3-L4 secondary to diffusely bulging disc.I afraid that surgery (discectomy) will not fix as this recurs. What is your opinion doctor? I was a geriatric speech pathologist (retired), so I know it is difficult to say without seeing the patient and how they present. Please do your best. ### Response: I understand your symptoms. Before we go ahead and discuss the MRI, I would like to know some more clinical details. Revert back with the details to a neuro 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: Hello,I am a 20 year old boy having epigastric pain only early in the morning before going to the toilet. I also have a complaint of sticky stools, lower back pain and loss of appetite.What would be the cause for my problems? Is it curable? Is it due to sexually transmitted diseases? Because,unfortunately, I did homosexual anal sex before two years.If it is amoebiasis due to homosexual anal sex, can it be cured permanently? Is there any special treatment in ayurveda for that? ### Response: Before advising any treatment, I would like to know the following: Following are the possibilities according to your complaints: You should be careful about the cleanliness during your sexual life. Revert back to an ayurveda specialist online for further follow up" "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 face is so dark when compared to my body. I am a sports person so from my childhood I am exposed to sunlight a lot. Is there any solution to come back to my body color? ### Response: Hi. I understand your concern. You should use sunscreens with SPF 50 or more daily. Try to avoid sun exposure as possible. The creams used to increase skin color will do more harm than good. Melanin is the pigment which causes darkening. Its production increases on exposure to the sun. So protection from the sun by using sunscreen will definitely help to prevent darkening" "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 had a spine tumor removed one and a half years ago. Now, she still has back and leg pain. Her doctor has advised surgery, but she is 72 years old with diabetes and blood pressure. Also, she is reluctant to undergo a surgery. I need a second opinion. ### Response: I read your query and understand your concerns. I hope this helps you. Feel free to write back to me if you have more questions." "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: Regarding the transmission of HIV by mosquitoes, I have following query. I know the virus does not survive in insects, but what if some mosquito bites a very high viral load HIV-infected person and then bites an uninfected person on his wound, who crushes it on his wound. If the above situation happens at three or four places on his body simultaneously by an HIV-infected mosquito, what is the possibility of HIV transmission by this method? ### Response: Hi. It is good that you have an interest in HIV transmission. Hope your query is answered, but if you have any other question, please do not hesitate to ask or call anytime." "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 (1-month-old baby) is suffering from breathing problems and lung infection. We went to a pediatrician, he suggested doing 2D echo. In that we found moderate OS ASD. Will it cure on its own? Please give a suggestion. ### Response: The treatment of atrial septal defect in neonate or infant depends on the size of the defect and clinical condition of the child. If the child is stable, it can be left alone and sometimes it closes by the age of 3 years. If still, the problem persists, the surgical closure is recommended. Small or moderate size, not causing any complication may be left alone. A regular follow up with pediatrician and pediatric cardiologist is recommended. Heart defect may lead to a recurrent chest infection and breathing problem. So the child needs utmost 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 noticed that I have an extremely irritated vagina with chunky discharge that looks yellowish green. I am negative for trichomoniasis and waiting for gonorrhea and chlamydia results. ### Response: Hi. An irritated vagina with chunky discharge is a definite sign of vaginal infection. Most of the time, character, color and odor of discharge helps in identifying the type of infection. Since your discharge is yellowish green, have to keep in mind sexually transmitted diseases. Please wait for the further reports. All the vaginal infections can be treated well with antibiotics. So do not worry. If it is recurrent, please rule out diabetes. Please use condoms, and avoid multiple sexual partners. These two steps can help get rid of STDs forever." "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 and my grandmother died within 3 months. After they expired, I started to face many issues like LIC claim and others. Due to too much stress, I am unable to sleep at night properly and feel sleepy in the morning. Because of this reason, I am unable to concentrate on my work. I am working in software industry. Due to the issue I am facing, I am not able to complete the tasks on time and going through a lot of problems. I am also suffering from body pain. Presently, I am on Zincovit multivitamin tablet. ### Response: I feel sorry for your loss. Your problems are stress, unable to sleep at night and body pain. So, basically it is your stress that is leading to other problems. Stress can be managed both by medication as well as by lifestyle modifications (behavior therapy). First, try lifestyle modifications which include: Also, proper sleep hygiene needs to be practiced daily, so as to help you to maintain good sleep in the long run. Sleep hygiene entails following important points. These lifestyle modifications will help in improvement of symptoms and you will feel better. If symptoms persist even after lifestyle changes, then visit a psychiatrist. Visit a psychiatrist for proper prescription of this" "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 four days back with my fiancee. Her next period date is two weeks later. During the intercourse, the condom tore and the sperm entered her vagina. Within 24 hours she consumed an I-pill. Her stomach was paining a lot and feeling drowsy the whole day. The next day (after 48 hours) she consumed an I-pill again. Her stomach is paining a lot. Will she get pregnant? In how many days the periods should come? The symptoms of the I-pill and pregnancy are almost the same. So, I am very confused. Should she get a check-up done with a doctor? If yes, should we go to a gynecologist or a sexologist? ### Response: Hello. There was no requirement for a second dose of I-pill. The pain in the abdomen is due to the Progesterone effect and that can be countered by increasing the water intake. Presently, if the pain is more, then she can opt for an NSAID for pain relief and hot fomentation. Please ask her to take 3 to 4 liters of water in the day and that shall soothe her symptoms. She is unlikely to get pregnant as she has taken the first pill within 24 hours but should have waited for the bleed to start." "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 59 years old. She has gallstone and she was supposed to have cholecystectomy but was postponed due to quarantine. Last month was the supposed schedule and that time the size of the stone in her gall bladder was 3 cm. Now she is experiencing increased pain on her right shoulder. I would like to know if there is something she can do for the pain or should she have her gall bladder removed? ### Response: Hello. I will help you with your problem. Gall stone surgery is not emergency surgery. It should be done in an emergency if there is gall bladder perforation or malignancy. In your case, the stone size is large, and with the age of the patient malignancy is ruled out. I will advise to go for CT (computed tomography) scan if possible. If not at least USG (ultrasound) abdomen should be done. If everything is normal and only stones are there then you can wait for some time. Consult in an emergency if she developed jaundice any time. For pain, she may take any regular pain killers. Avoid fatty diet and get back to me after investigations." "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 an ear perforation two months before. My ear was healing really well. The doctor told me to clean my ear by ear syringing. He gave me two shots of syringing. After that, earwax clean up. My ear had gone bad. I feel like my eardrum is hardened. Whenever I put my finger in my ear to pop up my eardrum, my eardrum does not flexibly move at all. It is like it got stuck in one place. It does not move up and down when I put my finger. It is just fixed up in one place and the tinnitus has also gone bad. It vibrates really bad when anyone talks to me or I talk to anyone. I am so worried. Will my eardrum heal again? ### Response: First of all, tympanic membrane is anchored to bone and does not move up and down but moves inward and outward because of sound. Secondly, it is placed 2.5 cm from external ear orifice and cannot be moved with a finger. Since you had a perforation two years back, it might not have healed at all. The other symptom you are talking about is tinnitus. It is possible to have in presence of a perforation. You should get the ear examined. Also, I would like to know if you have any discharge 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 am 17 years old. I am facing a shaking tooth in my bottom jaw. What is the solution for this? ### Response: Shaking tooth means tooth mobility. Causes are various like periodontal (means your gums are loose not enough to support the tooth, or because of less oral hygiene). Other reason might be trauma, broken, and shaking (mobile) tooth. Iopa. Proper oral hygiene." "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 missed the pulse polio drops campaign for my daughter 3 years old. I really wanted to know, is there any difference between these drops and the ones we give through the regular immunization schedule. We spend thousands to get the immunizations done. Considering this, does it become mandatory to get the drops in government campaigns done? Or, is it just customary? Hope this will educate many. ### Response: Hello. I understand your concern. Pulse polio dose is an extra dose other than the routine immunization. This dose (pulse polio) is given on specified dates in a calendar year through government agencies.This campaign aims towards eradication of polio. If your daughter missed this dose, you cannot give it now until further dates are declared. It is not customary. Rather, it is the responsibility of the citizen to give these extra doses to kids under 5 years anywhere in the country on the given dates. By doing so, we are helping our country and the world eradicate polio." "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 took i-pill yesterday night and then accidentally had an unprotected sex today evening at 5 PM.Should I take another i-pill? If yes, when and any side effects? ### Response: As you took an i-Pill one day before having sex, no need to take it again. i-Pill has something around 72 hours of action. No major side effects. Your periods may get delayed for a week. Hope it helps. Revert back to an obstetrician and gynaecologist online for further clarifications" "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 lower back tooth hurts severely. I have taken Tylenol and it is still not helping. ### Response: Hello. You may have an abscess with infection. You need antibiotics along with painkillers like Tylenol. Get an early appointment with your dentist and get an X-ray done to find which wisdom tooth or other molars are infected. You may need extraction or root canal treatment for 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: Sometimes, the faraway objects become blurred as well as I cannot see the writing in class on the board clearly or the slides on the projector. But, the problem is that it is not regular. Rather sometimes, as I can see everything clearly like when I go to the movies I sit at the back still everything is clear. What should I do? Do I need an eye test as I have done it last year? It was clear at that time. These symptoms were still there but not frequent as now. ### Response: Hello. We need to know if you are far-sighted, that means hyperopic. They usually have good vision at a young age. But the vision deteriorates with aging and when stressed. For that, you may need a cycloplegic refraction. The other thing may be tear deficiency. Use refresh tears every four hours and increase the blinking rate when you have blurred vision" "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 32-year-old man. I had gay encounters with three men in a massage parlor on three different days. In all the three cases, we have used condoms. In my second and third encounter, I got a lot of blood and that too very dark colored blood and something else also came. I had a word with my doctor. He has asked me to get it tested. Three weeks after my encounter, I have taken tests for HIV 1 and 2. Both antibodies screening test (serum) and VDRL-RPR (serum) were nonreactive. Now it is more than 16 days. I am not feeling well. I cannot sleep during the nights thinking about the possibility of AIDS. My company has laid our entire team. So, I am free nowadays. From today, I started feeling weakness. From the past two to three days, I am also suffering from indigestion. Please help me. ### Response: Hello. I read your query and understand your concerns. To conclude, I like to state that your current problem is psychological and there is a need to take the right approach to manage 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 friend had his deamidated gliadin IgG antibody test done recently. The test result is 152. Does it mean that the person is having celiac disease? ### Response: Hi. Deamidated gliadin IgG antibody level of more than 30 is diagnostic of celiac disease. Since the number mentioned by you is 152, it indicates that the person is having celiac disease." "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 39 year old male. I tested blood for lipid profile and found: total cholesterol 224, LDL cholesterol 144, and triglyceride 135. I do not have any other problems like diabetes, BP, etc. I want to make my lipid levels normal and make my heart healthy. Since from the last three years, my lipid levels are above normal, I am afraid now that does this cause any blockages in the heart? ### Response: Hello. The most important aspects for lipid control: Diet - avoid non-vegetarian foods. Eggs are fine. Avoid fried food. Exercise - for a minimum of 30 minutes daily. Sleep - minimum of eight hours daily. Medicine - Shilajitwadi lauh vati one tablet twice a day. Three glasses of water boiled with three teaspoons of jeera for five minutes" "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 29-year-old female. Lifestyle is healthy with exercise and good food mostly. Since last year, on both sides of my cheeks especially on the right cheek, there are three to four pimples. They produce the white head dries off leaves a red scar and again another erupts. I have slightly oily skin and stops applying all the serums. Please help. ### Response: If possible provide me photographs of the affected areas which will help me for a better understanding of your skin problem and proper treatment plan." "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 PBC stage 4, Gave, COPD, Hashimoto\s, etc. I have been around someone who was just diagnosed with mono. I have used her water bottle. Should I be worried and, if so, what symptom could I develop? Do I have to stay away from this person now? I am currently under Urso 300 mg six per day. ### Response: I can understand your concern. Do not worry, and I will clear your doubt. Infectious mononucleosis usually caused by EBV (Epstein-Barr), and it can spread through saliva mainly. So sharing of the objects like water bottle or glass object can spread infection. So you are at risk of spending it. But do not be panic. The symptoms are fever and sore throat, mainly with enlarged cervical nodes. Splenomegaly also can occur. If fever, malaise, and sore throat occur than investigate by CBC (complete blood count) and serological test for EBV, which includes ESP (extrasensory perception), Ig M (immunoglobulin M), and Elisa (Enzyme-linked immunosorbent assay). Infectious mononucleosis usually resolves by its own with time. Anyway if you suffer from fever and sore throat that will discuss further and you can consult a nearby physician for examination at that time. It is advisable not to share an object with an infected person. I hope this will help you. Get back with more query if you still have doubt." "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: Just above my upper left canine tooth, in the gum, a tiny protrusion of tooth or bone (painless) can be felt with the finger. The gum surrounding the protrusion is slightly raised, but the whole thing is only about 2 mm in diameter. No other symptoms or visual abnormalities. I have not had a tooth extraction. ### Response: Hello. I would like to know if you remember any history of injury to the site? And how long have you been noticing this? Did it increase or decrease in size or observed any color change? There are 2-3 probabilities in your case as much I can make out from photograph/your attachment: (attachment removed to protect patient\s identity). 1. This can be a pyogenic granuloma. 2. It can be a cyst. 3. Can be simply an infection. I would suggest you consult a dentist if there is associated pain or any discharge from the site. For now, I would suggest you to keep the area clean, do warm water and salt rinse three to four times daily, and not to hurt the area with a toothbrush or anything. Follow up after a week." "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 trying to use Lidocaine spray to numb the pressure sensation I get from wearing my retainer. Could you please tell me how to properly use Lidocaine spray without numbing my whole mouth and tongue? I just want to target the lower jaw. ### Response: I should recommend you revisit your Dentist to get it adjusted. The retainer might be too tight ,it should not be as tight to take a numbing spray (Lidocaine). For now if you are using a numbing spray there is no way you can stop numbing your tongue in as you cannot manage the aerosol of the spay, eventually it is going to spread and numb the entire mouth as you are saying. For the time being, I might suggest Rexidine M Forte gel (numbing gel). It contains Chlorhexidine + Metronidazole + Ligocaine. It will help you better but its action might be less than the spray but definately will help you with the issue of numbing the entire mouth. These two.things will help you a lot. Pressure from a tight retainer" "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: From past few days, I feel very weak while sitting and working. I do not feel energetic, and most of the time I feel sleepy and lazy. I have a little pain in the body, so I am not able to concentrate properly on anything.My blood pressure is 119/72 mmHg, and pulse is 72. I even have pain in my legs and back, and I do not have much energy in my body. ### Response: Hello. There are various causes like thyroid problems, anemia, vitamin deficiency especially vitamin D and even psychological issues which are the most common. You should get hemoglobin levels, thyroid function test, and vitamin D levels checked. I suggest you try doing the following : Do you have any psychological issues like stress or depressive? If yes, then you need to consult a psychiatrist. Revert with more information to a general 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 a 23-year-old male. Two years ago, I had intense palpitations, and I was diagnosed with anxiety disorder. I had panic attacks, but then I was able to recover by myself. From a few days, I had two panic attacks. And I am afraid if this is anxiety, or if my diagnosis was wrong as if I had some serious health issues.I worry that I have a heart problem. Even if someone touches my chest I feel uncomfortable. I do not think a lot. I try to calm myself, but somehow I am not able to calm myself no matter what I try. The main problem now is my anger. I suddenlt feel so much angry, on very stupid things like I am walking on a road and a car blows horn continuously I feel very irritated and angry, if my girlfriend does not pick my call I get so much angry and it is not normal.If I try to control my anger I feel numbness, and hand shakes, I even have palpitations. This is very worrying for me as I think this is very serious this time. My heart palpitations go away only when I am in deep sleep or when I am doing something so deeply without noticing anything. I had palpitations two days before my exams, I tried calming technique but it did not went away. But when I was in the examination center, when I started writing my answers I was so deeply busy in writing, that my palpitations go away. And then after the exam I was fine. But anger is ruining my life. I want to change the way I am. Please help. I am currently taking Sertraline, and Beta-blockers. ### Response: Panic attacks often mimic a heart attack. In fact one of the common differential diagnosis for panic attack is cardiac arrest. If it is happening often it is advisable to get an ECG (electrocardiogram) done. Please tell me from last how many days are you taking anti-anxiety medications? Secondly, I would advise you to start cognitive behavior therapy. Anxiety is caused by negative thoughts called cognitive distortions these can be improved with various techniques used in the therapy. Once you learn how to cope up with these negative thoughts you will be able to control your anxiety. Find a local therapist or you can opt for online therapy via video consultation. The relaxation techniques such as box breathing and progressive muscle relaxation help in long-term efficacy. 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 an 18 year old female, and I do not know what is happening with my body. I have itchy blisters on my five fingers, and my entire body feels very itchy. ### Response: Though the description of your query is a bit brief and vague, I could think of two possibilities in your case. I would be able to help you more if you could send me the following details: Since how long do you have these lesions? The exact site and morphology of these lesions." "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 total free PSA test done and these were the results.PSA 7.7.PSA free - 1.49.% free PSA - 19.4.What does this mean? ### Response: PSA (prostate-specific antigen) is only a screening test that can be raised in any prostate abnormality. Coming back to your query, as your total PSA levels fall in the grey zone of 4-10, free PSA is done. If free PSA is more than 25% chances of you having CA prostate decreases to less than 9 %. If your free PSA would have been less than 10% biopsy would have been recommended. So when your free PSA is 19.4 so chances of you having CA prostate is relatively less and you can be kept on three months PSA and free PSA follow up. 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 diagnosed with keratoconus. My recent report showed K value 49.90, I-S 2.16 D, KISA 244%, and Pachymetry 461.465. My doctor advised me to go for C3R. I would like to know is there any other treatment option for keratoconus? ### Response: Hi. C3R (Corneal Collagen Cross-linking with Riboflavin) will help to check further deterioration of corneal thickness. May I know what is your vision with spectacles or contact lenses?" "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 25 year old male. I am 91 kg, and my height is 5 feet and 2 inches. My cholesterol levels are high, and I am over weight. I have hypertension, and I am taking tablets for cholesterol. I need a Paleo diet chart. Please help me. I am attaching my recent reports. ### Response: I went through your reports (attachment removed to protect patient identity) and saw a marked elevation of cholesterol levels with low vitamin D levels. So, it is very much necessary to take up a strict diet so that you get all your vitals to a near normal range" "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 gave birth before nine days, and we did a blood test yesterday, and her RBC count was 3.54, hematocrit 33.3, and hemoglobin was 11.4. Is this a normal result considering she just had a C-section? ### Response: Her hemoglobin level is borderline, and there is only mild anemia. There is no need to worry regarding these results. There is no need for any medication for anemia just now. I hope this will help you. Let me know if you have any questions." "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 plantar fasciitis. I am having swollen feet despite taking anti-inflammatory medications. Please help. ### Response: Hi. I do not know what anti-inflammatory medicines you were taking, but you need to take the correct medicines and the main treatment of plantar fasciitis is stretching exercises. When the pain reduces, you have to do calf stretching exercises to reduce the pain of plantar fasciitis. I suggest you the following medicines to get it cured. Consult your specialist doctor, discuss with him or her and take the medicine with consent. You need to wear silicon heels to reduce the stress over it. You need to go to a physiotherapist and do ultrasound physiotherapy for at least 10 sittings in two weeks to the affected area. Do calf stretching exercises twice daily for 15 minutes. Exercise is the main thing. Also, put your feet in hot water when you get up in the morning from bed. This treatment will surely help you. Follow up with me after 10 days. Medicines, ultrasound physio and exercises. To wear silicon heels. Revert back after 10 days to an orthopaedician and traumatologist 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: Are there chances of developing chickenpox after shingles? ### Response: Chickenpox and shingles are caused due to the same virus. Chickenpox occurs first and the virus stays dormant in the dorsal ganglia of the spinal nerves. After years or when immunity decreases, the person gets an attack of shingles. Most people get shingles only once, but few can get 2 to 3 times. After shingles no one gets chickenpox." "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 brother just turned 26 years old three days back and he is a smoker from last seven years. On an average, he smokes 6 to 7 cigarettes a day. He developed a morning cough within a year of smoking. Now my query is that a few days back his stomach was upset and he puked. After puking he was cleaning his mouth and in the process, he was collecting phlegm and spitting. He noticed something red in the spit one time. He is not sure if it was blood or vomit since it was not bright red. He spat 3 to 4 times after that but nothing came out. It has been a week since then and no such incident has occurred after that. There is no other complaint. He is not breathless. Appetite is excellent. Stamina is very good. No weight loss. He has had his last X-ray a year back during job recruitment. Now my query is that he has said he is not going to smoke again but is not going to meet the doctor for the red thing. I am really worried about the chances of lung cancer. ### Response: It is unlikely to be lung cancer. Firstly, the lung cancer is unlikely at this age group and frequently develop after 45 to 50 years. Next thing, blood should have been present consistently and other symptoms would have been present. Most of the times such occasional bleeding is due to mucosal bleeding in mouth or GIT. However, it is better to get evaluated once and get chest X-ray, although unlikely. So, try to convince him." "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 AVS for the last two months and have been suggested to undergo core decompression. But according to some physiotherapist, by seeing my MRI, it can be treated using some exercises as my femoral shape has not changed or collapsed. I cannot understand what should I do. I am 35 years old. ### Response: Hi. Avascular necrosis is an irreversible disease. Once the process has started, it cannot be reverted. The rate of progress depends on person to person. The treatment depends on symptoms and quality of life. Initially, the patient experiences only pain and range of motion is not limited. The pain is because of raised pressure inside bone and since the shape of the head is maintained, so the range of motion is good. So in this case, core decompression helps in reducing the pressure and in turn pain. But, this surgery does not stop or slow the progression of the disease. In the later stages when the shape of the head is deformed and there is pain and hence the quality of life is severely affecting, then the only option left will be the hip replacement. I would be able to help you more in the decision if you could tell me what are your symptoms and what all you feel you are not able to do in your daily life." "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 husband had a deep filling in his upper second to last molar (left side). About several hours later, he started having discomfort and taking Tylenol and Ibuprofen interchangeably. Now, it has been the second day with severe pain and his cheek is swollen. And the gum over the tooth is in pain but not swollen, and it is a throbbing type of pain. We have no access to the dentist. Please help. ### Response: In this condition the tooth should not be filled and instead, root canal should be done. As the filling was near the pulp, pulpal irritation is causing the pain. Take tablet Amoxiclav (Amoxicillin and Clavulanic acid) 625 mg one tablet twice daily for five days, Zerodol SP (Aceclofenac, Paracetamol, and Serratiopeptidase) one tablet twice daily for five days, capsule Pan D (Pantoprazole) twice daily before meals for five days, Betadine mouthwash gargle in lukewarm water. If nothing is available right now warm saline gargle will also help for the time being. Take the medication, your husband would be relieved. Do not worry, but I will advise to get the filling out by your local dentist. And your husband needs a root canal. Kindly upload an image of the tooth along with the affected area. Treatment was not done properly. Should have gone with a root canal. Removal of filling and root canal procedure. Upload an image and x-ray available. Your husband will be fine once he gets the medication. But as you both are travelling even warm saline gargle two or three times will help." "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 removed all the four wisdom tooth before nine years. I had a safe and successful operation. After removing my wisdom tooth, I started to have bad breath. Before the removal of wisdom tooth, I do not have this problem. Currently, I floss daily, and I brush my teeth twice a day. I am using mouthwash twice a day, and I also do salt water gargling after taking foods. Nothing helps me. What could the problem behind it? Please help. ### Response: You are maintaining your oral hygiene well. Having bad breath after extraction or surgery is quite common due to an open socket. But it generally disappears after a few days. There are other possibilities also. The first cause can be periodontitis. It is the inflammation of the periodontal ligament or the structure supporting the gums. Bad breath can also occur due to GERD (gastroesophageal reflux disease) because of chronic acidity. Infections in tonsils or other areas of the throat can also cause bad breath. Food impaction around the teeth also causes bad breath. You can consult a dentist for a checkup and try to rule out periodontitis. Try to see the presence of calculus and do scaling. After ruling out periodontitis, you can see a physician for other health-related problems." "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 lost a filling present on my bottom left tooth next to my wisdom tooth. Some portion of the tooth has broken away. I do not have pain in that tooth now. Is it right to have a new filling on that tooth or can I have a dental crown on that tooth? Is it possible to have a crown on that tooth? Is it a complicated procedure? ### Response: Hi. A filling can be placed again, and the tooth is contoured correctly. A composite can be used to build the tooth and then the tooth can be contoured adequately. Then a crown can be placed. If the tooth is not broken much, then a cutting can be done, and a crown can be placed. If the crown of the tooth is broken more, a post and core can be used. All these measures are taken depending on the status of the crown structure. These measures are entirely noncomplicated and can be done without a problem. Please send a photograph of the tooth. It will be easy for me to guide you. If there is no pain, then it is easy to fix the problem." "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 acne since I was 14 years old. In the beginning, I did not want to see a dermatologist because I thought it is hormonal, but the acne was not stopping from popping up on my face and making my face look full of spots and acne. So I visited a dermatologist when I was 16, the doctor gave me two ointments and a tablet.The treatment continued for six to seven months, and my acne was gone and did not pop up for the next year. After this, I started having acne again just like before, so I revisited the doctor and asked him why is it so? He answered that it could happen because of some changes in diet and prescribed me the same tablet and the ointment for two more months. For the two months, I took all the medicine, and there was no acne for one month after the two-month medication. Now acne is coming back on my face. Why is this happening? ### Response: There are many causes of recurrent acne, the food, and dietary type is a factor as too much oil, and less fiber diet can cause acne breakouts. So if you are constipated and are already acne prone, this could have exacerbated the acne. If you are overweight or have facial hair, you must get checked out by an endocrinologist or a gynecologist for the polycystic ovarian syn" "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 currently have severe anxiety due to a recent health scare. I currently take 40 mg of Celexa daily. The Celexa is not helping the anxiety at all. What else can I take to ease the anxiety? I have Xanax and can take 0.25 mg every four hours. That helps, but I still have extremely severe anxiety. I have never actually had to take my Xanax until now. What do I do? I just want it to go away. ### Response: Hello. I can understand your concern. You are taking a sufficient dose of Celexa (Citalopram), and if the 40 mg dose is not acting properly. the symptoms should be re-evaluated properly. The addition of some another antidepressant as an augmentation agent can help control the persisting anxiety. Bupropion is a good option. For health anxiety, proper reassurance and psychotherapy also help to a great extent. For symptomatic exacerbations, you can take Xanax (Alprazolam) on an SOS basis. There is no harm in taking this" "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 mom is 66 years old. She is living a healthy life. She has no health complications as such but she complains that she is exhausted after doing very little work. So, just as a measure, we got her blood test done. The reports (lipid profile) suggests that there is some issue with cholesterol levels. I have attached two reports, one which is latest and another one two years old. Can you please have a look and examine the situation? Here the pathologist suggested to start immediately taking the below medicines: Ecosprin 150 (one tablet daily in the afternoon).Avas 10 mg (one tablet daily at night).Another tablet called Atorvastatin 20 mg (is it better than above medicines?).Along with brisk walking for one hour every day, consuming flax seeds and avoid intake of desi ghee.I have few questions for you please:What do you suggest after examining the reports?What medicines and other things you suggest for her?Will that medicines be for a lifetime or for a limited time?What precautions my mom should take?What lifestyle my mom should follow now?What foods should she favor?What is the role of the medicines which he suggested?Any other suggestions which will help her to get back to normal/healthy reports?Looking forward to your help. ### Response: I have evaluated your mother\s reports (attachment removed to protect patient identity). Her cholesterol is high and at this age, she should be started on medicines. Her thyroid levels were high in the previous reports. I want to know the current status. Following are your answers: I hope it helps. Good luck" "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: About six weeks ago, I had protected sex with a male. About two weeks later, I developed a cold, which got better. Now, I have been feeling random zings (not really painful) in my armpit. I have also got five \x80\x9cpimples\x80\x9d in a cluster on my back. Do I need to be worried about HIV? ### Response: Hello. Protected sex is safe and there is no risk of HIV (human immunodeficiency virus). Having cold or flu is not a specific symptom or sign of HIV. Cold is otherwise very common in the general population and is not a reason to suspect HIV. For pimples, I would suggest you use a triple antibiotic like Neosporin ointment (Bacitracin Topical, Neomycin, and Polymyxin) twice daily. I do not think you even need to worry about HIV. Moreover, since it has already been six weeks from your sexual encounter, you may take a fourth generation HIV screening test for your own satisfaction that is HIV combo test (p24 antigen and anti-HIV antibody). The results would be conclusive. Regards." "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 age is 28, height is 176.78 cm and my weight is only 56 kg. I do not have any type of disease. I want to gain weight very fast. In five to six months up to 10 kg. Please suggest me a medicine, syrup, or protein supplement. ### Response: Hello. Looking at your BMI it is slightly below normal. You must better see a gastroenterologist and get some basic tests done which is quite possibly a diagnosis even if you do not have any other symptoms. Thyroid profile, CBC, anti-Tg antibodies are some test you should get done. If all the reports come out to be normal then I would advise you to take tablet Longifene DS (Buclizine) 1 HS which has some role in improving appetite. Test increase your calorie intake. Regards" "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 regarding co-infection of HIV with various other diseases like syphilis, herpes 1, herpes 2, gonorrhea, hepatitis C, hepatitis B, chlamydia, CMV, HPV, and molluscum contagiosum. Some time ago, I had a paid unprotected oral sex encounter but vaginal sex was mostly protected. I say mostly protected because the condom was very loose due to my erectile dysfunction. I received oral sex from her without any protection. Please take into account that prior to this episode I have been experiencing chronic penile sores and burning in urethra supposedly due to my established herpes infection (earlier tested positive for both herpes 1 and 2). I also have a weak immune system because I suffered from malnutrition while growing up.I have four questions that I want to ask. Would my herpes infection affect the window period for HIV 1 and 2? Would the window period for any of these aforementioned diseases be affected in case of pre-existing or simultaneous co-infection with another STI? Also, would my herpes infection increase the likelihood of getting infected with HIV or any other STI? Lastly, please advise when should I get tested for all these STIs in order to have conclusive results. ### Response: No, herpes does not affect the window period for HIV 1 and 2. Yes, it could be if the immune system is compromised. The term window period is used mainly with reference to HIV. Herpes infection per se does not increase the chances of an STI. But the mode of transmission of herpes is similar to the mode of transmission of other STI diseases. So the risk of exposure to all STIs is the same." "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 24-year-old female. I am 5\7"" and weigh approximately 280 lbs. I am overweight. My question is that I have had this calf pain intermittently ever since I went bowling over a month ago. It comes and goes and the pain is honestly very random when it appears. It does not hurt worse with walking or working out and I really notice the pain only if I am not focused on something (I work as a nurse and never notice at work). It is maybe a 3/10 pain. It is not a sharp pain, sometimes it feels like I need to stretch my leg and other times it feels like a burning pain.I am also having a chest pain intermittently. No short of breath. It changes with positioning. I basically want to know your opinion, do you feel it is a DVT with a PE or that I could have pulled a muscle? I should also note that I just started a new job which gives me a massive amount of anxiety and worry, which I realize does not help with any of this. I am currently taking Norvasc and Lisinopril for hypertension. Please suggest. ### Response: After reviewing your info, I think there are a couple of things I can tell you. I am assuming you have a B/ L (bilateral) pain and aching discomfort and not a sharp localized pain. 2) My second differential would be varicose veins. 3) Medication side effects of your anti-hypertensive" "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 I have an inner ear infection. I went to the doctor last year and he asked me about my symptoms. I told him and he said I had a viral thing in which he gave me antibiotics to take which I did not take. When I got my summary it is said that I had sinusitis. Now until this day my sinuses have been bothering me. The doctor said I had fluid in my left ear. I think the fluid in my left ear is causing me to feel bad. Last weekend I was laying on the couch on my right side and turned to my left fast over and saw the pictures on the wall go by when I turned fast. I tried in the night to lean back in the recliner part on the couch and had the same feeling almost, but I sat back up. I also have that feeling when I bend down but not a lot. I am worried and want to get relief for my left ear. What I just described to you is it a certain type of vertigo? ### Response: As I understand you have three issues. Sinusitis, for this, take steam inhalation daily for one month. Also, do send me pictures of CT (computed tomography) scan for sinuses. So that I can further suggest what is the treatment or surgery. Fluid in the ear, if it is significantly there, then this needs to be removed and a ventilation tube needs to be inserted. It is a small procedure. Vertigo, can be due to fluid in the ear or an independent episode too. Do take good rest. Avoid much neck movement. Take tablet Betahistine 16 mg three times a day and consult a local ENT doctor, or take a video consultation with me with reports." "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 few and little genital warts in my vagina. I can send you a picture if you want, I am very worried that it could be VPH. Please help me. ### Response: Hello. It seems to be HPV (human papilloma virus) warts only. But need to be confirmed. Are you sexually active? If yes then does your partner also has similar lesions?" "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 minor injury four weeks ago when my partner while on the bed accidentally hit my erected penis on the left side next to the frenulum under the head. I had some minor pains here and there but I stopped all sexual activities. I did notice a very sharp pain today after an erection only, and the pain was at the same location of the injury. As I wanted to feel if there is a lump I did feel something there at the same location I described above (size of 1-2 millimeters). Please tell me if this will heal in a good way such as no scar tissue or bad way with scar tissue and Peyronie\s as my age is only 26 and I do not have any medical history or problems, and the same for my family. I do have varicoceles on my left nut sack grade 1. I have attached a picture of the frenulum.My questions are: What will be the healing time and pain healing time? What are the percentage of chances of developing or not developing scar tissue or Peyronie\s at this age? Will you recommend any medicines like Pentoxifylline or anti-inflammatory? I am not taking anything now. ### Response: I have seen the pictures. (attachment removed to protect patient identity). If the trauma was at the level of frenulum then you can go for frenuloplasty so that frenulum will be freed from glans and there should not be any problem further. Peyronie\s disease generally develops after trauma to the shaft of penis. There is no recommendation to start medication for this prophylactically. Take some pain killers and anti-inflammatory medicines so that pain and inflammation will subside early. It may take three to five 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 44 year old female. From the last four days, I have a pain when I breathe in. It is felt just above my left breast, not exacerbated by lifting, but when I stand up from a lying or sitting position, it gets worse. I also have a slight ache in the left shoulder and on the top of my left arm. I am not taking medication. The pain is not relieved by anti inflammatories or codeine. I cannot recall injuring myself at all. ### Response: Hello. I went through your query. Let me tell you few important things about chest pain." "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 nephew who is 4 and a half years old. He is quite active as a child with a normal height and weight according to his age. Two days back we happened to measure his blood pressure at home normally. We were quite taken aback as it was 144/100 and later also it was around 130/96 even while sleeping it is around 120/80. He is otherwise not sick, but he sweats a lot while sleeping since the time he was born. Is there any problem with his BP, we are quite worried. ### Response: Hi. A blood pressure of 120/80 is definitely very high for a child of 4 years and 6 months." "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 itchy and watery eyes. I cannot look at an object for a long time as tears come out from my eyes. I always blink and stay calm. Please help. ### Response: I advise you follow these precautions. Reduce the screen time which in turn increases the blink frequency. It gives you some relief. If still, it persists, you can use artificial tear supplements which are preservative free. If there is no improvement, you can use tear supplements in gel form so that the" "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 daughter is 6 years old and weighs about 24 to 25 kg. She is having throat pain and cough and running a fever of 100.5 degree since yesterday. She got throat infection from me. I consulted with my doctor and she gave p250 7.5 ml and Betadine gargle for her and told us to consult a Pediatrician. But my daughter is not getting better. Please help. ### Response: Hi. Please continue the same treatment as going on. An antibiotic like Augmentin may need to be added based on the clinical examination of the child (to see if it is required). Also, Ibugesic may be started to reduce the pain and inflammation (if any) based on the clinical examination. As of now to relieve the pain you can use Ibugesic 8 ml (SOS only). As far as the cough is concerned, you may cut down on the Betadine gargles and instead take one teaspoon of honey with lukewarm water twice a day for a soothing effect. Show the pediatrician tomorrow for further course of treatment." "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 niece was born with a small hole in her heart. The hole was automatically closed when she was 18 months old. As per our doctor, the hole is permanently closed, and there will not be any problem in future. I just want to clarify that if there is any chance for problems in the future. ### Response: It is less likely that a hole that has closed will open again. Hence as regards to the hole in the heart you need not worry if it has closed. A repeat 2D Echocardiogram would be advisable to see the exact status of the hole (if not done) to detect for any other anomalies and prospects regarding the heart." "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 planning my second baby. We had unprotected sex. My last month periods were twelve days before that. Two days after the intercourse, I got cramps. I visited the doctor, and she said you are ovulating. Still, some cramps are there, and there is a white watery discharge. My periods are due on the 13th of next month. I do not know if I am pregnant; only my breast is getting heavy a bit. ### Response: Hello. It is true that you should have some pain while you are ovulating. But ovulation pain mostly lasts for four to five hours only. If it is from seven to eight days, then it can be due to some other reason like acidity or stomach infection, which leads to some cramps. White discharge is normal, but it may suggest infection due to which you are having pain. If you are planning for pregnancy and pain is tolerable, then I would suggest not to take any medicine for it. Wait up till 13th, and if menses do not come, then do a urine pregnancy test after three or four days. Heaviness in the breast is maybe normal before menses. If you still doubt that something is wrong and you have minimal bleeding on the last menstrual period then do urine pregnancy test today itself and not to wait up to 13th of next month. And if the pain is not tolerable, then you can take Paracetamol like tablets as a painkiller." "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 25-year-old male with extreme hair loss. I was on Rogaine 5 %, Finax 1 mg, but losing lots of hair from the vertex. ### Response: Are you still using Rogaine and Finax? Minoxidil and Finasteride are the medicine of choice for an" "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 read that great stress will cause brain development inhibition in children. Can this be caught up through something? Is this permanent? ### Response: Hello. As the brain develops till the age of 18 years, stress can affect the development. Stress can, in general, affect the functioning of the body, hormonal balance, and immunity levels as well. If the stress persists beyond the child\s tolerance, the effect can be long-lasting or permanent. However, if the child is relieved from stress, he can show a tremendous spurt in development. Some ways to help chil" "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: Dear doctor,I am on Ortho-Cyclen pills for five months. I skipped my placebo pills and went on to the next pack. Now, I am having stomach cramps after eating, brown discharge, cloudy urine, and fatigue. Kindly advise me. ### Response: Placebo pills are just vitamin tablets. So, skipping those pills will not cause any problem. Stomach cramps might be due to gastritis. For this, you can take some antacid. For ""brownish discharge, cloudy urine and fatigue"" please take urine pregnancy test. If it is negative and there is only minimal discharge, you can continue the pill which you are using. Please let me know your age and the date of the last period for me to guide you better. If you have further questions, feel free to 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 had a crown in one of my teeth on the lower left bottom. The crown came off. I went to the dentist who suggested root canal even when I did not have any problem. The root canal was completed and the crown was placed. After a few days, my teeth used to pain only on consuming hot water. I went to the dentist and she performed RCT again and now she has left it open because now I have a constant pain which is there a from two weeks. The dentist said I might be allergic to calcium hydroxide and then she said it could be an infection. I am not sure what is happening. Kindly help. Pain is unbearable. ### Response: Hi. I had gone through your question I can understand your concern. The pain may be because of post RCT infection or because of the accessory canal in the root that becomes sometimes difficult to manage. In case it in infection you need to take antibiotics and that will help you. If you had antibiotics and pain still persist, please let me know about the name of antibiotics because you may be resistant to it. You can also upload the pictures of X-ray done during root canal treatment so that I can tell you, if RCT is done properly or not. An allergic reaction does not precipitate in the form of pain only there could be certain associated complications too." "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: Yesterday onwards I could see one small swelling, seems to be a pimple like one appearing above my penis area. Could you please explain this? I do not have any pain but feeling afraid. ### Response: The pimple like small swelling you say is not painful and no other similar swelling anywhere else. Was there a history of sexual contact with an unknown woman unprotected prior to the appearance of the lesion, any swellings around your groin, the swelling, is it ulcerated? Is the color same as your normal penis colour or is it darker? Is there any pain on urination? Based on your presenting symptom, if there was a history of unprotected sex, it may be primary syphilis or penile wart because these do not come with pain. 2 g daily for 10 days, tablet Doxycycline 100 mg BD for five 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 was just playing football and got stamped on rather severely. I always get studded, but this one is much worse than the rest. The top side of my foot and a bit to the right has large swelling and pain. Is there any ligament damage? I hope not as it was only the first game of the season. Attempting full range of motion is difficult with pain. I never had the same issue previously, but have torn the ligaments in my other ankle. ### Response: I saw the photo that you have attached (attachment removed to protect patient identity). X-ray as soon as possible. Revert with the reports to a physiotherapist 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 20 years old. I have never had sex. But within a week, I had nightfall for about 5 times. Will this affect my health? ### Response: Since you are 20, you will obviously have higher testosterone levels. If you do not masturbate, your body needs a way to get the semen out and hence occurs nightfall. Nightfall is nothing but the involuntary ejaculation of the semen from the penis during sleep. It is healthy and there is nothing to worry. I will advise you masturbate may be twice a week, as it will also enhance healthier semen formation. Consult a sexologist online for further 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: I am a 40-year-old dental surgeon with no past or present health issues and I am trying to conceive. I have a regular cycle of 28 days and I have consulted a gynaecologist before who has put me on Clomid for three months. I have also taken all the required fertility tests which show normal values that are needed for conceiving. This cycle I had all the pregnancy symptoms like implantation spotting for two days, tender breasts and lower abdominal mild cramps for a week after spotting. However, I have got a negative urine and blood test, blood hCG level being 1.2 mIU/mL. On the first day of the last period, there was spotting and light bleeding was seen for three to four days. I tested for blood hCG after seven days and it showed <1.2 mIU/mL. I want to know if there is still a chance that I could be pregnant and retest myself after a few days? ### Response: Hello. As your serum beta hCG (human chorionic gonadotropin) result is also negative it definitely indicates you have not got pregnant in this cycle. The symptoms you have mentioned could also be possible because of the progesterone hormone secretion in the postovulatory phase which may mimic pregnancy and the spotting could be due to the breakthrough bleed. A possibility of delayed conception can be taken into consideration but because the serum beta hCG is negative it is ruled out. I would suggest you get your day two LH (luteinizing hormone), FSH (follicle-stimulating hormone), prolactin, TSH (thyroid-stimulating hormone) levels, fasting blood sugar and postprandial blood sugar levels, and serum AMH (anti-Mullerian hormone) levels and an HSG (hysterosalpingography) done and let me know the results. The treatment plan would be ovulation induction with a follicular study" "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: Please help. I have struggled with a chronic yeast infection for at least the past year. It never really seems to go away, and this time it is so painful. Not much discharge, but the itching and sex is very, very painful, and it hurts to pee. I am so frustrated. I take an estrogen-based birth control (had yeast infections starting before I was on this) and am mostly gluten-free. Please help me. ### Response: Hi. When yeast infection result occurs positive recurrently then, husband and wife both should be treated at the same time, otherwise, it gets infected to one another. You should wash your vaginal area with Triphala Kwatha twice a day and after" "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: The last six months I have been experiencing fast heart rates. Just by walking my heart goes 130 to 150. I have no symptoms at all, no dizziness, no shortness of breath, no tiredness. Even by sneezing my heart goes at 150. I do not even know it till I check my pulse or put my hand in my chest and I see my heart is racing. I have done three EKG and three echoes by different doctors and all were fine. In rest, my heart is in 60 to 90. I am taking 10 to 20 mg Propanolol every day. If I miss a dose my heart goes fast even during rest. I had a very sedentary life during the last year, which is changing now. But my heart rate is still the same. Is this something to worry about? ### Response: It appears you are suffering from what is known as inappropriate sinus tachycardia. Of course, we have to see the ECG during palpitations to confirm that. I would also suggest a thyroid function test to rule out thyroid disease. It is good to exercise daily as that itself can regulate the rate. Also, continue Propranolol as having constant tachycardia can cause heart pumping to become weak" "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 1 and a half years old. A few months ago we came to know that his Hb is 4.3 and Hb F is 92 percent and that he has beta thalassemia intermedia. He was immediately transfused once. Now he is taking vitamin C, and Hydroxy and Folic acid and his Hb are 10.2. Please suggest some diet for him to maintain his health. ### Response: As your child is suffering from thalassemia intermedia, you should avoid giving iron rich food and food that leads to an increase in iron absorption.The foods which decrease its absorption are, (i) cereals and (ii) dairy products. The foods which increase the absorption are, (i) fruit and vegetables rich in vitamin C, (ii) meat, fish, shellfish and poultry and (iii) pickles, sauerkraut, soy sauce, vinegar, and alcohol. You can also supplement the child with folic acid 1 mg a day. Give nutritious diet and vegetarian protein sources, avoid meat and liver. Have a regular follow-up with your pediatrician for Hb level and iron overload." "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 want straight teeth. I do not want braces or accelerated orthodontics or veneers. And I do not want a retainer. Is there any hope? ### Response: The various methods to obtain properly aligned teeth include braces, accelerated orthodontics, veneers, retainers and few others. The suitable method for you can be decided by knowing your age, teeth alignment, gum and jaw bone condition, any parafunctional habits like mouth breathing, lip or nail-biting etc., and your general health. In case you are more than 50 years old and have loose teeth, your malaligned teeth can be extracted and replaced with artificial teeth. Kindly provide a detailed history of yours and attach pictures for further follow up with 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: Can rabies transmission occur from cats to humans? If the suspected cat is alive for more than 10 days, is there any chance of infection? ### Response: Yes, rabies could be transmitted from cats to humans. The maximum incubation period for this infection is 10 days. So, till that the animal should be observed. If you can describe your wound and its depth, the treatment can be decided." "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 this insane swishing noise every time I move my head or eyes. I feel like I am going to pass out. Even opening some doors does it, if they create pressure from pulling. ### Response: Hello. Since the movement is worsening the symptoms, it must be an inner ear problem. There could be additionally middle ear block or eustachian tube block as the pressure change worsening it. However, since you have not mentioned the duration, I am mentioning all possible differentials. Recurrent vertigo lasting under one minute is usually benign paroxysmal positional vertigo. A single episode of vertigo lasting several minutes to hours may be due to migraine or transient ischemia of the labyrinth or brainstem. The recurrent episodes of vertigo associated with Meniere\s disease or recurrent vestibulopathy also typically last hours, but can be briefer. Further evaluation need local examination by an ENT surgeon. I suggest you Betahistine 8 mg three times a day for symptom relief. Consult your specialist doctor, discuss with him or her and take the medicine with consent. It may cause gastritis." "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 used to be an obedient girl since my childhood as I am the youngest in my family with two elder brothers, which I am till now and I think I should not be so obedient to elders as from childhood I have faced every kind of abuse.I have been into three relationships out of which two relationships ended because of my family and one I ended it myself because he abused me and I could not take. My family tries to support me, scolds me in my failure, and happy when I progress but no one asks me what I have been through so many years.I am currently single, 22. After facing this cruel world for so many years, I have lost faith in people. I have been through many bad things. I had a social life, kind of have it now. But I never feel that connection with someone unless he is my boyfriend.But after having three bad relationships, I do not want to hurt myself more. When I am with my friends, I am the one who is most cheerful. But I want my alone time after some time to get back my energy.I am a private person, I am ambivert in my terms. Also, I never make or want to make new friends. If they approach, I do not have any problems. I guess I have some psychological problem.Also, I have anxiety issues and I have periodical depression. Also, I am always confused about everything, be it my career or anything.I guess I should not be confused because I have always been appreciated for my work everywhere.Recently, I was promoted in my probation period, but still, I feel I do not have confidence. I think that my past ugly experiences pull me back. I wanted to know what is the remedy. ### Response: You seem to have mild depression and mood swings. You need relationship counseling and career counseling to get out of your confusions. Past failures are only a lesson. Learn the lesson and move on. Past failures do not predict your future. Be it your past career opportunities or past relationships. Look for friends, socialize, find a good conjugal relationship. That is our little world. So keep exploring and look positively into the future" "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 9 months old baby had convulsions. We feel that he has crossed eyes, neck moving issues and feeling partial seizures during sleeping alone. I also have a doubt whether there is any brain development problem. Currently, he is on Keppra 100 mg/mL, 1 mL in 12 hours and so to be given twice a day. We had a CT scan and an MRI of the brain. ### Response: Hello. I am very sorry to hear about this condition. However, I would like to know some details to help you better. HIE - hypoxic ischemic encephalopathy (brain damage due to less oxygen). EEG brain. 1. Encephalopathy.2. Meningitis. 1. Continue Keppra as advised.2. Keep Midazolam spray with the child to control any active convulsion that may occur. Revert back with the reports and detailed history to a paediatrician 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 hip pain in the lower back region. It is behind the buttock bone on the left side. As I twist my upper body towards the right side or just bend down front and move little to the right side there is pain. I am suffering from it for almost five months and still, the pain is there. I have been placing ice packs and was doing lower back exercises regularly three times a day and I still have no effect. I have not met with any kind of accident or lift any heavyweights. ### Response: Hello. I can understand your concern. In my opinion, your SI (sacroiliac joint) joint would have got into a bit of dysfunction as it normally happens from faulty posture. In addition to the ice packs, I want you to do cobra raise exercise with left leg bent at the knee and foot kept under opposite thigh like a figure of four position at least 20 times once in two hours if possible. Do lots of stretching for your piriformis and gluteus muscles. Gently massage the butt muscles. It will give you relief. Avoid any faulty posture especially sitting in a slouched position for a long time. Hope this is helpful for 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: When I create suction in the back of my throat as if to pull the snot into my mouth, essentially to clear it and hock a loogie. I feel like the back top of my throat is being sucked down. Like a flap of skin or a little bullfrog action then it goes back when I stop. Not painful but uncomfortable and disconcerting. Started today but had a little sore throat for about a week. ### Response: Hi. Can you please send me a picture of your throat and oral cavity? It can be due to throat infection which will cause edema of throat and uvula and you will feel as if something is stuck in your throat. Also, let me know if phlegm trickles down from nasopharynx to throat or if you have headache (to rule out sinusitis)" "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: From the last few months, I am having pain in both the soles. It gets worse when I walk or stand for a long time. Also, it gets worse when I sleep. I suspect it is plantar fasciitis. What remedy do you suggest? ### Response: This is a condition in which the fascia or the tissue at the heel is inflamed, and pain is there especially in the morning after getting up from sleep. You need to do the following exercise: Doing all these things will help reduce this pain" "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 tinea cruris, itching near scrotum, for a very long time and left untreated. Now, I am losing my hairs from the left side of the scrotal area. I went to a doctor and he gave me a cream and a medicine for 10 days. After 10 days, I got relief and also hairs are growing back. Over two days, I had noticed some redness in the scrotum. It may be due to sweating in summer as I go to the gym. But, I am a little worried because when I checked online, I came to know it is one of the symptoms of STD. Please clear my doubt. ### Response: Hi. Tinea cruris is a fungal infection of the groin. It is possible that you may have got a recurrence of the same. It would be of great help if you could tell me the medicine and cream that you have used and after how many days of stopping the medicine did the problem recur. Till then, you may apply Abzorb (Clotrimazole dusting powder) on the area of concern. STDs (sexually transmitted diseases) do not remain silent for so long and additionally, you generally will have pus-filled lesions or discharge with STD. Revert back with the name of the medicine 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 am a 74 year old male in excellent health, and I am not on any medications. Recently, I had a strange chest sensation. It felt like my heart stopped or skipped, and I felt lightheaded like I might pass out. I had an EKG, echocardiogram, and a Holter test done. The EKG results were normal. In the echocardiogram, I was given a reading of 77 % and was told that my heart was in a very good condition. Holter tests showed supraventricular tachycardia but not extreme. I have only seen the physician assistant as the cardiologist is too busy. I would like to send my Holter test reports to you and get an opinion. I have cut back on caffeine and alcohol, which are the only measures I have taken so far. ### Response: Hello. I understand you are a little worried about your heart and have been on the Holter monitor for a while. I appreciate that you have uploaded the reports in full for my consideration (attachment removed to protect patient identity). 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 been taking Vitamin B medication for over one year and my Vitamin B12 level is very high, greater than 2000. What should I do to reduce the level? I am 27 years female. Please advise. ### Response: Hi. Vitamin B12 is a water-soluble vitamin. It means any excess of Vitamin B12 in the body shall be flushed out in urine. So just stop taking further vitamin supplements and the B12 level shall normalize. You can repeat the test after one month." "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: Hi Dr. I was operated for Nasal polyps surgery 3 years back. From last one month or so, It seems that some mucus is always stuck in my throat and I have to clear it every now and then. This gets worse while lying on bed. I showed it to my ENT specialist and he mentioned that it is GERD and prescribed some antacid tab that did not work. I have no other symptom and I always feel some kind of phelgm in my throat that hardly comes out or go inside while swallowing. This is very irritating. Please prescribe some medicine / any lifestyle changes to get rid of this. ### Response: " "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 35 years old, and suffering with multiple health problems like hypertension, high tgl, sinusitis, sleep apnea with insomnia (a big problem), hemorrhoids, hydrocele, migraine, gastric ulcers, weakness during daytime, severe eye pain, difficulties in urine like feeling not easy, frequent urination, yellow coloured urine since three months, and now I want to go for infertility treatment, will it work? ### Response: Yes, infertility treatment can work in your case. The all mentioned condition is treatable, and they have no direct correlation with infertility treatment. For gastric ulcer, antacid can be prescribed like Rabeprazole. For hemorrhoids, if medical management like stool softener failed, then surgical management can be done. For hypertension, if no secondary cause found than antihypertensive medication can be prescribed. For migraine, Rizatriptan or Ibuprofen can be specified during an acute attack. I hope this will help 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: Recently, I have done some cardiac tests like ECG, 2D echo, TMT and serum electrolytes at my regular consultant. Four months ago, I got blood pressure 140/100. So, my regular consultant suggested I use Telvas CT 40 tablet (only half tablet at morning) daily. Recently, I got gastric problem. So, I went to my regular consultant and he suggested I use Pantop IT 40 mg and I went after 10 days for review and I have done the cardiac tests as mentioned earlier.My actual problem is when the ECG was done, the diagnosis report mentioned flattened T wave (I, V4, V6). Previously, I have done ECG last year but the diagnosis shows normal ECG. Now, it changed. Because of this, my doctor suggested me to do other tests like 2D echo, serum electrolytes, and TMT. Finally, he told me that all the reports are normal. There is nothing to worry but still, I am worried about my reports. Can you please check the reports and suggest me? I smoke one cigarette every day and drink 180 ml of brandy every week. ### Response: Yes, there are changes in the ECG (attachment removed to protect patient identity). But, your evaluation is normal including echo and treadmill test. Now, the changes in the ECG are likely due to high BP and not any blockages. I guess you do not have any symptoms like chest pain or chest heaviness on exertion or during the treadmill test. So I do not think there is anything to worry about now. Is your blood pressure well controlled? You have to check your BP frequently, thrice a day at least for a week so as to know the pattern of BP. Have a low salt diet. It is important that gradually you quit smoking because smoking is much harmful than alcohol and alcohol occasionally is acceptable but not smoking. Hope this helps you and get back if you have any doubts" "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 examine the reports attached below? I had a high fever for two days in the last week. Then it again came back a day before yesterday. It was a high fever. ### Response: Hello. I have gone through your reports (attachment removed to protect patient identity). In the first one, malaria is negative. And the second one shows low WBC (white blood cells) and borderline hemoglobin, and platelets. This is suggestive of viral infection and another possibility is of typhoid infection. Since your cells are low, it is very important that you get yourself examined by a local doctor in person for any other abnormalities. In my opinion, you will also need some more tests, like dengue NS1Ag (antigen) and dengue IgM, typhi dot IgM, to find the cause for it. Get liver and renal function test done as well. Also, repeat complete hemogram day after tomorrow. You should only have tablet Paracetamol 500 mg up to three to four times a day for fever, avoid other painkillers, have rest and avoid the possibility of injury, avoid outside, unhygienic or even raw foods till your count recovers. And you should visit a nearby doctor once." "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 query is related to the necessity of rabies vaccine for me. I am a 27 year old healthy male. I am a student, staying in the large campus of my institute. This campus is filled with stray dogs and many other types of animals. People caressing those dogs is a very common scene here. One week ago, while I was walking, a dog ran in front of me. That time, its back leg touched my feet. I inspected that part well, but no visible break in the skin was observed. Should I approach a doctor for any treatment? As the disease is quite frightening, I request you to consider the minute risk too. ### Response: I understand your apprehension. As it is already one week since you had the dog touch your feet and there was no bleed or break of skin as such. No vaccination is required now. You should have thoroughly cleaned the region immediately after the dog had touched your leg. I would like to know if you have any idea about the present status of the dog? As a watch of the dog for 10 days post-bite would be ideal. Also, precautionary vaccination is not usually advised. Only, a post-exposure vaccine is advised in rabies. If anyone has a bite or break of the skin or if there is lick by a dog on a broken/cut skin or if there is any bleed from the site of bite then vaccine is recommended. For a lick or fondling on an intact skin, only cleaning and washing the wound in running tap water is sufficient." "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 and I had sex this weekend. It was unprotected and I ejaculated inside. We had sex during her safe days. She is expecting her periods in a day or two. Can there be any chance of delay in her periods? Can she consume a contraceptive pill within 72 hours and avoid pregnancy? I have asked her to consume the pill tomorrow (60 hours after sex) in case she misses her periods. Please advise. ### Response: If she is getting regular 30 days period cycle and you had intercourse after the 20th day of her period then there are no chances of pregnancy. Also, no need to take any contraceptive pill as her periods are due in two to three days. The period can delay because of stress and tension." "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 tight foreskin, and during sexual intercourse, I have issues with the ring constricting below my head. I also found out that I have a skin bridge between my foreskin and head. Due to this reason, I cannot fully enjoy sexual activity, and I cannot ejaculate inside my wife. I have tried masturbating and ejaculating inside, but having done that for several months, we are still not getting pregnant. I consulted a urologist, and he said that I should get a circumcision. Does having a tight foreskin and skin bridging affect the ability to have kids? ### Response: Hello. Your problems are not due to the skin bridge. Everybody has it. But the tight foreskin makes the intercourse a bit difficult and sometimes even painful. You are prone to get abrasions while having intercourse. You will be benefitted by the circumcision surgery. It is a safe procedure. If you do not want to undergo surgery, you can go to any infertility clinic and get an Intrauterine Insemination of your semen into your wife\s uterus and make her pregnant." "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 some health issues that I would like to address. I have depression, fatigue, low energy, tiredness, and red eyes when I wake up, and I feel exhausted after masturbation. I have a history of masturbating for eight to nine years since I was 12 years old. The first few years, I was continually masturbating with lots of pornography. I am now masturbating one to two times a week yet still feel exhausted and fatigued daily and even watch porn one to two times a week. I have trouble with morning wood maybe once a week. What can Homeopathy offer me to heal from masturbation and get back to being healthy? ### Response: Hello. I understand that you are concerned about various health issues, and it seems most of the symptoms are related to over masturbation. Masturbation at the teenage is prevalent. Homeopathy has a vast number of remedies to heal this issue. However remember that masturbation was is not bad, but overuse is something that causes health issues, twice or thrice a week is not bad.Homeopathic remedies will help you to deal with this habit, and you would be able to concentrate more on other things in life like a career or job, etc. Homeopathic remedies are prescribed after taking your mental, emotional and physical health in to the consideration. Based on the little information you provided here you can start Lycopodium 30c four pills once a day for five days. Then begin with Kali Phos 6x two tablets twice a day for 15 days.These pills and tablets usually dissolve as soon as you keep them over the tongue. Hence there is no need to swallow these with water or anything liquid. Kindly report back on15 days. I hope you start feeling better. Let me know if you have any questions. I would be happy to answer." "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 several months ago with bladder stones. Tests on stones indicated uric acid content also. I have been on Flomax, then one week ago started Avodart. Most days, I drink lots of water and sometimes coconut water. I pass stones every two or three weeks - different sizes. Within past 12 hours, I am experiencing lots of pain typical of when I am to pass a stone. However, the stone has not passed. Also, noticing blood in urine for the first time. I have passed urine about four times within the hour. I am aware that this is part of the symptoms but want to know if I should see a doctor immediately. Any other advice appreciated. ### Response: I hope the bladder stones you mentioned you had earlier had passed. Blood in urine after renal colic suggests stone may have reached the lower end of kidney tube (ureter) and may pass soon. However, it is best to confirm it has passed by getting an ultrasound done. Flomax (Tamsulosin) helps dilate lower end of the ureter and so may help stone to pass. You may take painkiller or antispasmodic for pain. Increased fluid intake helps. If the stone is of pure uric acid, taking citrus juices or taking potassium citrate syrup may dissolve the stone. I suggest, if bleeding continues, or there is pain or fever, or you have difficulty emptying your bladder, go see your doctor. Later, a metabolic workup of your 24-hour urine collection may be needed to see why you form so many stones" "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 very blurred vision due to high eye grade and astigmatism. My left eye is 225, and the right eye is 675. I am planning to get a pair of contact lenses, but the special lenses are a bit pricey. Will it damage my eyesight if I am going to choose regular contact lenses? ### Response: In general, contact lenses are only meant for occasional use and cannot be used every day. In case you meant the special lenses have higher oxygen permeability and help your cornea stay healthy, please go ahead with those. The best option to remain permanently free from glasses is refractive surgery. If your power has been stable for around a year, I will recommend that you see your ophthalmologist for SMILE (small incision lenticule extraction) or PRK (photorefractive keratectomy) than using contact lenses for a long term. In case you need further information, please let me know." "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 27 year old son inhaled a fly. He is in good health with no respiratory distress. Will it get trapped in the cilia of the bronchial tree and end up causing illness? ### Response: You have mentioned that he has no associated respiratory distress after inhaling the fly. Nothing major can happen since his breathing is fine. It is very unlikely that the fly may go into airway as there is a protective mechanism at the throat level. Hence, the fly may go into his stomach and will be digested there. So, there is no need to worry." "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 had accidentally swallowed tooth crown an hour ago, she is not facing any problem till now, what should she do, kindly advise. ### Response: I understand your concern but I think as so much time has already passed and by God\s grace everything is fine then I think it has not gone into the airway, problem erupts only when it gets stuck in the airway, it might have gone down through the digestive tract and shall pass out normally through faeces. The biggest question is whether it went inside along with breath or food? That will surely subside the confusion and the one who swallowed most probably can feel this. I would surely want to know which number tooth it belonged to in order to know whether it was bigger or smaller in size. Anyway, an X-ray is always advisable for safety if your area is now open for the same. Be careful and look for the engulfed crown in your passed out fecal matter that will also relax you if you find it sooner. It mostly passes out in 24-48 hours. You can have banana so as to help it pass digestive tract smoothly." "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 induced my period last month due to its delay after confirming no pregnancy. This month as well period us delay by a week, but urine pregnancy says negative, should i induce periods every month?? Iam trying to get pregnant, after taking treatment for hypothyroid ### Response: If HSG is normal and you have irregular periods. Than have to try different dose of medicines to induce ovulation and do ovulation study. And if required than injection for healing ovulation. Intercourses after ovulation for 5 days. And endometrium support hormonal medicines. And if no pregnancy than periods will come. But this treatment you have to go to gynaecologist and ultrasound sonographis for ovulation study in the middle of the cycle. Wait for one or two months due to current pandemic. Than consult nearby gynaecologist for further investigation and treatment." "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 wearing the same eyeglasses prescription for a few years now. I recently had another eye exam, and not much has changed. However, every time I put my current glasses on I starts feeling dizzy. My vision does not seem quite right, and it is giving me headaches. They did adjust my glasses as they thought they were off a bit. That has not seemed to help so curiously what your thoughts might be on this. ### Response: Hello. Eye strain after a change of glasses might be due to over or under correction of glasses or improper spectacle frame and centration. So you need to recheck your refraction and lenses whether they are dispensed according to your prescription. If you are having trouble in near-vision or near work, then it might be due to presbyopia. Presbyopia usually starts at 40, but some people might have problems after 35. Other symptoms like headache, neck tightness, and shoulder pain might be due to other causes like glaucoma. So you need a complete eye exam and intraocular pressure IOP check along with the retinal exam. Your doctor might suggest a few investigations if required. You are most welcome for any queries." "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: Please help me in understanding a few things. I had one sexual incidence with an unknown HIV status lady. Although it was protected, I do not know the status of the condom after sex. Then, I had 2 CMIA tests. First test by 24.5 weeks and the second test by 25.5 weeks. Both were having the index of 0.14 and 0.08 with nonreactivity. I am attaching the reports for the reference.Are my reports conclusively negative? Do I need any further test? Is CMIA equally good as 4th generation ELISA? In my case whether it was tested for both Antibodies and P24 Antigen or not? What is the false negative chance using CMIA? Is CMIA better than Rapid kit test? ### Response: CMIA tests done at 24.5 and 25.5 weeks are nonreactive. It implies that you are not infected. CMIA TEST is only 4th generation tests, and Elisa tests are 3rd generation. The only test which is better than CMIA duo is RNA PCR TEST, and however, it is not required in your case. CMIA detects both p24 and antibodies. It is to find out infection at earliest possible days like say three weeks after exposure. And, this test is conclusive after 12 weeks so as in your case. It is 99.9% accurate and false negative chances are low, and after 12 weeks those are negligible. CMIA is definitely better than rapid tests." "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 30-year-old female. I had diabetes during pregnancy, and it continues after childbirth. Now I am a diabetic patient for past three years. My average sugar levels are ranging from 100-245 mg/dl. My sugar levels are not stable at all, and I had consulted my first doctor, and the prescription was Metformin 850 mg and Amaryl 1 mg. The results after taking these medications are not stable.Therefore, I consulted my second doctor and he prescribed me insulin. However, I am confused whether I should keep taking medication or insulin. Kindly advise. ### Response: Hello. I just read your query, and from what you have mentioned it appears that you have diabetes. Your blood sugar is not that uncontrolled that you have to take insulin. You can do one thing, do HbA1c test and then get back to me so that I can put you on better treatment. Hope you find my advice beneficial." "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 80 years old. Height 5"", weight 40 Kg. No history of sugar or BP. The respiratory system is normal. Diet is normal, two or three chapatis. She is suffering from cramp in legs and hands for the last one year. She is advised for Methylcobalamin 1500 OD with Becozinc multivitamin for the last six months. There is a relief of about 20 % by this treatment. Will you please advice any other medicine? ### Response: I read about your mother\s complaint. I would advise you to have a basic blood investigation to look for serum potassium level. If potassium is low, she will need extra potassium in her diet like tender coconut water and other dietary supplementation. You will also require a complete physical examination. She has been taking Vitamin B12 which is fine in case of neuropathic pain but here she might be beneficial if she takes some muscle relaxants like Myoril 8 mg twice daily for three 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: What is accure laser? I have done cosmelan, but my skin looks dehydrated and dull. Will accure laser help? My skin was fair and now it seems dull and little reddish. Please help. ### Response: Hi. Accure is a diode laser used mainly for inflammatory acne and rejuvenation of skin. It will reduce sebum production to decrease acne. Cosmelan is a peel used for pigmentation over the face. I also suggest Epithelial AH cream (Sodium hyaluronate). Consult your specialist doctor, discuss with him or her and take the medicine with consent. Do you have active acne or pigmentation?" "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 fell off a roof. After ER visit w/ct scans and X-rays I received 7 staples in my head and was discharged. Prescribed Cephalexin and Percocet I went home for recovery. Two days ago while coughing I felt an excruciating pain what seemed to be under and behind my lowest rib on my right side. This pain continued only when I strain myself such as with a cough or sneeze, etc. Since beginning this pain has gotten more intense with each involuntary strain. ### Response: Have you undergone any chest X-ray? While coughing is there any sputum? Have you feeling any pain in the abdomen? Is there any blood in urine? Did you land on head or abdomen during fall? If possible, answer above questions please." "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 developed a very bad face allergy, possibly caused by my new perfume. It itches very badly. It has created swollen patches on my chin, jaw, and cheeks. Please help. ### Response: Hi. Stop using all the creams or cosmetics for the time being. I suggest you try doing the following: Consult your specialist doctor, discuss with him or her and start taking the medicines after 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: Last night I started experiencing some tightness in my upper left chest area, just below my armpit. This extended up my left side through my throat, cheek and up to the top of my head. This was persistent throughout the night. This morning I woke up and it was a little better but my face and throat area feel numb and the inside of my cheek and tongue feel swollen. This tightness is starting up again today though not as bad as last night and it is mostly in my throat. I also have tinnitus and when this tightness comes my tinnitus gets much worse. My left arm also goes numb and cold from time to time, particularly my pinkie and ring fingers.I have had a history of neck pain and I have had pain in my upper left chest and back area and my left arm numbness has been around for many years. It started after a weightlifting injury. I am wondering what this might be and if I should go to the hospital. ### Response: This is most likely due to cervical pain, due to compression of nerves between spine. You should get X-ray cervical spine AP (anteroposterior or lateral view) and further may need MRI. You need to visit physiotherapist after X-ray and also an orthopedician. Till the time he can have tablet Neurobion Forte (Riboflavin, Pyridoxine, etc.) once a day which is a nerve vitamin. If this is not helpful, then you need to have tablet Pregabalin 75 mg bedtime, which is a nerve stabilizer. However, it is better to visit a hospital and get EKG done in order to rule out cardiac cause although appears to be less likely. You can also upload EKG here if you can get it done somewhere" "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 was young I tripped and chipped my tooth. It was when I was 20 years old that I got braces and the dentist told me I had to get a root canal for that specific tooth. She said that the tooth was dead already. I thought it was just a chipped tooth because it looked normal and did not show any discoloration at all. Then after the root canal that tooth starts turning gray. Now that I had gotten out of my braces it really got me worried that the discolored tooth is really obvious. It also got me thinking that I should not have done a root canal cause before it looks normal but now it is really gray. Can this dentist be wrong about my tooth? ### Response: When you banged your tooth and part of it chipped away, the pulp or the core of nerves and blood vessels that provide nourishment to the tooth probably died. It is not possible to judge this now but your dentist must have done the required tests to come up with this diagnosis. The discoloration that you noticed following root canal treatment could be due to decomposition of pulp remnants left inside the tooth following treatment. The problem can be solved in different ways. You may try first internal bleaching which is a form of tooth whitening directed at the inner part of the tooth. If this fails you can think of a veneer or even an aesthetic (tooth-colored) crown to mask the discoloration of your tooth." "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 21 year old male. This is the fourth time I am changing my spectacles. But this time, the spectacles are hurting my ears and my right eye. And I also have a headache. What do I do? ### Response: From the history, it seems that you are having a refractive error with frequent change of spectacles. The probable cause for your headache is the change in the refractive error. I advise you to undergo refraction testing and change your spectacles according to the refractive power required." "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 sister is suffering from skin rashes. It comes and goes. Whenever she goes out in sunlight, the parts of the skin exposed to the sun are turning red and start itching. It disappears after a couple of hours. When we did blood test, IgE level is 220 IU/mL. ### Response: Hi. Your sister might be suffering from photoallergic dermatitis. Please send the photographs of the lesion for confirmation of diagnosis and treatment. Serum IgE is a little bit raised and again indicates an allergic response to sunlight." "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 16-year-old male. I want to gain weight. Please suggest. ### Response: You can take four to five soaked almonds daily in the early morning and take a banana shake in the midmorning. Try to include a whole milk curd in your lunch. Do regular exercise to build your muscle." "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 26. I had dry cough from the 10th of last month and it did not go away completely. I was a smoker until the 2nd of last month and then gave up. I smoked for five years. Within the last few weeks, I must have smoked 10 cigarettes. My issue is whenever the temperature is cold, I cough and when it is sunny, I would not. I do not cough too much. It is once or twice in the morning and whole day nothing. Clear mucus and no medicine is required. I just drink hot water and everything becomes fine. Can you tell me what the problem is? I have no chest pain or throat discomfort. No weight loss. Whenever my stomach is gassy, I cough. Please help. I have smoked for five years. What is my cancer chance? ### Response: Hello. As you said that you have been smoking for five years and now have cough with clear mucus expectoration, it is most likely due to bronchitis. It is very common to have cough if you smoke more than five cigarettes per day. Also, because of cold weather, it gets aggravated and takes longer to heal. So, better is to stop smoking as you did rightly and take a good expectorant like syrup TusQ-X 10 ml (combination of Ambroxol, Guaifenesin, and Terbutaline) three times a day. Continue with salt water gargles and steam. It will help to loosen and liquefy the cough. If there is no relief even after seven days, better get your chest X-ray done from your family doctor and get treated accordingly. Usually smoking for five years at this age does not cause lung cancer but you should stop smoking. Smokers\ cough because of bronchitis is very common." "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 want to buy some equipment or medial device to prevent snoring during sleep. It should be safe and be able to buy online, preferably FDA approved. ### Response: Sleep apnea is a sleep disorder in which pauses occur in breathing during sleep. Symptoms usually occur due to obstruction of the airway.For the treatment of snoring, we have to treat the sleep apnea first. Few such devices which I would suggest are: Before purchasing them, do consult a sleep medicine specialist in person for clinical 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: My son is 9 months old and has swallowed balloon. Post that he had food. He had no breathing problem. Now he is sleeping. What should I do now? ### Response: Hello. Please give the child laxative food like banana, rice, etc., to help the child pass stool. Usually, the balloon should come out from stools in 24 hours if it has gone into the stomach. It is less likely that it may have gone into the wind pipe because there is no breathing problem. Please watch for any signs of breathlessness, vomiting episodes, abdominal distension till the balloon does not come out in the stools." "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: Almost everytime I suddenly get up from sitting or laying, I feel very dizzy for about five to 10 seconds. I am better the longer I stand, it is just initially I am dizzy. I recently had a CBC, blood glucose, thyroid, and kidney function test that came back normal and during my physical exam, my doctor said I seem perfectly healthy. What could be the cause of this? It is like orthostatic hypotension but why would I have it? ### Response: It is very common to feel this way when one suddenly changes his/her position from lying down to standing very abruptly. One should not abruptly stand up from lying position. It happens due to the sudden flow down extremities from above. So, due to a sudden change in circulation, it can lead to that. It is advised that you always get up slowly to avoid further similar episodes. I hope you find this helpful" "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 total sperm count of 38.4. I am addicted to alcohol, and I took a drink four days ago. I am trying for a baby for two months. I have a history of seizure. I am taking Levera 500 mg, Oxetol 450 mg and Cloba 20 mg. Could I take Folic acid? Can you check my report and help me out? ### Response: I have seen the reports (attachment removed to protect patient identity), and it is evident that your sperm count is low along with high abnormal forms as well. This is called oligoasthenozoospermia. You have to avoid alcohol completely if you wish to increase your sperm count levels and have to be on antioxidant supplementation with Carnitine, Lycopene and Ubidecarenone (Coenzyme Q10) to increase your sperm counts in the next two to three months. You should not stop your seizure medications at all. I suggest the following for improving your sperm count. Consult your doctor, discuss with him or her and take treatment with consent. Review semen analysis after a month. Avoid alcohol and smoking completely if you wish to conceive as a couple." "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 diagnosis important? I have been diagnosed by many therapists and each one has had a different diagnosis. One doctor says it might be BPD and other says it might be a bipolar disorder or Asperger syndrome or cyclothymia. Why is it so? I am starting to feel like I am wasting my time trying to get diagnosed correctly. ### Response: BPD and bipolar disorder have similar symptoms. Cyclothymia is its minor form. Persons with BPD are said to be on the borderline between neurosis and psychosis, persons with bipolar disorder experience episodes of extreme mood swings ranging from depression to mania. PTSD is posttraumatic stress disorder. Depression like features after significant trauma. As you mentioned, your problem and medication (attachment removed to protect patient identity) along with your history seems that you are having severe depression with psychotic symptoms or bipolar disorder. Tell me your problem in detail, so I would be able to provide you a definite diagnosis." "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: Kindly explain my nuchal translucency scan and double marker blood test reports in details. I am very worried due to in NT scan nasal bone could not be discretely seen. Gestational Age (as per USG) is 12 weeks and three days. All report attached here for your guidance and suggestions. Kindly help. ### Response: I do not see any problem in your reports (attachment removed to protect patient identity). Your blood reports and scan are within normal limits. 1. Your age first diagnoses this, usually, as you cross 35 years the risk increases. For your age of 25 years, the risk is, very low. It has been mentioned in your report too. 2. The Nuchal translucency is the skin thickness of the baby\s neck. In babies with Down syn" "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 healthy person. I have a cough with white sputum production. I do not have a fever. I have done sputum culture. The result showed a presence of Pseudomonas. Do I need an antibiotic? ### Response: Hi. If there is a presence of Pseudomonas, then there can be an infection. Since you have a productive cough, you may need to take antibiotics. Please repeat the sputum culture if possible. Also, get a chest X-ray and full blood count done. It could help you to identify the infection." "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 epididymis in the right scrotum. Two months ago it was cured by taking Linezolid and Doxycycline B. Now my right scrotum is paining and swollen. I have a fever also at night. In a week, my lower back pain is increased. I am not able to stand and walk without pain. Report is attached. Kindly guide me. ### Response: Hi. By the description provided by you, it appears you have developed right epididymorchitis this time. As there is fever along with pain and swelling in the right scrotum, you need intravenous antibiotics and need admission as an in-patient in the hospital. Outpatient treatment will not be sufficient as chances of sepsis are very high. Hence, I sincerely advise you to get admitted under a qualified urologist and get treated rather than treatment as outpatient. Wish you a speedy recovery." "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: Prostate biopsy was prompted by rising PSA over several years (20%-25% per year) reaching over 4 this past year (spiked at 7.3 which I think really is why they wanted the biopsy but I expect it to come down since then). 12 core came back benign, but I do not understand the implications for some of the additional descriptive language and why I need continued six months follow-up.DRE had nodules and TRUS shows calcification and volume of 27cc. Path description says reactive and atrophic acini and focally reactive. Does that mean BPH or prostatitis, or is that a precursor to PCa? I have no symptoms of BPH or prostatitis, other than getting up between 3 AM and 4 AM every morning. I think it is just an age factor. I am not interested in the DREs and TRUS procedures if it is not going to tell anything new, and I can have bloodwork done without the time and expense of a doctor\s visit. ### Response: I have studied your reports and consulted with my pathologist. (attachment removed to protect patient identity). As per her advice and mine too, your reports are normal, the biopsy changes are age related. In the biopsy no carcinoma is identified. And results are negative for cancer and BPH (benign prostatic hyperplasia). Biopsy was done because in benign prostatic hypertrophy and prostate cancer calcification occurs in 10% of cases. And your biopsy is normal. Biopsy is the choice of diagnosis. And your biopsy is normal. Your doctor has asked for the followup to see the changes in prostate calcification. Yes, TRUS and" "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 crown has become loose as there is decay inside the crown and around half the edge but not visible. I was told that tooth is stable underneath. I saw one endodontist who said to rule out implant and he would do root canal but bone and gum are less than ideal and 50-50 chances are there that it will work. He also did not clear all the decay, did not take the crown off but drills straight through. (A wobbly decayed tooth underneath crown?), did not do the post or crown. There is a long standing chronic abcess at root for years. Current root canal was done 7 years ago. I do not have any other molars left in lower. I am in shocked, sad, anxious and 60 years old.I feel tempted to go to an unknown dentist just to see if he could do a hemisection as the Endodontist I talk to ""no longer do them as implants are available and hemis tend not to last long"". Does anyone reading this please see any hope for this tooth? I chew on it and have no sensitivity and no pain; no symptoms at all. There is gum recession I have complained to dentist about for the last couple of years. I am concerned I will regret not trying to save this tooth if at all possible. Also told to see prosthodontist to ensure a crown could be made if I get the retreatment. I have two tracks I am pursuing. I will see an oral surgeon tomorrow to rule out implant and then see prosthodontist. I am attaching X-rays. Concerned in this decision making process about any further damage being done to gum and or bone. Impeccable hygiene history. ### Response: Hello. Seeing the recent X-rays (attachment removed to protect patient identity) it is obvious that the distal root has abscess and should be removed. Hemisection might be a good idea but it alone cannot withstand the biting force and if you can afford, then go for a molar implant behind this tooth so that you will get one extra molar to chew on. A hemisection to retain the mesial root of this tooth along with another implant behind it will give adequate tooth structure to have a normal biting force. If you cannot afford both then go for extraction of this abscessed tooth and an implant as hemisection alone is not strong unless it has more support behind 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 four month old baby weighs 7 kg. He has a 100-degree fever since today noon. I had given 4 ml of 125 g Paracetamol syrup. But the temperature is still at 100. ### Response: In the follow-up query, please tell me more about his feeding, activities, vomiting and if his urine and stools are normal" "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 56 year old male. I am on BP medicine Cresar 40 since a month. Prior to that, I was on Aten 50. Now, my BP is around 130/100 mmHg and before it was 160/106 mmHg. When I take my walk or I am standing I feel giddy, probably for less than a second. It is more prevalent when I turn my head or look up suddenly. What can be the cause? ### Response: Hi. This is called postural hypotension. It is very common in hypertensive patients. Consult your specialist doctor, discuss with him or her and take the medicine with 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: My wife underwent double marker test. Results are as follows. Please tell me if there is any risk factor regarding the pregnancy. Her age is 31 years. PAPP-A : 0.35 MoM, fb-hCG 2.14 MoM, age risk 1:743, biochemical T21 risk 1:54, combined trisomy 21 risk 1:226, trisomy 13/18 + NT. ### Response: To confirm it, there is a test called chorionic villus sampling where the sample of the placenta is taken and chromosomal analysis is done to rule out trisomy 21, 18, and 13, that is abnormal chromosome. But there is another blood test which is done at 16 to 18 weeks of pregnancy plus level 2 ultrasound scan to rule out any stigma of trisomy 13, 18, and 21. To confirm at this stage of pregnancy, amniocentesis is done for chromosomal analysis. If AA tests are suggesting trisomy then I suggest you go for termination of pregnancy" "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 eight years old. From birth to till now, my son is taking Penicillin for the ear and throat infections. He cannot breathe through the nose. He uses mouth for breathing for years. What can I do now? Please suggest. ### Response: Hi. You son is suffering from upper airway obstruction. It causes him to breathe through the mouth. It could be a result of allergies or inflammation of adenoids behind the nose. It can be cured by steroid sprays. It is just a part of the treatment. If there is some other form of inflammation of adenoids, then he needs removal of adenoids. If your son becomes unresponsive at any stage, then he needs surgery. Mouth breathing can also lead to a complex problem such as adenoid facies." "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 27-year-old female. I had a history of on and off acid reflux for a few years. Last month, I had a bad episode of GERD and was prescribed Pantoprazole for a month. It got better and I stopped taking Pantoprazole, but I still have epigastric pain on and off. I had an upper endoscopy last week where the findings were all normal except for erythema atrophy of antrum. No more obvious acid reflux signs though. But epigastric pain still comes and goes. I was prescribed Hyoscyamine, but not sure why. What does erythema atrophy of antrum mean and why do you think I was prescribed Hyoscyamine? I have not had biopsy results from endoscopy yet, but I am hoping and praying for the best. ### Response: Hello. Your symptoms likely from your stomach. Atrophy and erythema mean there is inflammation, might be from a bacterial infection (helicobacter), which we have to wait for the biopsy result then to be treated with triple therapy. To be honest, we rarely use it for stomach, PPI (proton pump inhibitors) like Pantoprazole usually are better with stomach inflammation, and decreasing its acidity. For now, we have to avoid smoking," "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: Accidentally, I ate pineapple infected with house rat saliva and urine. I suspect it because I saw rat urine and feces near it. Is there any risk for me to get rabies? Please suggest. ### Response: You do not have a chance to get rabies. Even if the rat is infected, transmission from a non-bite exposure is relatively rare. Some cases have shown rabies being transferred from corneal transplant and liver transplant. Rabies transferred from ingested infected saliva is not seen. The disease which you can get by contaminated rat urine is leptospirosis." "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: One of my friends recently pointed out that my pupils are sometimes uneven. I searched and got many scary possibilities. However, I did look at pictures from years ago and noticed different degrees of anisocoria. Now that someone has pointed it out, I obsess over it and see it a lot. It only happens periodically (at various times during the day), no other symptoms. What could cause anisocoria that is occasional and been going on at least three years as indicated by pictures? I am on medications for gastroparesis and generalized anxiety like Zofran, Phenergan, Pantoprazole, and Paxil. I read Paxil could potentially cause anisocoria. ### Response: Hello. There are different pathological causes of anisocoria, as you mentioned that you are taking medications, including Paxil (Paroxetine)." "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 61 year old man and in reasonably good health apart from being overweight and diagnosed diabetic 10 years ago. The following has started after I lost a lot of weight.For the last 9 months, I have had to sleep sitting up in a chair and leaning to my left side. If I lie down to sleep horizontally, or remain sitting up but tilting even slightly backward, or if I slip down on to my back on the chair while asleep, my heart begins to get faster and faster. I feel no pain and it does not wake me up. That is the problem, I sleep through it until I wake up with the need of going to the bathroom. I suspect these episodes last for hours with my heart going dangerously fast. These are not palpitations.When I wake up, my heart is often racing, and I have to take deep breaths for a couple of minutes to get enough oxygen inside me for the heart to return to its normal beat. It all started very suddenly, not progressive. For all these months I have been scared by the prospect of having to go to sleep and leave it as long as possible before trying, just praying that I can get through the night keeping myself upright and with a reasonably clear nose. If I can do that, I can usually make it through reasonably fine, but this is the exception rather than the rule.Body position seems to be one key factor, clear nose another, but the first always overrides the latter in importance. I recently had to make a 6 day 1500 mile dash drive and slept every night upright in the car seat right next to an open window. I had no problems at all during those 5 nights. A cardiologist has run tests and told me there is nothing abnormal with my heart's muscle or function.I rented an automatic CPAP machine for 4 months, but have now returned it. It does not do much of help, but its data shows no continuous waking such as might happen with obstructive sleep apnea. It does, however, show that I go into periods of shallow breathing while asleep. The only other suggestion that I have had is that this might be some form of central sleep apnea and therefore perhaps more neurologically based. The company that rented me the CPAP machine say that a BIPAP machine might be better, as it will force me to breathe, but I would really like a more expert opinion before going down that extremely expensive road.Do you know any other people who have had similar symptoms and experiences, and if so, what was the cause and how was it treated? Current daily medications I take are 75 mg Aspirin for blood thinning, 1 x 15 mg Pioglitazone/ 850mg Metformin tablet for controlling diabetes, 5 mg Ramipril for blood pressure, and various vitamin and fish oil supplements. ### Response: My compliments for a detailed medical history of what you have been going through in the last nine months. I have gone through it and following are the points which are important to show the way to diagnosis: What are the problems you do not probably have: What you may have: My suggestions:" "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, and I have an issue with my upper teeth. I lost the right canine tooth when I was young, which made my upper front teeth to move to the side. And my front two teeth are a little big. I consulted a local dentist, who said the solution is to take out one normal tooth, that is, the tooth after my left canine. Then he will put braces to align the other teeth, and he said he will bring my teeth back in the center. I just want to know if there are any other options to correct my teeth. I do not want to loose a good tooth. Can you help me? ### Response: Hi. Without any clinical pictures, it is hard to comment on the situation. However, I will give you some basic facts" "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 28-year-old girl. I am working. I am in a relationship with a boy. In our starting years, we both were very well. But now, he has no time to spend with me. When I talk to him, he ignores me. I cannot control myself in this situation. I start crying suddenly. I am sleepless, and I am unable to sleep overnight. The next morning I am busy with my schedule again. I tried to stop talking to him. But I cannot do it. I cannot live without him. What is the solution to my problem? ### Response: Hi. You should have a face to face meeting and clear all your doubts with your boyfriend. You both decide a schedule for each other. Spend at least a half an hour daily with each other. Go for a vacation at weekends. Spend quality time. Spend time with your hobbies like reading books together, painting, playing, sing a song, watch movies together at home, and cook food together. Give some surprise gift or surprise visits. Do not be boring for him. If you both are in love, then you have lots to do together. It is a commitment to give time for your loved ones. Otherwise, there is no meaning of a relationship. Do not get stuck in a toxic relationship if you cannot handle. Life is beautiful if you are in love. But if you cannot enjoy it, then think over it. Live your life." "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 my right lower wisdom tooth removed three days ago. Now the swelling is somewhat near my lower jawbone seems to have hardened. The right cheek looks puffy. And have localized slight pain on pressing the lump. Could you suggest a solution for what the problem seems to be? ### Response: I understand your concern and feel sorry for the way you are feeling. Though the pain may last for five to seven days, hard swelling is unusual for us to see. Get it checked to rule out any possible complication. Ice packs are usually recommended, but I recommend you check it with your doctor as hard swelling may not get softened with cold application. Painkillers give patients virtually pain-free recovery over 7 to10 days. Some enzymes also help subside the swelling. Keep all this when you go for follow-up. 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 have these bumps around my vagina. They look like skin tags. They do not itch, but when I have sex, they start bleeding. I hurt them while shaving, and they started bleeding. What could I have? Or could it be some sort of STD? ### Response: Hi. With the symptoms you have provided, it is not an STD (sexually transmitted disease). But if you have any doubt, I advise you to take an ELISA test. Most probably, you do not have skin tags, but a collection of vasculatures, as they bleed on any injury. You can get it removed by laser or cauterization. And avoid injury to the area as much as possible." "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 few bumps on my penis skin. I do masturbate. I am concerned because I do not know what might have caused this or what these bumps are. They do not burn. I have not experienced any discharge or burning sensation. I am confused what this is. I am attaching a picture. ### Response: Hello. I have gone through your complaints and seen the images (attachment removed to protect patient identity) as well. These measures will help in maintaining genital hygiene as well as prevent any infection in the future. Regards." "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 32 years old female. I went today for the third follicle scanning on the 18th day. It showed the rupture of follicles, and there was a lot of free fluid seen in a POD. But in my second follicle scanning, on the 14th day, it showed no free fluid. Is it healthy to have free fluid or something wrong? ### Response: I have gone through the attachment (attachment removed to protect patient identity). Your follicles have ruptured, and hence today you have free fluid in the pouch of Douglas on the scan. You should have intercourse today to become pregnant. Were you given any tablet for the first five days or injection for the rupture of follicles? Let me know the treatment you have received in this cycle, for better guidance and treatment" "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 took CBC test before six months. My WBC is 8970 cells/cmm and lymphocytes are 45.4 % 4080 cells/cmm. Yesterday, I took another CBC test. My WBC is 7.5 cells/cmm and lymphocytes are 46.4 %. Is it anything serious when there is a high level of lymphocytes? I have GERD like symptoms. Yesterday, I took an endoscopy and everything is fine. ### Response: Hello. Lymphocytes are usually increased following a viral infection, some bacterial infections and also in conditions of stress. If you have a cold, it might be due to viral infection. The percentage of increase in your lymphocytes is not very high. Continue taking medication that has been prescribed for GERD (gastroesophageal reflux disease). You are slightly anemic and try to have food items like green leafy vegetables which are rich in iron to prevent iron deficiency" "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 two indented lines about 1 inch long across the top of my breast. I noticed them this morning, and they have not gone away. Should I be concerned about this? Is this a sign of cancer? ### Response: This professional advice provided by me stands subject to the actual examination of report or image and is based entirely on inputs provided to me. It should be correlated with clinical findings. Regards" "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: Why do I get recurrence of genital herpes as soon as I stop antiviral drugs? ### Response: Hello. If the sexual partner has it, then there is a chance of developing it. I suggest applying Acivir (Acyclovir) gel locally and taking capsule Acivir 400 mg five times a day for one week. Consult your specialist doctor, discuss with him or her and start taking the medicines 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 am a 25 year old guy. I am working in a private company although my dream is to work in government sector. I have that caliber which I know and I believe I can, but the problem with me is nowadays, I take everything for granted. I lost my father three years back. Till then, everything was fine as my bonding with him was like a friend. I used to discuss a lot of things with him just like a friend. I have spent a big amount of his savings. Now even I know the financial stage of my family. If I do not get a government job, it will not be possible to live the life the way I want to. I am not happy at all with my private sector job. A year back, I had a breakup with my longtime girlfriend.The problem now is although I know the outcome of everything, I am not working towards my goal .instead, I am a regular drinker. I really want to stop drinking. I keep myself motivated that I will not drink today but somehow I do end up drinking. It all started after my father\s death. I do not want to make it an excuse for my drinking habit but still, I do not know how to leave this habit. I am losing so much due to these things. I feel like I am behaving like a numb person even after knowing everything. I live alone as well. What should I do? ### Response: Hello. I have gone through your problem and understand your concern. As you are regularly" "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 the following on the second day of the menstrual cycle- a headache, lots of bleeding, abdomen pain, general weakness. Is it fine to have a dental implantation surgery during this time? It includes tooth extraction and implantation. ### Response: Hi. Yes, it is absolutely fine to have implantation surgery during your menstrual cycle. You can take Ibuprofen 400 mg four hours before surgery. You should have a proper meal at least an hour or two before your surgery so that you do not feel nausea during surgery or hungry right after surgery. Hopefully, everything will go smooth. Best of luck. Stay happy and blessed." "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 done a FET transfer cycle before ten 10 days. My hCG pregnancy test is tomorrow. Are nine days too early to test? My other real concern is that on the day of transfer, my estrogen levels were 223, and progesterone was >40.0. Before four days my estrogen levels were 106 and progesterone was 35.I am still currently supplementing both estrogen (Estrace by mouth twice a day) and progesterone (PIO 1 ml IM once a day, and Endometrin suppositories twice daily). Does the drop in both hormones indicate that implantation did not take place? I find it unusual for both levels to drop simultaneously, especially while supplementing. ### Response: Usually, the levels of estrogen and progesterone will increase from early pregnancy to the third trimester. But often there will be some range of the hormones according to the gestational age. Though the levels of hormones little decreased in your case, they are still in the normal range according to the gestational age. Like during four to five weeks, the progesterone levels should be 11.2 to 90 ng/ml. And estrogen levels should be 100 to 400 pg/ml. So, according to this, your levels are still within normal limits so better to follow the course advice to your gynecologist and undergo hCG test as advised. I hope I have answered your query, and I will be happy to answer any further follow-up queries. Blood test for hCG as advised." "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 started the process of getting four implants. Last week I went for bone grafting. It has been a living nightmare ever since. I was completely fine, pain-wise, until three days after the grafting. Out of nowhere, I was in excruciating pain. Like deep in the nerve type pain. At that point, it was only my lower right side that was in pain. One of my stitches busted, and the bone grafting material was oozing out. The dentist saw me that evening on an emergency basis and cleaned it up and stitched me back up. Reassured me that my pain would end. He also switched me to a stronger antibiotic. Well, not only did the pain not go away, my left side started in on the same excruciating pain on the next day. The pain is that sharp, stabbing, throbbing pain that increase with each heartbeat. Worst pain of my life. It seems to be coming from teeth next to where the grafting was done. I should also add that I have a bridge on my lower front four teeth, with teeth as my anchoring teeth. No one knows where my pain is coming from, so no one knows how to treat me. I am miserable. Have not eaten anything in three days. Talking, drinking, and eating cause immediate, intense throbbing. It feels like nerve pain to me. Similar to the way I have felt in the past when an infection has reached my nerves. I am wondering if something is now touching my nerves in the teeth next to where the grafting was done? I am at a loss and would love to hear what anyone else thinks. ### Response: Do you have X-rays of teeth that caused you pain? You seem to have an infection either due to bone grafting procedure or abscess of the roots of those anchoring teeth of the bridge. Get an OPG x-ray done to find out more. Continue antibiotics and painkillers. Use warm salt water gargle twice a day for a week or two. Please attach an X-ray for analysis of your problem. You may need root canal treatment. Do not get an implant done until everything clears up." "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 68 years old. She lost most of her teeth. Our doctor suggested full mouth dental implants. My mother has diabetes, and she is worried about the surgery and pain. I would like to know if she can go ahead with full mouth dental implants at this age? Will her diabetes create any issue?I have listed the last three blood sugar levels taken two months before. Fasting 73.8 mg/dL, after meals 124.5 mg/dL. Fasting 278.9mg/dL, after meals 206.2 mg/dL. Fasting 175.5mg/dL, after meals 109.2 mg/dL. ### Response: Hello. One can go with full mouth case with dental implants when the underlying bone conditions are ideal, which means patient\s boney ridge should have adequate height and width. As per the age, there should not be any bony resorption. Bone conditions are important for implant stability. Systemic conditions like blood pressure and blood sugar levels should be under normal levels. After going through your given reports, patient\s blood sugar levels are not constantly under control. So, need to check HbA1C (glycated hemoglobin) and follow up with diabetologist for strict diabetes control. Blood sugar level is important for the proper healing of bone during the process of implant placement. It will be beneficial if you upload image of an OPG (orthopantomogram), or give further details about the bone condition for proper treatment planning and management." "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 38-year-old female. I have anxiety, stress, breathing difficulty, dizziness, and, loose stools. Also, I am not able to eat. Currently, I am not under any medication. But a few years back, I had a medicine called Typlin C. Kindly help. ### Response: Hello. Your symptoms could be related to a panic disorder. For this reason, I would recommend consulting with a psychologist or psychiatrist. Starting Typlin C again or another type of antidepressant (SSRI) may be necessary. I would also recommend checking thyroid hormone levels for possible thyroid gland dysfunction. In the meantime, I recommend avoiding coffee intake and start practicing yoga and meditation. Recreational sports can help too. I remain at your disposal for any further questions whenever you need." "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 LMP is 20th April. I carried out two UPT last month and the results were negative. Today morning, I again checked and found that the result is positive. I am feeling pain in the pelvic region and dizziness in the morning. Please suggest me what to do. Are there possibilities of medical abortion? ### Response: The pregnancy symptoms can present with mild lower abdominal pain, especially in the flanks, with occasional dizziness, retching, and nausea, which are the effects of increasing progesterone levels and it is normal. As long as there is no bleeding per vaginum, there is no indication of miscarriage. You should be on Folic acid, antiemetics, and progesterone support. Regards" "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 wants to get pregnant. Last month her period was 12 days late from her original period\s date. This month she has not got her periods. Please give your expert opinion on the issue. Tell us how to confirm her pregnancy? ### Response: Hi. Please get a urine pregnancy test done. You can get a urine pregnancy kit from the pharmacist and test at home itself. If there are two pink vertical lines that means your wife is pregnant. If the test is negative you can wait for about a week and take medicine for getting periods." "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 review my ECG? I am on long-term Azithromycin and Minocycline for Lyme disease. ### Response: Hello. I have gone through your ECG result (attachment removed to protect patient identity), and I can see evidence of a second degree AV block (atrioventricular block), which is a common finding amongst patients with Lyme\s disease. Since you have already been placed on antibiotics, the ECG will clear up and become normal in weeks. There is no need to worry." "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 injured my back at work after lifting, pushing, and pulling boxes. The boxes weighed up to 75 lbs. I was diagnosed with sprain or strain of the lower lumbar spine. The pain varies from time to time. It happened a month ago, and I have had physical therapy for three weeks. The pain goes from the lower spine to the right lower part of the back, the abdomen, the groin, and leg. At first, the pain shot halfway between the hip and the knee. It got to the point of the knee, and then tonight I felt it go down to my ankle. At first, neither standing nor sitting helped, now sitting helps better. I have had three muscle relaxer injections and two steroid injections since this happened. I was on Ibuprofen 800 mg, thrice for three weeks. I was on Tramadol and Cyclobenzaprine for a week. I was also prescribed Metaxalone 800 mg, for three times a day. For a week, I was prescribed to take it two times a day. I have been prescribed to take extra-strength Tylenol and Gabapentin. I have been using ice and heat as directed since this happened and placed on lifting no more than 30 lbs, push or pull no more than 60 lbs and sitting 50 %. The pain is still present today, so I took my first dose of Gabapentin and Prednisolone. I need a second opinion. ### Response: I have reviewed your question. I am sorry you are experiencing low back pain. In fact, nearly 80 % people experience back pain at some point in their life" "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: How can I naturally get rid of molluscum contagiosum? Are there any products, herbs, oils, etc., that I can use or ingest to help it heal? How long will it last? ### Response: Hello. I just read your query. See molluscum contagiosum is a viral infection and if it is not spreading then you do not require treatment. It is self-limiting and will stop on its own. If the lesions are spreading very fast then you may require contemporary treatment like cryotherapy or laser. If you only have some lesions, you can follow this management: Try all these things regularly and you will feel better results. In case of any problem, you should visit a nearby skin specialist" "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 saw a sports injury doctor with mid back pain at night. The first MRI scan was poor quality, so a second was carried out, and that noted elliptical bilateral lumps at segmented levels. I have been referred to a neurologist who is examining the scans. I am seeking clarification that the description in the report does not indicate malignant disease. I only have the reports and not the scans. I had nocturnal mid back pain for four weeks and getting slightly better now. ### Response: Your MRI report (attachment removed to protect patient identity) indicates neurofibromas in your dorsal spine, which is a benign growth originating from nerve sheath cells. Often it is symptomless, but at times can give discomfort to the patient due to mass effect and pressure in the surrounding structures. This growth is usually benign but may rarely turn malignant over a period of time. Your doctor may suggest a biopsy for the same to confirm the cell type. If you have any more doubts, please feel free to discuss." "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 want to tell you that I have sensineural hearing loss and tinnitus according to my reports.My doctor told me that I have mild sensineural hearing loss. I am sending you reports. I want to clear my doubts about sensineural hearing loss. Is my sensineural hearing loss progressive in future. Will my tinnitus cure of its own? Do I need any further testing like MRI? Please check. ### Response: Since how many days are you having hearing loss and tinnitus? If it is since a few days you should try taking oral steroids. Your hearing loss can revert back. MRI or any other scan is not needed. But you do let me know if your tinnitus and hearing loss is sudden in onset or not." "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 26 years old, currently pregnant with my second child for 26 weeks and 5 days. I just left the doctor\s office having done an anatomy ultrasound. The doctor said there is a little fluid around my baby\s heart, but not to worry. I have been scheduled in three weeks for the same ultrasound and also have been scheduled I believe for an abnormalities test. Even though the doctor has told me not to worry I am just freaking out and have been crying all day. It would be nice if I could get an answer as to what may have caused small fluid around the heart? What would the worse outcome be and what I can do now with my everyday habits if that makes sense, as I will be stressing for three weeks about this? Any information would be helpful. ### Response: Hello. I understand your anxiety. Let me clear you some facts. A basic anomaly scan is done at 18-20 weeks and if that was normal, it shows that no structural anomalies are there. Secondly, this scan was done at 26 weeks and 5 days when the fetus is half developed. As far as the fluid is concerned around the heart, it is the pericardial fluid. The fluid inside the pericardial layer covering the heart to initiate smooth functioning. It is around 5 ml in adults with progression in pregnancy it would regress and my advise would follow it up with serial ultrasounds. Unfortunately, every day habits cannot make a difference. I would like to suggest you not to be worried and stress yourself. All is well. Just get three weekly serial ultrasounds to follow up on the fluid level. Baby\s growth is not affected as I learnt." "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 on a contraceptive pill called Yasmin since the last two months. In the last pack, I missed the pill twice, but each time, I took two pills the next day. I take the pills roughly around the same time, approximately around one to two hours each day. I am currently on my 7-day break (today is the fifth day of break). If I plan to get sexually active on Thursday (the day I am due to start my third pack), would I need to take any additional precaution? Can I be intimate even if it is the first day of my third pack? Also, can I start my third pack a day in advance, that is, on Wednesday, as I am still on my period, so it will stop the period? ### Response: Hello. I read your query and understand your concerns. I hope this helps you. Feel free to write back to me if you have more questions." "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 20 years old, and since a couple of days, I am having difficulty passing stools as there is a subtle pain and when I checked there is a pea-sized, skin colored blister covering the anus. It is not that painful but there is a subtle pain. I do have constipation problems and I do take over-the-counter medications for constipation. Please tell me how to get rid of it or treat it as I am worried about what it can be. ### Response: I have seen the image (attachment removed to protect patient identity). This looks just like hemorrhoid typically that occurs with constipation and goes away on its own. Also, avoid meats and non-vegetarian items currently as they aggravate this issue. You may continue the laxative that you are taking as well till your constipation is better but not more than two weeks." "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 bottom teeth have been feeling very sensitive for the last few days now. However, I have had a blast on my gum towards the back of my tooth for about a month now. I have seen my dentist and he explained it was just like a spot, although it keeps coming back even when I pop it myself. I was wondering if these issues may be linked in any way? ### Response: Hello. The sensitivity of bottom teeth can be most commonly due to gum infection leading to gingivitis or periodontitis. So, my suggestion is to consult an oral physician and get evaluated. An X-ray can also be done for confirmation. For now, use anti-sensitivity toothpaste twice a day. Use a soft toothbrush to brush your teeth. Hope this helps. Regards" "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 got cervical neuropathy 10 days back. Got MRI 6 days back. On bed rest, analgesics, got Depomedrol 80 mg shot, Pregabalin, Methycobalamine and oral Medrol. Have not got any muscular weakness or UMN signs. Mild parasthesia in thumb and index finger of right hand. Pain has decreased by around 30-40 percent since it started 10 days back and I am not taking any NSAIDS for last 2 days. I have got a few concerns.Do these changes occur at this age (43 years)? How bad are the degenerative changes? Any need of surgical intervention? How much time usually it takes for complete resolution of acute episode? Is it going to be a trouble in future as well? I mean repeat episodes or further complications. What should be the life style changes after resolution of acute episode (you know the nature of a pediatrician's job)? If at all surgery is required in future (further canal stenosis causing cord compression), how risky is the surgery and how are the results? ### Response: Hi. I have gone through your medical history and the attached reports in detail (attachment removed to protect patient identity). It does not seem to be a serious matter at present. Yes neuropathies are common at this age. Usually, it takes around 3 to 4 weeks for an acute episode to resolve depending on the symptoms. If proper care is taken (avoiding use of pillow, avoiding lifting heavy weights, neck exercises) usually symptoms do not recur. At present there is no need of surgery. You are doing pretty well and recovering fast. Use cervical soft collar and take analgesics for atleast 10 days. Get a repeat MRI after 3 months. Well, decompression surgery is risky and has side-effects and should better be avoided." "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 want to know about going off birth control.What are the five to ten most common physical and emotional changes women can expect when they discontinue hormonal birth control use? Will these changes differ depending on the type of birth control and how long you have been on it? How so? What are some myths people tend to believe about going off birth control? Can you debunk these? Any last words of advice for women nervous about going off birth control? ### Response: " "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 21 year old male. My voice is like a girl. But hair growth pattern in my body is like a guy only. What is the remedy? ### Response: Beard, mustaches, pubic and axillary hair are named as the secondary sexual characters. If your secondary sexual characters are properly developed you need not have to worry. Your voice sounding like a girl can be corrected. This can be corrected throughspeech therapy and voice training. Consult a sexologist online for further help" "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 oily skin type. Recently I am experiencing pimples, white bumps, red dots on my cheeks close to my ears. Sometimes I feel very itchy near the pimples. I have developed one or two new big pimples on my forehead also. When the pimple subsides after a week or two it leaves a reddish brown mark on that area. I feel the need to wash my face very often as it starts feeling very heavy and sticky from all the oil on my face. I used Clear Gel for some time but it is not working on my skin. Not using any other medication at the moment. Kindly help me with the same. ### Response: Attach a picture of the lesion for details. Use Ahaglow face wash twice daily for 15 days. Are there pustules? Inflammatory red lesions? Photosensitivity?" "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 in depression. Feeling nervous. Feeling guilty. Suffering from over thinking. Suffering from mood swings. I need your help. ### Response: Hi. I guess you did not mention all symptoms. If you did so, then it shows you are suffering from anxiety and not depression as the last one could be more chronic. From my experience, you will need two medications to get better from this situation" "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: the bottom part of my abdomen hurts, and i can\t poop. ### Response: I can understand you must be very upset about your problem. It seems that you have a defecation disorder. which is difficulty in passing stools. It can occur to any body, but common among individuals who have difficult learning the art of passing stools. For this you have to relax , remove your anxiety and start learning the art of pooping. Here are some tips for that. If all above fail then there is computerized therapy called biofeedback therapy. I want you to follow above tips first, and let me know if improvement; if required, I will suggest when to go for biofeedback therapy. The pain is a secondary phenomenon, once your stools became normal the pain will go away. Do not use painkillers, because they may slow your bowel and can cause more constipation. Defecatory disorder Slow transit constipation Defecatory disorder As above Follow up in 1week and update me about your problem" "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 29-year-old, married male. I have a baby who feeds on breast milk. I had a sexual encounter before 8 months with a professional with a condom. I am 95% sure that my protection was intact. Then I started reading about the HIV symptoms and technicalities of testing online. Five days later, I went to a Dermatology and Venereology specialist and described about the incident. He was confident enough that he advised me not to go for any testing. Although my fear of infection remained.Around two months post-exposure, I felt tenderness here and there like on the back of my head, arms, one lymph node in my underarm was swollen and I developed cold and cough. I started sweating during that time as well. I looked a bit thinner. I got panicked and went to the doctor again. He checked me and was still confident that I am not infected. But for my mental satisfaction, he prescribed me thorough testing which includes HIV1/2, VDRL, HBsAg, HCV along with urine R/E, M/E, C/S analysis.On 74 th day post-exposure I took all those tests and they all came back negative. After lapse of a few days again I felt some skin irritation on theback and burning sensation on my forearms. Although no skin changes can be seen. Again I got panicked thinking that I may be in the window period for HIV. But the doctor remained confident and he adivised me not to go for any repeat testing. But my sense of fear, anxiety, panic, guilt, and impurity continues.On 110th day post-exposure again I repeated the tests but I excluded the urine analysis this time. All the tests came negative again. The HIV tests were fourth-generation combo test both the time. I am on the eighth month post exposure. Still, I feel tenderness hear and there. Recently, I am developing small red blood vessel like dots just underneath my skin on my hand and feet which is staying for 5-7days and going away leaving faint black spots. I again showed it to the same doctor. He is confident and repeatedly asked me to stop worrying. He also gave me anti-anxiety, anti-OCD, anti-depressant drugs.I am also taking sessions with a psychologist. But still, my mind is not free from the fear of HIV and also fear that my wife and child might get infected by me.My questions are, do I need to repeat any test to out rule the probability of HIV? Are there any probability of error from lab test given the fact that I took the tests twice? Do I need to worry about the window period as there is conflicting information available on the internet? Do I need to worry about the phenomenon of delayed seroconversion? Do I need to opt for the tests from a different lab? Do I need to worry about HIV 1/2anymore? How to unroot the fear from deep inside my mind? Any other opinion on my history? ### Response: The chances of transmission of HIV by the given description is almost nil. HIV tests are repeatedly negative and after three months of exposure it is conclusive. You are free from HIV. There is no need for you to worry about seroconversion. You can forget about the episode and lead a normal life. There is no need for any further HIV tests in any lab. Just relax. Do some yoga, exercises, meditation, etc." "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 experienced spotting in the last week for three days. It was a small amount of spotting discharge, which was brown with a bit of red. I did not get my period on the actual date. May I consider the spotting as my periods? But it was not the usual amount of bleeding as I have in my period. I only used a liner with it and not may napkin pad. ### Response: Hello. Your spotting for the three days cannot be considered as the menstrual period. The usual amount should at least be at 80 ml per cycle, and that would approximate at least 10 moderately soaked pads. Some possible causes would be a hormonal disturbance, and this could vary as far as pregnancy, and hormonal imbalance is secondary to stress, weight loss, current illness, etc. I would suggest you to have a pregnancy test first if it is negative, then you may opt to observe until the second week of next month. If there is no period still, you need to consult your gynecologist to help you with the diagnostics such as transvaginal ultrasound and if no other causes, she may prescribe you with pills to regulate your period back. Hormonal imbalance." "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 stomach is consistently growling while, I am eating and after I am eating, sitting, standing, talking. The good thing is that there is no other symptom.What can I do to stop them? ### Response: This is normal bowel sound which you tend to notice frequently. The movement of bowel cause sounds in the stomach. There is nothing to worry about this condition. If it is persistent and you experience symptoms like pain or swelling, you need to get evaluated with an Ultrasound scan of the abdomen" "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 three sessions of a root canal, but I am still having a dental abscess. The treated tooth does not hurt and the root canal seems to be properly done but the abscess keeps coming back even after taking antibiotics. Why is this happening? Also, how can I know what type of abscess it is (periodontal, gingival, or periapical)? ### Response: Hi. An X-ray would be required. Some abscesses are recurrent which cause necrosis of bone at the root level. Such conditions make root canal treatment unfavorable. In such situations, extraction and replacement of the tooth will be the best option going forward." "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 itching on my face for the last two years. I took Levocetirizine, Fluconazole and some ointment. My doctor also advised me to use soft soap. But, my problem continues. Please help. ### Response: I have read your query in detail and do understand your concern. I also viewed the attached pictures (attachment removed to protect patient identity). Revert back with the answers 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 have recently had the bar inserted in my arm and have had side effects weeks after. I was wondering if these side effects are normal or are something to look into going to the doctors for. For two weeks, my period has not stopped, with the past week my flow has been fairly light and although I have had cramps, it is not as bad as when my period was originally due. ### Response: You are having a continuous bleeding problem. For that, you need to find any underlying specific cause, if present. It is advisable to investigate with USG pelvis and pelvic examination for primary work up. If all comes normal then investigate further with serum FSH, LH and DHEA estimation. If no cause identified then dysfunctional uterine bleeding is the possibility. You can be prescribed Tranexamic acid tablet and a Hormonal pill for bleeding. USG pelvis. DUB or other organic cause. Tranexamic acid just now and if needed Progesterone containing pill." "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: Why a pimple should not be popped? When to pop a pimple? What to do after popping a pimple? What should I apply to heal the pimple and to avoid acne scars? ### Response: Many individuals with acne or other problems have a habit of popping up the pimples. It is never good to pop a pimple because it can lead to scarring. Patients are always advised to never pop up the pimple, as the risk of infection increases. The natural healing process gets disturbed and results in scarring. If someone pops up the pimple, he/she should wash the area, and apply topical antibiotic like Fusidic acid ointment to protect from infection and scarring." "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: Dear doctor,Sometimes I get low BP, low sugar blackouts and palpitations. Please advise. ### Response: Low blood pressure may be due to genetic factors. Mix one teaspoon of Electral powder (essential electrolytes) in a glass of water and" "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 MRI cervical report impression is mild posterior protrusions from C3-4 to C5-6 levels causing indentation of the thecal sac. I am 32-year-old and a desk worker, need to sit 8 to 10 hours on the computer every day. I am suffering from neck pain, stiffness in the neck, and stress. Please suggest me whether daily exercise will help, does the above condition will heal or not. Please help. ### Response: Hello. It is an early change in cervical spondylosis. Kindly follow following instructions. 1) Change the working habit, and prolonged chair sitting as it cause misalignment of the cervical region leads to decrease mobility, either take a break in every two hours for 10 minutes. 2) Can do neck physiotherapy slowly flexion and extension. 3) Apply cervical collar if you are working prolong. 4) Check your vitamin D level and go for tablet Shelcal D one tablet for four weeks. You can prevent progression. At present, you have no risk. Connect me if any questions." "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 5-year-old son is suffering from bilateral hearing loss. He was born as a normal child. Suddenly, he got such problem due to cold. ### Response: Hello. Your son is suffering from bilateral hearing loss following a cold. This is most likely due to obstruction of the tube connecting between the ear and the nose (ETD: eustachian tube dysfunction). You can start the following medicine syrup T-Minic (Chlorpheniramine maleate and phenylephrine) 5 ml two times for two weeks. If not improving, then you need examination by local ENT surgeon and hearing test (audiogram)." "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 suffering from headaches frequently. They usually last for two to three days. I am taking Sibelium 10 mg tablets since a long time. I also observe a swelling on my face and stiffness and heaviness around my eyes during the event of a headache. I am unable to lead a normal life. When I take Sibelium, the frequency of the headaches get reduced. What is the permanent solution? ### Response: I went through your post. You are suffering from a migraine and your symptoms are caused by it. Regards" "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 84-year old stepfather had, apparently, two radical left-ear wall-up mastoidectomies in the late 50s and 60s. The second was done to fix the poor job done by the first at a county hospital for the indigent. Recently, caregivers said they were planing on using hydrogen peroxide in his left ear to clear much wax buildup. I learned of these surgeries from my step dad and from reviewing some ancient medical records. As his POA, I need to know of any dangers possible if hydrogen peroxide is administered in such an ear canal that, I understand, is permeable, and leads into his mastoid chamber. ### Response: As I understand, your father had undergone two ear surgeries when he was in his 30s or so. He would have either undergone canal wall up or canal wall down mastoidectomies. Radical and modified radical come under CWD, and cortical comes under CWU mastoidectomies. The ear has been disease-free for many months now, implying, there has been no ear discharge of pus or liquid. 2. No ear perforation, which would have presented with discharge and pain. 3. No raw area in the ear canal. The posterior canal is not permeable. In a wall down surgery after removing the wall, we close the defect with autologous cartilage or some material. Probably in his days, they may have left the cavity open. In either case, it gets lined by the skin, and that will be the case in your father also unless he has any disease or perforation. It is okay to use 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: For the past two days, I have redness and flaky skin on the lower eyelid, and it looks swollen and irritated. I had this once before and went away with the usage of some sterile drops for around one week. I have no itching, no pain, no vision problems even when looking at the light. I have no issue within my eye, just on the skin surrounding it. I want to know what it could be and why it reappeared again? I have not changed my makeup products or started using something different on my face, either. ### Response: Hello. There are a number of different conditions which could cause such a problem. The red and flaky skin suggests that the problem could be related to inflammation or a reaction of the blood vessels in the eyelids. Since you mentioned that you have no itching or pain, this rules out allergic conditions." "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 18 years old. I had sexual intercourse. We used contraceptives like a condom. But the condom got broked. I do not know whether the sperm has gone inside. I washed my genitals quickly after knowing that the condom has got broken. I took a pregnancy test, and it came negative. Can I put my trust in the pregnancy test or should I have to consult a doctor? Is it possible to get pregnant in two days after having sexual intercourse? ### Response: If you had intercourse around 10th to 17th day of your cycle, and if you have a regular menstrual cycle, then the possibility of conception increases with each day within that period when the condom has broken. In this situation, you can take an emergency pill within 72 hours of sexual intercourse to avoid pregnancy. Sperms can stay alive in the vaginal tract for up to seven days whereas the egg remains available for fertilization for 24 hours. In conception, you have to wait for at least a week to get a positive pregnancy test with urine dipstick. Serum beta hCG can be detected earlier, but you have to wait for a few days. You do not need to go to a doctor. Just repeat the urine pregnancy test after two weeks or get a blood pregnancy test 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 am a type 2 diabetic for four years. I was diagnosed at a very high level (520) and have been on a low carbohydrate diet ever since and managing it. I have lost all my body fat and at 6 % body fat right now. I take 1000 mg Metformin once a day and Farxiga once a day. My goal is to gain fatback, but I keep losing weight. I need help with this. ### Response: Hello. Metformin is weight neutral or may cause mild weight loss. So you can omit Fargixa, and take Sitagliptin, Metformin combination, e.g. Janumet XR 50/1000 once a day. Try the suggested regimen and see whether you can gain back some weight in a few months. Otherwise, you have to switch over to Sulfonurea or Insulin which have much higher risk hypoglycemia, though less so if adequately adjusted." "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 two months old baby. Since two days I am observing that his diapers are not wet and heavy as they used to be. So I checked his urine output by laying him down without a diaper for five hours and fed him twice with two and a half hours gap between each feed. He peed thrice after the first feed with 20 minutes gap and he did not pee until he had his second feed. After the second feed, he peed thrice with 20 to 30 minutes gap.Recently, I have reduced his feeding amount on pediatrician advice as he was vomiting. I used to feed him up to 100 ml with 3 to 4 hours gap and now I am feeding him 60 to 70 ml with 2.5 hours gap. I am exclusively expressing milk and feeding through the bottle and sometimes on formula. He is having motion 3 to 4 times per day. Please advise me if this is normal since I feel that his urine has decreased compared to previously. His weight is 4.5 kg checked 20 days before. ### Response: I understand your concern for your baby. Your baby should urinate 6 to 8 times per day. As you have told that the baby peed after feeds, this seems absolutely normal. You may just keep a track on total 24 hours urine. Should be 6 to 8 times in a day. Reducing feed amount is fine but feed every 2 to 3 hourly and on-demand feeding. The bottle feeds increase the risk of infection. The stools 3 to 4 times is normal. Weight is 4.5 kg, it is a good weight but need to know the birth weight. Then only would be able to know whether adequate weight gain is there or not. And also the present weight, if you know." "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: There are small flat bumps on penis. Is it herpes?I had rather rough sex with a partner a week before noticing these. I have been tested before and it has been negative and I have never had this before. ### Response: I am not going in favour of herpes.It looks like initial stages of penile lichen planus (attachment has been removed to protect patient identity). Herpes genitalis starts with a fluid filled blisters and do not remain for so long" "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 contacted my psychiatrist because of day-time sleepiness and weariness. I am a student, so I have a lot of work to do and sometimes do not sleep at night. He suggested the use of Modafinil. While doing some research, all the side effects did not bother me, except for SJS syndrome. My psychiatrist did not have experience with this side effect while dealing with other patients. I am a bit anxious about it, so I decided to have someone else to give me advice about it. What do you think and is there a way to predict or avoid SJS? ### Response: It is known to cause cutaneous side effects in some people. SJS (Steven-Johnson syn" "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 help. I had my molar extracted last week. The area where the tooth was removed is looking very weird. Green, white, blue, yellow, with a tint of blood? It looks like a mold. I am taking Mefenamic acid thrice a day, I put ice on it, and I am on a soft diet. It is sometimes painful, throbbing. ### Response: Hi. I have gone through your question. I can understand your concern. As per your history and sent photos (attachment removed to protect patient identity), it looks like the wound is healing and the color changes occur during the healing period. If you feel continuous pain and throbbing, you may need a course of antibiotics like Augmentin 625 (Amoxicillin and Clavulanic acid) twice daily for five days. If the pain is an intermittent and only boring type, wait for three to four 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 27 year old male. My weight is 85 kg and height is 179 cm. About 2 years ago, I participated in a half marathon. On that day, I started feeling pain in both knees above the patella. I think in quadriceps tendon. I followed RICE and the pain went off. But, after that, whenever I do some running or exercise it again starts paining and I have to take rest for a week to reduce it. Recently, I have started going gym and doing light exercises. Even for this, it is paining very badly near and just above the patella. I feel pain while running, staircase movement and bending knees. I am not taking any medicine or medical help now. I am just using pain relieving ointment. Please help me. ### Response: Considering your symptoms and pain, I have a few points to mention. X-ray bilateral knee AP (standing), lateral and skyline patella. 1. 2. Chon" "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: Yesterday while preparing food, a spoon full of hot oil splashed on my hand. Small blisters started popping up, and it started getting more significant. By today morning, the skin around the blisters has become black. I applied ice and cold water and also one over-the-counter cream. Please find attached the picture of the burn. Should I keep applying ice or should I do anything more to expedite the healing? Is it healing as it is supposed to be? ### Response: Hello. I have seen your query and examined your given picture (attachment removed to protect patient identity). It seems you have developed superficial burn.Take injection Tetanus and use Silverex ointment (Silver Nitrate) local application twice daily for one week after consulting your general physician or nearby dermatologist." "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 irritation on the back of my neck. Sometimes, it extends up to the throat. But, I do not have any problem in speaking or swallowing. Please help. ### Response: However, there is no difficulty in swallowing or speaking. As a first step, I would suggest you take a course of antibiotics and anti-inflammatory tablets. Amoxicillin-Clavulanic Acid (dosage based on age and weight) and trypsin-chymotrypsin combination can work if it is an infective origin for the irritation. If the same does not resolve, then we have to think of other causes. Malignancy can be a reason which may often be accompanied by loss of weight and appetite. Pain also will frequently present in such a case.Any problem with the vertebra, like TB, spondylolisthesis, etc., can also present similar symptom with minute variation along with additional symptoms. For diagnosing the same we require to do an MRI scan of the neck. Kindly give all the details as I have listed. I suggest you go ahead with a course of antibiotics and see if there is a resolution of symptoms." "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 low-risk event (no penetration but exchange of fluids through fingering and immediate masturbation). At 26 days, I received a PCR/RNA test that came back undetectable. At 30 days, I felt a small posterior cervical lymph node which I know is connected to HIV. At 36 days, I received an ab/ag test (blood drawn from a vein) and that too was non-reactive. Would you consider these conclusive? I just cannot get over the lymph node and after digging have found two more small ones in my cervical chain. Should I get tested again? I have a family and want to protect them. ### Response: Hello. I have noted your concern. A fourth-generation HIV screening test (antigen /antibody) is considered conclusive at four weeks. So, a negative test at 36 days is conclusive. Regards" "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 left-sided headache, mostly frontal and behind my eye for a week. I have ear pressure and pressure in my nose while moving and chewing. I have seen my PCP, and I was given Imitrex that does not help. I have tried Aleve, Motrin, and Excedrin. ### Response: Your symptoms could be related to a sinus infection, especially considering the pressure in the ear, eye, and nose. For this reason, I would recommend performing a sinus X-ray study to investigate the possible cause. Antibiotics and nose decongestants may be necessary in case of sinus infection. I hope you will find this answer helpful. I remain at your disposal for any further questions whenever you need. Sinus infection. Sinus X-ray. Migraine. Sinus infection." "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 appendix was operated (open surgery) five months ago. I ate pulse one week ago and I feel little pain in this area. Can this wound be cured? ### Response: A pulse or legume, that has a specific kind of sugar called oligosaccharide which cannot be broken down by the human body on its own. For breaking of these oligosaccharides, bacteria in intestines come into action and break these sugars by fermentation and as a result, produce gases in the body owing to flatulence. The pain you are experiencing could be because of that. The other reason could be phantom pain which is a pain in the part of the body which no longer exists. These are sensations origination from the nerves via spinal cord and brain. However, if you have any other symptoms, like warmth over the surgical site or fever, you may need to be evaluated for surgical site infection." "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: Dear doctor,I am 16 years old. I have got pimples. What should I do? ### Response: Firstly, you need to consult a dermatologist nearby to assess the grade and severity of acne. As a general treatment measure: Follow these above measures for two weeks to see how much response you get. If the acne is of mild grade then, it will respond. But if it is of severe grade then, oral medicine will be required. Hope this helped. Revert back to a dermatologist online for further help" "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 27 year old male. I am suffering from a unique neurological disorder for about 5 years. I have consulted many doctors, but there is no improvement. So, I want your suggestion in regard to this. I am explaining my problem below. Five years ago, one morning when I got up from bed, I felt numbness in my left lower limb. It continues for a few days and then my right lower limb also felt the same. Apart from that, I also started feeling difficulty in passing urine. I consulted neurologist and they performed a number of tests, but could not find out the reason. They took the MRI of whole spine and brain, but there was nothing. Today, after five years, the condition is that I have very difficulty in walking and also I am using a catheter for passing urine. Each time using the process of self intermittent catheterization (SIC). My life has become a burden for me. I become a fully dependent person to others. If you can help me anything in this regard and if there is any cure of this disease, please let me know. I will be always thankful to you. ### Response: I understand that you have numbness and weakness in legs, difficulty in walking and difficulty in passing urine. Please scan and send all the reports you have with you. We will evaluate and get back to you. Revert back with the reports to 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 been experiencing light-headed feelings, and daily headache as soon as I wake up. I will be uploading an MRI summary, and want to know what the results mean if this is treatable, or is it terminal?I am currently on Temazepam 30 mg daily for sleep, Diazepam 5 mg as needed for Meniere,s disease, and Soma as needed for low back issues. ### Response: I read carefully your question and would explain that there is a non-specific finding in your brain MRI (attachment removed to protect patient findings), which could be a small inflammation region, a born defect or a tumor. This lesion is too small for biopsy. So the next step to follow would be a lumbar puncture in order to examine the cerebrospinal fluid and exclude any possible infection or inflammation of the brain. If the cerebrospinal fluid is normal follow up with a new MRI after three months would be necessary in order to investigate for possible progression (increase in dimensions or a new lesion). 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: My partner and I have not had sex for quite a few weeks. I have talked to him about it around three times and each time he tells me that he wants sex and wants to have more of it and that he will try to push away the thoughts of the stress he is going through that keep him from getting an erection. I can understand but why he cannot? I have needs too. I am currently taking Mono-Linyah. ### Response: Libido can be decreased if a person is undergoing stress and can affect sexual performance. I would recommend that he should either visit a psychiatrist and take some medicines if his stress is affecting his personal, social, and occupational life. The doctor will place him on some medicines which should help with the stress part. In addition to that, you can give him some medicines like Sildenafil 50 mg or Tadalafil 10 mg to take one hour prior to having sex, provided his blood pressure is fine. This will help him achieve an erection. Stress. Erectile dysfunction secondary to anxiety or stress. Tadalafil 10 mg or Sildenafil 50 mg one hour prior to sex upto a maximum of twice a week. Discontinue in case of headache, chest pain, or dizziness. Also do an internet search and start doing Kegel\s exercises which will help improve the muscles at the base of the penis and improve the strength of the erection. Can follow up after one month if 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 am a general practitioner. I struggle to differentiate these conditions: scabies, flea bite, bed bug and folliculitis. I would really appreciate your clinical knowledge and goodwill in enlightening me about this, so I can provide better care for our patients. ### Response: I have seen your query. Scabies is caused by mites. In this, the patient presents with nocturnal itching with burrows over the web space of hands. In flea bite or bed bug bite, you may find itchy erythematous papules that may be localized or generalized depending upon the hypersensitivity reactions. Folliculitis is the inflammation of hair follicles and always presents with pain" "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 husband has been diagnosed with Alzheimer\s and panic disorder with agoraphobia and is on several medicines. He is taking Glimepiride, Furosemide, Metformin-Januvia, Amlodipine, Lisinopril, Memantine, Pramipexole, Trintellix, Protonix, HCTZ, Tamsulosin, Donepezil, Clonazepam, Xanax, and Trazadone. I am concerned he is taking too many medicines. He just went off Abilify four months ago and started Haloperidol in the last two weeks. Both make him a zombie, with no facial expression, slowed movement, muscle weakness and restlessness. I took him off Haloperidol yesterday and he is now nervous, cannot be still, and cannot sleep. What medicines should he be taking? ### Response: Hello. I went through your query. I can understand you are worried about your husband\s health and the medications he is taking. Hope it helps. Feel free to ask more if you need further assistance. I would be happy to assist. Regards" "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 30-year-old male. Recently, I went in for a check-up. I suffer from insomnia and fatigue. Below are the only two abnormalities:TSH 9.86 (mU/L)FT3 4.22 (pg/ml)TT3 1.29 (ng/ml)T4L 1.45 (ng/dl)TT4 6.30 (d/dl)Thyroid ultrasound: slightly inflamed isthmus (3.46 mm thickness). Normal blood supply.High cholesterol, VLDL and triglycerides:Cholesterol 265.00 (mg/dL).HDL 36.40 (mg/dL).LDL 159.60 (mg/dL).VLDL 124.00 (mg/dL).Triglycerides 620.00 (mg/dL).AIP 1.231.Is it possible that the high TSH level is the reason for my chronic fatigue and insomnia? Is it also elevating my cholesterol and triglycerides? I am guessing the doctor is going to want to put me on hormone medications to treat the high TSH? ### Response: A high TSH (thyroid stimulating hormone) indicates a condition called hypothyroidism. This condition can cause fatigue and high cholesterol levels but insomnia is very unlikely in this condition. Yes, your doctor will initiate a hormonal medication called Thyroxine which you may have to take for a long time. Hope this information was useful to 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 18 years old. I go to the gym six times a week. I am taking protein supplements and milk. I am not taking caffeine, alcohol or any other medicine. My resting heart rate is 84. When my pulse is under 100 I do not feel anything, but during some tension it goes above 100. While sleeping it is 72 and normally it is approximately 78. I want to know, is it dangerous? Please help me. I am worried about it. ### Response: We are here to help you. The normal heart rate varies from 60 to 100 beats per minute (BPM). During activity, heart rate of every person increases and it may cross 100 BPM. So, what I can see in your query is something that I also have. In fact, this is the pattern with every normal human being. So, there is no issue with your heart rate and it is not going to harm you. The supplements you are taking can be accepted if you are taking them in a moderate amount. Remember excess of everything is bad." "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 23-year-old girl and my physician has prescribed me Inderal and Cheer Up at night for a month. Will these medicines lead to a gain in my weight because I have my wedding after two months and I do not want to put any extra pound. ### Response: Hi. While Cefiget (Cefixime) is fine to give in a urinary tract infection. If you are having UTI for more than two months, rather than taking an empirical (experimental) antibiotics, you should go for a urine culture and sensitivity testing. Hope you are not suffering from any psychiatric illness. Otherwise, I do not see any indication of prescribing Cheerup (Escitalopram), Lacosbar (Lacosamide) and Inderal (Propranolol). Those medications are given to patients suffering from neuro-psychiatrist manifestation (except for Propranolol). Both Escitalopram and Lacosamide are associated with an increase in suicidal tendencies, while Escitalopram also affects sexual function and can cause loss of libido, and can cause anorgasmia in females. However, no effect on body shape or weight gain has been observed with Lacosamide and Propranolol, but Escitalopram can cause weight gain in about 1 % individuals." "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: Hello! I am a 20 year old female. I have a few questions regarding my IUD,HPV, and BV. The itch around the genital area I had first last year, and it went away and came back three days ago. The OB said I was spotting (I recently got my IUD when I visited the OB)1. I got my copper IUD last year, and have been experiencing \x80\x9cspotting\x80\x9d since. It's not everyday but it happens before and after my heavy periods. Is this normal?2. I have been to the OB before that too and they told me I have genital warts inside my vagina. I plan on just letting it go away since there seems to be no other option. I'm concerned if the IUD will make the HPV worse?3. At the same visit, I took a pap smear and results came back positive for BV-like flora. I went undiagnosed. Will my BV go away on its own? I don't have symptoms like grey discharge or fishy odor so I'm not that worried.4. The reason why I went to the OB last time was because I was itching like crazy down there. My discharge was like cottage cheese. It went away for a while but just just now, I checked for the string to myIUD and my finger came out with some cottage-cheese like substance. Do I have a yeast infection? Been itching for a few days too. ### Response: Hi, I understand that your IUD and the vaginal infection is troubling you. Regarding the IUD,it\s normal to have spotting after putting it in for some time.I assume you are having regular periods .If so wait for a month as your bleeding is not heavy.If it does not normalise,then it\s wise to see a gynaecologist who will need to check u to see if the position of the IUD is normal 2.Regarding the BV,it would be wise to treat it at the earliest as even if u don\t have symptoms now ,later it can cause issues. 3.Regarding the HPV,once your BV is treated it would be good to consider taking HPV vaccines (if u r not already vaccinated)" "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 2.5-year-old young girl got X-ray diagnosis bronchopneumonia, but her blood tests are all fine, nor she has a temperature. Just cough. We would like to see a second opinion on X-ray images. ### Response: Hi. I have viewed the X-ray chest image sent by you (attachment removed to protect patient identity). There are mildly prominent lung markings in the bilateral lunes and this can suggest hyperactive airways or a mild lung infection. There is no focal lesion or patchy opacity visualized. There is no pleural effusion. Keeping in mind the above findings, there is a possibile mild respiratory infection. There is no obvious pneumonia patch visualized. It is important to keep track of the symptoms and report to your doctors if there is an increase in cough or persistent fever, which I guess is not there right 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 have about six broken teeth. They are a mess. I am so scared of the dentist, but I need to see one. I am in constant pain all the time. I have had two abscesses in the last six months. I had eye infections as well on the same side. I am sure that it is connected. What to do? ### Response: Yes, the tooth infection can cause redness below the eyes. Please go to a dentist soon, and there is no need for fear as dentists are very smooth and painless in their treatment methods and you will not even know it. If the tooth is restorable and you can afford it, then root canal treatment is the treatment of choice. Otherwise, you have to extract it soon. You need at least start taking antibiotics like Amoxicillin-CV 625 mg as soon as possible for five days to reduce infection. Send a picture for better treatment plan after diagnosing the exact problems. Revert with pictures to 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 suffer from anxiety and my anxiety is always centered on my heart. With anxiety/panic alone, can my heart rate go too high that I cannot calm it down? ### Response: Hello. Anxiety can cause both normal increase in heart rate as well as abnormally fast rhythms (known as automatic tachycardia). I would also suggest a thyroid function test to rule out any malfunctioning of the thyroid gland, which may also cause fast heart rates" "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 a 1-month-old baby. I am giving breast milk and formula milk to my baby due to insufficient breast milk. However, my breast milk was not too low. I used to provide formula feed for one or two feeds. Before three days back, I was sick, and so I could not breastfeed my baby for one day. After recovery, my breast milk has been dropped drastically and hardly. I was able to pump only 10 ml per feeding which was 100 ml before. Is this because I have not breastfed or pumped milk for one day? I want to recover my milk supply. Kindly advise. Can I take fenugreek supplement? Currently, I am giving formula milk to my baby, and I want to do breastfeeding. I am taking Razo D and Histac 180 for acidity and Livogen before breakfast and Shelcal in the afternoon. ### Response: Hi. Breast milk secretion works on a demand-supply basis. The more you breastfeed, the more milk is produced" "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 autistic and hyperactive person in my family, who is around 19 years of age. He has been having epileptic seizures for more than a year now. The medication he has been prescribed by the doctors right now is Tegretol (Tegral). However, we think it has may have side effects. I want to ask are there any other appropriate alternate options of medication available for such seizures. ### Response: You are absolutely right that there may be side effects of prescribed medicine. There are many more alternative anti-epileptic medicines available.But every medicine has possibility of its own side effects. Consideration to change to alternative medicine is done if some side effect of medicine develop in a patient or that medicine is not effective." "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 experience a burning sensation while urination. I have taken the antibiotic course. It is still not relieved completely. It has been four to five months now. I have indulged in oral sex in this period. So, it is a UTI or STD/STI? ### Response: Hello. As per your reports (attachment removed to protect patient identity), urine culture is sterile. You can repeat urine routine and urine culture with midstream urine sample. Take a urinary alkalizer for three to five days. That will relieve you of burning sensation" "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 32-year-old male with a height of 170 cm and weight 50 kg. I had sudden deafness of left ear last year. No infection, no injury, no other disease. Treatment started with Mecobalamin, Dexamethasone sodium phosphate, and some other medication through IV. Also treated with mouse nerve growth factor and hyperbaric oxygen therapy. Oral Mecobalamin and B complex for a month. Now there is still some low-frequency hearing loss of the left ear and mild tinnitus. I am seeking for more treatment options and advice which may improve the hearing function. ### Response: As per reported by you, there is an improvement in the left ear however, in spite of all the treatments done, sometimes the loss is not entirely reversible. Thus there are high chances of the damage in the left ear to be the same, which is mild at low frequency. The main rates responsible for speech perception are that of 500, 1k and 2 k which are mild. However, your right ear will compensate so there would not be much problem in communication. Regarding tinnitus, you can consult an audiologist for TRT, which is called tinnitus retraining therapy from where you might get some results for tinnitus. If you want, you can ask an otolaryngologist for low-frequency hearing loss for further treatment. If your tinnitus is reduced, you will hear much better." "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 testicle pain on both sides (more pain felt on the right side). Sperm count is also low. What to do? ### Response: Hi. You have not mentioned your age, marital status, body weight, occupation, how long the testis pain has been there and any swelling in testis. With the available information, the answer is as follows: Kindly follow the below 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: Is Cifran 500 good for mild throat pain and voice hoarseness? ### Response: Hi. It is good that you asked this question here because taking unnecessary antibiotics can be extremely risky and unhealthy for your body. This tablet is mainly used to treat pneumonia patients that have a severe cough, fever, and abnormal symptoms and blood reports. Hence I would advise you to avoid it at all costs for now, unless you have all of the above. Throat infection causes your symptoms and the right medication for you is TusQ (Paracetamol, Bromhexine, etc.) or Lozenges like Vicks, Honitus lozenges, whichever is available and 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 baby is 22 days old. He suffered from jaundice when he was 7 days old. So, the doctor advised me to stop breastfeeding for three days. After that, breastfeeding did not fulfill his stomach so he was given powder milk a few times a day. He is passing stool more than 6 to 7 times in a day. Sometimes, it is runny, sometimes, yellow curd-like. Kindly suggest is he suffering from serious stomach problem and is it fine to give breastfeeding as well as powder milk to a baby? ### Response: A baby can pass as many times stool as they are fed. The stool can be slight curdy in nature and may vary in color from golden yellow to greenish yellow in color. You should focus more on breastfeeding your baby. But if milk output is not adequate, you may give top feed. But try to maintain utmost hygiene" "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 squeeze my shoulder blades together, my spine always cracks or pops (like cracking your knuckles). I do this maybe 20 times a day. I think it is becoming a habit. It helps to loosen it up. What causes this? Do I have muscle weakness? It has been an ongoing pain for three years and it is getting worse. It is very easy to pop and it is addicting. ### Response: The sounds coming from the spine is called as snapping of joints. A synovial joint is a joint where two bony surfaces are enclosed in a capsule with synovial fluid enclosed in it. It is like sound coming from two wet surfaces placed together and now separated. It is a normal physical property. You feel good or relaxed on repeatedly doing it because of your habit. You do not have any muscle weakness. You should avoid doing it repeatedly as repeated forces over a limited area of the spine will predispose it to degenerative changes over the long term. To avoid getting feeling of back stiffness, start to a regular spinal exercise programme." "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 cysts in both my ovaries. I had medications for a while, but I stopped using them. Since then, I have been vomiting almost everything I eat, and my stomach gets swollen all the time. I feel uncomfortable. I feel really sick every time I go to the restroom (almost every half hour). To be honest, I do not drink much water, and I do not eat well. I feel I lack nutrients and antioxidants. I also have really intense pain in the right lower side of my abdomen, and I also have pain during sexual intercourse. ### Response: Treatment of ovarian cysts depends on the size and type of the cysts and your age. If your age is less than 40 years and if the cyst is a simple one, it will resolve with medications. You can ask your doctor to prescribe some medicines to prevent acidity and vomiting and can continue your medicines (for cyst) along with them. If the cyst is a complex one and causes too much pain (as you have described), it is better to consult your doctor for the removal of the cyst. Most of such cysts can be removed laparoscopically. 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 was diagnosed with chlamydia trachomatis about six weeks ago. After that, I had some discharge and discomfort inside the urethra. They did a PCR test, and the diagnosis was Chlamydia trachomatis. The doctor gave me Azithromycin, I took six pills as a single dose. I still had discharge and discomfort after one week, so I went back. I had a sensitive reaction to Doxycycline before, it gives me strong oral thrush, very painful. So I told the doctor to give me something else. He gave me Levofloxacin 500 mg, once daily for two weeks. I still had discharge after that, although the discomfort was less pronounced. I tried to take Doxycycline, but after taking only one pill, 100 mg of Doxycycline, I immediately developed oral thrush (it was hard to speak and eat for 10 days) and itchy and painful fungus on my penis, so I stopped. Now after two weeks the oral thrush is gone, but I have discharge and discomfort again like in the beginning. What should I do? Is there another antibiotic I can use? Do I have to use Doxycycline and take antifungal medicine like Fluconazole at the same time? Kindly help. ### Response: Hi. Yes, if you can tolerate Doxycycline, you may combine it with Fluconazole. Fungal infection may have occurred as a coincidence. So it may not be due to Doxycycline itself. Another option is to try Cynomycin (Minocycline) 100 mg twice daily for 14 days. You may add an anti-inflammatory after consulting your doctor. If there is dysuria or straining in urine, add an alpha blocker like Tamsulosin. Please use a condom till your infection goes away." "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: Does economic stress affect a person\s health? Is there a link between financial stress, poverty and poor overall health? Do people who worry about their financial status have higher risk levels for certain types of diseases or illnesses? Can lowering stress levels improve overall physical health? ### Response: Yes, financial stress, poverty, and poor overall health are all linked. Because financial stress and poverty lead to deficient nutritional status hence affect physical health, worry about it lead to impaired mental health. Poverty is seen in researches that poverty leads to poor mental health and poverty again is a significant risk factor for mental illnesses. Yes, physical health and mental health both are interlinked. A healthy mind has a healthy body, and vice versa one cannot achieve complete health without being mentally healthy." "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 very small red blisters on the glans and corona with lot of itching. For that I have used Acivir ointment. There is temporary relief but it reoccurs. Please help. ### Response: Small red blisters on the genitalia usually occur in herpes virus infection. But they are associated with pain and burning. You are complaining of itching which is unlikely for herpes infection. I would recommend you to upload the photographs of the blisters, so that I can have a clear picture of the condition and can guide you accordingly. What is the duration of the blisters? Are you sexually active? If yes, any similar history in your sexual partner? Do you have diabetes or any other ailment? Are you taking any medicine for some other ailment?" "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 saw your pin about tear drop cells. I am trying to understand the meaning of this. Recently my 4 years old son had a CBC and the RBC was abnormal, he has tear drop cells 1+, schistocytes 1+, crenated cells 1+, stomatocytes 1+, schistocytes 1+, macrocytic 1+, microcytic 1+, poikilocytosis 1+, anisocytosis 1+. Please help me to understand this. ### Response: Hello. The G6PD deficiency, spherocytosis, immune hemolytic anemia, etc., are some of the causes for that. Microcytes and macrocytes could be due to anemia. It is called dimorphic anemia which might be due to iron or B12 deficiency. I suggest you investigate further with full CBC, reticulocyte count, serum LDH estimation, DCT for primary work up. You can Consult a nearby pediatrician for detailed 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 a 34-year-old female. I am on my second pregnancy. My last menstrual period was a month ago. Last month my beta hCG was 2708 mIU/mL, and transvaginal ultrasound showed GA (LMP) 5 weeks. Gestational sac 0.66 cm (no yolk sac or fetal embryo seen). A single intrauterine pregnancy with left corpus luteal cyst. I was suggested to take Ecosprin 75 mg, Folic Acid, and Progesterone injection weekly. Kindly advice. ### Response: Your details show that there is no yolk sac seen on the scan until now (attachment removed to protect patient identity), but you have not mentioned any query. I suppose you are worrying for absent yolk sac. I would suggest to repeat a scan after a week or so and also repeat beta hCG after 48 hours of the previous test date and check if it is almost doubling or not. If it is nearly doubling that would mean that your pregnancy is viable. And soon yolk sac will appear, but if the level is falling, then it would mean that abortion might be there. I hope it has helped you. If you have any further queries, please do not hesitate to contact 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: I am a 40-year-old male. I have perforated right ear for the past 20 years and get discharges on various occasions and treated every time. But I have no discharges for the last three years. As a routine checkup, I am asked for a CT scan and the findings are as follows: 1) Right -sided mastoid air cells are partially sclerosed with reduction pneumatization, however, no collection is seen at present in mastoid air cell or middle ear cavity.2) Right maxillary small retention cyst.3) Mild DNS with nasal septal spur.I have no problem in the ear except a tension (pull) in nerves (veins) around the right ear while moving my head to and fro.I am currently taking antibiotics and Montelukast.My lab report shows WBC 9600 / cu mm, Neutrophils 74%, lymphocytes 18%, monocytes 01%, eosinophils 07%, basophils 00%, ESR first hour 06 mm. ### Response: You have right-sided chronic otitis media which is a common type of chronic middle ear infection. Since your ear is" "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 diabetic for the last five years. Presently I am having rashes and cut on my penis covering skin. Sometimes there is itching. Please advice me with appropriate medicines. ### Response: Hello. It can be balanitis from your description. Apply Miconazole 2 % cream or Clotrimazole 1 % cream twice daily. Please send image and revert so that oral medications can be decided." "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 31-year-old male and I was diagnosed with spondyloarthropathy seven years back. I am taking only Sulfasalazine tablets daily. Currently, I do not have any pain or stiffness. My HLA-B27 report is negative. Now, if I do the following MRIs, how much chances are there that any abnormality might be found in my body?DL Spine MRIHip Joint MRILumbosacral MRIPlease tell me only about these three MRI test as I need to show it to someone and I do not want to be caught with any disease.Last week, I did a blood test and chest X-ray (PA view). The X-ray report was normal. ESR was 20 mm. TC and DC were normal. Please help. I have attached the MRI report for your reference. ### Response: I am unable to find the attachment. It is good to know that you are doing well on Sulfasalazine only. But if you are doing well and have no symptoms with normal blood tests, I will not recommend MRI (magnetic resonance imaging) to be repeated. The MRI is only needed for doubtful diagnosis initially and to look for inflammation in the joints if there is a doubt. For followup, we only do X-rays of the neck, mid spine and lower spine. That usually is good enough to see if there is any disease progression when we compare it to the previous ones. But if really you want to do an MRI and you have no symptoms, I am sure it will show improvement. A look at the MRI report would be helpful. Do let me know if you have more queries" "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 baby is 6 months old (9.50 kg) and is suffring from cold. Doctor has prescribed Wikoryl 1.5 ml three times a day, L Montus suspension 5 ml once at night. Please advise whether the dose of L Montus is fine considering age of the baby. ### Response: Yes, for 6 months old baby, I will not advice any cough medicine. L Montus contains Montelukast used for treatment of asthma and allergic rhinitis. Safety and efficacy at 6 months of age is not yet established. I consider these medicines are higher for the age group and should be given with due consideration. Your doctor might have strong reason and better experience with these 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 blood report came today surprise me that my creatinine is 3.05 mg/dL. How bad is it? I am very concerned. Is there any way I can avid dialysis and treat with medication, diet and excursive. Please guide me if possible. I am taking Verapamil ER 180 mg and Atorvastatin 20 mg for high blood pressure for last 15 years. ### Response: Hi. As I understand, you are having hypertension for past 15 years, apparently under control at present. Many a time, hypertension can remain undetected, without symptoms for long. So we may not know the exact duration of the disease in many patients. You have hypertension for a minimum of 15 years. It is not mentioned about the status of control in initial years. I hope that it was controlled. Looking at your results, this is most likely to be hypertensive kidney disease. However, we have to rule out precipitating or complicating factors like recent intake of painkillers, obstruction of urinary tract like prostate enlargement (normal PSA- prostate-specific antigen need not rule it out), recent infection, etc., many of these factors, if treated, may to some extent reverse kidney failure which you have. I suggest you have an ultrasound abdomen and urine routine" "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 taken 1000 mg of Encicarb. I tested it, after two weeks my hemoglobin raised. First, it was 10.7 and then after taking an injection, it came to 11.1. Will it increase more after two weeks as my iron medicines are going on? ### Response: Iron injections take up to four to six weeks to show an increase in hemoglobin levels. So, there is a definite chance that your hemoglobin levels may increase further if you are on ongoing treatment. But, it should be kept in mind that if the cause of your iron deficiency anemia is due to any other cause than nutritional deficiency, like bleeding stomach ulcers, heavy periods, any other bleeding manifestations or kidney disease, then they need to be treated as well. If not, it will not allow your hemoglobin to raise. If there is no other cause than nutritional, then your hemoglobin is sure to rise 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 creatinine level is 1.9. What should I do? My BP is normal. I am currently on Zyloric 100 mg thrice daily, Atorvastatin 10 mg, and Eltroxin. I have done an ultrasound. I had a USG done with no abnormal findings. ### Response: Hello. This rise in creatinine levels is usually related to a kidney dysfunction. For this reason, I suggest performing further tests to investigate your kidney function like creatinine clearance, a urine analysis, urine microalbuminuria and consult with a nephrologist. It is also necessary performing a urinary tract ultrasound. Chronic hyperuricemia can lead to chronic damage to the kidneys. Anyway, I reviewed all your performed tests and would explain they are normal (normal blood lipid profile, complete blood count, thyroid function, fasting glucose, uric acid levels)" "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 age is 18 years. I had a root canal last year. I have many cavities in my teeth. I brush three times a day nicely then also cavities grow up and come on other teeth. Please tell me any of your solutions. ### Response: I have been through your query and I can understand your concern. The cavities (caries) have many causes to occur in the mouth. And overall cleaning with proper technique of brushing and flossing is essential to maintain good oral hygiene. Good oral hygiene with regular dental check-ups will ensure no cavities in the future. I would advise you to have a visit to your nearest dentist and get the remaining cavities filled (restored). And have a proper cleaning and scaling done for the teeth. In order for proper brushing technique, ask the dentist you visit to show you the suitable and proper brushing technique. As for now, you can search the modified bass technique for brushing your teeth. Be gentle while brushing. Always brush after breakfast in the morning and after the dinner (before sleeping) in the night. Do regular oral rinses after having meals and floss regularly in order to ward off the cavities. Maintain good oral hygiene and follow above said things and I can assure you that your teeth will never get any cavities." "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: What are these lesions? ### Response: Please provide me with more details. How does this lesion develop? Any recent history of unprotected high-risk sexual intercourse? Any discharge from penis? Any pain? The lesion appears to be vesicle (attachment removed to protect patient identity)." "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 25 years old, female, married 8 months back. Sexually active and using condom. I have hypothyroidism and I am taking Thyronorm 75 mcg and one Levocetirizine in daily basis. My last period was three months back. Then I got my period two months later and it was late and the flow was also very little even I was not using a pad also. Then I consult a doctor. She told me to get an ultrasound test of pelvis. The report is normal. She adviced me to take Regestrone for three days. I started it from that day. Then I got my period yesterday night with little flow again and having pain in stomach and back badly. She suggested me to go for hormone tests in 2nd or 3rd day of my period. I am very confused and do not undetstand what is going on. I am feeling very weak and sleepy all the time. Please give me some advice what to do. ### Response: Hi. There are many causes for irregular periods and scanty flow. Some are due to structural abnormality in the uterus, for which you were asked for Ultrasound which came out normal. Other causes are certain hormonal imbalances in the sex hormones secreted by pituitary or ovaries or thyroid also which can be confirmed by doing the hormonal assay. Your doctor is going in the right direction. But if you can mention me what hormonal test has been advised I can give you more information on that. I also advise you to get TSH test also. Kindly get the tests 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: I have a small little pimple and I am worried if it could herpes. I have not had sex in about two months and I always used a condom. I never had unprotected sex in my life, but I have seen this little red spot and I am worried if it can be an STD. ### Response: Hello. I have noted your concern and I have viewed the images (attachment removed to protect patient identity). No, it is not herpes. Genital herpes usually presents with multiple, grouped, fluid-filled lesions or genital sores which are quite painful. Regards" "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 36-year-old male. I vomited yesterday, feel fine now. But I puked up three worms. About 1.5 to 2 inches wide. How do I kill them? ### Response: You seem to be having severe worm infestation. In such case scenarios, I recommend my patients to take tablet Albendazole 400 mg twice a day for three days. However, I first recommend a stool examination for ova and cyst." "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 a problem in my left eye. I am often getting tears in my left eye, and it is causing banging pain in the left side of the head. A kind of headache starts beside my eyes, causing irritation, and feeling sensitivity for light. How can it be treated? What is the recomended medication for my problem? ### Response: Hello. Is there any redness or blurring of vision? Do you have a headache all the time or more when you wake up from sleep? Is there any family history of glaucoma? All the above details are necessary because you have not explained your headache or any kind of eye problem. Use at least three to four times in a 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 45 years old, suffering from diabetes. I have fasting blood sugar avarage 140 to 150 and also I have urine infection showing pus cell in plenty. Kindly suggest me for controlling infection in urine. ### Response: Hello. I have read through your post and I can see that you are on antibiotic. However, the one you are taking is most likely not effective against urinary tract infections you are suffering from. It is important to treat the infection so I would advise you to get a culture and antibiotic sensitivity testing of your urine to see, what kind of organism is causing the infection and what antibiotic will likely to be effective against it. Based on the results, you can be put on the most suitable antibiotic for this. Please go to the hospital, if your symptoms worsen or if you develop fever, shivering or generally start to feel unwell." "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: There is a cavity on my left molar tooth and it pains a lot even when the tongue touches it. ### Response: You need to visit a dentist as soon as possible. If it is not treated soon, you may either need a root canal treatment or extraction of the tooth. For the meantime, I suggest taking the following medicine: Consult your specialist doctor, discuss with him or her and start taking the 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 an 28 years old and I have a skin problem on my face such as acne, blackheads, big pores, etc. It is usually not that bad but once my spot is gone, I have a red mark that could stay on my skin very long. As a result, all my skin looks a bit reddish due to spots marks. I would say my skin type is combination since it's dry after I wash my face and then it gets oily, especially on my T zone. I am currently using La Roche Effaclar Duo to get rid of my acne and especially my spot marks but it does not seem to help a lot. That is why I was just wondering if you could recommend any skin routine that would help me to get rid of my acne and make my skin look better and healthier. ### Response: Hi. Skin in adolescent and young adult are covered with sebum secreting glands mostly over face and trunk. They increase during the summer and varies according to menstrual cycle. Besides oily cosmetics can hamper the acne formation process and aggravte the problems. You can regularly cleanse the skin using facewash containing salicylic acid and or glycolic acid or mandelic acid. To improve the acne and facial skin we frequently use gel containing retinoic acids specially at night. But if you have bigger acne lesions sometimes we need to have some laboratory investigation to start oral retinoic acid. Could you please send me your picture so that I can discuss with you in detail." "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 two miscarriages one was in the fourth week. While taking the scan, the sac was not found and two-week delay in growth. Another one for almost seven weeks and two-week growth delay. Now I am pregnant after six months of the second miscarriage. Now I am in my third week.My doctor advised to take injections for Progestogen and Aspirin, and one more substance was there, and I do not remember the name. I need to take the injection every day until the fifth month of pregnancy.In the second pregnancy till sixth-week heartbeat was everything was fine. After the second miscarriage, I had a delay in my periods and took a scan at 12 days of my period, and my dominant follicle was smaller when compared to regular size 11.58. I would like to here second opinion for this. So please advice. ### Response: Probably the name of the third injection would be Heparin (blood thinning agent). And there is no harm in taking these medicine in accordance to doctor advice. And it will be helpful for your pregnancy. Hope it has helped you. If you require any further queries, please do not hesitate to contact 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 father had a stent surgery two months back. After that, he has been feeling a burning sensation and deep coughing. Yesterday at his CT scan, the left anterior descending artery had a calcified plaque with proximal LAD of moderate intensity of more than 70%, and also a densely calcified plaque was noted. Calcified plaques were noted at the ostium. The left circumflex artery was noted between 50% to 70%. The obtuse marginal plaque was noted with 40% to 50% stenosis. Kindly suggest the severity of the disease. ### Response: Hello. If the patient had a stent surgery then why he is only on aspirin? He should be on dual antiplatelet, high dose statin, ACE (angiotensin-converting enzyme) inhibitor and a beta blocker. Please revise the medication chart. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. A coronary angiogram only tells us that disease is present in a specific artery and does not tell the extent of the disease. If the patient is symptomatic then he should check angiography to assess the extent of the of disease present" "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 what you thought of these symptoms:Weight fluctuation. I gained weight then lost weight then gained weight then lost it. It settled.Now my stomach had problems for a bit, diarrhea for a bit, and that stopped.Then thrush I think. The tongue is coated white but gets worse when I eat. When I brush and scrape the tongue, the white coat thins and gets better, also if I drink water after brushing.Dry mouth is a symptom and lymph nodes prolonged but no pain.My feet (my toes) have dull shooting pain. I play basketball. So, they begin to hurt after a while and I am only 19. That should not be happening.Some days after basketball, I begin to feel ill and throw up water.Also, after playing, I sometimes crave gummy worms or very sugary snacks.I used to get terrible cramps in my thighs front and back and calf muscles that would cause me to stop abruptly.Can diabetes cause swollen lymph nodes? And what are the chances that what is happening to me is diabetes? ### Response: Hello. I think you are worrying too much. You are just 19. Enjoy life. The fluctuations in your weight will be most probably because of your different habits of eating and playing. When your eating more than you play, you are bound to gain weight. Right? The cramps in your muscles can be caused by electrolyte imbalance. You can add a pinch of salt to your water as well. Your symptoms are definitely not pointing towards diabetes as such. Still, if you suspect you are suffering from diabetes, you need to check your blood glucose levels in fasting and postprandial states. That is the only diagnostic method to label you as a diabetic. Symptoms are vague and non-specific even in cases of diabetes. Hope you are satisfied with my answer and explanation. Have a great day. Regards" "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 I take antihistamines (an OTC drug) when pregnant? ### Response: Hi. Antihistamines are used to treat allergy symptoms." "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: Dear Doctor,My daughter is 5 years old. A vaccinated dog scratched her right hand with its teeth. There is no skin damage but deep red mark is visible.Is anti-rabies vaccine optional or compulsory for her? ### Response: Let me explain the seriousness of the deep red marks simply : Visible deep red marks could mean a very small wound but it is still a large door for rabies virus to enter. If rabies has once developed, then it has no treatment. Prevention by anti-rabies vaccination is the only available treatment in a case of dog bite. Anti-rabies vaccine, available now are very safe. I advise you to give her the complete schedule of anti rabies vaccination after consulting a doctor immediately. Hope I have answered your 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: My son is 5 years and 2 months old. He has got continuous stomach pain, especially at night time. During the day he is fine. Can I give him Albendazole? ### Response: Hello. You can give a dose but that is not the main cause of his stomach pain. Most of the kids have stomach pain due to constipation. They say they pass stool regularly, but stool keeps getting accumulated. To confirm, you can just take an X-ray of the erect abdomen. We can see the fecal loading of the colon. I suggest giving syrup Looz 10 ml (Lactulose) twice daily till the stools become soft. Hope this will definitely help 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 daughter is 13 years old. She is suffering from strange allergy since two years. It became very bad and affects her psychologically. It started when we changed our location before two years. I have consulted three doctors and all of them said it as strange and did not show response to any medication. I even tried biopsy to find out the disease. Her doctor just advised to avoid potato chips, cream, etc. She become more frustrated and looks sad always. Please help us. ### Response: I have seen your concern and examined the given pictures (attachment removed to protect patient identity). Anxiety, depression and personality disorder. No specific laboratory blood tests are required to establish a diagnosis of dermatitis artefacta nor are any diagnostic imaging studies indicated. 1. Dermatitis artefacta.2. Factitious disorder.3. Striae distensae. Dermatitis artefacta. 1. General dermatologic care measures include baths and debridement (thorough cleaning).2. I suggest you to apply emollients like Emoderm cream (White soft paraffin and liquid paraffin) twice daily along with topical antimicrobials like Fusidin cream (Fusidic acid) twice daily for five days. Consult her doctor, discuss with him or her and take the treatment with consent.3. Consultation with a psychiatrist is recommended. She needs to be observed closely and she really requires psychological support. Revert back after a month 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: A few weeks ago I noticed that my bottom front teeth felt slightly loose. I looked up my symptoms and suspected it might be gum disease because I have always had poor dental hygiene and never flossed. Since then I started brushing, flossing, and using a natural mouthwash three times a day, then I went to the dentist and asked about my concerns.The dentist told me that I did not have gum disease and had nothing to be concerned about and the loose bottom teeth were most likely from grinding. I want to believe him but I also want to be sure he is correct. My gums are mostly pink close to the teeth but farther down they are very red and seem decayed. ### Response: Hi. Let me tell you something. Even I have undergone this situation (personally). There are several types of periodontal conditions, out of which, this is called trauma from occlusion due to bruxism, clenching. Your teeth may loose its normal curves or contour and may even get loose. Primary line of treatment involves splint or night guard, along with minor procedures. You can share a picture by following up and attaching a file. I would be glad to assist you. Many a times, such mobility turns out to be more physiological than pathological (as it turned out for 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 wife is 7 months pregnant. We found red rashes on her body two days back. Today, two of them found as blisters. We met the doctor and she said it as chickenpox. Can you advise the precautions we need to take? Also, what are the risks associated with this? She is currently on Amoxicillin and Potassium clavulanate 625 twice daily. ### Response: The chances are good that your baby would be fine. The risk is highest if you are infected between weeks 13 and 20. You can be given an antiviral" "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 dilated vasculature including the abdominal aorta, inferior vena cava and iliac veins (described as aneurysmal in size, 34 mm on right, 21 mm on left). What could cause this? Could stress cause that? ### Response: An aortic aneurysm may result from trauma, infection or most commonly from an intrinsic abnormality of elastin and collagen component of the aortic wall." "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 molar extraction and now water I drink comes out of my nose. I consulted an oral surgeon and he did a small surgery and gave stitches three times but no result. Is it very dangerous? Please advice further medication and treatment. ### Response: Usually, the area should be adequately closed by suture. This happens due to a hole in nasal sinus when the upper molar tooth is extracted. It is dangerous in long term if the hole does not close on its own. The hole should heal in a week or two when the wound caused by the tooth is healed fully. If it does not and you face the same problem, then you need to ask your surgeon to properly close it again." "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 mole removed yesterday from my leg and I am very worried despite my dermatologist saying she did not think it was melanoma. She said she knew I would stare at it constantly and worry and that taking an atypical mole off here and there was alright and saved a lot of anxiety. She knows I have severe health anxiety. This mole was 3.5 mm and the worrisome thing was that it had a darker dot. I was hoping you would take a look. Before I left, I said, \x80\x9cIf it is melanoma -\x80\x9c but she interrupted and said she did not think it was. What I was going to ask though, was if it was, then hopefully it would be early since it is small. ### Response: Hello. I saw the picture (attachment removed to protect patient identity). Clinically, it does not look like melanoma, but it is good that your dermatologist did a biopsy. So, the result will show us if it is a melanoma or not. It may most likely be a dysplastic nevus. I am sure your dermatologist would have looked at the lesion through a dermoscope, which enhances the features, and pattern of pigmentation. I feel it is good to get it biopsied rather than keep worrying about 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: I am a 38-year-old female. I have extreme fear, suicidal thoughts, and fear of failure. I am not able to concentrate on my daily activities. How to overcome all these situations? I had an aortic valve replaced through open heart surgery. I was under Nexito and Rivotril for two years after my open heart surgery. ### Response: Decrease in concentration, suicidal thought, fear of failure, and sleeplessness are features of a depressive episode. Why did you stop the medicines? Did you take the medications in the proper dose, and is there any episode similar to the illness has occurred previously? I think you should again start Nextio Fort (Escitalopram and Clonazepam) for the adequate duration, and if not improved, some second-generation antipsychotic can be added, or try cognitive behavior therapy. For sleep you can take help of sleep hygiene to wake up on fix time irrespective of sleeping hours. Avoid coffee or other stimulating agents, have a brisk walk, avoid food before three hours of sleep, and you can take a shower with lukewarm water." "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 30 years old and got married a year ago. We are trying for a baby for the last three months. My LMP was on the 9th of last month. I never faced issues with my menstrual cycle. It is a regular 29 day cycle. We had an unprotected sex from 17th to 25th for every alternate day. I have started getting pain on the right pelvic or pubic bone area from 29th. The pain is not continuous. Sometimes, it was a severe stabbing pain. I have consulted a doctor and performed a vaginal test as well and no abnormalities have been noticed. Also, I have got an ultrasound and thyroid test in the past two months and no abnormalities have been noticed. I got spotted on the 8th and till continued till 10th. It has started as pink and turns into bright red and then dark brown. In the whole three days of my spotting, I had on and off pain. Whenever there is pain, there will be spotting, I can wipe it up with the tissue. On the 8th evening, the spotting continued for 2 hours with 15 to 20 drops and few clots as well. I am sure that was not my menstrual bleeding. I do have proper menstrual bleeding for all these years for three days. I have performed a beta hCG test on 10th and the test results came as negative with the value of less than 1. Please clarify my doubt. ### Response: Hello. If the serum beta hCG test (human chorionic gonadotropin) as on 10th is less than 1, then you are surely not pregnant. But, full flow may be achieved in the next few days. There is likelihood that the flow may start in the next few days. Keep a watch, as you are not pregnant during this cycle for sure." "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 periods ended on 10th, and I had sex on 12th. Within an hour after intercourse, I took Unwanted 72. On 14th, I bled only for one day. Is there a chance of pregnancy or not? ### Response: Since you have taken the emergency pill within 72 hours of intercourse there is no chance of pregnancy. So, relax and do not worry" "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 FESS done before five months. Shortly after I noticed clear drainage from my nose. I had a pledget study done that confirm a bilateral CSF leak. Five weeks ago, I had sx to repair it, however in sx under intrathecal fluorescein, and the surgeon could not locate the leak. Nose still leaking and Beta 2 transferrin test came back negative.On Atrovent, for two days nose still drips, especially when bending over. Do I get a second opinion or assume it is caused by chronic rhinitis and start on a nasal spray that combines a steroid or antihistamine in it as my surgeon suggests? I never had any problems with a runny or drippy nose like this until after I had my sinus surgery. ### Response: Hello. CSF rhinorrhea is a known complication of extensive FESS (functional endoscopic sinus surgery). If a pledget had shown confirmed CSK leak, it sure needs to be investigated. Small leaks heal and recover by themselves however, if the leak persists longer, then it needs to be sealed by endoscopic surgery. In your case, any watery discharge from the nose should not be ignored. Especially if the release is more during bending, coughing, straining lifting weight etc. You may need an MRI, but I suggest meet an ENT endoscopic surgeon for further treatment. Sometimes this can get serious, so it is essential to meet your doctor." "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 rheumatoid arthritis two years back. I am on Ayurveda treatment and have taken Panchakarma treatment as well. There is a slight improvement, but still, my swelling on the left knee is not coming down, and recently a pain in the left wrist has begun. My ESR and CCP are very high, and the cartilage in the left knee is torn. I cannot walk fast or climb the stairs. I also started Methotrexate 7.5 mg and Vitamin D recently. Please give me the best advice to deal with RA. Should I continue with Ayurvedic medicines or should I try steroids? ### Response: Hello, Welcome to iclniq.com. I just read your query and saw all the reports (attachment removed to protect patient identity). I hope you are satisfied with my answer. Revert after four weeks to an ayurveda 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: Does the natural background radiation level (3 mS v per year) add to cancer risk on top of a dose from medical imaging, or is natural radiation separate or safe since we all receive it? ### Response: Hello. One mSv is the limit for the general public. The background is usually within this limit. But radiation workers have a limit of 20 mSv per year, which is also very safe. Also, doses from medical imaging can contribute. But the benefits from medical imaging offset any potential theoretical risks of increased cancer risk. Background radiation is 0.1 uSv per hour, which comes to about one mSv in a year." "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 vaginal opening is white, and I have so much of discharge coming out. I am sexually active. I feel like my vagina is really large. I looked at my underwear and it was just filled with a paste-like discharge. I know I am ovulating. But I am worried when I look down there as I see a white discharge in my hole. When I wiped it by myself, it does not have any smell. It smelled regular. Is this a regular ovulation discharge or an infection? I have no itching, and there is no pain. ### Response: I have gone through the attachment (attachment removed to protect patient identity). The white discharge is thick curdy. Candida infection causes the same. However, in the absence of itching or foul smell, it is recommended that you get a high vaginal swab culture test done to check for any possible infection first. If it is negative, it is likely a cervical mucus discharge during ovulation, and it can be controlled by using alkaline vaginal washes twice a 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: My fiancee wants to get pregnant within next eight months and is pressurizing me to get married by then. She says that even waiting for one month will be too late as she will turn 30 by then. Will 8 months make such a difference that her body will be deteriorated if she waits until next month? ### Response: Theoretically, it is ideal to have pregnancy before thirty especially the first pregnancy as after 30 we say it is elderly pregnancy and there are some inherent complications associated with elderly pregnancy like hypertension, GDM, impaired fetal growth, etc. So it is desirable to have first pregnancy before 30. So you talk to your fiancee and try to find a middle path and tell few months does not make much difference." "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 fatigue issues. Can you suggest a health supplement. I was thinking of using Amway Nutrilite Siberian Ginseng With Ginkgo Biloba. Further I am currently having vitamin B12 and Vitamin D deficiency for which I am using specific supplement as suggested by my physician which includes Mecobalamin 1500 mcg and Cholecalciferol granules in addition to spending some time in sun. I further wanted to know whether Amway Nutrilite Siberian Ginseng With Ginkgo Biloba will react with any of the current medication. Also, I have attached my latest blood test reports. ### Response: I appreciate your efforts for uploading the laboratory reports (attachment removed to protect patient identity). 1. 2. Yes, you may use the Amway product. It is a good brand for dermatological and dietary supplements. But there is little to no research available from third party or independent unbiased researchers. So, the safety of dietary products and other" "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 unprotected vaginal and oral sex with a sex worker three weeks ago. I do not know her status of HIV although she said she is clean. Exactly after seven days of my exposure, I feel something wrong with my body as it is feeling uncomfortable. I had oral thrush, loss of appetite, swollen lymph nodes in neck, body aches, needles like pain all over my body, night sweat although no fever but I can feel the temperature is high, it is 98.5-99.3 degrees for the next couple of days. So I suspected that I got infected with HIV.Due to anxiety, I took the HIV antibody test on the 9th day of my exposure which I know is a bit early come out negative. But then on the 10th day (exactly after 9 days 10 hours), I took HIV 1 RNA TMA test on stdcheck.com which they said 95-99% accurate in 9-11 days after exposure. I got the result yesterday, as negative no HIV 1 RNA detected.Now, still I am in confusion because I am 100% sure I got infected with HIV. I do not know if these tests are conclusive or not. I do not have guts to do another test. Please help. And also some of my symptoms are gone but I discovered some additional like pain in kidneys, lower abdomen, chest pain, joint pain, and extreme fatigue for two to three days. ### Response: I have gone through the details and reports. (attachment removed to protect patient identity). All the tests are negative is a good sign. The chances of transmission of HIV by unprotected intercourse with an HIV positive person is too low. If negative it is nil. You can allay fears. HIV RNA PCR is negative and is a good sign. It is almost conclusive. The chances of tests coming positive later are nil. But it is better to get tested for HIV 1 and 2 antibodies after three months to have conclusive results." "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 got married one month ago and since then we are trying to have sex. Me and my husband are both virgins. However, the first attempt did not succeed and with time we try more but until now every time he penetrates me I get pain and feel his penis is not entering fully like there are burdens that keep him from entering correctly along with burning feeling even when using gel. And when we try a doggy style I do not feel anything only air enters and no pleasure at all. Kindly help. ### Response: Hello. If penetration is the problem, then check for your partner erection status, and penis size. If pain is the problem, check for vaginal infection, vaginismus. If pleasure is the issue, few females respond only to vaginal massage or masturbation, not to penetration." "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 getting increasing acne day by day. How to prevent them from coming on my face? ### Response: Acne is very common in one\s teens and twenties. Some continue to have breakouts even later in their life especially if there are some underlying hormonal issues or genetic predisposition. Pimples develop because of increased sebum secretion, inflammation, and bacteria residing on the skin called P. acnes has an important role to play. Treatment requires knowing your detailed history, any hormonal issues, any treatments you have taken in the past, products you use on your face, etc. Oral medicines and creams/gels are used for the treatment of acne. For mild eruptions, creams containing Clindamycin and Nicotinamide may be used. Benzoyl peroxide and Adapalene are other commonly prescribed anti-acne applications. But it is important to discuss with a dermatologist to decide on the correct line of treatment. Meanwhile, eat healthily, avoid excess milk and dairy, chocolates, and junk food. Exercise regularly and sleep well. Also, avoid using oil or greasy applications on the scalp and face and keep cosmetic use to a minimum. 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 taking Diane 35 (21 pack) tablets, I missed yesterday\s pill (11th day). Today I have realized, now I have taken my regular pill. Please let me know shall I take yesterday\s pill today? ### Response: The following are the standard protocol with Diane 35. If you miss a dose of Diane 35 and are more than 12 hours late in taking a tablet, follow these guidelines to help you decide what to do. Week 1: Take the last tablet as soon as you remember and take the next one at your normal time, which may mean taking two tablets in one day. Contraceptive protection may be reduced and you are at risk of becoming pregnant unless you take other contraceptive precautions for the next seven days. Week 2: Take the last tablet as soon as you remember and take the next one at your normal time, which may mean taking two tablets in one day. You are not at risk of becoming pregnant and do not need to take extra contraceptive precautions. Week 3: Take the last tablet as soon as you remember and take the next one at your normal time, which may mean taking two tablets in one day. Take the remaining tablets then begin the next pack immediately without a break. Now do please check, which week of your cycle you are in and take accordingly. Do revert back for further queries." "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 brush my teeth every day and still cannot get my breath fresh. It comes from my throat. I have tried everything. Can you tell me what to do? ### Response: Hi. This is the age when you will be having new teeth erupting which causes gum swellings and accumulation of plaque (deposits) on teeth which might cause the bad breath. The other thing is any cavities, if present, cause bad breath as well. Any gastro problem such as GERD (gastroesophageal reflux disease) may also cause this. People who skip breakfast also suffer from this. So, in this way, there are many reasons for bad breath. First, we need to identify the cause so that we can come to a proper treatment plan. Just visit your dentist and get the solution soon" "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 placenta previa at 14 weeks. I have had one episode of heavy bleeding. Are there any foods (going above and beyond healthy pregnancy foods) that I should eat to ensure my baby gets the nutrients he needs to make up for the blood loss? ### Response: Hi. You have been diagnosed with placenta previa. Eat high protein diet via vegetarian and non-vegetarian sources, iron-rich diet to make for the losses. You can add Iron tablet daily if Hb is less than 10 gm. Your baby will get good nutrition if you eat a good diet. In your case, you can have the recurrent episode so be careful. Maybe because the placenta is big in case of twins, sometime this placenta migrates to the upper segment at around 28 to 30 weeks. Avoid any heavy weight lifting, exertion, long traveling, intercourse, squatting. Be careful as it is painless and recurrent and even causeless." "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 71 years old and I am in the process of getting major work done throughout my mouth. At the moment, I have only three grinding teeth on my upper. Two on the left and one on the right (numbers 4, 12 and 13). 11 days ago, the dentist reinstalled the crown on number four, but when I left his office there was no contact in number 4. There was only contact (occlusion) on 12 and 13. Of course, it was very difficult eating with only two teeth that had full contact. After a few days, I started to get a lot of pain in my neck and behind my ear and up almost to the top of my head on the side of number 4 (right side) and there was numbness in the area of my jaw joint (in front of my ear). I saw the dentist again four days ago and he added some type of material on top of number 4 to achieve occlusion there. I still have the pain constantly and it is pretty unbearable. 800 mg of Ibuprofen and Aspercreme on the area help me somewhat. I called the dentist and he said that the pain was related to some nerve problems inside the number 4 tooth. I have been thinking maybe there was some damage in my jaw or something because of my jaw having had overwork trying to make on the right side while eating. What do you think? ### Response: Hi I have read through your complaint and the relevant details. Firstly, I would like to ask you for what reason was the crown was placed for tooth 4. And usually, when there is no occlusion on one side, you will get pain and soreness on the opposite side. If the occlusion is high i.e. too high crown, the pain and soreness will be on the same side. Repairing the crown with extra material would not be ideal. If the occlusion is not there, the dentist must have given you a new crown in place. Were there any x-rays taken for the same tooth? In that case, any nerve problem can be easily identified. Please do not worry that you got a jaw problem. It is with the construction of the occlusion which helps you to do normal function. Ibuprofen 400 mg thrice daily should work well for this kind of pain. Heavy doses are not advisable. I reckon you check with the x-ray for that tooth if you have not had any before and forward it to me. I also request you to send the picture of the teeth so that I could arrive at a better diagnosis." "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 it safe to do strength training for osteoporosis? Does strength training improve the bone mineral density? What type of exercise or movement are good for osteoporosis? Which one has to be avoided, and why? What are the signs and symptoms seen in osteoporosis? When it has to be diagnosed in everyone? ### Response: Strength training is not safe, and it is highly recommended in osteoporosis. It helps to increase the bone mineral density. Do workouts that keep the spine straight such as squatting. Try to strengthen your back muscles. Have workouts on your hip and spine. Do cardio exercise along with these workouts. Have a regular walking. You have to avoid activity that involves the bending of the spine. Avoid doing the heavy lifting. Osteoporosis has to be screened in persons who reach menopause, persons having a history of fracture frequently after 40 years of age and persons with family history. Individuals having back pain, pain in the knee joint, and having fractures frequently has to be screened for osteoporosis. It has to be tested for men above 60 years of age and women above 45 years of age." "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 this lump on my hard palate for about three months now. It is located near the middle line and a few millimeters to the left. It is about 2 x 2 mm in size, pretty round and it does not hurt. I thought this might be torus palatinus. But, I heard that this torus is mostly symmetrical and my lump is only on one side of the palate. In the picture, it looks a little red because I scratched it with my finger nail. It was just a little bit more red than the other side of my palate as I scratched it. So, what could this be? I am scared that it might be some kind of cancer. ### Response: Torus palatinus. If torus palatinus, then it is completely harmless and require no further investigations. Revert back with the answers to the above questions to 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 have been playing volleyball, basketball, and athletics for around two weeks, but my leg muscles are still sore. Standing in the same position gives some relief. When someone touches my legs even softly, they ache hard. It is paining around my ankles and knees mainly. With this thing on, I am playing sports continuously. Can you help? ### Response: Hello. This professional advice provided by me stands subject to the actual examination of report/image and is based entirely on inputs provided to me. It should be correlated with clinical findings." "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 I have Telogen effluvium because my hair has been diversely thinning for over a year and I have even lost hair on my neck area and sides of my head, along on top the scalp. I went to the dermatologist once last year and he thought it was TE, but it has not gotten any better and they did not prescribe me anything. Please help. ### Response: In telogen effluvium, there will not hair loss involving the neck area. Is there any history of acute illness or systemic upset before the start of this problem? Why telogen effluvium was diagnosed? Is there any family illness of baldness? Hair loss over neckline is looking like alopecia areata type of hair loss. Diffuse type of hair loss can be seen in alopecia areata and also in telogen effluvium. Nutritional deficiency is the commonest cause. Keep your hemoglobin above 12g/dl. Take Biotin containing hair supplements. Have dates, fresh vegetables, and fruits rich in iron. After the Corona crisis meet your doctor and do a scalp biopsy to confirm the diagnosis." "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 21-year-old female, non-smoker. I noticed a bump at the back of my throat the other day, but I am not sure how long it has been there as it does not cause me any pain. I had my last dental visit before two months, so it must have developed sometime since then. I got the three-stage Gardasil vaccine when I was younger so I am not sure if that helps rule out HPV or not. I am out of the country until four months, so I am wondering if this is something that needs immediate attention or can wait until my next dental appointments. What is this red bump at the back of my throat? I am currently taking Ortho tri-cyclen. ### Response: Hi. I have seen the picture you have attached along with the complaint. (attachment removed to protect patient identity). It looks like a pharyngeal ulcer because of the patchy and reddish appearance. Chances of infection of the tonsils are also greater. But you have mentioned that it is totally painless and has been there for a while. So I reckon you visit an ENT specialist not a dentist for this issue. It can be treated with simple antibiotics then. If not this has to be ad" "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 gum is currently inflamed and I am a bit confused as to whether I have an ulcer or gingivitis, hoping you could clarify which one I have. There is not much pain and I have not had any bleeding when brushing my teeth. However, my gum is inflamed. ### Response: Hello. I have been through your query and I can understand your concern. The picture you have attached (attachment removed to protect patient identity) shows a bump on the gingiva of your front tooth. This does not look like gingivitis as if it were so, all the tooth would have been involved. The bump seems white in color. So, I suppose it can be a gingival abscess. I suggest you visit your dentist and have it examined in order to rule out other possibilities. Moreover, I would advise you to maintain a good oral hygiene" "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: Recently, I started taking Abhayarishta medicine. I was having pain in the anus. I consulted a doctor and they told that it is an infection. Now daily I take Abhayarishta medicine for better digestion. But the stool color is dark brown. Is it because of Abhayarishta or some other problem? Please suggest. ### Response: Abhayaristam is a laxative and appetizer. It is good for your concern. It might be causing dark brown stool. But there are other causes too. Some kind of foods, and internal bleeding are also responsible for that. You can check it very easily. Just stop Abhayaristam for two to three days and observe your stool. Also, give attention to your food. Spinach, beetroot, or other iron-rich foods also cause brown or blackish stool. You should avoid them and watch your stool. If stool color persists brown, you should consult an anorectal specialist. If you have any queries regarding this concern, feel free to revert back" "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 this melanoma? Does it look bad? ### Response: Hello. I have noted your concern and have viewed the image (attachment removed to protect patient identity). This could be an atypical/ dysplastic nevus - has irregular borders, looks asymmetric in shape and is perhaps bigger than 5 mm. It certainly requires a dermoscopic examination or a biopsy. Dysplastic nevi may be confused with early melanoma. Has it changed in anyway recently - in terms of size, shape, color or thickness? How long since you have it? Regards. 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 am 38 years old. My first IUI failed. Then one month gap. Now, today is the second day of my period. He told a retained follicle is present after scanning and prescribed Dronis 30 daily.When I get my period again, he told to come on the second day of the period for a scan and start my second IUI.Is Dronis useful because it is a contraceptive? I am trying to conceive naturally also in this gap. What should I do? Please guide me. ### Response: Hi. You will not conceive in the month you are taking the pills. But, it is necessary for the cyst to resolve before you can be given medicine for ovulation induction. So you should take" "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 a stone in gall bladder measuring 4 mm, one stone only. I do not want to go for surgery. Can it be treated with medicine? ### Response: The definite treatment for gallbladder stone is surgery. With medicines, there is very little chance for the dissolution of stone. As the stone is less than 5 mm, there are some chances that it may be dissolved, but it may take 6 to 12 months. Tablet Ursodeoxycholic acid (Ursodiol) 250 mg twice a day for at least six months." "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 trying to reduce my weight and belly fat, but I am not able to reduce my belly fat successfully. I am also getting kidney stones frequently and undergone surgery just two weeks back and also six months back. I want to reduce my belly fat without getting kidney stones. Let me brief about my details. I work for 12 hours, 15 days day shift and other 15 days I have night shifts. During day shifts, morning I have oats, afternoon I used to take fruits (mix of papaya, sweet melon and apple) and dinner (banana and an apple). Sometimes, I take avocado, pomegranate in the place of sweet melon. Weekly once I do have non-vegetarian like chicken and sea foods. I am 31 years old and a bachelor. My physical activities are walking during the break time (15 minutes walk during three breaks). My nature of job is sitting in the control room and no physical activity involved. Kindly suggest me whether my diet is proper and how to balance it for better results. ### Response: Hi. High protein, high fat containing foods and rich junk foods. 1. Diet.2. Exercises mild to moderate. Follow up after 15 days to a dietician 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 first beta hCG level is 16490 after the 14th day of embryo transfer. Is this high level harmful? ### Response: Hi. It is really a very short description of your query. This level could be for around six weeks of pregnancy, multiple pregnancies, gestational trophoblastic disease, any tumor, etc. If you have been treated for infertility its possible to have multiple eggs or embryo transfer or division of product of conception that leads to multiple pregnancies that can give this result. Other possibilities of gestational trophoblastic disease or previous history of disease that reappeared or not had treatment properly, etc. Better to have another beta hCG after 48 hours of previous and check an increase in levels and discuss here or with a local gynecologist. It is better to report to early pregnancy unit if tertiary care hospital to trace things nicely. You should have a scan as well after 1 to 2 weeks. In case of bleeding, pain or dizziness imnediately rush to the hospital" "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 66-year-old mother is suffering from diabetes for the last 30 years. Her gallbladder has been removed. Angioplasty has been done two years back. She had an infection in her scalp and took higher antibiotics for few months. She is now taking Basugine 20 at night, Actrapid 12 in the morning, Rosuvas 10 mg at night, Concor 2.5 mg, Clopitab 75 mg one in afternoon, and Pantocid 40 mg twice daily. Still, she has pain in her abdomen in her belly button area and above it and there is a burning sensation continuously. She has to use Cremaffin to pass stool daily. The stool is semi-fluid. She cannot sit for some time due to weakness and sleeps after her meal. She also takes Enzar Forte after meals in the morning. ### Response: Hello. It seems that your mother has acid reflux and pain due to stress. Stress could be mental or it could be related to removal of the gallbladder as well as taking so many medications. At this point in time, my recommendations would be to start her on capsule Colospa Retard (Mebeverine) twice daily half an hour before meals. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. Give it initially for 10 days and then write back to me with results" "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: Hey doctor,Four months ago on the 15th, I had unprotected sex with a spa girl, on 17th I started PEP, which ended on 13th the following month. Today, I took HIV and 2 antibodies screening test, and the result was negative, nonreactive with an index value of 0.13. Now can this test be considered conclusive or I need to get another test as well? Can the status change from negative to positive now? ### Response: HIV has a window period during which the test results can be false negative. According to WHO, all results beyond this can be considered as conclusive. Kindly mention the method of test employed and upload the concerned report so that we can suggest you accordingly" "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 40-year-old, suffering from scabies from a week. I have two kids, a wife, and a cat, and they keep on itching themselves continuously. Please suggest treatment. ### Response: Hello. You may have acquired animal scabies. I would suggest a single whole-body application of 5 % Permethrin cream from the neck downwards to the whole body, kept overnight for eight hours, followed by bath the next day. An OTC oral antihistamine, e.g. Cetirizine 10 mg once daily, will provide symptomatic relief from itching. Kids can take syrup Alerid (5mg/5ml) 1 tablespoon daily (Cetirizine). All the close contacts should be treated simultaneously in the same manner. Clothing, sheets, etc., should be washed thoroughly with hot water to prevent re-infection from clothing. For the cat, you may dissolve one tablet of Ivermectol 12 mg in milk and feed her." "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: How do I treat a migraine headache? If I take Panadol, but when should I take them? Before lunch or after lunch? ### Response: Panadol (Paracetamol) has to be taken whenever you get headaches, not daily. Preferably, it should be taken after some food. If your symptoms are troublesome and frequent, say more than twice a week, then you should take regular medication for it. Regular medication includes tablet Ciplar LA (Propranolol) 10 mg once a day in the morning after breakfast. Before starting this, your resting pulse rate should be more than 65 per minute or get it prescribed from a local doctor. This will one to two to acts and gradually increase the dose. The headache frequency will decrease progressively. This has to be continued for a few months. I hope this helps you and get back if you have any doubts." "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 with my fiance ten days back and my periods ended five days before that. Our condom bursts and I have taken I-pill within half an hour but before one hour of doing sex, I took my fever medicine and stomach infection medicine which I was taking from two days back. So, is there any risk for pregnancy? Will I get my periods on time? ### Response: Since you have taken an emergency pill within 72 hours of intercourse there is no chance of pregnancy. Even if you have taken medication for fever or stomach infection it will not affect your I-pill. So relax and do not worry. However, if you have a doubt then get 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: I have a small midline disc protrusion at C6/C7. Mild left side neural foramen C5/6 and C6/7 due to foraminal disc bulges. I am in constant pain daily and did three months with a chiro twice a week which has not helped and I am currently in my fourth week doing some kind of laser treatment (similar to acupuncture) followed by ultrasound treatment which has not helped either. Will surgery help? I am 39 and trying to have a baby (been doing IVF) want to try and fix the problem so it is not an issue when I have a baby. This has really impacted my life, I can no longer work as a carer as it is too physical for me and causes me too much pain. I can barely clean my own house and now have a cleaner helping me. I am desperate and scared it is going to get worse and that I will be in more pain when I am finally pregnant. Also, why are they wanting to repeat the MRI in four months for the thoracic spine? ### Response: Hi. May I know what kind of pain you have? Is it radiating to your fingers starting from the neck? Do you have pain in both the hands or only tingling sensations? Any aggravating or relieving factors? You have been asked to repeat MRI after some time due to a small lesion in the thoracic cord which is of unclear significance. Revert with more information to 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 15 months old son fell from a queen size bed and landed on his face. His lips swole up. He cried and seemed hard to calm down. He is now sleeping. This all occurred about one hour ago. He is responding to touch. He seeme very sleepy. But I do not know if it is because of falling or because it is late. I am afraid. ### Response: I can understand your situation. It is good that at present she is stable. Let me give you some information about it. He may be tired so he slept. It is possible that lip swelling can cause pain so need to give pain killer like Paracetamol. Sometimes in small baby like him it is possible that due to some trauma there may be some brain injury or inside bleeding. It is a very rare chance that your son has it but watch for some symptoms like persistent vomiting, seizure (fits), extremely irritability, prolonged sleeping, abnormal behavior or if you feel that he is not looking normal then rush to the nearest medical facility. Sometimes, these kinds of symptoms can take some time to appear. So be vigilant. I am giving this information not to panic you but to be more proactive. Make all child safety measures now onwards." "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: What happens to our skin on a cellular level when we put on makeup, cleanse, as you finish cleansing on a cellular level (that tight feeling)? Is it harmful to your skin to not have a barrier against the elements, even if it is in our home? Please help. ### Response: Your interest to know the skin system is appreciated. The skin has several layers of cells packed closed to each other. This packing is due to cementing substances between the cells that do not allow external things to enter inside the body. On cleansing the skin, the outer dead cells are eliminated, and inner cells are 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: A week ago I woke up with a very bad pain in my butt. I have a swollen red painful bump. I think I have hemorrhoid based on reading online symptoms. I tried preparation H cream and supposters, tuck pads, Cortisone cream, Aloe Vera gel but the pain did not go away. I cannot even pee. It is hard. Please help me. ### Response: Hi. It looks like an evolving perianal abscess than hemorrhoid (attachment removed to protect patient identity). An ultrasound scan of perineum will help to rule out the underlying abscess. You need to start broad-spectrum antibiotics. Stop Cortisone cream. Also get your blood tests done including fasting blood sugar. Get examined by a nearby surgeon as soon as possible." "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 2 months old baby is on Dexolac Premium from 1 month. The growth is good, but he is constipated. Can I switch to Nan Pro or kindly advise any other good brand. ### Response: I can understand your concerns. If child is constipated on Dexolac premium, then you can switch to Nan Pro 1, lactogen 1 or similar advance. All are equally good. Nan Pro 1 is more preferred." "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 22 months old baby has a very high fever. It has been fluctuating from 38 to 40 degrees. I gave him Tylenol but it still did not come down after five hours. I put suppository. Last week he was diagnosed with an infection in the stomach and was prescribed Nortop antibiotic and then the infection moved to the chest. So he is on Amoxicillin but now even after I put the suppository the fever is still not going down. I am really worried about what to do? ### Response: Hi. In view of such high-grade fever in such a small child, I would advise you to take the child to the nearest pediatrician in order to get the child physically evaluated and blood investigations like CBC, CRP (and others as per physical examination be done). Though the WBC count was 12000 last week they may have increased now since the fever is a little high (40 degrees). Also the antibiotics given previously may need to be changed) stepped up. As of now to bring down the fever you can do tepid sponging." "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 to ask about the ovulation period of a woman. How can we count the day of ovulation? Do we count from the first day of the period or from the last day of period? ### Response: Hello. The ovulation day is counted backward from the last day of the menstrual cycle. For example, if a woman had a regular cycle of 30 days so she will ovulate 14 days prior to her last day of that cycle. Meaning, she ovulates on the 16th day of her cycle. Another example is that if a lady has a regular cycle of 28 days then her ovulation will occur 14 days prior to her last day. Meaning, she will ovulate on the 14th day of her cycle. It is so because the menses start exactly after 14 days of ovulation" "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 daughter born 7 days back is suffering from meconium aspiration syndrome (MAS). I would like to know, how we measure her growth of lung capacity. ### Response: In newborns measurement of lung capacity is not as useful as in adults. These are the important parameters that show the improvement rather than just lung capacity." "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 32-year-old male. My height is 5\10"" and I weigh 82 kg. I got married two years back. We both are working professionals and love each other a lot. Since our marriage, we are trying to have intercourse but unable to. We are wanting to have a baby now, but are really worried about the situation. Also, we tried penetration a lot of times but the moment I come close to her I lose the erection. I am very uncomfortable with my foreskin rolled down and she is very uncomfortable when I touch her vagina as the sense of pain takes down the momentum and she feels stressed. She also feels dryness at her vagina. As we both are working hence at the end of the day we feel tired and have less sexual desire. You are requested to help us in our healthy sexual life and family planning too. ### Response: Hello. As you have explained, you never achieved intercourse? You both have fear about sex and you have fear for rolling of your foreskin and she also feels pain and uncomfortable. You both need therapy. You want to plan a baby but first, you achieve a successful intercourse, it is important. You have to do a simple exercise like try to uncover your foreskin when you urinate. Does that hurt? During masturbation try to uncover." "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 27 years old, with no chronic health diseases. For the past six months, I have had erection problems. Everything from infrequent morning erections to weak erections while having sex and masturbating. My doctors took a full blood test and everything, including my testosterone levels, came back normal. What is the issue here? I am having trouble figuring out why a 27-year-old would be having his erections change so drastically from what they were before. ### Response: It is now becoming very common for a young adult with erection problems, and most of the times, blood test are normal. Most common causes are, 1. Work or personal stress. 2. Diet habits. 3. Inadequate sleep. 4. Unrealistic expectations. Body as ages, it will not have the same frequency of erection as in teens age. Good sexual life requires good mental and physical health. Micronutrients vitamin will help in improving sexual life. Changes will be gradual. Along with you have to do active physical activity as it increases neurotransmitters in the brain responsible for sexual act. If you have any more doubt contact 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: I had unprotected sex about 12 hours ago. No ejaculation occurred but I knew there was still a risk of getting pregnant. I am thinking of using the Yasmin pills as a form of emergency contraception. Note that I have never taken the pill before and this would be the first time. I have read that I should take four tablets of Yasmin at a time and another four tablets after 12 hours. Would this still be the same if I had never taken the pill before? What will be the possible side effects of the high amount of dosage for the first time? Please advice. ### Response: Even if he has not ejaculated, you still stand a chance of pregnancy if the pre-seminal fluid, the clear fluid that comes out before semen, which is rich in young healthy sperms, comes in contact. This regimen is called yuzpe regimen where it is suggested to take four tablets of Yasmin (combination of Ethinyl Estradiol and" "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 head has red patches for the last six years. My hairs are falling (white hair only). I also suffer from low testosterone level for the last six months. Please help. ### Response: You have a condition called as scalp psoriasis. This happens due to an increase in turnover of cells at the level of skin. Stress, infections, climatic change, and consumption of eggs or red meat can cause this to increase. You can use a Clobetasol with 6% salicylic acid lotion on the patches everyday morning and night for two weeks. You can also use a coal tar based shampoo to wash your scalp on alternate days. Consuming fish is beneficial, you can also take fish oil capsules like Seven seas. You can apply Cobiwell S (Salicylic acid and Clobetasol) lotion over the patches morning and night for two weeks.Use Polytar shampoo thrice a week, leave on scalp for five minutess and wash." "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 want to perform PC muscle exercises. Will you guide me on how to locate it? ### Response: PC exercises (pubococcygeus muscle) are performed basically to improve the sexual performance in men, to delay the ejaculation. To locate PC muscle, it is located in the perineum area behind the scrotum and in front of the anus. It is deep to skin and soft tissue, and urethra passes through this muscle. Hence contraction of this muscle helps to delay ejaculation by compressing urethra. The exercises for the PC muscles includes sitting with a straight back, both hands on lap. Squeeze in the anus as if trying to hold bowel while defecating. Hold and count to 10 and then slowly release the muscle. Do this for 6 to 10 times per sitting. Every day you can have 4 to 5 such sittings. While passing urine, what you can do is hold urine for 1 to 2 seconds, then, pass it, then again hold. This hold-pass can be done 3 to 4 times every time you go for a pee. Both these measures help in strengthening the PC muscle. All you need is to have patience. It will need time to show results." "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 married. Right after two days, my wife experienced a sharp pain on her right head to the neck, it felt like someone hammering the head. Then after 20 to 25 minutes, she slept and it stopped. Then again after 5 to 6 days, it came up again in the same frequency and same pattern just right side of the head to the neck (right side) and then again after three days, it came back. Can you please suggest something? ### Response: Hi. If she does not have any other deficits like a hand or leg weakness or giddiness or cognitive deficits, then most likely it is a migraine. It is just recent in onset. So, we can wait with medicines. Tablet Topiramate 25 mg at bedtime for 21 days, tablet Sibilium 5 mg at bedtime for 21 days. Initially, she may get more sleep, but with lightheadedness for 3 to 4 days, then her symptoms will improve gradually." "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 crossing a bar, I come across people smoking marijuana. Would a person test will be positive on hair or urine drug test in any situation? I am not a drug user. ### Response: Hi. While crossing a bar, when someone smokes marijuana (Cannabis) out, there is a possibility of inhalation through the nose. Chronic exposure occurs for people who work in the bar. Sufficient amount can enter into the lung and blood, which can be tested in hair or blood. So, just crossing the marijuana smoke never makes the hair to accumulate marijuana or to make positive. There is a small chance for deposition of smoke on the hair. But, it would go off if washed while bathing. If the hair sample is collected after the exposure of smoke without a bath, then there is a chance for the test to be positive in the hair. If the sufficient amount of smoke enters into the lungs, definitely it goes to blood. Once it reaches the blood, it needs to get excreted through urine. Hence, within 12 hours of smoke exposure, the urine may show a positive result" "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 habit of tongue thrusting. Now, I am using permanent retainers for the past four months. How to overcome it? ### Response: Hi. Please say your age. Usually, tongue thrusting is done unconsciously. So initially, you should be aware of it. Habit breaking appliance can also be used, and it takes time. It can also be stopped by a process called cognitive behavioral therapy." "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 46 and a mother of three children. I have been diagnosed with multiple fibroids a few in the anterior wall intramural and a few on the posterior wall and a bulky 134 x 74 x 87 mm uterus. The endometrium is displaced posteriorly. The symptom is mainly heavy menstrual bleeding that lasts for eight to nine days. The symptoms began not more than a year ago. Ultrasound with an interval of two months shows slight growth. My doctor advised hysterectomy. Is it absolutely necessary for my condition? If so, then how quickly should I undergo the surgery? Is there any medication or alternative treatment that can be relied long term to avoid surgery? What are the possible consequences that I shall expect if I decide against hysterectomy? ### Response: You are having symptomatic uterine fibroid. This will make you to have peace of mind. If you do not get surgery, then there is a tendency of recurrent heavy menstrual bleeding resulting in fatigue and weakness. Then there is a chance of recurrent blood transfusion with all the complications associated with blood transfusion. The alternative is the use 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: I have spinal stenosis from last five years. I took a lot of medicine but the problem remains same. Pain also includes my legs down, foot, hips and standing more than ten minutes cannot bear. Please tell me the only best solution. ### Response: Physiotherapy is also beneficial. For neurological pain, Pregabalin can be prescribed. Reduce weight if obese through exercise and dieting. If all above measures failed then surgical management can be done. Consult orthopedic surgeons for examination and management" "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 husband smokes a lot. How can I make him quit the smoke? Please help me with the answer. ### Response: Hello. Nicotex gum is may be useful in his case. The 4 mg dose of gum is recommended if he smokes 25 or more cigarettes per day, whereas the 2 mg dose if less. He should chew the gum whenever he has an urge to smoke. He can chew one piece of gum every one to two hours for six weeks, with a gradual reduction over a second six weeks, for a total duration of three months. Acidic beverages (like coffee, beverages) should be avoided before and during gum use." "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 26 year old male. My height is 5\8"" and weight is 75 kg. For two weeks, I have been having a lot of gas and burping without any other discomfort. Due to my tough work schedule in the last week I slept only 3 to 4 hours every day. Now from the last four days, I am feeling pressure and pain in my upper neck muscles just below the head. Also, my head is feeling heavy and I have slight ear pressure in my right ear. I had some difficulty in breathing, but it was fine after I had burps and removed the gas from my body. My BP is 130/100 mmHg on average, which was 135/110 mmHg on the first day of the headaches. It has been one day that I started taking Capoten 25 mg. Even after taking complete bed rest for two days, still I have neck pain and gas problem. Kindly please advice on the matter. Also, what should I do now? ### Response: I have understood your problem and must say that it is quite a common complaint to my clinic. Sleep deprivation and increased physical stress. Acute otitis media. GERD (gastroesophageal reflux disease). PPI and antihistamine. Avoid sleep deprivation." "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 taken 3 peel and 3 lasers (Q-switching) for skin lightening. I have dark skin. After the treatment my cheeks have become very fair and it does not get tanned also. However the rest of the face is still dark. It has developed after the Q-switching session. I want to know is this hypopigmentation? Is it going to be permanent? My face is looking very uneven now. Currently, I am using DesOwen cream. Please help me understand. ### Response: Hi. It is post-inflammatory hypopigmentation. In most cases it is temporary and will automatically revert back to normal in few weeks and sometimes in few months. If possible please do upload the pretreatment photographs for further 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 took an emergency contraceptive pill (I-pill) yesterday. Can I take Norethisterone tablets now for a week? I need to delay my periods which are due in two days. ### Response: You have to understand that I-pill is a high dose Progesterone pill, much stronger than Norethisterone. Your menses if were due in the next two days, then they are naturally likely to be delayed because of I-pill intake by about 4 to 5 days because of high Progesterone content. If you intend to delay menses and at the same time ensure pregnancy safety together then it would be difficult to ensure any pregnancy safety, because if you get pregnant then this Norethisterone would further support the pregnancy and not prevent it. The I-pill increases tubal motility and hence if Progesterone is not 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 would like to ask you for a second opinion on the treatment prescribed for my 53-year-old mother by a cardiologist. She was diagnosed with chronic ischemic heart disease following a routine ECG which I would like to send you, and the blood tests indicated a cholesterol of 280. The symptoms are not too obvious, she says she had two to three bruises in the heart area in the last few years. The treatment is Pentaerithrityli tetranitrate (two per day), Aspenter (one per day), Rosuvastatin (one per day), Plavix (one per day), Metoprolol succinate 47.5 (two per day). Doppler ultrasound was normal and only EKG had abnormalities. ### Response: Hello. I reviewed the therapy prescribed by the doctor and I agree with it. It contains: I would just recommend reducing the dose of Metoprolol in case of a very low heart rate (below 60 BPM), or if she is experiencing chronic fatigue. Hope you will find this answer helpful" "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 very much anxious about my upcoming exam. This is my second drop. Last year because of my fear I ended up doing mistakes in the questions which I knew very well and just after coming out of the exam center I was able to answer all of them. This year too I am more fearful. I am very afraid as I do not want to take another drop and want to live my dream. Please help me out. ### Response: You seem to be suffering from some anxiety disorder. Detailed exploration of the problem is needed. Do not let this thing ruin your career. I would recommend you to go to a local psychiatrist and get some help. Meanwhile, you can try these things. Deep breathing exercise, as many times as possible. Yoga, meditation. Sleep and wake up at the right time. Positive self-talk, motivate yourself. You can try Propranolol 20 mg sustained-release tablets before going to the exam, to control your anxiety but it would be best if you consult a psychiatrist before that." "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 with condom. Is there any chance to get affected with HIV? Until now, there are no symptoms. Generally, how many days will it take to identify HIV after sex? Please suggest, and I am a bit worried. Generally, in my company, they conduct medical tests yearly and in that it shows negative. ### Response: Doing sex with condom is safe unless it has torn or leaked. Was your partner a known case or later diagnosed to be HIV positive? Company tests that you have done, if it was for HIV and if it is negative, then you need not worry about it as test results will be positive in four to eight weeks after exposure. And the symptoms and presentation may be late and vary depending on the patient\s immunity and other things. It is present with some symptoms be delayed even up to a decade or more. If you are already tested for HIV, and it is negative, then I do not think there is any reason to worry about your incident. If not yet tested and you want to clear your doubt, get it checked after this Covid period. It is not an emergency. Be careful and take safety measures." "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 24 year old female who has celiac disease and was recently diagnosed with cardiomyopathy, a left bundle branch block (starts I believe when my pulse gets above 80). I had atrial flutter and had an electrophysiology study, where they ablated some arrhythmias, and during the procedure, I went into atrial fibrillation and required cardioversion to fix it. They have also told me that I have left ventricular dysfunction that is causing heart failure. I also got a cardiac implant that records my heart but is not a pacemaker or defibrillator. My heart was completely fine twelve months ago. I had an EKG that showed no problems. Then towards the end of last year, I developed all of the above-stated problems. Recently I have been feeling quite sick and these are my symptoms:Sensitivity to sound.Lots of ringing and roaring in the ears.Dry eyes.Dry mouth.Very sore joints.Exhausted.Light-headed.Chest bubbles/fluttering.Bad memory.Diarrhea/constipation (causing bleeding).Tremors.No appetite.Significant pain in armpits.Sore neck.Night sweats.My main medical care is through Veterans Affairs. So, any possible answers would be greatly appreciated. ### Response: Hello. I understand all your concerns. So, I suggest that you tell me all your" "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 in my knees only when I climb downstairs. I feel pain below around knee cap. I am 48 years old and was quite active in running and sprints. My MRI shows nothing and doctors are stating chondro patella. I am on rest but no big difference in four months. All medical traits like vitamin D are great. Recently I started taking Glucosamine. I am healthy and quite fit. ### Response: Hi. I understand you have pain in the knee going downstairs. It is good that your knee MRI (magnetic resonance imaging) is normal which means you do not have something major to worry about. I would recommend you not take complete rest in fact you can just do some exercises of the knee to make your muscle strong like qua" "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 33 years old. I usually feel healthy after picking up a large box. Before a week, I got a sharp pain in the middle of my waist at the back. Then I was not able to bend, and I had very limited moving. I went to a chiropractor. He told me that I need to do 25 to 30 sessions of decompressing, three times a week, on an electric bed that he has. Do I need to have such an intensive decompression process? Can I do a spinal decompression on my own in my home? Before ten months, I had a CT scan. I found that my three discs are bulging at the lower vertebrae. ### Response: As long as you do not have any leg pain (electric or shooting type) or associated numbness you can do this without the intensive chiropractor sessions. Please have precautions to avoid lifting and do only gentle stretches for the back" "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 urine dripping problem after urination. I also have frequent urination. I have uploaded all test reports. Please help. ### Response: Hello. I have gone through your reports (attachment removed to protect patient identity)." "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 diastolic dysfunction. The report says velocity E is 84.2 cm/s, and the MVA max velocity is 133.5 cm/s. What does this mean? ### Response: Hello. Diastolic dysfunction means there is dysfunction in cardiac relaxation. This is not a worrisome thing and quite common in elders, overweight and patients with hypertension, and other diseases which must have been ruled out on echo and ECG. However, this may cause symptoms like shortness of breath, pedal edema, etc. Needs to have a low salt diet and low dose diuretics like Torsemide for shortness of breath. I Hope this helps you and get back if you have any doubts." "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: Recently I have been experiencing severe tooth pain and cannot reach a dentist at the moment. Due to the pain, I have been taking Advil. Yesterday I took three Advil, two at once and then waited eight hours to take one more. Today I have taken two Advil every eight hours for a total of six all together. Each Advil is 200 mg, so I was just wondering if I will be okay? I take Albuterol (asthma pump) before a workout or when needed. ### Response: Hello. In an emergency, if you have severe pain and take some painkiller then it is fine for temporary relief. But you should not take it as you have taken. If there is an infection causing your dental pain then your painkiller gives only symptomatic relief, but your dental infection will still be present. Excess intake of any medication (such as painkiller) may be harmful. Many dental pain needs treatment as well as medication. Only medication gives you symptomatic relief. So I recommend you to see your dentist to find out root cause and treatment. Do not take any medication without the advice of a registered practitioner." "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 baby is 1 year and 10 months old. Two weeks ago, she had severe diarrhea and around her thighs and around her genitals, there was inflammation. The doctor says that because diarrhea is a type of virus and inflammation of the fungus. The doctor prescribed Clotrimazole and burns ointment and Yomogi. Two days later, fever started and in the body, eruptions that were in the form of fungus were released, that caused itching. The apparent shape of the grain is juicy. This time the doctor prescribed Triamcinolone ointment and syrup Amoxyclav and Hydroxyzine. According to the doctor, this virus is contagious. ### Response: I have read your question in detail and I know that you are very concerned about your child but do not worry. By what you quote it seems that your child probably has got acute gastroenteritis with inflammation at thighs and scrotal region. In my opinion, you should give syrup Ofloxacin (5 ml = 50 mg) 2.5 ml two times a day for three days and apply a Zinc Oxide cream like Rashfree cream for five days. If no improvement in 24 hours, then do a stool routine microscopy test to confirm the diagnosis. This is not viral as fever and diarrhea have been for more than 3 days. Review after 2 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: My brother has jaundice, which comes after every three to four months. He feels very low and lazy, and his body becomes yellow. He also has a fever. We do not know why he gets sick every three months. The doctors say that the number of cells in his body that are getting destroyed are more than the cells that are created. This according to him, is the reason of recurring jaundice. We are really confused. Can you tell me what is actually happening? ### Response: If you have any further query, please feel free to ask" "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: Approximately six weeks ago, I got niggling wisdom teeth pain. The left top and bottom wisdom teeth were breaking through the gums. I got sudden pain which was severe in intensity around the back of my mouth and the lower left side. It got aggravated especially on chewing and radiating to the next tooth and along the jaw. The dentist suggested a wait and watch for few days. The next day when the wisdom tooth started to come out, the pain got severely worse over the jaw and the temporomandibular joint. I was unable to tolerate. I cannot even rest my top and bottom teeth together. I got complete numbness on the left side of the chin and lower lip and difficulty in opening my mouth for more than one or two fingers. I could not sleep and felt ill because of the pain. On the X-ray, the wisdom tooth is horizontally impacted, and there were no signs of infection or abscess. The tooth next to the wisdom has a large old filling nearing the pulp. But there are no signs of anything wrong with it on an X-ray. The dentists could not find whether it was the pressure of the impacted tooth on the next tooth or problem with the filled tooth. So, I was just given antibiotics. By the end of the antibiotics, it was slightly better, but I still felt ill. Again, the dentist decided to wait and watch. As I felt iller than the previous time, I was given another course of different antibiotics. The pain was reduced. But I still have numbness in the chin. However, most of the numbness on the lip has resolved.A constant cramp sensation along the bottom of my jaw and temporomandibular joint with the discomfort temporarily ease with rubbing or stretching or massage. I regained most of my mouth opening back, but it is uncomfortable to open and hold in that position. I also think the jaw discomfort and cramping are worse on the days when I have to talk more. The wisdom tooth and the next tooth are still mildly tender. I can eat soft foods comfortably, but I get pain in the two teeth and the gum surrounding the wisdom tooth on eating hard foods like a raw carrot. The pain will last up to an hour or more. I have never had any hot or cold sensitivity or nasty taste in my mouth. The dentist I saw thinks that it is because of the nerves from the filled tooth and wants to do root canal treatment or extraction. How would this change any of the nerve or temporomandibular joint pain? I am worried that if the impacted tooth\s pressure is causing the pain, then it will make no difference anyway. Do you know a way to differentiate? Which do you think is the more likely cause? ### Response: Hi. I had gone through your question. I can understand your concern about your tooth pain. Hope my answer will help you. Visit us back if you have any further queries. Regards." "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 took an I-pill immediately after unprotected sex. After five hours I had a reflux sort of vomiting, very little but now I do not know if I should take another pill or not? ### Response: Usually, it is not necessary to take an additional pill if one vomited after three hours. If just vomited a little then it is not necessary to take an additional pill. Then also confirm whether you had 0.75 mg or 1.5 mg tablet. If it was 1.5 mg then it is not necessary. However, if you have consumed 0.75 mg then it is better to take an additional 0.75 mg after 12 hours. So, overall it is not necessary to take any additional dose, just confirm the above factors for additional surety." "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 40 years old woman. My husband is 53 years old. Since I married late, is it safe to conceive now or will I face any health issues? If safe, then when should I have sex to conceive at the earliest? ### Response: Hi. There is risk involved for conceiving at this age. Age-related screening is needed before conception even if you both are healthy and do not have any problem. I am not confirming any mishap but it is the only recommendation for lots of precautions. If you and your husband have been treated for any disease, better to take full treatment like thyroid or diabetes. Quit smoking, tobacco, alcohol and other recreational" "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 husband aged 35 years had a moderate to severe stomach pain last morning which lasted for about seven hours and he had a mild headache as well. I gave him Topcid and Eno to drink in the morning suspecting it might be gas and he also had a Saridon for headache. The pain is now gone but he had a loose motion before sleeping and then one in the morning. Is it something threatening or was it just simple gas pain? ### Response: Most probably it is indigestion and probably some poisoning of food. Give him plenty of fluids. Avoid spicy oily foods, alcohol and smoke. Give him Eno symptomatically and let him take Pantoprazole 40 mg one tablet twice daily half an hour before meals for a week. Do let me know the progress. Warning symptoms are worsening pain, acute excruciating pain, fever, vomiting, blood in stool, etc." "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 suffering from chronic kidney disease. At present her creatinine level is 4.8. Her creatinine levels in the last two years have been increasing in order such as 2, 2.2, 2.7, 3.8 and 4.8 respectively. Her urea level is 114. Is there any treatment for reducing creatinine level? She is suffering from hypertension. Her current prescribed medicines are Cilacar 10 and Met-XL 50 mg. Please guide me doctor. ### Response: Hi. By seeing her reports (attachments removed to protect patient identity), I understand the pattern of rise in creatinine and her condition of chronic kidney disease (CKD). As such there are no medicines to cure creatinine. You just have to make sure that she maintains her blood pressure within normal range so as to prevent further kidney damage. I am sorry to say that she would eventually require dialysis. You can consider her for a renal transplant that would give her a better life. I know you would be disappointed after hearing my answer but your doctor must have said the same." "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 husband and I had protected sex on the 15th of the month. I have taken an I-pill on the 17th. There is no withdrawal bleeding yet. I was worried about a pregnancy as there was some pre-ejaculate involved. So, I took a pregnancy test and it came back negative. Now, when can I expect my period? Or is there still a chance I am pregnant? ### Response: Hello. Since you have taken an emergency contraceptive pill within 72 hours of intercourse, there is no chance of pregnancy. The delay could be because of hormonal changes due to the pill you have taken. Wait for another week or so, and repeat the test with an early morning urine sample to ensure that you are not pregnant. By then, you should be getting your periods. However, if you have a doubt, then get 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: How is it possible that I got heart palpitations from caffeine use (5.8 mg/kg a day)? Could it be that I also used Wellbutrin? ### Response: Yes, both these caffeine and Wellbutrin commonly causes palpitations. Even a lower dose of caffeine can cause palpitations and there is no as such dose relationship with respect to palpitations. It may lead to all your symptoms. Also, anxiety or stress is usually an additional factor which may cause or worsen the palpitations. Usually, palpitations like these are usually benign and non-life-threatening although they may be troublesome. Considering your comorbidities, it is better to evaluate these, not just due to palpitations but also as screening cardiac test, and to rule out the possibility of cardiac arrhythmia. So, you should have a baseline ECG especially during palpitations and may need 24 hours Holter monitoring if not able to get ECG during palpitations. Also, you may alternatively use mobile-based rhythm monitors like Alivecor Kardia or other monitors. Also, you should get one echo done to look for the status of heart and its valve. So, try to reduce caffeine consumption as much as possible and see the response." "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 18-year-old girl and I have a slipped or bulged disk in my lower back. I have had this injury going on for four months. I have been through physical therapy and that did not work. My doctor was talking to me about surgery. So I researched and found a surgery where they go in and cut the disk off that is bulging out. It is an open discectomy I believe. I was wondering what the risks are. Could I possibly get paralyzed? Are there any cases of getting paralyzed? How long would I be off my feet? ### Response: Hello. Surgery for bulging disc is only indicated if pain in back is servere and not relieved by physiotherapy, then you need fusion surgery or if you have moderate to severe leg pain because of nerve compression causing decreased mobility, then you need discectomy. Chances of getting paralysis after surgery are very low may be around 1 in 100 but other smaller problems after surgery are common. So, if pain is bad and is affecting your day to day activities then only you should think of surgery." "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 diagnosis of disc herniation. I have done an MRI. I have severe pain in the left leg. I have this problem for the past two months. It got started before four months when I lifted a heavy box. I have a sharp pain. After two months, it became normal. After a month, it came back suddenly. I have sent you the photos of the disc. ### Response: I have gone through the attachment (attachment removed to protect patient identity). Yes, you have a large paracentral disc prolapse on the left side. I cannot say about the level involved as you have not sent a sagittal section. If you have the symptoms matching with the level of the disc, then you have to wait for at least six weeks for the disc to have a shrinkage. If there is no improvement or if you are having motor weakness or bowel or bladder disturbance, then these are the indicators for the surgery rather than having a conservative treatment. A decision to have surgery should be taken by yourself along with the advice of the clinical examiner." "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 29 year old, who is 1.83 m tall and weigh about 70 kg. My health problems started two years back, when I had a lot of stomach pains, though they went away quickly once I had a filling meal. After an endoscopy, the doctor observed a large axial hernia as well as moderately pronounced gastritis. I was prescribed PPI, and the problems went away for a while. The effects of the PPI seemed to diminish after a while as the pain returned during nights and while exercising. In the mornings, I suffered from severe heartburn and short-term breathing troubles possibly because stomach acid went into my lungs at night. Over time, I have been prescribed different PPIs like Pantoloc, Esomeprazole, and Pariet, and the dosage always increased.As the symptoms did not improve, the doctors recommended a surgery last year. Beginning of this year, I had a laparoscopic fundoplication. I could not swallow anything, not water or even my saliva, during the first five days after the surgery. The doctors suspected this was due to strong swelling, and I was able to start swallowing again after the sixth day. After the suggested diet phase, I was able to eat almost everything and was very happy about that.Since the end of last month, however, I have had strong symptoms again. I celebrated my birthday by drinking some alcohol the day before it started. The stomach pains, bloating, gurgling noises in my stomach, and most uncomfortably, pain in my lungs started again. The chest pains come mainly when I bend my upper body or when I turn in bed. My primary care doctor prescribed me 20 mg Pantoloc to take for a week, as she suspected gastritis. The symptoms were still present after a week, so the doctor who performed the surgery did another endoscopy. He determined it is a moderately pronounced gastritis and suggested three weeks of PPI therapy.As I was still concerned about the pain in my chest, I also went to a lung specialist, who diagnosed an inflammation of the bronchi, probably caused by the yearlong influence of the stomach acid. He prescribed a Cortisone inhaler, which I have been using for two weeks now. Also, I currently take 40 mg Nexium in the morning and try to take a light diet. The conditions now have lasted for about six weeks already, and I am starting to worry. Can it be anything else? Is it normal that it takes so long? I should have no heartburn after the surgery, right? ### Response: Hello. You are having gastroesophageal reflux disease (GERD). You have undergone Nissen fundoplication, as such hiatus hernia and related diseases take a long time to recover and you need to maintain your lifestyle and food habits for a lifetime." "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 25-years-male. Before two months back, I got into a very fearful situation and I felt panicked at that time. I consulted a psychiatrist and he gave me Clonezopam, Propranolol and anti-depressants. After using it for seven to ten days I stopped them by knowing that they are addictive. And after stopping I felt new kind of problems such as heart palpitations whenever I try to sleep in the day time and I get irregular sleep at night, feeling anxious. For many days I kept tolerating them, after many days now the symptoms have diminished but still, I get palpitations whenever I try to sleep, then I took Medhavati for 12-14 days. My sleeping time at night somewhat increased but I did not use to get a refreshed sleep. I consulted a general doctor, he told me it is just a phobia and gave me Stalopam (Clonezepam and Escitalopram) for 15 days and multivitamins tablets. Then I consulted an ayurvedic specialist, he gave Manasamitra vatakam, Stresswin and Saraswatiristam. Please help me whether I should take these ayurvedic medicines or take antidepressants for 15 days? Are Manasamitra and Saraswatiristam safe for me and do not have side effects? And what time does it take to show effects and for much duration should I take them? Now I am almost fine but unable to sleep at daytime due to palpitations and getting some negative fearful thoughts at some times. Does Manasamitra increase serotonin in the brain and give enthusiasm. I am thinkng of going for allopathy for 15 days or will ayurveda medicines show early results? Please help. ### Response: I could understand how much confusion you experience and your mental pain." "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 an unprotected sex with my partner on the 24th day of her 28-day mensuration cycle. Within 30 minutes, she took an Unwanted 72. She is delayed by eight days and still no period has occurred. She complains of having vaginal dryness and lower abdomen cramps. Please let us know if she is pregnant or not. I am very worried. ### Response: Since she has taken an emergency contraceptive pill within 72 hours of intercourse then there is no chance of pregnancy. The delay could be because of hormonal changes due to the pill you have taken. She will be definitely getting her periods. However, if you have a doubt then get 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 and I had sex on the third day of her periods and she had an I-pill immediately. She took the pill six hours after we had sex. She noticed some bleeding after three days which was not like normal periods. She is not having her periods and it is one month now. Is she pregnant? Help me. I am really worried. ### Response: The emergency pill, I-pill can be used only once in a cycle. If the I-pill is used more than once in a cycle, it not only does not work, it also upsets the body hormones and can cause irregular bleeding. It is best to consult a doctor and check for pregnancy first. At the same time, you can also get advice to correct her menstrual cycle. It is also advisable to follow a reliable form of birth control to avoid this situation in the future. Taking birth control pills is a safe and easy method both for regularizing menstrual cycles and having protection against pregnancy." "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 75 year old male. Though I have diabetes since five years, I am still not able to understand the disease.Recently, I have checked my glucose levels with one touch ultra on the same day. They are:Fasting 130.Two hours after breakfast 160.Before lunch 112.Two hours after lunch 160.Two hours thereafter 110.Does this mean that the disease is well-controlled?I take 250 mg Glycomet after breakfast, 500 mg after lunch, and 250 mg after dinner.Is this dosage correct or do I have to change the dosage? My physician is not educating me properly.Kindly advise. I take Thyronorm for my asymptomatic hypothyroidsm. I am attaching my reports for your reference. ### Response: I just read your query and went through your reports (attachment removed to protect patient identity). From what you have mentioned it appears that you have type 2 diabetes. It appears that your diabetes is slightly uncontrolled as per your HbA1c of 6.7 %. The pre-meal and post-meal blood sugar levels are also slightly high. We do not ask the patient to check the blood sugar every now and then. The best detector of how good your blood sugar is controlled is HbA1c which is to be done every three months. The glucometer is used usually to check fasting, two hours post lunch, and in case of hypoglycemia only. Hope you find my advice beneficial. Good luck" "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 getting bouts of confusion, dizziness (when looking up and sometimes when getting up), headaches, pulses, and pressure in my head and what I can only explain as brain fog (during these episodes, I find that my problem solving and my cognitive function is diminished). The episodes have been happening on and off for the last year in which I have had three MRIs, a full cognitive function test, full set of blood tests, count, liver, kidney, cardiac panel, arthritis, and sleep apnea test. I have also had a cardiac stress test, 24-hour Holter monitor, 5-day event monitor, echocardiogram and these were all negative (no abnormalities were picked up). Of late, I have found that these episodes have been getting more frequent. Could you advise if this could be intracranial pressure, a tumor, seizures, epilepsy or some sort of neurodegenerative disease? ### Response: I passed carefully through your question and would explain that your symptoms do not seem to be related to intracranial hypertension or any of the other disorders. An inner ear disorder, vertigo, or epilepsy may lead to such clinical situation. For this reason, I recommend consulting with an ENT specialist and performing labyrinthine tests to exclude an inner ear disorder. If these tests result normal, I would recommend performing an EEG. It is necessary to check also thyroid hormone levels for possible thyroid gland dysfunction. Hope you will find this answer helpful" "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 want to know what is wrong with the test results. I have done blood test, urine, liver, and kidney function tests. Urine test shows pus cell 4-6 and RBC 1-3. ### Response: I have reviewed the lab results (attachment removed to protect patient identity), that you have sent and I see that the urinalysis shows RBC 1-3 and pus cells of 4-6. But there were few epithelial cells seen. May I ask how did you get the sample? Did you get it midstream? Because a poor catch may yield unreliable results. Your CBC (complete blood count) also showed relative lymphocytosis but aside from that, all rests are within acceptable limits. Any recent history of cough or colds? In addition to that, may I also know your symptoms and why were the tests requested? Do you have painful urination or back pain? Any other medical condition such as hypertension or diabetes? I would be needing this to clinically correlate your test results." "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: Today I visited a dermatologist for facial dryness, dandruff, boils and itchy scalp. I was prescribed Episoft cleansing lotion, Cetaphil cream, Fusirose lotion and 8X shampoo. Fusirose lotion is out of stock near my place and online. Can you please suggest a substitute lotion? I bought Fucidin cream instead of lotion. Can I use it? ### Response: Hi. Getting Fusidic acid in lotion form is difficult. You can use the Fucidin cream for the boils on the scalp. For scalp folliculitis, I suggest you try Betadine AD shampoo twice a week. Consult your specialist doctor, discuss with him or her and start the treatment with 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: For past four weeks, I have pain in my ribs. Also, I am experiencing breathing problems. It feels like something has stuck in the heart. For, a few days pain has been decreased. But breathing problem persists. I am also experiencing pain in my lower back. The pain is massive at night times. There is no sign of a cough. Will it be a sign of lung cancer? ### Response: Such symptoms are seen in the following conditions: 1. Heart diseases. 2. Pneumonia or Pleural Effusion. 3. Acidity or muscular pain. Now to be on the safer side, I would recommend you to get a Chest x-ray and ECG done. Based on the reports, we would discuss the treatment apart. I hope it 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: My 2 year old daughter has a bald patch on head. It is oval in shape with no hair in it. It is getting bigger time to time. I am waiting for her blood test appointment now. What is this condition called? How to cure it? ### Response: Hi. I presume it as tinea capitis or simply a fungal infection of the scalp. Do not worry, hair can regrow again and there is no permanent damage. It is very important to start the following early for best results: Before we commence treatment, wash baby cap or cloth coming in contact with the baby\s head in hot water with some antiseptic. It is crucial to kill the fungus sticking on to the cloth. Same applies to her comb. Otherwise, it will relapse." "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 twin babies with one boy and one girl. They are four months old now. Breast milk is very low for them. So we are using formula. During the first two months, we used Simyl LBW and Lactodex LBW. Then the doctor told us to use Dexolac 1 powder. Now, my babies motion is in dark green for the past ten days and sometimes it is yellowish green. The doctor told us to have Simyl MCT powder. Does this powder clear the problem? My babies motion is sometimes watery, and sometimes it is normal. But it is always in green color. They are going motion once or thrice a day. Please give me a solution. ### Response: The color of the stools that you have mentioned is normal. Any color of the stool is normal, except when the color is red or white. It is normal. So as per your history, the chil" "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 38 year old female. My height is 5 feet and 9 inches, and I weigh 130 lbs. I am a professional dancer. I dislocated my left shoulder while dancing. I had to make a move that involved throwing the arms out and across the body to the right side sharply and quickly. It popped out for about two to three seconds and went right back in. It was sore for the first two days. Initially, I wore a swing and then began moving it gently through a full range of motion. I had slight pain when rotating it outwards with my arm at 90 degrees and lifting up with arm straight out to the side. It has since been 11 days since the injury and the pain has completely subsided. However, I am now experiencing periods of numbness along a line down the center of my shoulder toward my elbow. I am wondering if it might just be a nerve swelling because I went back to activity too soon or if I should be concerned that the shoulder went back in and is compressing a nerve. Or is it something else entirely? Should I give it more time to rest or get to a doctor to have it evaluated? Any opinion or advice would be great. ### Response: Hello. I recommend you rush to your local orthopaedician for a complete 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 have been suffering from a disease of the stomach for six months now. I feel a pain in my stomach when I pass stools. My stool is like mud or liquid, but not like water. I have consulted many doctors but I do not have relief yet. Please tell me what I should do. I am very worried. ### Response: Hello. Your problems are not too worrisome. It can happen normally as well. Have good food and relax. You will be fine. If is not settling with this, please consider a detailed consultation." "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 suffering from body acne since 10 years. It is present on my upper arms, shoulders, back and buttocks. I have been using Benzoyl peroxide 5% since 6 months. But there has been no effect at all. ### Response: Benzoyl peroxide alone is not going to work. Please send the photographs of the affected area to find out the grade of acne and to prescribe you the proper treatment. Revert back with the pictures to a dermatologist online for further follow up" "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 regarding a mole. I just had my hair cut and noticed a mole on the back of my neck near my scalp. I might have had it for a while and did not know about it. Most of my moles are brown and auburn. But, this one is pink. I am wondering whether this is normal. My concern is about nodular melanoma, but my understanding is that the nodular melanomas are typically under the skin and then grow out. This one is on the top of the skin, almost like a skin tag that you could pick off. But, I think it is a mole and not a tag. It does not feel like a firm nodule under the skin. It is soft and mobile. Please help. ### Response: Hello. From the picture (attachment removed to protect patient identity), it does not look cancerous. Yes, it has a skin tag type appearance. But, I can give you a confirmatory answer that it is not melanoma because only skin biopsy is the tool which can give you a definite diagnosis. If you notice that it is increasing in size, changing in shape and color, then you have to go to the local dermatologist for further evaluation. Otherwise, at present leave it like this and wait for three to four months for further changes." "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 52. I noticed my glans penis has some measles-like red spots all over. Overall, the glans penis seem reddish and slightly inflamed. A light irritation is felt. ### Response: I have noted your concern and viewed the image (attachment removed to protect patient identity). Regards" "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 19 years of age. I have been suffering from a kind of allergy for almost 4 years. My mother has been suffering from same kind of allergy but her case is not worse than mine. I feel runny nose, sneezing, itchy nose and eyes, mild rashes after having a shower and breathing difficulty also. My heart beat gets faster and rapid. I am also suffering from noise sensitivity. I cannot tolerate loud voices, my heart starts beating faster and I feel dizziness and headache. In my own residential area, I catch allergy for almost 360 days of the year. I am feeling much suffocation and rapid heart beat.Another thing, whenever I get stuck in some kind of mental or emotional stress, my heart rates becomes faster and irregular and at that point of time I feel suffocation too. A nearby doctor suggested me the treatment of nebulizer, but I am not feeling much better. ### Response: I have read your query and there are two components so I will deal them separately. First, the increased heart rate in stressful conditions: that is anxiety and not uncommon. You can try breathing exercises but if not controlled/or aggravates to full panic attack, you will need CBT by a psychiatrist or psychologist and medication. Best breathing exercise is placing a paper bag over mouth and nose, and completely inflating and deflating it till heart beat and breathing become normal. Now for your allergy: seems to be allergic rhinitis/sinusitis. You can use a maintenance therapy of Myteka 20 mg once a day with once a day Softin and increase Softin on excessive exposure to allergens like dust, pollen, etc." "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 a revision rhinoplasty and it is going to be under sedation and local anestheia but I am very scared. I asked the doctor about it since I read that during sedation you are awake but he said under sedation, patients are asleep and they feel nothing. However I never tried it and I am really scared, I want to know what i.v sedation is exactly and is the patient put to sleep if the patient is actually asleep then what is the difference between sedation and general anestheia? ### Response: During general, anesthesia patients put in a deep sleep like state. Even respiration of the patient also under control of the machine. The patient cannot remember about surgery during the procedure. It may associate with little complications. Local anesthesia is blocking the area the part undergoing surgery. The patient may be awake. He may feel the movement of the body procedure. But if they use intravenous sedative or ketamine patient may go for a short sleep during the procedure. I think I answered your question if you have more questions feel free to ask." "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 five weeks pregnant now. Currently, my T3 is 1.05 ng/mL, T4 is 5.0 \xce\xbcg/dL, TSH is 27.62 \xce\xbcIU/mL. I started Thyronorm 75 mcg today. What if my T4 was low from the past five weeks? Has it affected my baby already? Will it affect the baby\s brain development? ### Response: Hello. I just read your query about your thyroid function test results, and it appears that you have hypothyroidism. Let us be positive and hope for the best. Hope you find my advice of some benefit. Good luck." "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 type 1 diabetes at 27 years old (diagnosed around eight years). Recently I was somewhat nauseous, and today diarrhea with a lime green tint. I read about diabetic enteropathy, but this is the first time I feel like it could be diabetic-related diarrhea mostly because I had not had much to eat other than peanut butter and jelly sandwich for breakfast and a juice box for lunch.I was 79 around 11 am, and at 8 am I was 118. The last few days I have been consecutively around 150-to-mid 200\s (but mostly in the 150 to 190 range). Otherwise, my numbers are generally stable overall, and I believe my last A1C was 6.8. I had two bowel movements today with diarrhea. I took my blood sugar just a few minutes ago, and it was 290, and going down (I gave myself a shot of Humalog to keep me steady for dinner). I was just a little worried because of the article I read on diabetic enteropathy. It is treatable by just keeping the blood sugar tighter, and I was a bit scared if it might be fatal. I assume it is, but I do intend to keep things better regulated after this. I need to be a bit more at ease after what I read. I did not want to contact my doctor if it is something I can fix with regulation. ### Response: Hello. Diabetic enteropathy is not diagnosed after a single episode of diarrhea. Usually, it is chronic and intermittent with regular bowel movements in between. Constipation can also be present. Diarrhea can occur during the night. There are other causes for acute diarrhea-most commonly infections, food poisoning, or adverse reactions to medications. I suggest you wait and see how this whole thing pans out. As long as there is no blood in the feces and no abdominal pain or fever, I would not worry about some serious underlying condition. Tighter control using insulin is possible but can be difficult due to hypoglycemic episodes. I suggest you go through these articles about this. Also, if you can afford or if your insurance covers it, try getting a CGM (continuous glucose monitor). I hope this helps. Please let me know if you have any other questions." "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: Yesterday, I underwent a root canal treatment and almost 5 mm file was left behind. Will it cause any problem? ### Response: How are you doing? The file is completely sealing the root canal till the working length (the exact length of the canal till which the root canal is done). So, it is not a problem. I hope the doctor had cleaned and shaped the canal, and the file was sterile before the breakage of the file. And trust your dentist, if it was to create any problem, they would have informed you and tried to resolve it. Still, there is a minimum chance to get mild discomfort in future and since yours is exactly in the working length range (no over or under extension), the chance of further complication or discomfort can be brought to very minimal. Do not worry" "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 34-year-old female. 5\4"" 130 lbs. I discontinued my Depo-Provera when my shot was before seven months. Before three months, I had a lot of discomforts and went to urgent care with suspected UTI. UTI came back negative, after the ultrasound, doctors confirmed I was likely close to ovulating and should expect the first period in about two weeks.Before two months, I had very light pink, then very light brown discharge when I wiped after urinating, but no period. Since then, I have had pelvic pressure, ache, nausea, dizziness, headache consistently. I do have one child. The discharge and other symptoms were consistent with my last pregnancy, but tests so far have come back negative. My husband and I are not preventing pregnancy. Is this a hormonal imbalance that needs treatment or possibly ovarian cysts? Consistently dry heaving at work has become very bothersome, and symptoms do not seem to be lessening. ### Response: Hello. But this scenario of menses being delayed and often taking 3-5 months post depot Provera stoppage is a common side effect of prolonging depot usage." "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: Tell me the treatment of primary premature ejaculation. I am suffering from many years, facing from the beginning of sexual life. I did not consult with a doctor and did not take any medicine for this problem yet now. I have no other health or physical problems without this. No erectile dysfunction. ### Response: Hello. Premature ejaculation in most individuals occurs because of anxiety and psychological reasons. Lack of experience, less foreplay, stress, etc., result in rapid ejaculation. Relaxed mind helps to improve the time. Distraction during sexual intercourse helps to increase time. Try to divert mind away during sex and this will help. Dapoxetine is used commonly. The" "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 21 year old male, and I am studying nutritional science. Over the past year, I have been experiencing these symptoms. I have a fast pounding heart, especially after a night of drinking. The following morning, I always wake up early to a pounding heart, and it scares me. This happens after big meals and while exercising also. When I exercise, my heart feels like it is going to explode. I also have fatigue and mental fogginess, my concentration is low, and I feel like I am just overall slow or have low energy. I have anxiety, and I have been diagnosed with anxiety in the past. I was in a dark place for awhile, but things seem to be getting better. The doctor wanted to put me on Zoloft, but I declined and had thankfully found peace with daily meditation.I have a low libido, and I am just not that interested anymore. My testosterone levels are low for my age. My last readings were 302 ng/dL, 290 ng/dL, and 270 ng/dL, which were all taken in the morning. As a person who exercises a good amount, I find it hard to gain strength or any muscle. I want to fix this, and I have consulted many doctors, but none are willing to help me. I honestly believe that my testosterone level is the main cause with all this. I have thought about taking matters into my hands and starting a treatment regimen but, I would rather do so under the supervision of a doctor. ### Response: Hello. As your BMI (body mass index) is 34, in obesity, the decreased levels of testosterone-binding protein cause a decrease in the total testosterone levels, but not the normal free level. Before we evaluate you for low testosterone, we need to confirm it by doing free testosterone levels. If free is also low, then we need to find the cause, for that, we need FSH (follicle-stimulating hormone) and LH (luteinizing hormone) level. So, you first get free testosterone levels done. Also, any anxiety, depression, or any psychological issues can cause loss of libido. You can visit an endocrinologist for the same. Secondly, regarding your heart rate, it is certainly not related to testosterone. But it can be related to anxiety, alcohol, and heart. There are two possibilities, one is anxiety related and secondly due to heart arrhythmia." "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 couple of conditions, and I would like to enquire whether there could be an underlying cause. I am a 27 year old female, and I have recently been told I have PCOS. I am not entirely surprised, as I have painful ovulation. I am due to have a follow-up to further discuss scan results. Before this, as a teenager, I was diagnosed with slipped upper femoral epiphysis (SUFE), which I have managed to keep under control. Prior to my hip condition, I developed kidney scarring from a bad infection. For both of these, I was monitored for a few years. ### Response: Certainly, there is a possibility of underlying hormonal abnormalities. Scarred kidney is due to infection, that should be left apart. You should get the following tests done: Anyway if you are visiting endocrinologist, then he will definitely order all these investigations. You also mentioned about anemia, if still have it, then you will need investigations for that, like serum iron studies, vitamin B12, and folic acid levels. Do you have blackish foul smelling stools? If yes, then you need to get occult blood testing. Hope this helps you, and get back if you have any doubts. Revert with more information 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: I have a patient who is female, 79 and has a large breast tumor. Rather than give chemo, I personally would like her to try out hormone therapy. Would hormone therapy shrink a large tumor? Your advice would be greatly appreciated. ### Response: Hello. Hormone therapy will shrink the hormone-sensitive mass, but by how much is difficult to predict. It is really helpful if the patient has poor performance status and significant comorbidities." "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: Earlier at work, I experienced the most bizarre episode of palpitations I can remember. I do find them to occur fairly regularly once in every couple of days. Today, however, rather than just the one small bubbling and skipping feeling, it happened in sequences shortly one after the other for around four times. It went on for about 30 seconds and had me pretty concerned that I had some attack. Any of your help would be appreciated. ### Response: There are two possibilities like heart issues and even anxiety related. It is likely to be a cardiac arrhythmia like premature complexes, PSVT (paroxysmal supraventricular tachycardia) or atrial fibrillation. We first need to find out the cause, and so you should get one ECG done. If ECG is not informative, then you will need a 24-hour Holter monitoring if symptoms are occurring on a daily basis. So, visit a nearby cardiologist for these investigations. Also, get one thyroid test done. Is there any stress or anxiety associated, as it can be related to it as well? Until the time your evaluation is complete, you can ask your local doctor for tablet Ciplar LA 20 mg Propranolol or other beta blockers once a day. Revert with the reports to 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: I have attached the blood reports, medical reports and doctor\s prescription of the patient. Doctor advised for the operation. I would require you to please review the attached document and provide your feedback. ### Response: Hi. I have thoroughly gone through your case, attached reports (attachment removed to protect patient identity) and can well understand your genuine health concerns. 1. You have normal thyroid profile means gland is working normal and no issue with it.2. Your complete blood count is fine meaning there is no issue with your blood.3. Kidneys are working normal.4. MRI is not normal. It shows a fistula and needs proper management as directed by your doctor. 1. Your physician is right on a decision for surgery as there is a fistula in the sphincter of anus and is causing issues right now.2. If left untreated then it can damage the sphincter of the anus and that may lead to permanent loss of control on stools.3. It is very miserable condition that needs to be corrected in the first place right now. Please follow the instructions of your physician." "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 family member has been advised for the removal of teeth and then the braces to be fixed for alignment. Kindly give a second opinion. ### Response: Yes, this is right. Alignment of teeth can be corrected only if we remove a few teeth which are not going to be needed in the future too to give space for teeth to shift themselves and align." "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 spots on my chest for the last two weeks. They are not itching, but I am worried about that. Is this some sort of rash or just chest acne? Should I be worried? Please help. ### Response: Hi. I have read your query in detail and viewed the attached pictures (attachment removed to protect patient identity) and do understand your concern. If you did not have any fever or viral in the recent past, these are quite unlikely to be some associated rash. If these are only on the upper chest and not on other body areas like legs, arms, etc., you need not worry. 1. These could be acne if you have acne on the face, upper arms, shoulders, etc.2. If they occurred immediately after waxing or shaving of chest hair then it can be folliculitis. In that case there should be little pus points or some discomfort or pain.3. 4. For acne you will require antibiotics and for seborrheic antifungal combinations. Let me know if there are any associated features, so that appropriate creams can be prescribed to you Revert back with detailed answers 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: My mother is having melasma on face. Can she use Kojivit gel? If yes, please suggest whether it can be used at night time or otherwise? ### Response: I have few questions for you to suggest the most appropriate treatment. Also, please get her hormonal tests done to ensure that it is not hormonal (FSH and LH). And please do follow the below suggestions: Avoid sun exposure - Use a sunscreen (UVA and B) minimum 30 SPF. (Neutrogena is good but you may use any as per your skin or requirement. Even shalaks pharmaceutical has a good sun cream- UV AVO) If she has to go out or even indoors, she must clean her face and then apply sunscreen." "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: There are spots on the scrotum for over a year. They are not painful. I just wanted to know if it was normal. Currently, I am taking Proguanil 100 mg (anti-malarial). ### Response: It is steatocystoma multiplex which is basically a benign cyst (attachment removed to protect patient identity). The Line of management is surgical incision and extraction of sebaceous contents with destruction of sac to avoid recurrence. Laser, Radio-frequency can be used." "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 puncture wound that is very swollen and painful. Went to urgent care and they gave me an antibiotic. How would I know if it needs to be drained or not? ### Response: Hello. Usually, it is visible outside and there is pus point called anabscess. Also, if it is not responding to antibiotics then we have to suspect the underlying pus collection and need investigations like ultrasound in those cases to confirm the underlying collections. So I think, you should upload the picture for me to have look. Also, if puncture has happened due to metallic objects or a lot of wound contamination also request for tetanus shot if not had recently." "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 baby boy is 3.5 months old. He was diagnosed with VSD when he was 2 months and his cardiologist asked for followup after a month. On out checkup his 3 mm VSD was closed, but the doctor discovered 6 mm ostium secundum ASD. He said that it can close spontaneously just like the VSD, so we have to check it after three months. We needed a second opinion so we consulted another cardiologist who echoed my baby and found out the same results, but he said that it is 6 mm superior secundum, but it will not close on its own cause of its position. Is it really true that my baby can get it closed only by open-heart surgery? I am worried about the scar and the side effects on my baby. ### Response: Hello, Welcome to iclniq.com. I understand your worries. No need to worry all will be fine. From my experience, ASD (atrial septal defect) of 6 mm can still close by itself regardless of its position. I will advise you to wait till your baby is 6 months old to have him checked again before a decision can be made to operate on him. If it does not close, later on, scars would not be a problem. Scars will be minimal and be eliminated using cosmetic or plastic procedures. There is hardly any effects after surgery, he will live a normal life. I hope he gets better soon." "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: The patient is a 65 year old, hypertensive and diabetic female with T-wave inversion V1 to V6 on ECG. ECHO and TMT have done to evaluate further, which was reported to be normal. The patient is on Metformin XR and Tazloc-H. The patient is asymptomatic. Six months back, ECG did not show these changes. She is hypertensive for 15 years and diabetic for the last 10 years. What could be the cause of these changes? Please advice. ### Response: Hi. Global T-wave inversion carries a very little significance (attachment removed to protect patient identity). I would suggest repeating the ECG again in six months if the patient is asymptomatic. If otherwise, you can get a CT coronary angiography to rule out any CAD (coronary artery disease)." "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: Please suggest me the yoga names to improve blood flow to the testicles. I have weak erections, watery semen, and loss of libido. I am taking Pantogem DSR for indigestion and Stalopam plus for stress. My local doctor prescribed these medicines. ### Response: Continue with the prescribed medication. Along with that meditation, exercises, and yoga can help improve your condition. Deep breathing, inhalation through nose and exhalation through the mouth, improves blood circulation. Suryanamaskar is the most efficient form of yoga that can be used for all conditions. Morning time count of 10 should be followed. Balasana (child\s pose) can improve the pelvic floor organ functioning. I also suggest: Along with all these yoga poses, a good diet rich in fiber and proteins can help alleviate your condition. Pranayama should be included with all yoga poses. Destressing is the most important factor" "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: There is a colorless ridge on the roof of my mouth on the hard palate. This thing is troubling me for near about eight months now. It occurs occasionally swells up and burns and then at the end of the day it subsides. It stopped for a month but now again it comes for like a day and then subsides for two or three days. Please tell me what it is. Currently, for allergy resulting in sneezing and cold, I take Duanose nasal spray. ### Response: It looks likes a bleb which can be due to trauma to hard palate due to spicy and sharp food. You should stop taking hard and spicy food. Do you smoke or consume alcohol? You should start taking antacids and apply local antiseptic and local anesthetic gel over the bleb. Do chlorhexidine mouth gargles" "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 9 years old. He is 4 feet and 11 inches and weighs about 107 lbs. I checked his BMI, it said he was obese in the 95th percentile. He is active. Should I worry about his weight? And if so, how can I help him with it? ### Response: Your son has good height and for the same reason, his weight is not worrisome. But definitely he is on 95th centile for his height as well as for his age. Also, his BMI (body mass index) is 22.4 which puts him in the category of obese. Let him have a lot of outdoor activity, avoid sitting for a long time in front of the computer or tv, and avoid junk foods. Swimming is the best activity for this age and swimming for at least 30-45 minutes daily or at least five days a week will help him. Let him have a good balanced home food with less fat. Child Obesity at this age has higher chances for him to be obese as an adult with all its other consequences. So it is better to have some precautions but no need for a dieting regime at this age as he is a growing boy and needs more calories from proteins for his overall growth. 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 had sex with my fiance 10 days back and took the 72 pill on the next day but did not bleed. I had sex again a week later and took the 72 pill that very day. I began to bleed soon after taking it which lasted for two days and now I am having a slight lower stomach and back pains. Am I pregnant now? ### Response: Hello. It can take up to 21 days to have bleeding after taking emergency contraception and although it is good that you took it very soon after unprotected intercourse, you should not use this as your primary method of birth control. It will cause cycle delays and unpredictability. Emergency contraception is not 100 % effective, even when taken as directed. There is always a chance of pregnancy when you have unprotected sex. A pregnancy test is advised and a reliable form of birth control in the future is strongly recommended." "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 facing issues of erectile dysfunction. But, I have a bad habit of masturbation since childhood. I am unable to keep my organ hard for a long time. It is big, very flaccid and not very hard. My testis has got shrunked day by day due to masturbation. Please suggest as I am getting married very soon. ### Response: I would like to mention that masturbation does not cause any weakness or sexual dysfunction. It is associated with guilt and anxiety that causes the problems. Do not get worried. Treatment is possible. Consult a psychiatrist or a sexologist in person for evaluation and treatment" "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 high sugar level in mornings around 140 plus and at night it is normal around 100. I am overweight rather obese and trying to lose weight. Now, I want to know whether I have insulin resistance or diabetes? I mean what is the difference? Can I get insulin test also? ### Response: Hello. Insulin resistance is a pre-condition towards diabetes. According to American heart association, there are criteria to decide pre-diabetic or diabetic. I would advise you to see a physician and get tested. It is a well-appreciated thought of losing weight, hope you stick with it and also control diet" "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 was on Cymbalta minimum dose but did not feel better. I felt worse and was told to up the dose then I took 120 mg, still felt bad. So I abruptly stopped this and it triggered discontinue syndrome and hypermania. I have not felt the same since. I am not suffering so much now from hypermania after a month or two. I am Lamictal and when needed on Seroquel.On current medicines, I feel blank, unstable, unable to think normal, and some frustration, anger thinking, concentration, and speech affected at times. I feel I need to go back to antidepressants, my brain needs that and boosts mood and taper off appropriately like Effexor or Lexapro. I have had success but Lexapro cause stomach issues and Effexor is good but can cause weight gain or if working in the night it can cause mood swing. I believe my current issue is just because of Cymbalta induced hypermania. I did get psychosis from LSD. Do you think I should taper off Lamictal to Effexor low doses? ### Response: So, I would suggest you discuss with your treating psychiatrist regarding starting Seroquel regularly as it also acts on depressive symptoms, or starting low dose Effexor along with Lamictal (as mood stabilizer). 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: My mother in law is 75 years old and she is diabetic. She had been treated for ulcer one year back. She is suffering from cough and breathlessness for more than two weeks. Doctor advised for a CT scan. Please see the attached report and guide us further.What does the report say? How serious is her health condition? Kindly mention the precautions to be taken and treatment for the same. ### Response: Hello. I have read the history and CT scan report (attachment removed to protect patient identity). If she has not received any antibiotics, I would suggest the following: Hope she will be fine with this treatment. Revert back to a pulmonologist online for further follow up" "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 on birth control (Aviane) for almost two years. I stopped taking the pills after my serious relationship ended before two months. My first period after my withdrawal bleed happened in the middle of last month. It lasted about two days, was somewhat heavy, but then I mostly spotted for two days. Since then, all of my periods have been the same. Somewhat heavy for two days, then light spotting for two or three days. My cervical mucus has not seemed fertile, and I have not felt any ovulation pains like before I was on birth control.Everything about my period seemed different, and I have been thinking that meant that I was not ovulating like before, but I know that might not be the case. I had unprotected sex on day 10 of my cycle. We used the pull-out method, but just to be safe, I took five orange pills (Aviane) about 12 hours later, then five more orange pills 12 hours after the first dose. Today, four days later, I am feeling mildly crampy, but I am experiencing a lot of white thick discharge.My question is, are my chances of pregnancy low considering everything? And also, if I experience a withdrawal bleed from the bc pills, when should I expect my real period again? ### Response: Hi. Since you have taken pills, there is no chance of pregnancy. These symptoms could be because of hormonal changes due to the pill you have taken. Your next period could be a bit erratic, because of the hormonal changes due to the pill you have taken. But from the third month, usually, it get back to normal. So relax and do not worry. However, if you have any doubt then get 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: Please tell the best way to how can we control, remove and also prevent the swine flu? ### Response: Swine flu is caused by a virus called H1N1 and H3N2 group of influenza viruses that are widespread across continents. Vaccination is one of the effective ways of preventing swine flu although it may not be 100% effective. Get yourself vaccinated before the onset of the flu season every year. If you are an asthmatic or having chronic respiratory problems it is all the more recommended to get yourself vaccinated for flu. The best treatment is prevention, by maintaining hand hygiene, cough etiquette, i.e. covering one\s mouth and nose while coughing and sneezing and turning away from surrounding people, frequent hand washing. Once you suspect that you have flu, take adequate rest, 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: My wife had stomach pain and we had done an ultrasound and the doctor said to take a scan. On CT scan result it is showing splenic hamartoma, left renal angiomyolipoma. What does it means and what treatment we have to follow? ### Response: Hi. Please attach the report of CT scan. Let me first evaluate it. See splenic hamartomas are usually benign that is non-cancerous. Similarly, are renal angiomyolipomas. They are removed with surgical excision if they are causing any hematological disorders, a decline in renal functions. A lot of surgeons recommended the removal of these structures. A lot may not recommend you. At this point of time, your wife needs further evaluation. Meet an oncologist, vascular surgeon and get further tests 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: Can I pull out hard teeth out no pain because I got a hole in my teeth? Whenever I use to eat something, it got stuck in it and caused severe pain. Kindly give me some advice about pulling it out without any pain. ### Response: Hello. I had gone through your question, and I can understand your concern. If the pain occurs only when you eat food and it gets stuck into it, it is reversible pulpitis. For that, you do not need to get it extracted. You need to get it filled, and it will cost you less than that of pulling (extraction). Second, you will save your tooth too. My suggestion is to get dental filling done as soon as possible. If you want to get it removed, you need to visit a doctor (dentist), and there will be no pain because during extraction local anesthesia is given." "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 seeking fitness expert insight on nausea after the workout. If someone feels nauseous after a workout, what might that mean and if someone regularly feels nauseous after workouts, what could be causing that? What can someone do before, during and after a workout to prevent nausea? What types of workouts are more likely to cause nausea? Are there any good pre or post-workout snacks that can help with nausea? ### Response: Regular episodes of nausea could be due to high intensity or overhy" "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 heartburn and gas problem. I have burning pain in between chest and stomach. I have feeling of something stuck on throat. I am facing difficulty with continuous burping. ### Response: Hello. According to your complaints, you are having GERD- gastroesophageal reflux disease. You can undergo endoscopy examination to rule out any upper GI problems. Try the following medicines and review: 1. Tablet PAN D 1 BID before food. 2. Tablet Libarex 1 BID after food. 3. Tablet Alprax 0.5. 4. Liquid Sucralfate 10 ml BID after food for 10 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: My daughter is 18 days old. Yesterday she vomited out milk three times in a day. Also sometimes she coughs for four to five seconds several minutes after the feed. She arches her back and folds her leg when I lay her on the bed. She is more comfortable lying on my chest and tummy all the time. She is exclusively on breastfeeding. Tell me how to prevent reflux. Should I make her sleep on sides as that way she is more comfortable? ### Response: This usually happens due to inadequate burping after the feed. After every feed, you should keep baby upright, at least for 15 to 20 minutes. Make sure baby is latching to the breast properly as improper latching leads to air swallowing, which can lead to gas or colic pain, and baby gets uncomfortable. It is good, keep baby exclusively breastfeed. Sleeping on inside is not recommended as it can lead to aspiration. Feeding gap should be maintained as much as possible, two hours so that you get time to rest, and milk secretion improves" "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 51 years old with DM and thyroid and is suffering from MDR tuberculosis. She is on medication for 15 months. Recently her medicine has been changed due to diarrhea. Her new medicine are Elox OZ, Rabifit DSR, Calvit 500 mg, Doxid 50 mg, Trixid-H, Petril MD, Rejunex CD3, Ativan 1 mg, Zenoxa 300 mg, Censpram plus, Redotil, Combutol 1000 mg, Augmentin 1000 mg, Pzid 750 mg, lcin 500 mg, Ethide 250 mg, Linox 600 mg, Econorm sachet, QPAS. Does any of the above-mentioned medicine can cause this problem? ### Response: This contains a big list of medicines including anti-TB medicines, antibiotics, antidepressants, anti-diarrhea medicines, etc. Few of them are the same compounds, especially antidepressants containing Clonazepam. Rabifit-DSR contains Domperidone, which can cause increased gut motility. You can substitute it with plain Rabeprazole. Augmentin has the potential to cause antibiotic-induced diarrhea by altering the gut flora. Your list contains Econorm which helps in relieving diarrhea. All the antidepressants can alter gut motility but mostly decrease 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: I am a 31-year-old physically active male and I have been worried about the size of my superficial dorsal vein of the penis. It has slowly increased in thickness over the past few years. It looks extremely engorged in both erect and flaccid state. I am not experiencing any pain or erection problems so far. I had one varicocele surgery on the left side and two inguinal hernias repair seven years ago. I am not sure if there is any correlation. Is this a cause for concern? Should I consider any treatment? ### Response: Hi. They have to be tortuous so that when the penis becomes erect, they do not stretch too much. The superficial vein is prominent because it is just below the skin. I would not worry about it. This is normal. Any lumpiness or ballooning or skin changes are abnormal and will require medical attention." "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 30 years old. I do not like being in public. I do not do anything fun. I have a thought that always people in my surroundings are looking at me. So I would rather be at home. I do not like using the phone. I am taking Klonopin 2 mg 3 times a day. But I am not taking it now as I am travelling with my husband state to state for his job.With regards to anxiety my symptoms are extreme worry, classic panic attacks sometimes 5-6 times a day, feel hard to breath, stomach sick. I do not get motivated to do anything like shower, changing clothes, cleaning house, keep a job. My husband will do most of the shopping including grocery. I forgot any type of social get together with friends and family. I do not even visit my in-laws. I feel tiredness in my whole body, a tense feel and headache. When I take Klonopin these symptoms will disappear. I have been on this medication since 13 years.Can anxiety be the cause for such issues or is it something else? I wish to spend some time outside with my family. Please explain what is wrong with me. ### Response: You are suffering from panic attacks with agoraphobia (fear to go to public place). You are taking Benzodiazepine (Klonopin-Clonazepam) of very high dose. Continue it but should take it occasionally only, as high chance of dependence is there. You should start an antidepressant, which is useful in panic attacks, for maintenance. Take tablet Pari CR (Paroxetine) 12.5 mg for 5 days, then shift on Pari CR 25 m and continue it in the morning.You can take psychotherapy sessions (CBT - Cognitive behavioural therapy) by therapist or psychiatrist. Thyroid Function Test. Review after 21 days, to adjust dose of medication.Revert back after 21 days to a psychiatrist 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 just started fasting from yesterday morning and last night I was having slight kidney pain. Then I awoke in the middle of the night with some kidney pain and a swollen kidney feeling and urinated with difficulty like having to really push it out. Similarly, last year my kidney got worse when I was fasting. When I was under 1 year of age, I had an operation on my kidney and have a large scar in front of the bladder or abdomen area. It was a blocked urethra, which caused whatever fluid back to the kidney causing damage. They said that my kidney would have to get removed at one stage in my life and 21 was the oldest patient in the past that lasted before removal. I am now 30. My height is 183 cm and weight is 85 kg. I wanted to know if it would be advisable for me to stop fasting and if so would that be for the rest of my life? ### Response: Kidney stone. Urinalysis, urea and creatinine, uric acid and non-contract CT abdomen and pelvis. Crystalluria. Revert back with the investigation report to urologist 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 went to my dentist a few days back with the discovery of an abscess which was connected to a broken tooth. It then spread to my cheek and got swollen. I am on Amoxicillin and Flagyl for five days. Today is my last day. Unfortunately, the swelling has not entirely decreased, I am still left with a small hard sack of presumable pus. How can this be removed or will it go away naturally in a few days? ### Response: Hi. I had gone through your question and I can understand your concern. It looks like the infection is over if there is no pus and pain anymore. The swelling if hard remains there is called antibioma and it may take some time to get fully over and will not need any further antibiotic medication. In case the swelling is tender on touch, there is a pain still, you may need medication for two more 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 25 years old,male. I am getting wierd type of muscle spasms since past 15 years. Those spasm gets triggered when I do sudden movements like when suddenly get up from chair and start walking, I get spams. It lasts for 5 to 10 seconds. Spasms look like my legs and hands are rapidly contracting and cramping just like tetanic cramps. I consulted neurologist and he told me that those spasms are due to deficiency of vitamin D which leads to poor absorption of calcium. He has given me Vitamin D treatment for six months and told me that my spasm will completely vanish. One month has passed since I have started the treatment and I am seeing improvements. Still I get spasm but intensity has reduced. Still 5 months to go. So will I get rid of them? I am feeling anxious about them. Please give me your opinion. ### Response: I must assure you that you are in right hand and right thing communicated to you about the tetanic spasms which you are experiencing for the last 15 years. Majority of patients (read all) show good response to Vitamin D supplementation when there is deficiency and same can be hoped in your case. I would like to add something at this level. Since you are taking Vitamin D but not the Calcium. This leads to inadequate calcium to absorb and low calcium and spasms. Talk to your neurologist to add Calcium or increase at least 500 to 1000 mg per day. This will ensure that there is enough calcium to absorb since absorbing machinery is overworking due to supplementation of Vitamin D. The Calcium supplementation is likely to cut short the duration of symptoms." "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 deep brain stimulation surgery for generalized dystonia 18 months ago, I have developed mild startle myoclonus a fortnight later and was prescribed 0.5 mg Clonazepam. Since being on Clonazepam, I developed mild anxiety and my myoclonus continued to worsen. Now, I have violent full body jerks that cause me to fall over backwards every day. I am now on 1 mg Clonazepam in the morning and evening. After six months of Clonazepam and just after increasing my dose to 0.5 mg twice a day, I developed pressure of speech and the longer I have been on the drug the worse my myoclonus and anxiety has become. I am now in a vicious circle as the myoclonus episodes are so violent and I fall backwards heavily despite whatever I hold onto. I have become anxious at having an episode and the actual anxiety can trigger a myoclonus episode, although it also occurs when I feel safe such as sitting down, reading a book or chatting with friends.Six weeks ago, I was told to double the dose due to the high number of falls I was having during myoclonus episodes and since then I have developed mini-seizures and worsening of anxiety. My neurologist is referring me to a psychiatrist for CBT for anxiety and now believes anxiety is the likely cause of my myoclonus. I am happy to do this as I just want to overcome my fear of falling. My dystonia also is causing me to fall due to motor control problems with my legs. The behavior of my legs is very unpredictable, so without warning I regularly trip or my legs suddenly buckle, especially when tired or if I am on my feet for too long. Every drug I have been on since been diagnosed with dystonia has caused serious side effects, even at a low dose and I was told by one of the neurologists that my brain is very sensitive to the side effects of the drugs. The anxiety has only developed since being on the Clonazepam and seems to have worsened whenever the dose has been increased. Could Clonazepam cause anxiety?I have now lost my confidence to leave the house, even with my walker as during a myoclonus episode it is so vigorous the walker just tips over with me and I have episodes every day, but just do not know when one may occur. I have not walked as far as the end of my road about 100 meters for nearly five months now and even with friends still feel apprehensive when walking even a short distance with them. I have lost my confidence to stand in the kitchen to do chores in case I have an episode. I often crawl around on the floor, especially when tired as tiredness definitely increases the episodes and the higher dosage of Clonazepam makes me feel very tired by midday.I am also under stress at home as I am a carer of my 86 year old father who has Alzheimer\s, although I get some support from social services with carers, who come in to get him up and his breakfast and then his evening meal. I am normally a very positive person, but right now I wonder if I will ever get better. I am keen to start CBT. But, I am still concerned that Clonazepam initiated the anxiety as a side effect and so would need to withdraw from the Clonazepam in order to recover properly. All I know for certain is I never had myoclonus before my DBS surgery. I never had anxiety or a single fall. Right now, I wish I never had DBS as it done little to help me physically and my quality of life right now is far worse. I am finding it hard to stay positive and feel very discouraged. Please help me. ### Response: We are here to help you. Reading your complete details I understand your concern and pain. First of all I would say that Clonazepam does not increase anxiety. You might be having myoclonus following DBS as it is a known adverse effect of DBS (deep brain stimulation). Following DBS, there are people who have worsened symptoms. However, myoclonus and frequent fall could be a feature of your Parkinson\s only and that has appeared now and you might be linking it to DBS." "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 48 years old male. A couple of months ago, I was diagnosed with a bulging disc in C6 and C7. I had pain and weakness associated with such a problem, and after some treatment, the pain subsided. Since then, my left index finger developed a twitch. Always at rest and occasionally twitching on and off most of the day. Some days I would hardly notice it at all if any. Now my left middle finger is starting to twitch the same as my index finger, and I do not notice the twitch in my index finger as I did before. And I also noticed an occasional toe twitch on either foot before falling asleep at night. I could blame the finger twitching on the, disc, but the toes on each foot make me concerned. I am concerned about Parkinson\s disease. I researched all I could online. I do not have any of the other symptoms associated with the disease. I also tried to figure out the difference between tremor and twitch. It seems Parkinson\s tremors are very rhythmic while mine are more sporadic twitches. I have attached a video of my index finger for your review. ### Response: Hello. I watched your uploaded video and would explain that your symptoms are not suggestive of Parkinson\s disease. (attachment removed to protect patient identity). This kind of twitching is usually related to different causes like: 1. A pinched nerve, 2. Thyroid gland dysfunction, 3. Electrolyte imbalances, 4. High uric acid levels, 5. Anemia and 6. Vitamin D or vitamin B12 deficiency, etc. For this reason, I would recommend performing nerve conduction studies and some blood tests: Complete blood count, PCR (polymerase chain reaction), Thyroid hormone levels, blood electrolytes, Vitamin D, and Vitamin B12 plasma levels and uric acid plasma levels. 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 30 years old. I can see a lot of new moles on my face, chest, back, and neck. Two to three of them are slightly asymmetrical too. All the moles are less than 5 mm. Please suggest. ### Response: Hi. I have read the query and seen the pictures attached (attachment removed to protect patient identity). These moles look normal. If there is any sudden change in size, shape, pigmentation, or any bleeding, then a dermoscopic examination or biopsy can be done by your local dermatologist. Avoid going out in sunlight, as it reduces the occurrence of moles over the covered areas. Apply sunscreen over the exposed areas twice daily and regularly." "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 recently had an MRI and ultrasound scan for acute cholecystitis and they showed multiple cysts and a 16 cm x 12 cm cyst in my liver. Please could you tell me is that large for a cyst as I have been told it needs further surveillance. It is showing two benign looking hepatic cysts. ### Response: Hello. A 16 cm cyst is a bit large cyst. A few more details about your condition would be quite informative. Have you ever had any pain in the abdomen or jaundice in the past? Any contact with sheep, any pet dog? Kindly inform what was the management for acute cholecystitis, was cholecystectomy done or just managed with antibiotics and other medicines? If it is possible to upload the images or reports of the ultrasound and MRI, it would be really helpful to give a comprehensive opinion." "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 baby is 3-month-old she was having a fever now with a weight of 5.8 kg. What should I give to gain more weight and look humpty she looks too much weak also. ### Response: 5.8 at three months is fine. The child should not be Humpty. A good weight is must, not under or over. If she had a fever, the most common is viral fever characterized by fever and nasal discharge with or without mild cough, and child will be active otherwise. If she does not have all these features, it could be other infection also, for that we need to discuss by direct conversation. 1. If it looks like viral fever, give her only Paracetamol syrup 4 ml three times a day along with frequent breastfeeding and monitoring of the temperature. 2. Give her breastfeed exclusively up to six months. 3. After six months start on cereal supplements, and report with weight so that we can decide how much to be given. 4. Complete vaccination. Report back if you need assistance for any purpose related to parenting and child health." "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 daughter is almost 9 months now. She is gaining good weight and height. What should I include in her diet chart to boost immunity, height and make her complexion bright? Please provide a good dietary solution. ### Response: Hello. Congratulations for having the little miracle. I guess she is breastfed. If that is correct, then she got plenty from her mom. Regarding the diet, the important point is to make sure that she gets all essential nutrients. Add diet rich in vitamin C, E and A, fruits like strawberries, blueberries, banana, dates, peaches and mangoes." "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 9 months old and weighs about 8.5 kg. He has reached all his milestones in time. But the problem is he does not sleep well at night, maximum at a stretch it is only one hour. He keeps walking up and only a bottle can soothe him. During the day he is active but nights are really tough. He does not wake up completely but will be crying in his sleep itself and can soothe only with a bottle. Please suggest something with regard to this. ### Response: Do not worry. Baby is asking for the bottle because it pacifies him. So to put him to sleep follow these steps. 1. Wake him up at morning 7 AM. 2. Do not allow the baby to take more than two naps per day. Each nap should be less than two hours. 3. Avoid all screens and gadgets. Screen time should be less than half an hour. 4. Give him a warm bath at night before going to bed. 5. Rocking motion that is cradle helps to make baby sleep better. Put him in the cradle. 6. Usually, babies wake up at night due to short sleep. You can make routine by putting him to sleep without picking him up. You can give the bottle once or twice during nights. 7. Engage the baby in physical activities in the morning like making baby crawl or creep. 8. Light should be dim at night and you have to make him see early morning sunlight because it resets clock in the body. 9. First try all this. If it does not help then I will prescribe a hormone. Behavioral." "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: One year back, I suffered from ringworm on the jock and legs. I applied Dermikem OC and it helped. After one year, it appeared again on the same spot. I used the same ointment, but it did not help. It started as a very small circle, and after that, it became very big. I then used Clotrimazole ointment and Fluconazole tablets. For a few days it was fine, and then after stopping it, it came back, this time on the face too. Please suggest me a solution for this problem. I do not have any other health issues. ### Response: From your description, it appears to be tinea cruris, a fungal infection which increases with sweating. You will need to take oral medication as well as apply creams topically. For topical application, I suggest: The oral medications can be decided depending on the extent of involvement. You will have to send me a picture to enable me to decide. Wash your clothes separately. If not, it can spread to your family members" "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 three nose and septum surgeries and my septum is deviated. My workplace wants me to do the nasal Coronavirus test as I recently came back from overseas. I am already on day 10 of Quarantine but they want to do the test.Is there any risk for me to do this test considering the previous surgeries? Can they force me to do the test? Do they need me to consent to the procedure? Can I request to finish my quarantine instead of testing? Or is there any other test that is less invasive? ### Response: Hi. I see that you are concerned about previous surgeries. Nasopharyngeal swab for Coronavirus is a very simple test just like how you use your ear buds. So n\xc3\xa8ed not worry, it can be done even if you have deviated septum. At this pandemic season, it is recommended by world health officials and your employer can demand you to get tested before joining your work as you have traveled overseas and 14 days quarantine is also recommended by World Health Organization. No other tests is as less invasive and highly yielding than a nasopharyngeal swab test. 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 a 400 lbs, 35-year-old male who did not do exercise but I just started going to the gym since past week. The first three days my maximum HR was 150 on the treadmill and I felt fine and I would do 40 minutes on it and today I only did 30 minutes because I started to feel a little dizzy and my HR went up to 158. Why is that? ### Response: I understand your concern. It is normal for the heart rate to go as high 300 bpm. You are exercising the wrong way for someone with your weight. You have to start exercising by taking a five-minute walk on the treadmill before gradually increasing the pace to a speed of 5/6 for 10 to 15 minutes. You should do this routine for two weeks before gradually increasing the duration to 20 minutes. Increase the speed gradually as you get used to. You get the dizzy feeling because your heart is having to pump more blood as you run, which it is not used to. You will over come this feeling as times goes on." "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 23 years old and slim female. Three years back, I had been diagnosed with PCOS, mild stage as doctor said. I had Hyponidd tablets for one year or more. After that my periods were regular. I got married two years back and I am not on any regular medication from that time. Now, I am trying to conceive. It is seven days since I missed my period. Today, I got my pregnancy test result as negative. What shall I do? Should I wait for another week to test again? Is it PCOS shooting again? Will I have to get treatment for conception? Can PCOS be cured? Please help. ### Response: Hello. If you have taken the urine pregnancy test after seven days of missed periods, then the results are usually conclusive. You may repeat the test after 48 hours and if it is still negative then you are not pregnant. The delay can possibly be due to stress induced hormonal imbalance, especially during this cycle due to stressors which can easily delay your menses. A single delayed period is not an indication for infertility workup." "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 3-month-old baby is sick. He is not taking breastmilk but drinks a little water by spoon. He has loose motions. I have tried few medicines but he has not stopped vomiting frequently after feeding. I have tried giving antibiotics twice but it increased the loose motion and it does not go. Sometimes, he murmurs during sleep. He is fussy, needs company and want us to play and talk with him all the time. He feels comfortable only on sitting or lying on our shoulder. Please help. ### Response: Your child seems very fine because he has got a good weight gain. Now, coming over to your problems, your child is suffering from simple viral infection because multiple systems are involved like the respiratory and gastrointestinal tract. 3 ml thrice daily for five days. Put Nasivion nasal" "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 caught by very bad cough and cold. Please suggest some medicine for dry coughing. ### Response: Hello. Since when are you suffering from above problem? Is there any throat pain? Probably you may be suffering from acute viral rhinitis with bronchitis. I suggest you the following medicines: If symptoms not improved please consult your doctor, he will examine and treat you accordingly" "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: This is regarding fat accumulation at major fats at stomach area. Is there any method so that it could be reduced since my marriage is fixed in 15 days. Is there any diet plan? ### Response: Hello. Well, you have a very limited time then. Follow a strict regimen that should be performed regularly twice every day. Have a carrot, cucumber, every day in the morning after breakfast and in the evening to avoid binge eating. Walk twice a day, minimum for 30 minutes each is good." "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 took off my first molar teeth due to careless RCT before a week. And for the past two days, I am having severe pain in the whole region from where the tooth has been removed. Especially it pains after evening time. Can you please tell me any treatment that I can perform now for temporary relief? ### Response: You can take fresh radiograph fresh and send it with a photograph of the socket to confirm whether it is due to" "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 3 and a half-month-old baby is suffering from loose motion. I am giving Enterogermina, but it is not working. She does potty all the time after feeding. What can be done? ### Response: Hello. Since your baby is just 3 and a half-month-old, I wanted to know whether the child is exclusively breastfed or on any formula milk. If the child is on breast milk, then there is no issue, but if the child is on any formula milk, then there is a chance of contamination leading to stomach infection. Generally, it takes five to ten days for this to settle, meanwhile continue Enterogermina (Bacillus Clausii) and add some Zinc supplement also. It will settle slowly." "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 six months ago, I removed four wisdom teeth (one tooth per month). I remember the first two were not very painful, but the third and the fourth ones, especially the fourth, gave me really bad headaches and it even made my whole cheek swell for a few days.Anyways, I also noticed this one tooth from my lower teeth started moving after all of my wisdom teeth were removed, and so I started putting on my retainers at night, but the problem is that in the morning when I eat, that tooth starts moving again and I get a headache eventually during the day.My orthodontist told me that there is nothing wrong with my retainers and that this headache could be caused by me grinding my teeth at night. I have also been told to do a CBCT scan.Any suggestions on what I should do? Should I go back to wearing braces on my lower teeth? ### Response: Hello. Braces are not good for the time being. Allow the molar tooth to become firm. Get an X-ray done to confirm whether there is any periodontal recession. The bone support may be very less at the area behind where the wisdom tooth was removed, hence more mobility to front tooth. You may need periodontal surgery along with root canal treatment to make it firm." "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 recently diagnosed with an anxiety disorder and have not consulted an ADHD specialist. My doctor prescribed 37.5 mg of Venlafaxine for my anxiety and possible ADHD, but it made me feel extremely moody, sad, and sluggish. I have consumed one tablet for two days alone. I am afraid of taking Venlafaxine due to potential withdrawal symptoms. Is it recommended to stop immediately or continue until the side effects subside? ### Response: Hello. You are on a low dose of Venlafaxine (37.5 mg once daily) to manage your anxiety. Usually, the dose will be increased to 75 mg once daily after a week or so. In your case, consult with your doctor about any increase in dosage. It will take one to two weeks for you to get used to the medication, and then you will have the therapeutic benefits gradually. In most people, side effects will wear off when the medication is continued for one to two weeks. If it is difficult for you to manage the side effects or if it does not wear off, consult with your doctor so that he can monitor you and switch to another medication if needed. Follow relaxation techniques like breathing exercise and progressive muscle relaxation. It will help to manage anxiety. 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 was going through follicle stimulation. My doctor started with Siphene 100 mg for five days, moved to FSH injections 75 for five days and when there was not enough growth in follicles she asked me to inject Humog 75 for two days. However, I got my periods the day I took the first Humog injection. Is it normal to get the period mid follicle stimulation cycle? ### Response: Hi. Getting periods in between only means that the follicles were not healthy enough. This is usually triggered by poor ovulation induction. Endometrial growth depends on the estradiol release from the follicles. So if follicles are not good, estrogen levels are not correct, so, the endometrial lining will not be healthy enough. In short, I would suggest, if I may, just forget this cycle. During the next cycle, it is better not to have injections as the ovarian response will be poor if stimulation is given every month. Month next to that, have CCQ (Clomiphene citrate) 100 mg from the third day of periods and at the same time start on HMG (Menotropin) or Humog (human menopausal gonadotropin) 75 or 112.5 IU. Further dose depending on follicles response." "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 back, I had a kidney transplant. Now, I have swelling in legs and foamy urine. I take Prograf 3 mg in the morning and 2.5 mg at night. My BP is 102/55 mmHg. I do not have diabetes. Please help. ### Response: Hope it helps. Please feel free to ask more queries if you need further assistance. I would be happy to answer. Regards" "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: How long does Yasmin or Lucette birth control take to work? I have just started my third month and heard that it takes about three months to work. However, I have already seen much improvement and it did not break me out really badly in the first few weeks which it did for many others. I am taking it along with Erythromycin, just wondering if things should change soon. Previously, Roaccutane, clear skin for about six months, breaking out again but nowhere near as severely and only really on my cheeks with hormonal ones on my jaw and chin. ### Response: Hi. Hence the effect of contraception will not be hampered but the side effects of the pill may be more apparent, including acne breakouts. As for the pill working, it should start right away in terms of contraception if you are taking it strictly according to the schedule" "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 7 years old. Diagnosed with mild autism when he was 3. Currently, showing hyperactivity, unable to sit still without supervision. Seems restless all the time. He has delayed speech development. He is not on any medication but under behavioral therapy. ### Response: Autism, unfortunately, is sometimes associated with an array of other behavioral co-morbidities like intellectual disability and ADHD (attention deficit hyperactivity disorder). The symptoms you described are almost suggestive of ADHD. Along with behavior therapy, medicines like Methylphenidate, Amphetamines, and Atomoxetine are very helpful in controlling hyperactivity and attentional problems. These medicines are FDA approved for such problems." "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: Hello,I would like to have a remote eye view on a question related to glaucoma.I am 35 years old and I am being followed for 5 years for ocular hypertension.I have between 23 and 26 mmHg by applanation tonometer.My field of vision is good.Optical Coherence Tomography (OCT) examinations are good.And my optic nerves seem normal.During the first 4 years I had followed every six months.I do not have any treatment for the moment.Given my age, this worries me somewhat. So, I would like to get your opinion in response to some of my questions:Given my young age and this pressure, will it likely lead to glaucoma?My potential life expectancy is still important, is there a risk of blindness?I have a 4 years old boy, when should he start being examined for this problem?I would like to have more children, however, I wonder about the risk of transmitting a possible glaucoma which slows me yet. ### Response: I reviewed your history. It seems from the history that you are having ocular hypertension. Since the results of visual field, optic disc changes and OCT are normal, there is no glaucoma. But treatment of ocular hypertension is necessary for you to prevent development of glaucoma. Hence, you need to start the treatment and aim should be to bring the intraocular pressure below 16 mmHg and keep it around 14-15 mmHg. If treatment and follow up is done, the risk of blindness is minimal or nil but better follow up and treatment is important in your case. Hope it helps. Consult an eye care ophthalmologist online for further clarifications" "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: He is 30 years old, and his height is 6ft. Gondotropin levels show moderate testicular failure, but no treatment was given. We had a micro TESE done for him, and no abnormalities were found. What does it mean? Should he have received medication to support this? ### Response: I have gone through the reports (attachment removed to protect patient identity). The sperm analysis shows azoospermia (complete absence of sperm from the fluid ejaculated during orgasm) and testicular failure. If even after Micro TESE (testicular sperm extraction) testicular biopsy, there has been no sperm seen, and there is no blockage disorder either, then his chances of contributing to natural or assisted conception are grim which means that testis is not producing any sperms and have gone in failure. The next chance would be to opt for donor sperm, and IVF (in vitro fertilization) followed by embryo transfer to conceive." "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 recently had an eye test done and it revealed that I have astigmatism, also there is a hemorrhage 2 DD superior to macula 2 DD in the left eye and a cotton wool spot 2.5 DD supero-temporal to the optician\s disc in the right eye. I am hypertensive but my BP is under control with medication.My question is could this be related to my BP and what degree of urgency would this be? I have been referred to an eye hospital. ### Response: Yes, this probably is related to hypertension. You are currently suffering from hypertensive retinopathy. Now your BP is under control but previous longterm episodes of uncontrolled BP has led to the narrowing of blood vessels in your retina and this has led to a response from your retina which led to the formation of new and leaky blood vessels. These vessels leak blood. Also, cotton wool spots indicate that it is hypertensive retinopathy. Now, coming to the treatment part: Both these tests will confirm if there is fluid accumulation inside the retina and also areas with these new vessels. In this treatment, you have to get pan-retinal photocoagulation plus I suggest you get injection antiVEGF substance. Along with that kindly see your specialist doctor to revise your antihypertensive treatment." "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 week ago, I was going to the bathroom and noticed a swelling of my right testicle. After feeling around, I then noticed that the testicle is normal size. There is just some excess fluid around my right testicle. This immediately freaked me out as anything wrong makes me think of cancer. Luckily, I had a physical scheduled already for Wednesday of next week, so I had my GP look at it. He noticed the fluid and did some inspection along with his assistant and felt was around and did not feel any lumps, bumps, or swelling of the testicles themselves. Regardless, he went ahead and referred me to a urologist. The fluid has remained pretty consistent since I noticed. I have some time before I visit the urologist, but my GP did not seem to be concerned. Do you have any idea on what this could be? Is there any way this could be from testicular cancer?Currently, I am on anti-anxiety medicine Lexapro 10 mg. I had my complete blood count done a month ago and everything was normal. ### Response: Hello. Relax and do not worry. If you or GP do not feel any lump from testis, then it is not likely to be testis cancer. So, do not worry at all. Yes, show to the urologist as he will advise you an ultrasound of scrotum to diagnose 100 percent. Till then relax and enjoy. Until and unless lump felt from testis, it should not be testicular cancer." "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 gallstones (multiple with largest 14.4 mm in gallbladder lumen). The allopathic doctor says surgery is the only option. Currently, I do not have any symptoms apart from dull ache during daily exercise. Can homeopathy help to dissolve gallstones? Kindly help. ### Response: Hello. Yes, homeopathy can be helpful to you, and you have to take medicines for a long time. At present, if there are no symptoms then do not go for surgery. It will be useful if you can give details regarding, flatulence (gas), acidity, pain site, and constipation. At which time does the pain get increased? Do you have any other health issues?" "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 bloating for five years. Whenever I take food into my stomach, gas comes out by making a huge sound. Often blood is coming out through stool. Could you please suggest me the treatment? ### Response: You need to visit gastroenterologist as soon as possible. For symptomatic relief, you can take effervescent Psyllium spoons twice a day and Simethicone 125 mg after a meal in the night" "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 25 years old having 61 kg and 173 cm in height. How can I gain some weight? ### Response: You should focus on a balanced diet. You can take a banana shake in the morning. It will give you instant energy as well as help in weight gain. Start taking milk and milk products. You can have pulses, beans, legumes, fruits, and vegetables. Apart from the exercise, you should be active physically. Go for a walk or do some exercise on daily basis to increase your stamina and muscle building. Thyroid test, CBC (complete blood count) test. Underweight." "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 ECG is normal. When I sleep on back and take deep breaths, I feel pain in the chest. I am BP patient. After delivery via C-section, I am taking tablet Almovas 2.5. Please advice me. ### Response: I read carefully your question and would explain that your symptoms do not seem to be related to the heart. Gastro-esophageal reflux could be the most probable cause of your complaints. Coming to this point, it is necessary performing a fibrogastroscopy to investigate for this disorder. An antiacid or PPI (Omeprazole, etc.) can help improve your situation. Regarding Amlodipine, it can exacerbate acid reflux as a common adverse effect." "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 miscarriage at 12 weeks. It has been two months now. Can I plan for the next baby and conceive now? ### Response: It is better if you conceive after two more months. Give a gap of four to five months after the miscarriage. The uterus will return back to its original contour in this time period. Until then, I suggest you practice contraception." "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 afraid that my 10-year-old daughter might have Asperger\s syndrome. She obsesses over spankings all day long. She watches videos of spankings all day long also, and she fantasizes of getting hit. She even spanks her brothers and sisters. I can tell it gives her some pleasure. She has no friends, and she wants to sit fantasizing about it if she does not have an iPad to look it up. She also obsesses a specific type of people. Does she have Asperger\s? Is this a symptom of it or something? ### Response: Hello. Your daughter is into the screen most of the time, and hence, it will be her primary advisor. She is just modeling what she sees and is quite common at this age. Try to minimize her interaction with the screen. She requires more human interaction. Put her in extracurricular activities to the maximum. Spend time with the child talking to her, and she will like it. Do not punish her, as it will have a negative impact, and the behavior can increase because of scolding. She will slowly get out of it. You can review with me for further follow-up." "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 suffers from low sodium levels. Although she tries to maintain them through a sodium-rich diet, she loses the levels when she is affected by any ailment. One doctor suggested her to use Tolsama on alternate days and monitor the serum electrolytes to check the levels and stop when they are in good range. I need a second opinion. ### Response: I need more information to know the main diagnosis. I would like to know why is she having low sodium levels" "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 dog bit me hard in my leg. I had a lot of blood flowing from my wound. I cleaned the wound with disinfectant for 20 minutes. Now the blood flow has stopped. I have done preexposure prophylaxis before three months for safety. Do I have to go to the hospital immediately? ### Response: You should go to the hospital soon and begin post-exposure prophylaxis as early as possible. It is better to have rabies immunoglobulin injection soon. You should clean the wound with soap and water. You have to do" "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 8 weeks pregnant, and I found some blood spot with blood clots coming out while urinating. I consulted the doctor and underwent an ultrasound scan with the following observation. Number of fetuses - 1, Viability - Live, Fetal Cardiac Pulsation - Seen, Fetal Heart rate - 160 bpm. Peridecidual fluid - a chunk of fluid covering one-sixth of sac dia is seen at the fundal end of the sac. Yolk sac - seen. Fetal Biometry CRL 9.2 mm, 6W6D. Maternal Cervix length - Adequate, Internal OS - Closed. Maternal Ovaries - Normal. Impression - Single live fetus of 6 weeks of gestation. Mild Peridecidual Bleed.Post which, I was advised by the doctor to consume Duphaston thrice a day. There is no blood spot post that, but there is still blood clot coming continuously. About four days back, the doctor recommended consuming Duphaston with Sustain 200. I need to know the following. Am I or my child in danger? What percentage is the success rate of such pregnancy? Is there any issue in consuming so much medicines? Is there any other way forward? ### Response: I have gone through your reports and understand your concerns (attachment removed to protect patient identity). There is some kind of a problem, but if you take all these" "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 unprotected anal sex with the neighbor lady before three years, and after a week I got jaundice, and it suffered around one month, and I got treatment with some ayurvedic medicines and got relief. Then around three months later I tested for hepatitis B and C both, but the result was negative, but in LFT test my bilirubin was a little high, and I got a fatty liver grade one by the doctor. So I have the following questions that, 1. Can I get infected with hepatitis B and C in the future? 2. How can I overcome with high bilirubin? 3. My digestive system is also not as good as previous. 4. Will I suffer from any sexual infection in the future. ### Response: Hello doctor, A negative test for hepatitis B and C, three months after that unprotected anal sex rules these out as a cause for your hepatitis. Perhaps it was another cause for hepatitis, may be hepatitis A which is transmitted through contaminated food rather than by sex. Hepatitis B and C are transmitted through unprotected sex or blood, e.g. transfusion or sharing needles. So, these scenarios can pose a risk of hepatitis. For raised bilirubin, I suggest you consult a physician kindly. I also suggest you screen for hepatitis A. STDs can happen if you indulge in unprotected sex or sex with partners with high-risk behavior." "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 2 year old son is suffering from fever. The temperature right now is 100.4 degrees. He is vomiting every thing he is eating. ### Response: Hello. I suggest the following: I am worried about his tongue color. If it is cherry red, then the possibilities could be different. Provide a clear picture of the tongue and BCG vaccine site (upper part of the left arm). Revert with more information to 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: Today, I felt something strange which I cannot understand. Normally, I sleep in the late morning. But, today while I was sleeping, suddenly I came out of my dream. But, I found that I am still dreaming. I was at a place that is not where I was supposed to be that time. I was not in my bed. I was into another space and time. After that, suddenly my dream got disturbed and I found that I am not awake yet. That was into another dream because still my surroundings were unfamiliar to me. I never knew or experienced such kind of things before. I checked on internet and found dreaming into a dream called false dream. But, is it possible that you dream in multiple states in your dream? I mean, you sleep and dream then you find out you were into another dream. Now, I am really feeling confused. Is it possible that I am still dreaming? What should I do? What is the thing that I experienced? Please help me. ### Response: Therefore, following are the suggestions which may help: Lack of sleep, dietary habits and workload. 1. 2. Sleep assessment.3. Work-life balance. 1. Anxiety.2. Lack of sleep. Anxiousness, lack of sleep and over-thinking. 1. Awareness and counseling.2. Sleep hygiene. Sleep earlier. Revert back after the investigations to a psychologist counsellor 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 a big problem with my feet. They are turning green on the heels and the skin is very dead and cracking really bad. Can you tell me what to do about this and what it is? ### Response: Hi. I have gone through your case. You are having keratoderma. Soak your feet in lukewarrm water for 30 to 40 minutes and then rub with file or pumice to remove dead skin and then apply vaseline or petroleum jelly two times a 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 think I might have glaucoma. I have vomiting, loss of consciousness, and blurred vision 6/12 in the right eye and 6/6 in the left eye.All details are in the attached report. I can send photos. I am currently taking medicines for depression. ### Response: I have seen your attachments. (attachment removed to protect patient identity). It seems like you have posterior uveitis. There is a reaction in vitreous and also inflammation in the retina. However, vomiting and blackouts can be due to neurological deficits. Please get an MRI brain and also followup with a neurologist." "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 molluscum on my pubic area and my doctor said that was cleared a month ago. Today, I found two small bumps, which are 1 mm or lesser than that. One is yellowish brown in color and another one is pink in color. It might have a hair coming out of the side, but I am not sure. I am attaching the photo. Could either of them be molluscum? Please explain me. ### Response: One of the lesions looks like milia, obstruction of sweat duct, which is very close differential of molluscum contagiosum (attachment removed to protect patient identity). Another lesion just looks like pseudofolliculitis. Both of them have very less chance of spreading. Do not worry about them. You can get the milia removed at any 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 feeling jaw stiffness on the right side, I had OPG and my dentist said to remove the wisdom tooth, but I do not see any issue with it in my OPG. I want to get a second opinion. ### Response: Hello. Your wisdom tooth on both sides of your lower if you observe are at the angle of your jaw where there will be movement when you open the mouth causing stiffness. And in the second point is there are no adverse effects if you get rid of your wisdom tooth. Your brush cannot reach there. You will not be able to chew on them." "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 23 years old female. Can you please explain to me the clinical presentation of decompensated phoria? I have had diplopia for over two years now, binocular, horizontal, worse on distant gaze. I have had an MRI as well, but no lesions found in my brain stem or other areas. Only a few white spots, punctate, in both hemispheres. They say, it is not cranial nerve palsy, so I wondered if it could be some kind of muscle-misalignment caused by decompensated phoria. I also have astigmatism, myopia (left eye -3.75 and right eye -4.25). I am very anxious about this diplopia being a sign of MS. (I have severe health-anxiety). I have no other symptoms, no headache, and taking no medicines. ### Response: Diplopia for distance vision is more common in neurological conditions. If you do not have any neurological problems (ruled out by MRI), other problems can be considered. In your case, as you have high myopia, it can be due to decompensated tropia (phoria). In myopia, there is a loss of accommodation since childhood. This will lead to loss or decrease of fusion (focus on an object). This may lead to intermittent diplopia. This can be improved to some extent by fusion exercises like holding a pen in hand and looking at the tip of the pen, bring it slowly near to your nose. Repeat this exercise daily 5 to 10 minutes morning and evening. You can send pictures of your eyes for better evaluation and treatment. You can also call for any queries" "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 weird uncontrollable eye movements similar to nystagmus. I feel bad when I walk behind the people. My eyes have a flickering problem. It makes people feel uncomfortable around me. I have a peripheral vision starring problem too. I am attaching my picture. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). Your eyes look fairly stable. You have a normal involuntary pursuit movement of the eyes in which your eyes can track anything which moves in front of you. There is no need to worry. If the people around you feel uncomfortable, try to look momentarily towards them, and then shift your gaze to someone or something else. People feel uncomfortable when they have a feeling that someone is staring at them. Still, I recommend you consult a neuro-ophthalmologist soon." "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: Tablet containing Acyclovir 200 mg is only available here. I have arranged to receive tablet Valcivir 1000 mg, but it will take a week to reach here. Kindly advise. ### Response: Acyclovir can be taken as 800 mg five times daily. Usually, Acyclovir is a dispersible tablet. Repeat this five times daily for five days. After a week, there is no point in taking the 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 smoked excessively (a pack a day) for six years now. I feel the need to quit now but nothing will give me the same feeling and hit that a cigarette gives me. So I have decided to gradually reduce the habit. I have bought a pack of Nicotex and instead of quitting cold turkey, I plan to have one smoke a day and have the recommended 9 to 10 Nicotex gums a day. I want to know if it is safe and hoping it will not cause Nicotine overdose. Please advise. ### Response: Hi. My recommendations would be not to take Nicotine on regular basis. Instead of that, take it whenever you have craving for it. You may take up to 8 to 10 tablets initially, but you have to reduce that also, as few people get addicted to that also. I would recommend you to discuss with your doctor to put you on a medicine known as Bupropion for short duration as it reduces the cravings of cigarettes." "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 digestive issues for some time, gotten a bit worse. Symptoms: bowel bloating and pain after meals or sometimes on empty stomach middle of the night, mornings, acid reflux with everything I eat, I eat purely healthy, puree my veggies and small amounts of chicken, eggs, salmon when I can. My stools are loose in the mornings with oil-like substance floating on top of the water, yellowish or green. At times, mucus as well. Discharge looks like white cloudy pieces floating. Feeling fatigue pains, depressed, cannot go to work. Going in for a consultation and testing soon. I just wanted to know what could be going on with me. ### Response: You have acid peptic disease (peptic ulcer) which is usually controlled by PPI (proton pump inhibitor). You are already taking this. If you could not correct dietary practices, you may not get complete relief. You should avoid, chilly, fresh onion, and oily foods (fried items) and non- vegetarian foods. Stomach finds it difficult to digest foods. So, consume easily digestible foods like fresh fruits, fruit juices, sliced vegetables, steamed foods, etc. Avoid tea and coffee which never allow the peptic ulcer to heal. Daily morning take one cup of pumpkin juice on an empty stomach. Do not eat raw vegetables (such as cucumber cut pieces, etc) in large quantities. Eat the same in small quantity after completely chewing into a paste. While sleeping you should sleep in left lateral or supine. Never sleep in right lateral and prone position. You can practice pranayama to balance autonomic systems. You also need to come out of stress situation, because stress certainly increases acid secretion. Do not skip any meals. If required, please undergo endoscopy to see if any ulcer is present" "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 sputum always in my throat. I have this problem for the past six months. For the first two months, the sputum was in the larynx, and it was very less, but later on, the sputum began to go back to the throat. I recently consulted an ENT doctor and underwent a CT scan and a chest X-ray. I was diagnosed with small nasal polyps in the right maxillary sinus. The doctor prescribed me Floresp Nasal Spray. I used it for one month, and this resolved nearly 80 % of the symptoms, but I feel there is still thin mucus in the throat like a thick, sticky saliva. I used Largy M too for a short course of 10 days. Recently, I developed an urge to cough to clear the sputum in the throat. Should I still continue with the spray? Can I continue for longer periods? How long will it take for a complete recovery? What foods should I avoid? Should the urge to cough, which I get, be ignored since it is just to clear the throat? ### Response: Hello. Do revert back for any support which you deem is necessary. I will be happy to help 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 father is 64 years old. His CBC report shows an absolute monocyte count of 93. His WBC was 4700 per microliter of blood and has a hemoglobin of 12.5 g/dL. He has platelets of 20,500 per microliter of blood. He has rhinitis for the past three months. He is taking Cilacar 10 mg, Thyronorm 25 mg, and Lasix 20 mg for the past eight months. He had leucopenia and thrombocytopenia before three months. Please help. ### Response: Your father\s blood report does not show a significant finding. His monocyte count is low. His hemoglobin level is low, and foods rich in iron can be taken. If the congestive symptoms are severe, then a PNS (paranasal) X-ray can be taken to check for sinusitis. For rhinitis, he can take a decongestant tablet. You can consult a physician for an examination and for doing allergic testing." "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 solid little thing on my arm that looks like a cyst or wart that I would like to get treated. I thought it to be a pimple so I tried to take it out with a small needle but was afraid to go deep. So, I did not achieve anything and I just made it red. It has grown a bit over a period of eight months and I cannot see a hair or blackhead or head on it. I would like to know what this is and how we can remove it. ### Response: Hi. I need some pictures to help you precisely. I cannot guess it by your description. Most probably, it might be an epidermoid cyst. Let me confirm when I see few pictures of 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: I have worn braces for four years and finished my orthodontic treatment before five years. I am 20 years old. Since then my teeth have been healthy but I have been suffering from an eating disorder for three years and I am still in recovery. Two months ago one of my top central incisors started feeling slightly wobbly and after looking at it in the mirror I noticed the gums had receded by 2 mm compared to the pictures I had from last year. I saw my dentist who told me everything was fine but since then my tooth has become even more wobbly and my other top central incisor has started to wobble too. I had a look at all of my teeth today and realized that all of the gums had receded by 2-3 mm. I brush my teeth with a soft toothbrush and floss twice a day, and I use mouthwash every two days. I am very scared that my teeth are going to fall out because I can feel the roots being unstable when I chew food and I cannot bite into a sandwich or any other harder texture without feeling discomfort. Due to COVID-19, I am unable to see a dentist right now unless it is an urgent case causing a lot of pain. What should I do? ### Response: Hi. Nothing to panic as such. Your gums need complete scaling (cleaning) but due to COVID-19, you cannot have now. If the gums are swollen, you will definitely have a wobble feel. Do enforce brushing twice daily with normal paste and medium toothbrush. Use Betadine gargle thrice daily, Take tablet Oflox OZ 10 twice for five days and Becosules capsules once daily for five days. If you have an eating disorder you can try with probiotic sachets for five days preferably in the nights. Visit the dentist once the pandemic is over. Do salt water gargling twice 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: I was diagnosed with otosclerosis of left ear at age 42. Thirty years later, I am now 72 and wonder if the condition has likely progressed and/or if surgical correction is still possible or advisable. I have good hearing in my right ear. I recently had a wax impaction in the right significantly reducing hearing and it got me thinking perhaps I should have had the surgery. ### Response: Otosclerosis often causes mixed hearing loss and can cause a maximum hearing loss of 60 to 70 db hearing loss which can be serviced to a good degree by doing stapedotomy. However, aging often causes presbyacusis that is an age-induced hearing loss which is neural and not salvageable by surgery. Since stapedotomy is a procedure done under local anesthesia, it may be still considered. However, it is possible if there is no significant SNHL (sensorineural hearing loss)." "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 right ear has been blocked a few days ago. Whenever I tried to laugh, smile or wink, the jaw line muscles went up and it pushes to block the right ear hearing. Doctor told me that it is partially ear wax blockage. But, I do not think so. I did try to put olive oil. And also I did not suffer from cold or flu lately. ### Response: Hello. From the details you have given in your query it seems to me that it is indeed wax only. However, one can be sure of that only if you see inside through an otoscope. If the doctor looked in through an otoscope and then said it as ear wax then it is most probably correct." "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 are trying to conceive a baby. But the semen analysis report says that I have low sperm count (6 million counts) with very low motility. Please help me. ### Response: Firstly, we have to diagnose the cause of your problem. The most common cause of this is a condition called varicocele. For the detection of varicocele, I suggest you do the following:" "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 24 years old. What type of crown is recommended for an endodontically treated upper molar (tooth #26), solid zirconia or eMax? I am worried about the abrasive effects Zirconia might have on the opposing dentition. Will a zirconia crown cause secondary caries under the crown as a result of abrasion against opposing teeth? I also understand it may be difficult to detect decay or treat decay under zirconia crowns, is that so? If so, would eMax or any other all-ceramic crown be a better choice for my endodontically treated molar? I am not a grinder or clencher, and this would be my first crown. I would greatly appreciate all insights and recommendations. ### Response: Hi. Zirconium crown will be a better choice because you are young. If the tooth is properly adjusted, that is, if the crown placement is done properly, there will not be abrasive effects. Yes, it costs a little more than ceramic or porcelain-fused metal crown, but they will chip off with time" "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 unprotected intercourse with my fiance and he ejaculated inside me 20 days back and within 24 hours I took a pill. After a week, we again had unprotected intercourse and he ejaculated inside me and again I took a pill within 24 hours. I have not got my periods yet. Could you suggest what to do? ### Response: Unwanted 72 has a side effect of messing up periods and since you have taken it twice so probably your periods are delayed due to this reason. I would suggest doing a pregnancy test to be sure and if you vomited the next day, then it had not affected the efficacy of the pill, and your symptoms may be due to anxiety or stress due to delayed periods." "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 my thumb accidentally scratched (small to be precise) by a stray dog. While there was no blood, a small scratch remained. I took only one dose of the rabies vaccine and a tetanus injection. Is that alright? ### Response: Hello. Scratches on any region of the body by a rabies animal or suspected rabies animal need to be treated with a five-dose schedule of Rabipur (inactivated rabies virus vaccine) on days 0, 3, 7, 14, and 28. And if that scratch is on regions like head, neck, shoulder, arms, and hands, it must be treated with an additional human rabies immunoglobulin injection (within seven days of the first dose of vaccine) in addition to a five-dose schedule of Rabipur. You have not mentioned how long it has been since you have been bitten and taken the first dose. You should check with your local physician and discuss regarding further doses of vaccine" "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 problem with my shoulder. I have a pain between my shoulder and neck. I had treatment for it. It was good for three months. Again, I started to have pain between my shoulder. I do not know the reason. What to do? ### Response: You have soreness, and it triggers the trigger points. There is nothing to worry. Try to do a lot of icing and mild rolling with a foam roller in your neck and back. Once the pain gets reduced, try to do a lot of stretches for neck and chest muscles. Try to strengthen your neck muscles." "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 15-year-old female. My grandmother, her parents, and two of her brothers, as well as my father, all died before the age of 50 because of heart attack. Do I have a higher risk of dying of a heart attack before the age of 50? ### Response: Hello. First of all, I would like to tell you that a strong family history of heart disease or heart attack does not place you at higher risk at all. So please do not worry about it. Now medically, heart diseases do have some level of genetic inheritance, but nobody can assure you the same about heart attacks. Heart attacks occur due to various causes related to all systems of the body. So inheritance does not play any role here. I can assure you that if you follow a strict diet routine along with 30-45 minutes of exercise or workout a day, including your cardio-exercises, then you will be fine. You are not at all on higher risk, and if you follow this routine with your BMI (body mass index) under 24 kg/m2, then you will never be at higher risk." "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 39-year-old man suffering from a common cold from last evening. There is very much sneezing, however, sneezing is obstructed sometimes. Also, there is water dripping from the nose. ### Response: It looks like you may have allergic rhinitis. I would recommend using Flonase nasal spray one spray in each nostril twice daily for three to four days also. Take tablet Levocetirizine 10 mg one tablet once daily for 3 to 4 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: My 15 month old baby is having spots with pus. It is itchy and scaly. The spots have increased in a week. It seems to heal, but then they appear in other region. I have attached the photos. Kindly check them. ### Response: Hello. I have gone through the photos (attachment removed to protect patient identity). You child has atopic eczema (atopic dermatitis). He scratched it a lot and so the lesion got infected. Basically, two things have to be in mind. Atopic eczema is very common problem, as age increases it goes of itself. Keep the skin moisturized. Use some good moisturizer and apply it four to five times in a day. Avoid exposure to dust, chemical, powder, irritant clothes, spicy food and sea food. Cut the nails and keep body clean. Avoid over use of soap and shampoo as these are too chemical only. Use steroid cream like Diprovate (Betamethasone dipropionate), Clonate (Clobetasol propionate) over itchy eczema. It should not be applied on infected, crusted and bled part. Antihistamines are a must. Give syrup Atarax (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 recently started taking the combination pill. I started the pill about a week before I was due to have my regular period. I had the pills regularly for eight days before I had unprotected sex. I took the pills at the same time every day with no issues and I am now two pills away from the placebos, but I have been having slight cramping and some brown spotting for two days. I cannot think of a reason as to why the pills would not have worked, and I know that the breakthrough bleeding can happen especially when just starting, but I associate that type of cramping and bleeding with implantation and am worrying about the possibility of a pregnancy. ### Response: How are you doing? I see that you have not been properly advised about taking the pill. Let me try to explain. Hope I have clarified your query. Do write back if any more queries. All the best" "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 four months pregnant. My hand and leg palms feel like burning and become very hot, and I have the same feeling in my vagina too. I also get an occasional sharp pain in my lower abdomen for a few seconds. Is this normal in pregnancy? Kindly suggest.I have attached my reports and I am currently taking Fol 123, Duvadilan, Duphaston 10 mg, Udiliv 300 mg, Pan-D, Thyroxine 12.5, and Eltroxin 75. ### Response: Hello. I read your examination. (attachment removed to protect patient identity). They are all normal. The symptoms that you prescribe above are common during pregnancy. The burning sensation in the vagina is because your sexual organs are more vasculated (more blood comes to them) during pregnancy. To exclude vaginal infection you can perform a vaginal swab and urinary analysis. Your cervical length is 31 mm, so you do not have to worry about abdominal pain, that does not seem to be a uterine contraction. Countinue your medication and especially you have to consult with an endocrinologist to secure that the thyroid hormone levels are normal." "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 Best\s disease and am currently undergoing injections in my left eye and it is improving. I have now been told that my right eye has a full blown macular hole but surgery may not help. Why not? ### Response: Hello. There are two surgical outcomes of a macular hole surgery. Anatomical correction, that is, whether the gap (hole) that has formed will be filled again or not. Usually, it has 90 percent chances in a macular hole surgery. Functional correction, that is, how many functional retinal cells remain there or who again take part in bridging that hole. This functional correction depends on the timing of the surgery, that is, how old is the hole. Older the hole, poor is recovery. Also, it depends on the grade of the hole. More the grade, poorer the recovery. Your hole is old and as you said full-blown (which I am assuming grade 4), and also there is a concomitant Best disease which primarily affects retina and macula. So, combining all these factors makes surgery a less likely intervention" "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 some white spots inside my cheeks and some sores on my tongue and bottom lip. ### Response: I have gone through the photos you have provided and noted the sores and white spots inside your cheeks. There are a few explanations for those: 1." "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 fiance and I decided to take a break for a few weeks and yesterday we had sex. My body wanted it but my mind was all over the place. It was not an \in the moment\ situation. We both noticed my vagina felt loose. What can be the cause of this? ### Response: Hello. I suggest you consult your gynecologist and get yourself examined to see what exactly is causing this. They will check to see whether there is any laxity of the tissues or not" "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 HSG test report is as follows. Impression: Contrast spill into the peritoneal cavity was not visualized on the left side, however faintly probably seen on the right side. Clinical correlation is suggested for further management. What does this mean? ### Response: Hi. I have read and understood your problem. (attachment removed to protect patient identity) However, I would like you to answer a few questions so that I can help you better. Did you get a pelvic ultrasound scan done? Your HSG report says tubes visualized and no dilatation seen, this is good. But the second part mentions contrast spill into the peritoneal cavity was not visualized on the left side, however faintly probably seen on the right side, this may indicate a block in the tubes at their outer end. Alternatively, a laparoscopy and fimbriolysis may open it. Blocked tubes are usually caused by Pelvic Inflammatory Disease (PID) due to infection with chlamydia, tuberculosis, and other microbes and also by endometriosis, a condition where there is a collection of menstrual type blood around the uterus, ovaries, and tubes. If you can send me the image, I can comment better." "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 62 year old male. I am suffering from multiple neurofibroma of spinal cord and acoustic neurofibroma. I had bypass surgery four years ago and since then I am under medication, which is given below. My present problem is related to stomach. Since the operation, I started having sudden bouts of loose motion. Earlier, the interval between the bouts was about 15 to 20 days which gradually reduced now to about three days. I have consulted numerous doctors including gastro specialist. Sonography reveals all organs to be normal except grade one fatty liver. No blood, pus cells in stool. My hemoglobin is 16.1. I have undergone deworming course by taking Rcifax 400 bd for five days, Noworm 400 and Nortryptomer od for three days, but there has been no effect. The consulted doctors have different opinions, some say that it is due to neurofibroma and some say it is due to reaction of medicines which I am taking. But no remedy has been suggested yet. If the loose motions become uncontrolled, I am forced to take Norflox TZ, which gives temporary relief. These loose motions are sudden, often soil clothes and have imprisoned me in the house. My current medication includes Nikoran 5 bd, Cardivas 3.125 bd, Cardace 2.5 od, Flavedon MR od, Lasix 40 half tablet od, Becosule od, Clopivas 150 od and Rosuvas 10 od. Please help me. ### Response: IBS is of three types: You seem to be suffering from IBS diarrhea predominant. However, IBS is a diagnosis of exclusion. We investigate suspected cases of IBS with thyroid profile, fasting blood sugar and ultrasound abdomen. If all investigations are normal as you have mentioned blood and stool test (considering these investigations have been performed), then you are probably suffering from irritable bowel syn" "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, 43 years old, I was born with cleft palate but it is fine now and I have sinusitis and loss of smell sensation. I took steroids Prednisone nearly two months back and got my smell back but suddenly four days ago now the smell is gone again. Just to let you know I have moderate sleep apnea and using CPAP, I also have some allergy in the nose. I also use a nasal spray, just started like three days ago after stopping for three months.My question is how can I get my smell back? Shall I continue the Avamys Nasal Drops? ### Response: Hello. 1. Your recurrent problem of not able to smell is due to sinusitis and allergy. Once that gets treated smell will come back. But in chronic sinusitis, the smell may or may not come back due to prolong disease. 2. Avamys should be helpful. These steroids sprays reduce inflammation inside our sinuses and nose. For steroid sprays to act in our nose we should have wide sinus openings. To see if you have space in your nose for sprays to act you will have to get plain CT scan of nose and paranasal sinuses done. If your nose is very crowded and infected then you will have to undergo endoscopic sinus surgery which will remove active disease and inflammation. Following surgery, you will have to continue sprays for a few months to avoid recurrence and it will make your nasal mucosa healthy and you will be able to smell. 3. Oral steroids will relieve your symptoms temporarily, but in case of sinusitis we need to treat the disease for a long time." "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 33-year-old male and I am single. I suffer from poor erection (two years) and premature ejaculation (since start). I tried Viagra and Caverta, the result was good but I feel a headache and heaviness in the head after taking medicine. I also noticed high BP. I have also tried herbal or Ayurveda products but after taking Swet Musli I feel heaviness in the head and heavy gas. I also tried some more medicine like Nano Leo, ED Save and some more as prescribed by one doctor but did not work well with no side effect. Please advice. ### Response: " "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 happened to pass a large firm stool today. It hurt a bit and I was a little sore after it and the stool had bright red blood on the outside of it. I do have a small internal hemorrhoid that was spotted during a colonoscopy last year. Has the blood come from there or is it a torn vein? There was no blood when I wiped myself and the water did not turn red. I have attached photos for your reference. ### Response: Hello. I have reviewed your health query and seen the photos (attachment removed to protect patient identity). Hope it helps. Regards" "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 mild depression five months back and overweight. Now blood pressure is high.My doctor has prescribed me to take Citalopram 20 mg, Duromine 40 mg and Idaprex 2. Also for the last 10 days, Panafcortelone 5 mg. From what I have read, the first three medications should not be taken together. I am after a second opinion, please. ### Response: Duroxime (for weight loss) can increase blood pressure which will be counteracted by Idaprex (for high blood pressure). There is no" "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 epilepsy since childhood. It had disappeared for a while, but it has resurfaced now. My doctor has given me tablets of Lactum 500 mg and 250 mg. How can I prevent it? Are there any precautions? Please help me. ### Response: Hello. I read your query and understand your concerns. I am sorry to inform you that currently, medications are the only effective option to prevent further occurrence of seizures. I am glad to note that there is a response with medication. So, you need to follow the advice of your doctor. In addition, to prevent seizure episodes, the following things should be practiced to the possible extent. Although I am not sure what the dot in your CT scan is, often it represents either tuberculoma or cysticercosis. These two conditions need treatment for a duration of two years or more and many of the individuals get cured over a period of time. I hope this answers you. Feel free to write back to me if you have more questions." "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: About a week ago, I started to notice a fuzzy tingling sensation going down my neck and back when I look down at the floor. If I continue to stretch my head forward and back, I no longer get the sensation down my back and neck, but this sensation will come back after I have not looked down for a while. The closest thing I can find that matches my symptoms is the L'Hermitte sign. I do not have any other symptoms, my vision is fine, I have no problems with balance or anything else associated with MS (as L'Hermitte is typically found in MS sufferers) but this was the only disease I could find that fit my symptoms best.Nothing is painful it is just a weird sensation. I have had no accidents or traumas to my neck or anywhere, and I do not take part in any aggressive physical activity. I am otherwise active and healthy, BMI of 26.2. I am a 25-year-old male. Just to mention, I do have a bad back posture if this is contributing? ### Response: Now Coming to your condition, your BMI (26.2) comes in preobese category which could be one of the cause of tingling sensation because weight puts more pressure on your spine and your bad posture may add up to your condition. Do you spent lots of time in front of screen like mobile or laptop? Given your medication history, are you taking it for asthma? Which other medications have you taken for it before? Is it under control? I can prescribe you proper" "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 one-minute unprotected sex but just after one minute, I took my penis out of the vagina and I myself masturbated. Should I go for HIV testing? ### Response: Hello. If there is a chance of HIV in the partner then certainly get yourself tested, but after at least a period of two to three weeks as it will be negative inthe early period. You can hiv antibody and antigen test (p 24 assay). Hope this helps you and get back if you have any doubts" "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 young teenager who has a receding jaw and I am wondering if changing my eating habits might relocate my lower jaw. I used to have poor eating habits. I ate too fast and I did not chew much. My older brother\s jaw is fine. Will changing my eating habits cure my jaw? ### Response: I have gone through your question. I can understand your concern. You need to check if you chew one side or use both sides equally. Second what you think is jaw receding, sometimes it is a malocclusion which is associated with jaw disorientation. If your lower jaw is looking small or your teeth are placed backwardly, it will be checked only if you upload a picture of your jaw. No, there is no relationship between the chewing or eating habits that will precipitate at this age. I think you are having skeletal malocclusion or maxillary prognathism." "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 I got balanitis. Which cream should I buy? I had sex five weeks ago without protection. Painful peeing lasts for two years but not as strong as this time. Sores came out after having unprotected sex. ### Response: Hello. I would start with a combination of antibiotics like Doxycycline and antiviral pills like Valacyclovir. However, in your place, you need to get in touch with your general physician to undergo the necessary tests. Ointments alone will not be sufficient for treatment." "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 always feel my body needs to be stretched. My back starts paining when I hold a baby. What should I do? ### Response: Hello. This could be due to a number of causes including potassium, calcium, and vitamin B12 deficiencies. So I would recommend that you get a blood test for their levels or take multivitamin supplements three times per week. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. If the pain does not resolve then get a CT (computed tomography) scan of your lumbar vertebrae to exclude disc prolapse" "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 child is 3 years old. she was suffering from cold and cough and was under medication like Mucolite, Timinic, Septilin, and Asthalin 2.5 mg. For the last two days, she was doing mucus potty, now it is getting better today. We did a test and attached is the interim report. Please advise. The anal side is a bit red and once when trying to clean it she in not allowing it. She has no fever. ### Response: Hi. I have seen her reports. (attachment removed to protect patient identity). Your child has a respiratory infection and nothing to do with her potty. The mucus you say is due to the swallowed phlegm. Continue Astahlin syrup also and give Calpol syrup if there is a fever and get back." "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 curious about why we go back to ex relation again and again even after two to three years of breakup and more than a year of total detachment? I know that relation did not work for me, and maybe I had nothing more to give to or get from that relation. I do not want to get back in that again and all the way I blocked myself.But still kind of thoughts follow me again and again, and I feel I cannot grow because of that, or maybe that is not the reason, but still, I think about and feel sad and old why I am feeling like still moving around old-time and searching though I do not want to get back that time. I know everything, and everyone has changed with time. Please advice. ### Response: There are two possible reasons, 1. Familiarity mind always tends to cling to familiar things which makes it comfortable. Fear of unknown makes the mind choose what is known, even if it is wrong. 2. Lack of a better opportunity, maybe you have not found someone better as of now, so because you crave the belongingness, it is like something is better than nothing. Have patience, think it through. If there is something, you can work on and mend the relationship, it is good, if there is no scope, keep yourself busy and occupied. Give your mind something better to think." "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 30 years old. I am suffering from dizziness and headache. There is some fluid sensation in my inner head. I have seen a neuro doctor and they said there is nothing to worry. But, there is a fluid leakage sensation which is quite disturbing. I would like to take an MRI. Kindly suggest me what should I do? ### Response: You may be having BPPV (benign paroxysmal positional vertigo) which is nothing but an inner ear inflammation. This can be mostly due to a viral infection. An ENT doctor will easily be able to check and examine your ear and this usually does not require any test. I suggest you take Vertin (Betahistine) 16 mg tablet three times daily or 48 mg once daily for three days. Consult your specialist doctor, discuss with him or her and take the medicines with their consent. Do not make sudden movements of your head. Try to move around the head slowly and try to keep the head still. You should get better soon. Regards" "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 subjected to a loud noise in my left ear. Since then, I have had a high pitch whine and my ear clicks. It seems as if I can contract a muscle in my ear and force it to click and then sometimes it seems to happen on its own. It happens more often than not, with brief episodes where it will not and I cannot make it click. ### Response: Hello. Your problem could be diagnosed following a simple audiological evaluation with tests called pure tone audiometry and impedance audiometry to determine any hearing loss and eustachian tube dysfunction that you might be having. Treatment will depend on the result of these two investigations" "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 33 year old female. I am married. I have two sons. I was diagnosed with hypothyroidism over ten years ago and I am on medication. I am having a horrible time with pms over last few months. I used to have terrible headaches and irritability before few days of my periods. Now it has been two weeks as my period is ten days late. I am having the worst time in my life right now. My headache and the pressure drive me crazy. I am having hard time. I am getting into deep depression. I do not know how to get through this. I cannot stop crying. I have an appointment finally with an endocrinologist in two weeks. Whenever the thing gets worse my gp will increase the dosage of my medicine. My hair is falling out. I am not the same person at all anymore. I feel like this is killing me. Need some help. ### Response: I went through your query and I can understand your condition. First of all, I need to know whether your hypothyroidism is under control or not. Kindly upload your recent TSH (thyroid stimulating hormone) report. Your endocrinologist will evaluate for that. But a simple way to know is to halt your periods for two months and observe what happens. Ask your general practitioner to prescribe you certain oral contraceptive pills. This shall halt your periods for a month or two and if you feel better then it is due to PMS. But if there is no improvement then other evaluations have to be done including your blood pressure testing, eye check up and if necessary brain scan. If there is an improvement then you can take the contraceptive pills for three to four months and then stop and observe." "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 daughter aged 10 years had swallowed button cell accidentally. In the x-ray, it is in the intestine. Will it come out through waste? ### Response: Hello. I can understand your concern about your daughter\s health. Yes, button cell would come with stool generally. But sometimes it get stuck at the junction of the large intestine and small intestine. In such a case, she might require a colonoscopy or surgery to remove the cell. But the possibility for such a scenario is very rare. You should give her a soft, semi-solid diet which is good in digestion and also facilitate intesine movement." "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: Does staying indoors excessively cause social anxiety? ### Response: Staying indoors excessively does not directly cause social anxiety. It is possible that having social anxiety will prevent you from going out more, which in turn makes anxiety more prominent. Talk to your parents and family about your anxiety so that they can understand and support you. Are you able to manage to go to school or college? Try going out regularly. Avoidance does not help. Regular exposure to anxiety-provoking situations will help to treat anxiety. Exercise regularly. It will lower stress and improve your confidence. Practice deep breathing techniques and progressive muscle relaxation exercises for about 20 to 30 minutes daily. If anxiety is more generalized and severe, consult a doctor for an assessment. Counseling can be beneficial." "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: How to know if a baby is getting the right amount of milk? ### Response: Hi. The ways to know if the baby is getting an adequate amount of feed are as follows. The baby sleeps well for two hours post an adequate feed. Baby passes 6 to 8 times urine. Baby has a weight gain of 25 to 30 gm per day. These are the three main points determining the adequacy of the feed in babies." "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 sore throat on and off, for the past few weeks. It is not severe, but more of an annoyance with some referred ear pain. This week, I had a family member, who is a nurse, look at my throat to see if it was red or irritated. She noted I had quite a bit of post-nasal drip, but she could see no other issues. I had my tonsils removed as a kid, so they definitely are not the issue. I was thinking this might be caused by allergies, the trees and plants around are starting to bloom. I started taking some Claritin on top of painkillers, earlier this week. I also have been gargling with salt water. Those things seemed to help for a day or two, and the issue seemed to go away.Fast forward to last night, I woke up in the middle of the night with a burning pain in my stomach. This morning the burning pain keeps coming and going, and I can feel a lot of mucus dripping down the back of my throat. Is a burning stomach usually something that can be linked to post-nasal drip? I have never had an issue with acid reflux, so I do not think it is that. Also, the burning sensation is limited only to my lower abdomen.I typically do not have issues with severe allergies, so I am wondering if this could be caused by a virus? To be honest, I do not have a lot of confidence in my local doctor\s office, and they tend to order a bunch of tests then overcharge for them. So I am wondering if I can get away with not seeing a doctor. I have ordered an air purifier for my room, and I am taking the allergy medicines religiously. Is there something else I can take or use to alleviate these symptoms? Or should I suck it up and see a doctor? I will also add that with these symptoms, I have had little to no nasal congestion or coughing. ### Response: You seem to be having some mild inflammation of the sinuses and nasal cavities. Let me suggest some medicines that I would do in my practice. In case you do not find any improvement, you can show your local doctor. I would suggest you take a mucolytic medicine that will help lighten the mucus and remove it from sinuses. We have N-Acetylcysteine and Ambroxol in tablet forms. N-Acetyl cysteine comes in a dispersible form also. Ambroxol 30 mg or N-Acetyl cysteine 600 mg, twice daily. You may or may not take an antiallergic medicine. To avoid acid reflux, I would suggest you take Pantoprazole 40 mg twice daily. Acid reflux which can occur in the pharynx causes a sore throat as well. Do revert to me if you need any further support. Hope you feel better soon" "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 experiencing upper left abdominal pain just beneath lower ribcage and on the opposite side in the back. I have intermittent, dull, and deep chronic pain.I am 43 years old, nonsmoker but consumes alcohol (not for the last four months). My blood pressure is 120/80 mm Hg. I am currently on Omeprazole 20 mg daily (one month).I am diagnosed with pneumonia and pulmonary embolism. It is confirmed by chest CT. I was prescribed Pradaxa for three months (stopped taking medication on Mark 26). I have a history of acid reflux, sleeps on a 6-inch wedge pillow to manage the symptoms.Tests I underwent are:Abdominal CT with contrast: unremarkable, mild diverticulosis, not considered relevant to pain.Chest CT with contrast: unremarkable, PE and pneumonia cleared.Blood tests all normal, no sign of pancreas or kidney trouble.My primary care physician suggests pain is associated with PE. My pulmonologist says it is very unlikely to be associated with PE and recommends to confer with a gastroenterologist. Could this be an ulcer or some other issue within the stomach or GI tract? Perhaps caused by the Pradaxa medication? Would the abdominal CT have uncovered peptic cancer or other serious GI issues? What further testing would you recommend? Should I wait to see if things get better or act soon? If it is safe to wait, how long should I give it? ### Response: Hello. I must appreciate the detail history you provided which is very helpful in diagnosing your condition. After reviewing your history, in my opinion, this pain is not related to pulmonary embolism. It looks like to be associated with some gastritis and stomach issue. Now coming to your queries, the CT Abdomen has ruled out serious abdominal issues such as malignancy but it could not rule out peptic ulcer disease. You can just wait for it and take the medications which I am prescribing. I do not think that waiting is going to cause any further issues as it does not look like to be something serious. Take the following treatment for two weeks and if no improvement then we can consider EGD. None at the moment. Gastritis. Peptic ulcer disease. Esophagitis. Gastritis. Continue Omeprazole but increase it to twice daily before meals. Syrup Gaviscon (Alginate)10 ml three times daily after meals. Both these for two weeks. If no improvement will consider EGD." "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 complete blood count test and it seems my lymphocytes % is high. Please help me. Is this something I should be scared about? I was in my period when the blood test was taken in case this has any relation to the results. ### Response: Your lymphocytes percentage is slight high. Kindly mention your clinical complaints so that I can guide you further. It is not a matter of getting scared as your all other parameters are within range. I suggest you repeat CBC after week. Usually, a temporary viral infection can lead to lymphocytes elevation temporarily. It has no relation to menstruation. If after one-week lymphocytosis persist, then investigate with peripheral smear examination report for further work up." "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 29 years old with 180 cm tall and 62 kg weight. I was diagnosed with hereditary spherocytosis before five years, and my gallbladder was removed. Recently had an ultrasound to see the liver and spleen. I would have mildly elevated liver readings. Hematologist wanted to check that these organs were fine. He thought they would be. Do elevated liver readings mean liver damage? I do not drink and eat a very healthy diet. Please help. ### Response: Hello. Your spleen is enlarged in size (attachment removed to protect patient identity). The liver appears normal in size, and the echotexture looks normal. I would like to know which liver readings get elevated? Liver enzymes can get elevated when the hemolysis is not entirely compensated for. In severe cases, it can cause jaundice. It looks to me that still the hemolysis is being compensated by your system on most occasions and less frequently. The liver enzymes might be elevated. Please have a discussion with your hematologist regarding details of the compensatory mechanisms." "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 arthritis for about a year. Due to arthritis, I am almost on the bed for six months. Now I am fit but as I was on bed for six months my leg muscles (behind the knee) was badly stiffed and band to 90 degrees. I cannot stretch my legs straight, because the leg muscles which is behind the knee is hard and badly stiffed. I cannot walk.My doctor advised me to exercises, but I do the exercises for the past two months but there is no satisfactory relief. Now please advise me on any medicines, topical ointment and multivitamins or anything, so that I can recover fast. ### Response: I have studied your case. As per your symptoms you need to do physiotherapy and knee exercises to improve the range of motion. You need to consult a physiotherapist for proper rehabilitation. You can flex and extend your knee while lying supine flat on the bed with the foot resting on the bed. With standing position, you can lift your patella superiorly as you do in qua" "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 an upper respiratory tract infection which is now resolved. It was in the acute phase. I had a very painful earache. I am fine now except for a blocked right ear with tinnitus (ringing) and muffled hearing. I can feel a crackling sensation in my outer ear. What can I do to unblock my ear and resolve the tinnitus and hearing problem? I am on Augmentin and Allegra. ### Response: Hello. According to your symptoms, it looks like you had an acute otitis media. It is common to have a blocked ear after the infection is resolved. You need to do a pure tone audiometry with impedance audiometry to know about your middle ear status and to know about tinnitus. Consult your specialist doctor, discuss with him or her and with their consent take the medicines" "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 it true that you need to expose your face to the sunlight to maintain facial bone structure? Or is it enough to expose the body and the vitamin D distributes all over? Or does it work only in the specific areas where it is actually being produced? ### Response: For the prevention of vitamin D deficiency, you need to expose your body in sunlight early in the morning before 10 AM. The duration of exposure needed is ten minutes daily. It is not necessary to expose particular area of the skin." "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 12 weeks pregnant. From the last three days, I am suffering from a dry cough. My doctor prescribed me Ambrolite D syrup 10 mL at bedtime and Vozet tablet once in a day. He said that it is an allergic cough. But, after consuming the medicine for two days, my cough does not improve. I am still coughing. I was advised to take the treatment for five days. Can I wait for more? ### Response: Hello. You do not need to take antibiotics unless you have a fever. At the same time, you said you are 12 weeks pregnant, so you should try to avoid taking over-the-counter medicines for a cough. It may affect the growing child in your womb. So, I advise you to do gargles with any good mouthwash three times a day and finish three days of Vozet (Levocetirizine) tablets. If you continue coughing for more than a week, then you should take an expert opinion. For me, it looks just like a sore throat." "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: Recently, I had increased bilirubin level around 1.6 mg/dL. But now it is decreased to 1.2 mg/dL which is at the boundary level. Can I do an exercise like skipping, running? ### Response: Coming to the serum bilirubin, it is a breakdown product of hemoglobin. Any increase in bilirubin level is needed to be assessed for liver enzymes and HBsAg (hepatitis B virus surface antigen), to rule out the cause. Bilirubin can increase due to: So, to confirm the problem, we need to do full liver function tests. Yes, you can do exercise at this level of bilirubin. Normal bilirubin is total bilirubin ranging from 0.1 to 1.2 mg/dL with direct being less than 15 % of the total bilirubin" "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 unprotected sex on the last day of my period. Three days later I took unwanted 72. 10 days after taking the emergency contraceptive I experienced spotting accompanied with mild stomach pain and sore breast. Could I be pregnant? ### Response: Hi. If you have had sex on the last day of your period, your chances of getting pregnant are slim. When you say you took unwanted 72 after three days, did you take it within 72 hours of having sex? If you have then it is unlikely you are pregnant. Breast soreness too is because of the pill as it is very high in hormones. It should only be used in emergencies not as a routine contraceptive. Effects can change. It has a failure rate of 0 % to 2 %. So if you do not get your next period in two weeks, do a pregnancy test" "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 like something is stuck in my throat from two months, and I also have the problem of food coming in the mouth sometimes, and acidity. When I went to the doctor, he recommended Pantoprazole after which I had little relief, but not so much. Please prescribe me something better. ### Response: Have you been back to your doctor after he recommended Pantoprazole? I think that you need to have an upper endoscopy to look at your esophagus and what is causing this problem. It sounds like you may have a Zenker\s diverticulum. This is an outpouching of the lining of the esophagus. There are treatment options for this, but you have to Consult a gastroenterologist who may be able to fix the problem through the endoscopy. I hope this information is helpful." "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 30-year-old woman that has been diagnosed with a partially dislocated disc at L5 to S1 that shows a posterior bulge with a focal annular tear causing indentation of the adjacent thecal sac and abutment of left traversing nerve root. The pain has reduced in my back but now I am left with a horrific pain in my left leg that radiates down to my foot. A majority of the pain is the inside of my knee and I am unable to sit for more than five minutes. There is almost a heaviness inside my knee as if there is a ball stuck there. And I regularly wake up with pins and needles that go once I start walking. I have met four orthopedic surgeons who have all given me different opinions. I am not keen to have surgery performed so what are my best non-surgical options for this pain? Can I get rid of this intense pain without having surgery? What is the best way to treat this? Currently, I am taking Robinaxol-D. ### Response: Hello. From your description, I think there are two problems as follows: All these I have judged from your description. Exact diagnosis can only be made once I see you clinically" "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 dandruff, hair fall, and lately, I saw tiny white balls on my scalp after which my scalp became very itchy. Please tell me how to treat this condition. ### Response: You have seborrheic dermatitis probably. Use the following medications. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. 1. Zydip-C lotion (Clotrimazole, Beclomethasone) apply once at night on the scalp. 2. Protar K shampoo (Ketoconazole, Coal tar) three days per week. 3 Tablet Desloratadine 5 mg once at night. Do this for 20 days and avoid hair oil." "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 32-year-old healthy woman. A few days ago, I noticed a small bony lump on the side of my foot below my ankle, which was not symmetrical on the other foot. It was a small sharp bony protrusion of around 1.5 mm and I could see it through my skin. I am very sure I did not have this thing before say one year ago or so. There was no pain when I touched it and no inflammation visible. I have attached a photo of it as well. You can easily see the pointy bony protrusion from that position. My question is can this be a benign bone spur or is it possibly something more serious? Is that spot on my foot typical for bone spurs? I have been walking a lot lately since I have a 10-month-old baby and I did feel my ankles getting a bit strained after each walk. ### Response: This seems to be benign. So, you should not worry. This professional advice provided by me stands subject to the actual examination of report or image and is based entirely on inputs provided to me. It should be correlated with clinical findings" "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 a white coating on my tongue. Also, since my childhood, I have had a problem with frequent urination. I have a slightly enlarged prostate of 21.9 whereas less than 20 is normal. My skin has always been very dry. For about 1 or 2 years, I am losing hair and suffering from dandruff. Now I am doing daily tongue scraping, oil pulling for 3 minutes, asanas and some pranayama. My diet is mainly vegetarian. I am on my 8th day of a kitchari mono-diet. I have taken 30 to 60 mL of ghee per day for one week. I am eating twice per day (breakfast and lunch). However, the coating on the tongue remains the same with no improvement. Should I continue the mono-diet? If so, then for how long? As for the urination problem and enlarged prostate, what is your opinion on Himplasia tablets? Would they be beneficial? ### Response: I have gone through your details and found that you are following certain kind of diet, which is not really beneficial in this condition. Instead of sticking with a mono-diet (ayurveda diet for detoxification) you can make the following practices. Aama (toxins formed in the body) and diminished digestive fire. Revert back after two weeks to an ayurveda 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 ate 12 eggs today. Will this cause any health issues? ### Response: Hi. Proteins in eggs are of most superior quality and now the cholesterol (in the yolk) is also not considered as a risk factor for cardiovascular disease. But eating 12 large boiled eggs (about 600 grams) will provide you more than 900 calories. Since already you have a high BMI (attachment removed to protect patient identity), try to reduce your calorie consumption. Eating raw eggs increases the risk of salmonella poisoning and deficiency of biotin (vitamin B). Also, boiled eggs have better bio-availability of proteins than the raw egg" "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 want to seal my semen and ejaculation pathway to preserve my semen in the body permanently. Please help. ### Response: Hello. I want you to know two things, 1) Semen is not something that can be stored permanently in the body. 2) Storing semen does not give you any benefit, despite what is in popular belief. The semen is continuously produced as per requirement. There are on and off switches within the body to produce and stop producing semen. If you do not release the semen, then the brain will switch off production. No matter how many years you hold the semen, the quantity will not increase. You will not gain anything. On the other hand, the sperm cells inside the semen will lose their functionality. Finally, there are no procedures to stop releasing semen and sealing it off permanently within the body. Even in the vasectomized males, some semen will still be released." "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 CRL is 5.18 cm. How old is my baby now? How can I get my gestational age accurately? ### Response: The CRL of 5.18 cm corresponds to 11 to 12 weeks of gestation. A difference of two to three days is possible depending on the position of the baby and the measurement of the caliper placement. Ideally, we recommend a first scan to know the exact dating and to calculate the expected due date (EDD). As you have not mentioned your last menstrual period (LMP), I am unable to estimate the gestational age by LMP. Please provide them. I can say the result whether there is a delay in growth or there is a delayed conception." "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 two problems in me. I have these problems for three months. I have disturbed sleep on several days and erectile issues (sustaining erection during intercourse). I am a hypothyroid patient for two years (I take thyroxine Sodium 100 mcg). I have high myopia (-10 power in both eyes) and severe dry eyes (Schirmer score of 2 mm in each eye).I take Restasis, Systane ultra and Eyemist eye gel for the dryness. I have tight schedules throughout the day. I consulted a psychiatrist last month. The doctor told me that the issues are due to anxiety and she advised me to take Vilano 20 mg in the afternoon, and Clomipramine 10 mg at night time. I have attached the prescription.After five days of taking medicines, I felt my mood to be better. But I faced several side effects with dry mouth, chest spasms, total erectile dysfunction, and a sore throat. I consulted an ENT specialist for a sore throat, and he advised me to stop the anxiety medicines as throat issues can also occur due to the medication. I quitted it, and I faced several withdrawal symptoms on the next day. I was getting brain zaps while going to sleep (electric currents running through my brain) and I was unable to sleep for two days. Hence, I consulted a neurologist.He suggested me Lonazep 0.5 mg, Sove 5 mg and advised me to do a psychological assessment. Based on the evaluation, he informed me to continue taking Lonazep 0.5 mg, Sove 5 mg for 60 days and also advised me to do cognitive therapy, relaxation therapy, and yoga.I have the following questions. Am I following the right direction? I think taking Lonazep 0.5 mg and Sove 5 mg will not be an easy one to stop. Can I have withdrawal symptoms after taking it? Is it right to take anxiety medicines? I still have brain zaps, and I always take alcohol for once a week. Will I have any impact due to the medication? If yes, please suggest. ### Response: Hi. You are not following the right direction regarding medicines. There are two types of treatment such as primary medicine like SSRI (e.g., Vilazodone) and supportive medicines like Sove and Benzodiazepines like Lonazep. We can take an example. If you have malaria or dengue, you will have a fever and Paracetamol is taken. But it will not cover the whole illness to cure it, and so we will take specific medicine for malaria such as Quinine. It is better to take proper medication. The side effects such as" "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 18 years old and I got told that I had chronic myeloid leukemia. Do I seriously have it? Or what do I really have? Blood test: high basophils and low hemoglobin. My symptoms are weight loss, anemia, dizziness and pale skin. Urine: leukocytes 1 to 2. And, I have a ball right under my left eyeball of the size of a pebble. ### Response: Well, CML (chronic myeloid leukemia) is a treatable blood cancer. The diagnosis of CML is suspected by a peripheral blood examination in which the number of basophils and eosinophils is highly raised and urine examination has no role in its diagnosis. So, on the basis of your report, it cannot be said that it is CML. For the confirmation and definite diagnosis of CML, you need to get these two tests: Once you get the reports of these two tests, only then it can be confirmed that you have CML or not. Please do not hesitate to ask me if you have any more doubts" "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 22 year old female, and I am getting married this month, and I am going for my honeymoon. So, I want to delay my periods without any side effect. I am still a virgin, so I do not want to ruin my honeymoon. So, please suggest the best medicine. When to start taking it, in what dose, and when to stop it? ### Response: Hi. Let me start by congratulating you in advance for your wedding. There are many methods, all using hormones, to either prepone or postpone the period. I would like to suggest the simplest and the best method. I would not confuse you with too many dates, as these hormones have to be taken on time without fail, any failure can cause bleeding in between. Try taking oral birth control pills or contraceptive pills, like tablet Duoluton-L or Dear 21 or Novelon or Ovral G or Intimacy plus 3. Have one tablet at night now onwards for 21 days, and without giving a break, start the next packet. Take it until the date you want to postpone the periods, and you will get your period 4 to 7 days after stopping the pill. It is also the best contraceptive method for a newlywed couple. You will have 100 % protection and no trouble with sex. In such a case, you will have to take it cyclically from the first day of bleeding." "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 35 years old male having weight around 82 kg. Last year I was diagnosed with hypertension as my reading in the clinic was 170/120 and when the doctor asked me to monitor my BP and wrote some blood test. I monitored at home for 15 days then it was around 145/100 and report for all the blood test was normal but the doctor prescribed me Met XL 25 so I am taking it at night. I have started the exercise in the morning like jumping rope, spiking and yoga as well. I play TT for one hour in the noon around 4 PM to 5 PM. Now in the morning after exercise, my BP is around 130/85 but in the evening when I measure while sitting, it is around 150/110 and when lying it is around 138/93. Is this a cause of concern having high BP in the evening or it is normal? ### Response: Hello. The medication you are taking is right, but I would like to know that whether you are skipping your medicine in between? And along with medication, stop over the counter salt." "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 6 years old and weighs 24.4 kg. He develops common cold quite often. I am also worried as dengue is spreading around my community and I would like to give him some medication which is preventive in nature. I would like to know what is the best medicine regime for my son to prevent dengue. ### Response: Hello. Eupatorium mother tincture is definitely a good choice of preventive remedy for dengue. If he has milder symptoms of fever or body ache then it can be taken twice a day. Gelsemium 200cc is another good remedy for dengue if he gets dull and" "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 just got back from the dentist today but my dentist did not give me a chance to ask further questions today, she just said I have short roots and left. I suppose she was in a rush? Not to mention she discovered four cavities under sealants I have had in the past. I have been here checking online about short roots and making myself paranoid. I wish I had a picture of my X-rays from today to make this more clear. But my main concerns are just does this have anything to do with root resorption and are my retainers making my short roots worse? I have not had braces since I was 14 and I have always worn my retainers since. I cannot sleep without them. But are my retainers causing my short roots more stress? And can this lead to root resorption? ### Response: I understand how you feel. But, root resorption occurs in deciduous teeth prior to shedding. In permanent teeth, root resorption occurs during pathology/disease. Regarding the cavities, if it is not near to pulp (blood vessel of the tooth), you can get it filled. There is nothing to worry about short roots. If the cavity is near the pulp, you will have to go for a root canal and again short roots will not create a problem with that but the crown placement might be affected. Yes, orthodontic treatment causes mild tooth resorption for tooth movement but is compensated and retainers will not cause much of root resorption. You may genetically or developmentally have short roots. Nothing to worry much, if there is no pathology, problem or mobility. I would suggest you remove the retainers at night as the tissues need some rest (eight hours). I hope I have answered your doubt. If you want, you can add up further details like which tooth or any other symptoms associated with it, like pain or sensitivity or swelling, etc., in detail" "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 76 year old male, who is 170 cm tall and weigh 68 kg. Presently I have anemia, and my hemoglobin is 9.6 g/dL. I also have high serum ferritin level of 1900 ng/mL. I have this problem for some time. Many years ago, I was diagnosed with thalassemia minor. I was feeling tired, and I had a headache in the right temple area more frequently for the past two years. At that time, I had high blood pressure of 160/80 mmHg and low testosterone of 4.6 ng/dL. My blood pressure was controlled by Losartan 50 mg and Hydrochlorothiazide 25 mg. I am also taking Viagra. A year back, I also had platelets clumping. My doctor is considering iron chelating tablets. Will chelating tablets lower hemoglobin? I used to take iron supplements, but due to iron overload, I stopped taking them. What can be done to increase hemoglobin and lower serum ferritin? I am attaching all my blood reports. ### Response: I have seen all your reports (attachment removed to protect patient identity). Thalassemia is an inherited blood disorder characterized by abnormal hemoglobin production. I do not have to explain you much about thalassemia as your doctor might have told you the details and consequences about it. Few symptoms and complications that you need to be aware of due to thalassemia are as follows: Major complications that you need to consider is iron overload, which could either be due to recurrent blood transfusion or due to excess cell break down. Comming to the weakness, it is generally due to low hemoglobin. Symptoms of anemia can result in feeling tired and pale skin. A decrease in the hemoglobin level was mainly due to blood transfusion. The patient can be on iron supplements, and it requires about two months on an average to improve hemoglobin level. Ferritin is a protein that stores iron and releases it when the body needs it. It usually lives in the body's cells, with very little circulating in the blood. Treatment will be based on patient\s response, how the patient responds to the chelating agent, etc" "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 planning to marry a boy who is known to me. But we have the same blood group B positive. Can we have a problem in having children? Or any other health problems? Please clarify my doubt. If a problem is present, give me a solution to avoid it. ### Response: Hi. The same blood group people can marry and can produce a healthy child. Do not get worried as far as the blood group is concerned. If you both are relative, then genetic counseling before conception is advisable. You can rule out hemoglobinopathy by HB (hemoglobin) electrophoresis and by HPLC method (high-performance liquid chromatography) especially thalassemia minor has to be ruled out" "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 7 weeks pregnant according to my last LMP. I got a scan on the sixth of this month, which showed 5 weeks and 5 days pregnancy, gestational sac 8.5mm, no fetus pole, and yolk sac. My doctor said we will repeat the scan after a week and will terminate the pregnancy. This is my second pregnancy, and the first pregnancy was terminated at 7 weeks and 1 day because of a blighted ovum. What should I do now? Is this a blighted ovum? Can anything be done for blighted ovum or growth of the fetus? How long should we wait before terminating the pregnancy? ### Response: How are you doing? I am sorry for the previous loss. This time again it does not look very promising. Do not lose hope. You have got pregnant twice. Unfortunately, it ended on the wrong note. Hope I have clarified queries. Do write back if any more queries. All the best" "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: The CT of my head and neck scan report mentions a defect in the platysma which may result in protrusion of subcutaneous fat simulating a true mass. What does this mean? ### Response: Hi. If there is mention of a defect then it is a hernia in the platysma which is a thin muscle in the neck area. Such a hernia can allow fat to pass through it to give the appearance of a mass in the area. It is therefore commented that a hernia may cause protrusion of fat below the skin to appear like a mass in the absence of a true mass in the area." "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 ear infection on my right ear for the past one week. So my doctor prescribes me some antibiotics Amoxicillin with Prednisolone. But my tinnitus did not go away. How long will it take for the tinnitus to go away if there is no pain in my ear? ### Response: The answer to your question entirely depends on how you developed the ear infection in the first place. If the ear infection has happened secondary to recurrent allergy or cold, then you will have probably developed a eustachian tube catarrh due to which the fluid is still present in the middle ear causing the tinnitus and will take around two months approximately in toto for tinnitus to resolve. If the ear infection has occurred due to trauma (by earbuds etc), the tinnitus will take approximately four to six weeks, as this the average time it takes to heal the 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: I am 60 years old. I am a Parkinson\s patient. For about the last six months I am having pain in the left arm, shoulder and right leg from thighs downward. ### Response: Hello. The pain could be just due to musculoskeletal pain which just requires some muscle relaxants like tablet Zerodol-MR (Aceclofenac and Tizanidine) two times a day for four to five days. But it could be also due to inadequate dose for Parkinson\s and that inturn causing muscle stiffness. Until then you can take the above mentioned" "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 usually get a popping and locking sensation in my left jaw which happens while eating and getting up in the morning. I also have a partially erupted wisdom tooth in that part. I read about TMJ on the internet and I am getting anxiety because of it. I am very afraid. Recently, the jaw got torn I think and I could not put my teeth together on the left side. It healed after five days of taking Zerodol-MR. I do not know what to do. Please advise as I am constantly thinking about it. ### Response: There is nothing to be afraid of. You seem to have recurrent disc displacement. The main cause can be the one you mentioned, your half-erupted tooth. I suggest you get it removed and make sure you eat from both the sides. The joint gets stressed if you eat from only one side and that causes lockjaw.If you have any cavity get it filled as soon as possible. Make sure during wide mouth opening to hold your jaw with your hand in front of the eye. Check TMJ exercises on the internet and do it in front of the mirror daily. You will get healed within months" "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 found a dark, round spot on the back of my foot towards my toe. Unfortunately, I do not know how long I have had it. I was told by my mom, who is a nurse, that it was probably a freckle. I am not sure because it is pretty big. It is still smaller than an eraser on a pencil though. When I rechecked it last week, I saw a little tip at the edge of the mark that I did not notice the first time I saw it, so I do not know if it is growing or not. Even after searching a lot of sites about this, cancer, etc., and knowing that my family does not have any history or genetics linked to cancer, I cannot tell what it is. Let me know if I should panic. ### Response: Hello. I understand your concern, but there are no attached photographs in your message. Kindly send a picture of the affected area to help you better. I need to see the affected area to assess the condition and to suggest the appropriate diagnosis and treatment. Please send the picture of the affected area." "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 missed abortion one year back and we have been trying for about eight months for the next pregnancy. My period lags regularly for three to four weeks after the abortion.An ultrasound scan showed typical PCOD on both ovaries with 9 mm follicles and have 5 mm endometrial thickness. My doctor advised taking Glucophage 500 mg for two months.Can I get pregnant soon? How many months should it take to correct my problems and to conceive? ### Response: If needed, a hormonal pill also can be prescribed. Clomiphene citrate helps in inducing ovulation. So, continue taking the prescribed medication and try to reduce weight if you are obese. Regular exercise will also be beneficial in your case. Take a healthy diet and more fruits. Try to have intercourse especially around ovulation time at around 14 days of menstruation cycle. If you do not get pregnant in a few months, then a USG scan study should be done to detect ovulation and Clomiphene can be prescribed If needed. If no medication helps then assisted reproductive techniques (ART) may be used" "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 hope you can help me with my anxiety. I am a 35-year-old female who has severe health anxiety and panic disorder with agoraphobia. I have been doing good until this past month. Then, I got sick and had a fever.My heart rate was high during the time of fever. I became extremely anxious about it and went out to buy pulse oxygen to keep an eye on it. WelI I think that was a bad idea. For example, when I am up around the house cleaning, it can hit 130. When I am walking into someplace I have anxiety it can get up to 140. And I feel it. Then I get more scared.I want to start walking with my mom. But I feel scared because it may increase my heart rate. I need some reassurance as I have stuck in this heart fear. Blood pressure generally runs 107/75 and resting heart rate is around 70.I weight 134 lbs (60 kg), and my height is 5\3. Seven years ago I had an echocardiogram when my anxiety first started, and I wore a 30 days Holter monitor. All was good except some PVCs. I also had a stress test without contrast during that time that was also fine. I have always been scared to exercise because of the fear of my heart rate and thinking it will make me have a heart attack or go into cardiac arrest.Please, can you give me some reassurance? I came to know that I can duplicate any chest pain by pressing on the spot then snap out of thinking I have a heart attack. ### Response: I passed carefully through your medical history. Considering your clinical symptoms and performed medical test I would explain as follows: Your heart rate increase recently is defined by your condition of high body temperature and systemic inflammation response. But the primary cause of the racing heart rate is your excessive anxiety. You need to fix and avoid it. The first step is to get rid of the oximeter. You should relax and go outside in nature. Yoga and aerobics are helpful in this regard. Hope to have been of some help to 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 had a tooth removed a while back, and the tooth next to it feels lower down, and I get toothache every so often my dentist said there is nothing wrong, but I feel it is going to fall out or crack and I have pain when I bite down. I cannot eat the rest off my teeth without really biting down, and when I do it hurts and feels like it is pushing my tooth back up, I cannot even bite down gentle without it hurting. ### Response: Hello. There might be following conditions involved in your case, 1. The tooth you got extracted would be a bit higher and functioning before extraction, that would be used in your bite and the second tooth would be malaligned and a bit lower in height. Once it got extracted now the second lower tooth is only there for a bite and chewing function all chewing load is shifted to it, so it started hurting, and it is not easy for you to eat from this side. 2. There could be an infection or a hairline fracture or split in this tooth that needs to be diagnosed through X-ray and some clinical examinations. You need a bridge that can adjust your bite and level down the chewing forces to all teeth equally and your generalized aching will be resolved. While for your second type of condition, the tooth will be treated according to diagnosis. If the infection is there, then root canal treatment is required along with the cap. If there is a bite fracture, then extraction is recommended. Kindly provide me with X-rays so I can suggest you the appropriate treatment. I hope this helps you. Feel free to ask if you have further queries." "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 26 years old male. I have had anxiety for six years now and panic attacks from even before. I have been feeling dizzy for a week now all day, a little bit of pressure on my head. I have alternate periods of sweating and chills. I have been to the hospital a few times because I thought I have cancer. And, they did some CT scan and blood tests and said I have anxiety and to avoid self-diagnosing. My question is, can my anxiety and stress make me feel dizzy or is something really wrong with me? I am really scared. Please provide me details about the symptoms of anxiety and stress. ### Response: Hello. I can understand your concern. I hope you understood. You are welcome to ask follow-up doubts." "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 getting blood after my toilet and from last night I have to go to the toilet every 10 minutes. I am a 25-year-old female with a weight of 55 kg and height 5\2"". ### Response: You are having blood in stool complaint as per history. Hereby, I am giving you my opinion on your case. It can be an acute infective condition like gastroenteritis or colitis. Your local rectal examination should be done and stool routine microscopic examination should be done for primary work up. You can be given an antibiotic course after stool report like Ofloxacin plus Ornidazole combination for five days. Avoid excess spicy foods. The probiotic tablet can be prescribed along with maintaining 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 am a 32 year old married female. I have retention cyst and seedling fibroid. I have this for the past eight months. Can you please let me know if there will be a problem in having a baby? Is this a pcod cyst? Is any treatment required? Or will it go off without treatment? Please clear my doubts. ### Response: Hi. Fibroids can cause fertility problems if they are too large in size or in the wrong location. If you have seedling fibroids, then they are unlikely to cause problems in conception. They may grow a bit during pregnancy, but will decrease in size after delivery. If you are married, then I would suggest you get another ultrasound done to check the status of the fibroids and if still seedling please try to plan your family and conceive. Fibroids grow over time, albeit slowly. If you delay by a few years, then they may cause fertility issues. Retention cyst is different from a polycystic ovary. There are multiple small cysts in the ovaries. If you have a single retention cyst, then it may be physiological. The cyst may resolve on its own. You will need to get another ultrasound on the second day of your next period to find out the status of the cyst. If it is more than 3 to 4 cm and of a dubious nature, then it may need laparoscopy and removal. This does not cause infertility." "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 fingered (inserted my finger) my fiancee in the shower (hot water). I touched my penis twice but I did wash it too with bathing soap. There may be precum which I may have touched. But I washed it once as I said. It is her 14th day from the first day of her period. Is there any risk of her getting pregnant? Kindly suggest, do I need to panic? ### Response: Hello. There is no need to panic as the chances of pregnancy are minimal as you have already cleaned your penis with soap and water. Pre-cum sperms once they come in contact with the soap, they get denatured due to chemical reaction. However, as she is in her fertile period and to allay the chances and be safe, she can opt for an emergency contraceptive pill like an Ipill within next 72 hours to avoid any chances of pregnancy." "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 21-year-old man. I would like to ask your opinion about laser hair removal. I have read a lot in the last days and almost everywhere it is said that it is not bad for your health and body and one of the best ways to deal with hair. I am thinking about doing laser removal of hairs in private parts and under shoulders. I had a problem with acne when I was teen on my face and back (not normal acne but a big one).Now I am almost healed but some years ago when I tried wax hair removal under shoulders and on the chest, I started having acne there also. So now I am a little scared to try it. What is your opinion and is it actually harmless? ### Response: Hello. The laser is a safe, painless and permanent method to get rid of unwanted hairs. It is called laser hair reduction to be more precise." "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 62 year old male. I have one stent but otherwise very healthy, nonsmoker, who works out one hour per day six days a week. I take Atorvastatin, 80 mg daily and Tamsulosin once daily, no other meds except 81 mg Aspirin. I have slightly elevated blood pressure 138/78 and have been experiencing some ED symptoms the last six months or so. I have read that Viagra has been shown in a 20 year study to lower blood pressure while improving erectile dysfunction. What is your opinion on this? I have ordered a few 25 mg to try out. ### Response: Is your ejection fraction normal? Yes, Viagra (Sildenafil) can cause fall in BP as a side effect and you are also having Tamsulosin. So, it also predisposes one to BP fall. You need to use it cautiously. It is better to stop Tamsulosin if it is not absolutely necessary with Viagra. Consult your specialist doctor, discuss with him or her and stop the medicine with their consent. And do not use other nitrates for the purpose of heart diseases like Nitroglycerin, Isosorbide dinitrate or Mononitrate, etc. Hope this helps you and get back if you have any doubts" "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 problem in understanding what others are saying. I can hear sound but cannot understand words. I have done hearing test many times in the hospital recommended by the doctor but the doctor always said that my ear is fine. This problem is there always. I do not understand what others are saying. I recently read an article on high frequency hearing loss. Can I have this problem? If yes, then what is the treatment of this problem? ### Response: Hi. Your problem is not related to hearing loss, nor it is high-frequency hearing loss if your audiogram is normal. It is related to a problem in one center in your brain which makes you understand what other person speaks. I would advise you to consult a neuro physician for the same. Also, if possible, please share your audiometry report with 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 doctor says that glucose reading given by home monitor is always 10% higher than the actual glucose reading from the laboratory test result. So, if my reading in the home monitor is 90 mg/dl, then my actual glucose is 81 (90 minus 9, 10% of 90). Is he right? Do you agree with this? ### Response: It is not like home glucose monitor will be 10% higher. It can be higher or the same or even lower than laboratory results. In fact, in my observations, I have noticed it be slightly lower than the laboratory test result. What I recommend is calibrate your home glucose monitor with the actual laboratory test report. I mean to say do the blood check immediately when the blood sample is being taken for laboratory test." "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 43 year old male. I am suffering from hearing loss for the past one year. It is severe in the right ear and average in the left. I am facing many problems in office due to this. I visited a doctor and he diagnosed it as otosclerosis after some audio test. My elder sister has such problem. She is 23 years elder to me. My doctor has advised microsurgery using titanium. What is the best treatment? ### Response: Hi. Otosclerosis is a disease in which the tiny bone of the middle ear gets fixed resulting in hearing loss. Unfortunately, there is no medicine to cure otosclerosis. There are two options for you. Surgical treatment entails removal of the stapes with prosthesis replacement. Patients who refuse surgery can be offered a hearing aid." "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 19 years old, seemingly healthy with a history of anxiety. I recently had CBC, thyroid, kidney, cholesterol, and glucose test and all came back normal so I am not anemic or hyperthyroid. For several years, when I go from sitting to standing my heart rate increases to about 110 and I get dizzy initially but I feel back to normal after about 30 seconds. My other symptom is when exercising my heart rate increases very fast very quickly. It often gets to 170. I feel fine when it does, and it comes down when I rest, but why does it get so high during exercise? If I had SVT or AFIB, would the heart rate not stay above 100 even when I quit exercising? What does it sound like I have? Does this sound SVT or POTS? Currently, I am taking Luvox 200 mg. ### Response: As you are concerned about this HR (heart rate) being atrial fibrillation or atrial flutter or SVT (supraventricular tachycardia), first, HR is usually more than 130 to 140 in these conditions, especially in SVT. Secondly, these disorders do not have any specific relationship with exercise or rest, meaning this does not start with exercising. It can kick in while resting all off sudden and can convert back any time. Your pattern is more consistent with sinus tachycardia. You may need a tilt test for diagnosis. Talk to your doctor. This will help you with symptoms" "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 has been diagnosed with adenomyosis. What should we do next? ### Response: The best treatment for adenomyosis and endometriosis, is hormonal therapy or a hormonal IUD (intrauterine device). Also, if you are planning for pregnancy, then plan for it immediately. As time passes by the problem may increase and interfere with the fertility. So, it is better you take up pregnancy in the first hand. However, if you are not planning for pregnancy, then you can go ahead and get a hormonal IUD. If you have any further doubts, then do get back to me with her age, periods, obstetric history and any other details, which you would like to share. Revert back with the detailed history to 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 61 years old. I have some weird swelling on my left ankle, and I took photos of it to send to my son. He is worried it is related to a Renflexis infusion I had last week. I have had RA since I was 39. ### Response: The edema due to renflexis is an uncommon side effect. If you have leg edema, then it is advisable to investigate as follow. 1. Serum protein estimation to rule out hypoproteinemia. 2. Sgpt (serum glutamate-pyruvate transaminase) to exclude liver disease. 3. Urea, creatinine estimation to rule out kidney disease. 4. Serum TSH estimation to rule out hypothyroidism. Echocardiography to exclude cardiac cause and finally local ankle joint X-ray if needed. If edema leg more than diuretic like Furosemide can be prescribed after consultation with your doctor. I suggest you consult nearby physician for a detailed discussion of all these. I hope I have answered your question." "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: Recently, I notice trash getting formed in the penis head. Sometimes, it is itching and sometimes giving a foul smell. This started early last month. But then it worsened later. I have been washing it regularly with warm water and after a couple of days, it again forms. Kindly provide a permanent solution. Do I need to show it to a urologist or will you be able to answer? ### Response: Hello. It could be a fungal infection. If possible send me images so that I can see and suggest you properly. Revert with more information to a urologist 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 son is 2 years old and his weight is 11 kg. He has a problem of cold and fever since last week. However, I took syrup of both and understand that the doctor would have missed the kid\s age and prescribed the tablets. I have been giving him both for the last four days but there is no improvement in fever and it comes back as soon as the medicine effect goes off. Please advise further. ### Response: I can understand your concerns. Fever for four days in a child with mild cough can be due to upper respiratory tract infection, typhoid, or malaria. Kindly do tests like CBC (complete blood count), malarial antigen test and widal test. Give Syrup Ziprax 3.5 ml three times a day for three days, syrup Sinarest 5 ml three times a day for three days, and syrup Crocin 6 ml if fever occurs. Review with reports." "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 baby boy who is 1 year 8 months old and his weight is only 8.4 kg (birth weight 2.6kg). Before one month, I recognized some irregularity in his walking and went for an X-ray and blood test by the recommendation of a doctor. And diagnosed that his vitamin D and calcium values are very low (vitamin D 19.9 and calcium 6.8) and also he is affected with a mild form of rickets. On the same day, started the medicine as one injection in two legs and vitamin D and calcium supplements are continuing. I was affected with chicken pox before 15 days of my delivery. Are these are connected? Anything to worry? Is it reversible? Also, I have one more doubt to ask you. My baby is not taking any food. By grating, I am giving everything as a semi-solid form by using spoon type feeding bottle. Is anything to worry regarding this? Is semisolid food is alright for him? He is not interested in any food including chocolates. Please give me the proper solution. ### Response: Hello. Firstly, rickets is completely reversible and nothing permanent. Your babies values are very mildly affected. So, by the course you are giving him it will be cured completely. Your pregnancy chicken pox has nothing to do with his condition presently. So do not feel guilty in any way. Coming to food issue, it is perfectly alright for your child to eat semi-solid food. Do not worry about that. Please encourage him to" "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 trying to conceive for the last four months. I have consulted my gynecologist and she found that I am having PCOS. She suggested me to take Ovares plus. Is it fine to take? ### Response: Ovares tablet is a multivitamin with few antioxidants. This is usually prescribed as an added adjuvant tablet along with other medication. Most of the infertility specialists will prescribe some or the other antioxidant and multivitamin tablets. Please share your hormonal profile reports for detailed consultation. Revert back with the hormone reports to 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: One week ago, my mother had a CBC done, and the results were all perfectly normal. However, the lab forgot to order a peripheral smear review (which her doctor requested). So a week later, the CBC was repeated with a smear.Oddly, the results of this new CBC were,Low WBC.Low RBC.Low neutrophils.(The smear was normal).At the time of this second lab draw, the lab tech commented this is going to bruise, and it did. A huge dark bruise and bump formed on my mother\s arm very soon after the blood was drawn. I assume this is a hematoma. My question is, can a lab draw technique error (as evidenced by the large bruise and hematoma painful) be the cause or reason for the low WBC, low RBC, and low neutrophils? Please keep in mind the Smear result was normal (unremarkable). I should also point out that this CBC was manual (versus automated).I know it is essential to repeat the CBC with smear again to verify, but I like to know if improper drawing or lab techniques could cause the odd results and if so, what the mechanism of action would be. I can show you her actual results, plus a photo of the bruise or hematoma. ### Response: I have reviewed your query and attached images as well. You are having superficial thrombophlebitis most likely as per given history and attached image. It can be most likely due to a technical error during collection. However, your low red blood cell count, low ANC, and the low total count could not be due to a technical fault. It can be temporary finding due to some unnoticed infection. I suggest you repeat CBC (complete blood count) after few days approximately after 7 to 10 days and it will come standard mostly. Your peripheral smear examination report is normal, so no need to worry. You can revert with reports once done after a few days. For thrombophlebitis or bruise, I suggest you apply ice wrapped in thin cloth frequently like five to six times a day. Thrombophleb gel also can be beneficial. I hope I have answered your question. Let me know if you have another problem in mind." "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 hyper burning in the stomach to chest area left side only, empty stomach burning much after taken food, cold water, fruits some relief but not full relief. Some belching also comes from the last two months, this issue from the previous 1.5 years. At present, I cannot eat hot foods, hot water, warm milk, and cannot eat spicy foods too. Anything hot tastes or drink immediate feels like heating in the stomach. Comfort zone when drink cold water, milk, cold juices, and very few times after dense food, some pain feels in the exact stomach area. The pain feels like a slow-digesting process after some time, and the pain was gone.Last few months, I have taken the Deltone capsule for two months, then Rekool-L then Nexpro Rd now this month given me Neopride total capsules. But after skip capsules burning again start. Along with Clistar Rt tablet, two times are given, and Nutrilite multi-minerals capsules in the night. Now I do not understand only name change brand change, but every time gastro doctor gives me pills like Dexlansaproazle, Esomeprazole, and Rabeprazole. Now I do not understand what issue I have? ### Response: I have gone through your query and can understand your health concerns. As your symptoms have started long back, you need proper evaluation. There are many causes of burning in the stomach and belching like gastroesophageal reflux disease, gastritis, peptic ulcer in stomach or duodenum, gall bladder stones, infection of the gall bladder, esophagitis, etc. In my opinion, you need an ultrasound of the abdomen and endoscopy to find out what is the cause of your symptoms. Sometimes inappropriate dietary habits like not taking meals at the proper time, eating a lot of junk food, oily, spicy, fatty food, excessive tea or coffee intake, less water intake can cause acidity and burning. Some infections of the stomach like H.pylori infections or hookworm infestations can also cause such symptoms. I suggest you go for an ultrasound of the abdomen and endoscopy to know the root cause of your symptoms so that proper treatment can be done. Avoid tea, coffee, soft" "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 braces three times now. First, during childhood, and second as an adult. First I had metal, wore my retainer religiously for a year, and then after being super strict, my teeth shifted. I then tried Invisalign and was not a huge fan, but considering it again. My teeth continuously shift, and I was told I have a tongue thrust, and hence, my teeth are always moving back. Am I wasting my time getting braces again? I was also considering veneers, but not sure if it would even qualify. ### Response: Hello. Why have not they put fixed retainers in your case? Especially if the case got relapsed. You must have got the second treatment done and then at end get fixed retainer at palatal and lingual side of your teeth for like good 10 years. This is the only way to avoid relapse. Moreover, if you are having tongue thrust, there is an appliance for it. I would suggest you to get treatment done (which could be fourth time) with conventional bracketing. And at the end, ask the dentist to put fixed retainer. After it gives you an appliance to limit tongue thrust. This would not cause relapse, hopefully. I could suggest you more proper treatment plan if you can provide me with clinical pictures of before, after treatment and now recent ones too." "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 itchy scalp and have started losing hair. Can I get help on this? ### Response: You have probably seborrheic capitis (an eczema). I suggest Ketoconazole shampoo on alternate day. Keep in contact with scalp for 7 to 10 minutes in each application and continue it for three to six months. Consult your specialist doctor, discuss with him or her and take the treatment with 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 had unprotected sex with my partner, and after 48 hours she took an I-pill. After a day, again we had unprotected sex, and she has taken I-pill after 48 hours. After a day, again we had unprotected sex. Now whether she needs to retake I-pill? Can I-pill cause any side effect when taken three times again and again between the period of 10 days? ### Response: Hi. It is better to have another I-pill. Although it works, the efficiency decreases with time. There are no other significant side effects. However, menstrual irregularities are more like delayed periods for few cycles, nausea, vomiting, and breast tenderness. Also, taking I-pill on a regular basis will reduce the efficiency and increases the failure rate. So it is better to take oral contraceptive pills" "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 erection problem and I cannot have a morning erection too. I am married but my penis becomes soft while having intercourse. I have done all tests like penile doppler, scrotum, diabetes, and prolactin but all were normal. What is wrong with my sexual organs? Please guide me to solve this problem. I am currently taking Eract X twice daily. ### Response: Hi. Coming to your query, I have some questions. Do you have diabetes or hypertension? Are you on any kind of medication other than you mentioned? What does Eract contain (is it L-arginine with a multivitamin)? Is your erection tight enough such that you able to penetrate into the vagina and after that it becomes flaccid? Are you able to masturbate and ejaculate?" "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 33 years old female smoker 170 cm, 72 kg and recently have my MRI scan on the brain. My reason for MRI was dizziness, headaches, and pain in joints, legs. Can you please tell me your opinion about the result? This the impression: T2 FLAIR hyperintensity foci within the white matter in the centrum semi ovale and near the vertex which are more than expected given patient\s age. The distribution is non-specific. Most of these are atypical for demyelination. ### Response: Hi. I understand the issue. In my opinion, the finding in your MRI suggests that some of the nerve coverings (neuronal coverings) in your brain have weakened. The changes are subtle, not to that extent when we can call it a disease. Giddiness you have is very less likely to be directly related to these changes but we can relate it to the probably associated weakness in the coverings of the balance nerves. Please let me know in detail about the pattern of your giddiness. Is it present all the time? Or episodic? Is it more when you are in stress? Is it associated with hearing problems? Do you hear any extra sounds from your ear? Please let me know so that we can 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: What is meant by 6/6 right eye, 6/6 left eye and 6/5 uniocular vision with glasses? ### Response: Hi. In laymen terms, 6 by 6 means scientificly defined perfect vision. In medical terms, 6 by 6 means what you see from six meters, a person with normal vision also sees it from 6 metres. 6 by 5 means what a normal person sees from 5 metres you see it from 6 metres only means better than normal vision. In this case, 6 by 5 is possible with spectacles." "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 miscellaneous tingling sensations in my face and left arm and leg. A couple times right leg but that is very infrequent. I have gone to the doctor and they did brain MRI which was negative. Neuro exam was fine. Carotids were fine too. I am worried about MS. They are not doing anymore. I am scared. I am currently taking medicines for reflux and blood pressure. ### Response: I read carefully your question and would explain that your symptoms do not seem to be related to MS (multiple sclerosis). TIA (transient ischemic attack) or epilepsy seizures may cause such clinical scenario. Other possible causes could be vitamin B12 deficiency and thyroid gland dysfunction. For this reason, it is important performing further tests to investigate the possible causes: You should discuss with your doctor on the above tests" "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 trouble breathing with my right nose and I get throat infection frequently like once in a month and ENT doctor said for CT SCAN and after the scan, he said I need to have a surgery. I want to know if there is a treatment for the following problem. DNS to right, right concha bullosa, right maxillary polyp. Please go through my reports attached. I want to cure this issue because I face difficulty in sleeping. ### Response: According to the reports (attachment removed to protect patient identity), you have two important problems like deviation of the nasal septum and right maxillary polyp. Lemna Minor Q was an effective medicine for polyp and Teucrium Marum 6C is also helpful for your problem. With these medicines, your breathing problem will also get relived. Teucrium MARUM 6C daily 10 pills three times per day (15 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: A few months ago, I have been having left side pain from my shoulder blade down to my arm till the tip of the last finger. I have had ECGs, blood work, chest x-rays and finally a CT angiogram. All were normal. I am tempted to go to the ER every time this happens, because I think this might actually be a heart attack. I am so frustrated. I have been feeling normal and I am back to my regular daily workouts, which are fine. But, my back always feels very tight after my workout and it takes me a while to catch my breath. From today morning, I have been feeling dizzy at times and my left pinky and back feel tight again the way they had in the past. I feel like I am breathing harder than usual. I have had tests done both in the ER and by a very good cardiologist, including a CT angiogram, ECG and blood work. I have had panic attacks and I fear that this is a real heart issue. Should I go to the ER? I am very concerned that my workout seems to make my upper back feel worse. Is this a sign of heart disease? ### Response: Hi. I appreciate you and have thoroughly worked through your case. I can well realize the sensitivity of the issues you are feeling right now. My discussion today will mostly comprise of reassurance and explaining the things in the best possible way for easy understanding. Revert back with the reports to 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: I have been diagnosed with Hashimoto\s five months ago. My anti-TPO and anti-TG were 115 and 33 respectively. My TSH was 1.5 and FT4 1.1, so normal function. Two months ago, I started having palpitations and tested my thyroid again. TSH was 0.0018 (suppressed), FT4 2.66 and FT3 7.8. I was hyperthyroid, so I had the TRAb test and it was 5.9. So, I was diagnosed with Graves\ and overt hyperthyroidism. I was put on 15 mg Methimazole and 6 weeks later retested my thyroid and my results are, TSH 0.0026, FT4 0.86. So, normal but low range and FT3 is 2.8. Over the last 2-3 days including before these tests, I started having a nasty dull head pressure and lack of focus, similar to what I have had a couple of years ago when my TSH came out 4.1. I also had fatigue and brain fog, which I do not have now. I feel this pressure or tension around my ears, nose, head and throat. I feel my jaw and upper throat tense, had nightmares, irascible and emotionally unstable. It all started rather suddenly. Can it be thyroid related? It is my only known health issue. I do not feel sick and I do not have fever too. But, this sensation in my head and throat annoys me and makes me very anxious. Could it be related to my FT4 going too low? And why is my TSH still suppressed? Why should not it rise with this FT4? Are the TRAb antibodies keeping it suppressed? I will now half my Methimazole dosage to 7.5 mg per day for another three weeks and test again. Does this sound right? Do you have any other advice for me with these symptoms and test results? Please let me know if you need any more information. ### Response: You have written a very detailed and engrossing history. Well done! Revert back with the answers for the above questions to an endocrinologist 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 son who is 11 years old now has a undescended right testicle. Ultrasound determined that it was in the inguinal canal when he was 8 years old. We have been waiting for it to come down, but it has not. Does the surgery to correct the testicle improve fertility? Or does it lessen the chance of malignancy? I would like to monitor through ultrasound. I am wondering what your thoughts are on this course of action. ### Response: I suggest that surgical correction should be done to bring it down as low as possible. Reason being, it permits self palpation of testis for early detection of any tumor. Frequent ultrasound is not feasible or practical to think of. Self palpation can be done every day. Ultrasound cannot be done every day. Surgery is a minor one. If it is already shrunken, in my opinion the surgeon may suggest removal of it. Do not be afraid and go ahead." "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 suffered from acne since I was in high school and have used over-the-counter creams such as Benzoyl peroxide. The sides of my nose produce a clear yellow substance that crusts over my pores. When I clean the area and the crust is removed, it then produces the liquid again. I have had this for nine months and whenever it clears, it comes back within a week. ### Response: It could possibly be an infection of the sebaceous gland. Please provide a picture of your problem. Revert with the pictures 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: My 5-year-old boy seems tense and thinks most of the time. He cannot accept if anyone is unhappy with him, he gets really angry, and he starts crying on things which we cannot understand. ### Response: Mostly it triggers because of present stressor in the environment such as unfulfillment of basic needs (food, social, hygiene, health, etc.). Other stressors might be lack of parental love and attention. You did not mention the type of thoughts or content he is experiencing. Are there any other behavioral observations? More behavioral observations and history are required to understand the case better as follows: 1. The onset of behavior. 2. Try to note crying behavior with surroundings. 3. Anger triggers. 4. Get physical check up of your child (iron and vitamin deficiency also lead to such agitation). 5. Mother\s history during pregnancy. 6. Home environment. 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: My wife is suffering from severe cold, headache and throat pain. Can she take Paracetamol, antibiotics, and Cetirizine? We are planning for pregnancy, using medicine for it. This is her 12th day after the period. ### Response: Hello. Your wife is having sore throat problem and cause is acute pharyngitis case. You can give her Levocetirizine 5 mg OD for five days. For throat pain, Paracetamol 500 mg SOS can be prescribed. Also, give her vitamin C 500 mg tablet BD for five days. Avoid excess spicy foods. If no improvement in three to five days, then will do further work up until then no need to use an antibiotic." "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 31-years-old male and a heavy smoker. I usually have some problems with GERD, but when I take Nexium, I feel I am suffering recently from the following symptoms. During my day, around two times, I got episodes of the following while resting.1. Strong heartbeats.2. Accelerated heartbeats.3. Feeling my stomach blow.4. Difficulty in breathing.5. Sweating.The episodes last for might be two minutes.I have visited a cardiologist, and I made the following analysis,1. Thyroid hormones.2. CBC.3. Urine.4. ECG and stress ECG.5. Holter for 24 hours.6. Chest X-ray.7. Breathing test.All measures are normal except high cholesterol and LDL. Now the episodes come maybe once every couple of days. I do not know what is the reason could be?. ### Response: You have to do ECG immediately once you have the episode or will need a loop recorder or event recorder for the diagnosis of arrhythmia if the incidents are recurrent." "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: An hour ago just like started feeling nauseous like he wanted to throw up, and a lot of pain in his stomach. Shortly after that started, his nose started bleeding for some reason. ### Response: He is having two different issues. 1. Nausea and stomach pain can be because of inflammation of gastric mucosa called gastritis. Cooked oatmeal will help in soothing the stomach. Curd can be included in the diet. Heavy fatty foods should be restricted for a few days. Avoid excess spicy foods. If no improvement, then antibiotic course prescribed and endoscopy planned if needed. 2. For nose bleeding, if one episode then it can be neglected. Or else rule out the underlying cause by measuring blood pressure, rhinoscopy nose examination, etc. If there is a history of trauma to nose then also bleeding can occur. You can pinch the nose with thumb and index finger to stop bleeding." "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 persistent floats on the lower side of the eye. I have consulted a doctor and since the eye power is the same (-4.5) she did not dilate the eye. She told me it is because of the sore eyes and it will get resolved. But I want to be sure, as the floats are more severely occurring in the right eye. ### Response: Hello. See first of all floaters at the age of 21 is not a common condition. It can be due to so many reasons but I feel in your case it is because of your high refractive error that is -4.5 as you said. So my advice is you should be very careful regarding your symptoms if floaters are not much then no need to worry. But when you will have suddenly excessive floaters or if you feel like flashes in your eyes, vision is getting affected then immediately you should consult your ophthalmologist because all these are symptoms of retinal detachment. That is common in high myopia patients. One more thing is you should undergo a complete ophthalmic check up every six months." "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: This query is regarding my baby boy's health. He is 18 months old and recently had his varicella shot last month. Last week, he suddenly started shouting in the middle of his sleep and kept scratching his forehead and neck region. When checked two mosquitoes were near him and had bitten him.Generally, he gets papular urticaria after any insect bite. But after three days, he got lesions all over his face, arms, and legs. Checked with my doctor and initially, it was ruled out as chickenpox along with insect bite allergy. But even after a week he still did not show improvement. The older ones are very slowly recovering. But everyday new lesions are coming up and he scratches like anything despite a lot of medications. Please help. His current medications are Aciclovir 2.5 ml thrice (completed the 5-day course), Azithral 5 ml (night only) for seven days, Xyzal 2 ml thrice daily. Now the doctor has started him on Omnacortil steroid medication and Kid pred 3.5 ml twice daily.Please suggest if we are treating him the right way. He weighs 10.5 kg. No fever, cold or body pain symptoms. ### Response: Hi. As per the history and pictures shown (attachment removed to protect patient identity), I would recommend to get the child evaluated for scabies if the above treatment does not work. Until then continue the treatment as going on. It appears to be fine as per my knowledge as I have not evaluated the child physically. If the treating doctor feels that it is scabies after examination, it would be advisable to use one dose only of Permethrin 5% on the body and 1% on the scalp. 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 undergoing treatment for stomach TB for the last one year. I take Sompraz D 20 capsule on empty stomach and Libotryp at night. Due to overeating today, I am having diarrhea and indigestion. Can I take Enteroquinol and Eelectral powder? Or would you like to suggest me any other treatment? Also, now I do not feel like eating anything else. Please help. ### Response: Hello. Yes, you can take these medicines. There is no issue with these medications with your present treatment. Consult your specialist doctor, discuss with him or her and with their consent take the medicines. The probable diagnosis is infectious diarrhea. If you have mucus or blood in the stool or pain in the abdomen then only you should take antiparasitic medications. Otherwise not indicated because the most common diarrhea is caused by viruses. If you suspect food poisoning then we should take specific medication according to your food intake. For now, you take ORS 250 mL per loose stool and normal diet You may revert back more details with the type of food to be taken, consistency and quantity of stool, blood or mucus in stool, and presence of pain or not, fever etc. You need to maintain hygiene" "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 21 year old female. I was bulimic for about a year. It happens once or twice a week. I never noticed any permanent changes in my eyes throughout my episodes. However, the last time I ever binged and purged three months ago, I vomited violently. A few weeks after this, I noticed that the vessels in my sclera are indefinitely more prominent than before. Did this happen because of the continuous pressure subjected to my eyes with vomiting? Or could it just be due to many hours of reading and laptop use? I have seen an ophthalmologist and he said that there is nothing wrong with my eyes and suspect a very mild case of blepharitis or bilateral dry eyes. I am using Optive comfort solution. I would like to know if my bulimic phase could have caused the prominent vessels in my eyes, as this has not been mentioned anywhere else online. ### Response: Hello. I can understand your concern regarding your complaints." "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 20 year old male. From the past three weeks, I have nasal congestion, which is not getting cured. I was also suffering from nausea and increased bowel movements. The nausea is cured, but I feel sick from inside. Is there anything serious? In my CBC reports, the neutrophils are 44 %, lymphocytes are 51 %, and platelets are 1.70 lacs. ### Response: You have not mentioned the medication that you are taking. According to your CBC report, you have high lymphocytes count. It is suggestive of a viral infection of the upper respiratory tract. I suggest you do the following investigations. Meanwhile, I suggest the following. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. If there is no improvement, and if influenza is positive, then your doctor will give you Oseltamivir like anti-influenza medication. Consult an ENT specialist for 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: My exams are about to start. I was not serious at the start but from the past few days, I have been working really hard. People near me say it is too late now something worse is going to happen. But the way I have planned things I know I could easily score good marks but the problem is I am not able to do as I thought. I am wasting most of the day wondering here and there. Plus the masturbation has also increased. Please tell me what should I do. ### Response: Hi. From the description, it seems that you had confidence regarding the exams before some days. But it seems that, for now, you have lost your confidence. Why have you lost your confidence? Is it because of other people who try to demotivate you? Is it because you could not perform well in mock tests? In any of the case, do not worry or think too much. The answer to your question is simple. You will score good marks if you have prepared well. You will score low marks if your performance is low and medium marks if your performance is medium. That simple. There is one more limelight. You have prepared 60 % and if almost all the questions are from the portion that you have prepared, there is still a chance of scoring 90 %. So do not be demotivated. You still have time. Last minute preparation provides more insight and knowledge. All the best." "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 one week late as of today for my menstrual period. Currently, my cycle is 38 days. I have been having protected sexual intercourse the past month, but just recently (Day 35) of my cycle, the condom of my partner leaked at the base. So I immediately took emergency contraceptive which is four birth control pills at 5 PM, then another four birth control pills at 5 AM the following morning. I started feeling the side effects, but I am worried since my period is a week late already and I just woke up at 2 AM on day 38 unable to sleep with a weird feeling in my stomach and I am extremely constipated, with tender breasts, and feel sick overall.I would like to know if my period will come soon? If there is a possibility I am pregnant, or if I am just feeling all these symptoms due to hormone imbalances? What I should do in this whole situation since I am very worried about it? ### Response: Hello. Yes, you are right, your period will come soon and that is most likely possibility. Your symptoms can be due to both pregnancy and/or hormones. Because in pregnancy there is increase in amount of hormones and you just take higher dose of hormones. And symptoms you are experiencing is due to the higher level of hormones in your body which can be due to both reasons. But it is more likely that symptoms are due to the pills you had taken. Because if it is due to pregnancy then pregnancy must be due to earlier intercourse which was protected. So there are very fewer chances of failure in that case. And right now your periods also get extended due to the pills you had taken. Basically, in this situation you should do a urine pregnancy test and see if it comes positive then it is due to the failure of previous precautions. And if it turns to be negative then just wait for seven more days and periods will come. And even after that if your symptoms are increasing in two days then you need to go for a test for confirmation to clear the confusion. And do not take much tension. With your history, it is more likely that it is just delayed menses due to emergency pills and side effects of oral hormones. Your period can be irregular for one or two cycles." "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 baby is one year old. He bangs his head on the wall or floor when he is upset. I want to know whether it happens due to any health issue. Please suggest. ### Response: I can understand your concern. Kids do it when they are in frustration, when they require attention seeking, and when they have a stubborn behavior. Rarely, it can be a part of hyperactivity complex. It is treated by behavioral therapy." "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 weird when I am among people. I get scared sometimes. On some occasions, my mind is just blank. I do not know what to say in response, and when the conversation ends, I feel like I should have to say something good. These things depress me more. ### Response: Hello. I understand your problem. You seem to have social anxiety or anxious personality traits. This is one of the most common psychiatric problem people usually encounter but there is always a solution to every problem. Yours also has a solution. There is a therapy called exposure therapy. The more you would be exposed, the less fear you have. Apart from them, learn some soft skills and social skills. They will also help you. If nothing seems to be helping, medicine can be started which would treat all your problem. TSH (thyroid stimulating hormone). Therapy and medicines." "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 mom is complaining about headaches and burning sensation in the eyes. She has put on weight as well and recently she started complaining about pain in the right leg heel. So, I took her to an orthopedic doctor. He asked her about her menstrual cycle and when she replied that it has stopped, he recommended me to consult an endocrinologist. Why? She is 55 years now. ### Response: It could be due to her stopping of periods called menopause. During this period there occur hormonal changes, which causes these symptoms. I recommend her to get the following tests done and revert back. Revert back with the reports to an endocrinologist 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: For almost a week, I have throat itching and some blood coming out of it. I had throat infections in the past and was smoking back then. Now, I do not smoke and it has been more than two and half months that I had a smoke. Could this be because of Nicotex 2 mg that I have been chewing to keep the cravings away? Also, my friend, who is a doctor, suggested me to take Azithral 250 mg three times a day after meals. Please suggest if I should. ### Response: Hi. For one event of little blood, you need not have to panic. In my opinion, I do not think it is due to Nicotex (Nicotine) and hence you can continue using Nicotex. Most likely you are having throat infection and most of the times it is due to viral infection and it does not require antibiotic such as Azithral (Azithromycin). My recommendation is as follows: Wait and observe for three days. If still the soarness persists or you experience fever or too much of cough, then in that case you can start antibiotic Azithral (Azithromycin) 250 mg two times a day for five days as per your friend\s 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 am here to ask some questions regarding HIV and some other possible STDs for the woman having unprotected oral sex (cunnilingus). I tested for HIV after 12 weeks and two days of exposure. I had no sex during this period. The HIV 1/2 rapid screen test showed me a negative result. Does the result conclusive? I consulted a doctor, and she told me that doing a home testing is inaccurate. Is it true?Since, in these three months, I do not have any severe symptoms. Now, it is four months after my exposure. I have small red bumps in the back of my throat. I do not have pain and difficulty in swallowing. Is this a strep throat or pharyngitis? Is it due to STDs? Is it possible for me to have STD symptoms after three months? Please help. ### Response: Please say whether the throat pain got resolved with medications. If you have it, then it is unlikely to be a cause due to HIV infection. Secondly, the home kit for HIV has a low sensitivity and low specificity. So, it is inconclusive. ELISA (enzyme-linked immunosorbent assay) is a standard test advisable for HIV testing. Since it is four months, the window period for acquiring an HIV infection has overlapped, and hence, having a negative report at this point is very sure to conclude as not having HIV infection. I would suggest you get tested for ELISA now and repeat it after four weeks again or after a month. Also get a swab sampling done for your throat pain and consult a physician." "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 in doubt that I am pregnant. I had safe sex with my husband as we are sure that there is no scope of pregnancy because we were very cautious but still I did not have periods this month. I need to be sure if I am pregnant. ### Response: Though chances of getting pregnant are really minimal with all types of protection but nothing is 100 percent safe. So if you have missed periods and you seem concerned then there is no harm in doing a pregnancy test for your own peace of mind to rule it out and to avoid further accidents, I would suggest you opt for a regular birth control method according to your preferences." "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 it possible to do birth control surgery also during C-section during delivery? ### Response: Hello. Yes, you can opt for tubal ligation during cesarean section but you have to give consent for the same prior to the cesarean. Usually, the doctor proceeds with the ligation only after the pediatrician confirms that the baby is doing fine. If not, then you are being informed on the table and the doctor usually avoids the procedure in good faith considering the condition of the neonate. The procedure can then be performed after six months to nine months by laparoscopy once the child has been found to be growing healthily." "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 paranoia schizophrenia for the past 16 years. The delusions have become very absurd and in her story, her immediate family is the culprit. She has very vivid auditory hallucinations and sometimes visual hallucinations. She has refused to see a doctor as she believes they are in on it. Her stage of psychosis is very violent in which she screams and shouts and also turns violent. This has been going on for 16 years, but now the episodes of psychosis are becoming more intense. Please advise on how to talk to her or at the very least medicate her because it is taking a toll on our mental health. My sister suffers from depression and I suffer from anger management. How our father holds it together I have no clue. Please advise. ### Response: However, nowadays Depot injections are available and their effect lasts up to four weeks. So talk to your psychiatrist regarding the injection. Once she is put on a monthly injection then it will be easier for you to give her a monthly dose. This will ensure" "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 recently diagnosed by my cardiologist with nonsustained ventricular tachycardia, unspecified syncope type, and orthostatic hypotension. Also, during an echocardiogram, it was reported. I was recently diagnosed by my cardiologist with nonsustained ventricular tachycardia, unspecified syncope type and orthostatic hypotension.Also, during an echocardiogram, it was reported they saw trace mitral regurgitation and trace tricuspid regurgitation. I was not given much information with these scary-sounding diagnoses. I was just looking for some explanation of them and also if it means something with them all together. Is there something I need to do to make these things better? ### Response: Hello. When was it diagnosed? Yes, during the episode of ventricular tachycardia you may feel syncope and palpitations due to reduced stroke volume. You may get it done tilt table test, 24-hour ambulatory blood pressure, ECG monitoring is useful. Do not worry, mild MR, TR may not cause much problem. In severe cases, a few people may need ICD insertion. Please check it out for hypo or hyperthyroidism, electrolyte imbalance or hypocalcemia or magnesemia, etc. Please consult your cardiologist. He will examine and treat you accordingly." "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 45-year-old active athletic female. I had inguinal hernia repair with no mesh six months ago. Recently during exercise, I noted a similar pain in the same exact area. If it is a recurrence, what happens next? Is there another surgery? It has only been six months. ### Response: I believe you had a mesh-free hernia surgery done six months ago. Now you have developed pain at the same site. I would need a few details before I can help 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 have a back and related pain since five weeks. I had a discotomy 17 years ago and have had ongoing pain since but never lasted this long. Please could you look at the results of my MRI scan and explain to me what it means and what I should do next? My current medications include Cod IPA right and Vimovo. ### Response: Hello. I read your query with keen interest and reviewed the attached MRI report. I hope this answers you. Feel free to write back to me if you have more questions" "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 went to the urgent care around 1 PM today for what I thought was cotton bud from Q-tip in the ear but the doctor said it came out and everything looks fine and that it is a bit red and gave me some antibiotic drops to use but have not picked them up yet from the pharmacy. At 3 PM my ear started to bleed through the canal. Is it a scrape or cut maybe? The doctor said all is fine now. It is still bleeding. What can be done? ### Response: I understand your concern. As your ENT doctor had already examined your ear and says no cotton is inside that means only infection is there. I think if blood is coming out from the ear and your hearing is impaired than thorough examination and some necessary investigations are must to diagnose the real fact. Till you are managing to consult an ENT specialist you may take antibiotics, anti-inflammatory, and antihistaminic" "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 is a heart patient and his ejection fraction is 35 %. He is now suffering from kidney stone which is currently stuck in the penis. He has heavy pain during urine passage. The urine flow is almost zero. The doctor suggested for the operation with high cardiac risk. Can catheter open the blockage instead of operation because there is a risk of life due to anesthesia? Please suggest. Currently, he is on Ecosprin gold 10, Prolomet R 25 for heart disease. ### Response: He has a stone in urethra, just proximal to a stricture (attachment removed to protect patient identity). Opening up of the stricture segment and stone removal will be done at the same time. Cardiac risk is a real risk but is usually managed by good anesthetists. Just catheterization may solve the problem temporarily and may be difficult to pass catheter with stricture. At 62 years of age, I would suggest he should undergo surgery at good center with good anesthetist. And the stricture will need repeated dilatation later" "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 is 28 years old. Her weight is 128 kg and height is 5 feet 3 inches. She has got a constipation problem since last 5 years and she takes Smuth for this. Since last four days, she has been getting severe pain between vagina and anus and that area is swollen. Also, her anus opening is swollen. Yesterday, she was identified to have a small hemorrhoid. The pain is very severe. Please suggest an effective tablet for the pain relief and to cure hemorrhoid. She had Zerodol-SP, Ibuprofen and Chymoral plus, but of no use. Still, she has pain. Also, she takes Himalaya Eve for PCOS and Iron supplement. 10 years ago, she had the same problem. Please provide your valuable suggestion on medication. ### Response: Hi. I have gone through your query and can understand your concern for her health. As you have given every possible analgesic and the pain is not relieved, I think the hemorrhoid has strangulated. It means it is entrapped within the anal sphincter. I suggest tablet Acenac-P (combination of Aceclofenac and Paracetamol) along with tablet Chymoral forte (Trypsin and Chymotrypsin) twice a day for three days. Also, I suggest her apply Diltiact gel (Diltiazem) over the anal area and inside the anus with finger twice daily. I suggest you to consult a surgeon as soon as possible to avoid any complication. She may need some intervention. Also, I suggest you try sitz bath. Tell her to sit in that tub for about 20 minutes. It will give some relief. Ask her to" "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 left eye developed a black wavy line that moves around every time I try to focus, at times obstructing my vision. After consulting a doctor and after an eye dilution test, she confirmed that bleeding had occurred in my eye around two weeks ago and the black line I could see was the blood that had spilled. She sent me to a retina doctor who said he had to inject me in the eye. He did not explain the reason why and was a bit unwelcoming to the point that he did not give me a chance to inquire. He prescribed two drugs (Maxidex sterile ophthalmic ointment) and Ceprolen-D eye, ear drops). I have been using these medications since I did not have money for the injection. I can see little improvement but I am afraid it is not cleared yet.All I want to inquire is, what could be wrong with me? I underwent many blood tests and passed them all. I have never been in accident. All I have had is little sensitivity to light. Also I had been working long hours in front of the computer without anti-glare glasses before my problem started. Do I need the injection or is there a medicine that is more appropriate? I am 21 years old..Please help me out ### Response: You seem to have vasculitis which is inflammation of blood vessels in your eye which makes your blood vessels leaky. Injections of an anti-VEGF compound are indicated in this but before this, you need laser therapy in your eye along with a course of steroids. You need to undergo fundus fluorescein angiography to locate the area of leaky vessels and we have to laser it. You also need to get a blood investigation to rule out infections like tuberculosis. After that is ruled out, we have to start steroids. Anti-VEGF injections come after that. Kindly do not delay it if this process continues. The visual prognosis becomes poorer if not done in time. You may need surgery which would be more costly." "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: How to relieve muscle soreness? What works on Epsom salt baths? Foam rolling? Using a Theragun or a similar tool? Hydrating? Eating foods that are high in antioxidants? Sleeping a lot? Eating foods high in antioxidants? Cryotherapy? Active recovery? Lacrosse ball fascial work? Stretch? For each reason can I ask you to explain how exactly that helps the sore muscles? What are the signs that your sore muscles are something more serious than just sore muscles? Anything else you would like to say about DOMS? ### Response: Muscle soreness or DOMS (delayed onset muscle soreness) generally occurs if someone does strenuous physical activity in any form. Strenuous physical activity means when one\s body is unable to do more physical work but that person pushes his body to do that. It can occur within 24 to 72 hours. It occurs due to small scale damage in the muscle fibers. The best way to get rid of it is to increase any physical activity gradually because it will help in increasing the strength and stamina. Epsom salt bath, massage or sauna, etc. are helpful in muscle soreness because first they relax the muscles and second they increase the blood flow. The clear role of cryotherapy is still not understood. 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: My mom had gone through biopsy and the report came today. The report shows SCC - well-differentiated invasive on right lateral side of the tongue. Kindly suggest me what to do. ### Response: Hello. The biopsy (attachment removed to protect patient identity) is showing tongue cancer. So, now she has to undergo further investigations such as CT Scan/PET CT to rule out metastasis (cancer spread to any other part). After all these investigations, the oncologist will stage the cancer. (There are 4 stages). Once staging workup is completed, she may need surgery to remove the tongue lesion or radiotherapy with weekly chemotherapy depends on the stage. During treatment, she may experience side effects which may affect her daily activities. The common cause of tongue cancer is smoking, chewing tobacco, snuff, gutka, pan, etc. Early stage tongue cancer is usually curable. I wish her full recovery" "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 a small blister on the inner thigh of the right leg. I had got a similar blister at the same spot last year. The new blister is just adjacent to it. This, as per my understanding is due to body heat. When I take B-complex tablets during the night, the pain subsides the next day but reemerges if I miss the tablet. Please advise proper medicine (tablet and ointment) as this reoccurs every year. ### Response: Hello. This is probably folliculitis and occurs due to unhygienic and sweaty local area. You should use powder like Nycil daily so as to keep 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: Someone suggested me to apply baking soda over the sunburn. So, I have applied baking soda on the face. The skin around my eyes is getting dark, wrinkles and has some pain also. Please suggest me some cream to get rid of this fast. Also, suggest me some medicine to get rid of sunburn. ### Response: Hi. I can understand your concern and I have reviewed your photographs (attachment removed to protect patient identity). Irritant reaction to baking soda. Irritant contact dermatitis. Revert back after 10 days 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: Today I went to the dentist for a checkup and cleaning. When I came out I realized that my two front teeth were loose. I guess they were too rough. When I was 7, I fell on my teeth and I have been told that the roots got extremely short after that. My dentist said there was nothing she could have done then. She suggested just using my back teeth and cutting my food into small pieces. I want to know if there was a way to make it not loose anymore or help it. ### Response: Hello. I have been through your query and I can understand your concern. After cleaning and scaling of the teeth, they generally become loose temporarily because of the ultrasonic movement of the instrument. You do not need to worry as it will get to the normal in coming days. I would suggest you not making the teeth more loose by moving them by your tongue or fingers. Just keep it like that and it will become normal after some days or a week. Follow up after one week." "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 changes and pain on the palate, obsessive jaw and tongue movements (I have a feeling something is wrong with my palate and feel the need to lick it with the tip of my tongue constantly), constant feeling of something leaking on the back of my throat and below my tongue and neck pain. I have been diagnosed so far with nasal septum deviation and tonsils to be removed. The CT scan shows my head before surgery. After the surgery, all symptoms still occur.Do I have Eagle\s syndrome? If so, is it just calcified or is it elongated?Do I have incisive canal cyst/fistula?Is there any sign of possible CSF leakage?Any other findings (except for the obvious deviated nasal septum)? ### Response: This causes pressure on the cranial nerves and results in pain related to the nerve compression. We usually measure a styloid process and if it is longer than 3 cm in length then there is a possibility of Eagle syn" "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 dad had a scraping of his bladder two months ago, it was extremely painful afterward, supposed to be a day surgery, he had to spend next two days in the hospital, with horrific bladder spasms. When he came home, he has had numerous, constant UTIs and also a kidney infection more weeks going to the hospital for IV antibiotics, and now again on antibiotics at home for another UTI. His bladder cancer is in the earliest of stages.His surgeon most likely wants to scrape 1 or 2 more times. He said he maybe got 70 percent of it the first time. I do not wish to my dad to go through more pain and complications. What can you recommend? Should he be monitored and if it gets into the wall later have his bladder removed? ### Response: The bladder spasm could be due to infection, coexisting enlarged prostate, or any intra-bladder chemo medicine given after surgery. Treating his disease is the first step. Urine cultures will help. Giving anticholinergics is next step to relax the bladder. The third will be to do a uroflow if not done and treat his prostate if there is any obstruction to flow. You may send any reports if you have them. Removing the bladder is a valuable exercise and is the last resort for superficial tumors. For deep tumors or recurrent tumors, there is no other option but the removal of bladder or radiotherapy. Better to preserve the bladder and treat tumor endoscopically if it is not deep or aggressive. For symptomatic relief, you may ask for Pyridium tablets (Phenazopyridine) or Amitryptylline as a temporary measure to reduce the burning." "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 getting red rashes on my skin when I apply some pressure or when I scratch my skin. They disappear after a few minutes. I consulted a dermatologist, and I am following these medicines. I am taking Allegra 120 mg and Rantac 150 mg. My doctor told me to continue the medication for a while. Do I need to take these medications for a few months? Can I have any side effect after using these medicines for a long duration? What is the reason for having hives? Are these harmful? What is the permanent remedy? ### Response: Hi. You have urticaria or hives. These medicines are safe, and they can be continued for a while if the problem persists. Hives can happen in response to a food allergen or food preservative, medications, infections, and alcohol. A large number of urticarias are idiopathic. There is no known cause for having it. Urticaria is mainly symptomatic, and it is treated with oral antihistamines." "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 12 weeks one day pregnant. I went in for my NT scan today and they said it has possible gastroschisis and I am honestly just so worried. I have a checkup in the next two weeks but I am just curious to know if it could be normal that the intestines still are not inside the fetus? Is it too early to diagnose? I am so stressed and worried. ### Response: Normally intestine is outside body of the fetus from 6 to 10 weeks of gestation is known as an intestinal hernia. Around 11 weeks it should be inside the body of the fetus. If you have been irregular periods there could be a discrepancy of dates between the scan and your menstrual periods then you need rescan to check things again. Gastroschisis and omphalocele two defects if a similar place of a fetal body with some difference. Better to have nuchal translucency check now as it should be done around 13 weeks via scan in fetus having a risk of congenital defects. So better to have serum beta hCG and serum PAPPA (pappalysin-1) checked. Have nuchal translucency and double marker test now and discuss here or local gynecologist and then repeat scan as per schedule after two weeks" "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 daughter is one month old. Her birth weight was 3.6 kg. After 15 days, she weighed 3.8 and then later she weighed 4.2 kg. Now, her current weight is 4.35 kg. She seems to pass drop by drop motion of about 15 to 20 times a day and she has some sharp pain followed by some intermittent pain while passing motions. We did a motion test today morning and I have attached the lab report. Is it something that has to be worried or is it normal? What can be done to cure her pain while passing the motion?We started giving syrup Ascazin 1 mL in the morning and in the night as per the recommendation of the doctor. Also, we reduced feed from 10 to 12 times a day to 7 to 8 times a day. Will this cure her pain or do we need to give any additional medications to her? Please advice. We are giving Ascazin syrup for the past one week. We are only breastfeeding from the beginning. There is no external milk. Please opine. ### Response: Hello. I have gone through the lab reports (attachment removed to protect patient identity). You need not worry. You need not reduce the amount of feeding nor you have to start any other medication. The report is also fine You just need to keep breastfeeding the baby. Avoid any external or formula milk. You can continue the same medication what you are giving. If the problem persists, just stop breast milk for a day and start a lactose-free supplement such as Zerolac or Nusobee. Consult your specialist doctor, discuss with him or her and with their consent take the above medicines. Breastfeeding can be started once motions are normal" "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 27 years old, female. 130 lbs. Have a history of smoking slightly less than one pack a day for 10 years. Quit a month ago. I am concerned about finger clubbing. I have noticed a new curvature in my nail over the last few months that was not present before. It is mostly in my index fingers and slightly in middle fingers. According to the Schamroth\s test, I have a very small window. I am really concerned. Could this be early signs? ### Response: This is mild clubbing and it is normal in young females. It is due to estrogen hormone in females. Please keep yourself miles apart from tobacco and alcohol. To be on the safe side, have a chest X-ray done and send me here to look for any pulmonary cause, as you have 10 years of smoking history. Usually, smokers develop clubbing when they have cyanosis, that is more concentration of deoxygenated blood in vessels but your fingers do not seem to be cyanosed. Cyanosis means the bluish appearance of nails, tongue and lips, etc. Your fingers and nails appear pink means no cyanosis. Again I emphasize to avoid smoking. Chest X-ray." "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 13-year-old sister has been diagnosed with various mental disorders since the age of 2. My parents have taken her to doctors since then because they have noticed that she was not developing like the other children. Almost every doctor gave another diagnostic such as autism (each doctor suggested a different type of autism) and mental retardation. When she was approximately 6 years old, she was also diagnosed with epilepsy.At first, the crisis was happening only while sleeping and they were detected during an EEG by a doctor. He prescribed the first anti-epileptic drug which was Ospolot. My sister felt very sick from it so another doctor told us to stop the medication. We did and then she started having a different type of crisis, absence crisis while awake. The doctor then prescribed Topram. Throughout the treatment with Topram, another type of crisis was added beside the absence, that is myoclonus. The doctor then prescribed Depakine instead of Topram.The absence crisis stopped, but the myoclonus stayed. Besides Depakine, she started taking Rivotril as well. With this combination, she stopped having a crisis for 3 months, but then the myoclonus started again and nocturnal epilepsy crisis was added as well. During this period, the doctor tried to replace Depakine with Lamictal (Lamotrigine), but my sister became intoxicated from it and started suffering from the Stevens-Johnson syndrome. She had to be at the hospital for one week to detox. My parents went to a different doctor then and he added Topram (Topamax / Topiramate) besides Rivotril and Depakine. This did not work again. My sister felt very sick from this combination while having a crisis both while being awake and asleep. She was then prescribed Depakine and Levetiracetam. The crisis while being awake stopped, but those while asleep still happen. At the moment, she takes Depakine, Levetiracetam, and Ospolot, but the nocturnal crisis persists.We do not know what to do anymore because the side effects of all these anti-epileptics have done a lot of damage. My sister is always very sleepy and drooling all the time. She already has mental issues so this just makes things so much worse.I know I wrote a lot, but I thought you should have as much information as you can. Here in our place, doctors are not that well informed about these diseases, so they do not really know how to deal with it. We also cannot afford to go to other countries anymore to check with other doctors. Any advice is very welcomed. ### Response: Hello doctor. I read your query and understand the feeling and problems faced by you. Despite her treatment, she continued to have seizures and in the medical language, she is known to have refractory epilepsy. I must acknowledge here that treatment of refractory epilepsy is one of the most difficult treatment in neurology and need considerable effort on part of doctors ad family members. Despite the effort we are not 100% successful in doing so. Regarding her treatment I will like to consider one of the two below mentioned strategies. Firstly, I need to know the dosage of current medications. If there is anything that can be changed I will prefer doing so as the current three medicines are rightly prescribed." "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 some lab work done and this was part of the blood test AFP, serum tumor marker 1.9, 0.0-8.3 (ng/mL). Can you please explain this to me? Five years back, I had a complete laryngectomy and a flap. So, I breathe through a stoma but my doctor did all the tests and found polyps and liver cyst and I was diagnosed with cirrhosis. ### Response: I have thoroughly reviewed your query. The laboratory investigation under discussion here is alpha-fetoprotein (AFP), which in your case might have been done to rule out a possible malignancy of liver (it is a common tumor marker used to screen hepatic or liver carcinoma). But at 1.9 ng/ml, your value was within normal limits. Apart from liver malignancy, AFP may also be elevated in various other tumors and also in certain common non-malignant conditions like active hepatitis (liver inflammation), cirrhosis and few other conditions" "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 8 months pregnant. My obstetrician did an ultrasound, and according to her, my unborn child\s heart size is at 64% when it should be less 50%. She advised me to have a 2D echo done, and I have not received the result yet. Is my child in danger? ### Response: Fetal echocardiography is not 100 percent reliable, so cardiac defects cannot be solely decided on imaging. Comprehensive patient history, other illnesses, medicines taken during pregnancy, and family history are important. If the fetus is normal with regular movements and growth, and no signs of fetal stress, then one should be satisfied about the fetus. Only a reliable diagnosis can be made after the birth of the baby. Echocardiography is repeated after birth if pre-birth echocardiography is abnormal." "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 do not have gingivitis or that sort of thing my gums are not bleeding, but they hurt and feel like I burnt them at times. My tounge tingles at times. My gums look a little inflamed, but they hurt, and some teeth hurt, but X-rays look fine. Also, behind my wisdom teeth, it burns but has not had dental work on them. I also have tingling lips and chin. What could it be? ### Response: However, some more details would confirm the diagnosis. It is often aggravated by pericoronitis, a soft tissue inflammation surrounding an erupting wisdom tooth. In BMS, it is better to avoid hot and spicy stuff and use gum astringent, and topical antibiotic with chlorhexidine. Also, look out for any ulcer that may be present. Use Betadine mouthwash and maintain good oral hygiene. See a dentist, and he will formulate a definite treatment plan for you. I hope it 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 hit my forehead against a wall and had a small cut on my forehead and now it has healed and it looks like a scar. Will I have a permanent scar? ### Response: Hi. First, you need to understand that scar treatment depends on its depth and lenght. Whether your scar is permanent or not, it is very important to evaluate it. Mostly scar lightens and becomes equal to the surrounding skin with passage of time. However, scars which are deep becomes permanent. Such scar will not go away with any creams or gels. Best treatment for permanent scar is reversal by plastic surgery or it could recover to some extent with C02 laser." "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 17 year old male. I have been suffering from pimples, acne, and scar since two years. I have many black spots on my face. Please help me. What can I do now? ### Response: Acne in this age is a result of overactivity of your oil glands due to hormonal changes. You could apply Clindamycin gel twice a day to acne. A face wash like D-acne would also help if used one to two times a day. You may also require oral medications depending on the severity of acne. Scars occur due to manual picking of acne and pus-filled acne that are not treated on time. These scars are not effectively treated with creams alone. You could undergo microneedling, chemical peels or lasers from your dermatologist. Timely control of acne can prevent permanent acne scars." "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 32 year old male. My buttock always stinks badly. Please help. ### Response: Hi. 1. Excessive sebum production due to massive hair in the area.2. Can be an issue of the external anal sphincter that causes leakage of fecal matter from anus and causes smell.3. Can be a hygiene issue. 1. Anal sphincter tonometry and anoscopy.2. For proper diagnostic evaluation you need a consultation from gastroenterologist surgeon who may also go for a proctoscopy if needed.3. Management options are best decided after diagnostic tests. 1. 2. While going restroom do not rely only on the paper towels. Rather use plenty of water to wash thoroughly every time in restroom.3. Apply some scented roll on the area for hygiene. Revert back after the investigations 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: I think my maxillary lateral incisors are not in perfect shape but my dentist thinks they are. I just need a second opinion. ### Response: Your maxillary lateral incisors are perfect in shape and place (attachment removed to protect patient identity). Only, maxillary left central incisor is a bit down from occlusion that only dentist or you can feel the difference. If your case is about to end, ask the dentist to remove the bracket from #1 left side upper and put it back just 0.5 mm above and then put the wire back for like 2 or 3 weeks. Then this tooth will be intruded and will be perfect in place. Otherwise, if he feels like he can do slight slicing of this incisor too so that both the incisors will be same in place. 19, 20 difference would not be much obvious. Give me followup after your next visit to the dentist." "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 not sure of mine or my parent\s blood types, but my sister\s is O-negative and is Rh-negative. Does this mean I am also Rh-negative? And is it possible that mine and my husband\s blood types, which could be incompatible, kept me from conceiving from 8 years? ### Response: Hi. There is a 50 % possibility that you could be an Rh-negative blood group. There is no blood group combination between couples that has known to cause problems in conception. If you are Rh-negative and your husband Rh-positive, then the problem of Rh incompatibility arises in the baby, that too in the second child. But it can be easily dealt with and identified at conception. Do not worry. Just get yours and your husband\s blood group checked and consult an obstetrician and 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: My mother is 59 years old. She has hemoglobin 5 and iron 7. Is it dangerous? ### Response: Hi. Low hemoglobin can be caused by various conditions including: Iron deficiency anemia. Blood transfusion. Revert back after the tests to a general 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: We are planning to have a baby. I have carried out a routine test for sperm analysis and want to confirm if the results are normal?1. Volume is 4 ml.2. Color is pearly.3. Viscosity is fluid.4. ph is 8.5.5. Sperm concentration is 62.6 * 1000000/ml.6. Total spermatozoa: 250.2 * 1000000. ### Response: I have gone through the reports. Your counts are fine with motility more than 30 % and immotile less than 10. Ideally, the counts more than 15 million are considered adequate as per WHO standard now, earlier it was 50 million. Also, there is no evidence of any infection as leucocytes are less than one. So broadly speaking, there is no male factor infertility, and you are fine to try to plan a child naturally." "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 going to marry next month. Actually, problem is, I have A +ve blood group and she has B -ve blood group. So, I want to know, will this blood group combination create a problem at a time of conceiving to the mother and the fetus in the future? ### Response: Hello. You are having a positive group and your wife is having a negative group. So, in the first pregnancy, it will not create any problem in the mother or child. But, sensitization to Rh antigen can occur and mother forms antibody against Rh D antigen. If she conceives for the second time, then the fetus can have severe hemolytic transfusion reaction by preformed Rh antibody." "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 dad had an angioplasty a month back and now he complains of SOB and numbness in his hands while walking. It occurs only while he goes for a walk otherwise he is completely normal. Please help. He is currently on Concor (beta-blocker), Ascard, Lipiget, and Brilanta. ### Response: One of the reasons for breathlessness can be a side effect of tablet Brilinta (Ticagrelor). It happens quite frequently in patients taking it (about 13 percent of the patients to be precise). So he should continue taking Brilinta. Another reason for breathlessness can be decreased ejection fraction, pumping of his heart, water getting accumulated in the chest and hence the breathlessness. And to make sure that this is not the cause I want you to answer my few questions. Is he having any swelling in the feet? Is he having difficulty breathing when he lies down? Does he have a cough? If the answers to any of these questions are yes and to prevent the water from accumulating in the lungs you can add a diuretic which will make him do more urine and get the water out of the lungs. But to confirm it as soon as the COVID situation settles down, you can get an appointment with your doctor for a echocardiography and get it done. For numbness, it can be usually a sign of a neuropathy either due to nutrient deficiency or any metabolic disease. I would prescribe you a few" "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 elevated optic disc with blurred edges only in the left eye, that was discovered on routine eye examination. I have developed headaches in the last few weeks. If this was papilledema would it be bilateral? ### Response: Papilloedema is always bilateral. It is due to increased pressure in the brain. If it is unilateral, it is called papillitis, that is due to underlying inflammation." "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 16 years old and not good. I have a smile issue. I think it started before 5 years if I am not wrong. I feel like I cannot put a smile for more than 3 to 4 seconds ,and sometimes I think it trembles. My smile is very uncomfortable and weird. This whole thing has caused me social anxiety. I want to do so many things that I cannot do. All these years, I thought that this is a psychological problem. But I started thinking that there is any facial issue or nerve damage. I thought to get in touch with a neurologist. Because, when I smile, I feel like my facial muscles cannot handle it and start twitching too. Also if I try to close a little bit my eye starts twitching, and same for my nose. I would be so glad if there is some physical problem and can be fixed. My life has been ruined all these years because of this. Please help me. ### Response: Hi. Smile is a complex process executed by a group of muscles and nerves. If you are having difficulty while smiling, then it could be because of psychological or organic cause. Psychological cause includes anxiety disorders, and organic cause includes nerve damage. I would advise you to visit a local neurologist for nerve conduction studies. There are lots of options to correct the smile. For psychogenic causes, you can meet a psychiatrist for counseling and medical treatment to deal your anxiety." "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 broke my nose in kindergarten, I am 26 right now and just now realized how my facial features are not symmetrical, how much does a broken nose affect that, as you can tell my right side of my face is more laid back and natural looking even my mustache above my lip, and my left side looks more tight and my mustache and lip does not match the right side. What causes this? ### Response: Definitely there is a whole lot of asymmetry as you suggested, because of the old broken nose. I can also see that the base of the nose is a bit too broad and gives a feeling of oddly joined fractured segments. This can be confirmed by few X-rays. Further correction if this is as well simple. We call it osteotomy and splitting. That will give you more symmetrical looking sleeker nasal dorsum. It\s better if you can get yourself examined by a board certified plastic surgeon." "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: Nothing seems to work for my acne. I have used Clindamycin and Surfaz but it did not work for long. How can you help? ### Response: I have gone through your case. You need to understand acne is an ongoing process and you may experience frequent exacerbation due to stress or hormones. Clindamycin is fine. In the picture (attachment removed to protect patient identity), you are having closed comedones and open comedones and hyperpigmentation. Apply any sunblock regulary in serum form like those available in body shop product. Do not use any creams or lotion as it can aggravate your acne. Apply Adapalene gel only at night in very little amount (about the size of a pea) for two hours. If you take excessive you may have burning." "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 this spot on the side of my tongue for some time now. I noticed it six months back. No change in that amount time, although I will post a picture from that time to show. I have been told that it is a frictional thing from adjacent teeth, but I want to get a second opinion to make sure that it is nothing more sinister. There are no symptoms in this spot. When I run my finger over it, I do not feel anything hard, different or even a hole. I want to know if I have a serious problem or if this is something I can safely let go. ### Response: Yes, it is not even traumatic ulcer. It is simply hyperkeratinized epithelium. That means it is normal tissue which is bearing some sort of stress. I think your upper tooth has a rough surface that may be the issue causing this or even it may be because of food if you are chewing only from that side. You need to take foods with much Vitamin A and B complex, fruits and carrot. Even you can take supplements like that of Vitamin A. No it is not something that can be the cause of concern. It is not a cancerous or ulcerous lesion. So, do not be too apprehensive. It is a normal tissue with little keratinization." "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 23 years old male. I have a short and curved penis. My penis full erection state is 12 to 13 cm, 4.7 to 5.1 inches, and the curvature is towards the left side. I went to a local sex clinic, and he suggested me an unbranded ayurvedic tablet. Is it safe to take tablets for penis enlargement and to cure penis curvature? Or Is there any other way to increase my penis length and to cure the bend? I used to masturbate before. But I stopped it now because of my small penis. I am losing my confidence level on everything. Please, suggest me a permanent solution for penis enlargement and curvature. ### Response: Hi. I have gone through the attachment (attachment removed to protect patient identity). First of all, there is no medicine to increase the size of the penis. It is not a muscle. Medications are available to treat erectile dysfunction and other problems. The size of the penis after erection should be between 4 to 6 inches, and the extent you have mentioned falls under the standard category. So there is no need to worry about the size. Your next concern is about curvature. The mild curvature is not a big problem. It can be present in many people. I cannot tell you exactly about it. So for that, you can visit a nearby urologist or a reputed ayurveda physician or any general physician so that he can examine you clinically and guide you appropriately. Do not take any random medicine in the name of ayurvedic medicine. You are almost normal except about one concern, so for that visit your physician. There is no need to lose confidence without any reason" "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 unprotected sex 15 days after my last menstrual period and took Unwanted 72 after seven hours. Till now did not experience any bleeding. What are the chances of pregnancy and when should I conduct a pregnancy test? ### Response: As you have taken Unwanted 72 within seven hours there are no chances of pregnancy. Wait till your period date or even later as they may get delayed for about two weeks and maximum. There is no need to do a urine pregnancy test in between if they get delayed by two weeks. Later you can do if no periods after that." "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 experiencing angina symptoms for past five months. I had an angiogram and that came back clear but I am still experiencing chest pain and back pain along with extremities pain coldness sweaty. I have ruled out gastro as well as a carpal tunnel with a neurologist. I have been in and out of the emergency so many times with chest pain it is brought on with exertion. They keep saying that I do not have ischemic heart disease yet my ECG show ischemia. When I am under stressful situations or having to exert myself I will get left upper chest pain and then to the back of the shoulder blades along with numbness in my hands and feet and sometimes pain in the left bicep. I have been dealing with this almost on a daily basis. I take beta blocker twice a day, Aspirin in the morning as well as Pantoloc for gastro. The angiogram came back clear so they say that is the gold standard and there is nothing to be concerned about. Then they prescribed me anxiety pills and sent me home. I am frustrated and scared over the past two weeks I have had so many near syncopal episodes upon exertion frustrated and needing help. ### Response: Hello. I have seen all your ECG reports (attachment removed to protect patient identity). These are all near normal. If your angiogram is normal then you need not worry. You would need to have an adequate control of your blood pressure. You would obviously need to rule out the problem in your shoulder or your nerves. Please do regular exercise and you can take short-term painkillers." "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 is too thin and weak. She had TB when she was young. Her blood group is O and Rh positive. Please advise something to help her gain weight. ### Response: I have gone through your case thoroughly and can well understand your genuine concerns. I want to assure you that you do not have to worry as everything is going to be fine soon. I hope she has no tuberculosis right now. Kindly get her checked for dormant TB too. Diet Suggestions for her:1. Taking plenty of water, fresh fruit juices made at home, salads and healthy diet. A healthy diet should include a good proportion of proteins like fish, eggs, meat, nuts, beans and wholegrain foods.2. Say no to alcohol and cigarettes.3. Avoid excessive tea, coffee, chocolates etc and other caffeinated" "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 10 years old. Since one year, he has been urinating in his pants in school and often arguing with adults and sometimes with other kids. He has once threatened me that he would commit suicide. He tells people he is a ""master manipulator"" and that there is nothing wrong with him. He has been seeing a counselor once a week for about a year, and she has twice diagnosed him with ADHD. He has no problems paying attention and is not hyperactive or fidgety. I do not feel this diagnosis is accurate. We have been trying to have an appointment with a psychologist for the past five months and have got one recently. In the meanwhile, we are hoping to find some answers. What could be going wrong on with him? ### Response: I understand your concern. From your description, there are two things which come to my mind apart from the ADHD (attention-deficit hyperactivity disorder). One is ODD (oppositional defiant disorder), and the other one is a conduct disorder. But, your description does not suffice the above diagnoses. For this, I need more data and a detailed description of his behaviors. Since how long has he has been exhibiting such behavior? Such behaviors need early treatment with medications and counseling. Psychotherapies can effectively control and prevent the child from doing something dangerous. So, I suggest you continue with your current treatment and consult a psychiatrist. All the best. Regards" "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 8-year-old daughter continues to have strong abdominal pains. Couple of months before, it was really bad and was also coupled with mono and fifths disease. At that time her levels were crazy high. AST = 1312, ALT = 1692. These levels freaked out the doctors so we went back the next week, still high but much lower AST = 394, ALT = 807, GGT = 84. We also did a sonogram at that point which was inconclusive. We went back two weeks later and not better AST = 532, ALT = 682, GGT = 71. Doctors have no answers and no idea about what was going on. The doctors seem to phone it in at that point.My daughter started feeling better so we did not push it for a couple of months and went back in and the levels seem close to normal AST = 57, ALT = 42, GGT = 12. We were given no comfort as to what caused it. My daughter does complain a couple of times a week about her stomach hurting, but she is not in the extreme pain she was in until this week. She is back to waking up in pain, spending most of the school day in the nurse\s office. So now we are heading back to the hospital for more blood as we did not get any answers from the first 37 vials of blood they have taken. Any clues what might be causing this? ### Response: I can understand your concerns. This appears to be a case of obstructive jaundice. The main cause of obstructive jaundice is gallstones. Since GGT (gamma-glutamyl transferase) levels are raised more than 70 in the first report it suggests an obstructive cause. AST (aspartate aminotransferase) and ALT (alanine aminotransferase) can increase in both hepatic and obstructive causes. In obstructive jaundice, the level of direct bilirubin increases more as compared to indirect bilirubin levels. Gallstones are easily visible on the ultrasound abdomen. It also causes severe acute abdominal pain." "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 had a vacuum abortion in the first trimester three days ago and just had sexual intercourse two days later. Currently, I am on my last day of antibiotics given by the hospital and will start on Microgynon tomorrow. I am afraid of getting pregnant again. Do I have to immediately go to the nearest clinic and get an emergency contraceptive? Am I allowed to take that after all that has happened? I am currently on Metronidazole and Paracetamol. Please help. ### Response: Hello. Since you just had an abortion, there is no chance of pregnancy as there is no ovulation happening during this period. So relax and do not worry. You need not take any medication, but be very careful next time" "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 dark underarms for a long time. I have tried everything possible when it comes to home remedies nothing has worked. I have used Retin-A cream in the past, skin peels, but it becomes red. I have very sweaty underarms. Suggest any treatment and aftercare. No hormonal issues. ### Response: Hello. I have reviewed clinical photographs attached it is acanthosis nigricans. Stop application of Retin- A cream it can lead to irritation in the intertriginous area. You may consider the application of Grazia up cream one daily but only in the armpit and not in the groin area. Consider weight reduction. It takes time for this pigmentation to subside." "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 left foot is swollen with purple color and pain. I am currently on Diamicron 60 mg and Xelevia 100 mg. ### Response: With history, I feel you have left foot cellulitis. It is the infection on the foot. You might need heavy antibiotics for the infection. Is warmth present on the wound? Any pus discharge from the area? Kindly update these details and also the picture of the purple color. And also I would like to know what is your sugars levels in present condition?" "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 an inguinal mesh removal and triple neurectomy 20 days later. What type of pain and side effects should I expect from the neurectomy? ### Response: Hello. I understand your concern and would explain that this type of neurectomy is usually used to treat chronic resistant pain in the groin area (inguinal region) due to inguinal herniation. So, it is supposed that your situation will improve, and you will experience only local pain due to the surgery and soft tissues inflammation. This type of pain will usually disappear in a couple of weeks, after healing. Acetaminophen and Ibuprofen can help improve pain. If neurectomy is not successful, persistent pain like heaviness or dull pain may persist. In such a case, Gabapentin or Pregabalin would help against the pain." "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 unprotected oral sex and protected hardcore sex with a commercial sex worker whose medical status was unknown. After four weeks of exposure, I had breathing and stomach bloating problem. I am allergic to cold and the climate in our area considerably dropped. I consulted a doctor and got a blood test for asthma but results were normal.In the fifth week, I got conjunctivitis, cough, and weakness at a time. The doctor gave treatment for conjunctivitis and syrup for a cough but still, I felt weak. Could you please brief on the above symptoms and I would like to undergo complete HIV test on the 90th day with results on the same day and doctor consultation for this. I am in a panic since that encounter of unprotected oral sex. ### Response: The chances of transmission of HIV (human immunodeficiency virus) by unprotected oral sex is almost nil unless there are bleeding wounds in both. This is unlikely. The chances of transmission of HIV by protected intercourse is almost nil. The risk is almost nil. You can go for HIV fourth generation tests and HIV 1 and 2 and PCR (polymerase chain reaction) now to be relieved of your anxiety. You can consult any major hospitals for investigation and management. The symptoms are nonspecific. It can be due to any simple respiratory infection or allergic manifestations. It is unlikely due to HIV" "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: Just as of today my nipples have got swollen and my boobs are tender to touch. It started less than an hour ago. I had headache all day. As far as I am aware, I am not sure what is going on? I never had this issue before. Please help. ### Response: A swollen nipple as well as tender breasts can occur if you are just before your cycle. If so, it is quite normal. It is due to the temporary hormonal fluctuation inside you. Otherwise, taking hormonal contraceptive pills could be a reason. Hard sex with rough handling of your breasts is another issue. Just apply some hot compress over your breasts and put them in tight undergarments all the time. If the pain is more, you can avail Paracetamol 500 mg tablets as and when necessary basis." "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-in-law is a 55 years old diabetic patient. She is suffering from a problem that whenever she eats anything she has feelings to use the washroom. Please help. ### Response: I will be able to help you better if you can upload the list of medications she is on. And since how many days is she having this problem? What is the stool consistency, watery, or semisolid, or solid? Does she have any abdominal pain? Has she lost weight? Awaiting your reply, depending on that I will be able to help you better with appropriate treatment. ? IBS (irritable bowel syn" "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: The CT thorax report for chronic cough in comparison made to chest radiograph. 5 mm nodule seen within the left upper lobe. No other discrete pulmonary nodule or mass is identified. 1.3 cm short axis pretracheal lymph node is identified. Calcifications noted within a normal-sized subcarinal lymph node. No enlarged axillary or hilar lymph nodes are identified. Mediastinum and great vessels are otherwise unremarkable. Osseous structures are unremarkable.Can you please help me to understand the report. ### Response: Hello. I understand from your description that you have a chronic cough and did a CT Thorax, but I am confused as there are no CT images attached. Still, I will try to help you with this report. It says, 5 mm nodule seen within the left upper lobe and 1.3 cm short axis pretracheal lymph node with calcified normal-sized subcarinal lymph node. Rest of the lung parenchyma is normal. I suppose it could be due to an old infection, may be tuberculosis (primary) which went unnoticed and it has nothing to do with the present situation. So you should not worry about this CT findings and try to find out any other cause of chronic cough. You have not elaborated your history in detail to guess any other cause. I advise doing a spirometry test to rule out asthma. It is the most common cause of chronic cough with normal x-ray or CT chest." "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 about RNA HIV early detection test. I took this test 16 days after exposure, my results were negative. Is that conclusive? ### Response: No, it is not conclusive. Go for fourth generation testing at four weeks interval" "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 this problem for years where a bad smell comes from my nose when I breathe. I am desperate for any type of help. It started after I got sick in high school. My tonsils were infected and enlarged. The infection came back a few more times until I was unable to get sick again. I have not gotten sick in a couple years, but I still get infections sometimes. ### Response: Hi. Do you smell the bad odor? Or the others only smell this odor? Please capture a photo of your throat using your mobile phone camera and send it to me. If you do not smell the bad odor, you may have atrophic rhinitis. If you can smell the bad odor, the problem can be in your throat or mouth. So I need a picture of your throat. Tell me about any other symptoms you have and your medical history as any chronic diseases. Chronic sinusitis can cause the bad smell too. Chronic sinusitis is characterized by a persistent headache, head heaviness, and persistent postnasal discharge." "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 10-year-old daughter\s back left tooth completely broke off on her gum, and it was hollow. I believe it is an adult tooth. How would a tooth be hollow? ### Response: If it is the second last tooth of the last side, then it is the last milk tooth that got broken, as it falls off in between age 9 to 11 years. If it is the last tooth of arch that got broken it is the permanent molar tooth. It is the only permanent molar in arch till 12 years of age. If it is molar, it is some serious issue. Get root canal treatment or filling done because this is the primary molar that will aid in chewing for your daughter\s entire life. If it is deciduous or milk tooth then you need not to worry. A permanent tooth from beneath might have given pressure for the eruption, and so milk tooth will be wearing off after becoming hollow. A hollow tooth is caused by cavities or a broken part of tooth. I can tell you a better exact diagnosis if you can provide me with clinical picture of your daughter\s teeth. If it is painful right now, you can give simple Brufen syrup (Ibuprofen) 8 hourly for three days. Stay happy and blessed." "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 TMJ disorder and I was wondering if there was anything I could do about the left side TMJ getting inflamed besides just letting it be and relax, as it is pushing on the inside of my ear. I can feel/hear it making a crackling wet noise when I push my jaw forward, or a painful pushing feeling inside my ear when I clench my teeth. It started yesterday and is better now that I\ve slept and it\s relaxed, but it\s still bothering me and the crackling/pushing is still there. ### Response: Hi! For a TMJ dysfunction you can consider the following advice Spasm in the muscles around the joint can be the reason for this probable dysfunction. It will take around 4 weeks for the muscle to get back to normal but chiefly depends on how much precautionary measures (mentioned above) you have followed. I hope I have answered your query. If there is anything that I can help, please do le me know. Get well soon! Warm regards!" "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 fiance was fingering me and when he finished, his hand was bloody. When I pee it burns and now it just hurts. What should I do? Never had a PAP test for discussable reasons. Never had sexual activity before. ### Response: There is nothing to worry as having sex for the first time (even fingering) may lead to mild bleeding due to breakage of the hymen and vaginal tissue. It may lead to burning sensation and slight discomfort which usually resolve in a few hours or may take a day or so. And you are only 18 years old. You are not in an appropriate age for PAP smear. PAP smear is usually recommended at or after 25 years of age." "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 receptive oral sex (received fellation) with an escort girl three weeks ago. Since then, I have got urethritis three days after. I have been treated with Levofloxacin for 10 days. The urethritis got cured, but I kept getting some strange burning sensations in my scrotum and the top of my buttock, but no lesions or bumps were visible. Only redness.The symptoms then disappeared then for four days, I got ticklings on my back, arms, chests, but again nothing visible on my skin. Since two days I have got paresthesia on my left foot, left arm and left hand that does not seems to stop (sometimes I feel it more or less) and sometimes some cramps in my leg or arm. I got a 4th generation HIV test at three weeks, which was negative. Do you think I have a chance to have HIV? Do I need to retest at four weeks or six weeks? If you do not think I have a chance of getting HIV, what options should I look for? ### Response: Oral sex is least related to HIV. Symptoms are very bizarre and mostly by oral sex HSV, and STI is common. The tickling sensation is different as such, may be seen in vitamin B 12 deficiency, and anxiety. Symptoms come but goes in a particular time. You can still go for the HSV test. And STD panel test. No signs you had related to both. Till then you can take, Tablet Mecobalamin (Methylcobalamin) 1500 mg one at night for one month. If you feel better, you can continue for another a month if at all required. Tablet Escitalopram 10 mg (esitelop10) one at night for ten to fifteen days if at all needed. It is not at all HIV. I hope you have understood." "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 was told that his growth plates are mostly closed. I would like someone else to view his X-ray. He is pretty much done growing standing five feet tall and four inches and 1/4. I find it so hard to believe and he is devastated. I want to to know if there is a possibility for two more inches of growth? ### Response: Hello. I just read your query and your report attached (attachment removed to protect patient identity), nowhere it has been mentioned that his growth plates are fused indicating a possibility of further growth normally. Secondly, he is not short-statured according to this report. In fact, it states that his bone age is normal. I would advise you to allow him to grow normally till the age of 18 to 19 years by actively participating in sports activities." "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 ulcer on top of the tooth on the gums (a white raised ulcer). Please help. ### Response: Hi. This is not an ulcer, infact it is big pus boil that has occurred due to some infection in your underlying tooth. You should start with an antibiotic regime immediately and get it treated. Most probably root canal treatment and scaling will be done of teeth under question. If it is not paining that does not mean it will remain silent for long. It can trigger up anytime. You must see the dentist as soon as possible. If you get a late appointment then I can prescribe medicine for you. Give me followup after a day for 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: I had diarrhea two years back, and since then I had gastrointestinal problems. But, I never had mucous or blood in the stools, so I thought it is because of IBS and did not take any medication. My stool test reports showed no signs of parasites or any other organisms in the stools. Later, I had alternate constipation and diarrhea, and sometimes the stools come hard and later soft. I have been straining to defecate, and I saw bright red blood along with the stool yesterday. I had a little bleeding before also, but yesterday I lost almost 30 ml of blood. I do not have any pain, fever, or any other associated symptoms. ### Response: I think you have the following issues" "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 primary care physician and his PA overlooked at least 10 years of consistently low hemoglobin and hematocrit levels. When recently had flu-like symptoms without any upper respiratory symptoms, I went to a new PCP who ordered the blood test. That PCP noted the low hemoglobin and hematocrit and had me repeat the tests six weeks later. Still small, she referred me to a gastroenterologist to check for bleeding. He had access to all of my blood tests for the last 12 years and was the one who pointed out that the levels had been low.He concluded that there was no blood loss. The PCP then referred me to a hematologist. I am waiting to be seen by him. Of note, I have been consistently exhausted with low energy and motivation. I also have a multiple-decade history of recurrent aphthous stomatitis that is worsening. My blood results also showed a Vitamin B-12 level in excess of 1000 and a healthy iron level. I am wondering what could be going on. Any thoughts or recommendations you may have would be much appreciated. ### Response: If hemoglobin level and hematocrit low than iron deficiency anemia could be possible, I need to know how much is your hemoglobin value. So kindly attach your CBC (complete blood count) report to give a further comment regarding that. The B12 can be high due to supplement intake, liver disease or kidney disease or myeloproliferative blood disorder. So apart from CBC, you can investigate with liver and kidney profile reports as well to exclude liver and kidney disease. If all comes clear than no need to worry because B12 is water-soluble vitamin readily excreted through kidney. Kindly attach your reports. I hope I have answered your question. Let me know if I can assist 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: I am having a bloating for the past three days, I never had one. I had my period around this month beginning. Is there any possibility that I am pregnant? Is it any sign of pregnancy? I am having Sibelium 10 mg for migraine. ### Response: Bloating sensation can be related to any sort of diet changes. Check if you incorporated anything new in your food habits. Any increased coffee or tea intake, sometimes physical or emotional stress can lead to acidity and bloating. Rule out all such things. Morning sickness is commonly associated with pregnancy, but it is too early to say about pregnancy. If you had an episode of unprotected intercourse, you can perform pregnancy test two weeks following that specific date. For now, you can take tablet Pan D (Pantoprazole with Domperidone) twice a day before meals for three days to relieve the bloating sensation." "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 29 years old. I had my tubes tied nearly four years ago but have been displaying symptoms of pregnancy for two months including weight gain in my stomach, nausea, sore breasts fluttering abnormal feelings in my stomach. It is believed I had a miscarriage nearly four months ago due to the sudden onset of my period and the extreme pain that was contributed to it.My cycles usually came to between one and two set days and last for four to five days with a heavier flow. Recently they have been sporadic in their comings lasting anywhere from two to seven days with a lighter flow and a change in color with no clotting as used to be normal. I went to my gynecologist after the first incident and as per him, my cervix was soft and sensitive causing me discomfort when applying pressure.My stomach now is still the same with a harder to touch feel with pain in my lower right hip side that radiates up towards the bottom of my ribs lasting seconds to minutes and recurring frequently. I have taken an OTC test that has came back negative and my blood pressure has been very low ranging around 83/67 mmHg. Can you please help me to figure out what is going on? ### Response: Hello. With the description you have given, I understand that with the tubal ligation done four years ago and the urine pregnancy test negative and you are having your menses each month (bleeding lasting between 2-7 days), with heaviness and pain over the right iliac region and off and on extending towards the ribs indicate an ovarian cause. It could be possibly a developing ovarian cyst which is duly enlarging in size. Oligo and hypomenorrhea are a feature in such cases. This is definitely not pregnancy. Ovarian cysts are known to produce estrogenic symptoms like sore tender breasts, nausea and bloating sensation as well. The softness of the cervix could be attributed to the same. My advice would be to undergo a pelvic ultrasound at the earliest to rule out right-sided ovarian cyst formation or probably an endometrioma accompanied. The size would further decide the course of treatment. you may contact me for further opinion." "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 32 years old female. I went to the hospital ER for hip or abdominal pain. They ordered a CT scan. During the scan, they used lead aprons on my breast, neck, and abdomen. Does the scan go through these aprons? They found nothing but a nodule on my lung. I am just wondering if it saw my abdomen since the apron was over it. I have a bulge in my left abdomen. ### Response: Hi. The lead guards used during scan prevent harmful radiation effects to your thyroid, ovaries, and breast and hence are used as protection. These aprons do not obliterate the radiations and all the organs covered are visualized minus the harmful effect of X-rays. For the bulge, it can be a small hernia or a lipoma. So you can go back and discuss the area of concern to your radiologist consultant and they would be glad to help I guess. Or else if possible, upload the scan here and I will have a look at your scans for 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: Hi,I used musli capsules for about 45 days. Even now I do not have erection for longer duration. Please suggest some measures in siddha medicine to overcome this. ### Response: I can understand your problem. 50% of this problem is related to psychology and the method of practice. Please follow the following medical advice: Consult a siddha medicine specialist online for further queries" "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 31-year-old male. I have discomfort, pain in my left side of the stomach below the rib cage for the last one year. It is there for 24 hours. Sometimes increases after eating rich food although I am not a heavy drinker, sometimes pain increases after five pegs. I did the following tests, USG: normal of all organs, endoscopy: normal of all parts, Colonoscopy test was normal. Stool test- Mucus +, starch +, vegetable +, pus 1-25. CT scan upper abdomen- Liver enlarged 165 mm and tiny cyst 3.7 mm. Conclusion: hepatomegaly with a small hepatic cyst. SGPT/SGOT normal. Amylase is normal. These are the test and reading. I have not been given any medicine. My question is what is the problem? Sometimes, I get burning sensation below the abdomen in the right side too. Please advise. ### Response: Hi. We are here to help you. I would highly recommend you to stop alcohol, as it will otherwise harm you. I would advise following in such scenario. To take a proton pump inhibitor like Pantoprazole and Rabeprazole. To avoid fat, pepper in the diet. To take smooth muscle relaxant like Mebeverine for stomach pain." "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 this black stain on my daughter\s teeth recently. what could be the cause? she has got her lower two teeth in 8 months and upper at 10 months. I started brushing her teeth a week ago. ### Response: I have gone through your attachment (attachment removed to protect patient identity). After watching the photograph, there seems to be extrinsic stains. These may be because of improper brushing, food stains, etc. Proper cleaning of teeth and cleaning of teeth after taking food will remove them if they are extrinsic food stains. If not getting removed kindly visit a nearby dentist. There may be another reason also for black stains or stains. What kind of toothpaste do you use, fluoridated or non-fluoridated? For any catch regarding caries, it should be checked clinically." "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 brother had five to six episodes of hallucinations, and he takes Risperidone 2 mg for one year. Is it safe to take this medicine for such a long time? Can psychosis come back after stopping the medication? What are the side effects? ### Response: Hi. Antipsychotics are usually required for long-term. After completing the" "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 having issues of on and off periods for nearly four years now. When I started my periods, they were completely normal, neither heavy nor light and nothing unusual. But, I started missing my cycle for about six months and then I would come back completely normal. My last episode of missing my periods had lasted for nearly 10 months and I have had no unusual symptoms, discharge or pain. I have been to my doctors twice and I have had an ultrasound, which came back completely normal, many blood tests and hormone tests, which also did not pick up anything unusual. I just want to get to the bottom of this problem. Is there anything else you think I could do? What do you reckon about this? I am not stressed, obese or underweight. I do not smoke or drink. I am a healthy 18 year old. Any of your advice would be very grateful. ### Response: It is a hormonal imbalance characterized by menstrual abnormalities. To diagnose and classify the type of PCOS, following hormonal tests should be done on day 2 of periods. The timing is very important. Once you had all these tests done on day 2 of periods, I request you to upload the reports as it is the ratio of hormonal levels rather than their absolute values that are deranged in PCOS. Since you say certain hormonal tests were done and came out normal, I presume that your thyroid and prolactin levels were normal. Get them done too if the report is more than three months old. Please do tell me if you have already missed a period by a month in this cycle, so that I can suggest medication to induce periods. Please give the exact date of periods in that case. If you have not missed your periods yet, then wait for your periods and get the test repeated on day 2." "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: 1. I took ECP during withdrawal bleeding (as I stopped contraceptives). Will it work?2. Will this affect my menstrual cycle as I have not got my periods in my due date. I am freaking out.3. When should I go for pregnancy test to clear my doubt? ### Response: 1. But as you took the pill already, if at all there is any possibility of pregnancy, it can help. 2. Because of high dose of hormone in it, it can affect your periods. Sometimes after taking emergency contraceptive pill, you may see 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 had a root canal done some years ago. Now, the tooth has broken off. I can still feel some screw in the gum. I am now getting some constant puffiness and bleeding. ### Response: Hi. I have read your complaint. Firstly I would like to say that you do not have any screws unless you have done an implant. It is the broken tooth root which you might feel sharp. That is again the reason for bleeding as it irritates the gums around. The root canal treated tooth when not protected with a cap or crown always break eventually and that is what has happened in your case. Now the treatment would be to pull out the remaining tooth remnants. Meanwhile, some painkillers like Panadol (Paracetamol) would help you. I reckon you to visit a dentist and get it treated as soon as possible. Kind regards." "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 swelling, pus, and swollen throats. It is hurting while opening and closing the jaw and hurts more during eating, and this is all around my wisdom tooth, and it is causing a lot of pain. Please help. ### Response: I can understand your concern regarding dental health. The swelling and pain around the wisdom tooth are called pericoronitis, which is very common during the eruption of wisdom tooth and easily treatable by removal of the same tooth as there is no need for it during chewing function. So consult your nearby oral surgeon for clinical examination of the affected area and further treatment as early as possible. Till then, you can take Ibuprofen for temporary relief in pain. I hope this information will be helpful to resolve your query, and further questions are always welcome. I will like to answer them. IOPA of affected wisdom tooth." "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 depression, social anxiety, anger issues, insomnia and from last month I do not feel very hungry. I always forget to eat and I do not even feel like eating. I do not know if this is important or not, but my hands and legs shake like crazy sometimes and it is happening for the last six years. ### Response: Hello. I completely understand that you are concerned about your symptoms of social anxiety, panic, and depression. All of the signs you mentioned are clearly indicative of a psychological disturbance which is affecting your current life functioning. Generally, there are past negative experiences related to social and academic functioning which create fear of humiliation if the person undergoes panic attack in social situations. Therefore, individuals with agoraphobia avoid social situations and might experience panic attacks. Cognitive behavior therapy is found to be the best treatment for agoraphobia and panic attacks. Do start your treatment at the earliest as those who complete treatment at early stages of their disorder are likely to recover faster." "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 little over two years ago, I experienced some stress in my life that resulted in a high level of anxiety and depression. I was prescribed Paxil and took it for one year. At the time, I was also taking Diovan and Atenolol for hypertension, Pantoprazole for reflux, and Simvastatin for high cholesterol. One positive side effect of the stress was that I lost 25 lbs and went from 195 lbs to 170 lbs. I also started to eat more healthy foods and started to exercise regularly. One effect of my anxiety and depression is that I would awaken frequently during the night and morning between 3 AM and 5 AM and feel very agitated and get panic with upsetting thoughts. Over the past year or so, I have managed to improve my condition with counseling, meditation, etc. I am also no longer taking any medicine since my health dramatically improved. I am at the point where I am doing well, but still awaken very early about 4 or 5 AM, no matter when I go to bed I feel very anxious and my heart starts to pound. I used to have bad thoughts, but I have managed those and now just feel the physical feelings. The thoughts diminish gradually throughout the day and seem to end at about 5 PM. I am wondering whether I have a cortisol or adrenaline problem. What are your thoughts regarding the same? Please guide. ### Response: 1. Have a thyroid function test done first for given weight loss and heart pounding.2. You should also consider seeing a primary care physician PCP and have an electrocardiogram EKG done. Revert back with the details asked and to an endocrinologist 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: Give me a suggestion to free from smoking. I am very upset about smoking. ### Response: It is very difficult to quit smoking in a heavy smoker. Gradually you should decease the quantity of daily smoking. Suppose, if you are taking 10 to 15 cigarettes per day, then decrease it to 3 to 4 per day and then gradually 1 to 2 per day and finally stop it. You can" "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: There is dull knee pain while standing and walking for one month. What can be the cause of this? ### Response: Knee pain is a common complaint that affects people of all ages. Knee pain may be the result of an injury or some other medical conditions including arthritis, patellar tendinitis, ACL (anterior cruciate ligament) injury, knee bursitis, torn meniscus, gout, and infection" "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 cesarean delivery just two months back. From when can I resume my sex life with my husband? Could you please advice on that? ### Response: We usually advise our patients to be active immediately. You can have sex from six weeks onwards, but avoid a pregnancy till 2 years. After the cesarean delivery, your superficial wounds and deep wounds heal fast. But, the healing of uterine wound will take some time. You are now breast feeding. The last two are the best as they increase milk production and no periods. When you are breast feeding, the periods may not occur at all or irregular. So, do not use these dates to calculate safe periods to have sex. The time of 2 years is needed to replace your lost iron, proteins, and energy. All the best." "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: Dear doctor,This is about a tumor in the kidney case as follows.On the night of 14th, the patient found blood stain in the urine. No pain, no other symptoms.On 15th morning, after drinking two glasses of water, he developed pain in lower abdomen and back. Got an ultrasound done. Ultrasound showed a tumor in the left kidney (report attached).On 16th, we got a CT scan done and it showed a big mass arising from the lower pole of the left kidney of size 8.8(AP)*6.9(TR)*7.4(SI) cm and doctor suggested surgery which involves removal of the kidney to save from spreading.Let me know if kidney can be saved and disease eradicated and controlled from spreading further. ### Response: Hello. It looks a large tumor in the left kidney. The reports (attachment removed to protect patient identity) show that the disease is localized and not spread to other parts. The only curative treatment for this tumor is surgery (removal of affected kidney along with the whole tumor). It is difficult to save the kidney because of the large tumor size, but the surgeon will review the CT scan films with the radiologist to decide finally regarding any chance of saving the kidney. After surgery (removal of the tumor), the pathological report will be available which will show the type of tumor and pathological stage. That will guide us whether further treatment is needed or not. You have not attached kidney RFT/LFT, serum chemistry, LDH, alkaline phosphate blood test reports. So that I can tell you whether further tests are needed or not like isotope bone scan, etc. After surgery usually prognosis is good depending on the pathological report." "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 an ectopic pregnancy. It was my first pregnancy. I am scared to get pregnant again. What kind of birth controls should I use? Can I get a normal pregnancy again? ### Response: Hello. Ectopic pregnancy is a common condition in females of reproductive age group and there is no need to get anxious for getting pregnant as most of the women with previous one ectopic pregnancy contemplates successful pregnancies in the future. You can use any type of contraception which is suitable for your health but you must avoid intrauterine devices (coils) to avoid the risk associated with these as these coils slightly increase the risk of ectopic pregnancy." "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 24 years old and have been wearing glasses for myopia for six years. I have spectacle powers -9D and -11D in left and right eyes respectively with some small degrees of astigmatism. I had been consulting doctors for LASIK and ICL. I was found ineligible for LASIK but each doctor has a different opinion on ICL. Some say I am fit while some say I am not. I am really fed up. Please help. ### Response: ICl is a surgical procedure to implant an artificial lens on the natural lens. During the workup of taking up a case for ICL surgery, many parameters are considered as it has a high risk of secondary cataract formation later on. Some of them are endothelial cell count, anterior chamber depth, the angle of the anterior chamber, corneal topography, etc. Only if criteria are met, they proceed for surgery. I may be able to help you more if you can send me the reports of your eye exam." "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 2 year old daughter. She is breaking out with red dots all over her body. They do not look like measles or chicken pox. She weighs 30 pounds and has no other symptoms. I have tried giving her a child allergy medication because I thought she might have developed an allergy to dog hair. Please help. ### Response: I need more information for a quality answer. It could be ITP (Idiopathic Thrombocytopenic Purpura)/other hematological disorders/allergy/infection/HSP (Henoch-Schonlein Purpura) and many other disorders can present like this. We need to investigate these.Advice: Try to revert back with answers for the above-mentioned queries to 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 having a very good day working. But as the evening came by, I gradually felt an irritation in my left eye. I thought I am going to have an eyesore. But the next day, I was shocked after seeing a thin whitish film on my left eye. This stuff did not even make a little appearance the previous days. The sensation is very comparable to an eyesore though my eye does not produce any discharge. Any opinion? My sister had been diagnosed with pterygium and undergone surgery. I wonder if it is the same issue. ### Response: The photo attached (attachment removed to protect patient identity) is not very clear and has a lot of shadows, but I can tell you that the white thing is an inflammation of your cornea, most probably an ulcer. It needs a visit to your ophthalmologist as soon as possible and can be diagnosed only by a slit lamp. Measures you can take to lessen the irrigation: Hope you get well soon" "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 20 and about every two months I throw out my upper back and neck causing pain in my upper back, shoulders, neck, and down my arms. I am a waitress and I am assuming that is what is causing my issues but is there something more I should be doing? Chiropractic work seems to help but I feel like at such a young age I should not be having this happen so often. ### Response: Hello. Your description is suggestive of a trigger spot in the upper back and neck. Most likely this is postural and result of your professional requirements. You need to see a good physiotherapist who could help rectify your postural issues. You are already on Fluoxetine and need good NSAID tablets, hot packs or ice and deep myofascial release." "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 25. Since three days, I have been experiencing sensations like twitches/ jerks/ tremors specifically in my chin area. I noticed that when I talk, eat or when something falls down from my hand suddenly, I get a tremor in my chin. They last for a second only. I went to a doctor (not a neurologist but an internal medicine specialist) and as per him, I have a B-complex deficiency and he gave me 30 tablets of B-complex. He feels that the tremor while talking or eating that I face is coincidental. However, he did tell me that if I was very anxious we could get an MRI done. Apart from this, I also get mild muscle twitches in the eye, face, and legs. And sometimes, I feel a shortness of breath and when I get very scared there is tightness in my throat. I actually read a lot about this on the net and to be very honest, I have become very scared after reading about brain tumor, multiple sclerosis, etc. I wanted a second opinion. My doctor said I am otherwise very healthy so I should just take the vitamins and focus on my work and other activities. But I cannot stop thinking about brain tumor and other neurological disorders. Should I get an MRI? Or is this something that is not serious? Please help. ### Response: Hello. I understand your concerns. You should not worry, it is benign and you do not have to perform MRI or any other investigations. Do you feel anxious most of the time? Do you have a stressful life? Do you eat and sleep well? I suggest: Wish you all well being" "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 my wisdom teeth out yesterday and they have been bleeding for over 24 hours. Is this normal? ### Response: Hi. Yes, it is normal. You just keep a cold cotton pack for the next two hours at the socket. This will make the clot. Then start with saline water mouthrinses five times a day for the next whole week. Take a 1/4th teaspoon of salt in a cup of lukewarm water and do its rinses. It will heal up your socket fast. Stay happy and blessed." "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 abdominal pain for the past few years. My stomach is not clean, and I use my restroom four to six times daily. I feel nervous and have consulted many doctors and took many drugs. But my problem remains the same. ### Response: Hello. 3) Intestinal infection occurs after the ingestion of unhygienic, uncooked food. Diarrhea improves with treatment as infection resolve." "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 using a plug-in mosquito repellants for my baby for long, and she often gets cough and cold. Is it because of that? What shall I do? ### Response: Mosquito repellent liquids can cause allergic cold, and cough in some kids. I cannot say definitely if that is the cause of cold and cough in your kid. But in this season, many kids are suffering from viral respiratory tract infections. So the cause may be a viral infection or allergic cold due to other reasons like cold weather, dust, rain, etc. If you have been using the repellent for a long time and she has not suffered from frequent cold, cough then that may not be the cause. Better take her to the doctor so that cause can be identified. If you have any follow up queries please be clear about the age and weight of your child which are not tallying." "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 cracked tooth which I believe needs a root canal and a crown that I think went bad. I am in excruciating pain. I have been to emergency rooms they have given me Clindamycin and Vicodin for pain but it barely touches the pain. I have been on antibiotics for two days. I thought I would see some improvement but the swelling and pain are getting worse. I have had a staphylococcus infection before is it possible that this could be one? The infection was on the right side of my face. I have been waiting for two months to get into my dentist. ### Response: I read your complaint and relevant details. You have mentioned you got a swelling. I just want to make sure if the swelling is confined close to the tooth or is it spreading? The severe pain along with fever and swelling confirms that the infection has gone bad. Clindamycin is the only antibiotic that you are taking. I recommend you to take Metronidazole 400 mg orally twice daily along with Clindamycin for five days. This will fight against another group of bacteria and reduce the swelling to an extent. Also, continue with your pain killers as well. Tramadol works well for moderate to severe pain. But in your case, it does not sound so. You will feel better in 15 minutes. Otherwise, complete relief will be got only after the necessary dental treatment. Antibiotics are just add ons. Do not totally rely upon them." "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 one somewhat large scar on the right side of his neck and a small scar on the left side of his neck from a burn injury since 10 months ago. He has received three laser treatments, and it looks much, much better. My son is almost 2 years old. Our plastic surgeon would do a scar excision if we wanted him too (or more laser treatments) but is leaving it up to us. I have read that other plastic surgeons say to wait until the teens so that the natural growth factors produced by a child do not result in a more hypertrophic scar after scar excision. Are children really more susceptible to the formation of hypertrophic scars after scar excision? I am trying to determine if scar excision is really the best option for him. ### Response: Your son has a post-burn hypertrophic scar over the submandibular region. Post-burn hypertrophic scar. It is better not to do any surgery now for the scar as if the surgery is done, there will be a risk of hypertrophic scar again. This scar will improve over the period. Scar revision can be done later if wanted when the patient is a little grown-up. To improve scar, the following can be done.Scar massage, silicone gel to be applied twice a day, pressure garment if possible to reduce the chance of hypertrophic scarring." "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: 4 years old had an MRI for hearing loss. The report impression: Left mastoid and middle ear effusion. But my question is they listed left frontal region arachnoid cyst with adjacent mass effect. They are getting another MRI ordered and an appointment with a neurologist. I have looked at the symptoms, she has none, except dizziness when going in circles, she does not like it. Unknown from fluid in ear or cyst. Can you please give me some information of what this is? I cannot sleep. ### Response: Hello. I read carefully your question and would explain that the dizziness is not related to the arachnoid cyst. You should know that arachnoid cysts are usually asymptomatic and they are present since birth. Anyway, sometimes if they grow, they may lead to seizures or motor or sensory deficits. For this reason, it is important consulting with a neurosurgeon. Follow up with brain MRI every year may be 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 have a fever. When I checked it, it was 100 F. Please help. I am attaching the prescription of the medicines that I take regularly. ### Response: I just read your query about your fever and saw your medications for your other conditions (attachment removed to protect patient identity). Hope you find my advice of some benefit. Good luck. Revert with more information to a family 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: My 1 month old baby girl is sleeping for seven hours and five hours long stretch at night from last two days. And today, she is very sleepy taking feed for just 10 minutes almost every one to one and a half hours before falling asleep again. Is this normal? Should I let her sleep at night? Her urine output is alright. ### Response: A 1 month old baby can sometimes sleep for five to six hours without a feed, this is a normal thing. If the baby is passing urine more than six times in 24 hours, then the child is getting adequate feed. In that case, stop the medication. A child should feed for at least 15 minutes each time. If the child feels sleepy during feeding, then gently tap on the feet of the child to wake her" "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 32 years old. I have got some red spots on my skin especially on legs, where I wear socks and also one spot on my left hand. After long time, I recently started jogging. I am new to the place where I am now. I had encountered sock allergy earlier also, but got relieved after using some cream. I do not remember them. Now, this is itching and spreading slightly. Can you kindly check the photos and advise accordingly? How to get them healed? Can I continue jogging? ### Response: I have reviewed your photographs (attachments removed to protect patient identity). You are having eczema. I would recommend you to apply Clobetasol propionate cream on the affected areas twice daily and take tablet Levocetirizine 5 mg twice daily. Continue this for two weeks and revert back. Endogenous due to internal sensitivity of the individual. Eczema. 1. Avoid using soap and avoid wearing synthetic socks.2. Wear cotton socks. Go for regular oiling. Revert back after two weeks 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 am 41 years old, male having severe constipation. The stool is very hard. Hence difficulty passing it. Please suggest some good stool softener. Tablet form would be preferred. Any other medicine? ### Response: For that, you should eat high fiber diet like fruits, apple, banana, oranges, green leafy vegetables like spinach, raw cucumber. Avoid smoking if any, refined food, fatty, and oily food. You should have plenty of fluids and regular exercises. Lifestyle modifications are advisable to maintain the response. Also, it is worthwhile to get a thyroid test done if not had recently. In medicines, we usually prescribe tablets like Bisacodyl 5 to 10 mg depending upon the response, bedtime once a day. Also in syrup, there are options like Cremaffin plus 15 to 30 ml bedtime to maintain your stool soft." "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 21 years old. I have muscle weakness in both arms and legs since childhood. I cannot climb stairs without support and I feel tired most of the day. I cannot stand for long and also cannot run or walk. My legs and feet always get numb. I have decreased sensory sensations in both feet. A few months back, I was diagnosed with hypothyroidism and vitiligo. I visited a doctor last month. My EMG and nerve conduction study shows symmetrical sensory motor demyelinating polyneuropathy with clinical diagnosis of CIDP. CPK is 227 (reference range 24-195 U/L). I am on Prednisolone 45 mg, Levothyroxine 100 mcg and multivitamins for the past 17 days. Please guide me about my disease, prognosis and any rehabilitation that might help. ### Response: Hi I have read your question with care and understand your concerns. My opinion is as below: You are having both myopathy and neuropathy. You need to get treatment for both. Hypothyroidism and vitiligo are may be signs of abnormal functioning of the pituitary gland. You have to do a complete pituitary hormone profile along with thyroid profile. Please also do a diabetic profile and lipid profile. The further course of action can be decided based on the reports. 1. Complete pituitary hormone profile along with thyroid profile.2. Diabetic profile.3. Lipid profile. Revert back with the reports to 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 am working in an oil plant and suffering from hair thinning and hair loss for the past one month. I am extremely healthy with a clean diet and exercise (non-smoker and no alcohol). Is this due to desalinated water and heat? Is this permanent hair loss? What can I do to prevent further damage? ### Response: Use coconut oil mixed with castor oil on your hair. Give a gentle massage. Use a filter or soft water to wash hair. Do not wash hair frequently. Use a mild shampoo" "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 daughter was recently told by her dentist she has tongue tie (ankyloglossia). She has never felt discomfort from it and it has never caused her to have any issues. Is it mandatory she gets it removed? ### Response: I have gone through your question. I can understand your concern about your daughter. Tongue tie is an anatomical defect that means if it hinders in speech, eating, swallowing or there are many carious teeth in the mouth it has to be corrected. In case there is no problem, there is no need to relieve it. Also, there is nothing to remove, a small cut is enough to relieve it. If you face a further problem or need more accurate suggestions, upload certain photos, from different angles. I will provide you a better opinion. According to your description, I think she does not need" "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 got my last periods between 20th to 25th of last month. I had unprotected sex on the 28th and 1st. I took an I-pill immediately the next morning after both the times. I had a slight bleeding on the 19th that lasted only a day. I did a pregnancy test on the 26th, which was negative. Until now, I have not got my periods. ### Response: Since you have taken an emergency contraceptive pill within 72 hours of intercourse, there is no chance of pregnancy. You will definitely get your periods. If you have a doubt then repeat your urine pregnancy test after a week. I am very sure that there is no chance of pregnancy and the bleeding was just a 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 have acidity and I feel like something is stuck in my throat and have inflammation. ### Response: Hello. You have severe pharyngitis (inflammation of the throat). It is highly possible due to the reflux of acid from the stomach. You need to take some precautions: Please review with me after three days so that I can guide you further. Good luck. Revert after three days to a surgical 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: If the biopsy report of the cheek (buccal mucosa, left) showed chronically inflamed stratified squamous epithelium and underlying fibrous connective tissue which contains a number of irregularly shaped vascular spaces approximately the size of normal capillaries that contain numerous erythrocytes; what would be the differential diagnosis? ### Response: The current biopsy results are indicative of a lichenoid type of lesion in the buccal mucosa. Though the presence of rash, uveitis and recurrent mouth ulcers would be suspicious of Behcet\s disease, the biopsy results are not what would be typically seen in Behcet\s disease. I would advise you to consult a dermatologist for diagnosis and treatment" "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 48 year old mother is probably suffering from a recurrent unipolar depression as per the treatment that the local psychiatrist is giving. It seems that the medicines are not working this time. She is not able to get up from the bed and does not feel like doing anything, even her daily routine work. She is taking Tritin 20 to 60 mg from the last five years. The doctor now recommends ECT after trying different medicine combinations from the last four months. She got into a similar situation five years ago but recovered with medicines. I want a second opinion regarding the same. ### Response: So, you should not hesitate, because it is a good modality for treatment-resistant depression" "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: Hi,I am 5 months pregnant and my reports say that Mentzer\s index is 21. Will it affect my baby? ### Response: Hello. Menterz index 21 means that you have iron deficiency anemia. Yes, it can affect your baby in certain ways if you do not seek medical advice. Anemia may lead to smaller babies, growth restricted babies and also preterm labor ( labor before due date) which can result in delivering baby earlier and complications associated with early delivery. Also, a woman may suffer excessive bleeding after delivery who are anemic. So, I would suggest you see your local doctor, check the level of anemia and get appropriate treatment for that. 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: How long the effect of anti-D and abortion last in the body? ### Response: The effect of anti D will last forever until there is another exposure in Rh -ve woman of an Rh +ve blood in the form of blood transfusion or Rh +ve pregnancy. Usually, first pregnancy is spared as the Rh +ve cells when entering the maternal blood at the time of feto maternal hemorrhage like during labor, or rupture of membranes or abortion, there is sensitization of cells and no harm. That is why we give an injection of anti D to prevent the sensitization of these cells." "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 a detailed MRI review and report for my problem. Is that possible? ### Response: Sure, you can upload your scan with a proper history. Also, mention the areas of concern and re-evaluation regarding which aspect of the scan you want to know. That would ultimately benefit 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: Age 28, sex male, height 5 feet 9 and weight 80. I am HIV infected and I got red blisters on my tongue with a white coating on the tongue surface. ### Response: Hello. Your complaints are more in favor of oral candidiasis. This is an opportunistic infection in the immunosuppressed. Kindly mention your CD4 count, RNA load, and the ART medication that you are using. Please attach the appropriate images" "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 38 years old, my weight is 60 Kg. I have diabetes for the last four years with 250 to 350 sugar level, I take medicine tablet Glycomet GP 2 and Vobose 0.3 twice a day. Please consult me these medicines are right for me or not. ### Response: Hello. I understand your concern. You are on the standard medications that we prescribe for treatment of diabetes. A small dose of insulin may help you a lot in reducing your blood sugar levels. I suggest that you talk to your diabetologist regarding the options available that suits your needs." "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 13-year-old male. I have been recently struggling with sickness, yet, I do not know which one. I have 94\xb0 F, sore throat, and it hurts while swallowing. I can not breathe without coughing, and I blink a lot. Please give an opinion about my problem. ### Response: First of all, is your temperature reading correct? You have written 94\xb0 F that is very low, and we call such low temperature as Hypothermia. If that is your temperature, you need to keep yourself warm. As your other symptoms are concerned, it seems like a throat infection with probable tonsillitis. I advise you do salt water gargling three to four times a day. Also, you can take tablet Aceclofenac 50 mg three times a day and Paracetamol 500 mg three times a day. If your cough is" "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 swelling on one side of the throat. It hurts to swallow and I get chills and sometimes hot flashes. My body aches. I am a 19-year-old female. ### Response: Hello. As it is associated with hot flashes, and body aches, it seems to be due to an acute viral infection. My advice is to: If the symptoms persist, please consult with a doctor as soon as possible and run an ENT examination to rule out bacterial tonsillitis. If confirmed, antibiotics might be 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 a lump in my groin, which I pushed, and it popped. Now I have a small hole near my vaginal opening which leaks yellow clear stringy discharge and also a small amount of blood if I push where the lump used to be. I have had this a couple of months now what could it be? There is no pain. I currently have a copper coil, 5\8, 67 kg, and in good health. ### Response: The opening is your urethra. The yellowish discharge and blood tinged discharge is coming from urethral diverticulum which is an outpouching of the urethra. It is not infection although you see stuff that looks like pus. The treatment would be surgical removal of the diverticulum. I would recommend you to consult with a urologist." "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: There is no stiff erection for the last one year or so. ### Response: Hello. For providing you the proper suggestions, I need to know the answers to the following questions: Do have any of these features: I look forward to hearing from you soon in order to find out the proper cause and thus to provide a proper treatment.Regards. Revert with more information to a general practitioner 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 protected sex with someone whose status I do not know. I am kind of worried now. I did not ejaculate and the condom slipped half way during the session and pulled that back. Is that a matter of concern? Shall I go for any test? ### Response: I went through your post. Slipping of the condom makes it an unprotected sexual intercourse and there is a small 1 % risk of getting STD although non-ejaculation makes it a lesser risk. You can test after two weeks for syphils and HIV by doing FTA-ABS (fluorescent treponemal antibody absorption) and CMIA for HIV after two weeks to be on the safer side. However, as the risk is very minute, there is no need to worry." "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 25 years old. What can be causing me to get widespread muscle twitching (twitches last about five seconds and go away and reoccur in a different muscle minutes or hours after)? Legs and hands get shaky, hands get sweaty, at night I feel like my legs are vibrating and my heart is pounding for no reason. I just noticed my hair is falling out too. I am also getting lots of anxiety, especially at night. I am in good health, I am a little overweight, not too much though. Should I get a blood test? ### Response: Hello. I have read through your question and would like to suggest that you should get a number of blood tests done. The following are the tests that I would suggest. All these tests are just to reach a proper diagnosis. It is necessary to know whether all these symptoms you are having are due to a pathological cause or physiological. You said that you have anxiety. Even anxiety alone can be a reason for your symptom complex. If all these tests come clear we may have to investigate the reason for your muscle twitchings. I hope I was able to help. If you have any further questions please feel free to contact" "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 4-year-old boy is suffering from cold and cough. His symptoms are,1) Choked nose (not running).2) Time to time heavy coughing,3) No temperature.Suffering from last three days. Started with light cold, but today heavy voice and frequent coughing. ### Response: Hello. It is a common cold due to viral infection, but as you have said that cough is increased now so it may be normal or it may be complications. The common complications are viral pneumonia (self-limiting), and another one is croup. The second one is having problems and characterized by a sick looking child and barking cough. It will subside by the time. If he is sick looking and fever is increased breathing, then you need to visit your nearest physician. Then we need to give antibiotics. You can ask specifically if 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: My anal area is always moist. What could be the reason? I am 26 years old, female. ### Response: This could be because of overactive sweat glands, oily skin with or without chronic low-grade infection. I hope your bowels are fine and you are not constipated. If that is not the case, you need to be treated for the same." "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 allergic to Quinolones, Metronidazole, Ibuprofen, Diclofenac, and Aspirin. Please tell me whether I am allergic to Hydroxychloroquine or not.If yes, then please tell me ways to how to develop my immunity? Food that I should eat and should I drink hot or cold water? What all the special precautions that I have to take to fight Corona? ### Response: However, allergy is not the only criteria. A detailed physical examination along with an ECG (electrocardiography) report will have to be done to check if your body can tolerate the medication or no. There is no specific food for immunity. Any home cooked food that is not processed will do. You can" "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 it normal for my stomach to make squeaky sounds a few years after hernia surgery? ### Response: Hi. This has a history of constipation and alternative episodes of diarrhea, with or without pain. If you have these symptoms, then it is IBS. Fibre-rich diet and medications should be taken. There are rare chances of it being an obstruction, secondary to surgery. In this case, you have to get an ultrasound abdomen scan done. Revert back to 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 am a 62-year-old female. I was diagnosed with collagenous colitis following colonoscopy biopsies. I started on Entocort, three days later I have severe swelling in feet and ankles. I am fatigued the next day. On the seventh day, I had swelling of lips and a strange feeling in the throat. I called the doctor and he stopped the medication.My blood report shows: Hemoglobin - 3.6 g/dL, RBC - 1.38 million/mm3, Iron - 11,Saturation - 3. Fecal stool sample postive. I went to the ER, I was given two units of blood. My hemoglobin raised to 7.5 the next day. I was discharged. Endoscopy was performed and my biopsy report is negative. I had minor stomach inflammation. My next bloodwork shows Hemoglobin - 8.1 g/dL,RBC - 3.05 million/mm3,Iron - 51,Saturation 12. Vitamin B12 - 648.Immunoglobulins A and G are pretty low. Gastroenterologist says need to do small cap endoscopy to see if there is bleeding in the small intestine. My new stool sample results are not back yet, but stools have not been dark. What other tests need to be done to determine the cause of anemia? List the possible that medication caused anemia since I had such a severe reaction.Current medications:No prescription, only supplements. Vitamin D3, CoQ 10, Methyl B12, and Curcumin. ### Response: Hi. Entocort (Budesonide) is a corticosteroid. It is very unlikely to cause anemia, especially to the extent that you had." "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: Yesterday night a baby mouse cut my wife in her index finger without any discharge of blood or any sign of cut except pain. Is anti-rabies vaccine required? ### Response: Hello. No, your wife does not need the anti-rabies vaccine. But you should see if your wife gets any of following symptoms within 10 days from the day of bite then she will need an antibiotic dose. Fever, vomiting, headache, any rash or swollen area or pain in the back or joints. Just keep the area where the mouse bite you clean. You should give her tetanus toxoid injection only and if it pains too much then you can give her tablet Diclofenac sodium 50 mg twice for three 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: Hope this message finds you well. I had 10 cavities and removed them all. But the last cavity I removed, the tooth was so damaged but my doctor kept on drilling as much as he could and he put the dental filling right next to the tooth nerve saying that the tooth is still alive. I did these two days ago. All was fine until now when the tooth gave me one minute of pure pain when I drank cold milk. Please tell me what to do. ### Response: I think the cavity was very deep and so the filling was placed close to the nerve area. This could have given you severe sensitivity with cold items. My suggestion is to just wait for a few more days. If you experience sudden, severe, shooting pain, you need to visit your dentist and get that tooth either root canal treated or extracted. If the filling is too close to the nerve, it causes irritation and thereby pain. You could avoid very hot and very cold food for a few days to just observe the condition of the tooth. In case there is no pain till around two weeks, you can relax and need not visit the dentist" "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: Just had a baby three weeks ago. Three days ago it started to pain under left breast then under left armpit. The pain continued in a part of my arm, then a spot on my neck and then a spot on my shoulder. And I read about heart attack. And I have been under a lot of stress recently. Kindly advice. ### Response: Hello. Unlikely to be a heart attack. This is atypical chest pain. I guess you do not have any shortness of breath. Considering your age group the possibility of heart attack is extremely low. Next, the pattern of pain is not consistent with the heart attack. Heart attack pain is sudden onset, retrosternal or left-sided rather than just below the breast, going to left arm associated with uneasiness sweating, etc. It usually does not persist for three days even without treatment. The possibilities in you are musculoskeletal pain, cervical causes, pain from breast itself due to hormonal changes and stretching of tissues due to breast enlargement, etc. Try to press over the site and see if pain reappears, if yes then it suggests that it is a local pain rather than due to the heart attack. So, unlikely to be related to heart attack, but should get examined by a local doctor and ECG done if necessary after examination. Examination of doctor will also help to assess the possibility of peripartum cardiomyopathy, which usually presents with shortness of breath rather than chest pain. Hope this helps you and get back if you have any doubts." "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 prediabetics (102) two months before. Now I noticed white spots on my upper gums. Are the spots related to diabetes or some serious problem? Please guide. ### Response: Before commenting anything about diabetes and its relationship with oral problems, I would like to see images of your gums having a white spot so that we can discuss appropriately." "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 front lower teeth have become extremely sensitive and I have very severe pain in them. The gums are not hurting but the tooth itself is hurting. How to relieve the pain? ### Response: Hello. Take a painkiller like Dolo 650 mg or Acenext-P (Aceclofenac and Paracetamol) three times a day. Use warm salt water gargle twice a day for a week. Send a picture of the area if possible." "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: Sometimes, if I take a nap or close my eyes, I see a fan-type rotating thing in my eyes which goes in one minute. If I close my eyes, I can see that. It is a black-colored fan-like thing rotating. Is this normal? I am myopic and my retina was tested last year. ### Response: From what you have mentioned, you may have experienced a certain physiological entity called ""phosphene"". This is nothing to worry about" "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 undergone cystectomy in my left ovary to remove a chocolate cyst of 9 cm. It was done before two years. After that, I got conceived, and my baby boy is five months old now. I got my first period after three months of delivery, and I experienced mild pain in my left lower abdomen.I am experiencing mild constant lower abdomen pain. I have done an ultrasound and found the existence of the cyst with a size of 3 cm. As I was feeding my baby, I was told to wait for the baby to reach six months. I am worried about the cyst growth. I am looking for solutions to stop them growing. Please help. ### Response: Hi. Ovarian cysts are commonly known as PCOD. A cyst is a form of an immature ovum. It occurs due to hormonal imbalance, and it causes irregular menstruation. In this concern, some ayurvedic medicines taken along with yoga practices are beneficial. You need to have a regular check-up of your thyroid profile and USG abdomen. You can take the following medicines to prevent the further growth of cyst and to regulate the periods. Take Hyponid charak two tablets twice a day with warm water after meals. Take Kanchanara Guggulu (Kanchanara with Varuna) two tablets twice a day with warm water after meals. You can consume M2 tone syrup (Ashoka with Ashwagandha) 10 ml twice a day after meals. You can take Arogyavardhini Vati (Shuddha Guggulu with Shilajit) one tablet twice a day with warm water after meals. These are very effective. Avoid eating spicy and fried junk foods." "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 girl, age 20. I had sex four days before, but from that date, I am continuously feeling pain during urination and getting urine out very frequently. Please tell me if that is a serious issue. How to get out of this pain? ### Response: Hello. This is common post-coital urethritis. Take more water and baking soda half spoon in one glass of water. I also suggest taking painkillers like Diclofenac with Ranitidine. Consult your specialist doctor, discuss with him or her and start taking the medicines 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 am a 31 year old female. I am 12 weeks pregnant. I have received my NT scan and double marker reports. Below are the details: NT 0.70 mm, trisomy 21 and NT 1:675, trisomy 13/18. ### Response: How are you doing? Let me start by saying that you and your baby are absolutely fine. Hope I have clarified your query. Do write back if there are any more queries. All the best" "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 26 year old male weighing in 185 and 5\9"". I do not take any medications. I am worried if I am at risk of any complications after having breathed in some steam/air at about 350 F. I was covering a pot roast I had just taken out of the oven when I accidentally took a breath of its steam when I was directly overhead. After it happened, moments later I had shortness of breath and had pain on the left side of my chest. This happened six hours ago. Since then, I have slept and my breathing is normal. There is only a dull lingering pain on the left side of my chest now. I have no cough, my breathing remains steady when I lie down. I do not get dizzy either. ### Response: Hi. Based on the history, at times, though not very common, steam/air inhalation can cause inflammation of the airway leading to respiratory symptoms and even pulmonary edema. So, keep an eye on the following symptoms : If you develop hoarseness of voice, wheezing, stridor, breathlessness, or chest pain, immediately contact a doctor" "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 planning for pregnancy aged about 36 years. But I am an OCD patient on a prescription of Clofranil 50 mg daily. So what are the risks involved, is it safe to use the medicine during pregnancy? ### Response: Clofranil (Clomipramine) should not be used in pregnancy. As far as of now no well-controlled studies in humans, but it will not cause anomalies but it may affect your neonate after delivery like seizures, jitteriness, tremors, and dullness may occur." "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 this diet with no rice and meat for five months. Is it healthy? I eat meat but only when I attend occasions. I was 99 back then and now I am 73 kg. ### Response: Eating meat is not a necessity if you are taking adequate vegetarian proteins. If you are avoiding rice, but substituting that with any other healthy carbohy" "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: Why does my pathology report not include classification of my LCIS? ### Response: Hello. LCIS (lobular carcinoma in situ) is not cancer in comparison to that of ductal carcinoma in situ. In LCIS, abnormal cells grow in lobules. It can be converted into invasive cancer in the future in some cases. LCIS itself is one of the classifications of a breast tumor. Treatment is not aggressive in such a case" "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 23 year old male. I am having pain in the upper back. When I sit on the chair in office the pain starts and it reduces when I stand, stretch or walk. I work for nine hours, from morning 11 to evening 8. I do not have any previous injuries or accidents. Eight days ago, I felt pain in the upper right back just below the shoulder. Then, the pain shifted to the upper middle back. When I sit and look into the computer screen, it pains more. When I look up, I feel relief. Give me your advice. ### Response: You have given an excellent description of a common problem in persons who have a desk-based job. The condition you are experiencing is due to poor posture. Stretching and looking away from your constant position is helpful as you have also figured out. Get up and move around after every half an hour. Keep the top of your computer screen at your eye level while sitting with your back supported in the chair. You can do intermittent stretches of your neck and shoulder muscles. Practice isometric and range of motion exercises of the neck which will help you a lot. Take painkillers and apply an anti-inflammatory gel locally for immediate relief. Do not take the painkillers for a long time. If you follow these instructions, these will help you recover in a few days. If the pain persists, investigations may be required. Consult an orthopaedician online if the pain persists" "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 brother has swelling on his left foot. He has a boil on his left inner leg 4 inches above his left ankle inner bone. The doctor he visited gave him medicines for his boil and said the boil will come out in some days. The swelling in his foot has increased and so he visited the same doctor the next day and was advised to see an orthopedic. The orthopedic doctor did not diagnose it but referred him to a general doctor who again did not diagnose it but said there is pus buildup inside the foot and it needs surgery. My father who accompanied my brother asked the doctor whether it will subside with medicines or if surgery is needed. The doctor simply said you can use the medicine or you can do the surgery.I am out of the country and feel the doctor may have not specified the situation correctly to my father and also may have not clearly explained why he suggested the surgery. I needed a second opinion, as I want my brother to receive proper treatment and identify if it is a serious condition and I need to know the best solution. I also want to know why the doctor mentioned surgery for a pus buildup and what is the diagnosis of the foot condition. I can provide pictures of my brother\s foot if needed. ### Response: He is having diabetes? If yes, what is the sugar level? If yes, first you have to control the sugar level. He is having a deep infected ulcer with cellulitis. Meantime, start tablet Pan 40 (Pantoprazole) one-two times daily before food, tablet Ciprofloxacin 500 mg two times daily, tablet Combiflam (Ibuprofen) one tablet twice daily, and tablet Chymorol forte one tablet thrice times daily for five days after food, and wound" "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 anxiety for the last five months. Recently, I had an echocardiogram, it says grade 1 diastolic dysfunction of the left ventricle with E/A ratio 0.7. Rest other parameters of the echo are fine. Sometimes my diastolic BP goes to 90 due to anxiety. Can you please tell what is this dysfunction? Will it cause future issues and will it go away if I get rid of my anxiety and BP? My ECG is found to be normal. ### Response: Diastolic dysfunction in the echo is, in fact, abnormal function of the left ventricle during relaxation phase that is diastole (attachment removed to protect patient identity). It occurs when left ventricle muscle is hypertrophied due to increased blood pressure. Grade 1 is the initial phase, but do not worry it is reversible. Control blood pressure and it will be fine within a few months. No need to repeat echo but controlling BP is essential. According to the latest guidelines, optimal BP is <120/<80 mmHg. To reduce BP avoid anxiety, avoid smoking (if you smoke), avoid alcohol or any other form of addiction (if you are addicted), reduce salt intake in the diet, avoid junk foods, oily foods, ghee, etc. Do regular exercise, maintain a healthy weight." "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 24 year old female. Suddenly, I am having large floaters in my eyes. Is it possible that it will decrease with time? How long will it take to decrease? ### Response: Hi. I reviewed your history. It seems from the history that you have floaters. Eye floaters are because of problems in the posterior part of the eye involving vitreous and retina. Hence, this requires evaluation by indirect ophthalmoscopy, to rule out vitreous degenerations. Most of the floaters are caused by vitreous degenerations and may not require treatment. These will resolve over time. However, evaluation is required to look for associated retinal problems, like retinal tears which may be seen rarely." "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 tingling, warm and very uncomfortable sensation in my finger when I touch my phone. What could it be? I am very afraid it is due to the radiation from the phone. ### Response: We are exposed to variable amounts of radiation from our cell phones. However, it is not strong enough to cause tingling and numbness or nerve damage. The only way to know if your phone is causing it is to abandon using it for a day or two and check if the symptoms still persist. If it is only localized to the finger, then there can be a nerve compression or possible nerve damage which will self-heal in some time. However most commonly, it is due to vitamin deficiency, and hence it is advisable to take any multivitamin supplement for a month. Also, increase the vegetable intake in your diet. Try avoiding the phone for some time, just to see if the sensation stops. Keep taking the vitamin and watch out for any similar symptom in other places of the body. If it does, get back to a general practitioner 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 talking with my friend today, and after our conversation, when we met again, she asked if I was feeling alright. Apparently, mid conversation, I started going in and out of talking gibberish, then continuing the conversation as if nothing had happened. I have absolutely no memory of this happening. What could it be a result of? ### Response: Hello. I understand that you feel concerned about forgetting the content of your conversation. 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 trying to conceive since seven months. I am on medication for the past one month (Dydrogesterone tablets, Pyridoxine hydrochloride and Folic acid). This month I have not yet got my period and it is four days late by today. I just got a light brown drop on third day of missed period and got negative hCG test. Please help. ### Response: I understand your concern completely here with regards to inability to conceive. Revert back with the test results to 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: Can delirium be caused by fasting and lack of sleep? My 25-year-old daughter is delirious. She does not know who she is, thinks she was in a coma, etc. Hospital ran blood and urine test and a cat scan, all were normal. No new medications. I thought it has to be something physical because it came on so quick, but nothing was found. How do we help her return to herself? Hospital advised Benedryl to help sleep and to encourage food and drink. ### Response: Hi. The answer to your query is yes. Prolonged fasting and no sleep can cause mental and physical symptoms similar to mania or delirium or coma. It would have been helpful if serum electrolytes, catecholamine levels, and urea levels were recorded or mentioned because BP is on higher side. The advice for adequate rest and a proper diet is also correct. It may be beneficial to visit a counselor to prevent such episodes in the future." "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, 36 years old. I have eye powers 3.75 in my right eye and 2.75 in left eye both high cylinder. I have doctors prescription for glasses but after I bought the prescription glasses, I can read only for a few seconds and immediately printed text looks double. In the morning, I can read without glasses but in the evening I cannot read even with glasses. There is a lot of strain in the eyes when I try to read the fine print. I did not have glasses till two years back. With my left eye, I can read the normal texts without glasses so I did not get it tested. I do not want to go for LASIK surgery because numbers are not stable. Please guide me by alternative treatment to reduce and stabilize prescription number. ### Response: Hi. By going through your query I could understand that you are not able to tolerate your glasses. Glasses even though they correct your vision, the muscle balance can be achieved only after a few weeks of adjustment. During this period the glasses are to be continuously worn even though that is causing discomfort. Reading should be done under bright light. The minimum distance between eyes and book should be 33 cm for the eyes to be comfortable. I would be able to suggest the feasibility of contact lenses after I see your glasses prescription paper." "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 chest pain or esophagus pain while having food for the last two days. The pain is repeated for every 5 to 10 minutes. Please help. ### Response: There are many causes of chest pain. Pain while eating food is related to esophageal disorders like esophagitis, esophageal erosions, gastroesophageal reflux disease, esophageal spasm or peptic ulcer disease. The serious causes of chest pain like heart related problems and myocardial infarction needs to be ruled out. So, I suggest you to get an ECG done (electrocardiogram) and consult a physician as soon as possible to make sure there is no heart problem. You can take some antacid syrup 10 mL thrice daily for five days. Consult a gastroenterologist in person for a physical evaluation. Avoid tea, coffee, oily and spicy food. 1. Esophagitis.2. Peptic ulcer disease.3. Esophageal spasm.4. Heart related problems." "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 60 years old dad has knee pain from the past 1 to 2 years. After taking many x-rays, the doctor diagnosed him with osteoarthritis. The doctor suggested going for knee replacement. We would like to know, can the pain reduce without surgery? ### Response: Hi. I have seen the x-rays (attachment removed to protect patient identity). This professional advice provided by me stands subject to the actual examination of report or image and is based entirely on inputs provided to me. It should be correlated with clinical findings" "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 first mammogram result shows that I have dense breast tissue, and that was all. My doctor, who referred me for two small lumps in my breast, does not even look at the images. I have sent you the report that the radiologist sent me. Can you please take a second look and suggest your opinion about the results? ### Response: Based on the mammogram report (attachment removed to protect patient identity), you have heterogeneously dense breasts (Category C). There is no visualization of obvious breast lesions. However, I would surely suggest you do an ultrasound of the breasts for interpreting the mammogram findings. As you have not mentioned the side, I find markers in some images over the left breast, and I guess that there are lumps in the left breast. Please correct me if I am wrong. You have small axillary lymph nodes on both sides (more on left than right) and though they are small and not significant, getting it reviewed on an ultrasound scan is suggested." "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 pain and irritation while passing urine. My urine report says my blood cell count is more than 100. My ultrasound report is normal. I feel shy to tell the doctor about my problem. I do masturbation once or twice a week, but nothing ever happened. Now my urine color is almost red, and pain is unbearable. Please suggest me the solution to my problem. ### Response: Hello. The most common cause for your problem must be urinary infection or a stone in the kidney tube. Since sonography is normal, infection is more likely. Do a urine culture sensitivity test and start an antibiotic. I suggest tablet Nitrofurantoin 100 mg twice daily for seven days consult your doctor for the same. If the blood does not clear in one or two days, you may need a CT (computed tomography) scan and cystoscopy." "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 is 77 years old. He is diagnosed with moderately differentiated squamous cell carcinoma, in the right vallecula and at the base of the tongue aggregating 0.5 \xc3\x97 0.5 \xc3\x97 0.2 cm. He has pain and sensation while eating and drinking. What is the treatment? Please suggest. ### Response: Treatment of choice in this condition is radical radiotherapy using IMRT (intensity modulated radiation therapy) and IGRT (image-guided radiation therapy) technique with concurrent weekly cisplatin chemotherapy." "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's blood test report shows low hemoglobin 10.9 and high platelet count 623000. The sugar test report shows 107 glucose fasting and 144 postprandial. We also had her ultrasound done as she had pain on the left side of the groin area. I am attaching all the reports. Kindly advice. ### Response: Increased platelet is called thrombocytosis (attachment removed to protect patient identity). This can be present in anemia due to iron deficiency. Since your mother has anemia platelet count may be increased. Pain in her left side groin may be due to hernia. Lastly very rarely we have to rule out that is there any cancer lesions also. Kindly send your mother\s ultrasound report." "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 get these bumps on my feet every year every few months. They are filled with a clear liquid. They do not hurt or itch unless I am applying pressure or if I break open the skin on top. The skin underneath is so thick and raw that it hurts when exposed. I have gotten these for 15 years now. Kindly tell me what it is and how can I manage it. ### Response: It presents with itchy tense blisters over palms and soles usually, as it progresses the skin peels off. It worsens during winter like any other eczema. You would require: Use cotton socks, dust it with gold bond powder. Avoid hot shower, use lukewarm water for taking bath" "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 wrist pain on the top of it. Usually, when I use it in daily life it is all nice but as soon as I even swing a tennis racquet soon afterward pain develops. The pain is on the top and prevents my wrist from pronating. Whenever I play tennis it is usually only for five minutes. The pain goes away in a few days but recurs as soon as I even swing a racquet. What is the problem? ### Response: Hi. The wrist pain that you are experiencing could be due to the following reasons. 1) TFCC (triangular fibrocartilage complex) injury. 3) Carpal tunnel syn" "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 17 years old and suffering from pimples from last two weeks. It is increasing day by day. So what will I do? Please suggest some medicine ### Response: Once a regular bowel moment is established, you could apply Oxidoben cream (combination of Adapalene and Benzoyl peroxide) at night over the pimples. It will" "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 was operated for CABG a year back and is taking Carloc 3.125 mg and Cardace 2.5 mg twice a day, among other medicines. Presently sometimes her BP goes down to 100/60. Is it due to the above-mentioned tablets? Should the dose be halved for relief? ### Response: Hello. I have gone through the reports (attachment removed to protect patient identity). Firstly, her heart function being low 25 to 30 percent, she has the tendency for low BP. So her BP will remain low. Over and above, Carloc (Carvedilol) and Cardace, both lower the BP. But, in her case, these medicines are necessary in order to prevent further decline in heart function. So, if she is not having symptoms like dizziness, excessive fatigue, they should be continued with the same dosing. Usually, more than 95 to 100 systolic is fine if not symptomatic." "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 has bone tuberculosis. He has compression in D4-D5. He is bedridden now. Currently, he is taking medicine for TB. Is it necessary to do surgery or not? Please suggest. ### Response: I have gone through the attachment (attachment removed to protect patient identity). This condition is known as pott\s spine. There is a presence of tuberculosis in the spine. It is managed by taking ATT (antituberculosis medication). It is not good to have surgery during the active stage of the infection. A spine fixation surgery using rods and screws can be considered once when the infection settles down." "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 38-year-old male. My height is 5 feet 10 inches and weighs about 90 kg. I am a non-alcoholic and non-smoking person. I have two children. Now I am facing erectile dysfunction problem. First time I used Suhagra 25 mg and I enjoyed successfully. How long I have to use this tablet for natural erections? And what are the habits to overcome this problem? ### Response: You can use this tablet for the long term as this tablet does not cure your erectile dysfunction. It works when you use it and its effect lasts for few hours to days. Now coming to the habit to overcome this includes daily exercise or morning walk for at least 40 minutes. Avoid too much oily food. Consume low fat diet, whole grain foods, fruits, and vegetables will be useful." "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 my right shoulder surgery, do I need a physiotherapist? What would happen if I do not consult a physiotherapist? ### Response: I recommend you consult a physiotherapist for rehabilitation post surgery as it is very important that you gain strength and mobility. Otherwise, there would be some imbalance remaining within the muscle group and may give rise to minor nagging issues after a while. So, it is just a matter of few weeks of strengthening that keeps you away from many issues that might arise afterward. By saying this, I am not frightening you that you will definitely have, but there could be a possibility which may be avoided completely. Hope this is helpful for 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 22 years old. I have blood and blood clots flowing in my urine. It happened about two times. After an hour, when I did urination, it was normal. I went to a nearby hospital and checked my blood and urine. It was completely normal. After two days, I went for an advanced scanning. I did an ultrasound scanning for kidneys, bladder, and for the abdominal area. The scanning results were completely normal. After a few days, I had the same problem. I have a habit of masturbation for the past six years. I can see a blood vessel enlarged in my penis and the blood supply is blocked in that region. I have an erection problem now. Please help. ### Response: Hi. Blood in urine usually occurs due to infection or stone. Since your reports are regular, there can be a mild infection, or it can be a small stone which has not caused any pain. I suggest you visit a urologist and get a CT scan of KUB (kidneys, ureter, and urinary bladder) region done. If the results are healthy, and if there is no bleeding, probably there is nothing to be done. If the report shows something, or if there is bleeding again, further tests will be advised by the urologist. Do not worry about the veins over your penile skin, as they are not related to erection. So do not worry about erectile problems. Take plenty of fluids. Please provide your reports for further analysis." "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: Yesterday I ate some pizza and drank tea at around 9 pm at a party. I had a feel like there was something stuck at my upper stomach and had a little pain. I was ignoring it, but then I got worried it might be something bad. So I forced myself to vomit, and I kept vomiting for half an hour. I am not sure, but maybe there was a bit of blood. I felt a strong burn after that, and it got worse. I felt a sharp pain on the right chest every time I swallow. I am worried. ### Response: 1) Your symptom is suggestive of a small linear esophageal tear due to forceful vomiting. 2) In this condition, linear tear develops on the inner wall of the lowermost part of the esophagus. This is responsible for a small amount of blood in vomit and pain in the chest. 3) You should take semi-solid foods for a few days to promote healing of this tear. Otherwise, no specific treatment is required. 4) If pain is severe, then you can try antacid syrup to smoothen the lower part of the esophagus, which gives relief from pain and also promotes healing. 5) Also, remember, never induce forceful vomiting." "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 28 year old female suffering from chronic fissure from the past six months. It was bleeding two months back but not now. I am only feeling pain when I have non-vegetarian items. Do I need surgery? ### Response: The main cause of fissure in ano is constipation and passing hard stool. When hard stool passes through anal canal it hurts the anal soft tissues. Sometimes, it is healed up by medicines and sometimes surgery is needed. First, you should take ayurvedic medicines and follow some precautions. Hope it will be cured. Otherwise, it needs anal sphincter dilatation and surgery" "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: Respected doctor,My 63 year old mother was diagnosed with tuberculosis meningitis (TBM) 10 months ago when she complained of a severe headache. She has undergone CSF study and the report of the study is attached. She has been taking ATT medicines since then. The list of all the medicines she is taking is also attached. The medicines had come down to only one tablet (R-Cinex) in the last 10 months. But, now for the last two months, she started having back pain in the spine area and is now suspected to have a TB infection in the spine. She has a history of L3-L4 collapse four years ago, but that was due to osteoporosis. Her BMD score was -3.2. The spine has been severely infected from L1 to L5. The MRI revealed an abscess with a pus collection in it (report attached). The doctor says it could be Pott\s spine and may be because of a drug resistance (MDR), and they wanted to perform a USG aspiration for Xpert plus SRL, culture and sensitivity of pus. But, the test did not happen because the location of the pus was very deep in the muscle and could not be extracted. So, they extracted some tissues near by the infection area and sent for a small biopsy. The report of the histopathology (small biopsy) is also attached. It says mild nonspecific chronic inflammation. Since no strong evidence of drug resistance could be found in the small biopsy, the doctor has restarted the medicine of AKT-4 plus STM 0.75, and they want to see whether this reduces the problem or not. They said we cannot start DR/MDR treatment without any strong evidence of drug resistance. The current OPD card is also attached in which the medicine has been restarted. Now please guide us about what should be the treatment plan of the disease based on the information submitted. Can anything can be done to get a strong evidence of drug resistance since the ATT medicine is very heavy and the doctor has restarted this medicine only on the basis of his opinion? How can we assess the recovery from the disease apart from relying only on the reduction of pain? Does she require any further MRI or any test after some time? ### Response: I went through your post which has nicely described the events. Also, I reviewed her reports (attachment removed to protect patient identity)" "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 risk of becoming addicted to 60mg of prednisolone (prescribed to anti-inflammatory purposes) once a day for a month? - I\ve already been prescribed this medicine, I\m not asking for a prescription. My doctor hasn\t mentioned anything about becoming addicted and I didn\t ask when I was in hospital. However, because of the pandemic, I can\t go and ask my doctor if there is a risk and I wanted to make sure that I don\t suffer from craving steroids after I\ve come off my prescription. ### Response: Hello. The dosage of prednisolone prescribed to you must be according to your body weight which is usually 1 Mg per kg or in same cases the physician may prescribe an even higher dosage depending on the underlying disease. So your doctor will slowly taper down the" "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: During the ovulation time every month, I get a fever, cold, cough. What is the remedy? ### Response: Hi. I have reviewed your query and can well understand how worried you are about this issue. And you are not alone in this respect. Most of the females come to their physician with the same complaint. I usually describe it as a naturalization phenomenon and it happens due to hormonal changes that take place just before and after ovulation. It is to prepare the body for ovulation and (if the female conceive) for the oncoming pregnancy. If symptoms are bearable, avoid taking any medications. If moderate, you may take Acetaminophen for symptomatic relief (as needed). If severe, take Ibuprofen 800 mg as needed. Your OBGYN physician may also assist you in this regard and if needed she may go for your physical examination and some investigations." "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 25-year-old male. I have a boil on my testicle. It discharged some yellow fluid in the morning. It has turned red now. I feel pain when I walk due to friction. I applied Candiderma powder in the morning, but now I forgot to get the powder to the office and I feel uncomfortable while walking. Please suggest a cream or powder to reduce the inflammation. I assume it is Fordyce\s spot. ### Response: I have noted your concern. Perhaps, it is a bacterial skin infection - red, painful and swollen. Consult your specialist doctor, discuss with him or her and start taking the medicines with their consent.Regards" "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 19-year-old. I have never had acne problems. Recently I can see acne around one side of my mouth. It has been going on for a few months. I have tried every face wash, creams, toners, etc. I have an extremely irregular period. I am not on any medications. Does it have anything to do with my periods? ### Response: Hello. 1. Yes, it can be related to your irregular cycles also. 2. For that, you should consult a gynecologist. I am writing you the medications for this for now. A. Capsule Doxycycline 100 mg once a day. B. Adapalene and Clindamycin gel apply once at night on acne, do not rub it and wash after one hour. Do this for 15 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 29 years old.CT scan came up negative for problems associated with infection. I request for second opinion for possible hemorrhage/brain aneurysm or complications due to infection. I have attached the reports.Associated Problems: Tooth abscess. Symptoms: Light headedness, severe migraine, ice pick stabs on top of my head and a feeling of something running on top of my head.Note: I went to emergency room and was denied treatment due to the diagnosis of \routine headache\ and then discharged. ### Response: I have read through your query in detail and have seen the reports. (attachment removed to protect patient identity) The following will confirm it as normal. Report Findings: Impression: It is possible that your headache is due to irritation of the trigeminal nerve that supplies the skin in the head and face region. Hope this answers your question. Revert back to a radiologist online for further follow up" "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 42-year-old male. I had undescended testes from childhood which went untreated (hence I had always been and am on single testis only). The undescended testis still lies in the groin. I used to feel fatigued most of the times over the years, due to which I had difficulty in concentrating, focussing and managing day-to-day tasks. About a year ago, I started on TRT (testosterone replacement therapy). I used injectables (Nebido) for seven months. TRT worked very well for six months and I experienced positive results in various aspects (better focus, better memory, energetic, improved libido, was able to manage my tasks very well). After six months my hemoglobin increased from 16.6 to 18.5 and hematocrit went up from 46 to 54, and my doctor advised to donate blood. At this point, I started feeling fatigued and headache (typical high hemoglobin symptoms).I donated blood for the first time three months ago. However, after donation, I felt less energy and benefits of TRT also started fading away. Within a month, hemoglobin again went up from 16 to 17.6 and hematocrit was at 51. I went through venesection two months ago to bring it down. From then onwards, on the advice of my doctor, I switched from injectables to gel (Testogel). Hemoglobin and hematocrit again went up and I had to undergo another venesection last month. I was also low on Iron (ferritin - 46). So, I started taking a lot of oral iron supplements (ferrous sulfate - 65 mg elemental iron). I took up to eight tablets per day for three to four days. Iron levels improved (ferritin 118 ng/ml), but hemoglobin also shot up to 17.5 (as per recent report).Questions:What do you think could be the possible reasons for fatigue that I have been facing since last few months?When I started TRT it took six to seven months for hemoglobin to rise from 16.6 to 18.5 while after I gave blood in the first blood donation, hemoglobin rises by similar points in 30 to 45 days only.MCV results confirm that the size of RBC's is increasing since I am on TRT, it means that the new RBC's have more iron. However, I have been continuously feeling fatigued before first blood donation till now.My iron stores (ferritin) is still towards low (74) as per latest blood test and I am currently taking iron oral supplements. Do you think that the fatigue symptoms will improve once ferritin comes in the midrange (150 ish)? ### Response: I would like to know as to why you are receiving testosterone replacement therapy. I know that you have mentioned that you have one undescended testis. But many men do not have any problem even when they have a single functional testis. Testosterone replacement therapy is given only when there are both low levels of testosterone in the blood (less than 300 ng/dl) as well as symptoms of low testosterone. Your elevated hemoglobin is a direct result of the increased red cell count due to the effect of testosterone. Testosterone replacement therapy is contraindicated in people with a hematocrit of more than 50. I would suggest that you speak to your doctor and discontinue the testosterone replacement therapy for a few months and increase your ferritin levels to 100. If your symptoms improve, you need to get your treatment plan reviewed" "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 is suffering from urinary incontinence at the time of sleeping. She gave birth to two babies through operation, and now they are aged 9 and 5. After which she got her uterus removed through operation. Please help us. ### Response: Hi. I have read and understood your problem. Urinary incontinence is a common complication after surgical removal of uterus. You should do her urine culture and sensitivity test, also blood sugar PP (postprandial). If the problem is only at night then she should stop taking water one hour before going to sleep and pass urine. If she has to get up many times during sleep then she may need mild tranquilizers." "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 an MRI with a possible indication of MS. I want to know based on the following symptoms, what type of MS it could be? A few weeks back, I had blurry vision in one eye for 20 to 30 seconds. My bladder wall is thick, and I had frequent urination problem. I consulted a urologist, and he said that I probably have a chronic prostate infection. Sexual arousal is bad from the last two months. I am sweating more, and I was diagnosed with hypertension three months back. I do not have walking or running problems. Last year, I felt fatigued for a month. I get small light headaches occasionally during the day. There is no particular flare-up that I can indicate directly. I have a tingling sensation on my legs for 10 seconds. Could any of the above be MS related? ### Response: I read your query and understand your concerns. I hope this helps you. Feel free to write back to me if you have more questions" "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 got married four months ago. My wife and I are of the same age 26. We both are really trying hard to conceive a baby, but it is not happening. Even though my wife says that the penis goes like 40 % into her but I feel it is full. Even the sperm goes into her every day, but no results yet. We are very worried. What to do? ### Response: I understand your concerns. The successful conception is dependent primarily on two factors:1. The female has regular periods.2. The male has a normal semen analysis and good erection. Before proceeding to advanced staging you have to confirm to me that your wife has regular periods and you have a normal erection and semen analysis (you can send me the report). The next stage after excluding the male factor, we have to confirm that your wife is ovulating normally every month by a blood test. If there is insufficient ovulation a medication can be used to enhance ovulation. Have you experienced any degree of varicocele? I recommend that you follow up in order to reach the appropriate diagnosis" "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 brother who is 25 years old has been suffering from anxiety for the past four years. His doctor put him on Effexor and Elavil. Both the medicine has to be taken daily in addition to Xanax. Lately, the anxiety has developed into full blown panic attacks, two of which resulted in a seizure and passing out briefly. In addition, we just discovered through a DNA test that he has two MTHFR mutated genes. He seems to be rely more on the Xanax now as a safety net or crutch when he feels a spell coming on. I am very concerned that he has become too dependent on the Xanax and now that he is taking a prescribed vitamin supplement to counter the MTHFR. It is likely making all the drugs on board more potent than before. I have read that the cause of anxiety for some people is the MTHFR gene mutation. Therefore, I wonder if he even needs any of the drugs he is on, but I realize that he cannot just quit cold turkey. He needs opinion. He is in a real tough cycle right now where he can hardly function, which is not good as he is in final semester of law school. Please help. ### Response: I can understand your concerns. From your description, it seems that your brother might have become dependent on Xanax (Alprazolam). Hence when not taken, it leads to anxiety like symptoms which can mimic a panic attack. These are actually the 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 have acne for the past one year. It has got worse in the last few months. I am using Clindamycin cream. ### Response: Hi. You can get cured of from acne with your Clindamycin Gel. Use it in the daytime. You may experience frequent exacerbations due to stress or hormones or periods. Apply Adapalene gel only at night for two hours. Use it only on the pimples in a small amount because it may cause burning. Use Cetaphil cleanser" "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 woke up suddenly yesterday, I saw a spiral black cloud in my right eye. I can see through the cloud hazily and there is no pain. When I consulted my doctor, he said that I have a blood clot. Is it something serious? ### Response: If it is small, it will resolve on its own. You can wait and watch. If it is large and not resolving, it needs to be surgically removed. Revert back with photographs to 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: I suffer from jaundice and typhoid. I have vomiting, high fever, rashes, drowsiness, and stomach pain. Whenever I consult the doctor, he gives me medicines. I do not understand, and I am confused whether he gives tablets for jaundice and typhoid or whether he provides tablets for cough, headache, and vomiting. Please suggest. ### Response: First of all, jaundice is a symptom, and typhoid fever is a diagnosis. Jaundice is a state in the human body in which there is an increase in bilirubin (produced in the liver) level causing yellowish discoloration of sclera and skin. I am not sure whether you have typhoid or not. These symptoms you have seem to be due to acute viral hepatitis. But the picture you have attached (attachment removed to protect patient identity) is of antibiotic combination which is used in the treatment of typhoid fever (Cefixime and Ofloxacin). We cannot diagnose typhoid just by symptoms, and we need to perform some blood tests for it. You should take a lot of fluids and glucose water. If it is acute viral hepatitis, the yellowish discoloration or jaundice takes a month to disappear. You should not worry much about it, but get a full liver function test done along with PT (prothrombin time) and INR (international normalized ratio). Also if interested, get a screen for IgM anti HAV (hepatitis A virus) and HEV (hepatitis E virus) serology. Acute viral hepatitis occurs mostly due to improper hand hygiene or contaminated water source. You will get well soon." "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 started using Ashwagandha as a natural supplement for depression and anxiety. I have been feeling much better even after my doctor has reduced my sleeping medicines and antidepressant. My concern is if I stop using the Ashwagandha, will the depression anxiety return or get worse? ### Response: Hello. I understand your concern regarding getting the depression back once you stop Ashwagandha. I would advise you to continue taking Ashwagandha till you feel a good amount of improvement in your depression. Also, start doing meditation, and some yoga poses for getting rid of depression problems. Then gradually reduce the dose of Ashwagandha so that your body gets used to the reduced doses of Ashwagandha. Do not stop using it immediately. Make sure you do it gradually. This will help to maintain your health, and most likely, you will not get back with the previous symptoms. I hope I have answered your questions." "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 6 months pregnant now. Before pregnancy, I have been suffering through allergic rhinitis (sneezing and dry coughing). But as my pregnancy started, I got a cough with white phlegm. I wanted to avoid medicines during the first three months of pregnancy but due to late night coughing and phlegm I went to see a gynecologist. At first, she tried to control my cough through a mild cough syrup with ivy leaves but cough does not go away.Then my gynecologist asked me to visit a pulmonologist after a detailed checkup I was diagnosed with bronchial asthma. He advised me to take Budesonide with Formoterol dry powder inhaler and Montelukast sodium. I am feeling better nowadays. I do not have a cough now. I do visit my gynecologist for a monthly checkup and she knows that I am taking dry powder inhaler for bronchial asthma. This month my gynecologist advised me to take Rejuva tablet that contains vitamin D and K, it is a kind of nutritional supplement for bone health and Fiore-f tablet for iron deficiency. My Hb is 9 nowadays.My question is: Is it safe to take iron tablets and nutritional supplements while taking bronchial asthma medicine? I am afraid that may be due to iron I will get cough again. Secondly, I am extremely worried due to the reason of diagnosing bronchial asthma in pregnancy. I am taking medicine for asthma and I have heard it affect the unborn baby in terms of low birth weight. But my asthma is under control due to this medicine and I am feeling much better nowadays. I visit my gynecologist monthly for baby growth and she says it is perfectly fine.Note: I cannot take dairy products, citrus fruits, and rice because I got cough and throat irritation due to bronchial asthma. ### Response: Hi. You should continue bronchial asthma medicines. As it is required to control your symptoms and to make you healthy. If you do not take it then the effect on baby can be worse than while you are taking. As baby growth is fine do not worry about it. Iron and calcium are also minimum requirements during pregnancy and if you do not take it and your Hb is down during delivery then it can be very dangerous if you bleed more. So it is required during pregnancy. And, mostly it will not have any effect on bronchial asthma." "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 black stools along with fluctuating appetite, stomach pain, and diarrhea and general run-downness including being freezing. Do I need to worry? ### Response: I have gone through your query and can understand your health concern. Black colored stools could be due to many causes. If you are taking any of these" "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 blood sugar level of 8.3 mmol/l during fasting. Is this diabetic or still at the pre-diabetic stage? Can I reduce the sugar level without medication? ### Response: Hello. This falls in diabetic range. You should also get post-lunch sugar done. You will eventually need medicine. However, you can try a healthy lifestyle for some time period. You should have a healthy lifestyle like avoiding fatty, oily, sweet, and high-calorie diet. Regular exercises like brisk walking, jogging according to your capacity at least 30 minutes a day and five days a week. Try to achieve weight loss which is important. Repeat fasting and post lunch sugar after two weeks to look for the response. All the best." "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: Dear doctor,Is there a homeopathic cure available for lipomas? What are the treatment options available in homeopathy for lipomas? ### Response: Hi. Lipomas are essentially non-malignant and non-dangerouscollection of soft fatty tissues. Homeopathy has no medicines to cure lipoma. However, homeopathic scope in lipoma aims at reducing the size, pain if any, and can control new growths. Also,homeopathic medicines can soften the consistency of lipoma making you feel comfortable and confident. Surgery is the only option to remove it, but it is also a temporary one." "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: Respected doctor,I would like to know about the remedies or medicines for alcoholism for my husband who drinks a lot almost daily and has a bad habit of eating pan and ghutka. After all this, he abuses me and my daughter and family. I am fed up with his behavior. I request you to suggest any good medicine that can be given to him without him knowing. ### Response: Consult a specialist doctor, discuss with him or her and start taking the medicines with their consent. The second issue, regarding the violence that you and your daughter encounter, you should seek support from the relatives or the responsible authorities" "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 daughter is 2 months old. She feeds only for five minutes at a time. I am worried if she is getting proper feed and if not, what should I do? My milk let down is too fast. So, every time she feeds and gets choked. Please suggest how can I help her. ### Response: Hello. Please note the following points: Monitor the weight of the child to see if he/she is getting proper feeds and gaining proper weight. You can feed the baby with a bottle or with a sipper to monitor how much feeds the child is taking and this will also regulate the flow of milk. However, use a sterilizer to clean these so that there is no chance of infection. Visit a lactation consultant to find out what problems you are facing while you are feeding and how they can be rectified. Burp the baby for at least 15 to 20 minutes post feed" "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 15 months old. He was diagnosed with neutropenia. The neutrophils are critically low. My question is whether the illness is related to cancer? Also, what kind of treatment can be given? ### Response: I have reviewed your query and here is my advise. When there is a decrease in neutrophil count, the chances of infection are more. So, a close clinical observation is needed. If any unusual fever, dyspnea occurs, you should consult the doctor immediately. The low neutrophil count will not cause cancer. Infections can suppress the bone marrow and makes the count low. The CBC (complete blood count) report with peripheral smear examination report has to be checked for giving more comment. You can attach your report for giving more comment" "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 is 25 years old and she has PCOD. We are trying to conceive for 2 years. We had done an IUI which failed. We did IVF, but it ended with a chemical pregnancy. Last month, our doctor did Frozen Embryo Transfer (FET). He transferred 2 embryos on that day. We got a positive result through urine test. We did serum beta hCG test. The report shows hCG level of 1,50,000 mIU/ml. The value looks like very high. Does this value signify a healthy pregnancy? Does it mean a twin pregnancy? ### Response: Hello. The normal hCG levels in a singleton pregnancy as follows: In a twin pregnancy, the levels are 30% higher than the singleton hCG levels. Generally, during the Frozen Embryo Transfer, 3 to 4 embryos are being transferred, and hence the levels can be as high as this 1,50000 IU. But, as you are sure that there were only two transfers, then according to that the value is still higher for a twin pregnancy. Considering the present scenario, this may indicate a molar pregnancy. It would be important to get an ultrasound pelvis done to identify multiple gestational sacs, and if molar pregnancy is suspected, then an MRI would be warranted. You can follow up with the USG report, and I would be able to guide you better after seeing the reports." "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 IBS-D by a gastroenterologist. My CBC, abdominal ultrasound and FOBT were all normal. I was put on one-month medication consisting of Rifagut 550 (twice per day), Colospa Retard (twice per day) and Librax. My only problem was aggressive BM, not diarrhea but a lot of gas after getting up in morning followed by first BM and then another BM in a span of two hours. I weighed 79 kg seven months back and did drop to 72 kg weighed last month. The doctor says this weight loss is clinically not scary. I did consult another doctor who says this to be gut flora imbalance and not IBS as I have not had any relief from IBS medication and he believes my symptoms does not correlate with typical IBS. At present, I have a frequent passing of gas, especially after eating food or dinner. In the morning BM is smooth however I do feel the gas and pressure again in three hours time and this trend is regular. The stomach gets settled after second BM. I do hear stomach growling and if I press my stomach hard I do feel pain like tenderness but only if I press hard otherwise there is not any pain, cramp or anything. I was advised to take Nexium 40 mg empty stomach for three weeks and I am still continuing with my third week. I was asked to quit smoking, alcohol and all non-vegetarian items which I have done from past one week. I am also taking one capsule of 64 billion probiotic daily along with 100 ml Kefir. My breakfast includes probiotic yogurt along with oats. I also have suspected migraine or occipital neuralgia owing to which I have had a lot of Voltaren 50 mg tablets at least 10 to 15 days in a month from past four years.I really want to understand what is this gas, morning episode BM and stomach growling all about? And how can I get rid of this once for all if it is an issue? Is this gut flora imbalance or IBS? How can I live an effective and healthy life? ### Response: Going through your history and reports, I do not feel anything so scary with you. Your reports are absolutely fine. The diagnosis of IBS is reached when we exclude all other possible common problems, which was done in your case too. Now the basic issues need to be ad" "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 in my mid 20\s. I have noticed a weird pattern on the back of my arm today. I do not know how long it has been there. It does not hurt or do anything. Just wondering what it is? And what I need to do about it? ### Response: Hi. I have seen your photographs (attachment removed to protect patient identity) and to me it seems like pityriasis versicolor. It usually occur in humid weather or sunny season. Apply the following medications and it will be helpful. Increased humidity or sweating. Pityriasis versicolor. Ketoconazole 1% cream for local application in the evening and morning over the affected area." "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 brushing my teeth and went side-tracked and brushed my gums too hard and now my right upper gum by my right canine and first pre-molar hurts. It hurts to eat salty foods and I was eating some chips and that made it hurt too. What could this be? Is it serious? ### Response: You have actually traumatized your gums while brushing too hard, but do not worry since it is a minor problem. Our gums have a tendency to heal on its own, within a few days without any treatment. For faster results, you can use a mouthwash containing Chlorhexidine gluconate twice a day. This will lead to faster healing. It is nothing serious. Just be a little gentle while brushing from next time" "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 44 years old. I consumed alcohol (whiskey) last Friday, about 20 ounces over 5 hours. I do not drink often. I had my dinner after taking alcohol. The next day morning I vomited, it was yellow and no food. An hour later, I vomited again, it was green and no food. I have no diarrhea, no jaundice, no bloodshot eyes. Three days later, I have no appetite. Still, I am eating and having bowel movements. I am having an unpleasant odor in my underarms and having mild sweat constantly. Did I permanantly damaged my liver? ### Response: Hello. You consumed a lot of alcohol, very close to the toxic level, and hence you have developed alcohol-induced gastritis. However, if you keep" "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: Please help me. I have unbelievably dry, flaking, painful, itchy, and now folding skin above my eyes and it is driving me crazy. It looks awful and is affecting my self-image. Every day I moisturize, multiple times, from coconut oil to rosehip, Vaseline, even hydrocortisone to no avail. I have tried removing gluten and yeast from my diet and it is still just as painful each morning. What is happening to me? ### Response: I have noted your concern and I have viewed the image (attachment removed to protect patient identity). Regards" "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 took the I-pill within two hours of unprotected sex. Is there any more risk? And also her periods are due at this point of time. So, will she have her periods this month? ### Response: Hi. Since you have taken the emergency pill within 72 hours of intercourse, there is no chance of pregnancy. So relax and do not worry. However, if you have a doubt then get 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: I am a 27 year old lady. I started having a sore throat two months back. I just thought it was a flu coming. But then, when I noticed that it had been on for two weeks, I decided to take Amoxicillin. I took it but did not finish the course on the last day. I had traveled and forgotten them at home. The sore throat went away but came back a few days later. I took another full course of Amoxicillin and during the course, the sore throat went away. I finished the full course but a few days later, the sore throat came back again. I went to the clinic and the nurse noticed that my throat was inflamed and prescribed Erythromycin. I took it but the sore throat kept on coming back. The nurse then prescribed Ciprofloxacin. I took the full course but still the sore throat did not go away. When I went back to the clinic, the nurse said it was no longer inflamed but I could feel it, but only that the discomfort seemed to be going deep down the throat. It is like each day I can feel it is moving down. It is not a very painful sore throat. I do not take any painkillers. My body temperature and blood pressure are normal and have been normal throughout the period. Right now, I can feel discomfort in my upper part of the chest. Another thing is that the first episode of sore throat occured after I visited my sister who from time to time gets swollen glands (below the ear). What could it be and how can I get well again? ### Response: I have gone through your complaints. Repeated attacks of a low-grade sore throat suggest that it could be chronic pharyngitis. The other common causes of chronic sore throat are due to acidity and gastroesophageal reflux. That means stomach acids pop into esophagus silently and burn the throat in the nights. You should undergo upper GI esophagoscopy and a throat swab to rule out infection. Try taking antacids for a week. Do not take antibiotics. I think this would suffice" "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: Since a week or so, I have started to feel pain and itching in the tip of my penis and the foreskin. It is painful to pull back the foreskin. Also when I have passed urine, the head and the foreskin tip feels very itchy and I get burning sensation. The head looks discolored. Kindly help. ### Response: Hi. With your descriptions, it seems either you have balanitis or urethritis" "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 lactating mother. I feel dizzy and weak. My BP is 100/60. What should I do for this? What diet should I follow? Please guide. ### Response: Your blood pressure (BP) is absolutely normal. There are various reasons for your tiredness and weakness which are as follows. The wrong position of breastfeeding may cause back pain and tiredness. You should not bend your back while breastfeeding. Put some pillows behind your back and raise the baby to your breast and feed. Tiredness may also be due to blood loss and anemia during pregnancy. During pregnancy, the child takes up a lot of iron from the mother and also during breastfeeding. Check your hemoglobin level and contact me. You may also feel tired and weak due to lack of calcium. For which start taking more milk, curd, vegetables, and fruits. Start taking calcium and multivitamin tablets if needed. Less sleep can also make you tired. It is difficult to sleep with small babies, so sleep whenever the baby is sleeping." "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 bought Yarsagumba from my friend. How can I use it for myself and my daughter? Is it good or bad? Does it show any side effects after taking it? ### Response: Hi. It should be taken under a doctor\s supervision. On continuity, you can take it for three to seven days. Then you have to reduce the quantity gradually. On using it, it provides strength to the body. It is an immunity booster and an aphrodisiac. It is good. Consult a nearby physician for dosage" "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 Terbinaforce plus cream be used for a vaginal infection? I have itching after periods. Please guide. ### Response: Hello. Please do not use Terbinaforce plus cream anywhere on the body. Do not even think of using it on your genitals. Terbinaforce plus cream (Clobetasol Topical, Ofloxacin Topical, Ornidazole Topical and Terbinafine Topical) has a potent steroid in it. They would further aggravate all kind of infections. It makes skin thinner, red, and more sensitive. Please meet your dermatologist and get evaluated for the nature of vaginal infections and use the medications prescribed accordingly. Vaginal itching could be bacterial, viral, or fungal. So, the treatment would be different for each infection." "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: Sometimes, I feel my left ear is blocked. It is shut when I got too much of cough and bad throat. What should I do? Please tell me. ### Response: This is due to upper respiratory tract infection. We usually prescribe tablet Azee (Azithromycin) 500 mg once a day for three days along with tablet Pantoprazole 40 mg before breakfast for three days. Also, you need to do Betadine gargles four times a day. You may have Otrivin (Xylometazoline) one" "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 eardrum got perforated due to earbud trauma. According to the ENT, no treatment is requred except precaution (water should not go inside) to avoid infection. Some kind of low noise \hush\ comes in my ear with a little hearing issue (20 % lesser than my other ear). What to do and how do I come to know about improvement? Please advice. ### Response: Hello. Yes, he is right. Just care to be taken to avoid infection, which most commonly occurs by water entering into the ear. Tympanic membrane injuries heal within four weeks in a majority of the cases. The sound and minor hearing loss will recover as it heals. Also, you should get repeat ear examination done after four to five weeks to confirm if it has healed or not." "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: About five days ago, my 1 and half year old baby got a high fever, about 104 F. We rushed to the doctor. On examination, he said that the baby had a severe throat infection. He prescribed antibiotics and Paracetamol. Now it has been five days, and the fever is under control only when I give her the medicine. Once it crosses the eight-hour mark, the fever is back again. I am really worried about my baby\s health. She is very cranky and crying all the time. She rejects food and water. Please suggest some treatment. ### Response: Hello. I understand that you are very concerned about your baby. Hope your baby gets well soon" "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 baby has developed redness around the perianal area. We have been traveling for the last two days, and hence, the usage of the diaper was more. My husband has developed a fungal infection, and he is on antifungal. He avoids touching the baby. Please help. ### Response: Hello. If possible, please avoid diapers. Apply easy nappy or rash free ointment around the anal area in thick layer three to four times a day. Apply candid cream twice a day around the anal and groin area. Diaper rash. Diaper rash." "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 anxiety and panic since five years. My GP had given Nexito forte and Veniz XR 37.5. And, I felt better and asked him to reduce the dosage two years ago. He stopped both and gave Nextio plus from then till date. I felt better. I did not smoke or drink while on treatment. 10 days back, I stopped taking the tablet. I drank half a beer at a party, and the anxiety disorder relapsed. I will not drink any longer. Now, my questions are as follows. I am on Nexito plus. Suppose there is a relapse, should I take Veniz XR 37.5? When I completely stop all the medications, and there is a future relapse, should I take Nexito forte, Nexito plus or Veniz XR? ### Response: It seems to be an anxiety disorder. You need to avoid the triggering factors that cause the relapse. Be it alcohol or something like smoking, family issues or financial problems. It is better to be on Nexito forte (Escitalopram and Clonazepam) during the episode of anxiety. If your symptoms were not controlled then, add on Veniz (Venlafaxine) to your medications. Meditation and yoga will help control the problem" "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 irritability, anger, and mood disorder. Now I am taking Qutan 25 once at night, but the improvement is not good. Please help. ### Response: I understand it must be difficult for you. But it would be helpful if you could elaborate more about your irritability and anger, i.e., since how long you have had this problem. Do you get irritated due to some reason or nothing at all? Why exactly would you say you have a mood disorder? Is your mood too low or too happy? How are your sleep and appetite been? Do you have any other medical illnesses along with this? You are taking Qutan 25 mg. Has it been prescribed for you or you have started on your own? With this dose of Qutan, you may sleep better and feel less anxious. But it is not sufficient for your irritability and anger. Please let me know the details of your problem to help you better." "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 regularly have chapped and dry lips, and this spot was a cut on the lips, and I messed with it. I have attached a picture. Is this a pimple or could it be herpes? I have no other symptoms and a cluster of bumps did not form before this. It was red at first and pain-free, but now it hurts too bad to pop it. ### Response: I have seen the picture (attachment removed to protect patient identity), and I understand your worry. Revert after five days 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: Before two years, I got married. I have pelvic pain for around seven months. I also had back pain. But I neglected it, thinking that it might be some digestion issue. Now, I am getting a mild foul smelling watery discharge for the past one month. Will this affect my fertility? Last month, my periods were also delayed. I had a urinary infection before seven years. ### Response: You are suffering from pelvic inflammatory disease secondary to recurrent vaginal infections. Presently, foul-smelling watery discharge indicates a bacterial vaginosis infection which is a deterrent for the fertility indeed and needs to be treated first. Ideally, both partners should be tested and treated" "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 there is some pimple like structures on my scrotum skin. Is it warts? I do not have sexual relation with anyone till now. My father is suffering from eczema. Is it due to that? And also, I am seeing white spots on the inner part of the penis. Is it penile papules? Please suggest some medicines to overcome this. I feel shy on a face-to-face consultation. That is why I chose the online mode. Please help me. ### Response: Hello. I have noted your concern and I have viewed the images (attachment removed to protect patient identity). You have sebaceous cysts of scrotal skin. They are not warts. Sebaceous cysts need to be removed surgically. The raised lesions on the corona of glans are penile papules. They are quite normal. There is no need for treatment. If you still want to get rid of penile papules for cosmetic reasons then you may need to go for a Laser- CO2 laser vaporization" "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 bitten by a dog which is regularly vaccinated. So, what precautions should I take? Can you please let me know the diet for food or something else, please. ### Response: I have reviewed your query and here is my advise. You have been bitten by a dog, so tetanus toxoid and rabies vaccine can be taken for that to prevent tetanus and rabies. But as you said if you are sure that dog is fully immunized with rabies then no need to take the vaccine. No dietary restriction needed. You can eat everything" "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 missed the period last month. My LMP was two months before on the ninth day of the cycle I had protected sex after 10 days of the missed period I had UPT all negative. Yesterday (17 days after a missed period) I had a beta hCG test level is 2.6 also yesterday I got my period (47th day of cycle), but the flow is quite different. Yesterday I got dark brown bleeding, but today I am getting light red colored pinkish bleeding, but clots ate there, and bleeding has a high quantity of mucus. Is it normal? Is beta hCG 2.6 non-pregnant? Please help. ### Response: Hello. Your beta hCG values are of nonpregnant level, and you have also got periods, so be rest assured that you are not pregnant. Need to undergo specific investigations like USG lower abdomen, blood for CBC (complete blood count), sugar, TSH (thyroid-stimulating hormone) and prolactin. Based on the reports, proper treatment will help you to get regular periods." "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: For the last three months, I have noticed a strange deep line on the right side of my head just above my temple to the upper side of my head. I have no pain at all but it bothers me so much. I have also seen my GP and he recommended to see a neurologist but I am not able to afford the consultation fees. Hope someone helps me out. I have uploaded pictures for your reference. ### Response: Hello. I carefully saw your uploaded photo (attachment removed to protect patient identity) and would explain that this indentation could be related to differential possible causes like calcium or vitamin D deficiency and bone reformation, chronic inflammation, or a hormonal disorder or etching. For this reason, I would recommend performing some tests if this phenomenon persists: All the above tests can be performed by your GP (general physician). Hope you will find this answer helpful" "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 brush, my gums bleed and are painful. However, I do not brush very hard. My gums have an indentation and feel rough. I brush twice a day, floss at night, and use Listerine mouthwash. I take Ibuprofen in the morning sometimes due to a bit of mouth pain. ### Response: I have seen the pictures attached along with your complaint (attachment removed to protect patient identity). It looks like trench mouth (in dental terms acute necrotizing ulcerative gingivitis). It is one of the common dental disease caused by bacterial infection. It is aggravated by stress, weak immune system, or habits such as smoking. It is usually painful and ulcerative. Instead of Ibuprofen and Listerine mouthwash, I suggest using warm salt water rinse thrice daily or Colgate Peroxyl rinses twice daily after meals. Just use 10 mL of the mouthwash to gargle for one minute and spit it out. This helps in pain relief and removing dead tissue on the ulcers. Please avoid smoking habit if you do and also avoid hot and spicy food. Brushing and flossing are to be continued, and never stop doing it. But, avoid vigorous brushing. The indentation and the white gums in between the teeth is the appearance of the ulceration and this disease usually presents in this form. It will heal as you do the rinse treatment along with good oral hygiene. Meanwhile, I also advise you visit your dentist to get a professional cleaning done along with a blood check up to confirm any underlying infection. You might also be prescribed an antibiotic medication for the same" "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 21-year-old healthy male with no underlying conditions. Today about six to seven hours ago, I was getting a haircut and the barber had the cape/blanket around my neck pretty tight and so I asked him to loosen it and when he did, he yanked it back before unbuttoning it and it choked me for a couple of seconds. The cape was lying on above my Adam's apple so I know it got pressed inward. There is not a lot of pain just discomfort like the feeling after getting choked. It was not intentionally done hard but it might have been the angle and where it was lying because it is a bit uncomfortable right now. If I take my mind off from it I do not feel it but as soon as I am remembered I feel the discomfort. Wondering if I had any damage permanently or if it is just temporary discomfort? ### Response: Hello. Your symptom seems to be temporary. You need not worry about it. You can take a plain Paracetamol 750 mg (Tylenol) twice daily for three days after food. Tylenol will not only reduce the pain and discomfort but also the inflammation post-injury. Instead of Semithecone, you can take Nexium 20 mg (Esomeprazole) once daily on empty stomach for three days (because Tylenol can cause acidity)." "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 irregular periods and continuous bleeding in the genital area. So I am using sanitary pad always. And also have some kind of pain in the stomach. ### Response: Hi. I understand your concern. Please tell me, when did you attain menarche? Have your periods been irregular always? If yes, tell me your cycle length. You need to understand diagnostic as well as therapeutic curratage. Until then take tablet Pause MF (Tranexamic acid) three times daily for five days, and tablet Meprate 10 mg (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 2-1/2-year-old son has a problem with four teeth (front, above) and doctors are suggesting RCT (root canal treatment). Here are my questions.Can RCT be done for such a small child?Will it affect his next teeth at around 7 years of age?Is there any alternate for RCT available as he is least cooperating?The doctors are saying that general anaesthesia will be needed for RCT. Is it safe? ### Response: If he is not cooperating then root canal treatment is very difficult for him and he would need to be sedated. You can delay the treatment by taking antibiotics and paracetamol for a week. This will give relief for some months. Also, use a good toothpaste to prevent further cavities" "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 filling in my tooth of some metal (14 years have passed). I had flu and sore throat a few days back. So, I used Augmentin and another tablet of Actifit-P replacement. After three to four days, my toothache started and now if I chew anything, my teeth feel painful. That filled tooth pain has become unbearable. Kindly guide me. ### Response: First of all, I would like to tell you that consult your nearby endodontist to rule out the reason for pain clinically and radiographically. If the pain would be due to secondary decay below the restoration and deep to the pulp, then you will have to undergo a root canal treatment and if not so deep, then the pain will be overcome by newer restoration. Such kind of decay is very common and treated easily. So no need to worry. Till the time you can take Combiflam (Ibuprofen and Paracetamol) to relieve your pain." "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 not gay. But, 15 years ago, I had sex with a man. I am not sure if his penis entered my anus or not. I did it again with a man, a year later. And, ten years ago, I had sex with a male for the last time. I have not been involved in any such activities after that. I have got tested for HIV, ELISA, and CMIA several times last year and it all came back negative. Those were done in my teenage. I have turned over a new leaf and realized my mistakes. So my question is, can I get HIV in the future due to this? Is it likely that I am suffering from an STD and am unaware of it? I am unmarried. But, when I do get married and have sex with my wife, will there be a problem later? ### Response: Hello, I understand your concern. You will not get HIV due to past activities. So remain relaxed, you are totally safe and will remain safe." "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 19-year-old female. I had unprotected sex three days ago. He did not ejaculate inside me. He was having precum on his penis and it was his second ejaculation. He had washed and urinated before having the second session of intercourse. I am a bit scared to take Unwanted 72 because of its side effects mentioned on the website as I am having various skin and liver problems.My periods get delayed by five to seven days every month normally but last month it got delayed by 12 days. I had intercourse the very next day of the end of my period. What is the chance of me getting pregnant? Can I take Unwanted 72 now? I am really scared. ### Response: Sexual intercourse done the very next day after the end of periods is unlikely to lead to pregnancy. This is considered to be the safe period for intercourse. Moreover, pregnancy occurs only when there are ejaculation and deposition of the semen inside the vagina. The chances of pregnancy are nil in your case. You can simply avoid taking Unwanted 72" "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 my dad and just recently my 20 years old brother both have low testosterone levels, what are the chances that I will too? I am 18 years old. ### Response: Hi. If low testosterones are due to secondary (acquired) causes then you are spared. The cause of low testosterone should be ascertained in your father which could be done only after detailed history and physical examination because there are number of causes for low testosterone levels." "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 25 year old female, diagnosed with PCOD. Since last week, I am taking tablet Normoz for that. I had unprotected sex today, that is, on the 14th day of my menstrual cycle. I took the Unwanted-72 pill within one hour. What are the chances of conceiving? Can I get pregnant? Please help? ### Response: Hello. I have gone through your history and understand your concerns. Hope you found this useful. Good luck." "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 period was two months back. Then I postponed my period by taking lemon seeds and till now I have not got my period. I am taking sesame seeds daily for the past four days but I did not get my period. Can you please help me by giving medical prescription to get period? ### Response: If you are not sexually active then you may take progesterone tablets like Gynaset 5 mg (Norethisterone), thrice a day for three days and then wait for one week to get 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 experienced double vision in a 100-mile trail run around 18 hours into the race. The double vision cleared after 20 minutes of closing my eyes in the medical tent. After a week, I saw an ophthalmologist who did a few tests and concluded that it was eye fatigue. I experienced double vision in a triathlon just after the swimming portion (30 minutes into the race). What is the reason for having double vision and is it preventable? Is there any reason other than fatigue that causes double vision? It never happened in my regular day to day activities. ### Response: It seems that you have phoria (not strabismus) and the fatigue in eye muscle cause double vision. I advise you to decrease the effort. Take good time to rest and use vitamin B (1,6,12) and keep your vision good (always about 20/20) by glasses or without any problem in your vision" "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 ringworm for the past seven months. It comes and goes. I have used many creams tablets. No use. But finally, I found a cream named Valerate-C. It is a very effective cream. If I apply it once at night, it solves the itching problem overnight. The infection also reduces for a week. After a week or 10 days, the infection starts again. I tried using it continuously for two weeks. When I stop using infection comes again after two weeks. I am stopping using because of its lacking. I could not find that cream anywhere. I only find that in my village. I cannot stay in my village every time. I bought that cream many times bulky (four creams). After the completion, the infection starts again after two weeks. Please solve my problem. How can I kill ringworm\s root? I have used Sapat lotion also. It is just burning the skin and the infection. After four days or a week, the infection starts again. Please help me. ### Response: Hi. Please take a picture of the lesion and send to us. The cream you are using is a combination of steroid and antifungal. You may get similar creams everywhere." "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 head hurts, but only on the right side--specifically around the area of my temple. Sometimes, the headache spreads to my right eye. The pain in itself is tolerable but every time I lay down to sleep, it becomes more painful. Next to that, my stomach also hurts since the other day. I feel nauseous too. Earlier this morning, I experienced a weird thing. At breakfast, I was feeling nauseous. And then suddenly, my eyesight was blocked by this wall of black and white dots. My ears were ringing. I closed my eyes, thinking it was just an illusion, but when I opened my eyes the wall of black and white dots was still there. I felt really weird all over my body too. There was this tingling feeling on my limbs and when the wall of black and white dots finally cleared up a bit, I looked down and I was surprised when I felt the wetness between my legs. I urinated. I didn\t even felt it until I saw the puddle below my feet. I felt like I blacked out. My blood pressure is 90/70. Temperature is 36.2. PR is 85 (resting). PI is 2.1 and blood oxygen saturation level is 97%. ### Response: I would recommend you take celecoxib 200 mg/tab, twice a day for pain and topimarate 25 mg/tab at bedtime for 1 week. I would then recommend further consult done after 1 week of taking topimarate. I would also recommend that you check your CBC to check for anemia and your serum electrolytes since you mentioned you blacked out. The results will help us understand your condition better" "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 gouty arthritis and currently, I am drinking Urinorm to lower my uric acid. I am not eating anything that may increase uric acid but I do eat fish and pork. Right now, I am experiencing a pain in my right foot and I was wondering if I can drink Colchicine. I bought it when I had my gout attack and I do not want to experience the pain again. I already had three attacks this year. Please suggest. ### Response: First of all, you need to be sure that you are having pain due to an acute attack of gout or something else. Since you are already taking Urinorm, and if you have been regular in taking it, you should not have got the attack. In case you have been irregular in taking Urinorm or you have started it recently, it can be an acute attack. An acute attack is best treated by NSAIDs like Diclofenac along with Serratiopeptidase. Colchicine you can take but is not going to help you just in case you have been taking Urinorm regularly. So taking Diclofenac is the right choice at this point of time, with or without Colchicine. 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 an 18 year old female, and I am not on any medications. I am 5 feet 4 inches tall, and I weigh 133 pounds. About 3 to 4 days ago after having a bowel movement, I noticed a little bit of bright red blood on the toilet paper, and my anus was bleeding a little bit for the next minute or so and then it stopped. The next day, I had another bowel movement, and there was a lot less blood on the toilet paper than the day before. The next day it was completely gone. For the next two days, I did not have any bleeding. But yesterday, the bleeding was back except there was a lot more of it had dripped into the toilet. It went away shortly. The same thing happened today. I do not have any pain, constipation, diarrhea, weight loss, fatigue, or nausea. The only other symptom besides the bleeding is that the outer part of my anus feels irritated after I pass stools. ### Response: Hello. You need to get your stool examined for the possibility of parasites which can cause such local irritation. Also, malabsorption of certain compounds in food can lead to local irritation after passing stools. Fresh bleeding is possible if the stools are hard, but there is no such history in your case. I will advise you the following medicines for a week, and if it still does not resolve, please get yourself examined by your physician. Consult your specialist doctor, discuss with him or her and start taking the medicines after their consent. If the bleeding is persistent, please get yourself examined." "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: Would you please explain if this means I have allergy from olive trees (trees that produces olives), if I have allergies from (ash- fraxinud excel) or are they different? ### Response: Fraxinus excel is the common ash plant. It belongs to the olive family. Plants in same family have shared antigens. If you are sensitive to one plant in the family, you are likely to be sensitive to others also. Hence, the result means that you are sensitive to olive as well in addition to fraxinus excel plant. Being sensitive does not mean you are allergic. Sensitivity does not always result in allergy. Sensitivity means you have circulating antibodies against that particular allergen. However, it may or may not result in allergy to that particular antigen. Only when you are exposed to it in a particular format and quantity, you will develop allergy to it. Skin prick test only measures sensitivity to specific allergens. We need to infer the results based on your symptoms. What do you suffer from? Was the test done to check for aeroallergens or food allergens? The two are different with different symptoms. Kindly elaborate your problems to us." "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 25 year old male, my height is 5\10"" and I weigh 73 kg. For the last two days, I have been feeling pain in my chest (left side). Since then, I have been feeling tired and sleepy all day and unable to concentrate on my work. Pain is not so frequent, but when I take a deep breath, I feel pain. Also, I have the problem of morning cough. I have a history of regular constipation. I also have a history of increased cholesterol level in my body, which is fine now. I am a regular smoker (6 to 7 cigarettes a day) and a social drinker. Please advice. ### Response: Hello. It looks like you have pleuritic pain. This refers to pain due to inflammation of the covering of your lungs. You will need a course of antibiotics. The reason why you are getting such chest infections is your smoking. So, I actively encourage you to quit smoking. There are courses of medications available to assist you to quit smoking. Take lots of fiber-rich food to get rid of constipation. You can buy an over the counter laxative to overcome constipation if required. If the chest pain persists after the course of antibiotics, you would need an ECG and chest x-ray." "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 frequent urination problem (urine every 30 to 40 minutes and not satisfied post-void) since a month. My Kidney function tests, blood sugar level, prostrate size everything is normal. My pelvic ultrasound showed mild urine post-void retention of 25 ml and muscosal prominence was noted measuring 3 to 4 mm in thickness.Kindly advice me an ayurvedic medicine. I read about Chandraprabha vati and Bangshil. Let me know what is to be recommended. And Gogshuradi Guggulu is a diuretic so I will not prefer that. ### Response: Hi. I have read your case history. You have mentioned kidney function test, blood sugar level and prostrate size is normal (attachment removed to protect patient identity), even then you get frequent urination. See, only above mentioned causes are not responsible for frequent urination. Incomplete void due to any reasons like thickness of bladder sphincters or nerve conduction defects, infection, inflammation in urinary tract are also responsible for such conditions. Excess consumption of alcohol, using air-condition are also causes of frequent urination. Gokshuradi guggulu works as diuretic but it also helps to remove the cause of retention of urine. So as per your present case history and investigation reports you should go through following medications. 1." "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 was over two weeks ago I had my endoscopy. It was not sedated but they gave me the local anesthetic spray but after I had my endoscopy I feel like my heart is beating faster than normal and I feel like my nerves or you can say muscle are like twitching or throbbing and I went to some doctor and said I do not have toxicity but I got so curious if I actually have toxicity. So is it? ### Response: Hi. Local anesthesia toxicity can happen if the spray is used at high concentrations. Usually, they will have 10 percent Lignocaine spray. The other symptoms you had are because of your anxiety, stress because you are not sedated and you are just given local anesthesia, that is why and if toxicity happens, first you will have fits (seizures, numbness over the lips and around mouth)." "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 shiny, slightly raised bump on the shaft of my penis. ### Response: Hello. I do not think it is a genital wart. It does not look like any STD except maybe genital molluscum contagiosum, but those are some shaped implicated papules. Is it itchy? And what is the duration? Do any other body parts have the same lesions?" "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 darkness in my eyes. What to do? How to treat dark circles in the eyes? ### Response: First, you need to understand that dark circles around the eyes are sometimes resistant to any treatment and runs in families. Ensure you get a full night\s sleep. Do not take stress. Take capsule Perfectil plus (multivitamins and minerals) for three months. Apply Vitamin C cream around the eyes" "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 pterygium from last two years. I feel a burning sensation and redness in my eyes the whole day, currently using rose water as suggested by an Ayurvedic doctor. Is there any drops which heal it permanently without surgery? I found one online. Could you please suggest if it works for me? I am sharing the picture below. Kindly go through and advise me. ### Response: Hello. This is a very small pterygium. I would not recommend surgery for this small pterygium. I am sorry but there is no medicine to treat pterygium. One may claim anything, but we usually do not recommend any medicine unless it is approved by FDI. I hope this will help you. Regards." "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 haemoglobin D traits. What can I do, so that my child does not have that problem? I have done abnormal stuudies of HPCL. ### Response: I have checked the attached report. (attachment removed to protect patient identity). It is suggestive of Hb D (hemoglobin D) trait. It can get transmitted in your future child if you have that problem. You cannot prevent trait transmission. In fact HB D trait is not the major hemolytic anemia and you may need not worry about that. However, if your wife having Hb D trait then the child can have Hb D homozygous disease form. So you can investigate your wife for hemoglobinopathy. So, do not worry about Hb D trait. The patient usually does not have much symptoms and does not need a regular blood transfusion. 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 had an abscessed tooth for two months now. I am afraid it will lead to a jaw bone infection. What do I do to stop them before it gets into my bloodstream? ### Response: Hi. I have and gone through your query and would like to say that an abscess requires antibiotic coverage and specific treatment of the cause. If it is because of a cavity in the tooth, we can go for root canal treatment or extraction based on the condition of the tooth. If it is because of gums and supporting tissues, cleaning, curettage and further minor surgery if required has to be done. So, kindly visit you nearby dentist for examination and treatment. Do not worry. It can be treated. Since you have a chronic infection, it might shoot up anytime when your immunity goes low and cause pain too. So, better visit your dentist as soon as possible. You can send me an image of the tooth and lesion to guide you more properly with a provisional diagnosis. Anyways confirmation can be done with X-ray along with clinical examination 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 had a sexual exposure, oral unprotected and vaginal sex. I took the fourth generation test on the 16th day, 23rd day and 53rd day. All came back negative. At my 53rd day, my wife developed very swollen tender lymph nodes and I am worried the test were false negatives. Also, I read that Biotin can affect the testing. I was taking 300 mcg in a multivitamin. I also read it takes 5000 mcg or more to affect test results but I am still worried. I have read that 28 days and six weeks are considered conclusive for this test. Is that true? I have had extreme anxiety and could not live with myself if I infected my wife. ### Response: Hello. Your 53rd day negative test can be taken as conclusive, as six weeks is a good period for the fourth generation ELISA. Biotin does not affect test results. But, anxiety and HIV phobia after exposure are very common. Try not to research online much, as you will mentally disturb yourself with false information. Swollen lymph nodes in your wife could be due to some other reason or infection." "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 chickenpox started seven days back. The fever has subsided now.I had been taking:Azithromycin,Acivir 400 DT,Cetzine,vitamin E capsule and,applying Calamine only on spots.A few spots are getting covered with a crust. What should I use at this stage to avoid scars? Looking at the pictures, will it leave any scar? How long will it take to go away? ### Response: Hello. Chickenpox takes around two weeks to get scabbed off. Since as per your query, if it already formed a crust, then now it will scab off soon. Do not touch it or scratch it. Otherwise, there will be high chances for scars on the face. The treatment you were taking is entirely correct, and you need not apply any particular thing on that. Wait for a few days more around a week to get rid of them. As per your photos, I do not think that they may leave a scar. Just you be careful not to touch or scratch." "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: Yesterday my penis foreskin suddenly moved back and did not come back to proper place. Glans is still open and pain is there. Please suggest the way to restore that. Please guide me on how to pull it back. ### Response: This condition is probably paraphimosis and it needs urgent treatment. If you are not able to pull back it by yourself then consult a surgeon or doctor as soon as possible. He may correct it immediately as of now and may recommend surgery for further depending on the severity" "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 25 year old male. I am facing serious premature ejaculation issues since the last 7 years, and it has become worse with time. I have been masturbating five times a week since the last 10 years, but now when I masturbate, I ejaculate within 10 seconds. I also have two huge nerves or veins on my penis. They are quite huge and look odd. The head of my penis has also become huge, and the rest of the penis is getting thinner. If I do not masturbate for a week, l get wet dreams. My body structure is very thin, and I feel weak throughout the day. I want to solve this PE problem. Can I train myself with start and stop technique while masturbating? Will it help? Or should I stop masturbating? Please suggest a solution for my PE problem. I do not want to take antidepressants or SSRIs as they have major side effects. ### Response: Hi. There is no relation between premature ejaculation (PE) and masturbation. Due to anxiety, the ejaculation will happen sooner. This can be managed by calming down and avoiding stress. Think that everything will be fine. It is normal physiology that during erection, veins appear prominent. Penis size varies from individual to individual. For thin people, the penis will appear longer, as the fat in the lower abdomen is less. My suggestion is to distract yourself. Do meditation and yoga. Masturbate whenever you have the urge." "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 period never comes on the same day, just around the same time. Last period was on 25th and it is 29th this month and still no period and a negative pregnancy test. ### Response: Hello. A delay of 3 to 4 days is acceptable. By definition, if the menstrual cycle is between 23 to 35 days, it is still considered normal. However, the most common cause of delay in menses is stress-induced hormonal imbalances (80 %) and the remaining 20 % include PCOD (polycystic ovarian disease), hypothyroidism, and hyperprolactinemia." "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 73-year-old father is suffering from type 2 diabetes from the age of 7. He has undergone angioplasty. His fasting level is 140 and the postprandial level is 320 after taking Glimepiride 2 mg and Metformin 500 mg once a day. Should I increase his dose once to twice daily? ### Response: Hello. Your father seems to be on the right kind of medication. His blood sugar levels are not controlled, so he definitely requires a revision of prescription. Since he is having other coexisting medical conditions, it would not be a good idea to take an online prescription. By meeting a diabetes specialist or a family physician, he can get his vital parameters checked before changing the prescription. There is a possibility that the doctor may just add a second dose of Metformin or both Metformin and Glimepiride together." "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 playing with my brother of age 12 and I grabbed his arm tight and it caused redness line on its arm. Is it dangerous or what should I do? ### Response: Hello. Assuming your brother is 12 years old, he is not too young. If the lines are from grabbing him tight like finger impressions then they should fade and should not cause any damage. However, if you accidentally twisted his arm, there may be swelling or bruises. In that case, he will have pain and a more serious injury must be ruled out. If he is complaining of pain in his arm, he has difficulty moving his arm or if there are swelling or bruises, tell your parents and take him to the hospital." "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 is pregnant for the first time and it is her 12th week. We did a blood grouping and urine culture testing last week. It is found that the blood group is \O\ but the Rh was given as \weak D positive\. We did a second opinion testing in a different lab and the result was the same. Doctors are confused and they say that we need to check what is the blood group of the baby. We are a little bit worried and following are our queries.What type of blood group does she belong to (O+ or O-)?Does that affect my wife and baby for the first pregnancy?Do we need to take any preventive measures to make sure everything is normal or post pregnancy?Please help us. ### Response: Weak D in itself is a specific category of blood group. Weak D expression primarily results from single point mutations in RhD which encode amino acid changes predicted to be intracellular or in the transmembrane regions of RhD. Molecular RhD blood group typing is very efficient for managing donors and patients carrying any of the various molecular types of weak D and partial D. Weak D people belonging to weak type 1, 2, 3, 4.0, 4.1, and 5 can be treated as Rh-positive and be transfused by Rh-positive red blood cells, while subjects with weak type 4.2\x80\x9311 and 15 should be treated as Rh-negative and transfused with Rh-negative red blood cells. Ideally, it is important to know the status of the blood group of the mother if she is Rh negative so that anti D injections can be given to prevent complications in subsequent pregnancies if the baby is Rh positive. A weak D positive is generally considered as Rh positive and usually, the anti D injections are not required in such patients. It should not affect either your wife or baby during her first pregnancy and subsequent pregnancies as well" "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 50 year old male. I got my lipid profile, LFT and KFT done. I have attached the reports. Kindly check and suggest the following: Does LFT report indicate fatty liver? I consume 2-3 pegs of alcohol three times a week since last 14-15 years. If yes, then what precaution has to be taken? Can I take Liv 52? My triglycerides was 400 last year, but reduced this year. My cholesterol, HDL and LDL are the same as last year. I have some sleeping problem too. I am drinking amla and aloe vera juice daily. I am taking Isabgol in the evening and Revital capsule every alternate day. Please help. ### Response: Hi. We are here to help you. I have studied your case history and reports too (attachment removed to protect patient identity)." "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 some urinary issues in the past from a slightly enlarged prostate (37-year-old male). Two months back I had some testicle discomfort. The doctor gave me 10 days Ciprofloxacin. Last month I had unprotected sex. About six days later I had a sudden strong tingling in my scrotum that stopped me in my tracks. I had a chlamydia and gonorrhea urine test a few days later but was urinating so frequently that I could not hold my urine at least an hour before the test, and the test was negative. Frequent urination continues till today. I also had Keflex last month, a full panel STD test this month, and everything was negative. But wondering if the antibiotic mixed with me filling up the cup way more than 30 ml could skew the test? I did contract genital warts, most likely from this encounter (showed up three weeks after). I started 28 days of Bactrim about a week ago and symptoms have not cleared. Frequent urination and tingling scrotum are still there. Also, my lower back by my spine hurts, but does not feel like a kidney thing. It hurts for a bit. Wondering if a spine injury could affect my urinary system. I guess even though I took two chlamydia and gonorrhea test, I am paranoid that the two negatives may have been skewed from urinating too soon before on test one and being on antibiotics or providing a large volume of urine on test two. And the partner is of medium risk. She has no symptoms. The urine test was done with the Aptiva Combo 2 RNA/TMA test. There is no discharge, just this persistent urination and unable to empty bladder. ### Response: Hi. I have noted your concern. I do not think that the tests for gonorrhea or chlamydia would have been affected due to a higher volume of urine or oral antibiotics as the urine test relies on the detection of the nucleic acid material of gonorrhea or chlamydia which would have been present. Your symptoms could either be due to urinary tract infection or they could be those of prostatism. I suggest a urine routine microscopy, urine culture sensitivity, PSA (prostate-specific antigen) levels, uroflowmetry and pelvic ultrasound to estimate the size and volume of the prostate" "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: Before one and a half months ago, I had a skull fracture on the right side of my head. Is it possible to lose hearing? Because I cannot hear from my right ear since then. ### Response: Hi. It is possible to have hearing loss after a head injury, especially if it was as severe as in your case where it leads to a fracture. These little bones may have easily been dislocated due to the impact of your injury. This will cause a hearing loss of 40 - 50%." "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 I have gum disease. My teeth are starting to move. Will my teeth have to be removed? I have no bleeding gums there, not red. ### Response: I went through your query , I would like to see an image of the area myself, kindly upload. Let me know if there is any history of diabetes. Mostly seems to be a periodontal problem." "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 burning sensation on top of my head. This happens after my mom disturbs me whenever I try to study. I get irritated and I do not get along with her because she does not encourage me to study. How can I get rid of this feeling? Please help me. ### Response: First of all, you need to relax about your studies that for sure you will be able to manage it and be confident about yourself. The second important thing is that whenever you feel your mother is disturbing, you need to take a break for 15 minutes, go out to an open place and take deep breaths for 5-7 minutes and avoid thinking about your mother and continue study at that time. This will help you to vent your feelings out. You need to do deep breathing exercises four to five times a day which will include: Within 21 days, this will definitely help 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 28 years old. My weight is 55 kg. Whenever I am taking cold foods, I am suffering from nausea, headache, and chest pain. Kindly advice. ### Response: Hello. You feel those symptoms when you take cold foods, and so you may likely be having symptoms of common cold and malaria. The chest pain could be a symptom of an ulcer. There may also be fever, I presume. You can run a test for malaria (blood film) if it is positive then treat it. Tablet Artemether Lumefantrine 80/480 mg b.d (twice a day) for three days, tablet loratadine 10 mg b.d for five days, tablet vitamin C 2 t.d.s (thrice a day) for five days. Add tablet Rabeprazole 20 mg b.d in case of ulcer." "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 health anxiety and have recently become quite obsessive over my moles. A week or so ago, I became focused on a 2 mm mole on my knee. I have always had it as far as I am aware. I noticed a slightly raised bump towards the top with some small hairs coming out of it and was unsure if it had always been that way. I panicked and squeezed it and clear fluid came out. Since then, the mole has scabbed and is now just slightly raised pink skin. I am worried that when it heals, it will disappear completely and I will have hidden a melanoma. I have attached photos of it now but unfortunately, I have not got any of what it looked like before. ### Response: I have gone through the images (attachment removed to protect patient identity). First, you need to understand that for any mole which turns into melanoma require spontaneous changes. It means that any change in color, size, shape, or symmetry of lesions should be spontaneous without any provocation. But in your case you yourself have squeezed the mole. Moreover, in most cases developing into melanoma, the size should be more than 5 mm. So just relax. In my opinion, your lesions does not clinically look malignant" "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 28 year old female. I am suffering from mid back pain since two days. I did not take any medicine but applied Moov and Zandu balm. But, there is no relief. The pain remains the same all through the day and night. I neither had an injury nor lifted any heavy objects. I had no surgeries before. The pain persists more while sitting without back support and while working in kitchen. It is a constant pain and not spreading anywhere. I am feeling comfortable in bed. I have no extra symptoms other than the pain. What may be the reason for the pain? Can you please suggest a medicine? How long should I use it? ### Response: 1. Muscular strain.2. Discogenic. 1. Not to bend forwards acutely especially after getting up in morning.2. Not to lift any heavy weight. Revert back after two weeks for follow up to a spine 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: It has been eight hours now. I have extracted three teeth at the same time. There is excessive bleeding from the extracted site. Is this deadly? ### Response: Hi. You can use ice in the extracted site to stop the bleeding. If it still continues to bleed, consult your dentist. If it stops, then from the next day, rinse mouth with salt water and turmeric mixture twice a day. It will help. Maintain oral hygiene properly. Do not spit for the next 18 hours. Do not" "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 eye shape has started to differ than other one and looks droop. ### Response: From the photo attachment (attachment remove to protect patient identity), I can tell you that you have mild ptosis on your right eye. There are several ways in which ptosis can be corrected depending on the etiology. To get to the etiology a face to face consultation and examination is mandatory. I recommend that you visit an ophthalmologist preferably with experience in oculoplasty surgery. I also advise an urgent appointment in case you have the following: 1. Seeing double. 2. One side of the face or body (arms or legs) are feeling numb or do not move as well as the other or power is lesser. 3. In case you have been experiencing headache, severe vomiting, weight loss and problems seeing bright lights." "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 ago, I suffered from a miscarriage and had undergone D and C. I am suffering from hypothyroidism and on Thyronorm 75 mg, and now the levels are normal. After six months of D and C, I got pregnant while on ovulation induction treatment, and unfortunately, that was an ectopic. My right tube is now blocked as I had undergone surgery. The tube is not removed, but the tube is blocked.It has been a year since I had surgery. I am trying to conceive, but I am not able to. My doctor put me on Letrozole, and it is my fourth cycle for it. During the first cycle, the ovulation was on left tube with ET 6.5 mm, and I did not conceive. Next two were on the right side, so no chance. Now again luckily it is on the left with ET 7.8 mm on day 16. What are my chances of conceiving, and is there a risk of ectopic again? My left tube is clear HSG test was done. Kindly explain to me. ### Response: Hello. No matter which side the ovulation occurs, the egg will fall into the peritoneal cavity and moves into the available open tube through which it enters the uterus. Since you had one ectopic pregnancy, you have a higher chance of repeat tubal pregnancy. But since HSG (hysterosalpingography) shows a patent tube, you also have a high chance of normal uterine pregnancy. The only chance is to have a pregnancy and have an early scan to confirm pregnancy inside uterus. I hope I have clarified your query, do write back if you have any more questions, for feedback." "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 protected sex before two months. After a month, I got my periods, and it was slightly heavier. It lasted for an average duration, and it started on the expected date.After a month, my periods was late and I had a white discharge and have a feeling of getting periods. But I have not got it. Sometimes I also have sore breasts.Really worried. Why is my second menstrual cycle late after having sex? What can be done to have them now? ### Response: If you did not have any intercourse after getting periods, you would not be pregnant. Your periods can be delayed if you have taken an emergency contraceptive pill. Do serum TSH (thyroid stimulating hormone) and serum prolactin blood test on an empty stomach tomorrow morning to see if you have any hormonal imbalance. If you are not sure of pregnancy, do serum beta hCG blood test to rule out pregnancy" "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 husband is obese and requires a robotic-assisted partial laparoscopy. I am worried about his weight 294, height 71 inches and how pneumoperitoneum may affect him during surgery. Currently, he is on Lisinopril 10 mg. There is a possibility of RCC on left kidney 2.5 cm. ### Response: Hi. I understand from your query that you are very worried. It is a major surgery. Hence, all the required guidelines will be followed, at this juncture, I like to know more about your husband habits. Does he smoke? If he smokes, how many in a day? If he does not smoke then there are quite a sophisticated ventilators for anesthesia which is used to pump oxygen to the lungs so that patient is well ventilated. There are lot many surgeries going on with obese patients, for bariatric surgeries, robotic surgeries who require laparoscopic intervention. Anesthesia is well advanced and sophisticated now. Do not worry. He will be fine. If he smokes please tell him to abstain from it, till the surgery." "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 5-year-old with a front tooth abscess and four cavities in the back teeth. The dentist wants to put him to sleep and do at once. Is there a different or better way you do not wanna have him put to sleep? ### Response: At 5 years, it should be possible to make him calm with just a nitrous oxide inhalation, if possible. If he is not cooperating, then either just give him antibiotics for a week, delay for a month or so like that. Brush twice a day. The abscess and pain will go away for a few months. Then when he is relaxed you can go ahead with treatment. Else go ahead with general anesthesia as the doctor says" "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: Dear doctor,My 18 day old baby had gone for 96 hours of phototherapy. Her total bilirubin is fluctuating from 19.5, 14.5, 13.5, 13, 11, again 14 in 12 days. What can be done now? ### Response: Before advising you about the child, I need some information: Bilirubin may fluctuate during the treatment with phototherapy and the level of bilirubin depends on the maturation of the liver. And the rate of production of bilirubin in the child depends on the cause of raised bilirubin. If there is any incompatibility of blood groups between the baby and the mother, the bilirubin may rise in spite of phototherapy. But nothing to worry as the level of bilirubin of 14 is not dangerous around this day of life in case of babies with normal birth weight. In spite of phototherapy, if the bilirubin is increasing, then the child needs further investigations to look for other causes such as hemolysis, hypothyroidism, and other problems. If the fluctuations persist, consult a paediatrician 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 did an HIV rapid screening after eight weeks of exposure, and the results came negative. I do not have any other symptoms of HIV. Is this result reliable? Do I need to do other tests? ### Response: Hi. The tests available for HIV diagnosis are highly sensitive and specific and gives accurate results. Majority of the people who are infected with HIV develop HIV antibodies by two to eight weeks. Approximately, up to 5 % develop seroconversion by 12 weeks. Your HIV negative result after eight weeks is reliable. You can repeat the test at the end of three months, and not before that." "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 is 70 years old and was diagnosed with typhoid and was given Ceftas 200 TDS for 21 days and Argex 500 OD for seven days. The Widal test showed typhi O: 1:160, typhi H: 1:160, typhi AH: 1:80 and typhi BH: 1:40 after 10 days of treatment. The treatment was continued as above and after 2 to 4 days the temperature came down to 98.0 to 98.8. Now five days after completing the medicine course we again got her Widal test and results are the same as were in firsts test. Now, I would like to be advised how to treat her weakness and is there any treatment to kill the bacteria causing the fever and should we go for vaccine inoculation once more now. ### Response: Hello. I guess, she is not having a fever now. If fever has settled down then it means all bacterias are killed. These test may remain positive for some time or may be lifelong, so, not to chase the reports. Weakness will be there for few weeks. She should have a healthy diet and may have multivitamin supplements like syrup Zincovit two tablespoon once a day for two weeks for early recovery. Vaccination is recommended to repeat every three to five years, so she may take another course of vaccine as she is getting typhoid frequently" "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 premature ejaculation. I ejaculate within 20 seconds of penetration. Is it curable? Suggest me some medicines for the same. ### Response: Premature ejaculation is a common condition which affects men. If you are perfectly healthy without any medical conditions such as type-2 diabetes mellitus or hypertension, you can easily overcome your problem. Mostly, it is due to anxiety. I advise you to get rid of any anxiety which can affect your performance. Talk to your spouse, so that she understands your problem. Be more relaxed during the intercourse. There are some climax-delay condoms available, which you can try. Also, start taking tablet Cobadex CZS (vitamin supplement) and vitamin E capsules." "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 24 year old male, suffering from ED since the last one and a half years. I have gone through penile doppler thrice. The test which I took one year ago showed the PSV after 20 minutes as 38 cm/s, the EDV as 0 and the inner caversonal diameter was .15 mm and after the injection it was .70 mm. After the doctor had seen the reports, he advised me to take Tadalafil 10 mg and to masturbate after taking it. While masturbating, on the third day, I got pain in my penis, and it was in the middle of the shaft of the penis at the thumb point. I visited the doctor again, and he prescribed Polycovit, Mynubin-P, Zanocin 300, Trental 400 mg and I also masturbated four times a week. But still, the pain continued. So, I went through the test again eight months back.The value of PSV was 25 cm/s and EDV was 0, but the inner caversonal diameter changed to .44 mm pre-injection and after. The third time I underwent the test again. The values were normal at 25 cm/s, and EDV at 0, and the inner diameter was .6 mm and after injection at 1.2 mm. I still have the pain in the penis at the same point. It has now been a year since the pain has started. There is no bending during erection, but there is a deformation in the penis like an hourglass shape and hard flaccid. Now, I masturbate only once a week. Is the 25 cm/s good or does it mean an arterial insufficiency? Does Peyronie\s disease obstruct the blood flow in the penile doppler? I have no diabetes, no cholesterol, and I am not a smoker. I want to know why the flow is less. ### Response: I can understand your concern. Do not get stressed. Your PSV in the last test is normal and is not suggestive of a vascular insufficiency. The values do not remain same always and may come normally in the next test" "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: Hello,I want to confirm about some health issues of my son.He is a 19 year old boy, his weight is 46 kg and his height is 5 feet 5 inches.He is having fever, chest pain, back pain, diarrhea, weakness, complete loss of appetite, sore throat and bloating for the past 7 days.So, I took him to a doctor, he had prescribed some medicines and given some tests to do. You can see the attached pictures here. In that, some values of the tests are on border levels and some are on extreme levels.Please take a closer look at these test reports and tell me if there is anything serious to worry about.And now, the fever has gone completely, but he is having sore throat and diarrhea again from yesterday. Is there any solution for that?Kindly give me a detailed answer about my son\s health. ### Response: Hi. I have read through your query in detail (attachments removed to protect patient identity) and my observations are: Following are the medication details: Hope my answers done with your questions." "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, 51 years old, height 5 feet 6 inches, balanitis problem- An unpleasant smell, redness around the glans, inflammation, soreness, itchiness, or irritation of the glans. ### Response: If the symptoms have been present since a week, did you take any medicines or cream for those? Did you start any antibiotic? How is your personal hygiene? Can you take a picture of the affected area with retracted foreskin and send to me? Are you circumcised? You need a course of Ciprofloxacin, Tinidazole or Ofloxacin Ornidazole with some anti-inflammatory medicines, local application creams and lukewarm water rinses of the penis twice daily. You may refrain from sexual activities till you get better. Please provide us more details so that we can help you better. Are you a diabetic? Is there any medical condition for which you take medicines regularly?" "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 is 59 years old and suffering from diabetes for the last 15 years within control limit of sugar. Recently, he got attach with a brain hemorrhage on the right side, and he stopped to talk and his right side hand and leg become inactive. Slowly with medication and physiotherapy exercise, he recovered somewhat and able to speak. He can walk with rod support and his hand is still inactive. His creatine level in blood keeps on the higher side from 5.0 to up to 8.0.In the last few days, he started vomiting and unable to digest any foods. Doctor advised for immediate dialysis and is undergoing the procedure. Within a week\s time, this is the second time he is going with the procedure. The first time it lasts for one and a half hours, and for the second time it lasts for three hours. While discussing with the fellow patient taking the procedure, they said this is a regular procedure and may require on a daily basis also.My query regarding dialysis is if once we opted is it a regular procedure? Please clarify the doubt. ### Response: Hi. I have thoroughly gone through your case and can well understand your genuine health concerns. No, this is not a permanent procedure for every patient. It depends on the status of kidney functions and roughly we can predict from creatinine levels (just to make it clear to you). If he gets creatinine levels of 0.2-1.2 mg/dL and the kidneys will be doing normal functions, then we can stop doing dialysis as kidneys are now doing their job by themselves. Dialysis is alternative kidneys actually. The job which kidneys do normally, dialysis does the same for the time being until the patient gets normal kidney functions back. 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 a 32 year old male having a normal health condition. My height is 5 feet 6 inches, and weight is 58 Kg. Recently (yesterday), I noticed chest pain in the left side which feels like pinpointed pain (electric shock kind) and lasted for a few seconds. Please let me know what I need to do as it is the first time I have faced such a symptom.Previously, I had once felt once the same pain (before 30 days), but it was very mild. I read on the internet that, it is due to the gas problem, but I am not sure. Please advise on the same. ### Response: I understand your concern. Most common causes of such chest pain are:1. 2. Chest pain due to heart issues.3. Acid peptic disease. We cannot afford to miss cardiac reason for chest pain, so we always advise to get an ECG and chest x-ray done. This will give an idea if the pain is cardiac in nature or not.If you have recurrent episodes of acidity, get upper GI endoscopy and ultrasound abdomen done. For acid reflux, I would advise you to take a combination of Pantoprazole and Domperidone once a day.For muscular chest pain , do hot fomentation of the affected area and apply Diclofenac ointment locally. Avoid smoking and alcohol.Avoid hot and spicy food." "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 constant tinnitus and sensorineural hearing loss for about five months. I am sending you reports of my PTA and otoscopy. Now I have ear fullness, tinnitus, and hearing loss in my left ear. My right ear is normal. Tinnitus is continuous for past four months. I do not have any vertigo or dizziness episodes. Please tell me is my symptoms of Meniere\s disease. Please tell me the cure for ear fullness. ### Response: Hi. I have seen the reports (attachment removed to protect patient identity). There is minimal loss in the left ear. The symptoms do not seem to be due to Meniere\s disease. The tinnitus is due to the hearing loss. Take tablet Cinnarizine 75 mg once daily for 15 days and tablet Vitamin B12 1500 micrograms once daily for 15 days. You will definitely be benefited. Consult with your doctor before taking them. Avoid any excess mobile usage or earphones use." "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 penile infection/balanitis for almost three months. This is occurring every week once or twice but it is disappearing after two to three days and coming back again. Initially, my symptoms were:Itching.Redness around the head of the penis.Swelling under the foreskin, and around the penile head.Small red tips on the head of the penis.Burning sensation.White/thick fluid discharge.Little discomfort during urination.But now, along with these, I am experiencing pain and more burning sensation. Please suggest some medication to get rid of this disease. ### Response: Hi. From your description, you are suffering from balanitis. It can be due to irritation from soap or other products that you are using to wash that area, or it can be due to a fungal infection. I would like you to check your blood sugar. I suggest using Clotrimazole solution every night daily at bedtime. Follow up in two weeks. Revert after two weeks 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 have a fever with a cough. I have blocked ear. What can I do? ### Response: You are having upper respiratory tract infection. You can have associated middle ear infection because of the presence of ear pain. You can take Levocetirizine for five days. For fever and pain relief, you can take Paracetamol 500 mg. Steam inhalation can be done three times a day with warm water. It is beneficial. Avoid eating excess spicy foods. Take one teaspoon turmeric powder with milk daily. You can investigate with CBC (complete blood count) for primary work up. It is advisable to consult an otorhinolaryngologist for a detailed 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 a female of 25 years old. Since last month, I am noticing slight hand tremors when I am inactive and when I am performing an important task like meeting an important person. Also, I am a smoker. ### Response: Heavy smoking can lead to tremors in hands and so can tea and coffee if consumed heaviely. Slight tremors, particularly in the hands and fingers, is a normal phenomenon called physiologic tremor. It can get aggravated by stress or anxiety. You should cut down on smoking. If tremors do not disappear after cessation of smoking consult a physician and undergo some laboratory tests like estimation of thyroid hormone levels and blood glucose levels that can also cause tremors if found deranged." "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 19-year-old male. Three weeks ago, I did deadlifts and squats on the same day. I have been training for two years, and I never faced any lower back issues. I experienced pain and soreness in my lower back about two days and a week goes I thought it was a little pain, and I did deadlifts again this time the pain was so bad that till date I could not bend my back like I used to do.It was slowly recovering, and I did not go to the gym for four days, and then I started using machines for three days from now. Today I did my leg workout and thought leg press would not aggravate my pain, but it did, so bad. What should I do now should? I quit the gym for a while or avoid some movements? Is there any quick home cure for the pain? ### Response: It sounds more of the lower back ligament sprain. You may have injured the back. The first thing to do is to look for an MRI, like any soft tissue Injury if not focused, then might become chronic. I will advise you to do some exercises for strengthening the paraspinal muscle\s. Once you learn the correct pattern of the exercises I am talking about then before every workout regimen, you need to do that, and then your back pain would not come up. For now, give rest of three weeks, and then I can teach you proper exercises which will help avoid future back pains." "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 had a SPECT scan to evaluate a possible CSF leak. The scan was done with a dye injected into the spine. My brain was scanned and also the abdomen. The scan did not pick-up any abnormalities and a leak was not seen. I was informed today that I may need to have a CT scan of the abdomen for an adrenal issue due to high testerone levels. I assume that the adrenals were seen during the recent CT scan. I am curious to know as to the glands and organs that were visible during this type of scan. I do not want to have another scan if an adrenal problem could have been detected on the SPECT scan. ### Response: Hello. I cannot but appreciate what you call your ""curiosity"". I would rather call it your awareness and consciousness. One should indeed think twice before going through a radiation exposure for a second time. Let me explain and elaborate. Firstly, please note that SPECT and CT are two entirely different imaging technologies (despite the same surname ""CT""). When you had the SPECT, the dye was injected into the central canal, i.e. the CSF cavity of the spine. That way, the dye could reach wherever CSF could reach, so that it could be identified whether CSF was leaking out of its normal boundaries. The dye did not obviously reach the a" "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 daughter is 5 years old suffering from fever from last two days. We are giving Calpol 250 mg 8 ml dose for every four hours. After giving Calpol, temperature comes down. But immediately temperature is increasing. Today our doctor suggested having Monocef antibiotic. We have given two dosages til now. Is there anything to worry because fever is coming continuously. Please suggest. ### Response: Hello. Generally, fever lasts for 2 to 3 days. If it is viral and more if it is bacterial, since you have started antibiotic it takes 24 to 48 hours for the antibiotic to control infection. So, fever may be there but the intensity will decrease gradually over 2 to 3 days. If the fever does not subside in 2 to 3 days of starting antibiotic I suggest you go for further evaluation like blood tests. Nothing to be worried about" "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 root canal over a year ago, had a cap put on and no problems. A month ago it was pulled off when I ate candy. It was glued back on. Yesterday, the tooth suddenly felt different. It feels sensitive when pressure is applied and sometimes it feels to be throbbing under the cap. ### Response: Hi. Throbbing pain or sensitivity in a root canal treated tooth is an indication of re-infection in it. Sometimes the nerves regenerate from the apical end and start causing infection, it may happen due to food stuck around margins of gums for a long time, etc. There are two lines of treatment to it. 1. Medications- Take Augmentin 625 mg, tablet Metronidazole 400 mg and Brufen 400 mg for five days, twice a day. It will heal the infection and there will be no need for further treatment, your tooth will be back to normal. 2. If infection recurs after medicine regime like in 2 or 6 months with severe pain then cap will be removed for a while, re-endo or root canal treatment will be done, that is, deep cleaning of roots will be done and then it will be sealed again once infection is gone and tooth cap will be put again. There is also a third option that is a severe one, if root canal treated tooth is stuck with it then sometimes we have no option left except for extraction. Provide me with clinical picture and radiograph of your tooth so that I can exactly recommend you what should you opt for after 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: All my life, I have struggled with several problems that, after stumbling on a post online, I am now fairly certain are the result of a botched circumcision. My scar is very near my glans, with an unsightly blemish near the center. My erections pull my skin and testicles very tight, and also pull up the skin from my pubis, causing a visible shortening and an unsightly mound. I also have excess hair along the shaft of my penis, and my scrotal skin connects just underneath the glans. This has not directly affected sexual function, but it makes condom use exceedingly difficult and is also costing me significant penile length. What treatment options do I have? Surgical vs nonsurgical? Estimated costs? I would prefer to avoid the use of any mechanical stretching devices. I have one, but it is rather intimidating and I am worried about injuring myself. ### Response: Hello. Relax and do not worry. I have seen the images sent by you (attachment removed to protect patient identity)" "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: What would be the fascinating thing that happens to our brain during the period? And how does the brain respond to a woman\s menstrual cycle? ### Response: But as soon periodic bleeding starts, it gives healthy relief to mood, anxiety, fullness, irritation, and all other temporary disorders that appear cyclically. Although during the bleeding there is some restless feel as days pass it gives relief. Hormonal pressure also reduces during menses, but the irritative feeling remains with bleeding as soon as periods stop clean feel appear. Menses outflow reduces migraine and headaches as well as before menses some women feel it due to hormonal effects. After the stop of bleeding body look healthy and feeling comes like fresh and clean. The mood seems light and want to have recreational activities, outings, music, get-togethers, etc. So it is more fantastic mood after periods due to hormones and as well as a light feeling of cleanliness." "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 15-year-old son who was suffering from depression two months ago but is fine now except for having a few weird thoughts. The only issue currently is that he is not studying. He was suggested the following medicines- Cognium syrup and Shine-25 tablets. I plan to give only Cognium syrup, shall I go ahead? Please recommend the appropriate dosage. ### Response: Hello. The Shine 25 mg/d is an anti-depressant. You can start from 1/2 a pill at night (one hour before sleeping), if you do not use it then there will be no anti-depressant effect. The Cognium syrup is brain stimulating syrup, start from 1/2 of the recommended dose on the bottle. Give him a month and then if you see no effects then increase the dose to 1 pill of Shine and full dose of Cognium syrup. Lack of interest in studies could be a sign of depression. You may have to put more time and effort into studying with him." "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\s platelet count is 455 units. The normal range is 450 units. Her hemoglobin is 8 units. Is this platelet count dangerous? She has pain in the left leg below the knee portion. The nerves below are clearly visible. She took analgesics like Diclofenac, Signoflam, and Zerodol, but no relief. Please help. ### Response: Hello. A platelet count of 4,55,000 /microliter of blood is not dangerous. Your mother is anemic given her hemoglobin level of 8 g/dL. She should be evaluated and her anemia treated accordingly. I do not understand what you mean by visible nerves. Do you mean veins? Please clarify. I would suggest that you consult a doctor for her leg pain and not take analgesics on your own. Self-medication can be harmful especially if overdone" "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 question is about a septoplasty operation for anesthesia. Doctor says I need this operation but I am scared of the anesthesia. Mostly scared about awareness and being paralyzed. Can someone give me a brief summary of drugs used during general anesthesia for a septoplasty? Is it possible to not be given a muscle relaxant, or paralyizng drug? If I were to be given a paralyzing drug how long would it last? ### Response: First of all, you need not get scared about getting general anesthesia for your surgery (septoplasty). For your surgery, general anesthesia is the best option for anesthetizing you. While administering general anesthesia, the anesthesiologist would be administering" "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 42 year old male. I feel extremely weak after sleeping in the afternoon on weekends. And even after taking breakfast I feel sleepy, and I sleep off. I got a kidney transplant done five years back, and I am under psychiatric treatment from the past 15 years. I currently take the following medicines Nexito 20 mg, Quitipin 25 mg, and Modafinil 25 mg. How to overcome the ongoing depression symptoms? ### Response: Hello. I can understand your concern. Please follow these steps, and consult your treating doctor about the dose adjustments." "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 has acute heart failure and extensive MI since two months ago. Also, he got a pleural effusion and leg edema. He is in bed symptomatic depending on oxygen device most of the time. His EF is 21.The ECG shows possible left atrial enlargement, nonspecific intraventricular block, right ventricular hypertrophy, inferior infarct, and anterolateral infarct. QRS = 138 with right bundle branch block.He sleeps in a 30-45 degree. We did not do PCI until now. I would like to know will CRTD be good for him? ### Response: As he had a heart attack, first priority is revascularization of angioplasty or bypass surgery. If this is done and heart function improves, then it will be good. In right bundle branch block, there is very little benefit of CRT (cardiac resynchronization therapy). If revascularization is not possible, then maximum medical therapy is best. Yes, ICD (implantable cadioverter defibrillator) is indicated. It should be considered once the patient is out of the acute episode and is stabilized. First thing is to assess for revascularization if there is viable heart muscle. 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 had an oral sex with a girl without protection, and I licked her vagina too, later I came to know she has PSV which she had undergone treatment and she was cured, I came to know risks of the STD\s via oral sex and I was suggested to have test after four weeks, but they did not tell what test I have to go through in detail. My query is, what is the list of a test I have to go through? Please give me the names of the test in detail, so that I can approach a lab for testing. ### Response: Hello. There are many tests, but the below mentioned are usually done to rule out the infection. These are a screening test. 1. Test for HIV. Tridot test. 2.Test for gonorrhea (urine or oral swab) and chlamydia. 3. Test for Hepatitis B (HBsAg) and C virus. 4. 5. Test for HPV (human papilloma virus). Herpes virus test is usually not required if no symptoms are present or there is no outbreak of it. I hope this clarifies your concern. Ask again if anything unanswered," "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: To avoid an abscess, can I take an antibiotic like Azithromycin? If not, please suggest which one I can take? ### Response: Azithromycin is not recommended for skin and soft tissue infections. Generally, a combination of Amoxicillin and Clavulanate twice daily is used. However, unless you have a skin infection you should not use it. It is used for a treatment and not for prevention. Regards" "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 taking Phenytoin sodium 300 mg daily for the last 10 years. Will the medication impact on my first stage of pregnancy? If yes, should I take any alternative? ### Response: Are you pregnant already? Or planning for pregnancy? Phenytoin, especially in the first trimester (initial three months) of pregnancy, can affect the baby. If you are still planning for pregnancy, you should switch to other medication for seizure (after discussing with your neurologist). But if you are already pregnant, it is little risky to switch to another" "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 throat infection and sound is not clear. I have pain in left neck and shoulder. ### Response: Hello. You can have acute tonsillitis like infection of the mouth or Ludwig angina like infective etiology. Your posterior pharynx examination and lymph nodes palpation should be done for further work up in your case. It is advisable to investigate with throat swab culture report and CBC as well. According to examination and report, further course of management can be decided. If inflammation is more then, short term steroid course might be needed. Antibiotic is given according to the culture report if 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 unsafe sex yesterday and took I-pill in half an hour to avoid pregnancy. Today, I had sex again. Should I take another pill? ### Response: No, you need not take another pill. It works within 72 hours of sex. Hence, your second sexual act is also covered. Wait for the bleeding to start. Avoid further sex till bleeding occurs. Suppose you have intercourse, use barrier contraception like condom and not another pill." "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 is out of coma and on regular physiotherapy. However, we have a major concern now with frequent drop in his sodium level. Every five to six days his sodium level drops to 110-120. When that happens, his consciousness level goes down and stops body movement or response. He is given injection Sodium chloride 3% isotonic solution with Fludrocortisone one tablet per day. It takes about five to six days for his sodium level to improve around 130. When he starts responding, he opens his eyes and moves body parts. We have seen this three to four times since last one and a half months. Eight days back, his sodium level went down to 109 and currently it is 121, but he has not shown much of body movement yet. Normally, he recovers within five to six days. Please suggest what has to be done for faster recovery? What has to be done to prevent this happening again and again? I have listed the medicines he is taking currently. Initially Tolvaptan is given for 10 days (currently stopped). Fludrocortisone 10 g extra salt per day with liquid food, tablet Ofloxacin 200 mg, capsule or tablet Phenytoin sodium 100 mg, tablet vitamin B complex, tablet Losartan potassium 50 mg, tablet Metoprolol 50 mg and tablet Pantoprazole 40 mg. ### Response: I am sorry to note that he is having problems with sodium levels. I suggest the following. 1. Serum specific gravity.2. Urine specific gravity.3. Serum and urine osmolality. Revert back after the investigations to a general 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 15-year-old suffering from dark spots on the face. They are dark brown, and my usual skin tone is golden brown. I developed acne when I first started puberty, and I picked at my face, which caused these scars. I have tried Vitamin C, and Mederma gel to lighten them, but nothing works. I want to know if there is some way to lighten them. Would Calamine lotion work perhaps anything else? How long will it take to heal completely? Am I stuck looking like this forever? ### Response: I understand that you have acne scars and dark spots caused due to acne. Acne is usually age-related because of hormonal changes. However, I suggest you undergo PRP (platelet-rich plasma) therapy for the scars if they are bothering you. The spots will eventually fade away with time. Avoid exposure to sun and use a sunscreen with SPF 50 while going out in the sun. I hope this answers your question. Please let me know if you have more questions." "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 burning eye pain with a cluster headache which usually increases in the afternoon and keep increasing until bedtime. Tightly tying a cloth around my head and eyes covered gives relief. There is a severe allergy to light. Darkness is preferred during the attack. Please help. ### Response: You are most likely suffering from a migraine headache. Eye pain is part of the migraine complex. If you have these episodes you are advised a detailed consultation online or offline with a neurologist" "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 sister is aged 55 years, and the blood report says that it is mild anisopiokilocytosis macrocytic normochromic RBC. The WBC are having lymphocytic prominence with reactive lymphocytes. The platelets show marked thrombocytopenia. Her hemoglobin is 7.9, her neutrophil count is 1520, and absolute lymphocyte count is 5624. What could be the diagnosis and treatment further? ### Response: Hello. Her hemoglobin level is low. For that, further workup can be done in form of serum iron, TIBC (total iron binding capacity), and ferritin estimation. I need to know her hematocrit and RBC value as well to guide you further. You need to correct anemia with Iron or B12 supplement according to the need. Tiredness and dyspnea are because of low Hb level. High lymphocytes and low platelet can present in a viral infection. Kindly mention any other complaints if present to guide you further. If lymphocytes count does not improve with time then higher study like flow cytometry might be 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: Every time I exercise on the treadmill, my legs are blushing and itching. So, that is stopping me from exercising. What is wrong and what can I do to prevent this? ### Response: 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 understand your genuine health concerns. This is a very common problem for a lot of treadmill users doing cardio exercises. The main issue is the sensitivity of the skin. It looks very simple but I found this fact after a research on 150 people of different ages and with different health status, but with the same issue of blushing and itching on the legs while using the treadmill. Wearing tight clothes/jeans or trousers while exercising on the treadmill.Wearing tight and above ankle socks. 1. Wear cotton-only trousers (100% cotton; not mixed with any synthetic fiber).2. It is better to wear ankle socks compared to above ankle socks.3. Wax properly and timely on the legs and apply Eucerin cream (extra" "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 sprained my thumb last week. I still have some pain but grip, strength and movement are increasing. Can I skip a doctor visit? At first, my thumb was swollen and redness was present. I could not bend it at all. After using R.I.C.E, the swelling has decreased to near normal and it is much more flexible. There is still some pain on the index finger side of the joint when pressed, but grip strength is returning. I am now able to straighten the thumb without difficulty but I cannot fully close the thumb on itself. What should be my next course of action - more rest, work on stretching it out or consulting a specialist? ### Response: Hi. Your description of pain, the presence of swelling and redness and its site of maximum tenderness makes me worry about what is called the ""gamekeepers thumb"". This is the injury of the ulnar collateral ligament (UCL) of the thumb. If that is the injury then you should ideally have yourself examined by a doctor to assess the degree of the injury of the ligament. Because a complete tear will require surgery. But from your description, the chances are remote as you have regained movements and the pain is also settling. The main issue with the UCL injury is lack of or weakness in the pinch grip between the thumb and the index finger which can be quite troublesome for people who do heavy work with their hands. Revert back to an orthopaedician online for further follow up" "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\s hemoglobin is 8. The reports of various tests do not seem to show the reason. What could it be? ### Response: Hello. Yes, your wife is in severe anemia. Hb (hemoglobin) level is low at 8.1 g/dl. RBC count is low at 2.86 million/cu.mm. The reticulocyte count is 7.0 increased-that means bone marrow production increased to face the demand. LFT is normal. There is no hemolysis. Now we have to see blood peripheral smear study to determined the morphology of the RBC and cells. That will give the cause of anemia. Any history of heavy bleeding periods or any other blood loss conditions? But now she urgently needs (packed cell) blood transfusion to meet out low Hb,and iron supplement. And find out the cause for blood loss and rectify." "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 31-year-old female. I have lost my sexual drives, and it is affecting my marriage life. Kindly advice. ### Response: Medical causes like diabetes and hypertension should be ruled out. This might be due to hormonal issues. Your serum prolactin and progesterone levels should be checked. Normal levels will rule out the hormonal cause. Do you have pain during sex? Because pain could be one reason for low sex" "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 having burning sensations in my chest, arms, and back, numbness in both sides of face, and shortness of breath. I have also been having weakness of the legs. I went to the ER on sunday and they did not know what is going on. ### Response: I understand your concern and would explain that your symptoms are suggestive of possible anxiety. From the other hand vyvanse can lead to such symptoms as a common adverse effect. Coming to this point I would recommend taking Alprazolam at a low dose for anxiety. If this does not improve your situation I would also recommend performing further tests: Thyroid hormone levels for possible thyroid gland dysfunction, blood electrolytes, vitamin B12 and vitamin D plasma levels for possible deficiency, an exercise cardiac stress test. You should discuss with your doctor on the above tests. If all the above tests result normal I would recommend gradually reducing the dose of vyvanse and see if your situation improves." "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 vaginal sex with two condoms without a breakage before two weeks. I do not know the person whom I had sex and do not know whether she has HIV or not. Am I at risk of getting HIV infection from vaginal sex with two condoms? Does the partner\s fluid that touches the shaft cause HIV transmission? ### Response: Never use two condoms, and there are higher chances of having a slippage. Protected sexual activity shows a reduced chance to have HIV. The rates of transmission stand at 1 in 10000 sexual activity. So, you have a less probability of acquiring the infection. It is always better to get tested for your contact which clears your most doubts. You have negligible chances of getting an infection." "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: Bone-like lump near the uvula. Back of throat does not heal last three month. The tonsillar lymph node is swollen, movable but feel hard when finger touch. Minor difficulty in eating food, no fever, no cold. Currently, taking Rabtac -D, Allergent, Zinc Vitamin. ### Response: Hi. You have tonsillopharyngitis. If you have already taken the antibiotic course then it is better to get throat swab for culture and sensitivity and gram stain" "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 took a CBC test a few days back. Is everything normal? My eosinophil count has increased from 3 to 6 and I am worried as the normal range is 1 to 6. Can you please get back to me on this and if it is fine? Absolute is slightly high but within range. Please let me know if everything is alright. ### Response: I have seen your complete blood count report and understood your query regarding about eosinophilia (attachment removed to protect patient identity). First of all your reports are normal and counts are also normal, no need to worry regarding this. Your absolute eosinophils count 480 is within the normal range, and of course, in percent form, it is higher normal levels up to 6 %. If we will talk about eosinophilia if more than 500 cells divide into three categories of mild, moderate and severe. If we talk common cause is a simple parasitic infection, any allergy like rhinitis or skin eczema, up to blood malignancy. So you do not have to worry as you said your eosinophils count has increased from 3 to 6 % until you have any symptoms like rashes, pruritis, breathing difficulties, diarrhea, arthralgia. Repeat your absolute eosinophils count after three months, or if you have any symptoms above, then contact me. Otherwise, it is not significant." "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 itching and painful irritation around scrotum since two days. I applied Caladryl two times, it caused more pain for a while. It seems like the scrotum has slightly become red and there are some rashes on it. The rashes or pimples or pimples whatever, they are small in size and cause pain when they get in contact with anything. Due to this problem, I am not able to walk. I had fever some days before, so I did not maintain proper hygiene. Maybe this is the main reason for my problem. Please, suggest me a home remedy. I am a 22-year-old college student. ### Response: Hi. It could be folliculitis of the scrotum, a very common complaint in this season. Kindly upload appropriate images of the lesions so that we can suggest you better." "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 30 years old. I am planning to get married to a girl who is known to me. We have very good understanding. But, we have the same blood group that is O positive. Since blood group is a factor for having babies, do you think having same positive blood group could create problems for future generation? My father is very concerned about this. He talked with several doctors and they ensured that it could create problem. And they do not want me to marry this girl. I talked with another doctor, she replied me like it is not a big problem.I am in great trouble right now, how could I give clear explanation to my father about this issue. My father told me he knows two couples of same positive blood group who has been married for 10 years without having baby. And doctors could not find any problems for both men and women. But their blood immune system did not match to have a baby.I have these questions:Do the same blood group create problem? If yes then what basically create problems?Are there any precautions that need to consider for having baby after getting married with same blood group?Are the diseases like thalassemia occurring because of parent\s rhesus factors?One thing to clarify to clarify is that we are two brothers and two sisters and all the six members of my family have same blood group O positive. My elder sister got baby after 8 years and her husband is B positive. And my younger sister, she always gets sick since her antibody of her blood cell might not strong enough to fight disease.My father explained, due to my parents have same blood group; my sisters might got those above explained problems. I will explain my family based on your explanation. ### Response: Based on your query, my opinion is as follows: There are two major blood group systems and more than 400 minor blood group systems. The major blood group systems are ABO system and Rhesus system, which are important. In the ABO system, there is A, B, AB and O. While in Rhesus, if it is present, it is positive and if not then negative. If the girl is not a relative then blood group is hardly a concern. If both are O positive, it would not matter. If she is a relative, get genetic tests to rule out any common diseases, which can affect the future kid. This test is called as genetic counseling. Only among close relatives, the immune system behaves dangerously due to reduced genetic pool. To conclude, having a common blood group is not a problem. She can donate blood to you and you to her in emergencies just like your siblings can. No other complications with same blood group. If necessary in case of second or third-degree\x80\x8b relative then genetic counselling" "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 62-year-old single female with swallowing difficulties and pain in chest and throat when I eat. I am very fragile and live alone. I am scheduled for an endoscopy, colonoscopy but I am considering getting just the endoscopy. Can that test alone show any problems in the stomach or colon? And, there has to be more downtime? ### Response: Hi. You need to get an endoscopy for your current symptoms. If it is negative, we may go for other tests. A colonoscopy is not recommended for difficulty in swallowing. I think it was suggested in view of age. Endoscopy can show esophagus and stomach. To visualize colon we have to go from the bottom, that is, colonoscopy itself." "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 was diagnosed with infantile hereditary optic atrophy when she was young. She is now 52. Can you provide me with some up-to-date information or a webpage that explains the disease, its symptoms, if it goes by any other name or is a symptom of another disease, etc? I can only find some pages so far that are not very clear or shows a copy of an explanation from 45 years back. Has anything changed in the past 35 years or so in regards to the disease that we should be aware of or is it basically still the same issue it was back then? ### Response: I am very sorry about your wife, optic atrophy is an irreversible process and once the optic nerve has atrophied, there is nothing we can do. It is regarded as the end stage of the inflammatory process of the optic nerve called optic neuritis, optic neuropathy. Regarding newer advances in treatment, these are confined to optic neuropathy and no treatment currently available has been found to reverse optic atrophy. A few noteworthy and well-acclaimed treatment trails are ONTT- optic neuritis treatment trial and CHAMPS- controlled high-risk Avonex in multiple sclerosis study." "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 left leg is numb when I stand up and walk, and I feel like there is a bruise when I press it hard. There is also some pain in the knee when I bend it. ### Response: Hello. The information provided is very scanty, and it is rather difficult to give you any important advice. I need more details to be able to help you. Revert with more information to an orthopaedician and traumatologist 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 22 years old male and want to join technical duty branch in the Indian Air Force. But my height is 155 cm, and the airforce eligibility criteria for the required height is 157.5 cm. So I cannot hold this height criteria.I want to increase my height by up to 157.5 cm.My mother\s height is 147 cm, and my father\s height is 161.5 cm, and my sister\s height is 154 cm.So please give me a positive reply or result so I can start my future in the Indian Air Force. ### Response: Once you achieve 18 years, your bones of the whole body can become fused. Now according to scientific research, there will be very less or no chance to gain height. But for your satisfaction, you can do vigorous exercise pull-ups, yoga practice, and pranayama practice that may help you. Do not waste your money and time on protein powder consumption. I do not want to provide the wrong hope. You be happy first, I know your goal is to join the Indian Air Force. Join the Art of Living Happiness program in your area. Do not be discouraged. Do your best." "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 erosion in my stomach, severe burning sensation and sometimes vomiting and bloating. I have done endoscopy, colonoscopy, angiography and hospitalized for about four times. Recently, again I have done endoscopy found antral erosion. Please advice. ### Response: Hello. You have recurrent complaints of antral erosions and ulceration. I will advise some treatment and hope that it will help out. You should send me all your previous endoscopies and other reports done until now. I will also like to know about your H.pylori status. None at the moment. Peptic ulcer disease. Capsule Dexlansoprazole 60 mg one before breakfast for four weeks, Levosulphride 25 mgthree times a day before meals for two weeks, syrup Gaviscon (Alginate) 10 ml three times after meals for 10 days. Avoid spicy foods. Follow up after one week." "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 about my gums. I had a jaw surgery for an open bite a few years ago and the gums were all pink and normal looking a few months ago. Now they have a lot of white on the upper gums with the area slightly above the gum line being the non-whitened and discolored part. I have a picture. The discoloration showed up more recently and never in the past if I recall.I am currently on Vistaril Prozac Zyprexa Junel (birth control). ### Response: The gums looked blanched or whitish due to lesser blood circulation and less inflammation than before. There is no need to worry as it occurs as the gums are completely healed and also could happen due to decreased blood pressure and complete healing of inflammation post-surgery." "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 attached an x-ray report of my 1 year old baby girl. The report was ill-defined haziness seen in the right perhilar and para-cardiac regions - pneumonitis. What does it mean? She has cough since last five days. My mom is suffering from active tuberculosis. So, x-ray was suggested and the consulting doctor is out of town for the next two days. What should be done next? ### Response: Hello. I understand your concern. 1. Mantoux test.2. Complete blood count.3. Gastric aspirate for AFB (acid fast bacilli). An antibiotic should be given for seven days. Revert back with the answers to the above questions to a paediatrician 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 fasting blood sugar is 159.8 mg/dL. My postprandial blood sugar is 280.7 mg/dL. My BP is 160 by 90 mmHg. ### Response: Hi. From your laboratory report, I can see your blood glucose levels at a higher level than its normal range. HbA1C level (glycosylated hemoglobin) in blood will give us a better idea about your blood sugar control. You may need to start a treatment to reduce the blood sugar levels. Also, your blood pressure is also slightly high. It is difficult to achieve all this soon. I suggest you meet a doctor for proper clinical evaluation and subsequent treatment of your condition. Try to avoid taking processed sugar and sweets, and salty food. Take increased intake of water and raw vegetables, and try to do exercise for at least 30 minutes 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: I have a red vascular outgrowth on the left side of forehead for many years. It is causing pain and burning sensation. Please advice best creams to erase it totally. ### Response: It is pyogenic granuloma and it needs removal by radiofrequency or electrocautery procedure (attachment removed to protect patient identity). It cannot be eradicated by creams or lotions." "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 21-year-old male. I broke up with my girlfriend two months ago after a healthy relationship of four years. All these happened just within two days, and I could not even understand what to do and what not. She said that she forgot all the moments and memories of our relation, and this breaks my heart. I did everything to get her back, but she refused. She is the only thought in my mind all the time, and all my daily routine is out of track. I am going through the worst phase of my life. I am frustrated and feeling lonely. Please help. ### Response: Hello. You are facing an adjustment disorder. The relationship appears to be an important part of your life, but still, change is the hard fact of life. You may not be able to forget her ever, but her memories will stop giving you pain. Currently, you do not need any medicines. Practice the following tips, and it will help you tide over the crisis: 1. Set a schedule for yourself and follow it as if your life depends on it. Make sure you leave no space for free time in it. 2. Start spending time with those friends and family whom you had not given time earlier due to your commitment to your girlfriend. 3. Avoid social media and common friends for at least four weeks to avoid unnecessary encounters. 4. Do not take alcohol, smoking, or any pills to avoid heartache. You will end up adding another problem to your list. 5." "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 due for my periods on 8th, but did not get till 16th. So, I went for pregnancy test which came out negative. On 17th, I got my periods with blood clots and crampy stomach pain which was not usual for me. Was it a miscarriage? If yes, what may be the reason? ### Response: I have gone through your query and can understand your health concern. As per your query, the pregnancy test was negative. So, no need to worry. It is not a miscarriage. To be on a safer side and to confirm that it is not miscarriage, I suggest you to check your serum beta-hCG (human chorionic gonadotropin) level. High levels confirm pregnancy. You can do this test if you are in doubt. Menstruation can be delayed due to many factors. Such as hormonal imbalance and stress can delay menses. Sometimes, delayed menses can cause heavy bleeding. I think your case too the same. If there is heavy bleeding and you feel sick and dizzy, then check your hemoglobin level. If the menses continues for more number of days, then consult a gynecologist. For more clarifications consult a general practitioner 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 diagnosed with genital warts on the penile head. I was given Imiquimod cream to be applied for 10 to 15 minutes in the morning on alternate days and then wash off. The treatment went on for two months. Warts became lighter but did not go completely. It is definitely better than before.Do I need a biopsy or should I change to Glizigen cream which another doctor prescribed for two months twice daily? ### Response: Imiquimod is good medicine for genital wart. It has to be applied thrice a week for 16 weeks. If you see results with Imiquimod, I would suggest you stick to Imiquimod and complete the full course. Other options for genital wart are Podowart application (Podophyllotoxin), cryotherapy with liquid nitrogen, topical TCA (Trichloroacetic acid) application. You can discuss these options with your doctor" "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 47 year old female, who has had a 90 % blocked carotid artery and subsequent endarterectomy at the age of 42 years. A year later, I had a massive heart attack and 100 % block in my right coronary artery. I was just diagnosed with PAD (Peripheral Artery Disease) last week. Additional to the PAD, knowing that my left coronary artery is also 40 % blocked, just tripled my risk factor. What can be done and who do I need to go see to get preventive surgery before this disease of my arteries spreads throughout my entire body. All my doctors are stuck as to what to do and I refuse to live on statin drugs. Please advise. ### Response: Hi. I have read through your query in detail. Please find my observations below. Statins are widely used to treat PAD. Depending on other conditions, antihypertensives and medicines to control blood sugar levels are prescribed to patients with hypertension and diabetes respectively to control the progress of the disease. There are certain medicines which increase the flow of blood through the arteries by increasing the luminal diameter. They are Cilostazol and Pentoxifylline, and your doctors might have discussed it with you. Medicines to prevent clotting might also be given including Clopidogrel. You should consult a vascular surgeon and regularly follow up. Surgical options include angioplasty, bypass surgery, and thrombolytic procedures. Please consider medicine treatment first and then surgical procedures." "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: Please go through and advise. \Acute on chronic subdural hemorrhage in bilateral cerebral convexities measuring 2 cm in the right side and 1.3 cm in the left side. The mass effect is noted in the form of effacement of adjacent sulcal spaces and compression of ventricles. Thin rim of subdural hematoma is seen along the lateral convexity of the left cerebellar hemisphere with maximal thickness measuring about 4 mm. The C.P. Angeles and posterior fossa contents are normal. The basal cisterns and Sylvian fissures are normal. The sella, parasellar and suprasellar regions are normal.\Immediate surgery was recommended by the doctors. The cause suspected is the use of Ecosprin 150 for the last three months. It was prescribed when last admitted for high sugar level which caused stroke symptoms. But, the brain CT was normal at that time. The patient has been diabetic for the last 35 years on insulin. Please advise if surgery is needed or it can be cured with medications. How critical is this condition and is it risky to delay? Is this a major or minor surgery? How will it be done? ### Response: Surgery is absolutely indicated in this case. This hematoma cannot be cured with medications. Surgery should not be delayed as there is a possibility of permanent brain damage if the mass effect is not relieved. This is usually a minor surgery. In some cases, when there are membranes in the hematoma, craniotomy may be required to prevent recurrence.In addition to the surgery, Ecosprin (Aspirin) should be stopped immediately. It can be restarted at a later date depending upon its need" "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 34-year-old woman, otherwise in good health. I have a history of anxiety and panic attacks but I had not suffered any of these in a severe form in over 6 years. I was medication free for many years, up until 2 months ago when I went to see a psychiatrist for possible psychosomatic symptoms, I had chronic abdominal pains with no obvious source discovered after several medical tests.The psychiatrist gave me Gabapentin. She said to take 300 mg every night.I started the medication as she prescribed but after 3 to 4 days I found they were making me too groggy so I started taking 300 mg every three days. Then by the end of last month, went down to 300 mg every 6 to 7 days. I had no side effects except for a bit of nausea/dyspepsia, feeling drowsy and my mind was foggy. Around 2 weeks ago I stopped taking them altogether since my abdominal pain was getting better on its own.But around 8 to 9 days after stopping Gabapentin, I started having these weird symptoms that seemed to have come out of nowhere. Anxiety which has increased to dramatic levels over the last few days, panic sensations on every tiny negative or sad thought, a burning feeling in my throat and nose, horrible heartburn, waves of weakness like an adrenaline rush flowing through my chest, arms and legs. I have strange thoughts, bizarre ideas like mind control and telepathy (which is so uncharacteristic of me), confusion - I cannot get my thoughts together well, cannot remember things. Insomnia, cannot sleep for more than 1 to 2 hours at a time. I feel horrible. There is a bit of stress in my life at the moment but nothing that I would not have normally handled decently well. I also checked my thyroid and my TSH and FT4 are completely normal.It all started suddenly five days ago and since then it has been hell. Things have not gotten any better over these days, at the contrary I am worse.Can this be Gabapentin withdrawal symptoms? Because my doctor told me I can quit it cold turkey since it is not addictive but I am starting to believe it must be. No way I went crazy like this for no reason. I feel like I cannot fully control the way my brain is working and I am overreacting to any slight emotion and turning it into panic. Please help. ### Response: Hello. You have clearly described several psychosomatic symptoms. On the core of such symptoms is anxiety. Anxiety can take several forms and can manifest in different ways in different individuals. For some it may be palpitations and breathlessness, for some it might be butterflies in the stomach, frequent micturition, etc. Gabapentin is a good anti-anxiety medication but it can cause day time sedation (which you had). Rather it is anxiety which is manifesting in such a manner. The normal stress you have mentioned may not be normal for you. For a vulnerable individual who has had an anxiety disorder in the past, even mild forms of stress can trigger an anxiety or panic episode. My suggestion would be to take a few medications for at least 6 to 9 months and also practice some breathing exercises and yoga. My suggestion for you would be, tablet Desvenlafaxine 50 mg - 1 tablet at night after food and tablet Clonazepam 1 mg - 1 tablet at night after food. Additionally, you can take tablet Clonazepam 0.25 mg 1 tablet on a SOS basis (that is whenever you have an anxiety attack). The above medications will help with most of your symptoms as well as improve your sleep. The only issue is that Clonazepam should be tapered off in about 4 weeks. It can cause dependence." "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 I drink coffee during pregnancy and why? Please help. ### Response: Yes, but hold the refills. The American College of Obstetricians and Gynecologists recommends limiting your caffeine consumption to fewer than 200 milligrams (mg) per day. You can still enjoy a mug of coffee every now and then during your pregnancy. That is about two mugs of instant coffee or one mug of filter coffee. If caffeine intake is more than 200 mg per day, there are chances of low birth weight." "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 miscarriage two months ago resulting in a Dand C at 10 weeks.I am now pregnant (4 weeks and 3 days) and taking 400 mg Progesterone suppositories once per day due to low progesterone levels both in the last pregnancy and in the weeks leading up to the confirmation of this pregnancy. However, my doctor has told me that my estradiol is very low, and that is concerning me.My results so far:14 DPOHcg 69 U/LProgesterone 77 nmol/LEstradiol 220 pmol/L.Two days later:16DPO (yesterday),Hcg 129 U/L,Progesterone 75 nmol/L,Estradiol 239 pmol/L.Is my pregnancy doomed because of my very low estradiol? I was hoping my doctor would prescribe estrogen medication but he does not seem to think that would be an option. Why would he decide that? Do you think estrogen supplementation would help? Instead he is having me take 25 mg daily of DHEA. Do you think this will help and is it safe to take in pregnancy? Will eating foods high in phytoestrogens e.g. soy help increase my estradiol?Also, do you think my low Hcg levels are a bad sign? At 12DPO they were 15U/L so they increased rapidly to 69U/L on day 14 but then slowed a bit to get to 129U/L on day 16.I am due for another blood test tomorrow. I really do not want to lose this pregnancy, but these low numbers are making me worry. ### Response: I saw your concern. The normal levels of estradiol in early pregnancy can vary from 188 to 2400 pmol/ l. Similarly, progesterone can vary from 12 to 90 nmol/l. HCG (human chorionic gonadotropin) has doubled, which happens only in a healthy growing fetus with good trophoblastic activity. Do not worry much about estradiol, it has no big significance in treating previous early miscarriages. Everything looks normal. Continue progesterone for luteal support and prenatal vitamins as prescribed. Above all stay positive and confident." "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 18 years old, and I have this problem for about two weeks. I think this is because I did not remove my make up after a party and slept off. And the very next day, I got small red pimples on my face. I have this redness or spots on both sides of my cheeks. What could this be? Please give some affordable medicines or cream, but recommend me a good product. ### Response: Hi. This might be allergic contact dermatitis or cosmetic-induced acne. Make sure that you do not get exposed to that chemical within the next 10 days otherwise there are chances of sensitization and can cause further flare-up of the disease. Apply the following medicines on the affected areas: As of now, I am not prescribing any oral medication, but it might be needed if the response to the topical application is poor." "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 38. I have fibroids. The last time I went to the hospital, I had a blood transfusion. Both the legs were swollen due to lack of protein in the blood. I am on my menstrual period right now. My abdomen feels very heavy. And I cant control the bleeding. I cannot user tampons because the pressure from clots pushes them out. I am in pain. I have been taking Tylenol two or three about every hour or two. I cannot stand up because clots come out uncontrollably. I am feeling weak. ### Response: I understand your concerns. Fibroids may cause excessive bleeding. So, a strict management is required. If fertility is not required, hysterectomy (removal of the uterus) is an option. If fertility is required, myomectomy (removal of fibroids) is a good option. Before surgery, a medication is given for three months in order to decrease the size of the fibroids. It decreases bleeding greatly" "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 72-year-old mother is diabetic. Suddenly her right leg and right hand are not functioning. In MRI scan of the head, it is told that bursting of vein or tube is reported. Could leg and hand function be restored? ### Response: Hi. The recovery of the weakness of limbs depends on the extent of brain damage. For that, I need to go through the scan report completely. Kindly upload the scan report and I shall give you a precise idea of what you can expect in recovery." "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: How many times can we urinate in 24 hours? I am worried because I urinate as frequently as ten times in 24 hours. ### Response: It depends upon the seasons, more frequent in winter and rainy and less frequent in summer. There are no exact calculations for the number of times. But, the frequency may be increased due to conditions associated with diabetes. You can have your blood test to rule out diabetes or diabetes insipidus" "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 light patches on my chin area that grew overtime gradually. I wish I could provide a picture so you could see. It started as a white patches, but it is light and reddish kind of. ### Response: Hello. Perioral hypopigmentation in your age group is most likely because of a condition known as Pityriasis alba which is seen commonly as light patches on the face. You need to apply a moisturizer regularly for this. 1. Cetaphil moisturizing cream apply twice a day. I am sure it is not vitiligo. Other possibilities may be seborrheic dermatitis if with itching and scaling or simply post inflammatory hypopigmentation but not vitiligo." "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 fever, stomach ache, and loose motion for the past three days. Please tell me what has happened to me. ### Response: Hi. Now, the season of malaria and dengue has started. Get your blood tested for dengue and malaria. It should be your first preference. Dissolve one packet of ORS (oral rehy" "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 an association between polycythemia and hemochromatosis? I have a high Hb of 18 and hematocrit of 51 %. I am a student and found to have incidental polycythemia. I tested for all myeloproliferative neoplasm and bone marrow biopsy is negative for MPN. However, I was tested to have hemochromatosis type 4, an autosomal dominant disease for which I am heterozygous. But my HCT and Hb are always high at 18.2. Please advise me. ### Response: Usually, in hemochromatosis, storage iron is increased, that is serum ferritin. So you can investigate with serum ferritin as well. If you have myeloproliferative neoplasm like polycythemia, then usually it can be clear from bone marrow study and JAK2 mutation. It comes under primary polycythemia case. You can rule out the secondary cause for polycythemia like lung disease, cardiac problem, high altitude, smoking, etc. Both conditions are different." "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: What is the side effect of Mensovit Plus tablet? Does it effect seriously on getting pregnant in future? ### Response: Hi. These pills have side effects for sure as every medicine has. It may cause nausea, diarrhea, vomiting, breast tenderness, headache. Your gynecologist may help you with that. They may also cause a delay in the regular next periods or cause an early next period or spotting. You were asking about pregnancy and side effects of these pills and so menstrual irregularities are more likely in the next cycles following these pills. So someone trying to conceive may have difficulty but this issue may go away with the passage of time." "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 36, weighing 57 kg and having a resting heart rate of 60 to 65 bpm till last week, but now I am getting resting heart rate as 80 to 85 bpm. From last one week, I have started running every day for about 16 minutes, four minutes each lap (starting with 5 kmph to 8 kmph till 16th minute). I have heard that if we start running every day our heart rate goes down and down, but the reverse is happening for me, so scary. And also, I am a light smoker, smoke three to four cigarettes a day (till three months back, I used to smoke 10 cigarettes a day). Please help to figure out the issue. ### Response: Hello. I do not think there is anything to worry about. Running for a longer time, say for few months at least, will make the heart stronger and decrease the heart rate, not for a week. There are numerous factors which can affect our heart beat like exercise status, walking before taking heart rate, psychological status like anxiety, etc. So, this can cause an elevated heart rate. I guess you do not have any symptoms like dizziness, shortness of breath with elevated heart rate, right? Also, no harm in getting a thyroid test done as resting heart was on the lower side." "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 pain for the past four weeks already. The pain is consistently sharp and takes my breath away, and stabbing. And with the pain, I have spasms all over my body. I can feel some pulsation inside my left upper side under my ribs and the pain starts with the cramps on my back going to the front with the contraction pain. My blood and urine are fine. I had done an MRI scan.And the MRI says normal appearance of the liver. No focal lesions are seen. The gallbladder is normal. No intrahepatic biliary duct or common bile duct dilatation. I just would like to know what if no intrahepatic biliary duct or common bile duct dilatation is normal. Please help me to understand. ### Response: As of now, you can use analgesics and anti-inflammatory combination like Aceclofenac, Seratiopeptdase for symptomatic relief. If symptoms persist, it is better to consult a physician and get evaluated." "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 10 years old. He is having a problem in the left ear where a yellow liquid comes out with pain for the last three days. Please suggest. ### Response: Hi. I can understand your concern. The possibility of left ear infection is more likely. I would like to know, Is there any fever? Any reduced hearing in that ear? Please reply, so that I can guide you better." "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 concerned about a head twitch. I have gotten in a habit for seven months of twitching my head. If I am consciously thinking about what I am doing, I can stop it. However, it is extremely difficult and I feel an overwhelming impulse to do it, similar to how one would feel when cracking his or her knuckles. It seems like it has become a habit and I do not know how to stop it. I also want to make sure there are no underlying medical conditions, however, as I mentioned, when I pay attention I can control it, even though it is difficult and uncomfortable and I have to put a lot of effort into not doing it. I read online that it may have something to do with stress or anxiety? ### Response: From your description, it looks like you are experiencing a motor tic. Do you have any other symptoms? How old are you at present? You mentioned this tic started befor seven months. Have you experienced any tics before? Any vocal tic? Tics can be suppressed temporarily but can be uncomfortable as you mentioned. Tics can wax and wane depending on stress, anxiety, tiredness, etc. Usually, tics are common and harmless. It is advisable to consult your doctor to clarify the diagnosis and to exclude any conditions that can mimic tic disorder. Mild tics can be managed by stress management and relaxation exercises. If tics are severe and persistent, it can be managed by specialist therapy cognitive behavioral intervention for tics (CBIT). Sometimes medication can be used as well. 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 started to have a boil on my chin and since I have had one before I decided to use the same treatment as the last time that is apple cider vinegar. When I put the treatment on the boil it did burn which I knew was a sign of it working. But, the day after, the boil did decrease in size and my skin later turned red with bumps, almost like it was rubbed raw. Do you think it was a boil? What should be the line of treatment? I am currently taking Cetrizine, Hydroxine, and Wellbutrin. ### Response: Hello. It is because your skin is irritated with cider vinegar. Make sure that the pus inside the boil has been removed completely if any. The redness is the inflammation that persists because of the boil and aggravated by home treatment. This will help get over with the remaining infection and redness of the boil." "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 33 years of age. Since four years, I am taking Eltroxin thyroid medicine. For one week I stopped taking medicine. Then I did a thyroid test. At that time, my TSH levels came above the normal levels. I then took a dose of 100 mcg for a month. I again checked my TSH levels. It came to 1.01 mu/L (reference range 0.45 to 4.65). Please suggest me what dose of Eltroxin I should take. I am attaching my report for further reference. ### Response: Hello. I just read your query and went through the reports (attachment removed to protect patient identity). Hope you find my advice beneficial. Good luck" "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: Among Nicotine gum, Bupron and Varenicline, which is better for quit smoking? Please suggest. ### Response: All three have different indications. Still Varenicline is best to control smoking. They are known to reduce craving. Bupropion is preferred, if associated depressive symptoms present. Nicotine gum or patch preferred, if person is not able to control desire by above these. It is a replacement therapy." "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 unprotected sex with my partner a week ago. He did not ejaculate inside me. But, I had still taken an I-pill after about two to three hours of having sex. I still have not got my periods. What should I do? Am I pregnant? Should I wait for some more days? My periods were due a week ago. Please help. ### Response: Yes, it is better to wait for about one week. If your pregnancy test is also negative then there is no need to worry as you have taken precaution well in time. The medicine for postponing can also delay your periods and more dose after taking emergency contraceptive pills. So get one test done and wait and watch" "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 19 years old. I have lot of acne scars on my face and it looks ugly. Doctor advised me to use contractubexbut it is of no use. Please suggest some other treatment. ### Response: Hi. Contractubex gel is topically applied to reduce scars. It is very effective on various types of scars. Other modes of treating scars include: But the procedure is decided depending upon the type of scar. Consult a dermatologist online to find out the best treatment option for your acne scars. -" "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 fiance is having diabetes type 2. And I want to know what will be the impact in the following scenario. Can she postpone her period by eight days as we have some rituals to perform during our wedding? What will be the impact if she uses contraceptive pills in case of birth control? Will she face any problem during pregnancy? ### Response: Hi. I read through your query and understood your concern. These tablets may increase the requirement of antidiabetic medicines (tablets/insulin). So, she needs to monitor her blood sugar level (at least two to three times during the period she is taking tablets) to make sure that sugar control is fine. Contraceptive pills used nowadays are low dose pills and have little or no impact on diabetes. Even if sugar levels increase, it can be treated by increasing the dose of antidiabetic medicines. So, she can use low dose contraceptive pills. Just consult your physician before starting those pills to make sure that the medicines do not interact with each other. During pregnancy, if her sugar control is fine from three months before pregnancy, during pregnancy and till delivery of the baby, there will practically be no problem to the mother and baby. If sugar control is not good, there may be many problems about which there is no need to worry right 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 have a viral wart on my forehead. Is it caused by HPV? In my teenage, I had warts on my thumb. Even, my doctor gave me vaccine for HPV. Is that worth or useless? ### Response: Your clinical image (attachment removed to protect patient identity) is confirmative for a verruca plana, which is a plane viral wart. All warts are caused by human papilloma virus (HPV); however the strains causing it are different. On the face, it is usually due to HPV 3 and 10. The vaccines available for HPV are mainly to cover for genital warts caused by HPV 16, 18, 31 and 33. These vaccines do not protect you against the normal skin warts as they are caused by totally different strains of HPV. Taking a vaccine can only protect you against the four strains causing warts on your genitalia. I would advise to go for electrosurgical removal of your wart as it is safe and effective." "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 50 year old male, who until recently was in relatively good health, other than idiopathic severe osteoporosis and depression. Over the past six months, I have become lethargic, out of breath after very simple tasks, and loss of memory. My primary doctor noticed that my hemoglobin had been dropping over the past year. After more testing, I was diagnosed with iron-deficiency anemia. I underwent eight weekly infusions, which finally got my hemoglobin close to the normal range. However, while my iron is low, my unsaturated iron binding capacity is high at 421, total TIBC is high at 471, and my transferrin saturation is low at 11. Prior to starting the infusions, my platelets had been high and climbing. After the eight infusions, my platelets were only normal for a week. They have begun rising again and are a little high at 502. My RDW has always been out of range and is now high at 17.9.Also, a month ago, my CRP was 1.29, it is now 2.2. I have had an ANA screening for autoimmune, and it came back negative. My stool has been tested twice and it has no blood. My homocysteine and PSA are normal. I am still lethargic and getting worse, and I am constantly short of breath. My short-term memory is not good. I now have a constant pain in my lower back in the kidney area, but all tests for kidney function have been normal. My current hematologist has ordered a CT scan of my abdomen with barium contrast, but my insurance has not approved it yet. I understand that anemia is a symptom of something else, then what is the CT with contrast going to look for? Should I be concerned about the pain in my lower right side of my back? If you were in my shoes, would you see your doctor again or wait a couple of weeks until the CT is complete? What does your gut tell you is the most likely cause based on the limited information listed above. I have attached all my test reports. ### Response: Hi. Based on your query and attached reports (attachment removed to protect patient identity), my opinion is as follows: Hope it helps. Any further queries are welcome." "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 some painless red bumps (few are very small, and one may be less than 1 mm) on my penis. I have already consulted a dermatologist. He said this is molluscum and homeopathy medicines will be helpful. But there are no recovery signs for a month taking homeopathy medicines. I am afraid as they are spreading on the groin area and I am also in stress and not enjoying my sexual life. What can I do? Also, can a proper diet help in recovering as said by the dermatologist? ### Response: Hello I understand your concern. 1. Yes, this is molluscum contagiosum. On genitals it spreads via sexual contact, so it is an STD (sexually transmitted disease). 2. Try to avoid sexual contact till they get treated. 3. There is no role of diet as such in this condition, just maintain a normal healthy diet. 4. It can be removed by simple needle extirpation, which is not very painful and do not worry it will not leave any mark. And I do not think homeopathy will be of much help in this but can be easily treated with simple needle extirpation in single session." "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 problem is, I wake up in the morning and feel a severe pain in the lower back. Please tell me the solution. ### Response: Hello. This professional advice provided by me stands subject to the actual examination of report/image and is based entirely on inputs provided to me. It should be correlated with clinical findings." "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 24 years old. I have over imagination problems since when I was a child. I imagine that I am a winner and what I want and where I want to go. Still, I am facing these problems in my job, education, and personal relations. I imagine all my favorite, but in realities, it is not, what I am doing. I felt guilty about what I thought. Please help. How could I stop this over imagination problems? ### Response: The problem of excessive imagination occurs because imagination is one of the defenses used by the brain to overcome day to day stresses. Also, it prepares you for the future and motivates you. But if it is excessive and causing problem, then you may use some behavioral measures to overcome this. 1) Make a schedule. 2) Involve yourself in positive distractions. 3) Tie a rubber band on your wrist and pull it whenever you are going into the imagination too much. You may seek the help of local psychiatrist if it does not work." "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 27-year-old male with no history of joint issues. Can stress and anxiety cause joints to pop? I was okay last month but this month it has been really stressful for me and I know my hands feel stiff and all my joints pop. When I raise my arms, one can hear the tendons stretching like rubber bands. When I rotate my legs, my hips pop. They make pretty loud pop with no pain at all. My elbows sometimes pop, not often. I have no disease that I know of. Can this be caused by stress and depression? Please help. ### Response: Hello. Random clicking and popping joints is a common occurrence and as long as there is no associated pain or swelling, there is nothing to worry about at a young age such as yours. Excessive stress and anxiety can make your muscles taut. This can happen during periods of depression too. When you move any synovial joint around, the taut muscles around these joints cause the popping and cracking. You can try gentle stretching exercises every morning. This will help relax your muscles and subsequently relax your joints" "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 student and I feel so depressed nowadays. I cannot bear a bit of stress and I have to watch motivational videos every now and then. I am suffering from a lot of mental pain. I cannot stay happy and I also have exam fear. I cannot sleep when it is exam coming in a few days. My hands start shaking and feel so depressed and tensed. What can I do to be happy and tension free? Please help me. ### Response: Hi. You seem to be suffering from anxiety and depression. This is a common problem in the general population. I would advise you to seek professional help. It does not seem to be getting better, instead, it is worsening. Do not be alone, share your feelings with some close friends or family members, make a schedule. If nothing seems to be helping, you can always connect with me. I would be happy to help 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 have severe pain in the lower back region. I have this problem for a few days. The pain is present only on the lower back just above the hips. I feel stiffness and pain in the lower back in the mornings. I have the pain radiating towards my upper spine when I squeeze the upper back muscles. After a few hours, my pain goes away and comes back again after a night sleep. I always do weightlifting at home. Please suggest a remedy. ### Response: Hi. You have a muscle spasm. Evaluate your sleeping conditions and ensure that you are sleeping on a supportive mattress that is not over seven years old. When sleeping on your back, place small support under the lower back and knees. You can use a small pillow or rolled towel. When resting on the side, keep a medium size pillow between your knees to keep your pelvis straight. Try sleeping on a heating pad. Do light lower back stretches every morning and every night in every direction." "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 a UTI a few days back and prescribed Cephalexin 500 mg four times a day. I only have four pills left and some of my symptoms are gone but some still remain. I was told this is caused by strep B. I am 18 weeks pregnant and will be 19 weeks in a few days. I want the baby to be healthy and safe and am unsure what to do next. This is my third pregnancy and baby and this will be my third cesarean. I worry about this affecting the baby. ### Response: It can be prophylactically taken daily once till delivery and then two weeks post-partum to avoid any chances of recurrent UTI during pregnancy and negating canes of preterm labor. You may discuss with your obstetrician and discuss the option." "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 hip X-ray of 35 mAs. An average hip x-ray is supposed to be 20 mAs/.07 mSv. So if my hip x-ray was 35 mAs, how many more mSv have I received? Was I overexposed? ### Response: Hello. The x-ray power output depends on mAs (milliampere-seconds) and kVp (kilovoltage peak) parameters. The average hip x-ray can be done at about 20 to 30 mAs and 70 to 80 KVp. The general rule is that the percentage increase in mAs causes a similar increase in radiation dose. In your case we can take the average tube current as 25 mAs and dose given to you is 35 mAs. Therefore you might have received 30 to 40 percent over the dose if given a 25 mAs exposure. As x-ray dose for hip x-ray is less when talking about the harmful effects of radiation, so you do not have any significant increase in radiation dose risks." "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 while ago, I started noticing milky discharge from my breast, the discharge continued for about three months. After two months I started to develop red burning rashes on my breast. The rash first appeared as a single ringworm like red rashes on my breast and no improvement for two days now and rashes have increased at the sides of my two breasts. What could cause this? And are these two occurrences related? I applied a triple effect cream (Bmn plus cream) on it, that is when it started to produce blisters. Please help. ### Response: Hello. I can understand your concern. Rubbing of clothes to the nipple can also lead to discharge. Tight innerwear, allergy to fabric material lead to skin rashes, etc. can aso be the cause for the discharge. So, you, please consult your gynecologist once, get examined and go for serum prolactin levels and if needed sonomammography. With this work up the possible cause of your problem can be identified and treated. I hope I have answered your 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: I met with a mountain biking accident about two years ago. What I believe is I have a hypertrophic scar from the base of my nostril to my upper lip, which is about 3/4 inches. It is flattened a lot and is no longer red. Can I make it even better? ### Response: Yes, it is a hypertrophic scar (attachment removed to protect patient identity). It still looks bumpy and elevated in the picture, and it can be flattened with intralesional Kenalog (Triamcinolone Acetonide) injections. You may need two to three sessions to bring it to the skin level. There are scar gels like Serica (Pracaxi oil), you can use it along with intralesional Kenalog injections to improve the texture. Microneedling with radio frequency (MNRF) is an effective procedure for this type of scars, after getting it flattened using intralesional Kenalog." "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 32 year old male. For the past one month, I have been feeling an itchy sensation in my penis occasionally. Today, I checked and found some white substance inside the foreskin and the glans area on that side is red. The foreskin inside there is also red. The white substance cleared when washed but after one hour when I checked again, it was back there. I washed again and it cleared mostly but some still remained. There is no lump or fluid discharge except the white substance. There is no pain or unusual feeling while urinating or any unusual smell. But there is slight itchiness at times as I said. I did not have any sexual contact with anybody in the past seven months. Please advise what this could be and how to deal with it. ### Response: Hello. It would be better if you can take a picture of it and upload it. There are two possibilities. Is this whitish substance present at the base of glans where foreskin meets the glans? If yes, this is a normal thing. This is called as smegma. These are normal secretions and nothing needs to be done about it. Daily morning, you may just pull your prepuce back and wash it. No need to wash it frequently. If location is just on the glans, but not at the base then there is a possibility of fungal infection called as candida infection and you need to apply antifungal like cream Clotrimazole two times a day for two weeks. So overall, it is likely a possibility of smegma and nothing to worry about 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 cousin is a 23 year old student who is good at academics. He has limited himself to his room. He is not going out at all. Nowadays his exams are over. He does not talk with our family members. He does not have food for days together. If anyone, even his mother tries to talk with him, he shows aggressiveness or sometimes weeps. He is not sharing any of his problems rather states he is fine. It has been very hard to convince him to visit any counselor or doctor. But, he is in touch with some of his friends alone. He does not pick call from anyone. This problem has been persisting for about six months. Please advice about the kind of problem he is experiencing. What should we do? ### Response: Depending upon the symptoms you have described, in 23 year old student, there are two possibilities: 1. Psychic breakout: 2. Psychosis: Consult a psychiatrist online for further follow up" "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 an upper abdominal ultrasound. Report stated very suboptimal scan, bowel gas shadowing and patient habits and subcostal position of organs. Visualized sections of liver are increased in echogenicity and a coarse echotexture. Portal vein demonstrates hepatopetal flow. Liver enlarged 18.6 cm. Both kidneys, aorta and spleen are satisfactory. I am very worried. Can you give a second opinion? I have scan images too. ### Response: Hi. Your ultrasound does show hepatomegaly with fatty infiltration. No focal abnormality can be seen in the images provided (attachment removed to protect patient identity). However, ultrasound has its limitation and is not able to see through the bowel gases and fat depth which is why your radiologist has mentioned to avoid over diagnosis. If clinically indicated, they would recommend you a CT scan or MRI." "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 25-year-old female and for the first time, my partner did fingering in my vagina. And it was on the next day when my periods ended. He is pretty sure that his fingers did not have any semen. Also, he rubbed his penis over my body with both our lower body parts covered with clothes. Is there any chance of me getting pregnant in case his pre-ejaculated semen was on his hand while fingering into the vagina? Should I take an i-pill to eliminate the risk? ### Response: It was next day at the end of your period. So, the chance of pregnancy is nil on this day. Even if you had sex that day, you would not have got period. So, there is no need to take an i-pill" "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 burning sensations on my skin since 14 years. I am also very much sensitive to touch, which feels like my entire body is bruised all over. It is so hard to explain, but that is the best way I can put it into words. I feel inflamed all over at times. I had a brain MRI before 20 years after being diagnosed with tinnitus and it was cleared. Following that I had a C-spine MRI thrice in the next three years and everything was normal. I had another brain MRI last year and radiologist noted several small spots in the periventricular and subcortical areas consistent with small vessel ischemic changes. The neurologist said he did not see anything on the MRI films whatsoever. So, I was left in limbo once again. I still have that radiologist report that shows spots on my brain that haunts me. Giving all the MRIs through the years and the fact that my symptoms have basically remained the same (sensory). What are the chances of this being MS without showing actual lesions that resemble MS? I also was diagnosed with pars planitis before 20 years, which is linked to MS in small percentage. That, of course, is what has scared me about my skin sensations. They usually come and go. This time I have been dealing with them since four months. This is really hard to deal with. ### Response: Hi.I have read your question with care and understand your concerns. Let me explain some basics. Nerve conduction studies. Revert back with the report to 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 had unprotected sex yesterday but my partner is not sure if he withdrew on time. Today morning I felt certain fluid coming out of my vagina. Should I take an I-pill to avoid pregnancy? Will it cause any side effects in later stages? My menstrual date is around 7th of each month. Also, I have PCOD so will the contraceptive pill cause any problem? Please advice. ### Response: Hello. It would be better if you take regular cyclic contraceptives instead of emergency for few months generally. At present emergency contraceptive pills to be taken to be on safe side as millions of sperms in 1 to 2 most of semen and only one sperm enough to give pregnancy, if things go well at each step. Emergency and hormonal contraceptives have hormones so every hormone have its effects and it is not necessary that body get all side effect for every individual. It might be possible you would have irregular, unscheduled bleeding for some time. In addition, mood variations, breast tenderness, abdominal fullness can be observed." "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 unmarried woman. I got periods before 50 days. I am having kalarchikai from yesterday. Will I get periods within a week? Five months it is was a regular cycle the sixth month is like this. It was irregular now again same. What to do? ### Response: You have the delated period problem. If you have any history of unprotected sexual intercourse than rule out pregnancy by urine hCG card test. If the pregnancy test is negative than rule out thyroid issue by serum TSH estimation. You need to investigate with ultrasonography of abdomen and pelvis with particular emphasis on the ovary to rule out the ovarian problem if present. If you have gain weight recently then also it can be the cause. For that, you need to lose weight. You can consult a nearby gynecologist for your detailed pelvic evaluation. I hope I have answered your question. Let me know if I can assist 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: Feeling of something stuck in the throat that comes and goes. It is mostly there all the time but sometimes it will go away. It actually feels more like that flap in my throat is twisted or I am swallowing it or something. I had a scope down by a GI last week and they said they only thing they found was a hiatal hernia. I just did a barium swallow test today. Waiting for the results. A few weeks ago, I had a swallow study done and they could see somewhere food was catching there on my epiglottis. I just do not know how much more of this I can take. I feel like it is a hairball or something stuck there or like a small flap or skin. My question is would not GI doctor have seen it if that little flap in my throat or epiglottis? Or it was messed up or swollen or something? ### Response: Hi. The feeling of something stuck in the throat is usually due to gastric acid reflux causing pharyngeal irritation. Gastroenterologist will definitely see the epiglottis but it is not the pathology. The regurgitation of swallow can be seen only on swallow studies that tell functional problems. Endoscopic examination can tell anatomical causes. Hiatal hernia is a cause for it. Even your swallow study is suggestive of this. You should take some antacid regularly but the best solution for this is surgical correction. This can be done laparoscopically too. 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 a 21 year old female. I have donated blood twice (in December and March respectively) and my hemoglobin level was 12.1 g/dL. Yesterday, I had gone to donate blood. But, I was not able to do so because of my low hemoglobin level (9.5 g/dL). I am just wondering if the drop in my hemoglobin level is because of my periods? ### Response: It could be a result of frequent blood donation. Maybe your body did not get enough time to regenerate the lost blood. So, give some time for your body to regenerate the lost blood. Take Iron supplements and VItamin B complex for six months. Repeat Hb check after six months. Once your Hb level is back to normal, you can donate blood again. Before you donate blood the next time, check your Hb level and consult a 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 a 34-year-old lady. Trying to conceive. I had a follicular study. On ninth day, my right ovary size was 7 mm and left was not developed and on 11th day scan, it is showing the same values. But my embryo line has increased from 5.2 to 5.9. What does it mean? Am I pregnant or not? Please tell me. ### Response: Since the size of endometrial thickness has increased and the size of the ovary follicle has increased, there are chances of pregnancy. Try during your fertile period which is between 12 to 24 days of your periods. Get started with Folic acid supplements. However, if you have a doubt then get 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: I am a patient of hypertension and anxiety, taking treatment for the last two years. Presently, my BP is well under control (average BP 115/70) and pulse varies between 75 to 95 BPM. Presently, I am taking Telma CT (80 + 12.5) and Embeta-XR 50 daily & Esnax Plus (Escitalopram + Clonazepam) for anxiety. I want some advice whether I can reduce or decrease the dosage of my current medication. ### Response: Hello. Hope this helps. Please feel free to ask more queries if you have questions. I would be happy to assist. For more inforamtion 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: I wanted to know is it normal for a newborn to have eye bleeding. He is almost one month old. I was surprised that his tears are blood. Should I worry or is that just normal? ### Response: Such bleeding is not normal. The causes of such an occurrence are varied. A few common causes include a blood clot, a tear in the tear duct, infections like conjunctivitis, and sometimes a cut in the conjunctival lining can also cause this. The best thing, for now, would be not to rub or wipe your baby\s eye very vigorously. The pediatrician will evaluate him for bleeding disorders and then have an eye examination as soon as possible. In case you have any further questions please let me know." "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 an enlarged painless testicle and I visited a urologist. They confirmed that it is a hydrocele and said it would go away on its own. However, now my testicles are slightly hard and more firm. But there are no lumps or imperfections. Should I be worried? ### Response: Hi. Get an ultrasound done. It will clarify the picture. Sometimes, a fluid-filled tense cyst may also feel hard. It transilluminates well with torchlight. The main problem with 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: In the case of twin pregnancy with a different placenta, the packet of amniotic fluid is also different or there is only one packet on which both babies are living? ### Response: Twin pregnancy is of four types. One with two amniotic sacs and two placentae which is known as a diamniotic dichorionic twin. If there is only one sac and one placenta it is called monochorionic monoamniotic twin. If there are just one sac and two placentae, it is monoamniotic dichorionic. If there are two sac and one placenta it is called dichorionic monoamniotic twin. However, if you have a doubt then get 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: I am a 30 year old male. My height is 5\7"" and weight is 79 kg. I recently did some tests and the findings are as follows. Testosterone 239 ng/dL, HDL 24 mg/dL, VLDL 60 mg/dL, triglycerides 302 mg/dL, Vitamin D 29 ng/dL, Vitamin B12 164 pg/mL and HbA1c 5.2%. My BP is under control. I also have lower back pain due to loss of lordosis. I am now taking medicines for cholesterol and calcium. I have been masturbating quite frequently since age 16. I recently had sex for the first time and I ejaculated quite fast. My erection does not last long. I visited a local doctor and he observed my penis with a device and said my penis muscles are weak. What should be the ideal testosterone of a male my age? I intend to marry next year. Am I fertile? Are my sperms strong? Can I have a normal sex life? How to rectify the problem of weak penis muscle? ### Response: Considering your age, the Normal Testosterone Levels should be around 270-1000 ng/dL. The report of yours shows lower levels. Obesity or overweight is one of the important reasons for low laboratory levels of testosterone. Semen analysis can tell if you can have a child or not. Ejaculation in a minute is considered as normal. No need to worry. With practice your time will increase. If you are getting good erections, then there would be no issue of muscles. If your erection is good, then no need to worry." "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: Yesterday, I had some really bad itching in my clitoris. Today I woke up with inflamed lips on labia and more discharge than usual. Please help me my vagina is sore and I am only 18 years old. I do not want to tell my parents that I have been sexually active. I do not know if it is a STD or not. ### Response: It could be sexually transmitted disease. Have one vaginal swab to check in the laboratory to exactly know the organism of infection. Have a strict hygiene. Wear soft comfortable undergarments. Use condoms to prevent transmission of infection. After collection of vaginal swab start tablet Doxycycline 100 mg 12 hourly and table Metronidazole 400 mg eight hourly for seven days. Follow result of swab and discuss here or with a local gynecologist. Sit in warm water to reduce irritation. You can have tablet Postan (Mefenamic acid) for pain eight hourly" "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 went abroad a few days after my period ended. I start birth control on the last day or the day after the last usually. On the second day of my vacation, I started spotting and that has lasted till now. It has been about 10 days. I have been taking my birth control throughout. I only just got back. What could this be? Please help. How do I go about with my next cycle of birth control? Will my period be normal? Also, I have not had sex during this entire situation. The mistake I did is that I skipped a couple of birth control pills as soon as my holiday started and then I tried to make up for it by taking two on the same day. ### Response: Hello. You are experiencing a breakthrough bleeding occurring due to missing your pills and also probably due to not taking them on time. If it is a combined oral contraceptive pill, then it should be started from day 2 or 3 of your cycle ideally. Till then, you may use barrier contraception to prevent any pregnancy and if the bleeding is discomforting, then you can use antifibrinolytics for three days to stop it completely as well. The pills should be taken on time and regularly to avoid such breakthrough episodes, ideally." "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 here today to finally address my problem. I am an 18 year old male, who plays football and loves to play golf. I am here today to say, and I have an eating disorder. In this case, I am assuming it is an eating disorder or some type of phobia. But anyway, my problem is eating in public. I never had a problem with it when I was young, but it probably started when I was 13 years old. I cannot eat out if I go to a restaurant or a fast food place, I feel like throwing up instantly when I sit down with my food. I cannot eat at school and the worst one is when I receive the body of Christ, I almost jump out of my shoes to try and not to throw up. But luckily that never happened.It is probably been about two years since I ate out of my house. I do not understand how it just happened. I mean like I was fine when I was younger, and now I have this problem. What should I do? My family does not really believe me when I tell them, they just say it is nerves. But since it has been two years, I think it is buried in my head. Now I have some questions. Can this be fixed? What exactly is my problem? Will I ever be able to eat at a restaurant or fast food place again? Can this be fixed without actually going to the doctor? You honestly do not know how much I would love to go sit down with my family at a restaurant and enjoy a meal. I need help and a confidence booster. I can eat perfectly fine at my own house and that is why I am confused. Please help me. ### Response: I think it is not an eating disorder because, in the case of an eating disorder, the problem should be everywhere including your home. However, your problem of eating in public could be because of social anxiety disorder or because of Obsessive-Compulsive Disorder (OCD). So, I would like to seek more clarification regarding the following points: Now, I would like to answer your questions. Yes, this problem of yours can be fixed. Do not worry about that. This could be a social anxiety disorder or obsessive-compulsive disorder. Yes, you will definitely be able to eat outside. You can revert with the answers to the above questions for me to arrive at the diagnosis so that we can decide if you have to meet the doctor in person. I can understand and feel your pain as well. There are pharmacological and non-pharmacological treatments to solve your problem." "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 earache for the past two days, not terrible pain but it is still there. It has been giving me some tiredness and mild jaw pain as well. What should I do? ### Response: The middle ear infection can be possible according to the mentioned history. You need to get your otoscopy ear examination first to rule out any pathology in the ear if present. If impacted wax is present than wax loosening" "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 blurry vision in a small section of my right eye, and it keeps moving around. Sometimes, it completely disappears. In addition, I have pain on the inside of my top and bottom eyelids as well as the outer corner of my eye, but I feel the pain only when I blink. This pain is also alternated between those three sections of my eye while I was wearing the contacts, but the pain has settled in my top eyelid now. I also noticed the discharge a couple of minutes ago. These symptoms started this morning upon inserting my cleaned contact lenses. I am currently on Melatonin and Depo-Provera. ### Response: Hello. Stop wearing contact lenses until the eye is completely normal without redness. Consult an ophthalmologist nearby to check for eyelids and retina for moving things and weak spots (lattice). The moving thing is a floater. It is uncommon in your age unless you are myopic. There is a jelly-like substance in the eye and as age progresses it starts to liquify and you start seeing floaters. You should go to an ophthalmologist immediately in case if there is an increase in the number of these floaters, or if you are seeing flashes of light. Because these are the signs of retinal detachment. Get your retina checked at least once a year. Right now you have to ignore the floaters and you will get used to 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 partner is having a lot of pain in his wisdom tooth. I guess he is getting it but his whole mouth got swelling and he is not even able to talk. He is having fever also now and the pain is not bearable. What should we do right now as none of the doctors are available? ### Response: Your wisdom tooth got infection, so there is pain and swelling. The infection is spreading that is why you have restricted mouth opening and facial swelling. Better start with high dose antibiotics and pain killer temporarily. It will be easier for me to give correct treatment if you send an image of your face and involved 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: I have a question about my skin condition. I have developed a really itchy and dry skin after I dyed my hair. Here are the symptoms. I do not know what the condition is as my appointment is months away. Can I attach pictures? ### Response: Hi. I have seen your query and examined your given picture (attachment removed to protect patient identity). It seems you have developed allergic contact dermatitis to hair dye. Though you may not have had this on your previous exposure, now onwards you may have a severe reaction to the dye" "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 vomited a two-inch tubular gummy object that had black dots when dissected. I recently tested negative for parasites in my stool sample. Please help. ### Response: In the picture, it looks to be a part of the undigested food particle. However, making a conclusion based on the picture is difficult (attachment removed to protect patient identity). Please keep a close watch on such occurrences and any symptoms involving the airway or food passage. Symptoms like throat irritation, fever, and cough are also essential to look out for. If you have a repeat of vomiting similar substances, then please consult your doctor and get an upper gastrointestinal endoscopy 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 am a 37-year-old, healthy male. I have attached three views of my eyes. The top one is 13 years old, the middle one and the bottom one are from today. As you can see I always had a bit of droopy left eye lid and its prominence depends on the angle of the view. Do you think this is consistent with Horner syndrome? I have no neurological symptoms or health concerns. ### Response: Hello. It is usually associated with other symptoms like severe headache, dizziness, etc. So, I definitely do not think that you have this syn" "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: At birth, my son was diagnosed with a seizure. Now he is 18 months old. I am fearing about DTwP booster dose side effect. Earlier three doses had reaction of muscle stiffness and fever. ### Response: Hi. I have read your question in detail and I know that you are very concerned about your child but do not worry. Muscle stiffness and fever can occur after a DPT vaccination and is not a contraindication for vaccination. Contraindication for DPT vaccination are seizures, inconsolable crying, and central nervous system infection or encephalitis after giving DPT vaccination. If you want to be on safer side then go for acellular vaccine instead of whole cell vaccine. You should give DTaP vaccine instead of DwPT vaccine." "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: The dentist thought my tooth had a fracture, so he put on a temporary crown. That worsened the pain and throbbing exponentially, so he sent me to an endodontist that said my tissue was extremely inflamed and needed a root canal ASAP. After the root canal, the regular dentist put on the permanent crown. I felt the throbbing again after he put the permanent crown on. I got a second opinion and the dentist #2 did an X-ray and noticed the crown did not cover my tooth fully. I went back to Dentist #1 who had to restart. He took the permanent crown off and put a temporary crown on again. But, he had thrown my original imprint away and waited to take a new imprint until after he removed my permanent crown. The temporary crown is on now and is tiny compared to my other teeth. It looks like a kernel of corn. Should he have taken the impression first before taking the permanent crown off? I worry my new permanent crown that comes in will be tiny. ### Response: Did you have any pain after completion of root canal procedure before permanent crown placement? How is the pain? Is it the same pain which you experienced before root canal? If the pain did not stop after completion of root canal and before crown placement, then it should be from the tooth. You should get back to your endodontist in this case. Generally, a couple of days will be left as healing period before placement of crown. If the crown is placed immediately without allowing a period of healing, it hurts. If the pain started after placement of permanent crown, then you should visit your general dentist to check the status and fit of the crown. In this case, the crown needs some fine adjustments for a perfect fit and bite." "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 temporary crown on a tooth on the upper right side almost a week ago due to extreme sensitivity and pain when biting down. My dentist said that I had a microfracture and so he placed the crown. I am still experiencing pain when I bite down but less sensitivity than before. However, now I am also going through a general pain in my lower jaw on that side too. It is not coming from any one tooth, but it does seem to be radiating from the back. Could the crown cause this? I am currently on Hydrocodone, Verapamil and Spironolactone. I wake up in the morning with pain on that side, but only since having the temporary crown put on. I did have some nerve damage to that side of my face from a partial parotidectomy two years ago. However, it has never affected my teeth. ### Response: Hi. I have read through your complaint and the relevant details. 1. A carbon strip will be placed on the crowned side to check your bite, and accordingly, the crown height will be adjusted with still maintaining the shape of the crown.2. Temporary crown has to be changed to the permanent crown as per the treatment plan was given to 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 have got a skin problem in both armpits. Due to scratching the skin was torn. The images are attached. Please help. ### Response: Hi. I have seen your query and concern. Now you developed eczematization this is my assumption since you have not sent detailed treatment history or it may be irritant contact dermatitis due to duo. Now I can make severe eczematization, so I would advise you not to apply any such thing if you have applied in the past. Start applying Mometasone plus, Sertaconazole 2% twice daily over the affected area for seven days, then stop Mometasone and continue Sertaconazole. Also, take Terbinafine 250 mg once daily for 21 days and Cetirizine once daily for five days. Get review after five days with detailed history." "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 nerve pain between my left bum and left leg for the past two months. It is so painful that I cannot even walk, sit or lay down. ### Response: You have to get it done, nerve conduction study and MRI of the lumbar spine. If necessary, you need a color Doppler of the lower limb. Use tablet Naprosyn 250 twice a day for five days. If your symptoms do not improve or develop an allergy to the above" "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 not able to do intercourse with my wife for three months. My erection lasts only for three minutes, and then it will come down. How to increase erection for a longer period to have proper intercourse. Should I need to take any treatment? Please guide. ### Response: As you mentioned, three minutes erection is within normal limits. So you do not need any medication for this. However, you can do lifestyle modifications to manage your high blood pressure, and it will also help you with this problem. Do regular exercise. Take a healthy diet and avoid any substance use. Some exercise such as kegel exercises (pelvic-floor exercise) is also helpful; you can read about this and can start practice. 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 a 34-year-old unmarried female. My last cycle was two weeks back. I want to postpone my next period by almost 10 days. Should I take Primolut or Sysron N for delaying my periods? I have a 30 to 35 days cycle. Please suggest. ### Response: Hi. As per your description, you want to have some hormonal pills in advance to delay periods for 10 days. The body takes time to adjust according to hormonal support to induce or delay periods. Start Primolut N (Norethisterone) 10 mg twice daily 7 to 10 days before the expected date of periods. You have to continue medication twice daily 10 mg till 3 to 4 days before you want to have the periods. Periods might get upset for a few months as well. Mood variations, breast engorgement also can be observed." "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 a breathing problem. I feel like something has tightened my lungs. Please advice what should I do. ### Response: Hello. I just read your query. See if you do not have any other symptoms like fever, cough with sputum and pain in the chest, etc. It will help you. But if you feel some serious problem, then visit a nearby physician immediately because it could be due to some serious problem which is excluded with the help of clinical 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: I accidentally got Amdro indoor pest killer in my eyes. I immediately rinsed it out and continued to do so for 15 minutes under the tap water. Will the spray affect my vision? ### Response: Hello. It seems from the history that a pest killer went into your eye, and you have immediately washed the eye for 15 minutes. It is a good thing you have done by washing the eye. This is the first line of treatment, and you have done it. The next mode of treatment depends on the symptoms." "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 32 years old healthy male without any relevant medical history. I am married since 2 years and do not have kids. Till 3 months ago I used to have weekly sex with my wife but now since last 5 months I have been staying without her in some city so meet her only once a month. I also masturbate once a day mostly. In last 45 days we have met three times but I felt less confident in maintaining erection enough to have sex, so I had 5 mg tadalafil and did intercourse comfortably. But yesterday I had to to take 10 mg tadalafil and then also I was under confident. Kindly suggest:1) if I have erectile dysfunction and need to take medicine 2) If it is just psychological condition and need not worry3) Or keep consuming 5mg/10 mg tadalafil every time having sex. ### Response: Erectile performance and ejaculation can be influenced by many factors, if you are anxious, sad or stressed this can get lower performance, if you are relaxed and happy you will have better performance because it is affected by neurotransmitters, which is influenced by mood, stress level, etc. the more relaxed, happy and stress free you are the more levels of these neurotransmitters and better performance, it\s also influenced by emotional factors with your partner, if any problem between them can lead to psychological erectile dysfunction which is common in young couples. and when partners stay away they are not doing sex often and they get distanced in emotions and some level of anxiety builds up when they perform." "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 18 year old, and I have been sexually abused as a child for many years. I have never told anyone, and now my parents got divorced. I am experiencing numbness and psychosis symptoms, but they do not affect my daily life, and no one knows what I am going through. I wanted to know if I have a mental illness. Am I in danger of a mental illness? ### Response: I empathize with you. Sexual abuse in childhood is perhaps the most brutal and tragic thing that can happen to a person. The scars of that enormous trauma never fade away. I believe you have post-traumatic stress disorder. It is not a psychotic disorder but a neurotic (anxiety spectrum) disorder. The symptoms are: If you think you are suffering from the above symptoms, visit a psychiatrist at the earliest. Medicines like Paroxetine and Escitalopram are very much helpful in reducing the symptoms" "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 bronchitis today in the emergency room. I felt very weak and had difficulty breathing and could not wait for my doctor\s appointment in two weeks. I have an unproductive cough for a month and a half and burning in my chest. I have attached my reports.Do you see anything else in these X-rays (tumor)?Is bronchitis the correct diagnosis?Are the medications they prescribed correct? ### Response: Hello. According to your present and past history, it could be allergic rhinitis with bronchial asthma if rhonchi present on auscultation. it could be bronchitis in which rhonchi may or may not be present. I have gone through the reports (attachment removed to protect patient identity). There is no evidence of malignancy. Although medicines are correct, if symptoms are not controlled, then I suggest you should go for nasal spray BD, Montair LC (Montelukast and Levocetirizine) HS, Seretide Accuhaler (Fluticasone Propionate and Salmeterol Xinafoate) BD" "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 41 years old, single, non-smoker, and I do not have any illnesses or physical symptoms. Just I have chronic anxiety and I take permanent medications for 10 years for that under health care which are Zoloft 100 mg along with Buspar 30 mg daily. I have made a checkup and ECG and everything is normal and I have no abnormal symptoms. I have attached complete blood tests to take look at it since my query related to this results. My weight is 105 kg and the length is 173 cm note that the weight gain regarding side effects of constant medications especially Zoloft. The blood pressure is 140/82 and sometimes 150/90 and rarely became 159/110 as maximum reading. My questions now:I scare and worry always about heart attack and clots because of the following indices: my platelets are always 450, blood pressure borderline or mild high always, lipid profile borderline always and CRP high always. what do you think, please?To protect myself and encounter these risk early could I need regarding those values one of the following strategies. Note that I changed my lifestyle many times but no point because of the side effects of Zoloft and Buspar as weight gain.Taking cholesterol-lowering medication like Lipitor (Atorvastatin)?Taking blood pressure lowering medication like Cozaar (Losartan)?Taking baby Aspirin daily as 81 mg?Taking Metformin for encounter the weight gain resulting of Zoloft? And is it correct this medication can cause lactic acidosis poisonous by the time?Are the medications Zoloft and Buspar the reason of those abnormal values of lipid profile and elevated of blood pressure? Please let me know what is the correct and best options regarding your experiences or do you have any other options? ### Response: Hello. These medications should be prescribed under the guidance of psychiatrist and for behavioral counseling you can consult a psychiatrist" "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 used Accutane from 17 till 25 years on and off, it was always good. So 6 months ago I tried for 12 days Accutane and I saw after 2 days appearing scars on the skin for no reason. I did not have acne. It was for my hair that was alway very shiny. So I stopped ofcourse the Accutane and did bloodwork. I had low vitamine d and positive ANA and anti-DSNA. Drug included lupus. I went to every dermatalogist to help me to stop the disease because it is still haunting me. And the scars need to be stopped. Please is there somebody who can help me? ### Response: Hi. I went through all the reports and the image (attachment removed to protect patient identity). I think you are correct." "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 thinking about getting a kitten, my father and brother are allergic to it. So, it will be kept in the upper room. I want to know if I have the same allergies. During my college days, I have spent six years with cats, never touched them but you could see them walking around, some even came close and hid under my tables. ### Response: Allergy can run in families, you have a chance of being allergic as your father and brother are allergic to cats but not a must. Being close to cats in the past for many years is a good indicator that you might not be allergic to cats but still allergy can develop at any age. You can do a skin allergy test by a dermatologist (skin doctor) to know if you are allergic to cats or not. Skin allergy test. ?Allergy. Avoid contact with cats, if proved to be allergic." "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 want to ask whether composite dental bonding is durable or if I bite a mutton stew or chicken leg piece, it will come out? Is it for a lifetime? If it dismantles anyway, is it freely replaceable or I need to pay again? Also, I have heard that laser treatment leads to early fall of adult teeth in the late 50s. Is it so? ### Response: Hi. I had gone through your question. I can understand your concern. Yes, you can eat whatever you want to eat, there is no issue of chewing. Make sure you do not eat any hard substance for the first 24 hours. After that, you can eat mutton or chicken anytime. Better is to go with the best possible restoration provided by your dentist. Less expensive fillings are also available these days but their efficiency is not too good. No, laser curing composite does not affect your teeth or make them prone to fall. If the fillings fall or come out, it will be replaced by your dentist free provided it falls early, if it falls after two or three years it may not be replaced without charges." "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 starting Avenova spray and Cliradex wipes for my eyelids, which have blepharitis and MGD. How far apart should I space each one? I do not want to irritate the eyelids. ### Response: Hi. Do space them some time apart. 2 to 3 hours would be optimal so that each can act individually. Both have an antiseptic effect on low-grade bacteria causing blepharitis along with add on effects (detergent and non-detergent) and hence improving hygiene. Hence, spacing them would be ideal. However, if you are a busy individual and fund carrying things around a bit difficult, keep at least 15 minutes gap for the action of one medication to set in. Also, do not overuse either, twice a day is ideal frequency. Scrubbing of lashes with baby shampoo is also of some help and simple to follow for blepharitis." "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 33 years. I had emergency contraceptive pill last month and got my periods 39 days back for four days duration. But, this month still did not get my periods as expected. We had sex, but there was no ejaculation or precum discharge. So, we decided not to take any pill. Now, I have been feeling a little cramp like feeling in my lower abdomen as I feel during periods, but only water-like white discharge as in ovulation time coming out. Why is my periods late? ### Response: Hi. I-pill effect. Urine for pregnancy testing. Missing period following taking emergency pill. Revert back after the tests to 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: The frequency of urination and thirst has increased from the last two to three days all of a sudden. Sometimes it is two to three times even in an hour.I am a 29-year-old male. I regularly do HIIT exercises two times a day. ### Response: Hello. As you described the complaints, you seemed convinced that it is due to HIIT (high-intensity interval training) only. But there could be many more factors associated with it. To know the cause and prescribing further treatment I need to evaluate your case better. How much is your daily fluid intake approximately and what is your regular dietary routine for your HIIT? Since when you are doing HIIT? Do you feel heat in the sole? Any difficulty in urination? Any symptoms of headache or any other condition? Let me know in the follow up about the above questions." "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 know what dose of Clomifene citrate (Clomid) would you recommend for a 42-year-old with an AMH of 0.35? ### Response: I suggest apart from FSH (follicle stimulating hormone) and AMH (anti-Mullerian hormone) you do blood tests TSH (thyroid stimulating hormone) and prolactin. Clomifene is started at 50 mg daily for five days. If ovulation does not occur then the dose can be increased to 100 mg daily for five days. It is always advisable to start at the minimum dose" "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 cluster of white rings near a tooth on the roof of my mouth. My left lower wisdom tooth is coming out, and I have a failed root canal on the same side as the wisdom tooth. I am in a lot of pain, and I cannot eat. I keep biting my cheeks because the left side is so swollen. Any suggestions or tips on how to help myself till I go back to see my dentist? ### Response: Hi. Please upload your x-ray, so that I can guide you how to proceed with the treatment in the most appropriate way. Hope this helps. Revert with more information to 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: A year ago, I was diagnosed with Emphysema, and before four years, I was diagnosed with bronchitis, but after six months, I had a warm feeling in my stomach, followed by nausea. I need to know if I should be going back to the ER or continue to take my antibiotics and not stress over it. ### Response: Hello. No, you need not go to the ER. The burning sensation in the stomach and nausea you are having is not related to your emphysema and bronchitis. It is actually due to the antibiotics and other medicines you are taking because antibiotics cause secretion of an excessive amount of acid in the stomach, which leads to a feeling of burning and nausea. The treatment of your problem is simple, take these medicines along with antibiotics to prevent excess acid formation. (1) Capsule Rabeprazole two times a day. (2) Tablet Rantac (Ranitidine) two times a day. (3) Tablet Domperidone 10 mg two times a 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 have tears in my penis and I have sugar 390 after fasting. Milky discharge occurs frequently. The skin around the penis is reddish, thinner and peeling. ### Response: Firstly, you should upload the picture of your penis, where it is getting torn and reddened. Also, since when are you having the sugar problem? Is it detected for the first time, any medicines you are having for it? Usually, it is a fungal infection of the penis which causes these problems. I suggest Clotrimazole ointment three times a day for two weeks. Also, tablet Fluconazole 150 mg bedtime once only. Apply Abzorb (Clotrimazole) powder two times a day on the skin around your penis for two weeks. Your sugar level is very high and you should consult a doctor for that. You need to be started on the medicines as soon as possible. You should get your post-lunch sugar done as well. Also, get your HbA1C levels, renal function test done. Avoid sweet food, rice, potatoes and other high-calorie foods like oily, fatty foods. Do daily exercises in order to achieve weight loss. Repeat blood sugar after a week of medications and lifestyle changes. Have plenty of water" "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 dealing with anxiety for almost a year now. I have also been having weird electric current type zapping, which is very uncomfortable and painful. They go through the whole right side of my body, sometimes coming and going for minutes. I think it is from my anxiety, and not because of my medication. I take Librium, Gabapentin, and Seroquel. I did experience similar currents a long time ago, but they went away. This time, they will not go away, and I need help. ### Response: Hello. Hence keep these points in mind while you consult a nearby psychiatrist for your 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: I suffer from premature ejaculation. Kindly help. ### Response: Hi. Premature ejaculation can be managed by two approaches: It is advisable that you first try the behavior method to manage premature ejaculation. It is difficult initially to practice them but over the period you can learn them, and the effect of these techniques are longer lasting. Also, try to spend enough time during foreplay" "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 wondering about my friend\s case. I have just known that he has been suffering from panic attacks, fear, and anxiety for a long time. As a friend of his, I want to know more tips to do if I was there when he has them or I am not around, more tips about daily life and so on. He is 21 while I am 18. What can we do to make him feel better or to reduce his attacks? What to say and how to behave (we are not a couple), also sometimes he avoids talking to me for long periods. Is that a normal thing? ### Response: Your friend is suffering from anxiety disorder and panic attacks (an extreme form of anxiety). Anxiety occurs when our brain starts sensing danger without any external cause following which body and brain come to the activated level and physical and mental symptoms of anxiety occur. The things you need to know about anxiety and panic attacks are as follows: 1. Do not panic. It will increase the anxiety and panic of the person suffering from it. 2. Treatment is the mainstay, both pharmacological and nonpharmacological. Ask your friend to get the regular follow up of his psychiatrist. 3. Whenever your friend suffers from the panic attacks, tell positive motivating things like, ask him to take a deep breath, relax, offer him a glass of water, tell him that this will go off and he needs to stay little calm and everything will be alright. Treatment should always be the first priority." "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 an opaque, white discharge at the end of urination and it is painful and burning while urinating, and I feel a sharp pain on the tip of my urethra after urination. When I put pressure on my urethra (penis shaft) it hurts and I also have three inflamed lymph nodes in my right inguinal region, starting at the beginning of the crease. I went to my doctor and gave them a urine sample and tests shown no STI\s but I am still waiting on my UTI test to be received. I did have unprotected sex but my partner had tested a week before and nothing came up, and also I was her only partner for awhile beforehand. I do have simplex 1 but no symptoms for years. No lesions, rashes or other abnormalities are seen in my genital area. This has been going on for about five days now, had unprotected sex exactly one week ago. ### Response: Hello. From the clinical description, I can say with confidence that the symptoms clearly indicate toward UTI (urinary tract infection) and particularly urethritis. There is no symptom that indicates toward STI (sexually transmitted infection) other than the history of unprotected sex one week back. That is also can be considered negative as your partner have no evidence of infection. Please visit your doctor and ask for an antibiotic prescription. I understand that reports are awaited but in my view, empirical prescription should be offered as you are having significant symptoms to compromise function and add unnecessary stress. Last but not least focus on treatment now but avoid taking the risk (unprotected sex) as far as possible. 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: My left leg is swollen to twice the size of my right leg. I am 65 years old and weigh 72 kg. I am currently on painkillers as it hurts like hell. Could you please advise? ### Response: I have reviewed your health query and can understand you are worried about your leg swelling. It can be due to one of the many reasons like: In such a situation the best next step is to go to the hospital for proper investigation of the cause. Management goes according to the cause of disease. In the long run, this is dangerous to the leg tissues (if not treated)" "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: Are we allowed to drink water after a cesarean section? If not, what happens to the body if you drink water? ### Response: Hi. I have read your concern. Water is not prohibited after C-section. With this, since you are in supine and you just got an operation, your bowels are not yet fully functioning. If 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: What is the dosage of Meftal P for 5 years 10 months old boy whose weight is 20 kg, and is suffering from high fever for the past one week? I gave him Dolo 250, but it did not show any effect. I have read online that 25 mg per kg can be given in 24 hours. Is the minimum gap 8 hours? Or what is the minimum dosage gap? If the temperature is above 101-degree Fahrenheit, should this be given alone? So, can we continue to give Dolo 250 5 ml six or four hourly? And whenever the temperature is 101 degree plus, shall we give Meftal P 5 ml? Kindly tell me the timing of each dose. ### Response: So, we cannot give it to him. Using plain Paracetamol is a good option. Do not use round the clock. Use when it is necessary (temperature greater than 100 degrees Fahrenheit). You can give it four times in a day. More important is to find the cause of fever, and to treat the cause. The investigations to be done are complete blood count, blood culture, urine routine examination, and microscopy" "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 26 year old female. I am having anal fissure and some crack in the anus. I am bleeding when I go to the toilet. It is very much painful. Please help me and suggest some medicine for this. ### Response: I suggest you the following medicines for anal fissure. Consult your doctor, discuss with him or her and take the medicine with consent: 1) Intra-anal 0.2% Nitroglycerin twice daily for six weeks. 2) Use Ispaghol husk in warm water. This will allow your stools to be soft. Remember that constipation can make it worse. 3) Take warm water in a small tub or pan and sit in it for 10-15 minutes daily. 4) Take Paracetamol 500 mg two tablets twice daily for two weeks." "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: What is the next step done after cataract surgery when the cataract is falling into vitreous? Does it require vitrectomy surgery to recover lens from vitreous followed by streptococcus bacteria causing endophthalmitis infection and multiple antibiotic injections? The doctor examined and told me that my retina looks attached and my pressure is 13. My cornea has hypopyon. My iris has opacity, and I can see only a distorted and lighted background. My doctor recommends a cornea transplant for viewing and vitrectomy. Please suggest. ### Response: Hi. The lens falling into vitreous followed by endophthalmitis requires intravitreal antibiotic injections, and if the patient\s visual acuity deteriorates further, then vitrectomy is necessary. Regarding the corneal transplant, it is usually done in a disease entity called bullous keratopathy. But it can also be done for a variety of other reasons. Endophthalmitis is a very troublesome problem and needs a lot of patient cooperation with medication compliance and follow-ups." "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 jaw has been tingling for four days. I got a hit in the back of the head the night before it started not hard did not hurt. But I have been having headaches for months from a previous bang to the head. ### Response: Regarding your concern, I would explain that this situation could be related to the trauma. For this reason, I recommend having some rest and taking Magnesium supplements. If the tingling persists, I recommend consulting with your attending physician for a physical exam and some tests (blood electrolytes, complete blood count). I hope you will find this answer helpful. I remain at your disposal for any further questions whenever you need." "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 vitiligo on my face, and my skin and hair are turning white. This is a major problem for me. Please suggest some treatment. What should I do? ### Response: Hi. For vitiligo, there are many lines of management. If the patch is unstable, then oral medications can be advised. But if the vitiligo patch is stable, that is no change in the size of the patch over six months, then surgery can be done to re-pigment the vitiligo patch. Suction blister, nonculture melanocyte transfer or phototherapy can be done. Clinical examination of the patch is important before considering any therapy. 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: My 19 months old daughter has suffered with for around seven months. Then, we had an MCU test and it was diagnosed that she had grade 5 reflux in right side and grade 4 in left side. Her ultrasound showed she had 40 cc urine residual. Her doctor suggested ureteric bilateral surgery. She has an open vascular surgery before two months and her stents removed before 20 days. Now, she again had an UTI and reflux problem. Is there any problem? Please guide us. ### Response: Surgery to correct reflux will not prevent UTI (urinary tract infection). It will only prevent bacteria from reaching kidneys, thereby preventing renal damage. Yes, UTI can still occur after correction of reflux. If there are no other factors, then the child can be put on prophylactic antibiotics for a few months and this will stop the recurrence. Best wishes for your child." "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 form folliculitis for about 1 month. I regularly visit my doctor and take all medicines on time. The problem is folliculitis present on my legs and hands. Every week they are gone and then come again then my doctor ask me to do test of blood test and IgE test my blood test report was all fine but my IgE level is 170. So, please tell me what should I do to control my IgE and how to get rid of folliculitis permanently. ### Response: Hello. Folliculitis is inflammation of the hair follicles. Usually it is due to bacteria but sometimes fungus can also cause Folliculitis. Most commonly it is seen over face, beard, chest, arms and legs. Mainly diagnosed by careful inspection of the affected area by the specialist. Sometimes pus or blood tests and skin biopsy is also required to find out the cause. As you said, your blood tests shows IgE level 170. It is completely normal and it has nothing to do with the Folliculitis. So nothing to worry about IgE levels. If your Folliculitis problem is recurrent, then you have to find out the cause for recurring infection of affected area. Talk to your doctor for good antibiotic course or antibacterial cream to apply on affected area. Also it is very important to keep good personal hygiene. Do not share your towels or clothes with anybody. Use good quality soap for bath. If no improvement, then you should see any other Skin Specialist or Dermatologist for expert opinion." "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 23-year-old male. My height is 5.8. Some years ago I had an accident, and there are scars and black marks on my face. Please suggest me the ways to remove the scar and the black spot from my face. Also please provide me a solution for my dandruff. ### Response: Hello. A black mark on the face can be quite worrisome. It can be treated, but I need to know how deep was the wound and is the mark accompanied by any scar? It will be helpful if you could provide a photo of the same. For the time being, apply Aloevera gel (natural) over the mark daily twice as it helps in healing. Keep your scalp dust free. For oily skin, you can use good neem based facewash twice daily. Get back to me in 20 days, let us see how you have responded. Dan" "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: Dear doctor,I am currently paranoid about HIV. Recently, I had an encounter in a massage parlor, where the masseur gave a full body massage with a handjob. I never had sex, this is the closest thing I have come to sex. When she massaged my penis, I felt her hand quite rough, not sure if she had any cuts. She was fully clothed and I was naked. No vaginal, anal, oral, mouth kissing involved. Am I at risk of HIV? Based on your experience, have you come across anyone, who is positive due to handjob? I have consulted a local GP after a day of exposure. He told there was no risk whatsoever and told no need of testing. According to him, no one was infected with HIV through masturbation in any situation, in 40 years of this epidemic. He refused PEP prescription as well. I just wanted a second opinion. ### Response: HIV (human immunodeficiency virus) infection does not spread through masturbation. As described in your case, there is no risk of acquiring HIV. A handjob is not considered an exposure, thus ruling out the chance for any STDs (sexually transmitted diseases). You could relax totally and let go of your fears of HIV. PEP (post-exposure prophylaxis) would not be needed for 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 61 years old, male, 80 kg weight 165 cm height and I am a diabetic for the past 18 years and now I am on low carbo high fate diet (Keto). I am taking now januvia 100 mg tablet 1-0-1. I had a priking pain in the heart side of chest two days back and went to a hospital they have taken ECG, echo and blood test and found normal and hence they asked me to go for CT coronary angiogram. Find attached the CT-angio report. Please advice me what medicine I should take now to avoid heart atack in future. ### Response: Hello. It shows minor disease only. So, need to focus on healthy lifestyle which I guess you must be having, which includes healthy diet like avoiding oily fatty and high calorie diet. Regular exercises like walking or brisk walking according to your capacity. Such pricking pain are usually related to gastritis and reflux disease rather than cardiac. However, you may experience some exertional pain due to myocardial bridging which is usually benign. These 20-30 percent blockages would not cause any pain. In my opinion, you should be on Antiplatelet Statin combination like Ecosprin av 75/10 mg bedtime for long term, for preventive purpose. So, should discuss this with your treating doctor. If you get any pain on exertion which relieves with rest, then it may be due to myocardial bridging, then you may require beta blockers like Metoprolol. In the future, you should also undergo echo and TMT testing every 2-3 yearly to keep check on the blockages. Hope this helps you and get back if you have any doubts." "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 8 weeks pregnant and having mucus bright pink vaginal discharge for the past two days. I do not have any pain. No nausea or vomiting. Is it normal? Please help. ### Response: The evidence of bright pink discharge during early pregnancy is definitely abnormal and is termed as a threatened miscarriage unless proved otherwise. This calls for a visit to the emergency department to meet the gynecologist for a per speculum examination to rule out cervicitis and establish the origin of blood either from the cervix or intrauterine. If intrauterine, then an ultrasound transvaginal is mandatory to rule out any retroplacental bleed." "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: Are nightshades vegetables harmful? Please comment on nightshade vegetables. Do they cause inflammation? And if so, do we have to avoid them? ### Response: Hello. Except for tobacco, all other nightshade vegetables can be taken in the recommended amount. Though they contain some chemicals, they are mostly in a very minute amount and are beneficial for health. The side-effect documented is a personal account and no research has concluded any harmful effects of these vegetables." "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 fly bit on my neck around 2-3 days back. It has lead to red spot on that area and further the spots increased with time. I am not sure whether some of the spots have come as I shaved my beard at that time as well. But, such spots have never appeared due to shaving in the past. I have attached pictures of the same. Kindly guide me. ### Response: Hi. I have gone through your complaints and seen the attached photographs (attachment removed to protect patient identity). According to me, the small spots are due to pseudofolliculitis which is because of inflammation caused by shaved hair. I would recommend you to apply steroid antibiotic combination like Mometasone and Fusidic acid combination on the affected area twice daily for 7-10 days. Also apply the same cream on the insect bite area. If these spots are itchy take tablet Levocetirizine 5 mg one tablet daily at bedtime. Inflammation due to shaved hair. Pseudofolliculitis. Avoid shaving for few 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 have an eye problem which is that my left eye developed to be smaller than the other. It is more obvious when I take pictures. Is there anything I can do or will I need to do a surgery? ### Response: It is a medical condition called ptosis. Although your right eyeball is not small, due to the" "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 34 year old male, who weighs 82 kg. I am suffering from a bipolar affective disorder (BPAD), and have been advised to take Magnesium valproate 400 mg twice daily and Amisulpride 100 mg at bedtime. I am also taking Etizolam 0.25 mg in the morning and 0.5 mg at night, from two weeks, as advised by my psychiatrist. But, recently I feel short of breath while trying to sleep, I cannot sleep properly because of this. My sexual life is also not pleasurable anymore, and it has become just like a routine work. I do not feel joy after ejaculations. My head feels heavy, and I have vertigo problem, I feel as if I will fall while walking. Kindly help me get rid of these problems. ### Response: The symptoms like shortness of breath, poor sleep and loss of sexual pleasure are all the side effects of the medicines that you take for bipolar disorder. I will not suggest stopping these medications, but it will be better to take few medications with effective doses. Divalproex sodium 500 mg twice daily, will be better molecule than Sodium valproate as a mood stabiliser. If you are having palpitations, Propranolol or mouth dissolving Clonazepam will be a better substitute. Counselling with a good psychologist will help you along with medications. I suggest you visit your psychiatrist for above changes in medications. I am sure you will be completely fine with the instructions as mentioned above" "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 and I had an unprotected sex two months back, and after 3 to 4 hours, she took an emergency contraceptive. Her last period started three months back, and she took the pill (Unwanted 72) on the sam day after sex in 3 to 4 hours. I did ejaculated outside. After 7 to 8 days of taking the pill, she had cramps and bleeding like periods, and after 10 to 12 days, again cramps and bleeding like periods happened and today, her period has not come. Is that a sign of pregnancy? Is there any possibility of delay in periods? Please help. ### Response: Hi. Since you have taken emergency pill within 72 hours of intercourse, there is no chance of pregnancy. The delay could be because of hormonal changes due to the pill you have taken. There is nothing to worry about. However, if you have a doubt, then get 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: A 56-year-old patient went to his physician for evaluation of recurrent episodes of lightheadedness, chest pain, and shortness of breath with exertion. One week earlier, he experienced an episode of syncope while walking up the stairs of his house.Vitals:Heart rate - 116 bpm,BP - 164/102 mmHg.Respiratory rate - 18. Weight - 247 lbs.Laboratory exams: Troponin level - normal, hypercholesterolemia, hypertriglyceridemia.Imaging: Doppler echocardiogram demonstrates a significantly stenotic aortic valve and plaques within the coronary arteries.From the given information, which among his findings show abnormal results? What is the possible diagnosis of the patient? What type of muscle tissue is associated? What type of valve is the aortic valve and cite its function? How does the plaque build-up affect the function of the coronary arteries? ### Response: Hello. Did he lose consciousness while walking upstairs? Is he a diabetic? His cholesterol report seems abnormal, along with hypertension and uncontrolled blood pressure. His color Doppler report showing aortic stenosis. Possible diagnosis is age-related atherosclerosis with severe aortic stenosis with dyslipidemia and hypertension. No muscle tissue involved. The major blood vessel called aorta is narrowed. Aortic valve is a tricuspid semilunar valve that allows oxygenated blood from the left atrium into it. It will supply blood to all parts of the body. Due to age-related atherosclerosis (dyslipidemia and hypertension aggravate 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 father is suffering from hepatitis B and currently his medication is going on. Medicines are: Entaliv 0.5 mg, Reheptin, Pantodac L, Livoluk 15 a day, Ulyses 300, Norflox 400, Lasilactone once a day, Lket trice a day. Also, tapoing is doing. Condition- Fluid in abdomen, back pain, low BP (90/60). No improvement even after two months of treatment. ### Response: I can understand you must be very upset about your father\s health. Form history and medication history, it seems he has liver cirrhosis. In other words it is called scarring of liver, shrunken liver, or chronic liver disease. Well the medications he is on, and recent history of tapping of abdominal water, suggest he has advanced disease which require a close follow up and listing such patient on liver transplantation. The liver transplantation is the only definite therapy for advanced liver scarring such as in your\s father case. But it is required to assign liver transplantation not too early and neither too late. There are some scoring that should be performed before recommending liver transplant. The one such score require blood investigations, radiological test such as Contrast enhanced CT scan. The reason why you do not see any improvement even after 2 months of treatment is that all treatment is just supportive and does not correct underlying problem within liver, except Entaliv which is used for suppression of hepatitis B infection. To correct underlying liver, it is liver transplantation which could help. The survival are good after liver transplantation such as on average 70% individuals survive at 5 years after successful transplant. I want you to share me the complete blood investigations and tests that have been done, as I can be able to stage his disease, and give you reasonable approach to the problem. Chronic liver disease Hepatitis B related Follow up to provide more information and investigations" "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 very painful rashes on my left thigh which seems to be going up to my spinal cord. Is it shingles? I do not know but I want a good diagnosis soon. Please help. ### Response: Hello. Yes, this does look like shingles. Please visit a dermatologist on an urgent basis and start on antiviral like Acyclovir or Valacyclovir as soon as possible. Other possible causes for sudden occurrence of such lesions can be irritant contact dermatitis that you can rule out by thinking if you have come in contact with any chemicals or insects on these areas." "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: Please, I need help. My daughter is 10 years old. And she has ichthyosis hystrix in her body\s left section, many doctors said that creams are the only treatment for whole life. Please help. ### Response: Yes, it is ichthyosis hystrix. It is inherited condition and it is in her genes. Unfortunately, it cannot be reversed by any cream or oral medication. However, it can be improved with oral Retinoids and topical Emollients. Apply Emollients like white soft Paraffin plus liquid Paraffin 4 to 5 times a day. The treatment is the same in all the countries. I can understand your concern." "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 5 year old daughter was stung by a hornet about four hours ago. She was fine shortly after, but after her bath, the area is red, swollen and hard about the size of a softball (at least) around it. It hurts and it is right under her butt cheek. So it hurts when she tries to even lift her leg. I gave her Benadryl and Advil and put a cold compress on it. She is not running a fever and her breathing is fine. What do I do further? ### Response: Hornet bite may lead to swelling and pain, fever or infection. The redness and swelling which you have mentioned are due to the inflammation. In your case, swelling is large and it was not initially at the time of the bite and increased thereafter. This indicates an infection. So, we need to give antibiotics also along with analgesic and anti-inflammatory medications. If the swelling was at the beginning and had not increased later, then, only Paracetamol would do.I suggest: Revert back to a paediatrician online for any assistance" "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 spinal tap done two weeks ago, and a blood patch three days later. The blood patch worked but, I still get headaches and do not feel well at all. I have a swollen bump on my tailbone that hurts. I saw my doctor who did not seem too sure about it but, said there did not seem to be any fluid. I do not know if this is normal and do not want to go back to the hospital for no reason. I am on Tylenol extra strength. ### Response: Hello. You most probably experienced a post dural puncture headache (PDPH), for which you were administered an epidural blood patch." "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 inflammation inside the nose and ear clogged. I had water in the ear, and it went away, but I still feel some balance issue. I am currently under nasal steroid spray. ### Response: I need some details to understand the problem. Do you have postnasal discharge, if so what is the color of it? Do you have a nasal blockage? Do you feel better with corticosteroid spray? Please describe your imbalance. Does it look like spinning, a sensation of rotation, or just dizziness but you can still walk independently?" "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: Nothing good is happening in my life right now. I do not understand myself where I want to go, what am going to end up with. It is like everything is blank space in my head. Before I used to interact with people and laugh at times willingly but nowadays I do not even like to talk with anyone. When I think of it, I totally lose my strength and end up either sleeping or watching a movie inside my room. I do not feel like going out anymore. Please help me out. I am in need of help. ### Response: Hello. The symptoms you have mentioned are most likely occurring due to depression or due to some mood disturbance. Poor social interaction, loss of strength, increased sleep are symptoms of depression. If the symptoms are resulting in impairment in functioning, then please visit a psychiatrist for help." "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 black patches over the legs. It is not itching. Please explain what it is. ### Response: Please answer a few questions for better help. For the time being, you may apply Dermocalm lotion (combination of Calamine and Liquid Paraffin). Revert back with the answers for the above questions 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 had unprotected sex with my girlfriend who is 30 years old and I ejaculated inside her. The next day she took Unwanted 72 but until now she has not got her periods and not even bleeding. Her period cycle starts after 20 days. She is having cough, cold, body ache, and vomiting. Is she pregnant? We are very much worried. ### Response: I have gone through your history and understand your concerns. As you had the i-pill, the chances of pregnancy are not there in your case. Regards" "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 bleeding around the anus when whipping caused by hemorrhoids. Is this typical for outside hemorrhoids? I have hemorrhoid for five days now, just started bleeding last night. I take hot baths every night with Epsom salts. ### Response: Hello. So, hemorrhoids are two types. External will be painful and internal will be painless. Both will have fresh red colored bleeding. Yes, you are right to take laxatives. But I think as you are symptomatic, you need a definitive treatment like band ligation, sclerotherapy or surgical intervention. Also, I recommend you to take high fiber diet. Complete blood count is also required to see if you are anemic or not due to bleeding" "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 painful armpit lump. Please suggest. ### Response: It is an infection. Take tablet Cefixime 200 mg twice daily for five days, Mupirocin ointment daily for five days. Take antiseptic soap for bathing. Tablet Aceclofenac and Serratiopeptidase once daily if there is pain. Review after five days. Infection will subside, if lump remains it need to be removed surgically. Send a photo after five days. Bacterial infection. Fasting blood sugar." "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: Before two days, I had sex with a sex worker for the first time. I used a condom for the sex. But my condom got broken. I did not see it for a few minutes. Now I am afraid of any sexual problem that can come in the future like HIV. I am totally upset, and I lost my hope. Please advice what should I do? ### Response: Hi. Yes, there is a chance of HIV transmission with unprotected sex. But the risk is just one in 300. In other terms, it is only 0.3 %. The risk could be less if there were no mucosal lesions for you and your sexual partner. Regarding other infections, the risk is there. But most of them are treatable. I will request you to see a Dermatologist for investigation and treatment. For most diseases, it takes time to get confirmed by blood reports. You need to go for tests after three months of a sexual encounter to make sure that you are not infected. It is not a time to get panic. Try to see your doctor without any delay." "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 weight loss, cholesterol problem, and low vitamin D level. Please do check my attached blood reports and let me know if I have any other problem. ### Response: Hi. I have gone through your reports (attachment removed to protect patient identity). Based on your query, my opinion is as follows: Alcohol might be a cause for the liver related changes. Nothing major to worry for now. You will have to repeat the tests especially lipid profile and liver functions tests after 6 months to look for any changes. Avoiding alcohol should help." "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 cluster of small red dots on side of the knee. It looks like a hickey. It is smooth, painless, and itch-free. It has been on the knee for about two months. I have attached images for your reference. What medicines should I take? ### Response: I have noted your concern and I have viewed the images (attachment removed to protect patient identity). Regards" "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 GERD and was recently diagnosed with equivocal H. pylori after symptoms of wet mouth (not to the point of drooling), mild intermittent nausea (no gag or vomit) and minor upper abdomen discomfort. I completed the triple treatment (two antibiotics, Omeprazole) three weeks ago. The upper abdomen discomfort is gone. I still have mild intermittent nausea and loose stools and pretty consistent wet mouth (though still no drooling or spitting). Can this be GERD related? H. pylori possibly not eradicated? Or something entirely different such as C. diff, SIBO, etc? I have a follow up with my primary next week but cannot get in to see a GI for another month. ### Response: Hello. Nothing to worry. The loose stools may be secondary to antibiotics which you had. You can have some probiotics if it is persistent. Hope you have modified your diet and daily activities to reduce GERD (gastroesophageal reflux disease). Judicious use of Omeprazole or Rantac (Ranitidine) can help you in case of recurrent GERD. Hope your queries have been cleared" "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 dealing with a sinus odor problem for years. I am a fair online researcher and I have been shocked by how unique my problem seems to be. The odor varies in strength and seems to disappear and return over time. I have seen numerous ENT specialists over the years and with the exception of one, they seem to be totally baffled by what is going on. This is an odor that at times, it can be so strong that people can detect it when I walk into a room. Using Mupirocin in my nostrils and I am also doing the upside down nasal rinse with saline solution and peroxide. I thought they were helping but I am starting to have my doubts. I was addicted to nasal spray for many years and I am worried that I did some damage to my sinus cavity. Please advise. ### Response: Hi. You may have atrophic rhinitis due to long use of intranasal sprays. Do you have any hard crest inside your nose? What about your smell sensation? Please send me your CT scan" "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 super scared. I am 30 years old and have been in the hospital for nephrotic syndrome which was discovered to be membranous nephropathy. They tested my blood for many conditions which could be a secondary cause including hepatitis and autoimmune and nothing came up. Now, they are searching my body for malignancies. I am terrified that an MRI showed a growth on my pancreas. I have no symptoms of pancreatic cancer. No jaundice and no pain. However, a paternal great grandmother died of pancreatic cancer in her 60s.Please look over these notes from my chart. Worse case scenario, if the biopsy finds a malignancy, in your opinion is this something that can be operated on? Does it appear to have been caught early? I am terrified. I am an only child for my mother and I do not want to leave my mom. ### Response: Hi. As far as pancreatic mass is concerned, there are high chances for your mass to be benign lesions. So there is nothing to worry. Follow proper instructions for nephrotic syn" "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 23 years old, and I took an I-pill after having unprotected sex within 48 hours. I took the pill a month back; it was five days after I had completed my periods for that month. After taking the pill on the fifth day, I had the flow similar to my periods for five days. But I am worried that I have not got my periods this month yet and am still waiting for periods till date. Please tell me what is happening with my menstrual cycle. I am worried and need your help. ### Response: Since you have taken emergency pill within 72 hours of intercourse, there is no chance of pregnancy. So, relax and do not worry. So, you can be double sure that there is no chance of pregnancy. The delay could be because of hormonal changes due to the pill you have taken. However, if you have a doubt then get yourself checked by a gynecologist and get a pelvic scan done to rule out the exact 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: My 71-year-old father was admitted to the hospital for palpitation occurrence and fast heart beating at 143 beats per minute. He was feeling dizziness in the morning. He was given injections to reduce the heart rate and has taken Holter monitoring for one day. He had previously undergone two stent placements for blocks. According to his Holter reading, the doctor said his heart pauses for two seconds sometime in 24 hours. He has both bradycardia and tachycardia. They suggested him a biventricular pacemaker implantation that is a St. Jude medical pacemaker. He is allergic to Penicillin. During his discharge, he was prescribed the following medicines: Prolomet XL 25 mg two times a day, Xarelto once a day, Glycomet-GP 1 one and a half tablets a day, Ecosprin AV 150/10 capsules one a day, and Pantocid one a day. He takes his medicines regularly but once in 10 days, the palpitation occurs for about 10 to 15 minutes ranging 20 and sometimes 105 and then it stops. Palpitation does not come every day. The doctor says there is no need to worry. My concern is why does the palpitation occur even after the pacemaker implantation. Is there any way to stop the palpitation? Is it a serious issue. Please help me. ### Response: I have gone through the report that you have provided. In this case, the pacemaker avoids his bradycardia episodes 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: My fiance had her periods (period started) five days before, we had oral sex on the fourth day, and I had precum. When I tried to enter her vagina, she said it is paining, and we stopped. I have not ejaculated. Is there any chance of pregnancy? She had her period regularly after 28 days. If chances are there for pregnancy, please suggest pills to avoid it. When to take and can she take pills in the evening? ### Response: Hello. If her cycles are regular, then you had sexual activity in a safe period, and there is no risk of pregnancy. No need to get worried. Also, the sexual activity you had does not result in pregnancy. So you can stay relaxed and there is no need to take any pills to avoid pregnancy. Use condoms during sex to remain safe, and emergency pills are alternative but should be used in accidental or emergencies 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 dengue towards the end of last month. I was hospitalized for five days. I went through a lot during that period and since coming out of the hospital, I have developed this phobia that I might have dengue again because my area is dengue prone with lots of mosquitoes. Whenever a mosquito bites me, I get filled with this fear that I might have dengue again.When I went to my doctor with this fear, he told me dengue does not happen twice in the same season, it can happen again in the next season, but it cannot happen again this season.I want to ask if this is true? If it is true, then what is the logic behind that? Can you please explain? I am immensely afraid of the disease. ### Response: The fact that dengue cannot happen in the same season is true to some extent but not absolutely. Let me explain. Dengue is a viral infection caused by the bite of infected ades aegypti mosquito. Every mosquito bite will not lead to dengue fever as for infection to happen. First, the mosquito should be infected by the dengue virus (DEV). By infection of the mosquito I mean, the mosquito just serves as a vector or carrier for virus transfer to humans. Also, every mosquito carrying the dengue virus would not lead to dengue fever, shock, etc. Some people just have subclinical, asymptomatic infections too. There are actually four types of dengue viruses numbered from 1 to 4. Infection with one type, followed by recovery confers immunity to that type of infection. Our body produces antibodies against the virus and protects us from further infection, with time these antibodies fade away. So immunity in DEV is present but is short-lived. It can be said that the infection cannot occur in the same season, but if an infection with another type say (DEV type 1 followed by DEV type 2) occurs, the body does not have antibodies which are protective against type 2, as the body was previously infected by DEV type 1. This type of infection is more dangerous. However, in a season only one type of DEV infection occurs usually. 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 a body pain in the back left of my body, and I have pain on the backside of the head. Nowadays, I am waking up automatically during midnight, and I have a feeling of having reduced breathing. I am an asthma patient. I am using Budamate 200 inhaler. Is this due to my asthma problem or any other? ### Response: Hi. I can understand your concern and your symptoms could be related to a tension-type headache. You can have a wrong posture. Waking up in midnight can happen due to asthma or a panic attack. For this reason, it is essential to do a pulmonary function test and a cervical spine X-ray study." "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 ED after a penile Doppler study and observed with low blood flow. We both have been checked and confirmed with no issues with HSG (tube test, semen analysis, etc.). As we want to have a baby, and all the reports are normal, (only problem is ED, not able to perform intercourse), the doctor has suggested self-insemination at home. He has given a catheter, a container for collecting sperm and syringes to perform the self insemination. He suggested to add equivalent amount of ringer lactate solution with the sperm collected in the container. Then, take the mixture in a syringe and flow into the vagina through a catheter. We just want to have a second opinion to know whether it works out and mainly want to know why we need to add ringer lactate solution along with the sperm. What is the importance of adding ringer lactate? Is it mandatory to add this solution or can we do without the solution? Your inputs will help us to know the process in a better way. ### Response: Ringer lactate is not mandatory. Sometimes, it helps with the sperm speed, but you can do without it. Your erection problem may be due to stress or anxiety or due to any medicine or nutritional supplement if you are taking any. Penile Doppler often gives erroneous results. Usually, it is not performed properly with visual erotica. You need to do blood tests: Depending on the reports, the treatment is decided" "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: Kid age 9 months. weight not sure. Since Yesterday, she is having loose motion problem. Today also she is having frequent loose motion. ORS solution and paracetamol syrup given, but got little bit control again started. ### Response: - It is very good that you are already giving ORS solution which needs to be given frequently. Loose stools can last for some days before getting better. It will help to clear the body of germs & toxins. I need to ask you a few more questions to guide you in the right direction - How many times /day does she have loose stools ? - is there any blood in stool ? - is she is any pain ? does she cry while having stools ? - is there any vomiting ? - is there any fever ? if there is no fever , there is no need to give paracetamol." "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 31 year old male. My microalbumin is 10.3, urine creatinine 313, eGFR 113, microalbumin-creatinine ratio is 3.4 and HbA1c is 6.8. Should microalbumin be 0? Most sites say 20 and below is normal, but 10 is pretty high to me. I had levels done, which showed a microalbumin of less than 3. I worked for 6 hours before the test. I was moving patients around in an operating room, moving beds, etc. Then, I had a big lunch with bacon, sausage and eggs and had my testing done 30 minutes later. I am so worried for this. ### Response: Hi. We are here to help you.To help you better, I need to understand your case a bit more in detail. First of all, you have not mentioned the unit of your urine creatinine." "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 starting to get a boil kind of thing on my lips. Picture attached. How can I stop it? I hope it is not herpes. ### Response: I am sorry the picture is slightly blurred (attachment removed to protect patient identity). I am not able to make out if the lesion is a bump or blister or a pustule. It is very important for me to have a clear view of the lesion. Can you please attach clear pictures that focus more on the lesion? This can be: Can you please answer these questions as well so that it helps me narrow down to the most precise diagnosis. 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 appeared to have an allergic reaction to something, nearly two weeks ago. I was given antihistamines and a seven-day course of steroids (Prednisolone 40 mg). The allergy seems to subside, but it keeps coming back. I cannot be sure about the cause of this allergy. The surrounding skin around my eyes is itchy and red, from today morning. I have attached a photo of the initial flare-up. Please help. ### Response: Hi. I have seen the attached photo (attachment removed to protect patient identity). This is called as acute urticaria with angioedema. It is basically an allergic reaction, which can be due to change in diet or new medications or idiopathic (sometimes the cause cannot be known). Since there is swelling on the lips and eyes, you should visit an emergency room. You will need another course of oral steroid or injectable dose. Continue with the oral antihistamines. And oral steroid should be tapered from 40 mg to lower doses and then stopped. If stopped suddenly at 40 mg, then there can be chances of recurrence. Self-medication is not advised in this condition. Look out for symptoms like difficulty in swallowing or breathing. If they develop, visit a doctor as soon as possible. Do not wait" "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 on Metoprolol for CHF. I have got a usual heart rate of 60 to 65 BPM, but tonight my HR is at 90 to 95 BPM. May I take extra Metoprolol to control my HR. ### Response: At first, sit for 5 to 10 minutes comfortably, calm yourself, and recheck your pulse rate. It is not immediately life-threatening to have a heart rate in the range of 90 to 95 with no symptoms. However, if you take an extra dose of Metoprolol, BP may go down as well. So, if your BP is on the higher side and pulse rate continues to stay in that range, then you can have it. But since it is not an emergency, it is better to wait and get yourself checked and then hike up the dose. I hope this helps you and get back if you have any doubts." "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 burning sensation while urinating and a frequent urge to urinate. Can it be due to sexual contact? I am a 22 year old male. ### Response: Hi. These symptoms are classical of urinary tract infection, cystitis, prostatitis or urethritis. Yes, they can be acquired by sexual contact. Please get a urine culture and sensitivity done along with ultrasound abdomen, because stones in lower ureter can cause these symptoms. You can start on a good antibiotic like Levofloxacin 500 mg once daily in the morning till you get culture report. Revert back after the tests to a urologist 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 a severe toothache that prevents me from sleeping and eating, and there is a big hole in my teeth. I am currently using Tylenol. ### Response: Hi. It clearly indicates that the tooth is visibly decayed and gone deeper to involve the nerves and blood vessels of that particular tooth. Ideally, there will be sensitivity if the first two layers of the tooth are affected (enamel and dentin). If the third layer (pulp) is involved and further the bugs percolate inside the length of the teeth, then the symptoms you feel would be there. Now the situation looks like you must visit a nearby dentist for either root canal treatment or extraction depending on your preference. The steps involved would be an x-ray first to check the shape of the roots of the tooth (two or three roots if it is a molar tooth). You sound like an emergency, please visit the hospital or ring the dental practices who attend patients with an emergency during the COVID-19 times. Also, adding that pain killers will not help you come out of this for not more than three hours. I highly recommend you to visit the dentist closely." "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: Since last 7 to 8 months I am having an eye infection, like a stye. It is getting frequent almost after every 3 to 4 weeks. I recollect having collided with somebody about one and half years back, hurt on my right eye with somebody\s elbow and had a swollen eye, very painful and under the eye, it is red and swollen. After about 4 to 5 days, it started healing, and gradually I forgot about it. Now with this frequent infection in the same eye after every 3 to 4 weeks which lasts 3 to 5 days, sometimes pus and little blood come out and sometimes it heals without any pus coming out. This time it started with an itch and has gradually swollen and is very itchy and painful and red and swollen inside and outside the eye. ### Response: This is unrelated to that trauma with the elbow. This is suggestive of lid infection. Once this episode is over then we need to evaluate your lids and lashes carefully as sometimes meibomitis or blepharitis cause recurrent lid infection." "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 and I have the same blood group. Presently, my wife is pregnant. What is the problem for the baby\s physical body due to this? ### Response: Hello. The same blood group does not lead to any problem. The same blood group people can marry and can produce a normal child. So, as far as same blood group is concerned, do not worry about that." "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 red area that is itching on the penis head for a week. It looks like balanitis according to the pictures I searched. I also have pain after urinating. I have tried with Nystatin cream, but I have more itching than before. I cannot go to the ER, but the quickest appointment with the specialist can be scheduled in a week. Please help. ### Response: I understand your concern. Please send a picture of the affected area to help you better. I need to see to suggest the appropriate diagnosis and treatment." "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 experiencing lower back pain, and it hurts whenever I stand up. I am also suffering from abdominal pain. I do not know if my period is the one that caused it. ### Response: Sometimes these symptoms can be due to periods in young females, so your gynecologist should be able to give you an insight into this. As far as lower back pain is concerned, if it has been present for a long time even in the absence of your periods time, then it could be due to a spinal issue. If you have localized back pain with no other symptoms like radiating leg pain, neurological symptoms like numbness, weakness, paresthesias, etc., then you can start with following recommendations for an initial period of two to three weeks. 1. To maintain a proper posture of your back while working and sleeping. 2. If pain is more, then you can take a short course of anti-inflammatory medication like tab Ibuprofen or Paracetamol or one which suits you. 3. Physical therapy initially under the supervision of a trained physiotherapist and then to continue at home. 4. Adequate calcium and vitamin d intake if levels are low in the body. 5. Ice packs can be applied if your pain is acute, then hot fomentation can be done at home. 6. Analgesic spray for a local application can be used and is readily available. 7. Avoid lifting heavyweight and acute forward bending in mornings etc. We will observe you for the next two to three weeks how you respond to this conservative management protocol. If you are not feeling better, then we will have to get some investigations like, dynamic x-rays of lower back and few blood tests for evaluation. Do not hesitate to contact me if you need any further assistance." "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 70 years old, male with history of migraine for 40 years. The last few years for stress, I have taken 60 mg Cymbalta twice daily. My headaches sometimes give me the aura and sometimes slight dizziness for 10 to 15 seconds with headache to follow. Over the years I have tried all kinds of medicines like Paxel, Topamax, etc. Maxalt and this sort of medicine have not worked. My headaches were pretty well controlled with Cymbalta and Gabapentin twice per day. I went off the Gabapentin three years ago and only experienced 3 to 4 migraines per year. My headaches have a history of pain 3/4 on 10 but long duration 7 to 30 days. A few years ago a headache specialist prescribed Prednisone pac which generally works. I have had two migraines this month, this one started with mild dizziness for 10 seconds followed with headache. I started with three Prednisone for four days and restarted the Pac beginning with 6 tablets day one, five tablets day two, four tablets day three, etc. Also had Toradol shot three days ago. Headache is mildly better but not gone. Any ideas to abort? ### Response: Hi. First of all, one needs to confirm that it is indeed migraine. I would recommend the following: 1. Do MRI brain. 2. If MRI is normal, ask the neurologist to consider starting Valproate 500 mg once a day. If the migraine is resistant to all medicines, occipital nerve stimulation can be considered." "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 read several studies on the effect of autophagy on aterial fibrilation. I cannot understand most of the conclusions and need some help with this. I basically follow a regime where I eat every other day and fast at least 24 to 30 hours at a time. As I believe, autophagy is activated and can have a positive or negative effect on the heart, in particular, the atrium and remoddeling of electrics.Can you please tell me if you think what I am doing could possible cause afib or remoddeling of my heart? I have no current issues, low cholesterol and BP, no family history and have a structually normal heart. However due to my years of excess I have this fear of getting afib. I am male, 35 years old, mixed ethnicity. ### Response: Firstly, there is no good evidence for or against this rigorous fasting. Studies atleast have shown no significant increase in atrial fibrillation with such fasting. Practically, we do not have good evidence for it. Now if we consider theoretically, then yes fasting may stimulate autophagy and may have a beneficial effects on heart/ atrial fibrillation. It does improve your lipid profile and risk of myocardial ischemia which is a risk factor for atrial fibrillation. It may also reduce obesity/ bodily inflammation, which is again a risk factor for atrial fibrillation. So, there is no evidence to suggest that it induces afib or remodeling, but such rigorous fasting is not recommended based on current evidence. We are also not sure whether you are meeting the daily requirement of essential nutrients. You can share some studies with me so that I can clarify on them. So, fasting for few days say for 1-5 days a month is acceptable." "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 52 year old male. I have been using hair dye since last 25 years. Two years back, I had hair dye reaction on the scalp. Yesterday morning, I had dye reaction again. The entire skin of scalp came out like snake\s skin. After that rashes have come on the knee, elbow, and on the feet. What do I do? ### Response: Hello. As per the details given, it seems that you have hair dye allergy. Most of the hair dye products contain a chemical called PPD (para-phenylenediamine) which is responsible for allergic reactions. In such cases, I advise my patients to strictly avoid application of hair dye. You may use herbal henna for dyeing hair. Antihistamines like Levocetirizine also help. You need clinical examination. So, you should visit your doctor so that he can examine you and give you prescription accordingly. You can share my opinion with him. Stay healthy." "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 went to the dentist for a teeth-cleaning on Wednesday. On Thursday, I noticed that the floor of my mouth on the bottom right side felt sore. When I looked with a light, I noticed a couple of cuts that were kind of like paper cuts. They bleed when I brush. The pain can be managed somewhat with teeth pain relief gel.I do not recall these being there before my cleaning. Or if they were, they certainly did not cause any pain. Could they be caused by the cleaning?What do you recommend for healing, pain management, and preventing wound infection? ### Response: Hi. You mentioned about the bleeding of the gums after scaling. Usually, you can see bleeding gums and cut-like appearance near the border of the gingiva due to one of the following reasons. White appearance on the floor of the mouth suggests ulcers" "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: Before eight months, I had boils on both sides of my face. Now, they left dark black marks. They are very stubborn and extremely hard to fade. They are gradually disappearing, but it is too slow. Please help. ### Response: Post Inflammatory hyperpigmentation is tough to treat. The essential thing is protecting skin from UV (ultraviolet) rays, so sunscreen with SPF 50 (sun protection factor) is must in the morning hours, apply it for every four hours when you go out to beach or park for a longer duration. I would suggest you use a topical cream called Demelan (Kojic acid, Glycolic acid, and Arbutin). It will help to reduce the pigmentation and lightens the pigment. Use this cream twice a day. Other options are a series of glycolic acid chemical peel and microdermabrasion which will help to exfoliate the skin, and it lightens the pigment" "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: Twelve days ago I had protected sex with a girl I did not know after a night out. I showered that night maybe an hour afterward and used a perfume smelling body wash or shampoo. Whether it was in my head or actual, the next day I noticed an itchiness or rather a need to readjust my penis which persisted on and off for about a week with no other symptoms, visual or pain or burning. A week after the incident, the itch progressed to something between an itch and an occasional burn on the underside of the head of my penis where the ridge of the glans meets, but in total very mild, and I did not think much of it at the time. In the weeks prior and the week subsequent I was traveling with a lot of daily exercises and occasionally limited ability to shower or use shampoo. Eight days after the night out I noticed a small patch of red bumps that looked somewhat rash like in the same small area. To be specific, they do not look like pimples nor are they very raised and do not look to contain any liquid or if they do a minuscule and clear amount. The weird thing is that when these first came about, the itching also stopped, and I have no other symptoms such as discharge, burning while urinating, or other health issues. In days 10 to 12, I have had no such symptoms as well but the ridge of my glans penis around the front side of the head now appears to have symptoms similar to what balanitis may look like from other research, with a slightly swollen and red penis head and a rashy or bumpy looking appearance to the edges of the head. The itching has stopped, and from online research I figured it may be something like jock itch, a male yeast infection or another fungal situation so I began using an antifungal cream yesterday. The original red bumps on the back of the head have faded somewhat and have not blistered or scabbed or popped or shed any skin which I have been vigilant about from reading online. I am wondering if you can shed any light on my situation as I am worried just like any person experiencing STD scares. ### Response: I have gone through your case in detail. Well, you need not worry about any STD or fungal infection or jock itch or even about herpes as your lesions are not active right now. There is only mild redness which could be remnant of balanitis or friction. At the moment no signs of any sexually transmitted disease. All you have to do is to maintain a good hygiene. Avoid sweating and friction as much as you can. Wash it daily. Apply antifungal cream for a week so that it smoothe out your lesion in addition to antifungal effect" "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 25 year old boy and my face is very oily during summer while in winters it is quite dry. In summers, a lot of oil pops out with white heads on my face. Even a short-term sun exposure tans my skin. I am also suffering from the problem of dark spots. Kindly suggest a face wash, sunscreen lotion, overnight cream or whatever it takes. ### Response: La shield sunscreen can be used in the morning as it is non-comedogenic. Please upload an image of your face, so that depending on the skin type, pigmentation, and acne, medications can be suggested." "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 bent penis that causes pain and dissatisfaction. Please suggest me a solution. ### Response: Hi. A downward bent of the penis is an absolutely normal variation and is present in 15% - 30% of men. It will be a problem only when it is extremely bent and difficult to penetrate. Pain in the penis can be because of anxiety. If it has been since a long time, then there are chances of it being a cause of urethritis or some scarring in the musculature of penis known as Peyronie\s disease. You do not have to worry unless erection is normal. I would suggest you consult a urologist for physical evaluation to check whether the bent in the penis is a normal physiological variation or not. Stay calm and do not get tensed." "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 just started on Pradaxa (blood thinner) a week back. She has an antiphospholipid antibody, but she has not had any clot before. We started seeing a couple of small bruises today in her hand without any injury. I want to know if we need to stop it. We consulted a doctor in the next couple of days but needed a second opinion on it. What would be the effect if we stop taking Pradaxa? What is the other alternative? Does she need to be on the blood thinner, even though she has not developed any clot yet? She was allergic to aspirin, so she could not take that.Lab test report says that her antiphospholipid antibodies were high and as per the hematologist, she is at high risk for a clot. ### Response: Now coming to your question, Pradaxa (Dabigatran), as you know, is a blood thinner, and it will predispose her to have bruises, which are mostly harmless. What you need to look for is a huge hematoma (collection of blood beneath the skin), blood in stools, and urine. If you have discussed with your doctor to continue the Pradaxa for prophylaxis of DVT (deep vein thrombosis) and PE (pulmonary embolism), then do not discontinue it, although, as I mentioned earlier it is controversial." "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 tooth that is gone all the way down. So I think the pulp is exposed but I have no pain whatsoever. Is it only a matter of time before it gets infected or not? If I have no pain, it is dead right? ### Response: According to your history, the pulp is exposed and decayed by now. It means sensations are lost and that is why you are not feeling pain in it. But it does not mean your tooth cannot get an infection now. It can get infected because of the food stuck in it can cause infection in gums around broken tooth and root. That may be very painful. Therefore, I will advise you to visit your dentist and get it extracted or treated according to your clinical condition." "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: The findings during chromosome breakage study for Fanconi anemia are not in favor of chromosomal breakage syndrome. Is the patient totally free from the Fanconi anemia? ### Response: In Fanconi anemia, there is a presence of birth defects along with severed degree anemia. If such a finding is present, then further work out has to be done for that. I have checked your report (attachment removed to protect patient identity). It is not showing any chromosomal abnormality. So, no chromosomal abnormality present as per reports" "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 get a consultation regarding my father. His blood report showed hemoglobin (optical/impedance) 12.4 g%, platelet count (optical/impedance) 93 10^3/cubic mm, WBC count (optical/impedance) 3.6 10^3/cubic mm, packed cell volume (calculated) 36%, serum vitamin B 12 472 ng/L. Please let me know the treatment for this. ### Response: Hi. Based on your query, my opinion is as follows. Folic acid deficiency. Folic acid and vitamin B 12 supplements. Revert back after three months to 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 periods are usually 29 days apart. I had a period on the 5th this month. I was supposed to have the next period on the 2nd of next month. But, I started bleeding on 22nd itself. Could I be pregnant or has my cycle just changed? ### Response: Hi. In your regular 29 days cycle, your bleeding has started on the 17th day. This shows that you had an early menses this time. This condition is called polymenorrhea (menstruation occurring in intervals of 21 days or lesser than that). There could be various reasons for early menses including stress, sudden changes in lifestyle and eating habits. If the suspicion of pregnancy exists on your part, then do a urine hCG test (human chorionic gonadotropin) and revert with reports." "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 ear has been blocked for the past three days. There are mild pain and discomfort. This could have been caused because of the earbud. I used Ciplox ear drops and have tried Crocin pain relief, but it does not help. Ear feels extremely uncomfortable, and hearing is muffled. Please suggest some anti-inflammatory antibiotics as I am unable to visit a doctor because of the COVID-19 situation. ### Response: Hello. It does not necessarily have to be due to earbuds causing otitis externa though that could be one possibility. There are others also. Can you tell me if you had a cold recently? Does it feel like there is a fluid inside the ear? Do you feel like you need to pop your ears? Is there any throat irritation? How severe is the earache? It could be secondary to middle ear infection also." "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: Please explain about interlabial pads. How is it used? Why do some women prefer it? ### Response: Interlabial pad is a modified version of the traditional sanitary pad. It is petal or leaf-shaped, and it is highly absorbing. It is designed in a way to have a direct menstrual flow to the center and prevents the blood leaking to the surrounding. It also prevents the blood flowing into the gluteal fold. It is worn within the two labia. Women would like to wear it because it is highly absorbent and it prevents moisture build-up and fungal infections. It is worn externally, and the chances of getting bacterial infections in the urinary tract and pelvic inflammatory diseases are low. It is small and comfortable. The doctor prescribes it to the women having stress or urge incontinence." "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 fell this morning and I am pretty sure I broke a toe. It is a bit swollen, bruised, and painful. I landed on my knee and top of my foot. My knee is fine but the top of my foot is a little tender. It has a small bruise. My other toes are getting numb. Do I need to see a doctor? ### Response: Hello. I have gone through your history, as you have stated that you are having pain, swelling and bruising on dorsum (top) of foot region. In that event, I advise you to get: X-ray of affected foot (AP and oblique views) because we have to rule out any bony injury as management changes if there is a fracture. Do not put weight on affected foot as your swelling might increase further. Intensive ice packs need to be applied (10 to 15 minutes every 2 to 3 hours) to keep swelling to bare minimum. You can take OTC analgesic like Diclofenac, Ibuprofen, Paracetamol whichever is available and is not a contraindication for you. Keep your limb elevated over pillow at night while sleeping. Please contact me with X-ray of affected part and I can guide you as to further course of action." "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: Hello,I am a 27 year old female. I am feeling my heartbeat, breath, and pulse rate to be really abnormal since the past three weeks. It feels like my heart is pounding so bad. And then, I feel a difficulty to breathe, like I have run or jogged more than my capacity, even if I am sitting or lying. Sometimes, I feel a lot of pain in my lower abdomen area and on the left side of my belly. Please suggest me some remedy. ### Response: I went through your post. Your predominant complaints are palpitations and lower abdomen pain. Any person who notices a change in their heartbeats should go for ECG (electrocardiogram) to rule out arrhythmia. The most common causes of a one-sided pain in the lower abdomen are kidney stone or urinary tract infection. These are only the most common causes. However, there are more than 10 causes of the same. A USG (ultrasonogram) of the abdomen with a urine examination will help you come to a conclusion. Consult a physician with above investigations so he can help you. Regards" "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 mild vertigo for the past one month. There is no sweating or vomiting. I do not have any pain in the head and there is no problem of hearing and vision. I am only experiencing some balancing problem. My ENG test is absolutely normal. What will be the possible way to reduce this? ### Response: I understand your concern. I would like to tell you the causes of unsteadiness or dizziness. They are aural (disease of ear) and extra aural. Under extra aural there comes a long list of diseases. As your electronystagmogram (ENG) is normal, there is likely less chance of aural cause. Please consult your doctor for thorough examination and relevant investigation to reach correct diagnosis that may be managed accordingly." "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 stabbing pain in the chest while taking TB treatment with four types of drugs (DOTS) since one and a half months. Please help. ### Response: Hi. This pain can be due to fluid in the pleural space, due to pleurisy or due to a cardiac cause. I suggest you take tablet Combiflam (Ibuprofen and Paracetamol), twice a day for five days. Consult your specialist doctor, discuss with him or her and take the medicines with their consent. Meanwhile, get ECG (electrocardiogram) and chest X-ray done and let me know." "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 34 year old female weighing 300 pounds. My height is 5\2"". I have a vaginal issue that I need advice about. I have a knot that keeps coming up just on the outside of my vagina, and it eventually bursts and bleeds for a while. This has happened twice now, and it has really started to scare me. The knot hurts really bad before it bursts. What can I do for this? Is it something serious that I need to go to the gynecologist? ### Response: From the description you have given, it appears to be either Bartholin\s abscess or a boil. Both cases can be recurrent if immunity is low, most common cause being diabetes mellitus. Following is my advice for managing the symptoms:" "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 we rely 100 % on Ovral pills to avoid pregnancy? What are the side effects? Is there any other option with no side effects to avoid pregnancy for two years? ### Response: Ovral pills (combination of Ethinyl estradiol and Levonorgestrel) are 100 % reliable if taken regularly. They have very few side effects and can be taken same time every day. If you miss one tablet it is okay, but if missed twice, can lead to failure in that particular month. No other contraceptive method matches it. You can use the Multiload but only after first pregnancy. It is used for 3 or 5 years depending on the brand. Implant are also available which is inserted under the skin by a small operation over forearm. The advantage is you do not have to take tablets. I suggest you do the following tests. So, choose according to your convenience and future plans. Feel free to consult for any problem." "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 22-year-old female. About 20 days back, my history was this: I had diarrhea for two days (thrice a day). I had a low-grade fever too during those two days. I managed to carry it over with natural supplements. But it did not subside. The next day, it worsened with watery stools and I started getting dehydrated since I could not take anything inside. I had a fever and severe shivering. I took Doxicycllin (three tablets in one dose), but I did not get better. Then, I started vomiting up too. So, I was taken to the hospital and prescribed oral medicines since I hesitated to get admitted because I was to write my CA exams in two days. So, I took the oral medicines. They were: Orni-O, Pan DSR, and Bifilac. But I did not get alright still as I could not take any food inside and I vomited blue foamy.So, I was admitted and put on IV fluids and antibiotics. I felt little better but had the extreme discomfort in my tummy but I got discharged and followed oral medicines. The next day I was totally unwell, vomiting and watery stools (six to seven times). But the next day, on the day of my exam, this continued. So, I had to get admitted again and had a short session of IV fluids and medicines to stop my immediate symptoms as I needed to sit for three hours exam. So the JR there prescribed me to take Loperamide once in two hours. I took two pills as such and my loose stools got stopped and my bowel movements were nil.My stomach got bloated and I could not eat anything. So again, we went on a second opinion where they prescribed Racedotil, Endogen, Emecet and Pantocid diagnosing as viral gastroenteritis. After this course, I had my dehydration gone by and started taking fluids but I did not have proper bowel movements. Then started my severe constipation which ended up hurting my colon and I took Dulcolax. After that, I passed loose stools for two days but then now I stopped taking Dulcolax.But my botheration is my metabolism is still not alright. I am not able to eat as much as I feel hungry. I take bland foods only and on liquids too. But as soon as I take my food, my tummy is bloated and I need to walk but then it is not getting fine. Past two days, I did not have my stools. So, I took that soft stools drink and this morning with great pain passed out. But, I could not eat anything properly. My stomach is bloated and I feel like something hurts me badly in the stomach but I do not have a particular local pain but have some upper abdominal pain and discomfort after I eat.My questions are:Is it good to continue taking Dulcolax till my metabolism gets fine?Are these after-effects because of the viral gastroenteritis or do I need to check with any other specialist regarding this? I feel tired. Why do I feel so? It has been 19 days I am with this ailment.What type of foods can I take to ease my bloating? ### Response: It is always better to avoid regular use of Dulcolax (Bisacodyl). Your symptoms now are secondary to after effects of a severe diarrheal episode. This is self-limiting. You need to give time. Your aim now is to increase gradually your dietary intake and 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 am having type 2 uncontrolled diabetes. My endocrinologist is asking me to undergo a bariatric surgery. Kindly advise. Can you explain if it is required and how is it going to help control my diabetes and hypertension? ### Response: Hi. Bariatric or metabolic surgeries help to achieve long term remission from type 2 diabetes. These are scientifically proven, very safe and highly effective. They result in long term weight loss in individuals suffering from an excess weight problem, and also lead to long term remission from co-morbid medical conditions such as high BP and sleep apnea. Bariatric or metabolic surgeries alter hormones which control body fat stores and reset set value for fat storage to a lower level. Same hormonal changes are responsible for remission from problems like diabetes. Depending upon your weight, presence or absence of other medical problems, I choose different surgeries. Sleeve with bypass combination surgeries is more powerful and durable." "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 painful/itchy bumps on the inside of the upper eyelid on both eyes (outside corner) for over two months now. They started as red, irritated patches, and now are growths of some kind. My optometrist told me to use lubricating eye drops four times a day. It has not helped at all. What could this be and what should I do? (I am told the bumps are where my lacrimal glands are). ### Response: I have seen the images (attachment removed to protect patient identity). Sometimes they do respond to hot fomentation along with an antibiotic eye" "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 is 68 years old. He takes Novorapid 3 times, 8-8-12 and Lantus at night 18 unit, above that taking Olmesor 40, Rozucor ASP 10, Cilacar 10. For the past 8-9 months new problem of hiccups arises while taking food and drinking water and about to stop his breath. If he takes Nukast 10 then it is fine. Allergy test for IgE is 229 and full panel are also done. What is the solution for this? ### Response: Hello. I understand from your query that your father, who is diabetic and hypertensive, suffers from hiccups problem since eight months. He has hiccups while taking food or water. Can I get more details? Does he have hiccups or cough? Both are different." "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 17 years old. He is doing odd things, such as calling the police for ear pain. He is under a lot of stress from national exams and high expectations. He does not sleep much, but his appetite is well. After calling the police and talking to them, he was back to his room studying. Late evening he told me that he is doing well and not to worry about him. Overall, he is distracted, and his grades are dropping. I am desperate as I am in the health field and I know that can mean severe pathology or simply a reaction to stress. ### Response: It seems he is not in touch with reality, like calling the police for ear pain. Can you tell since when he has ear pain and how it started? Since how long has has such odd behavior and sleep problem? Does he express any other odd behavior? Is there any history of substance abuse or truancy? He might be suffering from adult ADHD (attention-deficit hyperactive disorder), depression, anxiety and ATPD (acute and transient psychotic disorder). The management depends upon the disorder he is suffering from." "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 hyperthyroidism. I also have tendonitis in both my shoulders. I have been having joint pain for years and I work a lot of physical jobs. Lots of bending, kneeling, lifting and twisting. I hang my hands quite a bit as well. I have been getting hives for the last two months, I have been using tide and gain in my laundry for eight months. My mom is allergic to Tide. My endocrinologist mentioned lupus because of joint pain and hives. I have an appointment with a rheumatologist in four months. I am considering changing my detergent back to see if the hives stop. Could it all be coincidental? How long would an allergy take to show? I have always thought it was the onset of arthritis. I never got a butterfly shaped rash on my face. I am currently taking Methimazole 10 mg, Multivitamins, and Gianvi birth control. ### Response: Hi. Well, the hives do go in favor of urticaria. It can be a part of lupus or can be independent as well. But usually, it is an autoimmune process triggered by some allergen (it is possible it is detergent in your case). But the joint pains you have do not really point towards lupus since it is only restricted to the shoulders. Most of the time, shoulders have a mechanical cause, that is you are overusing it in the wrong way. But never the less, since your appointment is far away, I would suggest you get a few tests done. Even with urticaria, we do these tests. Meanwhile, change your detergent and take a course of antiallergics and see if it improves. You can let me know the results when available. 1. CBC (complete blood count). 2. ESR (erythrocyte sedimentation rate). 3. ANA (antinuclear antibody). 4. CRP (C-reactive protein). 5. Ultrasound of the shoulder. Anti-allergics. With reports." "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 a hard yellow thing accumulated in lower four teeth near gums. I do not know what it is? It just happened a few days ago. ### Response: The hard yellow deposit is calculus (mineral deposits) on lower teeth which are receding your gum (attachment removed to protect patient identity). It can be apical periodontitis and/or apical periodontitis with abfraction. Please share a good picture just focusing on lower teeth. As per treatment, if you have calculus then get ultrasonic scaling done. Oral hygiene. Abfraction. Apical periodontitis. Maintain your oral hygiene and get ultrasonic scaling done every six months." "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 rash or bumpy area on the base of my ring finger on the side where it touches my middle finger. That occur several days ago while I was wearing a silver ring on that finger. I have taken off the ring but the area is getting painful with irritation and it seems to be getting worse. I have used an antifungal cream on it for one day so far, but I am not sure how to tell if it is actually fungal or not. ### Response: Hi. From the picture provided (attachment removed to protect patient identity), it is most likely to be a viral infection like herpes or a contact dermatitis. These lesions are usually tiny grouped blisters and cause pain. They last for about 7-10 days and resolve spontaneously. However, they may get infected secondarily oozing pus and spreading to surrounding area. You can apply Mupirocin cream to prevent further infection. I would also suggest you to see your dermatologist as you may require oral medications to prevent complications. Herpes infection, contact dermatitis, and fungal infection is the rare possibility. Tzanck smear or pus culture can help. Herpes infection. May require oral antiviral and analgesic 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 mother who is 67 years old is an osteoporosis patient. She has been recently operated for carpal tunnel in the left hand. A few months back, she had developed an ankle effusion which subsided after starting osteoporosis injections. She is on Gemtide and calcium. Recently, she has developed swelling in the right wrist with pain and stiffness. She had an ultrasound and an X-ray as advised by her doctor. The ultrasound report is attached herewith. The X-ray suggests osteopenia. Does the ultrasound report suggest she has tuberculosis? Please advise as to what should be done. ### Response: I went through your attachments (attachment removed to protect patient identity). This professional advice provided by me stands subject to the actual examination of report and image and is based entirely on inputs provided to me. It should be correlated with clinical findings. Regards" "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 a consultation on my diabetes. My fasting plasma glucose is 226 mg/dL and in PP it is 390 mg/dL. I am currently on Diamicron MR, Volix 0.3, and Novomix pen 30/70. Please suggest. ### Response: Your sugar is uncontrolled and Vitamin D is low as well. You did not tell how much you are using Diamicron, Volix and Novomix. Please let me know the doses. Another thing is you should get checked urine albumin creatinine ratio and I think you may need a change in medication. Your overweight is also due to these 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 need help. Two weeks ago, I was at a friend\s gathering or party. And we filled a barrel with glass bottle drinks and a lot of ice and a lot of water. Everyone picked up their drinks from the barrel. I had a cut on my finger and constantly dipped my hand in the barrel for a drink. I later got to know some colleagues at the party are HIV positive. But I did not see the water in the barrel bloody or anything of that sort. And I cannot tell if someone had cuts on their hands as well. A week after the incident, I got this mild cold. And I am worried. Please, is it possible for HIV to have survived in the water? Should it be the case that anyone had a cut on his or her hand? Is it possible to have gotten infected just like that? Please help me. ### Response: Hi. I have read your query carefully. You are tensed about your exposure to HIV. Now I am explaining you everything. HIV infection is usually acquired through sexual intercourse, exposure to infected blood, or perinatal transmission. You have to keep in mind that the HIV virus does not survive for a long time outside the body. You also keep in mind that exposure through oral route is extremely rare. So there is very very little chance to be infected by this mean. But if you are worried after that explanation, you can go for a test named ELISA for HIV. But it needs minimum 2 to 3 weeks to be positive in the fourth generation test. And 7 to 8 weeks in the first generation ELISA todetect the virus after exposure. So you should wait." "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 brother aged 35 years has undergone a kidney stone surgery on 21st and from 28th, he is suffering from high fever (mostly 104 F) with shivering. The doctor has removed the stent on 31st but the fever has continued with shivering. There is no detection of dengue, malaria, or sepsis. What is the cause of high fever? Please advise. ### Response: The stent and its removal induce inflammation which in turn can lead to fever. Paracetamol 500 mg SOS can be prescribed for fever. An antibiotic course can also be prescribed along with that to fight any mild infection if present. I suggest you investigate with CBC (complete blood count) as well. Consult your urologist for examination and discuss the management" "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 age is 35. I have black patches on my face and pores on the cheek. Black patches first occurred 3 years ago for the first time. How to remove them and get a fair skin? Please suggest. ### Response: I have read your query. 1. Postinflammatory.2. UV rays (sun damage). 1. Sunscreen can be continued for a long duration." "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 developed tinnitus all of a sudden last year. I am attaching the last year MRI images for your evaluation. Of late, I have some muscle pull in my calves. I am waiting for your evaluation. ### Response: Hi. I have analyzed your MRI images (attachment removed to protect patient identity). There are age-related minor changes in the scan. But nothing is alarming in the scan. The tinnitus which you have can be because of isolated eighth nerve or inner ear involvement. Regarding the muscle pull in the calves, I would like to know further. Please let me know the answers to all of the questions, so that we can discuss further. Revert with more information to a neuro 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 am 51 years old. I have had six low back surgeries including a fusion with hardware and screws. Today at work I lifted something heavy and had a very sharp pain that brought me to my knees. Now I am losing control of my bladder and bowels, and the pain is very bad. What could this be? ### Response: Hi. If you are developing radicular pain and losing your bladder and bowel, then it is an emergency and you need to quickly consult your spine surgeon. It could be due to some problem in the fusion segment or above that segment which is called adjacent segment degeneration. You need urgent surgery to decompress your spinal cord. I know it would be extremely mentally traumatic for you to get yourself again cut after six surgeries but the situation demands that and you need to fight it. Get yourself evaluated from a good spine surgeon and decide accordingly. Are you feeling numbness at your anal region?" "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: Third time on Lexapro started again two months back. Taking 10 mg, after about 20 days, I felt good again. Then it stopped working after about two weeks. My GP raised the dose to 20 mg. Today is a full week without much improvement. How long should I wait to see if 20 mg will kick in for me? I am also taking Metoprolol. ### Response: First of all, try to stay calm because it is your third episode and medications take time to act. If you have come out of your illness twice before then this time too you will come out of your illness. Do not lose patience. As you have mentioned you are taking third time this medication. So this is your third episode. Lexapro is an antidepressant SSRI (Escitalopram). It generally takes 14 days to start the action. As you have mentioned you are taking it for the past two months and you started feeling good so you should wait for another one week for this medication to act before switching to another medication or adding a medication with it. Since it is working for you because you did feel good after taking the medication, so I would suggest you take the medication for one more week minimum to experience the effect." "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 is having enlarged prostate and has to undergo prostatectomy surgery. But, it is getting delayed due to ITP (idiopathic thrombocytopenic purpura). Right now he is under urine catheter. From past 12 days he is using Silodal-D 8 mg. Doctor said that after 20 days the prostate gland will reduce. Through ultrasound test we came to know the size of prostate enlarged is 54.6 cc. My doubt is, if it is enlarged to 54, is it possible that it can reduce through tablets? Or is it a must to undergo surgery? Right now the platelet count is 40,000. Please suggest a solution for this. ### Response: Your father was on medication and has history of urine retention in the past. Currently, he is on catheter. Chances of medical management will not be successful. He needs surgery of either TURP (transurethral resection of the prostate) or HoLEP (Holmium laser enucleation of the prostate) for prostate. Size is never a criteria for surgery. Enlarged prostate can shrink by 30% if Dutasteride is given. But, this does not guarantee that the patient will become catheter free. However, it reduces blood vessels in prostate and helps decrease blood loss in surgery. Dutas-T (Dutasteride and Tamsulosin) also contains similar medicines as Silodal D (combination of Dutasteride and Silodosin). His ITP needs to be tackled and with all due precautions and keeping platelet concentrates on standby. He can undergo endoscopic surgery with due risks. Laser surgery - HoLEP will be better for him if available." "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 25 year old male, who weighs 240 lbs, and I am 5.10 feet tall. Tonight I had what I think was acid reflux or heartburn. I was not sure about it, as I have never had it. I felt like something is stuck in my throat, and also I felt a chest congestion when I tried to cough. I was reading online about the symptoms of GERD but also started reading about heart attack symptoms. I did not have any noticeable chest pains, but after reading about how people have a feeling of uneasiness, I had a weird feeling rush over my body for a brief second or two that felt like pins and needles and numbness, then I came back to normal. Is this a sign of anxiety, hypochondriasis, or a heart attack? ### Response: Let go of your anxiety. Gastroesophageal reflux disease is 80 % corrected by simple diet and lifestyle modifications. So, I would suggest you try the following. Your symptoms could also be due to multivitamin deficiency, especially, vitamin B12 deficiency. 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 a 19 year old girl. I had unprotected sex. My last periods was before two months and still I have not got any. Is there a chance of pregnancy? I have had i-pill twice last year in a gap of 6 months. My periods are sometimes a day or two late. But, I am really worried as I really cannot afford a pregnancy now. Please help. ### Response: I totally understand your situation. Handling an unwanted pregnancy can be very stressful. As you had unprotected intercourse within the safe time of your cycle, it is very unlikely that you might be pregnant. If you still have a doubt then get a home pregnancy test kit and check yourself in case you do not get your periods in next two weeks. As far as i-pill is concerned, it does cause alterations in the hormonal balance and cause period disturbances. So, you should wait for a couple of weeks. If periods do not resume, we can start you on oral hormones to get your periods as well as regularize your periods." "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: Please provide second advice on reports. I would like to know if any other tests I should undergo apart from the existing ones. ### Response: I have gone through your reports (attachment removed to protect patient identity). Regards" "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 got married a couple of days back. When I tried to have sex during first night after some foreplay, I found my wife\s vagina was having a small hole and my erected penis was not able to penetrate. When I tried a little forcefully, the front skin of my penis rolled back exposing the inner soft skin of my penis. It was painful at that moment but uncomfortable now. It became a little dry and occasionally I get itching sensation.My wife is feeling a burning sensation in vagina due to forceful trying. Let me know how to prepare my penis and her vagina for sex. Our age is 29 years and 26 years respectively. ### Response: From the available description it appears to be that both of you are first timers. This kind of problem is commonly encountered because of lack of knowledge." "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 32-year-old woman. My latest pelvic IRM imaging showed that I have a 4 cm subserosal fibroid that is undergoing myxoid necrobiosis. My question is: Does this type of fibroid need to be removed? If yes, does the surgery have any risks for the uterine? Is it fine to get pregnant while having this fibroid? ### Response: Fibroid in pregnancy may be increased in size and can hamper baby growth by occupying space. Subserosal fibroid does not affect conception but in your case, it is undergoing degeneration. This is a problematic part. Red degeneration is a fibroid degeneration in pregnancy which causes severe abdominal pain throughout pregnancy and surgery cannot be done. So I would suggest getting it removed. Subserosal fibroid removal has generally no effect on the uterus. But if it is deeply situated then uterus wall may become weak." "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 27 year old serving army officer. Three years back, I met with an accident and got a traumatic brain injury. The initial investigation report and treatment undertaken is attached. Also, the NCCT scan taken 11 months ago is attached.Now, the problems involved are having cognitive issues in doing physical exertion and have mental stress. Now, I am not able to concentrate and grab the concepts while studying. I am having issues like I memorize a thing and later I am not able to recollect it fully. Further, I get tired after physical exertion.Initially, after a long run it used to take a day to recover and relax. And now, when I go for long runs I get tired, feel too exhausted and it takes five or six days to get back to normal. While searching on the internet I came along nootropics to boost memory. Can I take that? Please refer me some medication or herbal products to solve my issues.Also, when I\m having some sort of examinations, I thoroughly revise my subjects like earlier I use to do but now in the morning I\m only able to get few points not the complete thing. I\m able to recall but not at the time when it is required. It happens while conversations also some points skip and I\m not able to give all the points.I\m currently taking tablet phenytoin, and dietary supplements of super omega 3 capsules, 2 times a day, always nutrikite\s Siberian gingsek with gingko biloba, 2 times a day and focus factor tablets that are nutrition supplement for brain which I got from the US., 2 times a day. ### Response: Hi. I have gone through your query and reports (attachment removed to protect patient identity) with diligence and would like you to know that I am here to help you. The head injury has left some damage in your brain. The frontal area on the left side is affected. This area of the brain is needed for attention. Hence, you lack attention. Attention is an integral part of the memory. Even though your long term memory may be intact, you seem to have a forgetfulness because of lack of attention. There are two ways to treat this. Also, a combination of both the above will give best results. Consult your specialist doctor, discuss with him or her and take the medicine with consent. For yoga, I would recommend you to consult a yoga master. Please let me know the improvement in three months with this combined treatment." "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 with a sex worker with a condom on but at that time, I had itching problem in my hip joints. I had sex for four to five minutes. That was my first time having sex. I am in too much fear of HIV. I tested tri-dot on the 31st day and it was negative. Before the test, I had a skin rash which was cleared by Levocetirizine? What should I do? How much percent cases were found to be positive after three months being negative on the first month? I have too much anxiety. I am unable to eat food too due to fear. Please help me. ### Response: The chances of transmission of HIV by protected intercourse is nil if used in a right way. Tri-dot being negative after one month is good. The chances of HIV tests coming positive later is almost nil. It would be better to go for HIV antibodies tests or tri-dot after three months to be relieved of anxiety totally. The rashes are not related to HIV. It may be due to fungal infection." "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 itching problem in the whole body since last six months. When I take the Cetirizine tablet for this then it is fine for 4 to 5 days after that it again occurs. ### Response: Hello. It seems you have chronic urticaria. In more than 50 % of cases, the cause is unknown. The rest of the patients it can be due to any infection anywhere in body or thyroid problems or diabetes, etc. I suggest you get the following tests done. CBC with ESR, S.TSH, S.T3, S.T4. Also, please note if it gets precipitated due to some stimuli such as sweat, exercise, cold, etc. Follow up with the above reports." "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 severe allergy. I tried different medicines for this, but everything was useless. Please help. ### Response: Depending on the severity and type of allergic reaction, the treatment is given. So, for commenting more, I need more information. Revert with more information to a family 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 have an eye disorder (keratoconus). I would like to know whether I can continue wearing soft lens. The hard lens/RGP lens provides a lot of discomfort. Do I have other options apart from glasses? ### Response: Keratoconus is a degenerative eye disorder. This causes corneal thinning and leads to a conical shaped cornea. Though RGP (rigid gas permeable) lens are preferred for better vision outcomes, a combination of soft and rigid lenses are also available. If this option fails, then go in for surgical options like microwave thermokeratoplasty." "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: There is something wrong with my right fingernails, but my left nails are fine. What to do with it? ### Response: Hello. I understand your concern but there is no attached photographs in your message. Kindly send a picture of the affected area to help you better. I need to see the affected area to assess the condition and to suggest you the appropriate diagnosis and treatment. Please send the picture of the affected area." "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 unprotected sex before 1.5 years. I was in deep mental stress after that with no proper food. After seven months, I got admitted to a hospital with skin rashes, headache and vomitings. Doctors tested and confirmed that I got meningitis TB and given treatment for 10 days. I was asked to use Forecox tablets for nine months. Now, that is more than a year after my high-risk exposure; I was tested for HIV 1 and 2 under enhanced Chemiluminescence, which was non-reactive. Please tell me whether my HIV results are conclusive despite all these parameters. Would my TB treatment and immune system alter the HIV results? Because my WBC count is low while testing HIV when compared to before. Please advice. ### Response: Unprotected sexual exposure is a risk factor for multiple STDs (sexually transmitted disease), including HIV. However, the risk is quite low ranging from 0.02 to 0.04%. HIV infection has a window period of one to three months during which the test results can be false negative. According to WHO (World Health Organization), all results are considered conclusive at 12 weeks after the last high-risk exposure. Tuberculosis and HIV are known to have a higher coincidence rate together. But, as your test results are negative and well beyond the window period, you can be assured that you have not acquired the infection. Kindly upload the report to check the method used and the laboratory to confirm the same. 1. HBsAg, (hepatitis B surface antigen)2. Anti-HCV (hepatitis C virus)3. Revert with the reports to a HIV AIDS 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 am 19 years old. I have a habit of smoking from the last one year. I tried to quit smoking. But, it is not possible. Is it correct to use nicotine gum? ### Response: Hello. Trying to quit smoking is a very good idea and since you have only been smoking for a year, quitting now will be much easier than doing it any later. Nicotine gum and lozenges are both good replacements and have proven to be effective. Normally, side effects may occur some times such as: But if you keep to the recommended dose, you should get minimal side effects. Also, make sure you give at least an hour or two in between two pieces (2 mg piece). The long-term use is not recommended and you should also bring down the dose gradually. 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 25 years old and had a pregnancy for five weeks. Four months back, I had used MTP kit. The problem is, even now I am having bleeding. Is this normal? How to sort this problem if it is not normal? Looking forward for your valuable feedback. ### Response: I understand your situation. This much of bleeding is considered unusual. Either the process of abortion has been incomplete, because of which the uterus is still trying to expel out the products of conception. Or you have some blood problem. Are you still passing clots? Or is it plain blood that is coming? Also, if you could tell me exactly how you proceeded to take the medicine it would give an idea of the cause of bleeding. For the time being, take tablet Tranexamic acid 500 mg, thrice a day. This will stop the bleeding, but not cure the problem. So, till the time we know exactly what is wrong, you can take this tablet. Incomplete abortion. Ultrasound pelvis for retained products of conception (RPOC) and CBC (complete blood count)." "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 want to know a few things about the clitoris.1. How does the clitoris work and how it helps women orgasm?2. What kind of signals does it send to the brain? 3. What are the psychological effects it might have?4. Why people tend to misunderstand the most about it? ### Response: The clitoris is a substitute for the male organ in the female. It has some tissues similar to that of male organ but not that much active. It has receptors that can be stimulated by touch on having sex, especially at foreplay. During foreplay, these receptors when get stimulated can initiate local lubrication and prepare the vagina for better sex by having secretions locally. In a few women, the clitoris is too sensitive while in some it is less. But it is sensitive to touch, increase lubrication in the process of orgasm to have penetrative sex. Some women feel this process like masturbation." "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 sinusitis, cold and ear infection for more than 10 days. Took antibiotics with ENT doctor consultation, I could see improvement in sinus pain, cold but one ear still remains clogged, finding difficulty in hearing. When checked with doctor, I was informed that the fluid has entered deep and need steroids to recover it. I have been prescribed Prednisolone 5 mg for 15 days with 6 tablets per day for first five days, then 4 for another 5 days and two for remaining 5 days. Along with this steroid, doctor have given Clarinase and one more tablet named Gasec for preventing the stomach related issues as side effect of taking steroids.My queries are is it fine to take such tablets while trying to conceive? If not, how many months I have to wait for conceiving? Is it the right treatment for clogged ears due to sinus? What type of side effects can I expect due to this steriod? ### Response: Hi. If you are trying to get pregnant you must stop Steroids because it has a harmful effects on the nervous and immune system of the fetus but do not panic because you have taken a small dose of Steroids for a short period. You can start trying to be pregnant the next few days from stopping Steroids. Do not wait for side effects as the dose is small, the period of treatment is short." "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: The following event has happened twice. I start feeling dizzy and extremely hot. I can feel my body heat through my shirt. I feel nauseated and was about to faint. Oddly, today, when I went to the kitchen to check my food in the microwave, I opened the fridge instead. When I tried to cut lettuce, I grabbed a spoon. I am not sure if that was a coincidence. I got anxiety after these incidents. After lying down in front of the air conditioner, I feel better. Also, cigarettes seem to intensify my feeling. Please help. ### Response: I think the main thing to consider is whether this is something significant related to any cardiac or circulatory problems or whether this is something relatively minor. I would certainly suggest you visit your GP or family doctor. You will need to undergo an ECG (electrocardiogram) of your heart to determine its underlying rhythm. You will need your blood pressure and heart rate checkup, along with your blood sugar level. Given that it has happened recurrently now, your doctor may want to send off some blood tests such as your blood count to check your hemoglobin level to make sure you are not anemic, along with your electrolyte levels to ensure that there are no endocrine abnormalities. ECG, observations (heart rate and BP) and blood glucose. 1.Cardiogenic arrhythmia.2. Presyncope.3. Endocrine dysfunction. Cardiac presyncope or faint." "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 went to a salon to have a skin cleaning and they used on my face blackhead extractor. And I am worried now if I could get hepatitis or HIV if they did not clean it between the clients. Is it possible to get any disease? ### Response: Hi, Welcome to iciniq.com. If instruments are not properly sterilized and if the blood of any patient who has hepatitis, etc., present over that, it is possible that it can be transmitted. Usually, in salons the exfoliator they use does not penetrate the body and procedure is very superficial, it does not come into contact with your blood, the risk is very very low. For caution next time, you should buy your own instrument and bring that to a salon. You should not be worried now as the transmission risk of hepatitis after needle stick injury is very low and even lower for HIV." "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 a feeling pin and needles like sensations near my heart for the past two weeks. I do not know if my ECG is normal, I wanted to get it checked by you. I have no cholesterol issues, no blood pressure issues, no diabetes. I have low blood platelets count from years and recently my abdomen ultrasound showed mild spleen enlargement and prostate enlargement. I am 31 years old. I have anxiety issues for years. I also feel the warmth on my face after evenings until the time I sleep, but no fever. Weakness is there with pain in the left leg. Chest x-ray is normal. ### Response: I checked your ECG (electrocardiography) (attachment removed to protect patient identity). All is normal without no sign of any abnormality. The sensation you feel, does it come with shortness of breath? Or chest pain? Do you have a history of stomach ulcer or trauma to the chest region? Have you taken any medications so far?" "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 fell down from bike 10 days back and since then I am unable to walk properly. I have a problem in the knee. In the X-ray report, there was no fracture found. However, in MRI it shows ACL grade 3 tear. So just wanted to know if surgery is mandatory or any other option (without surgery) is available to treat ACL tear. If I do not go for surgery then would there be any serious consequences? Please suggest. I have attached my reports here. ### Response: At your age, if you have a complete ACL tear, then the best idea is to have surgery and reconstructed. This can also be treated non-operatively by physiotherapy and muscle strengthening of the hamstrings. However, this does not fully compensate for the ligament loss. If you still have symptoms of knee buckling after physiotherapy then also it is an indication of surgery. If you do not get operated, then your chances of developing late osteoarthritis increases which may later require surgery. ACL grade 3 tear." "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 severe weakness in the muscles of the hips and butt. But no real pain. I stopped taking Rosuvastatin, Ezetimibe, and Paroxetine but I still use Enalapril (15 mg daily) to lower my blood pressure. Blood tests for muscle rheumatism are negative. Vitamin D is 95 nmol/l and I use a magnesium supplement to enhance my muscles. What is wrong with me? ### Response: Since when are you having this problem? Any history of trauma, or lifting heavyweight? Any perianal senory loss or difficulty in holding urine? What symptoms do you have like difficulty in walking, climbing stairs, etc?" "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 21 years old, I take Iron supplements for low iron and low ferritin levels and was on contraception pill for six years since four months back. I used a sex toy (dildo) this morning which is slightly bigger than my partner. After, which I noticed a bit of blood on the toy and a small amount came out afterward. I did not feel any pain during or after, I noticed it felt deeper than usual and a stretching sensation.Four hours later I noticed more blood coming out, I have continued to bleed what looks like my period. I have no other symptoms but more blood has come out, no mucous or clots either. I feel well. Could it be coincidental that my period has come back or could I have injured myself? What are the signs of injury and at what point should I get checked out?By the way of background, I have been waiting for my period since last year. I stopped taking the pill thinking my period would come but it never did. I had irregular periods prior to taking the pill (hence why I got on the pill). My periods were always relatively heavy. I also have had a number of ovarian cysts over the last two to three years which have caused me pain previously. I am not polycystic and have not undergone any treatment but for the removal of ovarian cysts three years back due to torsion. ### Response: Hello. As your history suggests that you experienced bleeding post insertion and usage of sex toy (dildo). There are two ways it can cause injury in women - one by frictional lesions experienced as stretching and vaginal wall tears leading to bleeding (reddish spotting to heavy) or presence of cervicitis or cervical erosions which can bleed after the act of insertion or intercourse (often darkish brown discharge to reddish spotting). This calls for a per speculum examination to rule out either -vaginal mucosal injury or cervicitis. Now that you have been amenorrhoeic (absence of mensuration) since last four months, there is all likelihood that post sexual act, due to orgasm and increased endorphins, your menses may have been initiated and have increased inflow in next few days without any discomfort. The chances of bleeding being menses and heavy is high considering there is no pain or fever and that you did not have your menses for the last four months. You should get an ultrasound pelvis done to check for endometrial blood collection which shall confirm menses and also a per speculum exam which shall rule out any cervicitis or vaginal mucous lesions. I hope I have answered your query in detail, Avoid use of sex toy till cause is ascertained and bleeding stops. Please consult 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: My wife is suffering from chest infection. She is also having cough, vomiting, and fever every time after getting diagnosed with chest infection. Please suggest. ### Response: I can understand your concern. According to your statement, your wife has been suffering from chest infection, fever, and cough with vomiting. Does she have a history of repeated chest infections? You have not mentioned the duration here. Please provide the history of allergy, previous disease, medications, environment, family, childhood, acid reflux, etc. She may be suffering from chronic cough followed by vomiting. So she have to undergo CXR (chest x-ray), CBC (complete blood count), ESR (erythrocyte sedimentation rate), Hb%, circulating eosinophil, skin prick test, RAST test, reversibility test, etc. Reversibility test is done to determine the presence of asthma. She can take broad spectrum anbiotic like Azithromycin, nebulization with Salbutamol, Salbutamol inhaler, Fexofenadine, Montelukast, and antiemetic 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 am 16 years old. My eyes were yellow, ALT level was 226, Hepatitis E result was 9.4 u/ml. I went to a gastroenterologist for checking and he prescribed me few medicines Siliver, Sulvorid, Dexxoo. In the follow up he prescribed me Ipride. After taking that medicine I am having loose motion and feeling cold now. ### Response: From your symptoms and your test reports (attachment removed to protect patient identity), it looks like you have viral hepatitis, particularly hepatitis E. Viral hepatitis affects your liver cells and causes their inflammation which can lead to dysfunction in the normal functioning of the liver. The disease can vary from being self-limiting to highly fulminant. Hepatitis E has been known to lead to fulminant hepatitis which has quite a high mortality. Pro" "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 breaking out around my groin and vagina. I have never had an unsafe sex. So, I do not think it can be an STD. I am on a birth control pill. I have attached images for your reference. Kindly suggest treatment? ### Response: I understand your concern and I have viewed the images (attachment removed to protect patient identity). Regards" "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 get stomach pain and diarrhea after meals. I do not want to do a colonoscopy because the preparation will cause more diarrhea. Therefore I want to know what can be done without colonoscopy for diagnosis? ### Response: Colonoscopy is an invasive procedure in which we can see the lesions directly. If we have doubt then we can take a biopsy and also if any lesion needs to be treated means it can be treated immediately. It is diagnostic and therapeutic also. CT abdomen, ultrasound abdomen and barium swallow, etc., are available but not possible to take the biopsy or treat the lesions. So, please consult your gastroenterologist. He will examine and treat you accordingly." "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 cold starting with a sore throat, followed by nasal congestion and post nasal drip/coughing. In the past few days, a yellow lesion appeared on my left tonsil. I have attached a picture. As you can see, capillaries have widened on this tonsil and it appears red. What is this? ### Response: Hello. I have seen the picture (attachment removed to protect patient identity). There is acute inflammation of your pharynx. That is the reason for widened capillaries. The yellow spot could be pus pointing or a tonsil stone. You need a course of antibiotics, decongestant, nasal spray and mouth gargles." "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: Does (Inozith-250) Azithromycin work the same as (Clavu-nova 625) Amoxicillin and Clavulanate Potassium Tablet USP? I am using to treat a back/chest problem I had two years back which the doctor prescribed Inozith-250 for me. I used the same drug when I had a similar problem and I am well. ### Response: No, Azithromycin and Amoxicillin plus Clavulanate potassium work via different mechanisms. Azithromycin is an antibiotic useful for the treatment of a number of bacterial infections. Azithromycin is a type of macrolide antibiotic. It works by decreasing the production of protein, thus stopping bacterial growth. That is, it is bacteriostatic. While not effective by itself as an antibiotic, when combined with penicillin-group antibiotics, it can overcome antibiotic resistance in bacteria that secrete \xce\xb2-lactamase, which otherwise inactivates most Penicillins. The doctor may have prescribed Azithromycin 250 mg twice a day earlier to you for maybe congestion or cold or some other problem but I would advise you to visit a physician in person and then take the medication. Then it would be of much benefit to 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: A few days back, I was diagnosed with minimal B/l hydrocele with the right simple epididymal cyst. The doctor gave me some medication, and the pain was gone. After a few days, I have to travel to another place for office purpose. Hence I took my medication in case required. I started the gym as well but now and then I have that pain in testicles and lower abdomen. I could not find the prescription tablets, and hence pharmacist suggest me to take Doxycycline. But after taking these pills, I have unbearable pain. I can attach all my X-ray and reports, but I could not find the option to attach files. Please suggest what to do? ### Response: Doxycycline is a treatment for any infection for urine. It usually does not cause abdominal pain. For the cause of abdominal pain need to be found out. You will need sonography of abdomen to see for cause if the pain is too severe then physical examination by a doctor will be required to see for the cause. Pain in testes can be due to infection of testes is called orchitis. Or occasionally lifting heavy weight can cause torsion in testes that are emergency condition and has severe pain. If pain is not critical, then you can take tablet Paracetamol for pain and continue Doxycycline for seven days. And will review with sonography of scrotum again. If you have any doubt, you can ask 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: I have a BB sized lump where my preauricular lymph node is, right outside my right ear. My dermatologist, who is treating me for melanoma in situ, is sending me to an ENT this week to check it out, but said melanoma in situ cannot spread. I have no other symptoms. It is not tender and he described it as rubbery and movable.I discovered it a few weeks ago incidentally because my jaw hurt a little one day, so who knows how long it has been there. It has not changed in the two to three weeks I have known about it. What are the possible things it could be (your differential)? Should I have it biopsied, and does it sound like cancer? ### Response: Hello. For swelling in the pre-auricular area, my differentials are: Since it is rubbery and movable, I feel it is more like a node only. Nevertheless, we need to investigate it. A fine needle aspiration cytological (FNAC) study will be required, but since the area is close to the branching of the facial nerve, we need to very careful with this investigation. An ultrasonogram of the swelling will be very useful for this. It demonstrates the likely contents of the swelling and indicates a diagnosis.The likelihood of cancer is there but not more than other possible differentials. Parotid tumors can occur in young individuals like you. They are not uncommon. Please revert back with details and we shall help you. Revert with more information to 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: Can you tell me why I get dizzy or disorientated when my brain expects something to happen but it does not happen? For example, if I try to click somewhere on my computer but my computer freezes before I notice so the click does nothing, it will disorientate me and make me dizzy. It will jolt my vision and make my head pound for a couple of minutes. It happens quite often, usually when I am not fully paying attention. I am 26 and male. I have had this problem for as long as I can remember. Currently, I am taking Thyroxine for Hashimoto\s disease. ### Response: Do you have a headache associated with it? Do you have nausea, vomiting? Have you ever lost consciousness? Have you ever had any visual problems? If the answers to these questions are negative then, what you are describing is not a neurological problem in a strict sense. It is probably a mental issue. If you have any associated anxiety, mood disturbances, fearfulness, please talk to a psychiatrist." "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 getting a pain, which starts on the right lower back. It hurts when I breathe and also when I stand, sit and sleep. I know that is not kidney stones. But, I do not know what it is. I am a 45 year old female. My weight is 190. I am not on any regular medication. ### Response: I have gone through your query, and I can understand your concerns. Minor trauma or lung infection. X-ray chest, ECG and echo test. 1. Pericarditis.2. Rib fracture. Sprained rib." "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 daughter had a root canal yesterday and now has a strong post nasal drip that tastes like hypochlorite. Should I take her to the doctor? ### Response: Hi. Typically, you will recover completely from a minor sinus issue like this within a few days, without any intervention from your dentist. However, if you are experiencing sinus issues that have worsened, or have not gone away after 2 to 4 days after your root canal or you believe you may be developing a sinus infection or you feel serious and significant pain and discomfort around your sinus or there is a metallic taste in your mouth, nose, or throat or you notice any kind of bleeding or pus in your nose or mucus, you should visit your dentist immediately." "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 27 years old male. I was sitting in front of the computer for more than 10 hours per day for past one month. I have mild pain in my lower back, not a constant pain. the pain either left side or right side but the right side is more time the pain always shift its position. and while walking my right side bottom thigh got pulling pain at a step in and sometimes my lower limb feel pain. and I feel some weakness in the right leg and while I sit for Iong feel some numbness in my left bud and left bottom thigh.I have taken MRI and consulted the doctor, the doctor says lumbar spine looking normal. I consulted a radiology specialist and she said the hip and sacroiliac joint MRI essentially looks normal. The lumbar spine mild disc bulges causing radiating pain and numbness in the legs and feet described in detail as below:At L4/L5 level: Mild posterior-central disc bulge is seen indenting the thecal sac and encroaching bilateral neural foramina (right more than left) compressing right exiting nerve roots and abutting left exiting nerve roots. The annular tear is noted at this level. At L5/S1 level: Mild posterior-central disc bulge is seen indenting the thecal sac without any nerve roots compression. So, I consult another ortho specialist and he suggested to do physiotherapy and exercise for 10 days now. I completed 14 days but I did not feel any improvement. Previously two months ago I have taken treatment for erectile dysfunction and the doctor suggests taking medicine for one month, but I took for two weeks and stopped the medicine. I do not know any side effects from the tablets. So please advise me to take proper treatment. ### Response: I have seen your reports (attachment removed to protect patient identity). According to your complaints, I will suggest you few things. Do not sit in front of the computer for a long time not more than one hour after that at least walk for 2 to 3 minutes and you can get back to your work. Because of long-standing sitting in front of the computer, your shoulder muscles must be weakened. So, to strengthen your muscles you need to start exercises for that. Coming to your disc prolapse. You have symptoms for that if you have weakness in your legs then it requires surgery. Before that, I will prescribe nerve related tablets. Tablet Pregabalin 75 mg daily once after food for one month" "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 know why people have blackheads and when you try to remove it, it creates acne and blemishes on the cheeks and mouth area. It is concerning my skin on my face. I have been feeling insecure about my skin later due to the blemishes and acne on it. I get a lot of blackhead on my cheeks and jawlines. Moreover, I get a little bump rising when I wash my face or when I exfoliate it with natural exfoliators. Whenever I try to remove the blackheads, it gives me blemishes and acne scars which really bothers me. ### Response: Hello. Acne is related to sebaceous glands. Some individuals have acne prone skin in which normal follicles becomes clogged with keratin, sebum, organisms, etc., resulting in blackheads formation. When inflammation occurs blackheads convert to pimples and bigger pimples lead to cyst and nodule formation. Treatment of acne is important because it can lead to scarring if not treated early and properly. Its treatment starts with oral and topical antibiotics. For blackheads and whiteheads recommended treatment is topical Retinoid. Acne vulgaris. Tablet Azithromycin 250 mg BD for the first three days, then on alternate days for three weeks. Apply Clindamycin lotion over the lesions BD, apply Tretinoin gel plus cold cream at night on the whole face in small quantity. Wash face with mild soap and water. Avoid using irritants." "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 ask which medicine I can take that does not have any side effects so that I do not discharge early as I have once taken Suhagra force which contains Dapoxetine. Is there any medicine for it without any side effects? And how often can I take it before intercourse?Secondly, I want to ask is there any medicine to increase the size and width of my penis? If yes, then how it should be taken? If there is any ayurvedic medicine then also you can suggest? ### Response: There is no medicine available to increase the size of the penis. But by cosmetic surgery, the size can be increased by one to two inches. Premature ejaculation is mostly psychological. First, you try to divert your self in between while having sex. If you are about to cum then squeeze your glans in between your thumb and index finger. You can also use local anesthetic gel but then it is better to use a condom with that." "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: Could you please check my blood test result? Does it confirm that I am pregnant? Could I know how many weeks? Do all the results look normal? Is there anything should I pay attention to? Do I need to do any additional blood tests or checks, such as for human chorionic gonadotropin and progesterone? ### Response: Hello. 1) From your reports, all blood reports are found to be healthy (but for platelet they have not mentioned the value due to clumped sample, but blood smear looks normal platelet, so that is taken as usual, for the value you can repeat it later). 2) Since your last period date was before five weeks, if you got urine pregnancy test positive, that means you are pregnant for five weeks five days now. 3) None of these tests are confirmative for pregnancy. Usually, pregnancy is confirmed by a urine pregnancy test, or blood test as you told (serum beta hCG), or by scan around six weeks. 4) So at present if you got urine pregnancy test positive means you are pregnant, no need to go for beta hCG now, do a transvaginal scan for viability by six weeks (means three days later from today), otherwise, the scan will be too early to see the pregnancy sac." "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 daughter, 2.8 years old was diagnosed with nephrotic syndrome. She had swelling in limbs, private part, stomach, and eyes. She also had slight cold during that time, but no running nose or cough. I have attached her reports.From the last one week, we started medicine, post which the eye swelling (by 90 %), face, hand, legs have reduced and hand have also reduced, but the private part and stomach still have swelling. Overall swelling is still present. Urine check showed improved creatinine results after three days. Her weight has increased 1 kg from the last five days, everyday it is gradually increasing by 200 to 300 gm. Even prior to start of her treatment she had good appetite, she used to eat every few hour either a biscuit or yogurt or a fruit or bread slice.My questions are:In how many days does this swelling reduce?The doctor here suggests albumin infusion if the weight continues to increase or the body swelling does not reduce by five more days. Is it safe to use albumin infusion? Does it require admission into hospital? How many days should we wait before we decide on albumin infusion? Any other alternate to albumin infusion to reduce edema? When will we know if the medicine is working, the doctor say it takes maximum of 30 to know the impact?Whats happens if the child does not respond to the current medication, doctors here are not disclosing but I want to be prepared financially and mentally? What are the scenarios to take child immediately to hospital? Please help. ### Response: I can see clearly that your daughter's condition is improving (attachment removed to protect patient identity)." "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 fimbrial ectopic pregnancy in my left tube. I received my internal ultrasound pictures but do not know how to read them. I am wondering what the orange spots are meaning on my ultrasound and where the fetus would be? I was told it was about 2 cm. ### Response: Hello. I have seen the images (attachment removed to protect patient identity) An ectopic pregnancy happens when the fetus starts developing at a location other than the uterus. In your case, the pregnancy is developing at the end of the left tube which is called the fimbria. You can see in the pictures that the uterus is empty and a sac-like structure is visualized in the location which is probably the end of the left tube. The developing fetus is very small and looks like a small straight line in the sac. The orange spots are flowing blood and usually, the growing gestational sac has blood flow which can be seen like a ring in cases of ectopic pregnancy. Regards." "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 18 years and I have been taking the birth control pill Yasmin for three months now. Today, I went to the pharmacy to go get another three months supply of Yasmin but the pharmacist gave me Elvina and told me it was the equivalent to Yasmin but I am worried to take Elvina because my body is used to taking Yasmin. I am wondering will it be fine to take this? ### Response: Hi. It is nice to hear from you that you are concerned about medication type before its use. You are a teenager, still under development stage of the reproductive system. Elvina is also a combination of two hormones (" "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 year before, I was getting regular periods. One day before period, I used to get spotting then bleeding for five days. I was on birth control pills. A year ago, I stopped the pills. So from nine months, I am having brown discharge with mucus before four days of periods, then bleeding for five days. I do not understand why every month brown discharge start so early before periods. Because of this, I am always with the due date of my periods every month. I visited a gynecologist, who said it is normal, but I am still not convinced. I am trying to conceive. Would it be the reason for not conceiving last year? ### Response: You have not mentioned for how long you took the birth control pills. There are many adverse effects of the pills, which women are not aware of and the doctors are also not telling." "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 38 year old female. I have recently developed a skin rash in my groin area. This is the first time this rash has developed. I am currently under no medication. My menstrual cycle is normal. ### Response: Hello. It is dermatophytosis, a kind of fungal infection, which is common in a humid environment. I suggest Candid B (Clotrimazole and Beclometasone) cream morning and evening for few weeks. You will notice the improvement in 72 hours. Regards." "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 boil on my inner thigh, which keeps recurring. I have had a boil in the same spot before. When I popped it went away, but now it has come back. It is also very painful. Please help. ### Response: I have read your query. It seems that you are having furunculosis. Boils (also called furuncles) are a deep bacterial infection of hair follicles. The cause of recurrence may be Staphylococcus aureus, which is most commonly carried in the nostrils, armpits, between the legs and in the cleft between the buttocks. It may be transferred to other sites from the nostrils through the finger nails. General measures to avoid the recurrence are as follows. Regarding treatment, I suggest oral antibiotics like tablet Augmentin 625 mg (combination of Amoxicillin and Clavulanate potassium) if you are not allergic to penicillin group. Take one tablet thrice daily for five days. Also, my suggestion is to apply Mupirocin twice daily for five days. Consult your doctor, discuss with him or her and take the medicine with 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 wonder if chlorine levels in a normal swimming pool kill all the microbes. If someone with a fungal infection swims in a pool, won\t it spread to others through the water? ### Response: Hello. I understand your concern. Swimming is considered as a safe recreational activity. But that is not totally true. Chlorination of water is known to kill most of the microorganisms (which include bacteria, viruses, fungi and parasites). But there are several factors to be considered like: 1) Type of microorganism (some organisms may be resistant to chlorination). 2) Adequate chlorination (if sufficient chlorine is not added, there could be a chance of acquiring infection). 3) Duration of chlorination (when a microorganism is introduced into the water, the chlorine may not kill the organism right away, some resistant organisms may survive longer in the water). 4) Microbial load (the stage of infection of the infected person is also important, during the acute acute/highly infective stage, chances of spreading infection may be higher). Consult a general practitioner online for further follow up -" "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 root canal done in one of my lower right teeth. It was done in one sitting with the help of a laser. Everything was fine for a week. Then, one day my right jaw started aching and I was not able to open the jaw more than half an inch. There wa mild pain below the ear and it increased while chewing.My dentist says it is spasm and it has nothing to do with RCT (root canal treatment). I am taking Flexon MR and doing few muscle exercises keeping the jaw in movement.What is the solution?How long will it take to heal?I am worried will it become permanent? ### Response: Hello. Yes, it can be due to muscle spasm but as it started after one week then it can also be due to infection in the root canal treated tooth. So, first of all, the exact cause needs to be ruled out. If Flexon MR (Ibuprofen, Paracetamol, and Chlorzoxazone) and muscle exercises are not resolving the problem then an X-ray of the tooth should be done to check for any infection. It can heal mostly within a week. No, it cannot become permanent and both conditions - infection and muscle spasm are treatable" "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 lost a crown, and as a result, I have to get the tooth out, and I have to get an implant. I have two teeth missing on the other side already for the last 10 years. They are all are molars, top, and bottom on the other side. I read that this can change the shape of the face, and I am worried even though it did not affect the other side. Kindly advise. ### Response: Hello. Please do not pay attention to such misconceptions. The treatment has now become very aesthetic and sophisticated. You should not worry at all about aesthetics." "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 unprotected sex on 11th of this month, and took an I-pill the next day and again on 13th, the condom leaked, should I take another I-pill? I finished my periods on 10th of this month. ### Response: Since you have taken an emergency pill within 72 hours of intercourse there is no chance of pregnancy. The pill will be effective for 72 hours of intercourse there is no need to repeat the same. However, if you have a doubt then get 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 brother is worried about his marriage because of the same blood group. Both are having a B+ blood group. Is there any problem after marriage for getting a healthy baby? Please explain it to me so that I can talk to him. ### Response: Hello. Same blood group people can marry and can produce a normal child. There is two common universal blood group system that is ABO and Rh. If they both are relative then genetic counselling is needed. As far as same blood group is concerned, do not worry about that. If you want to investigate, then I personally advise you that they both should get tested for thalassemia minor by electrophoresis by HPLC method. You can inform me your electrophoresis report for giving further comment." "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 58-year-old male. I am 180 cm in height and weigh about 85 kg. I have frequent constipation issues. I am currently on Obimet SR 500, Glimisave M1, Pinom 40 mg, Pivasta 2 mg, and Clopilet 75 mg. ### Response: Would you please answer few of my following questions. Please feel free to ask anything and answer my questions. CBC (complete blood count). HbA1C (glycated hemoglobin). TSH (thyroid-stimulating hormone). Serum calcium. Digital rectal examination. Ispaghol husk two teaspoons in a glass of water every night. Polyethylene glycol sachet in a glass of water every night for two weeks. Take plenty of water. Do 20-30 minutes walk 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: A 5-year-old boy has intermittent fever, muscle pain, cough, and blocked nose for the past four days. The temperature is shooting up during nights and is normal during the day time.The blood test results are:CPK 23056 U/L.SGOT 513 U/L.Leptospira IgM and dengue IgM tests in progress. Please advice. ### Response: Hello. The reports and history are suggestive of some viral etiology probably, however, it is advisable to do a blood culture also to rule out bacterial etiology. In the meantime, I would advise starting Ceftriaxone to be on the safer side along with proper iv (intravenous) fluid management. Other symptomatic management like nebulization and antipyretic medications to be given as per the symptoms. To trace blood culture, dengue and leptospira results and act accordingly. If symptoms worsen or do not resolve in the next five to seven days, detailed investigations in favor of Duchenne muscular dystrophy should be carried out." "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: These are the reports of my kidney function test and liver function test. I was on antibiotic Amoxicillin and Ibugesic plus when having this test. Is this report really abnormal? Is there something seriously wrong with these reports? I am worried. ### Response: Hello. Your reports (attachment removed to protect patient identity) do not have anything to panic about. I hope it helps you. If you have any further queries please ask 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 wife started her last menstrual cycle on the 22nd of the previous month. We had protected sex on the 27th of the previous month. Unfortunately, the condom ruptured but, I was able to pull it out a few seconds before ejaculating. Just to be safe, she took an I-pill seven hours after intercourse. She had light spotting after a week which lasted for three days. It has been almost a month since her last period and she is not showing any signs of PMS. Is there any possibility of pregnancy? ### Response: Hello. I have gone through your query and understand the concerns. I-pill has the usual side effect of delaying the next expected periods by two to three weeks. So, most likely her periods are delayed due to the pill. I will suggest her to get a urine pregnancy test done if the periods are delayed. If negative, then she can safely wait for the periods for another two weeks. Hope you found the answer helpful. Regards" "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 61 year old and was lately diagnosed by a doctor as sick in fibromyalgia. In the last three years during the night time, I am suffering from aggressive involuntary movements while asleep. Those movements include kicking in the air and arching and bouncing my back and the whole body. At first those aggressive movements started as a physical response to a dream where I was being attacked which happened once in a while, lately, it happens more and more often without any noticeable reason. As a result of the movements, I suffer from strong pain in my back and knees which lasts for a long period of time and restrict me to my house. I am also very depressed of my physical condition which projects to anything I do in my private life, family life and job. I quit my last job a year ago due to my medical condition. Can you please advice on physical/neurological treatment that will improve my poor physical and emotional conditions?In addition, I am using Lamictal 200 mg which according to the medicine brochure might rarely cause involuntary limb movement. Therefore, I wish to replace it with equivalent medicine. Can you please advise on a possible replacement? I have already tried Seroxat, Depalept, Gabapentin, Lyrica, Teril, and Cymbalta which did not help. ### Response: Well, these involuntary movements do not sound normal at all. It looks more of chorea/hemiballismus (movement disorder). If any problem there, we will have to treat it differently. I understand you have tried a lot 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: I have composite veneers on both of my front teeth. Sometimes, if I sense my bottom teeth touching the bonded teeth, even lightly while eating or brushing or what have you, I worry that since enamel is stronger than the bonding material, this will somehow alter the bonding. I spent a lot of money on the procedure and want to know what exactly would need to happen as far as my bottom teeth making contact with my top teeth in order to actually alter the appearance. ### Response: Hello. As far as normal occlusion or normal bite is concerned, the upper front teeth should not touch the lower front teeth. There should be a gap of at least 1 to 2 mm. But, sometimes when you are eating or trying to make the contact then it is absolutely normal. This way the bonding is not going to get affected. The doctors generally plan the treatment really well before giving the veneers. So, you need not worry about the bonding. Hope you got your answer. Regards" "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 unprotected sex at 11 PM but took I-pill the next morning at 9 AM. I have missed periods. I have heard about the disease amenorrhea. Is this pregnancy or a disease amenorrhea? If amenorrhea happens, can it be easily cured? How she I have regular periods? Is it a matter of fear or a common disease? Please help us. ### Response: Most probably, missed periods in your case, is because of I-pill. Please tell me the last periods date, date of intercourse, and usual cycle length so that I can guide you precisely" "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 27 year old male. Recently, I have gone through a full body check up and I am attaching the reports of that. So, kindly go through all the reports and provide your sound medical advice based on reports especially on the liver profile, ultrasound, and chest X-ray. Also, advice about the type of food which should be taken and what are the things need to be avoided. What are the medications to be taken to improve the health? I was having some pain in lower stomach parts while traveling, also some pain is chest area. So, I have gone through all the tests. ### Response: Hello. I have reviewed your detailed query and all supporting documents (attachment removed to protect patient identity). There is nothing wrong with the blood and urine tests at large. Your heart is working perfectly normal and there is no abnormality found in the heart. Blood sugar is all normal and working fine. Your lipid profile is a little out of range but this is manageable with a change in lifestyle. You need to start working out (better would be to join the gym and do treadmill and cardio exercises under the supervision of a gym instructor). Take healthy and natural diet. No junk food and lazy habits. Remain active and keep calm. ESR (erythrocyte sedimentation rate) is high and the reasons can be discussed with your treating physician. Causes of high ESR can be inflammations and infections in the body. Your chest X-ray shows infection (bronchitis) and that may be a causative factor. 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: After eating and drinking anything suddenly I burp and it is continuously happening. Sometimes, it feels painful when I burp especially while sleep it was very painful. Even while smoking I burp continuously, and I cannot stop. Only for the last two months, I am facing this issue. So, I think it is a starting stage. What are the possible remedies for this issue? ### Response: This can be due to GERD or gastroesophageal reflux disorder. I suggest you stop smoking as it reduces the lower esophageal sphincter tone and further aggravates the condition. You can take a proton pump inhibitor like Pantoprazole or Rabeprazole or Omeprazole along with prokinetic agents like Domperidone or Levosulpiride or Itopride" "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 sore throat since yesterday. There is also a slight fever of 37.4. I suspect my swollen tonsil. I had taken juices and gargled warm water with salt. For the fever, I took paracetamol if needed. ### Response: Hi. Do you have any other symptoms such as cough or difficulty breathing? Any recent history of travel to China? Or any exposure to someone who may be possible with Covid-19?" "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 daily take Pristiq antidepressant tablet 50 mg, which doctor had prescribed since a year. Now I am tapering the tablet gradually as per doctor\s instruction. The first week every other day and second week every two days and the third week every three days. And now this is my fourth week, and I am off completely. So my question is, can I use 5-HTP supplement tablet? So that my withdrawal symptoms will be less.And when I can take 5-HTP? Withdrawal symptoms are scary to me, and I want to completely stop this Pristiq because I tried many times to get it off, but unfortunately, I cannot. I had withdrawal symptoms, brain zaps, nausea, and diarrhea. I have some supplements like fish oil, b12, and 5-HTP but still waiting for a doctor advises. ### Response: You need to restart because of anxiety or depression disorder, not because of 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 have dry gray spots. After sunbath I got this and is uncomfortable while reading. ### Response: I understand that you are concerned. But the picture attached is quite blurry. Kindly send a clear and well-focused photograph to help you better." "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: The period was two days late. When it started, it was watery. Then on the second day, it had some clots. Then it thinned up again and ended with brown blood. Why? ### Response: Hello. How are you doing? The possibilities for this periods are: For normal bleeding, you need a normal hormonal support to the endometrium, ovulation and the proper and complete bleeding. But, in your history I note your BMI (body mass index) is very high, Your expected weight is 52 to 56 kg. This extra fat is converted to hormones in the body which alters the normal hormone balance, leading to the poor formation and improper bleeding, which can appear as such a brown discharge, fleshy mass, and mucoid discharge. This needs only weight reduction by at least four to six kg. Any sudden increase or decrease in weight can affect these hormones. Another possibility is an infection around the uterus. If you have any yellowish or white or grayish discharge with or without itching or foul smell especially after sex and periods, pain in the lower abdomen before periods, feverish feeling, this could be an infection in the inner lining. So, the bleeding will be lesser in amount with fleshy masses, brownish and painful. This needs an evaluation by a gynecologist and a good course of antibiotics and antifungal medicines for you and your partner. Periods plus or minus seven days the expected date is normal, so two days is alright. Hope I have clarified your query. Do write back if any more queries." "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 cold and have lost my voice. But my gum has swollen up significantly behind my last tooth in my lower right side. ### Response: I have been through your query and I can understand your concern. The swollen gum behind your tooth is a condition called pericoronitis. It generally occurs with the partially erupted last molar or teeth. The food gets entraped between the tooth and gum and it gets infected leading to pain and swelling of the gums. It is also characterized by the pain while opening the mouth. Also use 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: For the past eight months or so, I have had some problems with unusual headaches and sort of momentary feelings of lightheadedness, vertigo but it is like everything just shifts for a second instead of spinning. I have a background of stable migraine headache. I have had some face pressure as well and some momentary stabbing headaches. Some chronic low-grade nausea that can disappear for weeks at a time and is not usually accompanied by a headache. I went through the gamut with GP, he then referred me to an ENT, and then to a neurologist. I am still getting some headaches but have had a clear CT scan of sinuses. A full neurological exam was done and that was normal, and the neurologist did not seem to think that additional imaging (MRI) was needed because my exam was normal.Even though it was a CT scan of the sinuses, they would have seen the brain (particularly frontal lobe) and notified of any abnormalities they could see. I had a clear MRI approximately one year ago for some twitching and muscle pain. Do you agree that further examination is not warranted? In other words, with the above information is a structural problem unlikely? ### Response: Hello. You have been elaborate in providing your medical history and that always helps to form an opinion. Coming to your straightforward query, I really do not see any indication for a fresh brain imaging study like CT (computed tomography) or MRI (magnetic resonance imaging) in view of your transient, very short lasting symptoms and a normal MRI brain, just one year back. Instead, I would suggest here to get one electroencephalogram (EEG) done to look for abnormal electrical discharges in the brain during those episodes. EEG done during the time frame when you are frequently having those episodes will be more rewarding in terms of diagnostic importance. With a normal neurological examination and normal MRI, you should stay calm and assured that it is nothing serious. Lastly and importantly, anxiety is the commonest cause of such symptoms. Please start doing mental relaxation exercises, meditation, yoga and observe for improvement. 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 very thin and short eyelashes and eyebrows. I want thicker and longer eyebrows and eyelashes.Please help me. ### Response: Hi Thickness and size of eyelashes and eyebrows depend on your genetic inheritance. If your genetic makeup indicates your eyelashes to be thin then they will not grow bigger than your genes allow. In case your genetic material indicates your eyelashes to be thick and beautiful and because of some disease they do not grow well, the following steps will help: Consult an ayurveda specialist online for further queries" "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 want to know that whether my kid has a tongue tie or not. My kid will be 3 years old after two months and he is still not speaking properly other than papa, mama, and OK words. ### Response: Hi. The frenulum is a normal structure. It is only that when it attaches close to the tip, it causes problems with tongue rolling. Ask your child to protrude the tongue. If it causes buckling of the tip, it is tongue tie. And see if he is able to slip undersurface of the tongue tip underneath his upper 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: I have started taking Aripiprazole 5 mg tablets, after which I started getting spontaneous rashes. My question is, is this effect worrisome (should I go to urgent care)? ### Response: Aripiprazole can induce skin rashes though it is not commonly reported. It will be safer to get yourself checked to rule out any systemic involvement, especially if you have any fever, pain, signs of the exfoliating rash. So you need to be examined. Depending on the nature and severity of the rashes, you will be advised either to stop or discontinue Aripiprazole. So consult your primary doctor at the earliest." "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 problem with speaking. I cannot speak fluently. I struggle with speech. I have doubts about anarthria disorder. Please tell me clarification of that disorder. My age is 22 years. ### Response: Anarthria means inability to articulate clearly due to neurological conditions. It occurs usually in Parkinson\s or stroke. it is unlikely that you might have any of the above at this age. It is very rare. What you might be having is stuttering" "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 82-year-old man and noticed that my pulse was 54 late a couple of nights ago. I recorded it yesterday throughout the beginning with 8 am and ending at 10:15 pm. The pulse was 58, 60, 80, 78, 69, and 54. The 80 was after hiking 2.5 miles. I am concerned about the low of 54. I am currently on Valsartan and Hydrochlorothiazide 325 mg/25 mg and Amiloride 5 mg, each one per day. ### Response: Hello. I understand your concern about your health. Please do not be worried as it is nothing. It is perfectly normal to have a slightly low pulse as you age. It is a physiological change that occurs with aging perhaps 54 beats per minute can not be said to be too low. A normal pulse is between 60 to 90 beats per minute. This range differs with people. Age, body size, and activity level are some of the reasons for the variation. I advise you to continue your normal daily routine without worry. You can become concerned if it becomes lower as much as 40 and you experience symptoms like shortness of breath or faintness. Remain healthy. Best regards." "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 swollen eyelid for over five years, in one eye only, and it is more bulged than the other eye. The swelling is constant, it rarely disappears for a few hours, and it is affecting my look. ### Response: I have gone through your photo attachment and can infer a swelling of the right lower eyelid (attachment removed to protect patient identity). It can be caused by a number of different conditions. The commonest non-painful swelling being a chalazion, it starts off as a painful swelling accompanied with eye rubbing and irritation. In case, these do not heal adequately they become painless and hardened chalazion. The other causes including swelling due to hormonal fluctuations, swellings due to tumors and due to conjunctivitis. I recommend that you visit an ophthalmologist for an examination to see what exactly this is. In case you feel that it could be a chalazion, giving hot fomentation with cotton or a clean cloth can help and the swelling may subside on its own, although some do require surgical treatment." "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 broke my heel three days ago. The specialist said it is the worst break to get. My question is, should I keep the special boot on even with the fracture blisters. It is painful as it rubs on the boot. Should I keep it on at night also? ### Response: Plaster or a synthetic boot is designed for walking, and if you have blisters then a boot is not advisable for the reasons that you have found and that also indirectly means that you are allowed to walk but in reality, walking or lowering your leg will make the swelling and blisters worse. You need to be on strict elevation will heel above heart and ice the area 10 minutes at a time till the swelling is down. This also means that most are your activities are to be done on the bed until the swelling starts to recede." "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 using skin lite cream for the past two years. This cream contains Hydroquinone and Mometasone. Now I am stopping the usage of this cream. Now in my face, I am seeing redness and itching like skin allergy. Please suggest the best creams or medicine to cure this problem. ### Response: Hi. You have developed contact dermatitis due to this medicine. As it also contains a steroid, skin becomes steroid dependent, so when this is stopped the face becomes red and inflamed. First thing for treatment is to use a good Sunblock OG SPF 60. The second thing is Metronidazole gel 0.75 percent and third is an oral antihistamine. Avoid all irritants and skin lightening agents further. Treatment will be long term. It will take time. Contact dermatitis. Apply Sunblock Spf 60 frequently every two hourly. Apply Metronidazole gel 0.75 % at night. Mix it with cold cream. Take oral antihistamine. Avoid irritants, maintain hygiene of area, avoid cheap creams available in the market." "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 not getting a proper erection for the past three months. I consulted a sexologist, and the doctor told it as a sexual energy issue. Please help me. ### Response: The common causes for having an erectile issue in this age are stress, anxiety about erection, and due to certain nutritional deficiencies like Vitamin D. Take dates, raisin, anjeer, and almonds in your diet. Also, take Ashwagandha powder or capsules with milk twice daily. Practice kegel exercise and gomukhasana exercise daily. I suggest you take tablet Megalis (Tadalafil) 10 mg one tablet at night for three weeks and tablet Shelcal (Calcium carbonate with Vitamin D3) one tablet in the morning and night for four weeks." "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 foot pain while moving feet to left and upwards or back since last night. The similar uncomfortable feeling started to happen to me before some time (like sudden feet muscle or vein cramp or pain while standing up from sitting). Before, when I was awake and just when it started I used to straight and stretch my feet and fingers and there was no pain or it was gone within five seconds before to start. If this is the same thing, this time it happened when I was sleeping. I was not able to stretch my feet and fingers so woke up with pain and then it started getting more painful. I started to feel pain in every step while moving feet to left and upwards or back. This foot is now bit puffy or swollen than the other. Any suggestion about medication, rest, exercise? ### Response: I want to ask some questions regarding your condition. This condition occurs in those people who stand a lot of time, or who recently had surgery and are on be" "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 24-year-old bisexual male. 10 months ago a friend stroked his penis between my thighs, and suddenly his penis slipped and entered my anus for merely an inches, and he pulled out then we stopped performing it. And after four months I got constipation and hard stools, and then day by day I started to feel inflammation and burning sensation throughout my anus sometimes this burning pain moves to my perianal area and maybe in the rectum. As I read about the HPV infection, I got very scared, and I am in a deep depression. I do not know what this HPV or piles are? Kindly tell me what to do as I am in deep agony, pain, and depression. Please help. ### Response: Hello. HPV (Human papillomavirus), usually HPV infection does not cause any noticeable symptoms or health problems. Some time produce genital warts.For your complaints, constipation and burning sensation may be due to piles or anal fissure. So better go for the rectal exam and proctoscopy examination to rule it out. For piles and fissure try these medicines. Kindly consult your doctor to discuss the suggestion and take the treatment with consent. 1. Tablet Pilex 1 t.i.d (three times a day) for 20 days. 2. Tablet Dulcolax (Bisacodyl) one or two for constipation. 3. Proctosedyl ointment use, as per instructions are given in box for 20 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 have an infection in my root canal and also have wisdom tooth nearby root canal. So first what should I remove? Infection in the root canal or wisdom tooth? Please suggest. ### Response: From the X-ray, I understand that all your wisdom teeth are indicated for removal as they are erupting in the wrong path. However, I would suggest you get the one which is troubling you extracted first followed by re-root canal treatment for the adjacent tooth. It is better to get the extraction done first followed by the root canal. This sequence may vary from dentist to dentist and also based on patients preferences." "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 60, weight is 44 kg, height is 5.6, diabetes for past 25 years, on low carbohydrate diet for 80 days, taking no medicine for diabetes now. Sugar levels are under control, checking every day. The problem from past 50 days is that there are feet and ankle swelling that disappears in the morning and comes back by night. No pain or weight loss. Kidney function test, liver function test, 2D echo, thyroid test, HbA1C, lipid profile, stool examination, B12 tests were done. Met local doctor, and he said it is nutritional pedal edema or malabsorption. Prescribed below medicine. Oroalbumen powder three times for 30 days. Revidox LB twice a day for five days. Lasilactone 25 mg once in the morning for three days. Along with the above, taking Thyronorm 25 mcg, Vitamin C, multivitamin tablet, Omega 3 fish oil, Ecosprin 75. It has been three days, did not see much improvement. Vitamin B12 was 1271. My questions are why is Vitamin B12 high? Could this be small intestine bacterial overgrowth? Taking lots of proteins and healthy food, but no use. Could you please help to get the food absorbed. ### Response: High vitamin B12 can result from multiple causes. Since your liver function test, kidney function test, peripheral blood smear, etc., are normal (attachment removed to protect patient identity), we can rule out these as the cause. Other causes like diabetes (which you have as evidenced by HBA1c), nonvegetarian diet (do not know your status) and vitamin supplementation (which you are on) can also cause mild elevations. Small intestinal bacterial overgrowth results in Vitamin B12 deficiency." "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 darkness around my mouth area and forehead and dullness on my skin I suffer from acne scars all over my face and tanned skin. Please help. ### Response: Hello doctor, I understand your concern, but there are no attached photographs in your message. Kindly send a picture of the affected area to help you better. I need to see the affected area to assess the condition and to suggest the appropriate treatment accordingly. Meanwhile, you can use the following medicines, 1. Tretinoin 0.05 % gel at night for scars. 2. Kojitin gel local application at night for dark areas. It is recommended to use photoprotection with above creams. Please send the picture of the affected area to help 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 fiance fingered and rubbed his dick on my vagina. There was no intercourse, no clue if there was semen or not on dick and fingers. I was on the fifth day of my periods. Bleeding stopped on the second day. I have a regular period cycle. Four days later I experienced white sticky mucus high quantity in the evening. When is my ovulation day? Can I still get pregnant? There was no intercourse. Experiencing lower back and abdomen pain, high heartbeat, gastric issues. I am worried. ### Response: Hello. Overall chances of pregnancy are less because it is considered safe period for 2 to 3 days after the period to have sex, but if ovulation occurred four days later, then there are some but again fewer chances of pregnancy. Usually, ovulation occurs on the 14th day of the cycle. Also, since there was no intercourse, chances are less, but it also depends on whether there was any semen on his fingers or penis. So overall, chances appear to be less and do not worry about it at present. This will be cleared within two weeks. If you do not get period then get urine pregnancy test 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 am suffering from piles from nearly about a year. Suddenly yesterday, I felt pain around my anus, and I had 101 F fever. I saw that there is an infection around my anus. ### Response: For an advice specific to your problem, please upload the past medical records and a detailed evolution of your symptoms. And a picture of the problem site. Revert with more information to a general 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: My 10-month-old baby had a viral infection with roseola infantum. It started fever 38.5 degrees and 39 degrees measured rectally on the second day treated with Ibuprofen 3.5 ml and Paracetamol (Panadol) 4 ml administrated after 6 hours (almost three days of treatment). The third day, the baby did not have fever at all and on the fourth day a rash appeared on his face, after his ears and on his back mainly, with mild signs on his tummy. Also, in the fourth day she had changes in his stool- kind of yellow with mucus and quite fluid with no fever.Five days later, the blood tests indicated severe neutropenia with 0 neutrophils on a test taken from her finger. As we got very scared, we repeated the test the next day and the result was 0.2 neutrophils so again a very low value.My question is that is it possible that this neutropenia is a consequence of the roseola infantum plus the administration of Paracetamol? The baby is fine now, she is very happy, playing, and eating normal. Also, would it be possible that these indicators can be so low due to the way of taking blood sample? We got it out of her finger, not through the veins. We were given Azithromicin just to be on the safe side, but I would not give her antibiotics if clinically she is well and shows no sign of being unwell. ### Response: Hi. The low count may be because of the disease process and less likely the Paracetamol or Ibuprofen. Another reason can also be the way the sample was collected (although I am not very sure about it). Do not worry about it if the child is currently fine. However, I would advise taking a fresh sample of blood from the veins and checking the counts again. If they persistently stay low on three consecutive occasions, I would advise a detailed workup to rule out any genetic disorders in the child." "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 sex with me before ten days. During that time, my condom was out and went inside of her without our knowledge. I did an ejaculation, and so she took one I-Pill on the evening. Now, we are worried about unwanted pregnancy. She says that her breasts have become big and her nipples are giving pain. Is this a symptom of pregnancy? Will that one I-Pill works? Can she take one more I-Pill now? Please advise us. ### Response: If she has taken I-pill (Levonorgestrel) in a proper dose within 48 to 72 hours of unprotected sex, without any vomiting, then it will work, and she will have bleeding within one to two weeks. Please mention about the menstrual history. It would be better, and I can guide you further. If it was not a fertile period of her cycle, then the chance to have pregnancy is less. Due to externally induced hormones, she can have engorged breast. Externally induced hormone interferes with the periods to prevent conception by stopping fertilization, ovulation or implantation. I-pill is beneficial in the first 48 to 72 hours of post unprotected penetrative sex. It is already a week. She will have bleeding in the coming days if the I-pill is taken in a proper dose." "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 26 year old male. My problem is exhibitionism. I try to flash my penis to women. I know it is a bad habit. But I am not able to stop it. Please help me stop this bad behavior. ### Response: Hi. It is good that you have taken the very first step required for resolution of your problem and you accomplished that by seeking help. This is not recognized as a problem by a major part of the population due to ignorance or other reasons best known to them. There are various methods of treatment available for exhibitionism:" "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 pregnant with my first child and I am 39 weeks and 3 days. I have been having mild contractions all day. For the past hour, they have been really intense and I have felt a lot of pressure. The midwife has told me not to come in as my contractions are still two minutes apart. I have just felt down below and I am slowly crowning. I am in agony and the midwife is determined that I do not need to go in yet. Shall I just go in? ### Response: Do not worry. This is not crowning, this is the last phase of the second stage of labor when the head of the baby is on your perineum. The rate of contractions will occur once in 2 to 3 minutes and will last for around 30 to 45 seconds. I would advise you to go in, as you have already reached the date, pain has been there for all day (that is quite a lot of time) and you feel they are increasing, along with the pressure feel. Suppose you break out waters, the pain will be even more intense and you will not be able to move out easily. It is always advisable for you to be around the midwife when you are entering the active phase of labor. Just feel for the rate and duration of the uterine contraction and also for the severity of contraction. If it is getting closer and lasting longer, you better not wait." "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 vision-related tinnitus. I have been nearsighted for a while. Approximately, three months ago, I went to see a speaker, sat in the back and ended up looking at him out-of-focus for an hour. The next day, my ears started ringing. Looking at my computer tends to make it louder. I have special blue light blocking computer glasses. I got polarized yellow clip to use at night, in addition to three screens over my computer as well as a couple programs to warm the screen\s color temperature. But, I am still experiencing elevated ringing. My audiology test revealed a slight hearing loss in left ear, but nothing that would have brought on sudden tinnitus. I am currently on Nortriptyline to aid sleep. I have an appointment to see an ophthalmologist. I am searching for any immediate help possible. Do you like to give any suggestions for a particular polarized shade for to clip on or use over my prescription specs? ### Response: Hello. From what you have described, you have tinnitus that gets exacerbated on looking at the computer screen. There is no established connection between looking at a bright object and worsening of tinnitus, though there may be isolated reports. Tinnitus is usually caused due to an inner ear problem. In my opinion, you should seek an ENT consultation instead of an eye checkup as your main problem is tinnitus. An ENT consultation will help you find out the real cause for your tinnitus." "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 realizing that I am an extremely sensitive person. I fear socializing with people. I think too much about what people think about me. There is a lot of fear within me. When people scold me, I take it too deeply and even my mouth vibrates. It is conspicuously visible. I have a lot of social fear mixing with people. While greeting people in my sister\s engagement ceremony, while smiling at a woman, all of a sudden mouth started to vibrate in fear. Overall, I am extremely sensitive to what people think about me. I feel depressed because of my embarrassment in front of them. I am sensitive even to sound and noise. Because of this, I find it difficult to go around and play or work in a group. If someone asks me something I fear before answering. I want to be calm and tough enough to face the society. Is there any effective medication? I am a law graduate as well. This problem is affecting my career and relationship. I am too shy and absent-minded. My first and final query is what is the disorder I am having? Please explain my disorder. ### Response: Hello. What you have is social phobia, anxiety and mostly is a result of a hard or strict education in childhood. Here are some ways you can build your confidence in life in general and help you rid yourself of social anxiety: Anything else? Feel free to ask me again. Have a good 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 experiencing itching of the scrotum, below the scrotum area as well as in the tip of the foreskin. There is a dry and inflamed area on the right scrotum area. There is inflammation of the tip of fore skin. There is inflammation of the area below the scrotum. I am experiencing itching of the scrotum from the past two weeks. Please recommend an anti-fungal spray. ### Response: Continue it for 30 days even if there is an improvement. Consult your specialist doctor, discuss with him or her and start using the medicines with their consent. This will help 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 son, who is 26 years old, now has been diagnosed with ADHD when he was 5 years old. He went to various psychiatrist to make sure that he is actually ADHD. Six doctors confirmed that he has ADHD and two doctors said he has bipolar disorder. He says that he was given Xanax as a treatment for the anxiety caused by ADHD and bipolar. He takes 10 tablets of 1 mg Xanax a day and sometimes, 11 to 12 tablets a day. Occasionally, when he takes less tablets, he smokes weed. He says that the combination of 5 to 8 tablets of Xanax with weed is equal to 10 tablets of 1 mg Xanax a day. He also takes tablet 300 mg Seroquel at night to help him sleep. My questions are is Xanax considered a medication for ADHD or bipolar? Is it advised to take 10 to 12 tablets of 1 mg Xanax a day? Is it fine to mix Xanax with weed? What is the appropriate medication for ADHD and bipolar? If xanax is appropriate for ADHD and bipolar, then how much is the appropriate dosage? Does he need to go to rehabilitation to clean his body of the high amount of Xanax and weed? Is it compulsory to continue a low dose of Xanax lifelong? ### Response: Attention deficit hyperactivity disorder also called as ADHD is a problem with hyperactivity and decrease attention. Bipolar disorder is the disorder in which increase talk, tall claims, decrease need for sleep and high energy are the most common symptoms. Xanax (Alprazolam) is a benzodiazepine. It can be given in low dose for the acute phase of bipolar. Also, it is not advisable to take around 10 tablets a day. Both, weed abuse and Xanax abuse are very bad for health." "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: Hello,I am a 52 year old female with a 2 mm acoustic neuroma on the right side. There is no hearing loss, but I do have dizziness, imbalance, pulsatile tinnitus. Also, an essential tremor developed seven years ago. I get migraines with aura occasionally. Ten months ago, I developed a coccyx pain which got worse upon sitting. My colonoscopy was clear. Three months ago, I developed bilateral diplopia, lateral and horizontal, but no nystagmus. I have also been getting headaches upon waking and in the evening. I consulted a neuro-ophthalmologist who suspected cranial nerve palsy and ordered blood and MRI tests. I will go over the results with him at the next appointment. I want to be sure to ask the right questions. There are two areas that I saw on the MRI that are obviously strange: The left lateral ventricle has a bright spot and looks larger with a different imaging, not at the foramen of Monro, but above. Also, the right clivus looks off. I would like your opinion and also want to know specifically what questions I should ask my neuro. I will submit a few of the scans. ### Response: Hello. I read your query and understand your concerns. You need to ask your neuro-ophthalmologist the following questions: I hope this helps you. If you have more questions feel free to write 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 baby is 4 weeks old. I fed her a combination of breast milk and formula milk. I changed her formula to enfalac from friscolac slowly, and started solely on enfalac yesterday afternoon. I changed the milk (upon consulting with the pediatric clinic) because she was having constipation and gassy stomach. My baby had watery stool once yesterday and today (only after being completely on enfalac). She also is quite gassy (most days than not) and gets upset with it (cries last about 10 minutes). My worry is that if she is okay and, does the enfalac formula milk agree with her or she struggling with something else. I had to add formula milk due to insufficient supply of breast milk. ### Response: Breast milk is definitely best and first choice but as it is insufficient and you need to supplement with formula feeds, all these formula milk are cow\s milk. It is not clear from your query- which Enfalac formula you are giving as there are so many different types and also in the powder form and in ready to feed one. Watch it with the same formula milk for next 24 hours, feed more on breast feeding, and keep a watch on urine output. It may settle down slowly. If not then get, stool test - routine analysis, give Pedialyte - 15- 20 ml after each loose motion (give as small small sips), and better to give a milk formula which is HA (hypoallergic) like Similac or Nan or any other." "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 58 years old and currently working in a meat shop, working always in frozen foods. My problem now is about my hands (fingers). It is numb and painful. I always feel this everyday and wake up with numb and pain. Any medicine or vitamins aside from Vitamin B1, B6, B12? ### Response: Hi. Long time keeping hand in freeze or ice cold things, your blood vessels constrict to avoid heat to escape from the body. Continuously blood vessels constriction will not allow blood to reach to the hand tissues and nerves. So, numbness and pain comes. If you are diabetic or hypertensive, condition will be worse. So, in between your work just rinse your hand and fingers in warm water, not very hot. Use thick rubber gloves to avoid direct cold to your hand." "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 33-year-old woman. I am pregnant with my first baby in my 12 weeks. I had an appointment with my doctor two days ago, and she did an ultrasound to me, and she told me that th NT measure of the back neck of my fetus is 2.3 mm. She asked me to do a blood test called prenatest to be sure of that. Please advice what should I do? I am attaching the ultrasound report. ### Response: When NT (nuchal translucency) is towards higher value than a baby is more likely having a problem. Now there are two prenatal tests which can be done at 12 weeks. Most commonly done is a double marker test. And if high risk than how much is the risk, statistically like 1:148, which means there is a chance of one pregnancy to come positive for downs in every 148 pregnancy. So for further confirmation have to send liquid around a baby for examination. In that, we remove fluid under sonography guidance and send it for examination. They segregate fetal cells from it and do a DNA test for confirmation. But this test is directly invasive and also have some possibilities of side effects, so we avoid on the first basis. Because if it comes as low risk in double marker than no need to send liquid around the baby. So consult with your gynecologist and have detail about which test is carried and possible results." "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 repeated rash behind my ear. I am pretty poor. So, doctors are not easy to come by. It just pops up sometimes. ### Response: Hello. I saw the picture (attachment removed to protect patient identity). You have erythematous (red) papules (bumps) behind the ear. I can list a few possibilities: I would like to know: 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: My sugar level is 210 after breakfast. Is it normal or high? Can I control sugar level? ### Response: Hi. The sugar level 210 after eating food cannot be considered normal. It is suggestive of diabetes mellitus. However, you should repeat your serum fasting blood sugar estimation, serum post-prandial blood sugar estimation, and HbA1c estimation to confirm diabetes. In this early stage, you can control diabetes with weight reduction, less fatty foods, and regular exercise." "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 intercourse (he did not ejaculate) and took an i-pill the next day. I am suffering from PCOD and by doctor\s prescription, I took Meprate for seven days twice daily. But still no sign of periods. What can be the causes? Also, after taking the i-pill there is no withdrawal bleeding.My last period was before two months and it is causing stress and I am overthinking. Please help. ### Response: Do not worry, you have nothing to worry about. As you have PCOD (polycystic ovarian disease) your ovulation will not be on time. As you mentioned that he did not ejaculate and you took i-pill within 24 hours, chances of pregnancy are very low. Usually, you can wait up to 10 days after stopping. Because you had I-pill and Meprate your period would have got postponed. So I would advise you to wait for periods till 10 days after the last day of Meprate. If still no periods, just for confirmation get urine pregnancy tested. I bet it will be negative. Then take any of the oral contraceptive pills like Novelone, or Ovrel G, or Dear 21 or Diane 35 or Intimacy plus 3 twice a day for 10 days, throw that extra last tab. You will surely get periods within the next 10 days. If you get periods in between just stop the pills. In PCOD the inner lining of the uterus may not be thick enough, so your periods will be light sometimes with pink discharge only, so no 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 have a habit of overthinking simple things, and I make them complicated. I always waste my time and energy on deducing the multiple outcomes of a simple thing, which others may not even think about it. I make things complicated, and I repeatedly contradict my own words. I feel guilty. I do not want to waste my energy on this act. Please help. ### Response: Hi. Sometimes we do not have control over our thoughts. The train of our thoughts goes running continuously, and sometimes it reaches a destination which is so different than the actual goal." "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 cracked tooth. It hurts me a lot for a week. Now, I can eat only on one side of the mouth. What can I do to get relief? ### Response: Please say about the location of the cracked tooth. Please mention whether it is present in the front tooth or back tooth. If there is a pain, you can take Amoxycillin two tablets one at morning and night. You can also take Aceclopara (Aceclofenac with Paracetamol) for the pain along with it. You can take tablet Rantac before breakfast and dinner. If the crack is present in a front tooth or back tooth, consider going to the dentist to examine the condition. If it is present in a front tooth, you can treat it by bonding and root canal treatment can also be done. A crown can be placed over it for esthetic purpose. You can go for an implant also. If it is present in a back tooth, you can do a root canal treatment, and it can be managed by placing a crown over it. If the crack is too difficult to be handled by root canal treatment, then it can be extracted." "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 relating to my deceased father. I obtained his medical records after his death. While searching through his records to gain a better understanding of what may happen to me, I found he was positive for the rheumatoid factor and had been diagnosed with ankylosing spondylitis. However, the HLA-B27 gene test was negative. I brought this to my rheumatologist and she told me she thought he had something else, but would not elaborate. Does anyone have an idea of what she may thought because she still has not told me? Since then I have switched rheumatologists for that reason. My father passed away from leukemia brought on by myelodysplasia. I would like to know because doctors still have no idea what may be plaguing me. I have seen multiple doctors for my slightly high CK levels. I have been tested for myelodysplasia, rheumatoid arthritis, multiple muscle diseases, sarcoidosis, and many more. I have not received any answers as of yet. ### Response: Hello. Well, I do not think you should be worried about anything. Firstly rheumatoid factor is not transmitted genetically unlike HLA- B27 (human leucocyte antigen). Secondly, it can be positive in a lot of people but does not cause any symptoms. Thirdly, you have been tested so far and it has all been negative. Leukemia does carry a family history but you can get your blood checked every six months. One thing you need to understand is, there are no medications as such which can you take which can prevent autoimmune diseases. If it has to happen, it would or else not. But yes, stress would definitely make things worse. So I would suggest just take it easy since you have had negative tests and enjoy your life. Keep a regular health check. Eat healthily and exercise regularly. You have not got any answers since you are healthy. 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 woke up this morning with this dried up blood in between my upper front teeth and blood comes out when I touch it. It does not hurt, and when I brush my teeth, I can see it move. I have not noticed any changes in my gums or teeth. My gums usually bleed when the bristles of my toothbrush scrape against them. I am going to make an appointment with a dentist. But, I am a little freaked out about this as I am only 20. When I ate something earlier, it inflated a little bit, popped and bled without any pain. ### Response: I have viewed the images attached (attachment removed to protect patient identity). Periodontitis. Deep gum infection. Use a soft toothbrush to brush your 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: I want to discuss a sexual problem. I do not feel the desire to have sex. Although I try to have sex and also get an erection, I am unable to ejaculate. After some time, the erection just goes away without any ejaculation. I like to do foreplay but never really interested in sex as long as I can remember. I have never masturbated even. I got my testosterone tested and it was 241. I also have psychiatric issues for some time. Could the sexual and psychiatric problem be linked? What is the problem that I am exactly having? Is it treatable? ### Response: Your problem is treatable. It is called anejaculation. If you are taking any psychiatric medicine then your problem may be due to that. Psychiatric and sexual problems are mostly related. If you ejaculate in sleep then your problem is likely a psychological one" "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 chipped my front tooth two days ago. I saved the broken tooth piece in a cup of milk in the refrigerator. The piece is fairly small (bottom corner chipped off). What are my options to get my tooth fixed? It does not hurt but it is a little sharp to the touch. ### Response: Hi. That is good that you saved the part of the tooth. But actually little chipped off part of the tooth cannot be reattached to the tooth by any means. But if whole tooth and its root somehow got knocked out of socket while you fell down or so and that tooth is kept immediately under your saliva or milk and then re-implanted at the same place within one hour then this tooth definitely gets saved. But, unfortunately, its broken part is hard to re-attach. You should get filling of it done as soon as possible and get sharp edges trimmed else it will hurt your tongue or lips. Stay happy and blessed." "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 28-year-old with 60 kg, and 1.79 cm. My problem started as red skin on my glans, and the dermatologist told me to use Cortisone cream for two weeks, after that, my penis as had an inflammation, because I used Cortisone cream on my glans. (Now the inflammation is finished) but my glans is white, and my glans circle is purple and thickened, what can I do? ### Response: I checked your image (attachment removed to protect patient identity) if you have itching need to think of fungal infection. If no itching it can be PPP (pearly penile papules). Please share a clear image as it is blurred. 1. Do you have pain? 2. Did you have recent unprotected sex? 3. Do you feel any odor?" "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 tremors on my left hand. I am on Amantrel 100 mg tds, Frisium 30 mg and Propranolol 40 mg. I have been through two stents in my heart, but I have no myocardial infarction. I am on beta blockers Valent 40mg od and Retorlix 5 mg od. My neurologist says this as Rubral syndrome and my very senior physician said this is more likely to be muscle weakness because through a strict regime I have come down to 99 kg from 140 kg in the past 19 months. I would like to slowly discontinue Frisium because it makes me drowsy. My question is, should I taper one medicine after another just to see what works best? The physician told me to stop all medication completely which I do not think as a great idea. Can you please help? ### Response: I understand your concerns. Let me try to help you. Rubral Tremors (Slow tremors at rest). 1. Parkinson\s disease2. Parkinson-plus disorders (group of neurodegenerative disorders) Parkinson\s disease. Continue tablet Amantrel (Amantadine). Do daily morning and evening 45 minutes of walk. Revert back after two weeks to 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 32-year-old brother has acne problem on the face and upper back since the last 15 years. He does not smoke or drink. ### Response: Hello. From your description, he is suffering from acne vulgaris. As it is spreading to the upper back, it is problematic." "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 depression. I am having feelings of mild depression, but I do not know if I am actually depressed, but here is a bit of my life since I was a boy. I lost my mother when I was very young and did not have any memories of her. I grew up with my dad and my siblings, but I have always felt different, alone, cursed, and forgotten as nothing seems to work for me. Never felt loved, my dad was addicted to alcohol and, and most of my family members abandoned me till date.I struggled with the feelings of worthlessness daily as I grew up. I have little or no friends as I grew up, I had a lot of suicidal thoughts. My self-esteem was too low, had a dislike for myself, not able to express myself. I am short-tempered and a little caring same time. When I was 20, my feelings got worst, and I cried every day at night. I have extreme mood swings because when I am around people, it seems I am happy, but when I leave, I return to my hole. Kindly help. ### Response: You have described facing several adverse childhood experiences like losing your mother, and indifferent father addicted to alcohol and lack of loving support while growing up. These adverse life events could have potentially affected your feelings like, making you feel low, affect your self-esteem, and cause suicidal thoughts. Anyone in your situation would have probably felt the same. It is good to know that you had some support from a friend before. It is important not to isolate yourself when you are feeling like this. Try to meet supportive people regularly. If you are in education or doing a job, try to speak to a senior person and see whether they can be a mentor to support and guide you. If you are spiritual, try visiting holy places regularly if you find it helpful. You have said that you feel happy when you are around the people and low again when lonely, this is understandable. People feel better in practical social situations. You will also benefit by consulting a doctor who can do a full assessment of the nature and severity of your symptoms, and it will clarify whether you have clinical depression. Try to speak to your friend and family and make sure you get help. You may need some counseling support or therapy to help you move forward in life. Equally important is self-help measures like eating healthily, sleeping well, exercise regularly, keeping yourself gainfully occupied, and having positive social relationships." "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 suffering from depression and anxiety since 10 years. I went to a psychiatrist and he prescribed too many medicines, which made matters worse. My family doctor has put me on Mirtaz 7.5 and due to severe problems of falling asleep I am on Zolfresh 10. My depression is a little better as it has been 15 days, but still I am not being able to fall asleep. We have tried having the medicine earlier in the night so I sleep on time, but it does not help. I face erections problems too. Kindly suggest a medicine that works well with Mirtaz for falling asleep. ### Response: Hi. Serum TSH (thyroid-stimulating hormone) and hemogram. Depression with insomnia. Mirtazapine and Zolpidem 10 mg with careful instructions. Sleep hygiene. Revert back after a week to a psychiatrist 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 sex with a sex worker. I used a condom but I am still worried that I may get HIV or any STD. I did not see condom after intercourse whether it tore or not but I think the head of the penis was covered well. Am I safe? What are my chances of getting HIV? ### Response: As you have had protected sex, no chance of HIV, STD, or HSV may be there. If any symptoms appear then think about the test. At present, no need for ELISA (enzyme-linked immunosorbent assay) in 7 to 10 days. or RNA PCR on the 15th day or fourth generation CMIA kit test for HIV on 28th day. You can get any one test done. The last one is the best." "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 28 year old male and a regular smoker. I do smoke 10-15 cigarettes a day and have been smoking like this for almost 10 years now. When I started, I used different brands, from ultra mild to regular bidis. But now, for almost 3 years I am stuck with regular gold flake.Now, I am desperate about quitting smoking. I tried not to smoke for a day. But the next day, I would return back to the same. Recently, I came to know about a chewing gum called nicotex. It comes in 2 mg and 4 mg form. But I am not sure about this product.So my question is, does cipla nicotex chewing gum help in quitting smoking? Also to buy this chewing gum, do I need a doctor\s prescription? ### Response: This may include: These Nicotex chewing gums have nicotine in them in varying concentrations which allow a sustained but minimal release of nicotine while chewing. This nicotine is absorbed through buccal mucosa thus not allowing the 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 recently had two spinal surgeries for cauda equina syndrome. I was told that the second surgery was required due to a dural tear. However, on reading my clinical notes, I now question this. I have the operation notes, which I can send (about a paragraph each) if you have a spinal surgeon who can decode them for me. ### Response: I have gone through your query with diligence and would like you to know that I am here to help you. Can you please elaborate what your question is?" "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 using Minoxidil for nine months now for the bald patches on my head. A little progress was seen between 3 to 4 months but no progress recorded afterwards. Can you suggest me what is wrong or if I should change my prescription? ### Response: 1. Sometimes there can be shedding of hair in between but you will recover from it if you keep using it. So stick to it. 2. You can also add tablet Finasteride 1 mg daily which is the only approved oral medications for an" "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 molar pain for the past two weeks and then decided to see a doctor. One of my molars decayed and I needed a root canal. But here is a thing, my tooth is very very short for a crown, it is between 1 and 2 mm in height. Is it fine to just put a post and then refill the tooth? How essential is the crown? ### Response: Hi. If your root canal is being in process and the crown length is very low, it is best to have post and core done on it after a final step of the root canal. This will strengthen your tooth and it will last long for like 10 years or more. If you do not get the post and core buildup on it and will go for a cap on such small crown portion the cap will be taken out in your chewing process more often and there will be a chance of breakage of tooth also that is saved through root canal treatment. So, I will advise you to get the post done. And one kind advice is that wait at least a week before your cap is placed so that you may rule out any pain or sensitivity issues of tooth in this time period, as once cap is placed and then you start feeling some sensitivity in the root canal or any symptoms of pain then cap removal will be difficult procedure. So, do not rush for the cap. Get post and core buildup done. Finish antibiotics, then take some time without medicines to see if all is fine. Then after a week or two get cap done. Stay happy and blessed." "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 back upper tooth is feeling strange. But it does not hurt. I have checked to the dentist and doing some scan. But everything fine, what could cause this issue? Is it fine? ### Response: Hello. If x-ray also has nothing, it means there is no cavity. So the probable causes for your problem are, 1. Food impaction between teeth, which will cause such feelings for three-four days and will go away on its own. Use warm salt water for rinsing a few times a day for three days. 2. Sometimes sinusitis, i.e. infection or running nose, may cause discomfort of upper posterior teeth. For it, you should show it to a physician. If you feel there is specific pain which is increasing then show to one more dentist as the previous dentist might have left some finding. If you can, send the x-ray so that I can examine too. Use saltwater and a painkiller for three days and wait if it goes away." "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 psoriasis for the past 24 years. I have tried a lot of ointments already. I heard one of the reasons is lack of vitamin D. Is it true? I am 54 years old now. ### Response: Hi. Psoriasis is a T-cell mediated autoimmune disorder. These reduce the excessive cell proliferation and differentiation seen in the skin cells of a psoriasis patient. A few of these" "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 listless and tired when I return home in the evening. So much that I cannot exercise on the treadmill. I was on antipsychotics for 30 years which surely caused muscle stiffness and tardive dyskinesia. That could be one reason for the tiredness. Treatment for the above side-effects is now available and I will be starting it next week. Otherwise, it could be fatigue or something which I am asking you to pinpoint. Can you tell me what you suspect to be the cause? And what protocol we follow to resolve it? ### Response: The causes of fatigue are many including long-term antipsychotic medicines. Other causes include anemia due to iron and B12 deficiency, thyroid diseases, cardiac failure, diabetes, sleep disorders, and medications to name a few. You have not mentioned about your current medications as well as daily activities, your food habits, eating and sleeping habits exercise pattern. There is no mention about your stress level at work and at home. I would like to know the results of all tests done recently as well as the medication list you are currently taking. Do you do meditation, yoga, etc., to reduce stress? Nothing is also mentioned about your family history also. So, please provide all the details and I would suggest how to fix your tiredness. Please revert to me with the details I have asked for. Hope this was useful" "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 to pop my sacrum every day for my hips to feel good. I do this by putting a pillow in between my legs and squeezing my glutes as hard as I can. My question is why does the sacrum not stay in place? What can I do to make it stay in place? ### Response: I read your query. There are many reasons for sacrum not getting in its position. Mainly posture as faulty posture while sitting, standing, even lying can lead to malalignment of sacrifice iliac joint. Again faulty or improper firing of gluteus and piriformis muscles and pelvic floor muscles can lead to this issue. You have to maintain posture and lying on a proper surface (I mean lying on a bed that does not sag and properly supporting the body) and maintaining glute, piriformis, and pelvic floor muscles strength will help you achieve a good stable SI (sacroiliac) joint" "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 lower back pain since the last one year. I got an MRI done and it is attached below. I saw a radiologist and he did not advise me much. I have a sitting job. Will running be beneficial in this situation? Do I need to take analgesics? I cannot sleep at night because of the numbness I get in my feet, and if I do sleep, sometimes I wake up because of it. ### Response: I read your query and understand your concerns about an ongoing lower back ache. I have seen the reports that you had attached (attachment removed to protect patient identity). I hope this helps you. Feel free to write back to me if you have more questions" "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 underwent myomectomy surgery five months back for fibroid removal. I am planning for pregnancy now. Recently I did a follicular scan on the tenth day of my period and report showed that I have echogenic endometrium. What does it mean by echogenic endometrium? Does it mean my uterus is not healed completely and still have scars? Endometrium thickness is 8.2 mm. Kindly help me understand this. ### Response: It would be better if you can share black images of ultrasound. It looks like a cyst in one of the ovaries (attachment removed to protect patient identity)" "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 have had a long-term chest pain. It has been there for years, sometimes it is worse sometimes it is not. I am pretty scared of it when I think about it. I can feel the pain when I press against my upper left side of the chest (breast area). I cannot exactly pinpoint where the pain comes from but it is the upper left side of the chest where my nipple is. It has been like this for about two or more years. I cannot say it has gotten worse, it has stayed the same, just on and off in pain\s intensity, but always there, uncomfortable. Please note that my work has me in the seated position in front of my computer all the time. I do not know if it is the posture or something. I have not gotten it checked, my family has always been in a bad financial situation. So, I never bothered with it. ### Response: Hello. About your query, I need to determine what type of chest pain it could be. I advise you to do chest X-ray and ECG" "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 gap in front teeth may be it is diastema. Teeth are not fully separated apart starting from gum line like typical diastema. They have only slight gap below the gum line, may be less than an mm. I want to know:Whether this gap between the teeth require any kind of treatment other than for cosmetic purpose?In future, does this gap harm or shift adjacent teeth? I mean does this gap affect the functionality of front teeth as well as adjacent teeth?What areits causes and is there any exercise to close this gap like pressing the teeth together for 10 to 15 seconds. If I do that exercise, does it affect the functionality of teeth in a negativeway?In short, I want to ask whether one needs treatment for diastema if it is not showing any symptom or not affecting day to day life. I recently went for a regular dental checkup and the doctor told everything is fine no gum or any other disease. To the best of my knowledge, I do not have any tongue thrusting habit at present or thumb sucking habit in childhood. I am attaching the X-ray of the front teeth as well the real image of my front teeth. ### Response: The treatment is required for an esthetic purpose only. Radiographs look fine (attachment removed to protect patient identity) to me. Along the years, the gap might increase due to a shift of the two teeth leading to an increase in the gap. There is no exercise to close the gap. Please do not press the teeth to close the gap. If you are worried about your looks, then go for veneer, ceramic crown, or orthodontic braces. If you are fine with it, then you do not require any treatment. Just relax" "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: Why do I have fungus on the nail beds of my hands and feet? ### Response: Nail bed fungal infection could be due to either continuous exposure to water or immune deficiency. Immune-deficient conditions should be excluded. Please send me a photo of your nails in order to classify how severe it is" "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 PCOS. I had my period a month back. My periods are mostly irregular and I usually have cramps in stomach and my breasts hurt before periods not every time though. I had oral sex with my fiance yesterday, he was wearing a condom throughout but he rubbed his genitals on my vagina. I took an I-pill and Regestrone just to be safe after three to four hours. But today my breasts are hurting and I am having cramps. My vagina is also dry. Is there any chance that I am pregnant? ### Response: Hi. Since you have taken the emergency pill within 72 hours of intercourse, there is no chance of pregnancy. These symptoms could be because of hormonal changes due to the pill you have taken. So relax and do not worry. However, if you have a doubt then get 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: I am 21 years old and had ACL surgery six months ago in my left knee but I am not able to exercise for the previous two months. What will be the consequences? ### Response: Hi. Usually, it takes 1 to 2 months for recovery from surgery and 3 to 4 months for muscles to regain their usual strength after ACL surgery. Since you cannot exercise it means that your muscles have not reached their optimal strength till now. Arthrofibrosis is a common complication after such surgery that can prevent you from exercising. But to know the exact cause, I would suggest you have MRI or bone scan of the knee joint to know the exact cause. Also, I would advise you to have physiotherapy sessions." "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 is 15 weeks and five days pregnant. Recently, she had an episode of a moderate amount of bleeding per vaginam. We immediately shifted her to the hospital where she was given some conservative treatment, and a USG was done. It was found that the inferior margin of the placenta was covering the internal os. The baby was healthy as per the reports. I am anxious. Kindly advise. ### Response: Hello. However, if you have a doubt, then get back to me with the reports so that I can 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: My 10-week old projectile spits up after every nursing session. He is scheduled to have an ultrasound of upper GI one week from now to see if he has pyloric stenosis. Last night he was up until 7 AM screaming in pain. He is hungry all the time and I feel like I am doing more harm than good by feeding him all the time. At his two months check-up, he had gained weight, he was 11 lb 7 oz. He has very good urine output and I do not think he is dehydrated. He only has 1 or 2 bowel movements a week. Every day he seems worse even with Zantac three times a day. I do not know what to do for him while we have to wait a whole week to have his tests done. Is there any way I can help him? Should I take him to the emergency room? ### Response: Hi. I understand your misery. However, I feel the line of management chosen is appropriate. If you could arrange for getting a USG abdomen done earlier it would be good. An X-ray of the erect abdomen can also be done to get an approximate judgment about the same. Another study that may need to be done would be a reflux study (since you have mentioned Zantac is no good). Signs you need to take him to the emergency room include lethargy, abdominal distension, not passing stools for three days or more with recurrent episodes of vomiting. Beyond this, I do not think there is anything that can be done given the current scenario." "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 cannot sleep at my usual timings. I took half Bromazepam tablets of 3 mg. Tell me how much time would I sleep now? ### Response: As far as sleep hygiene is concerned, stress should be avoided through medication and behavioral counselling so that you can get proper sleep. Yoga, meditation, and exercise are beneficial in reducing stress. To induce timely sleep: Hope this will help 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 51 years old and have been diagnosed with an enlarged liver showing fatty changes grade-3. Is it life threatening? ### Response: Fatty liver change is a progressive condition that leads to liver cirrhosis after years if not managed properly. Risk factors include obesity, high cholesterol, and alcohol. Please provide me with your alcohol intake history and your lipid profile and liver function tests. I suggest: If you have any questions, please do not hesitate to ask" "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: Firstly, I would like to inform that I had got married eight years back. For the past eight years, my sexual life was going fine. Recently within a few days due to workload and pressure, I am losing my sex interest and I am just 31 years old. I have a kid of 5 years old. And during intercourse, my sperms come off very soon (premature ejaculation). Please help me on this and suggest me some good medicine for the same. ### Response: As you may be aware, stress in most forms will affect sex. But since it is only temporary and will vanish once the stress is alleviated (or you learn to manage it), your sexual performance will also return to normalcy" "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 four and a half years old, and he is suffering from reactive airway disease (enclosing the reports and prescription). Kindly suggest based on the above medication that till how long we can safely go ahead with Montair LC Kid. Is there any upper limit of giving this. I am very skeptical about continuing it in the long run. He is completely fine with this medicine, but if I skip a single dose, he starts coughing just anyways and ends up vomiting everything he had. So I keep on giving him a daily dose of MLC kid. Also, he is a bit aggressive and impatient. I do not know whether these are the emotional changes associated with this medicine. Please tell me that is he losing his natural immunity due to this. ### Response: Hello. Please note that the medications prescribed are to the best of my knowledge. Montelukast has been prescribed for patients for prolonged periods extending up to even two years without any problems. It uses has shown reduced requirements of admission and improving the quality of life in patients suffering from hyperreactive airway disease. However, it would be good if we can omit the LC (Levocetirizine) content by just giving Montelukast alone in the form of tablet Montair 4 mg daily at 8 pm instead of Montair LC syrup (Levocetirizine, Montelukast)." "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 diabetic. Does chewing nicotine gum will increase sugar level? Does stress in the heart increase the sugar level? ### Response: Hello. I went through your post. Nicotine chewing gum causes dental issues and sometimes hair loss and flushing. However, it does not increase blood sugar. So, you can take that it is 1000 times better to take nicotine chewing gum than cigarette especially once you have diabetes." "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 having some issues with my throat from the past couple of months. I feel a tightness in the neck. I do not have a runny nose, but I have post-nasal drip and lots of phlegm or mucus in the mornings. I feel like I need to clear my throat a lot. The symptoms seemed to go away for a week or so, but now they are back. There seems to be a bloody spot near the back of my throat, and I have attached a picture of the same. ### Response: I have seen the picture (attachment removed to protect patient identity). Do revert back to me if you require any further support. Hope to see you in good health soon." "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 regular headaches and I have done a consultation with a doctor and he advised for MRI. Please check my reports and let me know the reports. Is there any critical issue? ### Response: Hi. Your MRI is grossly normal with some evidence of ethmoid and frontal sinus mucosal thickening suggestive of frontal and ethmoidal sinusitis. These can cause your symptoms of a headache and are probably due to chronic allergic rhinosinusitis. Furthermore, you might also have a migraine as you have been put on Sebilium. You can continue Cetirizine and use FluMist nasal spray (live attenuated influenza vaccine) in case you have a nasal blockage." "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 use Melacare cream for the past four years. Now I want to stop using it. But when I try to stop, it produces irritation and turns my skin into very black. Can I use Keto soap to recover my skin? ### Response: Hello. 1. Your condition is known as topical steroid dependent face (TSDF). 2. Melacare has steroids and it is not advised to use it for more than six weeks and you are using it for the past four years. 3. Use the medicines I am prescribing. 4. No, Keto soap does not have any benefit in this condition. TSDF. 1. Tacvido Forte 0.1 cream once at night.2. Metrogyl 2 % cream once in the morning.3. Suncros lotion all over face before going in the sun.4. Tablet Allegra 180 mg once at night.For one month." "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 question is regarding WPW syndrome. I suffer from WPW syndrome, I just came to know about it. I am a mining engineer and work for a mining company, my day to day work involves blasting and exposure to heat, dust, and low oxygen environment. The blasts are severe, the peak particle velocity (a measure of vibration in rock after blast) is around 150 mm/sec. Can this working environment be harmful to me as it may increase my chances of ill health happening due to WPW syndrome? ### Response: However, some patients could collapse and have a brief loss of consciousness with WPW episode. It is recommended that those patient work in as safe as possible environment like avoiding the situation that requires being on ladders, and it is better in your condition to avoid areas with low oxygen and where ambulance and emergency help might be difficult to get to. The risk of WPW is if the patient develops atrial fibrillation that could end up with fatal VF. Have you thought about WPW ablation?" "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 18 years old. Nowadays I observe that I am losing my hair on the head and getting ball head. Is there any precaution to be followed? Kindly help. ### Response: 1. 2. For routine, you should wash your scalp daily. 3. Do not apply hair oil as it can increase dan" "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 is feeling pain inside her right ear. According to her, she feels the pain more when she lies on the bed or recline her head for any purpose. The intensity of the pain is also showing up around her ear too. It is her feeling that there is something inside the ear, which may be water or something like that. All these have started the day before yesterday. Please help. She used Paracetamol for the same. ### Response: Hello. Your problem could be due to an infection inside the ear or secondary to nose and throat problem. I would like to know if she has any nose block, excessive sneezing, or throat irritation? Any ringing sensation in the ear or giddiness? Any discharge from the ear, if yes, for how long? Any relief after taking Paracetamol? Please get back to me with the reply." "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 month, a doctor with HIV gave an injection in my vein without using gloves. She did not use any cotton, she just put her finger to stop the bleeding. She also rubbed my vein with her hands when it was still bleeding. Am I at risk?I did HIV DNA PCR after 9 days, and after one month fourth generation ELISA test. One of the doctor told me that the window period is 90-180 days. What test should be done after six months? ### Response: Let me answer your query step by step. There was no risk of HIV involved by the injection given by HIV infected doctor surgeon. Even if she touched with her finger at the bleeding site with the naked hand, you were not at risk. HIV cannot be transmitted by touching HIV infected person. Your risk was unwarranted in the scenario you mentioned. The test which you took, was highly sensitive and specific and gives accurate results. Window period is the time taken for antibodies to develop after infection and then to be detected by a particular test. 99.9% of the people who are infected with HIV develop HIV antibodies by three months. It is good that you know your HIV status now, you do not require any further test. 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: A 39 year old female patient is suffering from acute lymphoblastic leukemia. She is currently being treated at a hospital by an oncologist. I am attaching her reports. Please suggest a treatment. ### Response: Hello. I am sorry to hear about the patient\s condition. I have gone through the reports (attachment removed to protect patient identity)" "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: For the past three days, I ate something solid and it hurt my front teeth and since that day they are hurting and moving. What should I do? I do not wanna lose them. If I go to the dentist, what will he do? ### Response: Hi. I have gone through your question. I can understand your concern. The loosing of your teeth can be because of biting on hard object or fruit. You need to restrict yourself from eating things that may loosen them more. If the loosing happen on its own it can be because of bone loss. Mostly the bone loss may be due to deep bite (malocclusion), that may need orthodontic treatment (braces). If you can upload some pictures of your teeth in open as well as in closed position I will provide you with the better treatment options available for the dentist. Deep bite or overbite, trauma. IOPAR (intraoral periapical radiograph) X-ray. Grade 1 mobility. Mobility because of bone loss. Splint or orthodontic treatment. Avoid hard foods." "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 recently told me that she found out she had AFib and had to stop drinking hard liquor as it is a trigger. Listening to her I wondered if I was having the same issue. At night I sometimes wake up with a pounding heart. I always chalked it up to scary dreams as the heart-pounding is just like I get when I have a big scare. Currently, I am taking Citalopram 20 mg. ### Response: Yes, it is possible to have AFib (atrial fibrillation), but truly speaking symptoms may be very similar. However, during AFib one would be having a high heart rate, with irregular heartbeats and usually associated with shortness of breath, dizziness or chest pain. It is usually abrupt in onset and offset. So, you should check your BP and pulse rate during the episode. If you have a smartwatch to keep track of the rate or may use mobile-based rhythm monitor. Also, another option is Holter monitoring" "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 redesigning the common nutritional label to make it more to encouraging people to make healthier decisions while grocery shopping. I would love it if you can take a few moments to answer some of my questions below as they are important to our research and final design. Please feel free to answer as many questions and at any length that is comfortable for you. ### Response: Hi. All the best for your projects. I think it will take time to teach people to understand the importance of nutrition labeling but with my experience, I can answer your questions from the way I have understood by my patients. Misconception spreads mainly through advertisement. People does not read and they want to just understand what media say. The trend of looking into calorie content is increasing mostly on our IT people. I would prefer calories from sugar, calories from fat and sodium content of product per 200 g. About calories, I think we need to teach each detail of sources of fat, sodium and potassium levels. I guess all medical professionals need to teach the importance of reading, food labeling as we can observe an increase rate of metabolic disorder. If we guide in the proper way it could be helpful, it might be in schools or some awareness programs. A small note on the ingredient used and its importance or guiding note on macro as well as micronutrient uses in points. The mantra of advertisement needs to be changed or we need to explain the concept of being healthy with the use of daily simple products." "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 exclusively breastfeeding my 7 months old baby. My baby has started solids. I give her two meals and two snacks. I am planning to go back to work now. My question is how do I stop daytime breastfeeding? Should I breast pump and bottle feed her or should I start Formula? ### Response: It is better to breast pump and store the milk rather than Formula feed. The breast milk should be stored in hygienic conditions in the fridge separately from other food items. The milk need not be heated again before consumption but the bottle in which it is kept should be put in warm water (along with milk in it) so as to warm the milk." "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 22 year old female. I have always suffered from migraines. Recently, it seems like it has been getting worse. Last year, I gave birth to my son vaginally. Now, when I lay on my abdomen or even turn my head, I notice a heartbeat sound in my ear. My nurse practitioner thought it was coming from my neck and sent me for physiotherapy. And, she checked my ears, but there was no wax. Do I need physiotherapy? Should I get a referral and maybe go to a specialist? Should I be worried about a possible hearing loss? ### Response: If it is a true migraine headache, you will need a preventive and abortive treatment. Also, this would decide whether you need the physiotherapy or not" "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 anxiety and panic attack. I had chest pain and went to the doctor who said that EKG is normal. He prescribed me Zoloft and Buspar. ### Response: Yes, it could be due to an anxiety spectrum disorder. But do not worry as the treatment is possible. Continue with Zoloft (Sertraline) and Buspar (Buspirone). Medicines usually take around two to three weeks to start exerting the effect. Also, practice relaxation techniques like breath relaxation excercises daily as it will help you relax and ease your anxiety" "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 eyes become red and itchy whenever I visit my hometown. They remain fine when I am in the city where I work. But as soon as I visit my hometown, they become red in a day or two. I have the problem for about two to three years. There are no pollens present here, and the climate is the same in both the cities. What is the problem? How to treat it? Can you please recommend some drops? ### Response: Hi. You are suffering from seasonal allergic conjunctivitis. Although you do not have pollens or any visible allergens in your area, your eye is already sensitized previously. Allergic conjunctivitis can trigger spontaneously. Reduce the sensitivity of the eye to such allergens." "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 a sore throat condition for past one week and pain is increasing. I met a doctor at my place. She gave me Pan 40 and Vibact to eat. I am so worried about this because I smoke. Please help me. This is not cancer, right? ### Response: Hello. I went through your post and images (attachment removed to protect patient identity). You have pharyngitis, a bit severe but nothing to worry. You need to start Levofloxacin 500 and Telekast L (Levocetirizine and Monteleukast) bedtime. In addition, use Chlorhexidine mouthwash morning and evening. There is nothing to worry. It is just an infection and will settle within 72 hours." "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 husband has a heart condition that means his arteries build up a plaque at a much higher rate than normal. He had to have a stent put in his heart and will be medicated for the rest of his life. He has been told that it is vital he eats low fat and low cholesterol diet. I cook for him and I am worried whether I feed him the wrong things. I know that meat is not good for the heart, so we limit it and always go for lean cuts, but I am confused about the difference between animal-based saturated fats and plant-based saturated fats.For example, everyone raves about the health benefits of coconut oil and coconut milk, but both are extremely high in saturated fat. I googled this and find reports stating that it is a different kind of saturated fat and does not affect the heart badly, but I do not know if this is true. For someone like my husband, is all saturated fat bad? Also, is chicken really healthier meat than beef? It seems to have a high cholesterol content so I do not know if he should be eating it. Any advice would be much appreciated.He is currently Rosuvastatin, Bystolic, and Aspirin. ### Response: Hi. I understand your concern on the high-fat diet and follow the mentioned points below. Just to make it easy, we need some fat which is good and HDL (high-density lipoprotein) like almonds and walnuts are good as these are rich in omega 3 and 6 fatty acids. Similarly, the fat we have in coconut oil is different. The fat in the chicken can be removed by removing the skin, where as beef has inbuilt fat which cannot be removed easily hence we suggest to include fish and chicken avoiding beef. Considering fat, we miss out on other nutrients too, so it is advised to reduce the oil intake like healthy individuals can take half a liter of oil per month if you are two your cooking should be within 1 liter of oil only. Coconut oil is having saturated fat but it burns easily in high humidity areas. If we live in high humidity area it is better to include coconut oil to protect our joints and skin. If we leave apart from high humidity area it is better to use refined oil." "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 went to the doctor for a physical on 8th. I had blood work done. I went to the ER recently because I was feeling dizzy and tingling. The doctor said I have vertigo and they were not sure of the tingling. I received my blood work from my ER visit and I compared it to my annual exam. Below are the results:Between 8th and now:RBC 5.13 5.35HGB 16.1 16.7HCT 48.5 48.5MCH 31.5 31.2NA 131 141CL 105 97Protein 8.3 8.9SGOT 41 23All other numbers were normal. Do I need to be concerned with these numbers? After my 8th appt, the doctor did prescribe 20 mg of Lipitor (generic), but I stopped taking it after two weeks. I have also had diarrhea. I currently take Synthroid 0.05 mg. My blood pressure was high at my 8th appointment. It had never been high before. ### Response: Hello. I understand your concern. You say you are having vertigo and tingling and taking Synthroid. This makes me think about thyroid issues. So, a thyroid function test should be done. Furthermore, check your blood electrolytes and run urine analysis, and check blood sugar and pressure for a complete checkup. Have your meals regularly, do not skip any. 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 21 years old with acne prone skin. I have lots of acne scars and pits from popping pimples when younger. I tried benzoyl peroxide and did not work. What medical procedure can stop pimples and heal the pits and scars? I am suffering from this for the past six to seven years. ### Response: Chronic acne with resultant scarring is an indication for treatment with oral Isotretinoin besides topical antiacne preparations like Benzoyl peroxide or Clindamycin. For scarring, there are cosmetic procedures like laser resurfacing or dermabrasion." "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 months ago, I saw a dark brown mole under my right breast. The mole does not produce any symptoms. The mole when touched is noticeable bulging, is not smooth as other moles that I have. What can it be? ### Response: Hi. It could be a normal melanocytic nevus. If there is a sudden increase in shape and size with irregular border, an increase in color or rapidly evolving, then you can go for a non-invasive technique like dermoscopy and invasive technique like skin biopsy to confirm whether it is benign or malignant." "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 left ear pain for the past 7 days and I used Ciprofloxacin drop but no relief. Please suggest me. ### Response: Hello. Pain in the ear- If external ear infection was causing pain then there would have been swelling around ear visible, which I suppose is not there. Fungal infection can also cause pain, which is usually seen in diabetic and immunocompromised which I suppose you are not. Middle ear pain is caused by acute infection without ear discharge or chronic ear disease." "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: Actually, my father has just had the first attack of heart and his troponin-T test value is 1.76 ng/ml. Also, his echo test reports are showing the TR and MR results in higher. He is planning to have angiography but I do not think that he should stop there. So please guide him. I need your help. I am searching for treatment. ### Response: So basically after a heart attack, best possible treatment is angiography followed by angioplasty or bypass surgery. So he should have angiography done and further management will depend on angiography report. Till the time, he should continue medicines which will prevent development of further attack. If possible, please upload his detailed echo report so as to interpret it better. Usually, mild to moderate MR (mitral regurgitation) and TR (tricuspid regurgitation) needs just medicine, may resolve with time" "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 25-year-old female with no children. My husband and I have been together for six years. We have no extra-marital affairs and I am 100 % sure of that. My right labia is swollen and is very painful to touch, even a slight breeze of air causes extreme pain. The pain is similar to a sunburn. It is painful enough to make me cry. The swelling starts from my right vulva next to my vaginal canal and goes all the way to my anus. The area with the worst pain is next to my perineum. This started as a painless lump in the size of a peanut that could be palpated from within my vagina with a finger but not visible externally. This was about a week ago. Now, it is huge and painful.My labia is three times larger than its normal size and very red. There are no discharges, no foul smells, and it is not itchy. I am managing the pain with Clobetasol topical cream and Mefenamic Acid orally. The pain disappears instantly with the cream but I think it is also making the swelling bigger (steroid?). I am on my third day of Co-Amoxiclav 625 mg (twice a day every 12 hours) but I think this is what caused the swelling in the first place. Also, I tried to do a sitz bath and it only made the condition worse. Just a few hours ago, I had trouble breathing (allergy?). I have never been allergic to any medication before. Any impression or advice would be appreciated. ### Response: Hi. From the symptoms you described, it sounded like you developed Bartholin gland abscess which is an occlusion of the Bartholin gland duct and that turned to be abscess. Steroid cream is not used for treatment. You need to finish the antibiotic and continue a warm sitz bath three times a day. If you had this previously and have the abscess at the same location, it would be better to have a procedure called marsupialization. You can continue Motrin for pain." "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 regular 30-days cycle of periods. Last month on 10th, my menses started. On 11th, I had sex and he ejaculated inside me. Yesterday was my actual next period, but it did not come yet. Shall I wait for the period or take a pregnancy test? ### Response: Hello. Wait for three more days. In case, it does not start, then do a pregnancy test." "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 40 yrs old . My digestion is always a concern for me but since last month i am having bloting , stomach cramps , stool discharge 3-4 times a day. medicine taken rifagut, actigut for 5 days , meftal spas continuous , pentaprazole - 20 days till nw . at present bloting reduced but stomach cramps , stool discharge 3-4 times a day still persisit . USG abdomain found "" minimal edamatus wall ( avg 3mm) noted in sigmoid colon. "" rest is ok. as per stool test macrophagus present - a few .Kindly advise ### Response: I can understand you must be very upset about your problem. Well the symptoms you mention seem to be occurring due to irritable bowels. This abdominal pain can accompany diarrhea, which is called as Irritable bowel syn" "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 I had sex on the first day of my period. Will I get pregnant? ### Response: Usually, ovulation will not occur during periods. So do not worry, there are no chances of pregnancy. But, if you have any doubt, do a urine pregnancy test after 10 days to be sure. 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: Over the past three months, I have been experiencing some penis problem. I have a consistent red rash on the front of my penis glans that can go away and come back daily. After sex or masturbation, the rash will get brighter and red, unraised dots (not itchy) will appear all over my glans and foreskin. They will usually disappear on their own within three to four days. My penis glans are also very dry and have a wrinkled look to it, and the foreskin can stick to the penis glans and have a \bandaid\ effect when retracting the foreskin down. However, by applying Vaseline twice a day I have noticed the dryness to subside, although the red rash will typically remain.I have been tested for STD\s and have had a yeast swab test all come back negative. The doctor ruled out herpes by looking at it and said it was mild balanitis (inflammation of the glans). However, I have been washing with just warm water daily (ruling out any allergic reactions to soap) and keeping the area dry. This is more an esthetic issue than functional and it is ruining my confidence with my girlfriend. Why do I always get balanitis after sex or masturbation? The symptoms seem like yeast, but my swab test was negative. Please help. ### Response: Hello. I have noted your concern. On and off rash suggest that it is some sort of a skin condition like a noninfective balanitis, if not a yeast infection. Moreover, the swab test may sometimes reveal the yeast on a repeat test so that can be considered along with a fungal culture. I also request you to kindly upload an image of the affected area so that I am able to guide you better. Regards." "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 examined my right and left ear with an endoscope camera and I have found that my right ear looks different. I have less hearing power in my right ear on comparing to my left ear and I am wondering that there is something wrong with my right ear. I am hearing some ringing sounds in my right ear for a few years now. ### Response: I have gone through the pictures given (attachment removed to protect patient identity). This is a condensation of calcium on the 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: I had my periods on 20th of the last month and yesterday I had sex but accidentally the condom broke. So, I took I-pill within two hours of having sex. And today also I had unprotected sex and after sex immediately took I-pill again approximately within one hour. Is there any chance that I will be pregnant? Right now we are not planning to have a child so I am worried. I had a normal cycle of 32 to 35 days. So I am expecting my this month period on 22nd. Could you please tell me that is there any chance to be pregnant? ### Response: There was no apparent need of taking the second I-pill. The first would have sufficed for next 72 hrs as well." "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 drank a lot of strawberry mojitos and they were really dark red drinks. Now, my ejaculate is in strawberry color. It was nice and white in color before the day and there are no other symptoms. ### Response: The pigments in your urine/urethra can change the color of your semen. The other possibility is blood in the semen, which again without symptoms, is not a cause for concern. I would advise you to wait for a few days. If it is due to"